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12-155.00 Aztech Electric: Sprague Sullivan ITSContract THIS AGREEMENT, made and entered into this 16TH day of OCTOBER , 2012, between the City of Spokane Valley under and by virtue of Title 35 RCW, as amended and Aztech Electric, Inc. Hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and agree as follows: I. The Contractor shall do all work and furnish all tools, materials, and equipment for: Sprague /Sullivan ITS Project — CIP #0133 SVPW Contract 12 -035 In accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City of Spokane Valley. II. The City of Spokane Valley hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the attached plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City of Spokane Valley by reason of entering onto this contract, except as provided herein. V. The project was awarded for the bid amount of $202,531.21. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year GoIT- (55 first below written and the City of Spokane Valley has caused this instrument to be executed by and in the name of the said City of Spokane Valley the day and year first above written. Executed by Contractor OCTOBER 16 Date ANDREW R. DAHLMAN Printed Name PRESIDENT Title Signature City of Spokane Walley 2012. 0^%ta� SJ11VO& ,,;o*VA1ey- BOND NO: 023021598 CONTRACTOR'S PERFORMANCE AND PAYMENT BOND TO DUAL OBLIGEES KNOW ALL MEN BY THESE PRESENTS, that Aztech Electric. Inc. (Contractor), as Principal, and The Ohio Casualty Ins.uraaee Company (Bonding Company), as Surety, a corporation of Ohio whose principal office is located at Liberty Lake, WA are firmly bound unto the State of Washington and the City of Spokane Valley, a political subdivision the State of Washington, as Obligees, to fulfill the obligations of the Principal and the Surety under the Contract to which reference is hereafter made, in the amount of $ 202,531.21 (including Washington State sales tax) for payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns jointly and severally, Emily by these presents. Similarly the bond shall cover payment of all taxes incurred on said Contract until Title 50 and 51 Revised Code of Washington (RCW) and all taxes imposed on the Principle under Title 82 RCW. WHEREAS, Principal has by written Proposal dated 10 -16 -12 offered to enter into a Contract with the City of Spokane Valley for Contract No. 12 -035 pursuant to the terms and conditions set forth in the Contract Documents dated 10 -16 -12 NOW, THEREFORE, the condition of this obligation is such that if the Principal shall faithfully perform all the provisions of the Contract on its part, and pay all laborers, mechanics, subcontractors and material suppliers, and all persons who supply such person or persons or subcontractors with provisions and supplies for the carrying on of such work, indemnify and hold harmless the Obligees from all loss, cost or damage which it may suffer by reason of the failure to do any of the foregoing, and pay all taxes pursuant to Title 50, 51 and 82 RCW, then this obligation shall be null and void; otherwise it shall remain in full force and effect. All persons who have furnished labor, materials or supplies for use in and about the work provided for in the Contract shall have a direct right of action under this bond, to the extent and in the manner set forth in RCW 39.08. The said Surety for value received hereby stipulates and agrees that no change, extension of time, .alteration or addition to the terms of the Contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the WORK or to the SPECIFICATIONS. No final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied SIGNED AND SEALED THIS 2 5th DAY OF October ' YEAR20 12 William H. Davis TypadNarne , Attorney' -i n Fact Title (SEAL) Aztech Electric, Inc. PRINCIPAL PRESIDENT Title ,r,s 0 O Q m � N >3 � r0. C7 00 02 > d� O OC r O Od c� ai r tai d im t: O.0 E6 �v ca = O Z THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. 5012409 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Peerless Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire & Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of Ohio, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, that Peerless Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies "), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, MARLA J. DAVENPORT, THOMAS V. A. DAVIS, WILLIAMH. DAVIS, GAIL A. STEVERS . ..: ...................................................................................... ................................................................... :......._...