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HomeMy WebLinkAboutFoggle Pump & Supply Inc - Farm Well #3 Cleaning and Rehabilitation (Agreement No. 21-008) and Change OrderMemo q1I To: Project File From: Derek Wiitala, Public Works Division Manager Date: 03-11-2021 Re: Unanticipated work addition Pasco This memo is to provide for addition unexpected work to be completed on the project: Farm Well #3 Cleaning and Rehabilitation; Project #21-008. The Contractor has been removing an unexpected appreciable amount of material from this well. The additional work is estimated to take two (2) extra days. The additional cost of this work has been identified at $250.00 as indicated in the attached hourly breakdown. The total cost of the additional work is estimated at $7,560. The undersigned has authorized this work to be completed. Submitted by, k&- "I Date 3 /Z Zdz Tom Holmes, Public Works Division Manager CONTRACT MRSC SMALL WORKS ROSTER Farm Well #3 Cleaning and Rehabilitation Agreement No. 21-008 THIS CONTRACT is made and entered into this day of 2021, by and between the City of Pasco, Washington, a Municipal Corporation, hareinaf%referred to as "City", and Fogle Pump and Supply Inc., hereinafter referred to as "Contractor." WHEREAS, the Project qualifies under RCW 39.04.155 as a small works roster contract, or a limited public works contract; and VMRF`AS, the City having sought and secured quotations from its small works roster, and the Contractor being duly qualified as a Contractor on the small works roster having submitted a quotation moble to the City. NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows: 1. Descr3n0bn of Work. The Contractor shall furnish all equipment, labor, tools, materials and appurtenances and perform all services in a workmanlike manner and in accordance with the plans and specifications as provided in the Project Description and Specifications, attached hereto as Exhibit A. 2. Comrsensatian. Compensation for the performance of the service and materials as described in Exhibit A, and shall be: M That amount set in the quotation attached hereto as Exhibit B subject to any retainage or withholdings as provided below. 3. Time of Comoletion. The work coved by this Contract shall be completed with all respects within 60calendar days from the date of the Notice to Proceed.. Once the work is commenced, the Contractor shall diligently pursue the work to completion within the time specified in this Contract. 4. Warranty of Cont-aetor. Contractor warrants that it is qualified to be awarded a public works contract in compliance with RCW 39.04.350; and further agrees to comply with all State and Federal laws relating to the employment and wage rates to be paid. 5. IndenmUlcation. 5.1 The Contractor shall defend, indemnify, and hold harmless the City, its officers, officials, agents, employees, and volunteers from any and all claims and causes of action, including, but not limited to, actions of law or administrative proceedings for all injuries to persons or damages to property, and all losses, damages, demands, Farm Well #3 Cleaning and Rehabilitation — 21-008 Page 1 MRSC Small Works Roster Amt#: [21-008] — Fogle Pump and Supply Inc suits, judgments, including attorney fees, arising out ol; or as a result of, or in connection with the work performed udder this Agreement, and caused or occasioned in whole or in part by reason: of mors, negligent acts or omissions of the Consultant or its subcontractors in the performance of this Agreement, except for injuries and damages caused by the sole negligence of the City, its officers, employees, agents, and volunteers. 5.2 Should a Court of competent jurisdiction d -W=e that this Agreement is subject to RCW 424, 115, then, in the event of liability for damages arising out of bodily injuries or damages to property caused by or resulting from the concurrent negligence of the Contractor, and the City, its officers, employees, agents and volunteers, the Contractor's liability and obligation to defend hereunder shall only be the proportionate extent of the Contractor's negligence. 5.3 It is further agreed that the indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. 5.4 No liability shall attach to the City by reason of entering into this Agreement except as expressly provided herein. 5.5 This indemnification shall include damages, penalties and attorney fees agained as a result of Contractor's delayed or failed performance. 5.6 This waiver has been mutually negotiated by the parties, and the provisions of this section shall survive the expiration or termination of this Agreement. 6. insurance. The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, its agents, representatives, employees, or subcontractors. 