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13-146.00 Michael Terrell Landscape Architect: Park Sign Prototype AGREEMENT FOR PROFESSIONAL SERVICES Michael Terrell Landscape Architect THIS AGREEMENT is made by and between the City of Spokane Valley,a code City of the State of Washington, hereinafter"City" and Michael Terrell Landscape Architect, hereinafter"Consultant,"jointly referred to as"Parties." IN CONSIDERATION of the terms and conditions contained herein,the Parties agree as follows: 1.Work to Be Performed. Consultant shall provide all labor,services and material to satisfactorily complete the attached Scope of Services. A. Administration. The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work,Consultant shall contact the City Manager or designee to review the Scope of Services,schedule and date of completion. The Scope of Services is attached hereto as Exhibit 1. Upon notice from the City Manager or designee, Consultant shall commence work,perform the requested tasks in the Scope of Services,stop work and promptly cure any failure in performance under this Agreement. B. Representations. City has relied upon the qualifications of Consultant in entering into this Agreement. By execution of this Agreement,Consultant represents it possesses the ability,skill and resources necessary to perform the work and is familiar with all current laws,rules and regulations which reasonably relate to the Scope of Services. No substitutions of agreed-upon personnel shall be made without the prior written consent of City. Consultant represents that the compensation as stated in paragraph three is adequate and sufficient compensation for its timely provision of all professional services required to complete the Scope of Services under this Agreement. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City furnished information. C. Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by professional consultants engaged in the same profession,and performing the same or similar services at the time such services are performed. D. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Consultant will accept modifications when ordered in writing by the City Manager or designee. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by City without additional compensation. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by City. Either Party may terminate this Agreement for material breach after providing the other Party with at least ten days' prior notice and an opportunity to cure the breach. City may,in addition,terminate this Agreement for Agreement for Professional Services Page 1 of 6 0,013-1yl any reason by ten days'written notice to Consultant. In the event of termination without breach,City shall pay Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation. City agrees to pay Consultant$2,890.00 as full compensation for everything done under this Agreement. Consultant shall not perform any extra,further or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment therefore. 4. Payment. Consultant shall be paid monthly upon presentation of an invoice to City. Applications for payment shall be sent to the City Finance Department at the below stated address. 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 Scope of Services,City standards,City Code, and federal or state standards. 5. Notice. Notices other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONSULTANT: Name: Christine Bainbridge, City Clerk Name: Michael Terrell Landscape Architect Phone: (509)921-1000 Phone: (509)922-7449 Address: 11707 East Sprague Ave, Suite 106 Address: 1421 N. Meadowwood Lane, Ste. 150 Spokane Valley,WA 99206 Liberty Lake, WA 99019 6.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal,state,and local laws and regulations. Consultant warrants that its designs,construction documents, and services shall confirm to all federal, state and local statutes and regulations. 7. 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 department 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. Agreement for Professional Services Page 2 of 6 8.Relationship of the Parties. It is understood,agreed and declared that Consultant 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 Consultant. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Consultant.The Consultant shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9. Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Consultant 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. The written,graphic,mapped,photographic,or visual documents prepared by Consultant under this Agreement shall,unless otherwise provided,be deemed the property of City. City shall be permitted to retain these documents,including reproducible camera-ready originals of reports, reproduction quality mylars of maps, and copies in the form of computer files, for the City's use. City shall have unrestricted authority to publish,disclose,distribute and otherwise use,in whole or in part, any reports, data, drawings, images or other material prepared under this Agreement, provided that Consultant shall have no liability for the use of Consultant's work product outside of the scope of its intended purpose. 