Loading...
13-159.00 AM Landshaper: Sullivan Park ImprovementsContract THIS AGREEMENT, made and entered into this day of , 2013, between the City of Spokane Valley under and by virtue of Title 47 RCW, as amended and AM Landshaper, 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: Sullivan Park Improvements Project SVPW Contract 13 -031 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. Cot3 -i5`1 V. The project was awarded for the bid amount of $165,052.58. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year 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 August 29, 2 013 , 2013. Date e C. McGee Printed Name Sec /Treasurer Title Signature City of pokane Valley Ali& U SpXFF_W 41;00041FWky. BOND NO: CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley, Washington 2176301 The City of Spokane Valley, Washington, in Spokane County, has awarded to A.M. Landshaper, Inc. (Contractor), as Principal, a contract for the construction of the project designated as Sullivan Park Improvements Proiect, Project Bid No. 13 -031 in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington (RCW). The Principal, and North American Specialty Insurance Company (Surety), a corporation, organized under the laws of 1JH and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the City of Spokane Valley, as Obligee, in the sum of $ 165,052.58 total Contract amount (including Washington State sale's tax), subject to the provisions herein. This performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications, additions, and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract; and if such performance obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL (CONTRACTOR) S y North American Specialty Insurance Company 8/30/13 A.M. Landshaper, Inc. Principal Signature 8/30/13 Date S ty 6i a Date Printed Name y e-- C /7? el�- {, Heather Anderson Printed Name Sec /Treasurer Attorney -in -Fact Title Title Name, address, and telephone of local office /agent of Surety Company is: Wells Fargo Insurance Services USA, Inc 601 W. Main, Ste. 1400 Spokane, WA 99201 509- 358 -3800 Re k-d :....13 *A�a:�ne "'fty 2176301 BOND NO: CONTRACTOR'S PAYMENT BOND (FEDERALLY FUNDED PROJECT) to City of Spokane Valley, Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to A.M. Landshaper, Inc. (Contractor), as Principal, a contract for the construction of the project designated as Sullivan Park Improvements Proiect, Project Bid No. 13 -031 in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington (RCW) and chapter 60.28 RCW. The Principal, and North American Specialty Insurance Company P (:Surety), a corporation organized under the laws of NH and licensed to do business in the State of Washington as surety and named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly bound to the City of Spokane Valley, as Obligee, in the sum of $ 165,052.58 total Contract amount, subject to the provisions herein. This payment bond shall cover any and all taxes incurred pursuant to Titles 50 and 51 RCW, taxes imposed on the Principal pursuant to Title 82 RCW, and any additional sales taxes. This payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall pay all persons in accordance with chapters 39.08, 39.12, and 60.28 RCW, including all workers, laborers, mechanics, subcontractors, and materiahnen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work; shall pay all taxes due pursuant to Titles 50, 51, and 82 RCW; and shall indemnify and hold harmless the Obligee from all loss, cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments; and if such payment obligations have not been fulfilled, this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, except as provided herein, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL (CONTRACTOR) A.M. Landshaper, Inc. Principal Signature 8/30/713 ✓ Date 7H.e- C- 100'n 1(6--m Printed Name Sec /Treasurer Title SURETY Nort h : m �ican Specialty Insurance Company �� �06 8/30/13 Surety' 6 fore Date Heather Anderson Printed Name Attorney -in -Fact Title Name, address, and telephone of local office /agent of Surety Company is: Wells Fargo Insurance Services USA. Inc. 601 W. Main, Ste. 1400 Spokane, WA 99201 509- 358 -3800 Revised 1.11.13 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: W.W. WELLER, GEORGE C. SCHROEDER, KATHY GURLEY, CHRIS LARSON, ERIN L. REPP, H. KEITH McNALLY, DIANA R. WILLIAMS and HEATHER ANDERSON JOINTLY OR SEVERALLY Its true and lawful Attorney(s) -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9a' of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any. Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." `���Nnitilttlryp� appp...�`t'G�� L� ���mpS10Ng1�0. 01, By SEAL :n= Steven P. Anderson, Senior Vice President of Washington International Insurance Company w'e2 1973 Arno \ & Senior Vice President of North American Specialty Insurance Company ° F i m 6'•�'AM45 ?'yam\ y 6j . a° DaviY T aR d M. Layman, Vice President of Washington International Insurance Company °h2/q oaUsin & Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this26th day of June 2012 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 26th day of June 201? before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Vice President of Washington Intemational Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly swom, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. "OFFICIAL SEAL" /UCtQ oL/ �ti 0 DONNAD.SKLENS Notary Public, State of Illinois Donna D. Sklens, Notary Public My Commission Empires 10/0612015 I, Jeffrey Goldberg ,the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attomey given by said North American Specialty Insurance Company and Washington Intemational Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 30tbay of j /August 20 13 Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North wueriaan Specialty Insurance Company AMLANDS -01 MWHITNEY CERTIFICATE OF LIABILITY INSURANCE DAT 9IYYVY) 9/33 /20/2013 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED 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. certificate holder in lieu of such endorsement(s). A statement on this certificate does not confer rights to the PRODUCER NAME, Matina Whitney Spokane - Riverpoint Pa Insurance, Inc. PHONE FAX A/c No Ertl: (509) 838 -3501 (A /C No): (509) 838 -3511 neWest 50 N. Riverpoint Blvd., Ste 403 E - mwhitney@paynewest.com a ADDRESS: Y @P Y newest.com INSURER(S) AFFORDING COVERAGE NAIC # Spokane, WA 99202 INSURER A: The Cincinnati Insurance Co. INSURED INSURER 13: INSURER C: A.M. Landshaper, Inc. Mark Albin 8004 North Market INSURER D INSURER E: Spokane, WA 99217 INSURER F : _ REVISION NUMBER: COVERAGES CERTIFICATE 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 LTR TYPE OF INSURANCE ADDL IN_S_R_ SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MM /DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY EPP0128051 2/24/2013 2/24/2014 G TO RENTED PREMISES Ea occurrence $ 100 000 CLAIMS -MADE a OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG I S 2,000,000 WA STOP GAP $ 1,000,000 POLICY X jE Loc AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A AN Y AUTO EPP0128051 2/24/2013 2/24/2014 ALL OWNED SCHEDULED AUTOS AUTOS JX BODILY INJURY (Per accident) PROPERTY DAMAGE PER ACCIDENT $ HIRED AUTOS X NON -OWNED AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ A EXCESS LIAR CLAIMS -MADE EPP0128051 2/2412013 2/2412014 DED I RETENTION$ $ WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE WC STATU- OT H-1 TORY LIMITS ER E.L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? I NIA E L. DISEASE - EA EMPLOYEES (Mandatory in NH) L If yes, describe under DESCRIPTION OF OPERATIONS below S E.L. DISEASE -POLICY LIMIT A A Equipment Floater _ EPP0128051 EPP0128051 2/24/2012 2/2412013 2/24/2013 2/24/2014 Leased and Rented 250,000 Deductible 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: City of Spokane Valley Bid #13 -031, Sullivan Park Improvements, Phase 1- Sullivan Road West Bridge Replacement Project CIP 0155 The City of Spokane Valley is named as Primary and Non - Contributory Blanket Additional Insured per endorsment #GA233 02/07 including Waiver of Subrogation and Completed Operations if required by contract or agreement, attached. CERTIFICATE HOLDER CANCELLATION © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valle p y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE � I _ 1 I IAit/l/•"� w�"- 6 it © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage ................................................................... ............................... 2 2. Unintentional Failure to Disclose Hazards ........................................................... ............................... 7 3. Damage to Premises Rented to You .................................................................... ............................... 8 4. Supplementary Payments .................................................................................... ............................... 9 5. Medical Payments ................................................................................................. ............................... 9 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) .......................................................................... ............................... 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations ................... ............................... 10 8. Waiver of Subrogation ........................................................................................ ............................... 10 9. Automatic Additional Insured - Specified Relationships: ................................. ............................... 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions - Permits Relating to Premises; • State or Political Subdivisions - Permits; and • Contractors' Operations 10. Broadened Contractual Liability - Work Within 50' of Railroad Property .......... ............................... 14 11. Property Damage to Borrowed Equipment ........................................................ ............................... 14 12. Employees as Insureds - Specified Health Care Services: ............................. ............................... 