6.1 Minimum Scone of Insimmee. Contractor shall obtain insurance of the types described below: 61.1 Automobile Liability insurance covering all owned, non -awned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 6.1.2 Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for Farm Well #3 Cleaning and Rehabilitation — 21-008 Page 2 NIBSC Small works Roster Agreement#: [21-008] — Fogle Pump and supply Inc the City using an additional insured endorsement at least as broad as ISO endorsement form CG 20 26. 6.1.3 Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 6.1.4 Professional Liability insurance appropriate to the Contractor's profession. 6.2 Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 6.2.1 Automobile Liability insurance with a minimum combined single limit for fly injury and property damage of $1,400,000 per accident. 6.2.2 Commercial General Liability insurance shall be written with limits no less than: ❑ $1,000,000 each occurrence; ® $2,000,000 general aggregate; or ❑ $ each occurrence; and $ general aggregate 6.2.3 Professional Liability insurance shall be written with limits no less than: ❑ $1,000,000 per claim; ® $1,000,400 policy aggregate limit; or ❑ $ per claim; and $ per policy aggregate limit 6.3 Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 6.3.1 The Contractor's insurance coverage shall be primary insurance as respects the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 6.3.2 The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 6.4 Acceptability of Insurers. Insurance is to placed with insurers with a current A.M. Best rating of not less than ANII. 6.5 Verification of Coverage. Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not Farm Well #3 Cleaning and Rehabilitation — 21-008 Page 3 MRSC Small Works Roster Agreement#: [21-008] — Fogle Pump and Supply Inc necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. 7. Retainaize and Performance Band. 7.1 Unless it is waived as provided below, the Contractor shall provide and post for the benefit of the City a Performance and Payment Bond issued by a qualified surety insuring the Contractor's performance of all the provisions of the Contract and payment of all labors, mechanics, and subcontractors and materialmen as required by RCW 39.08.010. ❑ The City shall hold a 10% retainage in lieu of a performance bond per RCW 39.08.010 7.2 The City shall withhold five percent (5%) of the money due to the Contractor for the work performed under this Contact until completion and/or acceptance of the Contract as provided by RCW 60.28.011. Contractor may elect an option for management of the statutory retainage by notice to the City of the elected option under RCW 60.28.011. 8. W r §ft Conditions. The work performed under this Contract is done at the Contractor's risk and that Contractor is familiar with the conditions present and other contingencies likely to affect the work and has submitted their quote accordingly. The Contractor will assume the responsibility and risk of all loss or damage to materials or work which may arise prior to completion. The Contractor shall keep the work site in a neat, orderly condition and after completion of the work, the Contractor shall, at its expense, clean up and remove all refuse and unused materials of any kind resulting from the work. 9. General Provisious. 9.1 For the purpose of this Contract, time is of the essence. 9.2 Notice. Notice provided for in this Contract shall be sent by: 9.2.1 Personal service upon the Project Administrators. 9.2.2 Certified mail to the physical address of the parties, or by electronic transmission to the email addresses designated for the parties below. 9.3 The Project Administrator for the purpose of this Contract shall be: 9.3.1 For the City: Albert Obermiller, or his/her designee Public Works Project Coordinator 1025 S Gray St. Farm Well #3 Cleaning and Rehabilitation -21-008 Page 4 MRSC Small Works Roster Agreenent#: [21-0081— Fogle Pump and Supply Inc Pasco WA 99301 obermille ivi2asco-wa.gov 9.3.2 For the Contractor: Alaina Fogle, or his/her designee Fogle Pump and Supply Inc. 2250 N. Hwy Colville, WA 99114 Alaina@foglepump.com 10. Dispute Resoludon. This Contract has been and shall be construed as having been made and entered into and delivered within the State of Washington, and it is agreed by each party hereto that this Agreement shall be governed by the laws of the State of Washington. In the event of a dispute regarding the enforcement, breach, default or, interpretation of this Contract, said dispute shall be resolved by arbitration pursuant to RCW 7.04A, as amended, with both parties waiving the right of a jury trial upon trial de novo, with venue placed