10.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 Consultant'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 Agreement for a period of three years from the date final payment is made hereunder. 11. Insurance. Consultant 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 Consultant, its agents,representatives, employees or subcontractors. A. Minimum Scope of Insurance. Consultant 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 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 and personal injury and advertising injury. City shall be named as an insured under Consultant's commercial general liability insurance policy with respect to the work performed for the City. 3. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. 4. Professional liability insurance appropriate to Consultant's profession. B. Minimum Amounts of Insurance. Consultant 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. Agreement for Professional Services Page 3 of 6 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional liability insurance shall be written with limits no less than $1,000,000 per claim and$1,000,000 policy 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. Consultant's insurance coverage shall be primary insurance with respect to City. Any insurance,self-insurance,or insurance pool coverage maintained by City shall be in excess of Consultant's insurance and shall not contribute with it. 2. Consultant shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Consultant. 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, Consultant shall furnish acceptable insurance certificates to the City Clerk at the time Consultant 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. Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self-insurance. 12. Indemnification and Hold Harmless. Consultant 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 Consultant, Consultant's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Consultant'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. Consultant'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)Consultant, Consultant's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Consultant, Consultant's agents, subcontractors, subconsultants and employees. Consultant'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. Agreement for Professional Services Page 4 of 6 Consultant 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 Consultant's waiver of immunity under this provision extends only to claims against Consultant by City,and does not include,or extend to, any claims by Consultant's employees directly against Consultant. Consultant hereby certifies that this indemnification provision was mutually negotiated. 13. 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 a 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. 14. 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. 15.Subcontracts. Except as otherwise provided herein,Consultant shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of City. 16. Confidentiality. Consultant may,from time to time,receive information which is deemed by City to be confidential. Consultant shall not disclose such information without the prior express written consent of City or upon order of a court of competent jurisdiction. 17. Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between City and Consultant shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing,Consultant agrees that it may,at City's request,be joined as a party in any arbitration proceeding between City and any third party that includes a claim or claims that arise out of,or that are related to Consultant's services under this Agreement. Consultant further agrees that the Arbitrator(s) decision therein shall be final and binding on Consultant and that judgment may be entered upon it in any court having jurisdiction thereof. 18. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation(including expert witness fees). 19. Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties hereto. 20. 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. 21.Business Registration. Prior to commencement of work under this Agreement,Consultant shall register with the City as a business. Agreement for Professional Services Page 5 of 6 22. 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. 