14 • Nurses; • Emergency Medical Technicians; and • Paramedics 13. Broadened Notice of Occurrence ....................................................................... ............................... 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated Deductibles (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of a. The following is added to SECTION I (b) Payroll $5,000) $5,000) Liability Coverage. (c) Gross Sales (1) Insuring Agreement ity to pay sums or perform (d) Units (a) We will pay those sums that unless explicitly provided for the insured becomes legally e Other obligated to pay as dam- ments. b. Care, Custody (b) This insurance applies to ror or omission of sured, or of any other per- $ or Control ror or omission, is negli- sured is legally liable, to gently committed in the TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable limit in t. Employee Benefit Liability Coverage ane in the pay ment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay - obligated to pay as dam- ments. ages caused by any act, er- the in- (b) This insurance applies to ror or omission of sured, or of any other per- damages only if the act, e - son for whose acts the in- ror or omission, is negli- sured is legally liable, to gently committed in the which this insurance ap- administration" of your " employee benefit pro plies. We will have the right gram "; and and duty to defend the in- sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE; and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative "; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 2 of 15 Damages arising out of fail- i) Reports all, or ure of performance of con- formance of investment tract by any insurer. any part, of the (d) Insufficiency of Funds vehicles; or act, error or omission to us Damages arising out of an 3) Advice given to any insufficiency of funds to or any other meet any obligations under person with respect to any plan included in the insurer; "employee benefit pro- ". that person's decision gram any: (e) Inadequacy of Perform- to participate or not to ance of Investment / Ad- ii) Receives a vice Given With Respect participate in any plan to Participation written or ver- Any claim based upon: included in the "em- bal demand or 1 Failure of an invest- ) Y ployee benefit pro- ment to perform; claim for dam- 2) Errors in providing in- gram ". formation on past per- ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion; and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance. any workers' compensation, unemployment compensa- (2) Exclusions tion insurance, social secu- rity or disability benefits law apply or any similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of liability imposed on a fiduci- "Bodil injury", "property Y 1 rY" P P Y ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason - including the willful or reck- able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- (i) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to (j) Employment - Related meet any obligations under Practices any plan included in the "employee benefit pro- ". Any liability arising out of gram any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, evaluation, reassign- 1 Failure of an invest- ) Y ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 3 of 15 ment - related practices, acts or omissions; or (4) Consequential liability as a result of (1), (2) or (3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. (3) Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAY- MENTS - COVERAGES A AND B also apply to this Coverage. b. Who is an Insured As respects Employee Benefit Liabil- ity Coverage, SECTION II - WHO IS AN INSURED is deleted in its en- tirety and replaced by the following: (1) If you are designated in the Declarations as: (a) An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- ners, and their spouses are also insureds but only with respect to the conduct of your business. (c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are in- sureds, but only with re- spect to their duties as your managers. (d) An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and di- rectors are insureds, but only with respect to their duties as your officers or di- rectors. Your stockholders are also insureds, but only with respect to their liability as stockholders. (e) A trust, you are an insured. Your trustees are also in- sureds, but only with re- spect to their duties as trustees. (2) Each of the following is also an insured: (a) Each of your "employees" who is or was authorized to administer your "employee benefit program ". (b) Any persons, organizations or "employees" having proper temporary authori- zation to administer your "employee benefit program" if you die, but only until your legal representative is ap- pointed. (c) Your legal representative if you die, but only with re- spect to duties as such. That representative will have all your rights and du- ties under this Coverage Part. (3) Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other similar insurance applies to that organization. However, cover- age under this provision: (a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b) Does not apply to any act, error or omission that was committed before you ac- quired or formed the or- ganization. c. Limits of Insurance As respects Employee Benefit Liabil- ity Coverage, SECTION III - LIMITS OF INSURANCE is deleted in its en- tirety and replaced by the following: (1) The Limits of Insurance shown in Section B. Limits of Insur- ance, 1. Employee Benefit Li- ability Coverage and the rules below fix the most we will pay regardless of the number of: (a) Insureds; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 4 of 15 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 5 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations applies to all damages (c) Persons or organizations sustained by any one "em- making claims or bringing ployee ", including such ,.Suits"; ; "employee's" dependents (d) Acts, errors or omissions; or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram ". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all against any "suits" damages because of acts, er- seeking those dam - rors or omissions negligently "administra- committed in the tion" of your "employee benefit 2) Your duties, and the program". duties of any other in- (3) Subject to the limit described in volved insured, in the event of an act, error or (2) above, the Each Employee omission, or claim, Limit shown in Section B. Limits of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee ", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries, as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission; or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rors or omissions, regard- of the deductible amount as we have paid. less of the amount of time that lapses between such d. Additional Conditions acts, errors or omissions, As respects Employee Benefit Li- negligently committed in the ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program ". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program ". 2. Duties in the Event of an Act, Error or Omission, or Claim or Suit (4) Deductible Amount a. You must see to it that we are noti- (a) Our obligation to pay dam - fied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred; and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam - this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 5 of 15 b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, sum- monses or legal papers re- ceived in connection with the claim or "suit "; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investi- gation or settlement of the claim or defense against the "suit "; and (4) Assist us, upon our request, in the enforcement of any right against any person or organiza- tion which may be liable to the insured because of an act, error or omission to which this insur- ance may also apply. d. No insured will, except at that in- sured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our con- sent. (2) Item 5. Other Insurance is de- leted in its entirety and replaced by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is pri- mary except when c. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in b. below. b. Method of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this method also. Under this approach each in- surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not per- mit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of in- surance to the total ap- plicable limits of insur- ance of all insurers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery un- der any other insur- ance in force previous to the effective date of this Coverage Part. e. Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as fol- lows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees ", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs "; b. Interpreting the "em- ployee benefit pro- grams"; c. Handling records in connection with the "employee benefit pro- grams"; or d. Effecting, continuing or terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 6 of 15 GA 233 02 07 in any benefit included benefits, workers' com- in the "employee bene- pensation and disability fit program ". benefits; and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll de- sence programs, in- ductions; or cluding military, mater - b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- tance plans; transpor- or adequate limits of tation and health club coverage of insurance, subsidies. including but not limited to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' com- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- ceeding in which money 2. "Cafeteria P damages because of an plan authorized by applica- act, error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit" includes: tain benefits with pre -tax dollars. a. An arbitration pro - ceeding in which such 3. "Employee benefit P ro- damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees ", whether provided consent; through a "cafeteria plan" or otherwise: b. Any other alternative dispute resolution pro - a. Group ife insurance; P ceeding in which such group accident or damages are claimed health insurance; den- and to which the in- tal, vision and hearing sured submits with our plans; and flexible consent; or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee may subscribe to such benefits and 8. "Employee" means a per - such benefits are made son actively employed, for - generally available to merly employed, on leave those "employees" who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- "leased ". bility requirements; cludes a worker "Employee" does not in- b. Profit sharing plans, clude a "temporary worker ". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV - COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on such failure. c. Unemployment insur- ance, social security Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, shrinking or ex- a. The last Subparagraph of Paragraph 9 P pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or secretions, in- Exclusions q• PP Y Exclusions c. through do not apply sects, birds, ro- , to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow - b. The insurance provided under SEC- ing: TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of ment; water damage to premises that are both rented to and occupied by you. 2) - Water that backs up or overflows from a (1) As respects Water Damage Le- sewer, drain or sump; gal Liability, as provided in Paragraph 3.b. above: 3) Water under the ground surface press - The exclusions under SECTION ing on, or flowing or I- COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than L walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not; or to: c) Doors, windows or (a) 'Property damage ": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract; or from water that leaks or flows from plumbing, heat - 2) Loss caused by or re- ing, air conditioning, or fire sulting from any of the protection systems caused following: by or resulting from freez- ing, unless: a) Wear and tear; 1) You did your best to b Rust, corrosion, maintain heat in the fungus, decay, building or structure; or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main - age or destroy it- tained. self; (d) Loss to or damage to: C) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro - breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances; or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 8 of 15 caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6. of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, for damages because of "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance ap- plies. (3) The amount we will pay is lim- ited as described in Section B. Limits of Insurance, 3. Dam- age to Premises Rented to You of this endorsement. 4. Supplementary Payments Under SECTION I - COVERAGE, SUP- PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: Up to the limit shown in Section B. Limits of Insurance, 4.a. Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4. is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit ", including actual loss of earnings up to the limit shown in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- dorsement per day because of time off from work. 5. Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits of Insurance, 5. Medical Pay- ments of this endorsement. 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage a. Voluntary Property Damage Cov- erage We will pay for "property damage" to property of others arising out of op- erations incidental to the insured's business when: (1) Damage is caused by the in- sured; or (2) Damage occurs while in the in- sured's possession. With your consent, we will make these payments regardless of fault. b. Care, Custody or Control Liability Coverage SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, j. Damage to Property, Subparagraphs (3), (4) and (5) do not apply to "property damage" to the property of others described therein. With respect to the insurance provided by this section of the endorsement, the fol- lowing additional provisions apply: a. The Limits of Insurance shown in the Declarations are replaced by the lim- its designated in Section B. Limits of Insurance, 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage of this endorsement with respect to cover- age provided by this endorsement. These limits are inclusive of and not in addition to the limits being re- placed. The Limits of Insurance shown in Section B. Limits of Insur- ance, 6. Voluntary Property Dam- age and Care, Custody or Control Liability Coverage of this endorse- ment fix the most we will pay in any one "occurrence" regardless of the number of: (1) Insureds; (2) Claims made or "suits" brought; or (3) Persons or organizations mak- ing claims or bringing "suits ". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 9 of 15 b. Deductible Clause (1) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex- cess of the deductible amount stated in Section B. Limits of Insurance, 6. Voluntary Prop- erty Damage and Care, Cus- tody or Control Liability Cov- erage of this endorsement. The limits of insurance will not be re- duced by the application of such deductible amount. (2) Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit, applies to each claim or "suit' irrespective of the amount. (3) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit' and, upon notification of the ac- tion taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 7. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4. is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 8. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your on- going operations or "your work" done un- der a written contract requiring such waiver with that person or organization and included in the "products- completed operations hazard ". However, our rights may only be waived prior to the 'occur- rence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce those rights. 9. Automatic Additional Insured - Speci- fied Relationships a. The following is hereby added to SECTION II - WHO IS AN INSURED: (1) Any person or organization de- scribed in Paragraph 9.a.(2) below (hereinafter referred to as additional insured) whom you are required to add as an addi- tional insured under this Cover- age Part by reason of: (a) A written contract or agreement; or (b) An oral agreement or con- tract where a certificate of insurance showing that per- son or organization as an additional insured has been 'issued, is an insured, provided: (a) The written or oral contract or agreement is: 1) Currently in effect or becomes effective during the policy pe- riod; and 2) Executed prior to an "occurrence" or offense to which this insurance would apply; and (b) They are not specifically named as an additional in- sured under any other pro- vision of, or endorsement added to, this Coverage Part. (2) Only the following persons or organizations are additional in- sureds under this endorsement, and insurance coverage pro- vided to such additional in- sureds is limited as provided herein: (a) The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 9.a.(1) above to provide insurance, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" 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 in the product 2 Structural alterations, 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 of inspection, (b ) Any P 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- takes to make in (c) Any person or organization the usual course (referred to below as ven- 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 ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: g) Products which, a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the ven- 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- t or agree- ract a) From whom you 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 GA 233 02 07 companying or 2) This insurance does containing such not apply to "bodily in- products; or jury", "property Jam- age" or "personal and b When liability n- 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) spect to such above to provide insurance, products. but only with respect to li- ability arising out of "your d An state or political subdi- () Y p work" performed for that vision with which you have 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- piration date of this Cover - tion with premises you own, age Part. If there is no written contract or agree - rent or control and to which 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, manholes, marquees, (3) Any insurance provided to an hoist away openings, additional insured designated under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions 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 ele- ucts- completed operations vators; or hazard "; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, or use of any (e) and (f) does not apply to 'property elevators covered by bodily injury", "personal this insurance. damage" or and 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 issued a permit. 1) Defects in design fur- nished by or on behalf Includes copyrighted material of Insurance 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 insured, and such 9 , 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- neering activities. tional insured as an additional insured by 3 "Your work" for which a 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 Agreement The limits applicable to the additional 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 If a written contract or are specified in the written contract 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 fice 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 (a) Where required by a written c. Include coverage for 'your "; contract or agreement, this 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- strictive than was specifi- cally required in that written contract or agreement, the terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or coverage is included within the terms of the Coverage Part to which this endorse- ment is attached. If, how- ever, the written contract or agreement specifies the In- surance Services Office additional insured form number CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 9.a.(3)(a) and 9.a.(3)(b) of this endorsement shall not apply and Paragraph 9.b. of this endorsement shall ap- ply. 10. Broadened Contractual Liability - Work Within 50' of Railroad Property It is hereby agreed that Paragraph f.