in Pasco, Franklin County, Washington. The substantially prevailing party shall be entitled to its reasonable attorney fees and costs as additional award and judgment against the other. IN WITNESS WHEREOF, the parties have executed by their duly authorized official this Contract in triplicate, each of which being deemed an original on the date first written above. CITY OF PASCO, WASHINGTON By: Zlev"Worley. CONTRACTOR By:"00" b x Alaina Fogle,Direct r of Operations -- Farm Well #3 Cleaning and Rehabilitation — 21-048 Page 5 MRSC Small Works Roster Agreement#: [21-0081— Fogle Pump and Supply Inc Schedule A Farm Well #3 Cleaning and Rehabilitation March 120'-1701 Move Cable tool, service truck, pump truck and frac unit from Farm Well 2 to Farm Well 3. Use Cable tool with brush to brush well removing initial layer of scaling. Add liquid descaler chemical to well using Cable tool to brush and agitate. As acid is consumed by the well, use frac unit with venturi clean out tool to recirculate water into sediment holding tank and back into well. Use PH strips to test the PH of the well every 3-4 hours. When PH holds steady at around 2, camera the well and record video. Sanitize the well using Wet -Chlor plus. EXHIBIT A Request for Quote Scope of Work The quote shall include a description and associated cost for the following line items: ➢ Timeline of work ➢ Mobilization/demobilization ➢ Post—cleaning video inspection ➢ Cleaning method ➢ Treatment ➢ Rehabilitation/re-development ➢ Site cleanup — to include removal of all material removed from the well ➢ Any remediation required, i.e. pH adjustment, sediment disposal, etc. Information about the Farm well#3 A site visit will be required to bid on this job. The site visit will be held on January 15'h,2021 at 12:00pm. This work shall not begin until February 15th, 2021, and must be completed by March 31St, 2021. Information is from inspection completed by the City in December 2020. • 16" diameter well. • The year of construction is unknown. • Depth is 146.4. • Screen is perforated — roughly 112-149.9'. • Static water level —101.9' • Biofouling and incrustation are plugging screens and perforations. • Video can be found at https://Pascofileshare.com/link/K6fltFKzbgiYmUv9avKlnL (Instruction for fileshare site located on last page) General Considerations • Site Safety - The CONTRACTOR shall mark, barricade or take other safety measures as necessary to prevent tampering with the work site and to eliminate dangerous conditions for persons or animals in the area. All tanks, pits, or other excavations shall be properly flagged and barricaded as required to eliminate any potential health hazards. The CONTRACTOR is expected to maintain the site and any related equipment and supply storage areas in a clean and orderly manner in order to prevent injury to people and animals. The CONTRACTOR shall maintain a first aid kit, fire extinguisher, and other safety equipment required for the work by regulation on site at all times. All work shall be conducted in accordance with applicable State and Local regulations. • Noise and Working Hours - The CONTRACTOR shall comply with all applicable laws, orders, and regulations concerning the prevention, control, and abatement of excessive noise. Request for Quotes: Farm Well 3 Page 4 of 9 cleaning and rehabilitation EXHIBIT • Discharge of Water - The CONTRACTOR shall be responsible for preventing the release of water, or any other materials used in or related to the rehabilitation operation from the immediate vicinity of the work site onto neighboring properties or any open water bodies. Prevention of Contamination • The CONTRACTOR shall use a minimum of hydrocarbon products, other than fuel, motor oil, hydraulic oil, and grease that is normally used on site. • No hydrocarbon -based lubricants or oils shall be used on equipment that will enter the borehole. • Should any spills occur, the CONTRACTOR shall immediately repair the cause and take the necessary steps to contain and thoroughly remove all contaminated soils and materials, and transfer such wastes off-site for legal disposal at the CONTRACTOR'S expense. Site Access and Preparation • Access — The well site is located 3.5 miles East of Hwy 395 and .25 miles south of Foster Wells Rd., The Circle is to the west on the dirt road, the well is 210' east of the center pivot in City Farm Circle #3. • Services and Supplies — No on-site water or power is available. The CONTRACTOR is responsible for inquiring about the availability of services and supplies needed for rehabilitation activities. The CONTRACTOR assumes full responsibility for all supporting services and supplies necessary to properly undertake the work, not limited to water and power, and is entitled to no additional compensation for the lack of any such services or supplies. Request for Quotes: Farm Well 3 Page 5 of 9 cleaning and rehabilitation EXHIBIT B �p N Q D � Q I a m I pg O O O SIB 8 N IN N N v VT A O o 18 s N D m N c O v A W O OYi VYi A O N r O� m V fn Q o� W N 0 a m I pg O O O SIB 8 N IN N N v VT A O o 18 s N D W N N O 1Yp W V OYi VYi A w N r O� m V fn � A W N Y G 3 �15m 3$ m o 2m^2� 8 8 ? m m 3 o ce iv 2 m N Fymfi i � o O A c d 3 3.93.93,33 3az 3. 