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13-078.00 Pool World: Terrace View Pool ADA Lift Installation CONSTRUCTION AGREEMENT Pool World,Inc. THIS CONSTRUCTIONAGREEMENT (the "Agreement") is made by and between the City of Spokane Valley,a code City of the State of Washington("City")and Pool World,Inc.,("Contractor")jointly referred to as(the"Parties"). IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1. Work to Be Performed. Contractor shall do all work and furnish all labor, supervision,tools,materials, supplies and equipment and other items necessary for the construction and completion of the Terrace View Pool ADA Lift Installation Project(the "Work") in accordance with documents described in the Scope of Work and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof(the "Contract Documents")), and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall, for the amount set forth in paragraph 4,below, assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities provided for in the Contract Documents to City's satisfaction,within the time limits prescribed in the Contract Documents. The City Manager,or designee,shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,State and federal standards,codes,ordinances,regulations and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed [or execution of this Agreement] and shall complete the Work within the times specified in the Contract Documents, as may be extended in accordance with this Agreement and the Contract Documents. 3. Liquidated Damages. N/A. 4. Compensation.In consideration of Contractor performing the Work,City agrees to pay Contractor in accordance with the Contract Documents the sum of two thousand two hundred eleven dollars and 69 cents ($2,211.69), plus one hundred ninety-two dollars and forty-two cents($192.42) Washington State Sales Tax,based on the bid submitted by Contractor, and as may be adjusted in accordance with the Contract Documents. Total contract cost is two thousand four hundred four dollars and eleven cents($2,404.11). 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department at the below stated address. Pursuant to Chapter 60.28 RCW,five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents,City standards, City Code, and federal or state standards. Construction Agreement Page 1 of 6 �0-S 1 6. Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge, City Clerk Name: Pool World,Inc. Phone: (509)921-1000 Phone: (509)928-6585 Address: 11707 East Sprague Ave, Suite 106 Address: P.O. Box 14927 Spokane Valley, WA 99206 Spokane,WA 99214-0927 7.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal, state, and local laws, codes and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal depar l rent or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission or fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction;violation of federal or state antitrust statues or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records,making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification; and 4. Have not within a 3-year period preceding this application/proposal had one or more public transactions(federal, state, or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of RCW 39.12,and shall pay each employee an amount not less than the Prevailing Rate of Wage, as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&I"). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with RCW 39.12. The following information is provided pursuant to RCW 39.12.030: Construction Agreement Page 2 of 6 A. State of Washington prevailing wage rates applicable to this public works project,published by L&I are located the L&I website address: https://fortress.wa.gov/lni/wagelookup/prvWagelookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the offices of City located at 11707 East Sprague,Suite 106,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10.Relationship of the Parties. It is understood,agreed and declared that Contractor shall be an independent contractor,and not the agent or employee of City,that City is interested in only the results to be achieved,and that the right to control the particular manner,method and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11. Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to RCW 42.56 or other applicable public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine and make excerpts or transcripts from such records and to make audits of all contracts,invoices,materials,payrolls and record of matters covered by this contract for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials, Contractor shall, within the warranty period, remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. 14.Contractor to Be Licensed And Bonded. Contractor shall be duly licensed,registered and bonded by the State of Washington at all times this Agreement is in effect. 15. Insurance. Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents,representatives, or employees. A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute Construction Agreement Page 3 of 6 form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,independent contractors,products- completed operations, stop gap liability,personal injury and advertising injury,and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion,collapse or underground property damage. City shall be named as an insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 2010 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3.Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of$1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate, and a $2,000,000 products-completed operations aggregate limit. C. Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain,the following provisions for automobile liability, professional liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement. The certificate shall specify all of the parties who are additional insureds,and will include applicable policy endorsements,and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles,self-insured retentions, and/or self-insurance. Construction Agreement Page 4 of 6 16. Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify and hold harmless City shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify and hold harmless City against liability for damages arising out of such services caused by the concurrent negligence of(a)City or City's agents or employees, and(b) Contractor, Contractor's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Contractor, Contractor's agents, subcontractors, subconsultants and employees. Contractor's duty to defend,indemnify and hold City harmless shall include,as to all claims,demands,losses and liability to which it applies,City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection,and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 17. Waiver. No officer, employee,agent or other individual acting on behalf of either party has the power, right or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law, shall be taken and construed as cumulative, and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof 18. Assignment and Delegation. Neither party shall assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 19. Confidentiality. Contractor may,from time to time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City or upon order of a Court of competent jurisdiction. 20.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court for Spokane County, unless otherwise required by applicable federal or state law. 21. Subcontractor Responsibility. As required by RCW 39.06.020, Contractor shall verify responsibility Construction Agreement Page 5 of 6 criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.350(1)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement must be included in every subcontract of every tier. 22.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 23. Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties. 24. Anti-kickback. No officer or employee of City, having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement, or have solicited, accepted or granted a present or future gift, favor, service or other thing of value from any person with an interest in this Agreement. 25.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business. 26. Severability. If any section,sentence,clause or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence, clause or phrase of this Agreement. 27. Exhibits. Exhibits attached and incorporated into this Agreement are: 1. Scope of Work 2. Insurance Endorsements The Parties have executed this Agreement this 7� day of 4/i-t , 2013. CIT I '_OKANE VALLEY: Contractor: P�it �0 %/d (/t-c-- .ism Mike Jacks/ , City Manager ode,iveit,y( frtli;v,4ei.Pi-L— ATTES : APPROVED AS TO FORM: . I Christine Bainb dge, City C r Office f the City A rney Construction Agreement Page 6 of 6 WebSite: www.poolworld.biz Pool Work' E-mail Address: F'ools,Spas,Service and Accessories service@poolworld.biz April 19, 2013 City of Spokane Valley ATTN: Darin Hoffman 1126 North Monroe Spokane, Washington 99201 RE: Terrace View Park Pool Dear Darin: First, we want to Thank You for calling POOL WORLD. You are a valued customer and we appreciate your business. You can be assured of professional, dependable, quality service when dealing with POOL WORLD. Remember, we've been servicing pools and spas since 1976. We will always do everything we can to earn your continued trust and goodwill. The following is an estimate for the installation of a handicap lift anchor for your pool. POOL WORLD will: 1. Layout and remove concrete for lift anchor at pool 2. Dispose of dirt and concrete 3. Set and bond lift anchor 4. Replace concrete around lift anchor 5. Instruct Pool Operator/Owner on operation Materials and labor $2,211.69 Sales Tax- 8.7% 192.42 Total $ 2,404.11 Notes: This lift installation will take approximately 5 days to complete. Cost of lift and anchor are NOT included in this estimate. Concrete patch material will not match existing concrete. Bonding will be performed by a licensed electrician. The above price includes provisions for Prevailing Wage. Quality Products and Dependable Service Since 1976 Pool World Inc. Mailing Address: PO Box 14927 • Spokane, WA 99214-0927 Coeur d'Alene Store Spokane Valley Store Northside Spokane Store Central Spokane Store 235 W Sunset Ave 13524 E Sprague Ave 9111 N Country Homes Blvd 5701 E Sprague Ave Coeur d'Alene,ID 83815 Spokane Valley,WA 99216 Spokane,WA 99218 Spokane Valley,WA 99212 (208)765-5220 (509)928-6585 (509)466-8220 (609)534-4833 Fax:(208)676-1430 Fax (509)928-9469 Fax (509)468-2167 Fax:(509)535-4059 Toll Free(800) 876-4340 Washington State Contractor's Reg.#:PO-OL-WI'241 CP—Idaho Public Works Contractor's Reg.#:13698-A-4(47) City of Spokane Valley April 19, 2013 Page Two PLEASE NOTE: THIS ESTIMATE IS GOOD FOR 60 DAYS. Payment Terms: Balance due on completion. Please call us at(509) 928-6585 if you have any questions regarding this quote or when we can be of further service. Please also feel free to call us if you need any additional information. Best personal gards, Ted D. Puryear POOL WORLD, INC TDP:kao E:\QUOTES\SpokaneValley TerraceView ADALiftAnchor 20130419.wpd Verify Workers' Comp Premium Status - Employer Liability Certificate Page 1 of 1 Washington State Department of 5 F.T.