- -------------- ------------------- -- - all of the city of SPOKANE , state of WASHINGTON each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power ofAttorney has been subscribed byan authorized officerorofficial of the Companies and the corporate seals of the Companies have been affixed theretothis 23rd day of MAY 2012, �Ncax qF ` American Fire and Casualty Company z The Ohio Casualty Insurance Company Liberty utual Insurance Company a Y - Peerless Insurance Company c�wa yt� � NEq� cacoe� West American Insurance Company By: Gregory W. Davenport, R STATE OF WASHINGTON ss g ry p rt, Assistant Secretary COUNTY OF KING C cc On this 23rd day of MAY 2012 . before me personally appeared Gregory W. Davenport, who acknowledged himself to be the Assistant Secretary of American Fire and AW Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, Peerless Insurance Company and WestAmerican Insurance Company, and that he, as such, being authorized so to do, execute the foregoing Instrument for the purposes therein contained b signing on behalf of the corporations b himself as a duly authorized officer. _ 9 9� P P Y 9 9 rP Y Y C o IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Seattle,, Washington, on the day and year first above written. Q M ° :ornav By: PUBLE� - KD Riley, Nota4 Public 3 M HM This Power of Attorney is made and executed pursuant to and by authority of the following By -laws and Ai tfiorizations ofAmerican Fire and Casualty Company, The Ohio Casualty Insurance 2 c Company, Liberty Mutual Insurance Company, West American Insurance Company and Peerless Insurance Company, which resolutions are now in full force and effect reading as follows: ++ ai O = ARTICLE IV— OFFICERS —Section 12. Power ofAttomey. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, 3 CD acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective m powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so > executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey -in -fact under m the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. M ARTICLE XIII — Execution of Contracts — SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, L M and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys -in -fact, as may be necessary to act in behalf of the Company to make, execute, °O seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their Q r respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so 0 r executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes Gregory W. Davenport, Assistant Secretary to appoint such attomey -in -fact as may be necessary to act_ on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and biding upon the Company with the same force and effect as though manually affixed. I, David M. Carey, the undersigned, Assistant Secretary, of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, West American Insurance Company and Peerless Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 25 tray of October 20 12 �,-, AN F #pg4 J4tiK1 ?€d8(1 � �ugy;N£Cpq F �E�gURAA, �yS 1301 la r I By. S` la' David M. Carey, Assistant Secretary Hia POA -AFCC, LMIC, OCIC, PIC& WAIC LMS_12873_041012 A ✓R� CERTIFICATE OF LIABILITY INSURANCE OP ID 2J AZTEC -1 10/25/12 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Western States Ins. - Spokane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 501 N Riverpoint Blvd, Ste 403 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Spokane WA 99202 -1649 Phone: 509 - 838 -3501 Fax: 509 - 838 -3511 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Indemnity Co of Conn INSURER B: Travelers Casualty Ins Co of A Aztech Electric, Inc. INSURER C: PO Box 11795 INSURER D: Spokane WA 99211 -0795 i INSURER E: COVERAGES ITHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH anI IMPS ArrRPrATF LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM /DD/YYYY LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_] OCCUR X Employer Liab 4TC0347K1501TCT12 04/01/12 04/01/13 EACH OCCURRENCE $1,000,000 PR EM ISES(Eaoccurence) $300,000 MED EXP (Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP /OP AGG s2,000,000 Em Liab 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4T810347K1501TCT12 04/01/12 04 /01/13 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS / UMBRELLA LIABILITY X OCCUR EI CLAIMSMADE DEDUCTIBLE X RETENTION $10,000 4TSMCUP347K1501TIL1 04/01/12 04/01/13 EACH OCCURRENCE s4,000,000 AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE[:l OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below - TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Spokane Valley, Spokane County, The State of Washington and all of their officers, elected officials, employees, agents and volunteers are added as additional insureds per attached form CGD246 08/05 as respects to: Sprague /Sullivan ITS Project Contract No. 12 -035. CIP #0133. Coverage is primary and non - contributory Cont Ext End. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI CITYOFV DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CITY OF SPOKANE VALLEY REPRESENTATIVES. 11707 E SPRAGUE #106 AUTH IZEDREPRESENTATVE SPOKANE VALLEY WA 99206 ACORD 25 (2009101) " ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EPLS Search Results Page 1 of 1 x Ecl�c�`ec Pay zes L� s> Sxste Search Results Excluded By Firm, Entity, or Vessel : Aztech Electric, Inc. Firm, Entity, or Vessel : Aztech Electric Firm, Entity, or Vessel : Aztech as of 05- Oct -2012 1:59 PM EDT Your search returned no results. https : / /www.epls.gov /epls /search.do ?full nameO= Aztech+ Electric %2C+ Inc.+ &full _ namel = Aztech +Electric &full na... Verify Workers' Comp Premium Status - Employer Liability Certificate Page 1 of 1 Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 11/01/2012 UBI #: 328 054 758 Business Name: AZTECH ELECTRIC INC Legal Business Name: AZTECH ELECTRIC INC Account #: 267,780 -00 'Doing Business As' Name: AZTECH ELECTRIC INC Employer Liability Certificate Estimated Workers Reported: Quarter 2 of Year 2012 "21 to 30 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: Multiple Active Licenses Account Representative: T4 / BAC -NAM DO (360)902 -4724 - Email: BACN235 @lni.wa.gov What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). https: // fortress. wa. gov/ lni lerpsilAcctInfoPrint.aspx ?Ac_c ,-antId= 26778000 &AccountManag... 11/1/2012 Page 1 of 1 a Doing business Register my business Lookup business information 'Results Results Back to search results If "Non- revenue" appears after Tax Registration Number, the account is not registered with the Department of Revenue. However, it may be registered with other agencies in the state. Washington, State Depa ;bent OfReVelltle Mate Busniess Records Database Detail TAX REGISTRATION NOc 328054758 ACCOUNT OPENED: 06/01/19,68 UBId 328054758 ACCOUNT CLOSED: OPEN ENTITY NAME d AZTECH ELECTRIC INC BUSINESS NAME MAILING ADDRESS: PO BOX 11795 SPOKANE, WA 9921171795 BUSINESS LOCATION: 3000 QUEENSGATE RICHLAND, WA 99352 -0000 ENTITY TYPE: CORPORATION RESELLER PERMIT N0: A16 5864 13 PERMIT EFFECTIVE: 01/01/2012 NAICS CODE: 238210 PERMIT EXPIRES: 12/31 /2013 NAICS DEFINITION: ELECTRICAL CONTRACTORS (PT) FOR NON - COMMERCIAL USE ONLY 11/01/2012 8:40 AM http:Hdor.wa. gov/ content/ doingbusiness /registermybusiness/brd/Re sults. aspx ?RequestTyp... 11/1/2012 Contractors or Tradespeople Printer Friendly Page General/Specialty Contractor A business registered as a construction contractor with LElto perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information I Name AZTECH ELEC INC UBI No. 328054758 Phone 5095366200 Status Active Address Po Box 11795 License No. AZTECEW329KO Suite /Apt. Secreta License Type Construction Contractor City Spokane Effective Date 5/20/1968 State WA Expiration Date 4112/2013 Zip 992110795 Suspend Date 10 County Spokane Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company OF AMERICA Business Owner Information Name Role Effective Date Expiration Date DAHLMAN, ANDREW REID President 05/20/1968 Bond Amount DAHLMAN, CONNIE RAE Vice President 05/20/1968 675003159 DAHLMAN, ANDREW L Secreta 01/01/1980 05/12/2011 Rnnri Infnrmatinn Page 1 of 2 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 11 First National Ins Co 675003159 04/20/2012 Until Cancelled $12,000.0005/11 /2012 27 of America 4TC0347K1501 PHX11 04/01/2011 04/01/2013 Amount: $34,086.00 $1,000,000.00 03/30/2012 10 FIRST NAT'L INS CO 6668694 02/01/2010 04/20/2012 $12,000.0001/13 /2010 OF AMERICA 9 Berkley Regional Ins 0135371 02/01/2009 Until Cancelled 02/25/2010 $12,000.0012/17 /2008 INS CO 18 IWESTERN SURETY CO 1929355197 102/01/2005 102/01/2009 1 $12,000.00101/07/2005 /27/2009 Assignment of Savings Information No records found for the previous 6 year period 1-- .... Infnrmatinn Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date Date: 05/21/2007 Phoenix Open Date: 27 Insurance 4TC0347K1501 PHX11 04/01/2011 04/01/2013 Amount: $34,086.00 $1,000,000.00 03/30/2012 Company, The TRAVELERS 26 PROPERTY CAS 4TC0347K1501TIL10 04/01/2010 04/01/2011 $1,000,000.00 03/31/2010 INS CO 25 TRAVELERS 4TC0347K1501IND09 04/01/2009 04/01/2010 $1,000,000.0003 /27/2009 INDEMNITY CO 24 TRAVELERS IND DTC0347K1501TCT08 04/01/2008 04/01/2009 $1,000,000.00 03/11/2008 CO OF CT TRAVELERS 23 INDEMNITY CO DTC0347K1501T1L07 04/01/2005 04/01/2008 $1,000,000.00 04/02/2007 OF IL Siimmnnc /Cmmnlaint Information Cause County Complaint Judgment Status Payment Paid B 07 -2- 00761.7 THURSTON Date: 05/21/2007 Open Date: Date: TRAFFICORP INC Amount: $34,086.00 https: // fortress .wa.gov /lni/bbip/Print.aspx 11/1/2012 Contractors or Tradespeople Printer Friendly Page Electrical Contractor A business licensed by LEI to contract electrical work within the scope of its specialty. Electrical Contractors must maintain a surety bond or assignment of savings account. They also must have a designated Electrical Administrator or Master Electrician who is a member of the firm or a full -time supervisory employee. IBusiness and Licensing Information I Name AZTECH ELECTRIC INC UBI No. 328054758 Phone 5095366200 Status Active Address E 5204 Broadway License No. AZTECEI320KW Suite /Apt. PO BOX 11795 License Type Electrical Contractor City Spokane Effective Date 5/16/1968 State WA Expiration Date 2/28/2014 Zip 992110795 Suspend Date County Spokane Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company INSURANCE CO OF 6593315 05/16/2009 Master Electrician INFORMATION License DAHLMAR967C3 Name DAHLMAN, ANDREW R Status Active Business Owner Information Name Role Effective Date Expiration Date DAHLMAN, ANDREW R Cancel Date 01/01/1980 Bond Amount DAHLMAN, CONNIE R 7 01/01/1980 675002829 DAHLMAN, ANDREW L Until Cancelled 01/01/1980 DAHLMAN, ANDREW R Agent 01/01/1980 of America Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 7 First National Ins Co 675002829 04/20/2012 Until Cancelled $4,000.00 05/15/2012 of America FIRST NATIONAL 6 INSURANCE CO OF 6593315 05/16/2009 05/15/2012 $4,000.0004/16/2009 AMERICA 5 BERKLEY REGIONAL IINS 0129333 05/16/2008 Until Cancelled 05/30/2009 $4,000.0004/09/2008 CO 4 IWESTERN SURETY CO 1929361124 05/16/2005 jUntil Cancelled 1 1 .0004/15/2005 Assignment of Savings Information No records found for the previous 6 year period Insurance Information No records found for the previous 6 year period Summons /Complaint Information Summons and Complaints are not filed with the department for this contractor type Warrant Information Warrants are not filed with the department for this contractor type Infractions /Citations Information Infraction / Citation I Date I RCW Code Type Status I Violation Amount EBRET00482 11/22/2009 119.28.101 RCW JELECTRICAL CITATION ISatisfied 1 $250.00 https:// fortress .wa.gov /lni/bbip/Print.aspx 11/1/2012 AW ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `.►/ 10/01/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh&McLennan Agency LLC NAME: 1031 W.4th Ave,Suite 400 PHONE FAX (A/C.No.Ext): (A/C,No): Anchorage,AK 99501 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# 101890-KT-GAWU0-13-14 INSURER A:Evanston Insurance Company 35378 INSURED-- — — INSURER B:Zurich American Insurance Co 16535 Aztech Electric,Inc.! • P.O.Box 11795 INSURER c: Navigators Specialty Insurance Company 36056 Spokane,WA 99211 INSURER D: N/A N/A INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002390260-07 REVISION NUMBER:4 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE INSR MD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY 13PKGWE00232 10/01/2013 10/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREMISES Ea