3 � Q S S pp O O � S O 8 O ppO p O N in N i/1 VY N N Vi N N 1/) /A to 1/r to �A iA i/� to N N N N Vi 4f D O� p O p 1-+ Opo p TTn t 3 8 oO g oO g oO g oO g o0 g Yg Y w O ww v a O � 0 0 0 0 0 0 3 3 0 N C Op Op pO Q pO Q Q pO Q Q pSp O lA Va V+ 1/� N C f1 j l $ o $ 8 S d_ D o u' g OC 8 S a $ 18 e o m o e 3 0 e a vs�coPUBLIC WORKS OPERATIONS (509)545-3463/FAX (509)545-3466 PO Box 293/1025 S. Gray Ave- Pasco, WA 99301/www.pasco-wa.gov Quote Price Item No. Descriatlo nft -d Price Unit Price Quanft LA_en& Mobilization/Demobilization Lump Sum 101-1 k Kj e it bit ta 2 Cleaning Lump Sum I'l 1'1 2a Chemical Y Lbs (circle e o n e) 2b Cleaning Time Hrs 141,104 Ab 3 FrA �a Rehabilitation Lump Sum n., 4e le e) Hrs 3a Rehab Time :Hrs Lump Sum 4 Post work Video Lump Sum 5 Remediation (if applicable) Lump Sum 111-46 'rawl"..e- of i I M6D ! 6fuCleanup mp Sum .— —1 -- The undersigned has reviewed the RFQ and is familiar with the requirements herein, and has verified the quote Sub Total 6-D to be true and correct. Tax Rate (8.096) Signature Date Total 2,3l2 -I Request for Quote: Farm Well #2 Cleaning and Rehabilitation Page 6 of 7 PERFORMANCE BOND BOND TO THE CITY OF PASCO Bond No. 107368795 KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Fogle Pump & Supply, Inc. as principal, and Travelers Casualty and Surety Company a corporation organized and existing under the laws of the State of CT, as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors, as surety, are jointly and severally held and firmly bound to the City of Pasco in the penal sum of ***Twenty Three Thousand Three Hundred Eighty Two and No/100*** ($23,382.00), for the payment of which sum on demand we bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into a pursuance of the statutes of the State of Washington, and ordinances of the City of Pasco. Dated at Spokane, Washington, this 18th day of February, 2021. Nevertheless, the conditions of the above obligation are such that: WHEREAS, pursuant to action taken by the City Council of the City on , 20_____, the Mayor and City Clerk of the City of Pasco have let or are about to let to the said Fogle Pump & Supply, Inc., the above bounden principal, a certain contract, the same contract being numbered 21-008 and providing for Farm Well #3 Cleaning and Rehabilitation (which contract is referred to herein and is made a part hereof as though attached hereto.) WHEREAS, the said principal has accepted, or is about to accept the said contract, and undertake to perform the work wherein provided for in the manner and within the time set forth. NOW, THEREFORE, if the said Fogle Pump & Supply, Inc. shall faithfully perform all of the provisions of said contract in the manner and within the time therein set forth, or within such extensions of the time as may be granted under the contract, and shall pay all laborers, mechanics, subcontractors, and material men, and all persons who shall supply said principal or subcontractors with provisions and supplies for the carrying on of said work, and shall indemnify and hold said City of Pasco harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal, or any subcontractor in the performance of said work, and shall indemnify and hold the City of Pasco harmless from any damage or expense by reason or failure of performance as specified in said contract or from defects appearing or developing in the material or workmanship provided or performed under said contract after its acceptance thereof by the City of Pasco, then and in that event this obligations shall be void; but otherwise it shall be and remain in full force and effect. Approved as to Form: Travelers Casual"d Surety Company Fogle Pump & Supply, Inc. OI Surety SheaDonovan, Attorney in Fact Contractor PAYMENT BOND To City of Pasco, Washington Bond No. 107368795 The City of Pasco, Washington, City has awarded to Fogle Pump & Supply. Inc. (Principal), a contract for the construction of the project designated as Farm Well #3 Cleaning and Rehabilitation, Project No. 21-008, in Pasco, Washington (Contract), and said Principal is required under the terms of that Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW). The principal, and Travelers Casualty and Surety Company (Surety), a corporation