-1T c, Employer Liability Labor and Industries s*. '` `* ° z F` ;, Certificate Lit Department of Labor and Industries Employer Liability Certificate Date: 04/16/2013 UBI #: 600 183 883 Business Name: POOL WORLD INC Legal Business Name: POOL WORLD INC Account#: 363,031-00 'Doing Business As'Name: POOL WORLD INC Estimated Workers Reported: Quarter 4 of Year 2012 "51 to 75 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: T2/KATHY WITHERS (360)902-4829 - Email: WITE235 @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/crpsi/AcctlnfoPrint.aspx?AccountId=36303100&Accrn]ntMana a aii A/')n1 2 OP ID: LG At C°RCY CERTIFICATE OF LIABILITY INSURANCE DATE 04/23/13 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 509-624-3291 CONTACT Andre-Romberg Ins.Agency,Inc FAX S.400 Jefferson St.,Ste.333 509-456-0294 (ac,No,Ext): (A/C,No): Spokane,WA 99204 E-MAIL Kenneth D.Kurtz-Ext.324 ADDRESS: PRODUCER POOLW-1 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Pool World,Inc. INSURER A:Cincinnati Insurance Company PO Box 14927 INSURER 6: Spokane,WA 99214-0927 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY EPP0061142 02/01/13 02/01/14 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 500,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X JE° LOC Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO EPP0061142 02/01/13 02/01/14 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE A X HIRED AUTOS EPP0061142 02/01/13 02/01/14 (Per accident) A X NON-OWNED AUTOS EPP0061142 02/01/13 02/01/14 $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 A EPP0061142 02/01/13 02/01/14 — DEDUCTIBLE $ X RETENTION $ 0 $ WORKERS COMPENSATION WC STATU- X OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A EPP0061142 02/01/13 02/01/14 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) STOP GAP E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A PROPERTY EPP0061142 02/01/13 02/01/14 BLNKT 3,994,000 $1000 DEDUCTIBLE BLDG&BP DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate holder is named as additional insured including completed operations. Coverage is primary&non-contributory,waiver of subrogation applies as per form GA233 attached. Per project aggregate applies per GA101 attached. CERTIFICATE HOLDER CANCELLATION C 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y p y ACCORDANCE WITH THE POLICY PROVISIONS. Attn Christine Brainbridge 11707 E Sprague Ave,Ste 106 Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD (3) Damages under COVERAGE B. where ongoing improvements, al- PERSONAL AND ADVERTISING terations, installation, demolition or INJURY LIABILITY, maintenance work is performed by you or on your behalf. All connected This General Aggregate Limit will not ap- ongoing improvements, alterations, ply if either the Location General Aggre- installation, demolition or mainte- gate Limit of Insurance, Paragraph 2.b., nance work performed by you or on or the Construction Project General Ag- your behalf at the same location for gregate Limit of Insurance, Paragraph the same persons or organizations, 2.c.applies. no matter how often or under how b. A separate Location General Aggregate many different contracts, will be Limit of Insurance,equal to the amount of deemed to be a single construction the General Aggregate Limit shown in the project. Declarations,shall apply to each location 3. The Products-Completed Operations Aggre- owned by,or rented or leased to you and gate Limit is the most we will pay under COV- is the most we will pay for the sum of: ERAGE A. BODILY INJURY AND PROP- (1) Damages under COVERAGE A. ERTY DAMAGE LIABILITY for damages be- BODILY INJURY AND PROPERTY cause of "bodily injury" and "property dam- DAMAGE LIABILITY, except dam- age" included in the "products-completed op- ages because of "bodily injury" or erations hazard". "property damage" included in the 4. Subject to 2.a. above, the Personal and Ad- "products-completed operations vertising Injury Limit is the most we will pay hazard";and under COVERAGE B. PERSONAL AND AD- (2) Medical expenses under COVER- VERTISING INJURY LIABILITY for the sum of AGE C.MEDICAL PAYMENTS, all damages because of all "personal and ad- vertising injury" sustained by any one person which can be attributed to operations at or organization. only a single location owned by, or rented or leased to you. 5. Subject to 2. or 3, above, whichever applies, the Each Occurrence Limit is the most we will c. A separate Construction Project General pay for the sum of: Aggregate Limit of Insurance, equal to a. Damages under COVERAGE A. BODILY the amount of the General Aggregate g Limit shown in the Declarations, shall ap- INJURY AND PROPERTY DAMAGE LI- ply to each construction project and is the ABILITY;and most we will pay for the sum of: b. Medical expenses under COVERAGE C. (1) Damages under COVERAGE A, MEDICAL PAYMENTS; BODILY INJURY AND PROPERTY because of all "bodily injury" and "property DAMAGE LIABILITY, except dam- damage"arising out of any one"occurrence". ages because of "bodily injury" or "property damage" included in the 6. Subject to 5. above, the Damage to Premises "products-completed operations Rented to You Limit is the most we will pay hazard"; and under COVERAGE A. BODILY INJURY AND 2 Medical expenses under COVER- PROPERTY DAMAGE LIABILITY for dam- (2) p ages because of "property damage" to any AGE C. MEDICAL PAYMENTS; one premises, while rented to you, or in the which can be attributed only to ongoing case of damage by fire or explosion, while operations and only at a single construc- rented to you or temporarily occupied by you tion project. with permission of the owner. d. Only for the purpose of determining which 7. Subject to 5. above, the Medical Expense General Aggregate Limit of Insurance, Limit is the most we will pay under COVER- 2,a„2.b,,or 2,c„applies: AGE C. MEDICAL PAYMENTS for all medical expenses because of"bodily injury"sustained (1) Location means premises involving by any one person. the same or connecting lots, or The Limits of Insurance of this Coverage Part ap- premises,whose connection is Inter- rupted only by a street, roadway, ply