(1) of Definition 12. "Insured contract' (SEC- TION V - DEFINITIONS) is deleted. 11. Property Damage to Borrowed Equip- ment a. The following is hereby added to Ex- clusion j. Damage to Property of Paragraph 2., Exclusions of SEC- TION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform opera- tions at the time of loss. b. With respect to the insurance pro- vided by this section of the en- dorsement, the following additional provisions apply: (1) The Limits of insurance shown in the Declarations are replaced by the limits designated in Sec- tion B. Limits of Insurance, 11. of this endorsement with respect to coverage provided by this endorsement. These limits are inclusive of and not in addition to the limits being replaced. The Limits of Insurance shown in Section B. Limits of Insurance, 11. of this endorsement fix the most we will pay in any one "oc- currence" regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bring "suits ". (2) Deductible Clause (a) Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each 'occurrence" which are in excess of the Deductible amount stated in Section B. Limits of Insur- ance, 11. of this endorse- ment. The limits of insur- ance will not be reduced by the application of such De- ductible amount. (b) Condition 2. Duties in the Event of Occurrence, Of- fense, Claim or Suit, ap- plies to each claim or "suit' irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit' and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 12. Employees as Insureds - Specified Health Care Services It is hereby agreed that Paragraph 2.a.(1)(d) of SECTION II - WHO IS AN INSURED, does not apply to your "em- ployees" who provide professional health care services on your behalf as duly li- censed: a. Nurses; b. Emergency Medical Technicians; or c. Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place. 13. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit (SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDI- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced by the following: a. You must see to it that we are noti- fied as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence" or offense. This requirement applies only when the 'occurrence" or offense is known to an "authorized representative ". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 15 of 15 AMLANDS -01 MWHITNEY ACORO' �� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/9/2013 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 Spokane - Riverpoint PayneWest Insurance Inc. 501 N. Riverpoint Blva., Ste 403 Spokane, WA 99202 CONTACT NAME: PHONE 509 838 -3501 AX No l: 509 838 -3511 A/C No Ext : ( ) ( ) ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:The Cincinnati Insurance Co. INSURED INSURER 8: $ 1,000,000 INSURERC: $ 100,000 A.M. Landshaper, Inc. Mark Albin 8004 North Market INSURER D EPP0128051 2/2412013 Spokane, WA 99217 INSURER E: CLAIMS -MADE 7 OCCUR 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 CONTRACTOR 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 LTR TYPE OF INSURANCE POLICY NUMBER MM /DDY� MM /DDS LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,000 • X COMMERCIAL GENERAL LIABILITY EPP0128051 2/2412013 2/24/2014 CLAIMS -MADE 7 OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 2,000,000 WA STOP GAP $ 1,000,000 POLICY X PRO- LOC JFrT L1 AUTOMOBILE LIABILITY (CEO, MBccident d.nt)S NGLE LIMIT a $ 1,000,000 BODI LY I NJURY (Per person) $ • X ANY AUTO EPP0128051 2/2412013 2/24/2014 BODILY INJURY (Peraccident) $ ALL OWNED SCHEDULED AUTOS NON- -OWNED X HIREDAUTOS X AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ • EXCESS LIAR CLAIMS -MADE EPP0128051 2/2412013 2/24/2014 DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA EPP0128051 2/2412013 2124/2014 WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ , 000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, descr be under DESCRIPTION OF OPERATIONS below A Equipment Floater EPP0128051 2/24/2012 2/24/2013 Leased and Rented 250,000 A EPP0128061 2/24/2013 2/24/2014 Deductible 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Re: City of Spokane Valley Bid #13 -031, Sullivan Park Improvements, Phase I- Sullivan Road West Bridge Replacement Project CIP 0155 The City of Spokane Valley is named as Primary and Non - Contributory Blanket Additional Insured per endorsment #GA233 02/07 including Waiver of Subrogation and Completed Operations if required by contractor agreement, attached. 11JR!a;1112L61G111 I= I i If] 4Ja3 City of Spokane Valley 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AJ�UU /T�HHORIRIpZ�EDD REPRESENTATIVE I. ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage ................................................................... ............................... 2 2. Unintentional Failure to Disclose Hazards ........................................................... ............................... 7 3. Damage to Premises Rented to You .................................................................... ............................... 8 4. Supplementary Payments .................................................................................... ............................... 9 5. Medical Payments ................................................................................................. ............................... 9 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) ........................................................................ ............................... 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations ..................... .............................10 8. Waiver of Subrogation .......................................................................................... .............................10 9. Automatic Additional Insured - Specified Relationships: ................................... .............................10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions - Permits Relating to Premises; • State or Political Subdivisions - Permits; and • Contractors' Operations 10. Broadened Contractual Liability - Work Within 50' of Railroad Property .......... ............................... 14 11. Property Damage to Borrowed Equipment .......................................................... .............................14 12. Employees as Insureds - Specified Health Care Services: ............................................................ 14 • Nurses; • Emergency Medical Technicians; and • Paramedics 13. Broadened Notice of Occurrence ......................................................................... .............................14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated Deductibles (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of a. The following is added to SECTION I (b) Payroll $5,000) $5,000) Liability Coverage. (c) Gross Sales (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that (d) Units the insured becomes legally under Supplementary Pay - obligated to pay as dam- e Other ages caused by any act, er- the in- (b) This insurance applies to b. Care, Custody damages only if the act, er- son for whose acts the in- $ or Control flemplooyee "administration" tion of your plies. We will have the right benefit pro - TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable limit in t. Employee Benefit Liability Coverage ane in the pay ment of a. The following is added to SECTION I judgments or settle- ments. - COVERAGES: Employee Benefit Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay - obligated to pay as dam- ments. ages caused by any act, er- the in- (b) This insurance applies to ror or omission of sured, or of any other per- damages only if the act, er- son for whose acts the in- ror or omission, is negli- gently committed in the sured is legally liable, to which this insurance ap- flemplooyee "administration" tion of your plies. We will have the right benefit pro - and duty to defend the in- gram"; sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our a) You did not have discretion, investigate any knowledge of a report of an act, error or omission and settle any claim or suit on claim or "suit" that may re- or before the ef- fective date of this sult. But: endorsement. 1) The amount we will pay You will be for damages is limited as described in SEC- TION III - LIMITS OF knowledge of a INSURANCE; and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative "; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 2 of 15 T Damages arising out of fail- i) Reports all, or formance of investment Taxes, fines or penalties, any part, of the vehicles; or (d) Insufficiency of Funds act, error or omission to us 3) Advice given to any Code or any similar state or or any other person with respect to insufficiency of funds to meet any obligations under insurer; that person's decision Practices ,employee benefit pro- to participate or not to gram ". ii) Receives a participate in any plan (1) Refusal to employ; written or ver- included in the "em- vice Given With Respect bal demand or ployee benefit pro- ployment; claim for dam- gram ". 1 Failure of an invest- ) Y ages because of the act, er- (f) Workers' Compensation mation, harassment, ror or omis- and Similar Laws formation on past per- sion; and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance. any workers' compensation, unemployment compensa- (2) Exclusions tion insurance, social secu- rity or disability benefits law apply or any similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of liability imposed on a fduci- "Bodil Y injury", "property ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by any similar federal, state or Criminal or Malicious Act local laws. Damages arising out of any intentional, dishonest, (h) Available Benefits fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason - including the willful or reck- able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or other collectible insurance. tract Damages arising out of fail- (I) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to meet any obligations under (j) Employment - Related any plan included in the Practices ,employee benefit pro- Any liability arising out of gram ". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, 1 Failure of an invest- ) Y evaluation, reassign- ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- tion or other employ- formation on past per- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 3 of 15 ment - related practices, acts or omissions; or (4) Consequential liability as a result of (1), (2) or (3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. (3) Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAY- MENTS - COVERAGES A AND B also apply to this Coverage. b. Who is an Insured As respects Employee Benefit Liabil- ity Coverage, SECTION II - WHO IS AN INSURED is deleted in its en- tirety and replaced by the following: (1) If you are designated in the Declarations as: (a) An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- ners, and their spouses are also insureds but only with respect to the conduct of your business. (c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are in- sureds, but only with re- spect to their duties as your managers. (d) An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and di- rectors are insureds, but only with respect to their duties as your officers or di- rectors. Your stockholders are also insureds, but only with respect to their liability as stockholders. (e) A trust, you are an insured. Your trustees are also in- sureds, but only with re- spect to their duties as trustees. (2) Each of the following is also an insured: (a) Each of your "employees" who is or was authorized to administer your "employee benefit program ". (b) Any persons, organizations or "employees" having proper temporary authori- zation to administer your "employee benefit program" if you die, but only until your legal representative is ap- pointed. (c) Your legal representative if you die, but only with re- spect to duties as such. That representative will have all your rights and du- ties under this Coverage Part. (3) Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other similar insurance applies to that organization. However, cover- age under this provision: (a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b) Does not apply to any act, error or omission that was committed before you ac- quired or formed the or- ganization. c. Limits of Insurance As respects Employee Benefit Liabil- ity Coverage, SECTION III - LIMITS OF INSURANCE is deleted in its en- tirety and replaced by the following: (1) The Limits of Insurance shown in Section B. Limits of Insur- ance, 1. Employee Benefit Li- ability Coverage and the rules below fix the most we will pay regardless of the number of: (a) Insureds; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations applies to all damages (c) Persons or organizations sustained by any one "em- making claims or bringing ployee", including such "suits'; "employee's" dependents (d) Acts, errors or omissions; or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram ". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all against any "suits" damages because of acts, er- rors or omissions negligently "administra- ages; and committed in the tion" of your "employee benefit 2) Your duties, and the program ". duties of any other in- (3) Subject to the limit described in volved insured, in the event of an act, error or (2) above, the Each Employee omission, or claim, Limit shown in Section B. Limits of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee ", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries, as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission; or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part of the deductible amount as rors or omissions, regard- less of the amount of time we have paid. that lapses between such d. Additional Conditions acts, errors or omissions, As respects Employee Benefit Li- negligently committed in the ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program ". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the em- ployee benefit program ". 2. Duties in the Event of an Act, Error or Omission, or Claim or Suit (4) Deductible Amount a. You must see to it that we are noti- (a) Our obligation to pay dam - fied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred; and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- deductible. ages ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 5 of 15 b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, sum- monses or legal papers re- ceived in connection with the claim or "suit'; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investi- gation or settlement of the claim or defense against the "suit "; and (4) Assist us, upon our request, in the enforcement of any right against any person or organiza- tion which may be liable to the insured because of an act, error or omission to which this insur- ance may also apply. d. No insured will, except at that in- sured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our con- sent. (2) Item 5. Other Insurance is de- leted in its entirety and replaced by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is pri- mary except when c. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in b. below. b. Method of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this method also. Under this approach each in- surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not per- mit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of in- surance to the total ap- plicable limits of insur- ance of all insurers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery un- der any other insur- ance in force previous to the effective date of this Coverage Part. e. Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as fol- lows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees ", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs'; b. Interpreting the "em- ployee benefit pro- grams "; c. Handling records in connection with the "employee benefit pro- grams'; or d. Effecting, continuing or terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 6 of 15 GA 233 02 07 in any benefit included benefits, workers' com- in the "employee bene- pensation and disability fit program ". benefits; and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- s. Handling payroll grams; leave of ab- sence programs, in- ductions; or cluding military, mater - b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- tance plans; transpor- or adequate limits of coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' com- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- ceeding in which money 2. "Cafeteria P damages because of an plan authorized by applica- act, error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit" includes: tain benefits with pre -tax dollars. a. An arbitration pro - ceeding in which such 3. "Employee benefit P ro- damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees ", whether provided consent; through a "cafeteria plan" or otherwise: b. Any other alternative dispute resolution pro- a. Group ife insurance; p ceeding in which such group accident or damages are claimed health insurance; den- and to which the in- tal, vision and hearing sured submits with our plans; and flexible consent; or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per - such benefits are made son actively employed, for - generally available to merly employed, on leave those "employees" who of absence or disabled, or "Employee" satisfy the plan's eligi- retired. in- ". bility requirements; cludes a "leased worker "Employee" does not in- b. Profit sharing plans, clude a "temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock subscription plans, SECTION IV - COMMERCIAL GENERAL provided that no "em- LIABILITY CONDITIONS, 7. Represen- tations is hereby amended by the addi- other than an em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, a. The last Subparagraph of Paragraph 9 P shrinking or ex- pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or secretions, Exclusions c. through do not apply 9 4• PP Y , o- sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow - b. The insurance provided under SEC- ing: TION 1 - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of ment; water damage to premises that are both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer, drain or sump; gal Liability, as provided in Paragraph 3.b. above: 3) Water under the ground surface press - The exclusions under SECTION ing on, or flowing or - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than 1. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not; or to: c) Doors, windows or (a) "Property damage ": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract; or from water that leaks or flows from plumbing, heat - 2) Loss caused by or re- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- ing, unless: a) Wear and tear; 1) You did your best to b Rust, corrosion, maintain heat in the fungus, decay, building or structure; or deterioration, hid- den or latent de- 2) You drained the feet or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main - age or destroy it- tained. self; (d) Loss to or damage to: C) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro - breakdown in- tection systems, or eluding rupture or other equipment or ap- bursting caused pliances; or by centrifugal force; The interior of any ' building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 8 of 15 4. caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6. of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, for damages because of "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance ap- plies. (3) The amount we will pay is lim- ited as described in Section B. Limits of Insurance, 3. Dam- age to Premises Rented to You of this endorsement. Supplementary Payments Under SECTION I - COVERAGE, SUP- PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: Up to the limit shown in Section B. Limits of Insurance, 4.a. Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4, is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit ", including actual loss of earnings up to the limit shown in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- dorsement per day because of time off from work. 5. Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits of Insurance, 5. Medical Pay- ments of this endorsement. 