occu ante) $ 300,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 X Contractors Pollution Liab$1M PERSONAL&ADV INJURY $ 1,000,000 X Professional Liability$1 M GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY X JECT LOC $ B AUTOMOBILE LIABILITY BAP9319142-02 10/01/2013 10/01/2014 COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _$ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ $ C UMBRELLA LIAB X OCCUR SF13EXC739009IC 10/01/2013 10/01/2014 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY ,r/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re:-Sprague/Sullivan-ITS Project Contract No.12-035 CIP-0133 i Where required by written contract,City of Spokane Valley,Spokane County,The State of WA and all their officers,elected officials,employees,agents and volunteers are Additional Insureds on all policies except Workers Compensation,subject to the terms,conditions and limitations of said policies and the additional insured endorsement. It is further agreed that,where required by written contract,such insurance as is afforded the Certificate Holder shall be primary and non-contributory with any other insurance in force for or which may be purchased by the Named Insured. CERTIFICATE HOLDER CANCELLATION City of Spokane Valley SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 11707 E.Sprague Ave,Suite 106 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Spokane,WA 99206 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Kirk C.Leadbetter +.a_C'- - �® ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CA IZ_15S AGENCY CUSTOMER ID: 101890 _ LOC#: Anchorage AR® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh&McLennan Agency LLC Aztech Electric,Inc. P.O.Box 11795 POLICY NUMBER Spokane,WA 99211 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance This is evidence of insurance procured and developed under the Alaska Surplus Lines Law,As 21.34. It is not covered by the Alaska Insurance Guaranty Association Act,AS 21.80. This insurance was placed through the following Surplus Lines Brokers: Worldwide Facilities,Inc.regarding Company A&C Only. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4 E p o m nt Security Department MOW WASH lNGJi_+1,1 5 A_. P.O. Box 9046 Olympia, WA 98507-90461 Fax 360-902-9287 CERTIFICATE OF CITY OF SPOKANE VALLEY )PAYMENT OF CONTRIBUTIONS . 11707 E SPRAGUE AVE STE 106 )PENALTIES AND INTEREST ON SPOKANE VALLEY, WA 99206 )PUBLIC WORKS CONTRACT ES Reference#: 31254400 3 • UBI No: 328054758 CONTRACTOR: AZTECH ELECTRIC INC P 0 BOX 11795 SPOKANE, WA 99211-1795 The Employment Security Department hereby certifies those contributions, penalties and interest due from the above named contractor under the Employment Security Act have been paid in full or provided for with respect to the following public works contract: Description: SPRAGUE/SULLIVAN ITS PROJECT. Contract number: 12-035 The Employment Security Department hereby certifies that it has no claim pursuant to RCW 50.24.130 against the public body named above for tax attributable to service.performed for said public body by the above named contractor on the above described contract. The Employment Security Department releases its lien on the retained percentage which is provided by RCW 60.28.040 for contributions, penalties and interest due from said contractor. This certificate does not release said contractor from liability for additional contributions, penalties and interest which may be later determined to be due with respect to the above mentioned contract. Dated at Olympia, Washington on October 17, 2013. EMPLOYMENT SECURITY DEPARTMENT .,.....i. " Robyn R. Wells Authorized Representative Original - Disbursing Officer Duplicate - Employer Triplicate - Central. Office Files CO I7---- CS • SUPERIOR COURT OF WASHINGTON FOR SPOKANE COUNTY In the Matter of: ADVERTISEMENT FOR BIDS No. City of Spokane Valley Public Works Department Bid # 12 -035 ) Sprague / Sullivan ITS Project AFFIDAVIT OF PUBLISHING NOTICE STATE OF WASHINGTON ) )SS. County of Spokane ) W CHAF1 HUFFMAN , being first duly sworn on oath deposes and says that he is the EDITOR , of The Spokane ValleyNews Herald, a weekly newspaper. Thatsaidnewspaper is alegalnewspaper and itisnow andhas beenfor more than six months prior to the date of the publication