organized under the laws of the State of CT 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, in the sum of ***Twenty Three Thousand Three Hundred Eighty Two and No/100*** US Dollars ($23,382.00) Total Contract Amount, subject to the provisions herein. This statutory 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 RCW Titles 39.08, and 39.12 including all workers, laborers, mechanics, subcontractors, and material suppliers for the carrying on of such work, and all taxes incurred on said Contract under Title 50 and 51 RCW an all taxes imposed on the Principal under Title 82 RCW; 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 (2) 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 Fogle Pump & Supply, Inc. A (,(lflm.11 f�ft& 02/18/2021 Principal Signature " Date Al �1 ���EF, I,(-/ Printed Name 01 rP ohs' D Def Lh.J Title SURETY Travelers Casualty and Surety Company �g . & 02 1 2021 Surety Sign ure Date Shelly Donovan Printed Name Attorney In Fact Title Name, address, and telephone of local office/agent of Surety Company is: Affiant Insurance Services, Inc. 818 W. Riverside Ave., Ste. 800, Spokane, WA 99201, (509) 324-3025 Approved as to form: Signature Title PB -1 Date TRAVELERS Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint SHELLY DONOVAN of SPOKANE , Washington , their true and lawful Attorney -in -Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 17th day of January, 2019. ��� ',,1Y AAO •.� �`- ,%+� 0010E �o State of Connecticut City of Hartford ss. By: '444� Robert L. Rane , enior Vice President On this the 17th day of January, 2019, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. All My Commission expires the 30th day of June, 2021 * 4*0 rue`% Anna P. Nowik, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 18th day of February , 2021 V ANS.k 4 `?�pw*:�% - aCOWn ✓ ♦ sr Z�2� Kevin E. Hughes, Assiltant Secretary To verify the authenticity of this Power ofAttorney, please call us at 1-800-421-3880. Please refer to the above-named Attorney -in -Fact and the details of the bond to which this Power of Attorney is attached. AC Rte' FOGLPUM-01 �....�- CERTIFICATE OF LIABILITY INSURANCE T U MATE IS OWED AS A MATTER OF INFORMATION ONLY AND CONFERS NO MMM UPON THE CEIMFICATECEITIVICATE DOES NOT FlOLl1ER. 7iN8 BELOifN. THIS CERTI TEFOF INSURANCE DOES NOT CONSTITUTE Y OR 14EGATNELY AMEND, CONTRAD OR S BETWEEN TER THE CO7i1E�i&iUDKi GE AFFORDED DY THE POLICES REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.MWOR�(s). AUTHORIZED TANT: 8 the Cate holder Is an INSURED, the POLL- {ies) mast have ADDITIONAL INSURED Provisions or be ando eW. If SUBROGATION IS WANED, subject to the tarns and conditm of the Paltctr certain Policies map require an andorseanent. A st olemerd on this cardficats does not corder rights to the csrdliabe Itoldr in Lieu of such s , Wyb1*---- i'Alliant Insurance Services. Inc -,CT MOBS — -- — -_ 818 IN Riverside Ave Sw 800 Zia-* (W 3 85 i+KI Spokane, WA 99201 �k 6 ._ _ I _ — ce' rs �- r�tRllale OWNED Empk"M mukill ZOO Fogle Pump 3 Supply. htc. _ 22.50 N Hiphrwap 395 rtuna� a COW% WA 89114 statRtelt r - -------CIeR�TE pW@f:R: REVISIDl1 NUMBER: _ THIS IS TO CERTIFY THAT THE pCgMES OF ViSLgW CE UgTED BELOW HAVE SEN ISSUED 1 OIIiE INSURED NANyI LIABOVE FOR THE POLJCY PERIOD CATER NOTVYfT145TANDIfiO ANY REpUIR M TElikt OR CONDMON OF ANY CONTRACT OR OTHER DOCL A ENT 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 PND CLAW. ADDLSUWt TYPr ar sMtMR+era i - POLICY reR '"P POr rC1 EStP A X carrrefux�osr�e+u uaesirr - -urns i9" 0CC E _ ti 1,000.000" �- CWIrRiNDE occuR X X 515221 11h1120Za 1 iM%30$1 p,°g&' X50o„ s 508,000 12_DcPSArtt�w �ni�i 10,0001 ._A _e s --- 2,00•x t^,; 2,000,000' aerrOMaa uasltmt — - -f-_ ; 1.000 AIRY AUTO i - - - -- _._ 5X95221 11!112020 11111102= _OSIYRrIt1RYlPrrR+�__. t AilTOB OW.Y X -- X- " owy 046MOLALL46 X tIQB�.YMtr�ipsraoa4snt. i _.__ Wa' — s E%QESSLIAM AQWEGATE --. DED RErFN'TIONS E OY:aS° LM1Y pF�cnw_R*a 1111=20 11Ht2021 YF- - -_ ANY ARL UTIV€ NIA EL FRCP! — 1 1, 0� d P_L DMEAM-Ee4Fi�LOYEt•1_ i'�•9� I E drreaEs midlr �I DWIWTION OF OPERATIONS t LOCATIONa l VE)eM" 1e1. R,wnyrks ede,�lul�, f 6e 4"Cmd If nwm ap"s Is romki " - T, RE: Agreemsrt No. 21,0W for Desert Sunset �on Wait CkardrrQ and Ret-,! i on City of „ Its of kw% o4ficlrft, agents, employe" i volunteers are named as additional insured as R rekftB to yenerWi welwr of �granW as It retetea to general Uty In of ice with the Ua ma and condttlons of fm Polk". The above °= On iE I; roquimd by wrItfeo contrwt M P and where 0 CAUAWN !SHOULD ANY OF THE ARM DESCRIBED POLJC*3 RE THE MWWAYM DA THEREOF. NOTICE WILL BE D€LIV€REO IN 111 City of Pasco, ropct oor ACCORDANCE WITH THE POUCY pROviS MS Pubiie„ Warks Project