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage a. Voluntary Property Damage Cov- erage We will pay for "property damage" to property of others arising out of op- erations incidental to the insured's business when: (1) Damage is caused by the in- sured; or (2) Damage occurs while in the in- sured's possession. With your consent, we will make these payments regardless of fault. b. Care, Custody or Control Liability Coverage SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, j. Damage to Property, Subparagraphs (3), (4) and (5) do not apply to "property damage" to the property of others described therein. With respect to the insurance provided by this section of the endorsement, the fol- lowing additional provisions apply: a. The Limits of Insurance shown in the Declarations are replaced by the lim- its designated in Section B. Limits of Insurance, 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage of this endorsement with respect to cover- age provided by this endorsement. These limits are inclusive of and not in addition to the limits being re- placed. The Limits of Insurance shown in Section B. Limits of Insur- ance, 6. Voluntary Property Dam- age and Care, Custody or Control Liability Coverage of this endorse- ment fix the most we will pay in any one "occurrence" regardless of the number of: (1) Insureds; (2) Claims made or "suits" brought; or (3) Persons or organizations mak- ing claims or bringing "suits ". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 9 of 15 b. Deductible Clause (1) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex- cess of the deductible amount stated in Section B. Limits of Insurance, 6. Voluntary Prop- erty Damage and Care, Cus- tody or Control Liability Cov- erage of this endorsement. The limits of insurance will not be re- duced by the application of such deductible amount. (2) Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit, applies to each claim or "suit" irrespective of the amount. (3) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the ac- tion taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 7. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION 11 - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4, is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 8. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your on- going operations or "your work" done un- der a written contract requiring such waiver with that person or organization and included in the "products- completed operations hazard ". However, our rights may only be waived prior to the 'occur- rence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. 9. Automatic Additional Insured - Speci- fied Relationships a. The following is hereby added to SECTION II - WHO IS AN INSURED: (1) Any person or organization de- scribed in Paragraph 9.a.(2) below (hereinafter referred to as additional insured) whom you are required to add as an addi- tional insured under this Cover- age Part by reason of: (a) A written contract or agreement; or (b) An oral agreement or con- tract where a certificate of insurance showing that per- son or organization as an additional insured has been issued, is an insured, provided: (a) The written or oral contract or agreement is: 1) Currently in effect or becomes effective during the policy pe- riod; and 2) Executed prior to an "occurrence" or offense to which this insurance would apply; and (b) They are not specifically named as an additional in- sured under any other pro- vision of, or endorsement added to, this Coverage Part. (2) Only the following persons or organizations are additional in- sureds under this endorsement, and insurance coverage pro- vided to such additional in- sureds is limited as provided herein: (a) The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 9.a.(1) above to provide insurance, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" 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 in the product 2) Structural alterations, 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 of inspection, (b ) Any P 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- takes to make in (c) Any person or organization the usual course (referred to below as ven- 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 ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: g) Products which, a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the ven- 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- t or agree- ract a) From whom you 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- age" or "personal and b When liability n- tY 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) spect to such above to provide insurance, products. but only with respect to li- ability arising out of "your d An state or political subdi- () Y P work" performed for that vision with which you have 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 contract or agreement, but hazards for which the state in no event beyond the ex- or political subdivision has piration date of this Cover - issued a permit in connec- age Part. If there is no tion with premises you own, 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, manholes, marquees, (3) Any insurance provided to an hoist away openings, additional insured designated under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures; or injury" or "property damage" 2) The construction, erec- included within the "prod - ucts- completed operations tion, or removal of ele- hazard"; vators; or 3) The ownership, main- (b) Subparagraphs (a), (b), (d), (e) and (f) does note apply to tenance, or use of any elevators covered by bodily injury", property "personal this insurance. damage" or and 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 insured, and such 9 , 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- neering activities. tional insured as an additional insured by 3 "Your work" for which a 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 Agreement The limits applicable to the additional 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 If a written contract or are specified in the written contract 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 fice 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 (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- strictive than was specifi- cally required in that written contract or agreement, the terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or coverage is included within the terms of the Coverage Part to which this endorse- ment is attached. If, how- ever, the written contract or agreement specifies the In- surance Services Office additional insured form number CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 9.a.(3)(a) and 9.a.(3)(b) of this endorsement shall not apply and Paragraph 9.b. of this endorsement shall ap- ply. 10. Broadened Contractual Liability - Work Within 50' of Railroad Property It is hereby agreed that Paragraph f.(1) of Definition 12. "Insured contract" (SEC- TION V - DEFINITIONS) is deleted. 11. Property Damage to Borrowed Equip- ment a. The following is hereby added to Ex- clusion J. Damage to Property of Paragraph 2., Exclusions of SEC- TION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform opera- tions at the time of loss. b. With respect to the insurance pro- vided by this section of the en- dorsement, the following additional provisions apply: (1) The Limits of insurance shown in the Declarations are replaced by the limits designated in Sec- tion B. Limits of Insurance, 11. of this endorsement with respect to coverage provided by this endorsement. These limits are inclusive of and not in addition to the limits being replaced. The Limits of Insurance shown in Section B. Limits of Insurance, 11, of this endorsement fix the most we will pay in any one "oc- currence" regardless of the number of: (a) Insureds; (b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bring "suits ". (2) Deductible Clause (a) Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible amount stated in Section B. Limits of Insur- ance, 11. of this endorse- ment. The limits of insur- ance will not be reduced by the application of such De- ductible amount. (b) Condition 2. Duties in the Event of Occurrence, Of- fense, Claim or Suit, ap- plies to each claim or "suit" irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 12. Employees as Insureds - Specified Health Care Services It is hereby agreed that Paragraph 2.a.(1)(d) of SECTION II - WHO IS AN INSURED, does not apply to your "em- ployees" who provide professional health care services on your behalf as duly li- censed: a. Nurses; b. Emergency Medical Technicians; or c. Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place. 13. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit (SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDI- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced by the following: a. You must see to it that we are noti- fied as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the 'oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the 'occurrence" or offense is known to an "authorized representative ". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 15 of 15 Craig Aldworth From: Craig Aldworth Sent: Friday, August 23, 2013 12:37 PM To: Steve Worley Cc: 'Martin, Keith'; 'Mark.Brower @CH2M.com; Darla Arnold Subject: Recommend to Award Sullivan Park Improvement Project to AM Landshaper Attachments: Sullivan Park Improvements Bid Tab 8- 23- 13.pdf Steve I have reviewed the bids submitted for the Sullivan Park Improvements Project (phase 1 of the Sullivan Rd West Bridge Replacement Project) and found each to be complete. AM Landshaper submitted the lowest responsible bid. I have received three excellent references for AM Landshaper for past project performance from: 1. City of Spokane Maintenance Depart Jim Montague 509 - 625 -7905, 2. Spokane Valley Parks Department Patti Bischof 509 - 720 -5400 3. CDA Casino Sandy Dymale 206 - 971 -5581 I have checked and found that AM Landshaper is not on the Federal SAM Excluded Parties list or the WA State L &I Debarred list. The bid had several addition errors which are corrected in the attached Bid Tabulation. I therefore recommend awarding the Sullivan Parks Improvement Project to AM Landshaper for the corrected amount (including taxes) of $165,052.58. Sincerely, Craig Aldworth Project Manager Spokane Valley Public Works Department I AMLANDS-01 MWHITNEY ACCORCr DATE(MM/DD/YYYY) ‘,4____- CERTIFICATE OF LIABILITY INSURANCE 2/19/2014 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(les)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: Spolane-Riverpoint PHONE 509 8383501 FAX (A/C,No,Est):( ) (ac,No):(509)838-3511 Pa newest Insurance,Inc. E-MAIL 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:The Cincinnati Insurance Co. INSURED INSURER B: eA:M.Landshaper,Inc.," INSURER C: Mark Albin ' 8004 North Market INSURER D: 1 Spokane,WA 99217 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 INSR SWVD POLICY NUMBER (MMLDDY/YYYY) (POLICY DIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY EPP0128051 2/24/2014 2/24/2015 pREMISES Ea occu ence) $ 500,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 1 1 GENERAL AGGREGATE $ 2,000,000 bEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY X JECOT- LOC WA STOP GAP $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ A X ANY AUTO EPP0128051 2/24/2014 2/24/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS — X HIRED AUTOS X NON-OWNED (Pr PROPERTY ccint)DAMAGE $ AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE EPP0128051 2/24/2014 2/24/2015 AGGREGATE _$ 1,000,000 DED X RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A EquIpment Floater EPP0128051 2/24/2014 2/24/2015 Leased and Rented 250,000 A ' EPP0128051 2/24/2014 2/24/2015 Deductible 1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) _ Re:City of Spokane Valley.Bid#13-031,-Sullivan Park improvements;Phase I-Sullivan Road.West Bridge Replacement Project CIP 0155 The City of Spokane Valley is named as Primary and Non-Contributory Blanket Additional Insured per endorsment#GA233 02/07 including Waiver of Subrogation and Completed Operations if required by contract or agreement,attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY P y ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave,Suite 106 Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE n I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD N3tB—t 51 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 2 2. Unintentional Failure to Disclose Hazards 7 3. Damage to Premises Rented to You 8 4. Supplementary Payments 9 5. Medical Payments 9 6. Voluntary Property Damage (Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation 10 9. Automatic Additional Insured -Specified Relationships: 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions-Permits Relating to Premises; • State or Political Subdivisions-Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property 14 11. Property Damage to Borrowed Equipment 14 12. Employees as Insureds-Specified Health Care Services: 14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- 1. Employee Benefit Liability Coverage alncebin the limit payment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- (b) This insurance applies to ror or omission of the in- damages only if the act, er- sured, or of any other per ror or omission, is negli- son for whose acts the in- sured is legally liable, to gently committed in the administration which this insurance ap- your plies. We will have the right "employee benefit pro- and duty to defend the in- gram";and sured against any "suit" 1) Occurs during the poi- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- suit. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE; and claim or "suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 i) Reports all, or formance of investment any part, of the vehicles; or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or orris- and Similar Laws sion;and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ance. any workers'compensation, unemployment compensa- (2) Exclusions tion insurance, social secu- rity insurance does not apply rity or disability benefits law PP y or any similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of fiduci- "Bodily injury", "property liability imposed on a fiduci- Y 1 rY P P y ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reck- able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible insurance. Damages arising out of fail- (I) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to meet any obligations under (j) Employment-Related any plan included in the Practices "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, 1 Failure of any invest- evaluation, reassign- 1) Y ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- tion on past per- or other employ Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds,Consequential liability sureds, but only with re- (4) q y spect to their duties as as a result of(1), (2) or trustees. (3)above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury. or "employees" having proper temporary authori- (3) Supplementary Payments zation to administer your SECTION I - COVERAGES, "employee benefit program" SUPPLEMENTARY PAY- if die, only until your MENTS - COVERAGES A AND legal egal representative is ap- B also apply to this Coverage. pointed. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II - WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint ven- age under this provision: ture, you are an insured. Your members, your part- (a) Is afforded only until the ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business. whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in- c. Limits of Insurance sureds, but only with re- spect to their duties as your As respects Employee Benefit Liabil- managers. ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B. Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations (c) Persons or organizations applies to all damages ( ) 9 sustained by any one "em- making claims or bringing ployee", including such "suits"; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ance applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all damages because of acts, er- against any "suits" rors or omissions negligently seeking those dam- committed in the "administra- tion" of your "employee benefit 2) Your duties, and the program". duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act, error or omission, or claim, Limit shown in Section B. Limits of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission;or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part r of the deductible amount as ors or omissions, regard- we have paid. less of the amount of time that lapses between such d. Additional Conditions acts,errors or omissions, committed in the As respects Employee Benefit Li- negligently ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission,or Claim or Suit a Our obligation to pay dam- a. You must see to it that we are noti- (a) 9 p Y fled as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred; and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit" as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its (3) Cooperate with us in the investi- applicable limit of in- surance the total limits ap- gation of insur- and defense against the "suit"; ance l and ance of all insurers. (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. ance in force previous d. No insured will, except at that in- to the effective date of sured's own cost, voluntarily make a this Coverage Part. payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Other Insurance added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams";or other insurance by the d. Effecting, continuing or method described in b. terminating any "em- below. ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corn- in the "employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- de- grams; leave of ab- s. Handling payroll sence programs, in- ductions; or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transpor- coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' corn- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- ceeding in which money 2. "Cafeteria P damages because of an plan authorized by applica- act, error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit"includes: tain benefits with pre-tax dollars. a. An arbitration pro- ceeding in which such 3. "Employee benefit pro- damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent; through a "cafeteria plan"or otherwise: b. Any other alternative pro- a. Group life insurance; dispute resolution pro- p ceeding in which such group accident or damages are claimed health insurance; den- and to which the in- tal, vision and hearing sured submits with our plans; and flexible consent; or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed, on leave those "employees"who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- bility requirements; cludes a "leased worker". "Employee" does not in- b. Profit sharing plans, clude a"temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV- COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no "em- tations is hereby amended by the addi- other than an em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, of Paragraph shrinking or ex- a. The last Subparagraph pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or Exclusions c.through do not apply secretions, , in- Exclusions q. Pp Y sects, birds, ro- to damage by fire, explosion, light- dents or other ping, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- b. The insurance provided under SEC- ing. TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move- to "property damage" arising out of ment; water damage to premises that are both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in Paragraph 3.b.above: 3) Water under the ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than i. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not; or to: c) Doors, windows or (a) "Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- ing, unless: a) Wear and tear; 1) You did your best to b) Rust, corrosion, maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained. self; (d) Loss to or damage to: c) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances; or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 caused by or resulting 5. Medical Payments from rain, snow, sleet or ice, whether driven The Medical Expense Limit of Any One 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- ments of this endorsement. The Damage to Premises Rented to 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 Cov- 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 lim- 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 I - 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 fol- Liability Coverage of this endorse- lowing: fix the most we will pay in any lowin g: one "occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of (1) Insureds; 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 9. Automatic Additional Insured - Speci- fied Relationships (1) Our obligation to pay damages 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 of the deductible amount (1) Any person or organization de- 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 or 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 Hod; and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence" or offense to which thi Subparagraph a. of Paragraph 4. is would applys insurance d hereby deleted and replaced by the fol- lowing: (b) They are not specifically provision is af- named as an additional in- a. Insurance under this p cured under any other pro- forded only until the 180th day after 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 g 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 only 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 in the product 2) Structural alterations, 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 of inspection, (b) Any person or organization 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- takes to make in (c) Any person or organization the usual course (referred to below as ven- 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 ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded 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 ven- 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 dam- age" liability in- age" or "personal and b) tY 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) spect to such above to provide insurance, products. but only with respect to li- ability Any state or political subdi- ability arising out of "your (d) Y p work" performed for that vision with which you have 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 time required by the written with respect to the following hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- piration date of this Cover- issued a permit in connec- age Part. If there is no tion with premises you own, written contract or agree- rent or control and to which 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) tions and similar expo- does not apply to "bodily sures; or injury"or"property damage" 2) The construction, erec- included within the "prod- ion, or removal of ele- ucts-completed operations vators;or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), (e)and (f) does not apply to tenance, or use of any "bodily injury", "property elevators covered 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 9 , 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- neering 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 Agreement The limits applicable to the additional 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 fice 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 (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 9.a.(3)(a), 9.a.(3)(b) or 9.b. (a) Insureds; 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 9.a.(3)(a) and 9.a.(3)(b) of De- 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" Within 50' of Railroad Property irrespective of the amount. It is hereby agreed that Paragraph f.(1)of (c) We may pay any part or all Definition 12. "Insured contract" (SEC- 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 I - 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 li- 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. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this endorsement. These limits are Paragraph a. of Condition 2. Duties in inclusive of and not in addition to the Event of Occurrence, Offense, the limits being replaced. The Claim or Suit (SECTION IV - COMMER- Limits of Insurance shown in CIAL GENERAL LIABILITY CONDI- Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to it that we are noti- nesses; and fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible, notice should include: This requirement applies only when (1) How, when and where the "oc- the"occurrence" or offense is known currence"or offense took place; to an "authorized representative". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 15 SUPERIOR COURT OF WASHINGTON FOR SPOKANE COUNTY In the Matter of: ADVERTISEMENT FOR BIDS No. City of Spokane Valley Public Works Department Bid # 13 -031 AFFIDAVIT OF PUBLISHING Sullivan Park Improvements Project NOTICE STATE OF WASHINGTON ) )ss. County of Spokane ) MICHAEL HUFFMAN , being first duly sworn on oath deposes and says that he is the EDTTOR • of The Spokane Valley News Herald, a weekly newspaper. Thatsaidnewspaper is alegalnewspaper and it is now andhasbeenfor 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 f puve, issues commencing on the 2nd day of August. 2013 and ending the 9th day of puQ° Ol all at Jclusive, and that such newspaper was regularly distributed to its subscribers during all of said period ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY S/VBS BED an ORN to before me PUBLIC WORKS DEPARTMENT BID 413 -031 #6s 9th day of August, 2013. SULLIVAN PARK IMPROVEMENTS PROJECT JPyASEI _SULLIVAN ROAD WEST �� `p/ Igp�l��'``y State of Washington Notice is hereby given that the City of Spo- \` �PG Y Y Er y�`� B/ County of Spokane kane Valley, Spokane County, Washington 4 s'.. will accept sealed bids for the Sullivan ••• N Explig' •�. Park Improvement Project. Work dents �••5;\0 •. ��„ Icertify that Iknow or have satisfactory evidence that includeclear rig and gmbbing,tree removal, , • 5 Michael Huffman is the person who appeared before automated irrigation system, topsoil, sod, f • •: 2 r planting, cement concrete sidewalk, pre- 1 ;� pP d =me, and said person acknowledged that he signed fabricated picnic shelter with concrete b °0 0� G —this instrument and acknowledged it to be his free slab on grade, lighting and electrical, US :U �� : — g sprinkler system, water service, fencing, > t J� ; CD ::and voluntary act for the uses and purposes men - pavemenl markings, signing and other ; Q a related work. ,y,.•` \ s tioi in the instrument. Copies of the bid packet including spec'Ifi- • 0' cations and plans may be obtained in PDF (� • 5•� • C format by downloading from the Spokane F 11•• • ••• Valley FTP site. Contact Dada Amold, Spo- or by ante d is Works, at 6W720-5003 ���>E 0 �, `��` Jole e-Rae W entz Monday through Friday from 8:00 a.m. to Title: Notary Public 5:00 p.m. for instructions and to be added My appointment expires: 5 -16 -15 to the Planholder's Ilst. If a potential bidder is unable to reproduce the packet from the FTP bile, a hard copy half -size plans may the �� YV may be obtained from the City for anon- lJ 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 jIVJ(J._1 Ll�� deposit in the form of asurety bond, postal money order, cash, cashier's check, or certi- fied check in an amount equal tofive percent (5%) of the amount of the bid proposed. Failure to fumish 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 10M am. PST, FddaY August 23. 2013. Bid openings will be held immediately thereafter and read aloud in the City Council Cham- bers, Suite 101. The City of Spokane Valley reserves the right to waive any irregularities or infor- malities 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 penod 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. 2000d to 2000 -4 and Title 49. Code of Federal Regulations. Department of Transportation, Subtitle A, Office of the Secretary, Pad 21, non-dis- crimination in Federally assisted programs of the Department of Tmnsportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered Into pursuantto this advertisement, disadvantaged business enterprises 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 on the grounds of race, color cr national origin, or sex in co oration loran award. PUBLISH: Spokane August 2 and August 9, 2013 Christine Bainbridge, MMC Spokane Valley City Clerk 812, 8M ADVERTISEMENT FOR BIDS CITY OF SPDNANE VALLEY PUBLIC WORKS DEPARTMENT BID If 13 -031 'Federal Tax ID No. 68- 0617327 SULLIVAN PARK IMPROVEMENTS PROJECT RMW I - SBILIPANIf I, WEST BRIDGEREPLACEAFEN17 Notice is hereby given that the City of Spokane Valley, Spokane County, Washington will accept I sealed bids for the Sullivan Park Improvement Project. Work items include clearing and grubbing, tree removal, automated irrigation system, topsoil, sod, planting, cement concrete sidewalk, pre- fabricated picnic shelter with concrete slab on grade, lighting and electrical, UG sprinkler system, water service, fencing, pavement markings, signing and other related work. 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 @s ookaneva I lwore 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. PST. Friday, Aueust 23, 2013. 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 US.C. 20004 to 2000 -4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, non - discrimination im Federally assisted programs of the Depart- ment 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 advertisement, dis- advantaged business enterprises 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 on the grounds of race, color or national origin, or sex in consideration for an award. PUBLISH: Spokane, August 2, and August 9, 2013 Christine Bainbridge, MMC Spokane Valley City Clerk SR26500 AFFIDAVIT OF PUBLICATION STATE OF WASHINGTON County of Spokane) ss Name: City of Spokane Valley Client ID: 42365 PO No. SR2650O No. Lines: Total Cost: $977.30 / Order No. 115 132425 I, 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: August 2 & 9, 2013 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 9th day of August 2013. �\ S ONCF� �O gas exp9 . NOTARY N PU110CZ 9-tary Public in and for the State of Washington, 9 `MBEP ^ "' residing at Spokane County, Washington FOFWpSN YOLI) Notary Stamp Paper Affidavits