separately to each"coverage term". waterway or right-of-way of a rail- road. (2) Construction project means a loca- tion you do not own, rent or lease Includes copyrighted material of Insurance GA 101 12 04 Services Office,Inc.,with its permission. Page 13 of 23 caused by or resulting 5. Medical Payments from ra , snow, sleet or ice, The Medical Expense Limit of Any One or ce, whether her driven p y by wind or not. Person as stated in the Declarations is amended to the limit shown in Section B. c, Limit of Insurance Limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to ments of this endorsement. You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cove LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for"property damage" to property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured;or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault. you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY, 2. (3) The amount we will pay is Um- Exclusions,j Damage to Property, ited as described in Section B. Subparagraphs (3), (4) and (5) do Limits of Insurance, 3, Dam- not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement. therein. 4, Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION 1 - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. is replaced by the fol- its designated in Section B. Limits of lowing: Insurance, 6. Voluntary Property Up to the limit shown in Section B. Damage and Care, Custody or p Control Liability Coverage of this Limits of Insurance,4.a. Bail Bonds endorsement with respect to cover- of this endorsement for cost of bail age provided by this endorsement. bonds required because of accidents These limits are inclusive of and not or traffic law violations arising out of in addition to the limits being re- the use of any vehicle to which the placed. The Limits of Insurance Bodily Injury Liability Coverage ap- shown in Section B. Limits of Insur- plies. We do not have to furnish ance, 6. Voluntary Property Dam- these bonds. age and Care, Custody or Control b. Paragraph 4. is replaced by the fo!- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist 1 Insureds; us in the investigation or defense of (1) the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15 b. Deductible Clause e 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fied Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II-WHO IS AN INSURED: "occurrence" which are in ex- cess person or organization de- stated of the deductible amount (1) Any p g stated in Section B. Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below(hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Coy- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement;or (2) Condition 2.Duties In the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of nor Suit, applies to each claim or insurance showing that per- suit irrespective of the amount, son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations riod;and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence"or offense Subparagraph a, of Paragraph 4, is to which this insurance hereby deleted and replaced by the fol- lowing: (b) They are not specifically a. Insurance under this provision is af- named as an additional In- forded only until the 180th day after cured under any other pro- forded vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; 8. Waiver of Subrogation (2) Only the following persons or organizations are additional in- SECTION IV- COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or"your work"done un- Paragraph 9.a.(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability aris- and included in the "products-completed ing out of the ownership, operations hazard". However, our rights maintenance or use of that may onl be waived prior to the `occur- part of a premises leased to rence"giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. apply to: At our request,the insured will bring"suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights. which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change 2) Structural alterations, in the product ) made intentionally new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose or organization dese of Inspection, (b) Any person 9 demonstration, from which you lease testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in- 9.a.(1) above to provide in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- c Any person or organization takes u make in j (c) Y p 9 the usual course (referred to below as yen- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of your products"which stallation, servic- are distributed or sold in the ing or repair op- regular course of the van- orations, except dot's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises 1) t The insurance afforded h connection whe the sale of the the vendor does not product; apply to: "Bodily injury" or g) Products which, a Y 1 rY after distribution or "property damage" sale by you, have for which the yen- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of liabil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- tract or agree- a) From whom you ment; have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "bodily in- products;or jury", "property Jam- b When liability in- age" or "personal and y advertising injury" aris- cluded within the ing out of operations "products- performed for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) sped to such above to provide insurance, products. but only with respect to li- Ate political subdi- ability arising out of "your (d) Any you have work performed for that vision state or h which Y additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of with respect to the following time required by the written hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- Oration date