Coordinator 1025 S Cray St Pasco, WA 99301 ANTHOtUZED RPMMWATNE - - ACORD 252018103 _ —j � ) m 1888-2013 ACORD—C- OR- _ PORATION. A9 rsasrvad. The ACORD name and logo erre regisbred marks of ACOFW COMMERCIAL GENERAL, LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ELITE EXTENSION This endorsement mxlfres insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coiteraW. The provisions of the Coverage Form apply unless modified by endorsement A. EXPECTED OR INTENDED INJURY The a negate limit fisted abcve Is the most we wIn Sec a I — Coverage A, Exclusion a. is amended pay for all damages because of "property damage, as follows: to property in the care custody and control of or a Bodily injury- or "property damage, expected property loaned to an insured during the policy or intended from the standpoint of an insured. period. This exctusbn does not apply to "bodily injury" Any payment we make for damages bemuse of or 'property damage' resulting from the use of , property damage' to property In the rare, custody reasoroble force to protect persons or property. and control of or property barred to an Insured will B. NON -OWNED WATERCRAFT apply ,against the General Aggregate Limit shown in 8oction i — Coverage A. Exclusion 9.(2) is the declarations. ernencbd as follows: b, Our obligation to g your � damages e lf only (2) A watercraft you do not own that is: applies to damages in excess of the deductible amount listed above. (a) Less than 60 feet long; and We may pay any part or all of the deductible (b) Not being used to ca carry person(s) or amount fisted above. We may pay any part or all of the deductible amount to effect settlement proptrty for a charge; C. EXTENDED PROPERTY DAMAGE COVERAGE of any cern or `suit and upon notification by us, you will promptly reirnburse us for that part Section I — Coverage A, Exclusions j.(3) and (4) is of the deductible we paid. amended to add the following: c. If two or more coverages apply under one Paragraphs (3) and (4) of this exclusion do not "oocu", only the highest per claim apply to tools or equipment loaned to you, provided deductible applicable to these coverages will they are not being used to perform operations at apply• the time of loss. d. Insurance provided by this provision is excess SCHEDULE over any other Insurance, whether primary, excess, contingent or any other basis. Since Lirrdts Of insurirrca Deductible providve ed by this endorsement is _ $5,0 Each _ 6250 Per Chun _ -- excess, excess, we will hano duty to defend any claim or "suit' to which insurance provided by $10,000 Annual ate this endorsement applies if any other insurer ar. The each occurrence limit listed above is the has a duty to defend such a claim or `suit. If no other insurer defends, we will undertake to most we will pay for all damages because of "property do so but we will be entitled to the insured's damage to property in the care, custody and control of or property loaned to an rights against all those other insurers. D. insured as the result of any one "occurrence", PROPERTY DAMAGE —ELEVATORS regardless of the number of. SerAlon I — Coverage A.2. Exclusions paragraphs (t) insureds; j-(3), j-(4), j.{8) and k. do not apply to use of (2) claims made or "suits' brought; elevators. This insurance afforded by this provision is excess over any valid and collectible property (3) persons or organizations making claims or insurance (including any deductible) available to bringing "suits". the insured and Section IV — Commercial General Liability Conditions Paragraph 4. Other Insurance is changed accordingly. CG7578(2-19) includes copyrIgMe l of LSo Praperti,. tcrc, rvitb ft permission. Pape 1 of 6 E. FIRE, LK*frN G OR E) OSIQNDAMAGE Except w ie a It Is used In the tem 'hostile firer, r, the word fine Includes fire, lightning or explosions wherever 4 appears In On Coverage Dorm. Under Section i – Coverage A, the lest paragraph (after the excisions) is repWced with the following: Exclusions c. through n. do not apply to damage by fine, smoke or from automatc fire protections systems to s while rented to you or Thr occupied by you with Permission of the owner. A separate limit of Insurance applies to this coverage as described in Section Ili – Limits of IMUNWAL F. MEDICAL PAYMENTS if Section i – Cxiveme C. Medical Payntevift Coverage is not ottilerwiseo— ezc:luded from this Coverage Frrrrt The requirenumt, in the insuring Agrearrient of Coverage C., that Sxpensft must be incurred and reported to us within one yew of the accident date Is changed to throe . G. SUPPLEMENTARY PAYMENTS SuppWrientary PaYments – Coverages A and B Paragraphs IAL and 1.d, are replaced by the foAawi'ng; 1.b.Up to $5,000 for cost of bell bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applim We do not have to A RMh these bonds. 