hereinafter referred to, published in the English language continually as a weekly newspaper in Spokane County, Washington, and it is now and during all of said time was printed in an office maintained at the aforesaid place of publication of said newspaper, which said newspaper had been approved as a legal newspaper by order of the Superior Court of the State of Washington in and for Spokane County. That the following is a true copy of a public notice as it was published in regular issues commencing on the 14th day of September- 2012 and ending the 21st daX of b mb r 20 dates inclusive, and that such newspaper was regularly distributed to its subscribers during all of said pct �'— ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY PUBLIC WORKS DEPARTMENT SS RIBED .' SWORN to before me BID A 12 -035 SPRAGUEfSULLIVAN ITS PROJECT is 21st day of September, 2012. Notice is hereby given that the City of Spokane Valley, Spokane County, Washington will ac- State Of WdShlilc�rrlI--On ac- cept sealed bids for the Sprague/Sullivan t,,�� /// Washington ITS ProJed. The project consists of installing �� ,RAE // County of Spokane Intelligent Transportation System (ITS) equip• ,e ment along portions of East Sprague Avenue �� and North Sullivan Road. The project includes 2 �i I certify that Iknow or have satisfactory evidence that providing and installing fiber optic cable, CCTV' : \SS 'YAj • %� i cameras, Ethernet switches, pull boxes and 9r:•, ; MichaelHuffmanisthepersonwhoappearedbefore junction boxes. �infi and said person acknowledged that he signed Copies of the bid packet including specifica -� tions and plans may be obtained in PDF format NOTARY ltis instrument and acknowledged it to be his free by downloading from the Spokane Valley FTP Zn.d voluntary act for the uses and purposes men- aria Arnold, Darla Arnold, Spokane Valley p1 IBL'Cj Z Public Works, at 509- 720 -5003 or by email at r U C) motioned in the instrument. darnold®spokanevalley.org Monday through • ` Friday from 8:00 a.m. to 5:00 p.m. for •• •�� `� T_ and to be added to the Planhoider's list A L. 5.16.\,3,0, • \: • Qt (�J If a potential bidder is unable to reproduce L. .......... the packet from the FTP site, a hard copy with ` ^ *\ Jolene Ra Wen half -size plans may be obtained from the City'', Q� W r� �� J for a non - refundable fee of $50. Any addenda /// 1 \` Title: Ni Public to this project will be sent only to those on the t Planholder's list. M a o ent expires: 5 -16 -15 All bids must be accompanied by a bid deposit y pp �.\ p in the form of a surety bond, postal money order, cash, cashier's check, or certified check in an * , o o amount equal to five percent (5 %) of the amount of the bid proposed. Failure to furnish a bid bond in compliance with the City's bid deposit surety (�� k_', bond forth shall make the bid non - responsive and �" cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Spo- kane Valley, 11707 E. Sprague Avenue, Suite 106, Spokane Valley, Washington, 99206, and received not later than 10.00 am.POT Friday, Oclober -5-M2. Bid openings will be held im- mediately thereafter and read aloud In the City Council Chambers, Suite 101. The City of Spokane Valley reserves the right to waive any inegularhies or informalities and to reject any or all bids. No bidder may withdraw his bid after the time announced for the bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. The City of Spokane Valley in accordance with Ttle VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d to 2000d -4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A. Office of the Secretary. Part 21, Nondiscrimination in Federally- Assisted programs of the Department of Transportation issued pursuant. to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertise- ment, disadvantaged business enterprises as defined at 49 OFF Part 26 will be afforded full opportunity to submit bids in response to this imitation and will not be discriminated against on the grounds of race, color, national origin, or sex in consideration for an award. Christine Bainbridge, MMC Spokane Valley City Clerk 9114, 9/21, ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY PUBLIC WORKS DEPARTMENT BID # 12 -035 SPRAGUEISULLIVAN ITS PROJECT Notice is hereby given that the City of