23. Exhibits. Exhibits attached and incorporated into this Agreement are: 1. Scope of Services 2. Insurance Certificates fM pp�� "II— [,µs+ The Parties have executed this Agreement this day of Ife,2013. CITY : - POKANE VALLEY Consult. t: / Mil i 4 ili 71) Mike Jac e n, City Manager Its: Authorized Representative ATT ?f: APP OVED AS TO FOR : Christine Bainbri ge, City Cle 7 Office o e City tto r Agreement for Professional Services Page 6 of 6 Michael Terrell • Landscape Architect June 7, 2013 1421 N. Meadowwood Lane, Suite 150 Liberty Lake, WA 99019 (509) 922-7449 Client: City of Spokane Valley, WA Phone: (509) 720-5400 Contact: Mr, Mike Stone Fax: (509) 688-0188 Address: 2426 N. Discovery Place Spokane Valley, Washington 99216 Project: City of Spokane Valley Park Prototype Sign Address: Spokane Valley, Washington Michael Terrell • Landscape Architect Agrees To Perform The Following Scope of Services: City of Spokane Valley Park Prototype Sign Tasks Fees I Prototype Park Identification Sign Design 1. Discuss sign concept based on existing Spokane Valley Gateway sign design for smaller scale signs for parks. Sign to incorporate elements of gateway sign including shape, materials and columns. Sign information to include: a. City of Spokane Valley logo/name b. Park Name c. Park Establishment Date 2. Prepare construction drawings notes and specifications for the construction of a park identification sign. 3. Deliverables: a. Preliminary sketch of concept for installation at Greenacres Park. b. Presentation level preliminary design drawings of selected concept as a power point slide. c, Revised estimate of sign and site development. d. Final construction drawings for prototype. 4. Meetings: a. Meet with city staff to review preliminary design. b. Meet with city staff to review construction drawings for prototypical sign. c. Deliver final design, details and specifications. Subtotal $2,890.00 Total $2,890,00' PROPOSAL ' Project:City of Spokane Valley Park Prototype Sign Project#:13-029 Client:City of Spokane Valley A ® C'OROAL 41m.-.--."" CERTIFICATE OF LIABILITY INSURANCE R054 08-12-201)3 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 ADDITIONALINSURED,the policy(ies)must be endorsed. If SUBROGATIONIS 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 USAA INSURANCE AGENCY INC/PHS PHONE FAX 812846 P: (888) 242-1430 F: (888) 443-6112 MAILo,EXtI: (888)242-1430 (A/C,No): (888)443-6112 PO BOX 33015 ADDRESS: SAN ANTONIO TX 78265 NSURER(S)AFFORDING COVERAGE NAIL# INSURER A: Hartford Casualty Ins Co INSURED INSURER B: MICHAEL TERRELL DBA MICHAEL TERRELL INSURERC: LANDSCAPE ARCHITECT INSURER D 5312 S CHAPMAN RD GREENACRES WA 99016 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 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(EE a occurrence) $ 300, 000 A CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10, 000 X General Liab X ❑ 65 SBA PU5843 01/13/2013 01/13/2014 PERSONAL&ADV INJURY $ 1,000, 000 GENERAL AGGREGATE $ 2,000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 5 2,0 0 0, 0 0 0 POLICY 1 1 JECT PRO X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY Per person) $ ANY AUTO — — ALL OWNED I SCHEDULED _...� BODILY INJURY(Per accident) $ AUTOS AUTOS — — __ PROPERTY DAMAGE HIRED AUTOS NON-OWNED -RECEIVED Per accident) $ _JI AUTOS $ UMBRELLA L/AB OCCUR I EACH OCCURRENCE $ /•d 3 v ti - ' V — — EXCESSL/AB CLAIMS-MADE AGGREGATE $ u DEDI RETENTION $ f1RDVC R.13C(`DCtTIr:M r1CDT I $ WORKERS COMPENSATION �_w N I WC STATU- I IOTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A — E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) — E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERAT IONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remaks Schedule,if more space is required) Those usual to the Insured' s Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of Spokane Valley BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Attention Patty Bischoff DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2426 N DISCOVERY PL AUTHORIZED REPRESENTATIVE ` SPOKANE VALLEY, WA 99216 -70-z_. ---7a4.1,,L' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/24/2013 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 NAME Karen Bronson Leatzow Insurance PHONE (312)930-5556 FAX 741-2778 300 S. Riverside Plaza, Suite 2100 EMAIL ADDRESS karen @leatzowinsurance.com Chicago, IL 60606 INSURER(S)AFFORDING COVERAGE 9 NAIC# INSURER A: New Hampshire Insurance Company 23841 INSURED RECEIVED INURERB: Michael Terrell-Landscape Architect INuRERC: 5312 South Chapman Road Greenacres, WA 99016 �` INSURER D: INSURER E: PARKS&RECREATION PI NAURER 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS LTR INSR WVD (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES(Ea occurrence) CLAIMS MADE OCCUR MED EXP(Any one person) $ DOES NOT APPLY PERSONAL AND ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ POLICY PROJECT LOC .. - ... . $ AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO - Scheduled - - --------- Autos DOES NOT APPLY BODILY INJURY(Per person) $ ALL OWNED Nonowned BODILY INJURY(Per accident) $ AUTOS Autos Hired Autos PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB — OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE DOES NOT APPLY AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - ,WCSTATU- IOTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A DOES NOT APPLY E .EACH ACCIDENT Is OFFICER/MEMBER EXCLUDED? E .DISEASE-EA EMPLOYEE I$ E .DISEASE•POLICY LIMIT Is 1,000,000 each claim A PROFESSIONAL LIABILITY 012295667 1/16/2013 1/16/2014 1,000,000 aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Park Sign Prototype CERTIFICATE HOLDER CANCELLATION City of Spokane Valley SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Parks and Recreation Department EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Attn: Mike Stone THE POLICY PROVISIONS. 2426 N. Discovery Place Spokane Valley, WA 99216 AUTHORIZED REPRESENTATIVE LEATZOW INSURANCE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACCORD name and logo are registered marks of ACORD P/ E 7 UNITED SERVICES AUTOMOBILE ASSOCIATION ADDL INFO ON NEXT PAGE MAIL MCH-M-I RENEWAL OF (A RECIPROCAL INTERINSURANCE IXCHANGE) State 05106 0 7 108 Veh POLICY NUABER USAA® 9800 Fredericksburg Road-San Antonio,Texas 78288 WA 3801380138013801 Terr 00358 9 9 3 6U 7104 8 WASHINGTON AUTO POLICY POLICY PERIOD: (12:01 A.M. standard time) RENEWAL DECLARATIONS EFFECTIVE AUG 20 2013 TO FEB 20 2014 (ATTACH TO PREVIOUS POLICY) OPERATORS Named Insured and Address 01 MICHAEL D TERRELL { _ 03 KARA L TERRELL RE ERtJ 106 PHILLIP C TERRELL MICHAEL D TERRELL CAPT USN 5312 S CHAPMAN RD GREENACRES WA 99016-8834A.RKs :RECREATION Description of Vehicle(s) VEH USE* vccso- ANNUAL 5 VEH YEAR TRADE NAME MODEL BODY TYPE MILEAGE IDENTIFICATION NUMBER SYM was 05 93 PONTIAC TRANS SPT MINIVAN 0 1GMDU06D1PT224947 P 06 98 GMC 1500 PICKUP 2+ DOOR 4000 1GTEK19R1WR514466 P 07 05 CHEV TAHOE 4D 4X4 4 DOOR 10000 1GNEK13T85J264880 P 08 90 HONDA ACCORD 4D LX 4 DOOR 500 JHMCB7650LC061062 P The Vehicle(s)described herein is principally garaged at the above address unless otherwise stated.I*WO=work/Schoot Business;F*arm;P--pleasure VEH 05 GREENACRES WA 99016-8832 VEH 07 GREENACRES WA 99016-8832 VEH 06 GREENACRES WA 99016-8832 VEH 08 GREENACRES WA 99016-8832 This policy provides ONLY those coverages where a premium is shown below. The limits shown may be reduced by policy provisions and may not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this policy. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY 05 6-MONTH 06 6-MONTH 07 6-MONTH 08 6-MONTH ("ACV"MEANS ACTUAL CASH VALUE) D=DED PREMIUM D=DED PREMIUM D=DED PREMIUM D=DED PREMIUM AMOUNT $ AMOUNT $ AMOUNT $ AMOUNT $ STORED VEH-REDUCED LIMITS APPLY, IF DRIVEN STORED* PART A - LIABILITY BODILY INJURY EA PER $ 500, 000 EA ACC $1, 000, 000 17 .48 88 . 02 95 .32 80 .28 PROPERTY DAMAGE EA ACC $ 300, 000 10 .60 50. 77 54 . 88 46 .36 PART B - PERSONAL INJURY PROTECTION MEDICAL BENEFITS - EA PER $ 10, 000 INCOME CONTINUATION - $200 PER WEEK LOSS OF SERVICES BENEFITS - $40/DAY MAX, $200/WK MAX, $5, 000 MAXIMUM TOTAL FUNERAL EXPENSE - $2, 000 3 . 70 9. 04 10 . 15 10 . 93 PART C - UNDERINSURED MOTORISTS BODILY INJURY EA PER $ 500, 000 EA ACC $1, 000, 000 3 .48 36 . 81 40 .45 34 . 79 TOTAL PREMIUM - SEE FOLLOWING PAGE (S) LOSS PAYEE VEH 07 WELLS FARGO AUTO FINANCE, NA, CORAOPOLIS PA ENDORSEMENTS : ADDED 08-20-13 - NONE REMAIN IN EFFECT (REFER TO PREVIOUS POLICY) - 5100WA(01) ACCFOR(01) A400WA(04) A401CW(01) A155CW(01) -STORAGE A100WA(03) AOASA(01) A099 (01) INFORMATION FORMS: 663WA(06) E3 1051 XXX401000100I 1111 1 IXp61 XXX4013001301 1 1 1 1 1 V1°71 RMF501J001001 11111 ID81 XXX401300p01111 111 In WITNESS WHEREOF,the Subscribers at UNITED SERVICES AUTOMOBILE ASSOCIATION have caused these presents to be signed by their Attorney-in-Fact on this date JULY 13, 2013 t a ra Bishop President, USAA Reciprocal Attorney-in-Fact, Inc. 5000 U 07-11 53461-07-11 Verify Workers' Comp Premium Status - Employer Liability Certificate Page 1 of 1 Washington State Department of t; 7, Employer Liability Labor and Industries �fi :�, Certificate Lr49 Department of Labor and Industries Employer Liability Certificate Date: 08/14/2013 UBI #: 601 382 389 Legal Business Name: TERRELL MICHAEL DAVID Account#: 072,594-01 'Doing Business As'Name: MICHAEL TERRELL LANDSCAPE ARCH Estimated Workers Reported: Quarter 2 of Year 2013 "1 to 3 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? No Account Representative: Ti /FEARAED FEROZE (360)902-4797 - Email: FERH235 @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/AcctInfoPrint.aspx?AccountId=07259401&AccountManag... 8/14/2013