1.d.Ail reasonable expenses lured by the insured at our request to assist us in the investigation► or defense of the claim or "suis, irctudng actual loss of GwnkW up to $500 a day because of time off from work. K SUBSIDIARIES AS INSUREDS Section H – Who Is An Insured is amended to add the following: 1.f. Any legally inoorporaled subsidiary in which you own more than 50% of the voting stock on the effective date of this pocky. HarMwever, insured does not include any subsidiary that is an insured under airy other general or would ham been an insured under such a policy but for termination of that pokey or the exhaustion of that policy's Imits of liability. BLANKET ADDITIONAL INSUREDS – AS REQUIRED BY CONTRACT 1. Section 0 – Who is An Insured is amended to include as an additional Insured any persort(s) or organizations) UtOd to provisions in Paragraph 2. below, (hereinafter referred to as additional insured) when you and such person(s) or crWization(s) have agreed in a written contract or witten agreement that such person(s) or organization(s) be added as an additional insured ars your ley pied that the written contest or agreement is: AL Currently in effect or becomes effective during the policy period; and b. Executed prior to an "occurrence" or offense to which this tnaurance would apply. However, the durance afforded to such additional insured: a. Only applies to the extent permitted by law, and b. Will not be broader than that which you are required by the contract or agreement t to provide for such additional insured; and c. Applies only if the person or organUation is not specifically named as an additional insured under any other provision of, or endorsement added to, Section U – Who Is An Insured of this policy. 2. As provided herein, the insurance coverage provided to such additional insureds is limited to: si. Any Controlling Intent, but ortty with reaped to their liability arising out of their financial control of you; or premises they own, maim, or control while you lease or spy these premises. This insurance does not apply to struc h rat alterations, new construction and demolition operations performed by or for that person or organizion. b. Any architect, engineer, or surveyor engaged by you but only with respect to liability for 'bodily irJury", "Property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connecWn with your premises; or (2) In the performance of your ongoing operations. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "boddy Injury", "PmPer y darmage" or "personal and advertising injury" arlclng out of the rendering of or the failure to render any professional services by or for you. including: (1) The preparing. approving, or failing to prime or approve. maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. CG7578(2-18) iratliicles covyiVrbd trial of 160 PropotoK sbm wm ft isiaia. Pap 2 of 6 This exclusion applies even if the claims against any Insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that Insured, if the "occurrence" which caused the "bodily injury" or "Property darnage", or the offense which caused the "personal and advertising injury". Involved the rendering of or the failure to render any professional services by or for you. c. Any manager or lessor of a premises leased to you, but only with respect to liabiirty arising out Of the ownership, maintenance or use of that part of a Premises leased to you, subject to the following arclitiorial exclusions: This insurance does not apply to: (1) Any 'occairreriW which takes place ager YOu cease to be a tenant in alit prerrirsas. (2) SbUcturat a< rations, new construction or dm*ftion operations performed by or on behalf of such additional insured. d. Any state or governmental agency or subdivision or pol" subdivision, subjed to the following: (1) This insurance applies only with respect to the b1lowing hazards for which any state or govicemrner"I agency or subdivision or poral subd'nrision has Issued a permit OF authorization in cotnectim with premises you own, rent Or control and to which this Insurance applies: (a) The existence,maintenance, repair, construction, erection or removal of advert ing signs, canopies, car entrances, coal how, driyeways, manholes, hoist away Openings, vaults. street banners or decorations and sing exposures; or (b) The crosbnxction, erection or removal of ; or (c) The Ownership. ma ntertance or use Of any elevators covered by this Imo. (2) This Insurance applies only with resped to Operations performed by you or on your behalf for which any state or governmental agency or subdivision or political subdivision has issued a permit or authorization. This