Spokane.Valley, Spokane County, Washington will,.accept sealed bids fo,r the Sprague/Sullivan ITS Project. The project consists of installing Intelligent Transportation System (ITS) equipment along portions of East Sprague Avenue and North Sullivan Road. The project includes providing and installing fiber optic cable, CCTV cameras, Ethernet switches, pull boxes and junction boxes. Copies of the bid packet including specifications and plans may be obtained in PDF format by downloading from 'the Spokane Valley FTp site. Contact Darla Arnold; Spokane Valley Public Works, at 509 - 720 -5003 or by email at darnold@spokanevalley.org Monday through Friday from 8:00 a.m. to 5:00 p.m. for instructions and to be added to the Planholder's list. If a potential . bidder is unable to reproduce the packet from the FTP site, a hard copy with half -size plans may be obtained from the City for a non - refundable fee of $50. Any addenda to this project will be sent only to those on the Planholder's list. All bids must be accompanied by a bid deposit in the form of a surety bond, postal money order, cash, -cashier's check, or certified check in an amount equal to five percent (5%) of the amount of the bid proposed. Failure to furnish a bid bond in compliance with the City's bid deposit surety bond form shall make the bid non- responsive and cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Spokane Valley, 11707 E. Sprague.Avenue, Suite 106, Spokane Valley; .Washington, 99206, and received not later than 10:00 a.m. POT, Friday. October 5. 2012. Bid openings will be held_ immediately thereafter and read ,aloud in the City Council Chambers, Suite 101. The City of Spokane Valley reserves the right to waive any irregularities or informalities and to reject any or all bids. No bidder may withdraw his bid after the time announced for the bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. The City of Spokane Valley in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 20004 to 2000d -4. and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally - Assisted programs of the Department of Transportation issued pursuant to such Act, hereby not'dies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertisement, disadvantaged business enter prises as defined at 49 CFR Part 26 will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against an the grounds of race, color, national origin, or sex in consideration for an award. Christine Bainbridge, MMC Spokane Valley City Clerk $R25033 *Federal Tax ID No. 68- 0617327 AFFIDAVIT OF PUBLICATION STATE OF WASHINGTON County of Spokane) ss Name: City of Spokane Valley Client ID: PO No. SR25033 No. Lines: Total Cost: $909.94— 42365 107 Order No. 100677 I, E. Jean Robinson do solemnly swear that I am the Principal Clerk of The Spokesman- Review, a newspaper established and regularly published, once each day in the English language, in and of general circulation in the City of Spokane County, Washington; and in the City of Coeur d'Alene, Kootenai County, Idaho; that said newspaper has been so established and regularly published and has had said general circulation continuously for more than six (6) months prior to the 23rd day of July, 1941; that said newspaper is printed in an office maintained at its place of publication in the City of Spokane, Washington; that said newspaper was approved and designated as a legal newspaper by order of the Superior Court of the State of Washington for Spokane County on the 23rd day of July, 1941, and that said order has not been revoked and is in full force and effect; that the notice attached hereto and which is a part of the proof of publication, was published in said newspaper two time(s), the publication having been made once each time on the following dates: September 14 & 21, 2012 That said notice was published in the regular and entire issue of every number of the paper during the period of time of publication, and that the notice was published in the newspaper proper and not in a supplement. Subscribed and sworn to before me at the City of Spokane, this ZSS 24th day of September 2012. �\ L VI/v, �O �xSSiorv4+ A NOTARY 9N PUBLIC p ^ Notary Public in and for the State of Washington, BER �1'� residing at Spokane County, Washington OFWASN� Notary Stamp P�wC-/ Paper Affidavits