of this Cover- tion with premises you own, age Part. If there is no rent or control and to which written contract or agree- this insurance applies: ment, or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) lions and similar expo- does not apply to "bodily sures;or injury"or"property damage" 2) The construction, erec included within the "prod- tion, or removal of ete ucts-completed operations vators;or hazard , 3) The ownership, main- (b) Subparagraphs (a), (b), (d), (e)and (f)does not apply to elevators covered e or use any "bodily injury", "property el by damage" or "personal and this insurance. advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9,a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- issued a permit. nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 12 of 15 of the additional in- spects any other insurance sured;or policy Issued to the addi- tional The rendering of, tional insured, and such g , or other insurance policy shall failure to render, any be excess and/or noncon- professional architec- tributing,whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, In SECTION IV surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS,5. Other and specifications; Insurance, b. Excess and Insurance;or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- veering activities. tional insured as an 3) "Your work"for which a additional insured by attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph f) above, SECTION III - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(f)above only: Part,whichever are less. If no limits are specified in the written contract If a written contract or or agreement,or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicable to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part. The limits of in- a, Be provided by the In- surance are inclusive of and not in surance Services Of- addition to the limits of insurance Tice additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or 4. (a) Where required by a written c. Include coverage for contract or agreement, this "your work"; insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs (a) Insureds; 9.a.(3)(a), 9.a.(3)(b) or 9.b, above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought;or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages on your behalf applies ment is attached. If, how- only to the amount of dam- ever, the written contract or ages for each "occurrence" agreement specifies the In- which are In excess of the surance Services Office Deductible amount stated in additional insured form Section B. Limits of Insur- number CG 20 10 but does ante, 11. of this endorse- not specify which edition,or ment. The limits of insur- specifies an edition that ance will not be reduced by does not exist, Paragraphs the application of such De- ductible and 9.a.(3)(b) of ductible amount. this endorsement shall not apply and Paragraph 9.b.of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- ply. fense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or"suit" irrespective of the amount. Within 50'of Railroad Property It is hereby agreed that Paragraph f.(1)of (c) We may pay any part or all Definition 12. "Insured contract" $ C- of the deductible amount to TION V-DEFINITIONS)Is deleted, effect settlement of any claim or "suit" and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us, Paragraph 2., Exclusions of SEC- TION 1- COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not apply to your "em- ment loaned to you, provided they ployees"who provide professional health are not being used to perform opera- care services on your behalf as duly Ii- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place. Lion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement. These limits are the Event of Occurrence, Offense, Inclusive elimits of and not in addition to Claim or Suit(SECTION IV- COMMER- Limits limits being replaced. The CIAL GENERAL LIABILITY CONDI- Limits of Insurance shown in Section B. Limits of Insurance, Includes copyrighted material of insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 14 of 15 I - in ® V 0 ® o tr ® ty • ca o m e, ® to ® t.+ POOL WORLD, INC. 01' PO BOX 14927 SPOKANE VALLEY WA 99214-0927 005288 DETACH BEFORE POSTING 01 :0:::14g.,,,, . I P. I Ia 539 ;/` 41 N.r. STATE OF Iyi. 'f WASHINGTON =1 V:)I Z! Unified Business In #: 600 183 883 I 1,,, Domestic Profit Corporation Business ID #: 1 Location: 1 '' Expires: 02-28-2014 i1;4 POOL WORLD, INC. ��i1- r' 13524 E SPRAGUE AVE Ia I€'i1 SPOKANE VALLEY WA 99216 0888 y I ii Y TAX REGISTRATION UNEMPLOYMENT INSURANCE J` !f(- INDUSTRIAL INSURANCE I ri r' MINOR WORK PERMIT :i' h\ f CITY LICENSES/REGISTRATIONS: I�I° SPOKANE GENERAL BUSINESS #T12032490BUS 4, LIBERTY LAKE GENERAL BUSINESS ".. 1-' 7: i SPOKANE VALLEY GENERAL BUSINESS r` C , j j Vii;, DUTIES OF MINORS: I!=i Retail sales *May not be exposed to hazardous sub-stances, no power HI; tools/machinery or delivery driving)f)E3E - I`. LICENSING RESTRICTIONS: Minors employed in warehouse/storage work must be at least 16 years `' `�' of age. WAC 296-125-033 (4) IC I It Court permission and a variance from L&I is required to hire minors Is under the age of 14 in non-agriculture jobs. Call 360-902-5316 or '�% t.l email teensafety@Lni.wa.gov for information. _i t REGISTERED TRADE NAMES: `ii POOL WORLD, INC. I i a;a li 41 1,1 F. sl,l; I ; . I-` /. f t [;t This document lists the registrations, endorsements, and licenses authorized for the business r t�� �: named above.By accepting this document,the licensee certifies the information on the application / - r was complete,true,and accurate to the best of his or her knowledge,and that business will be ���' :i I conducted in compliance with all applicable Washington state,county,and city regulations Director Department of Re Il'l