insurance does not apply to: (a) `Roddy injury', or rrnd advertising VW arising out of operations perlbrmed for the federal goverrxnent, status Or municipality or (b) *SO* irW' Or "property d~ included within the "products- completed producecompleted operations haizwd". e. Any verKlor, but only with rases to 'bodily illur/ or 'property daniag#" arising out of Products" which are distributed or sold In the regular cocase of the vendor's business_ With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1) The insurance afforded any vendor does not apply to. (a) "Y Injury' or "Property „ for which any vendor is obligated to pay damages by reason of the as _ _ bion of liability in a contract or agreement. This bion does not apply to liability for dam's that any vendor would have in the absence of the contract or agreement (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by any vendor, (d) Repackaging, except when unpacked solely for the purpose of Inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such Inspections, adjustrnents, tests or servicing as any vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at any vendor's premises in connection with the sale of the product; (9) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for any vendor; or GG7578(2-19) Incktdec Mpyrlght o-, terial of 150 Properfiss, Inc. with its pamltslart. Page 3 o€ 6 (h) "Bodily injury" or "property doge" arising out of the sole negligence of any vendor for its own ads or omissions or those of its employees or anyone else acting or its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as any vendor has agreed to make or normal undertakes to make in the usual course of business, in connection with the distnbution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you haute acquiree! such Products, or any ingredient, part or container, entering into, accompanying or containing such products. f. Any Mor%pqee, Assignee Or Receiver, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of the premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. g. Any Owners Or Other Interests From Whom Laird Has Been Leased, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply (1) This insurance does not apply to: (a) Any "occurrence" which takes place aft you cease to lease that land; or (b) Structural alterations, new constructio► or demolition operlons performed by or on behalf of such additional insured. h. Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury. 'property damage° or "personal and advertising injury' caused, in whole or in part by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with You for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. I. Any Owners, Lessees, or Contractors for whom you are performog operations, but only with respect to liability for "bodily injury", "Property damage" or "personal and advertising injury`" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. With respect to the insurance afforded to these additional insureds, the following additional exclusions appy. This insurance does not apply to. - (1) o: (1) "Bodily injury', "Property damage- or "Personal and advertising injury' arising out of the rendering of. or the failure to render, any professional architectural, engineering or surveying services, including: (a) The prepari►g, approving, or to prepare or appmve, maps, shop drawings, trigs, opinions, reports, surveys, f , change orders or drawings and ns; or (b) Supervisory, inspection, ard*edural or engineening activities. This exclusion apples even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, emPloyment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "Property damage". or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. (2) "Bodily injury" or "property damage" occurring after: CG7578(2-19) kwudes copyrww "WWW of Rio P , km with its perndsators. Page 4 of 6 (a) All work, including materials, parts This endorsement shall not increase the or equipment furnished in connection with such work, on the applicable Limits of Insurance shown in the Declarations. pmfe t (other than service, maintenance or repairs) to be J. COVERAGE FOR INJURY TO CO -EMPLOYEES Performed by or on behalf of the AND/OR YOUR OTHER VOLUNTEER WORI(ERS additional insured(s) at the location Section 11— Who is an Imured, Paragraph 2a. (1) is of the covered operations has been amended tD add the g: completed; or e. Paragraphs (a), (b), and (c) do not apply to your (b) That portion of "your work' out of which the injury or damage arises 'employees' or %101urteer workers° with reaped to "bodily injury' to a co'empioyee' or other has been put to its intended use by "vokinbeer worker". any Person or organization other another contractor thncontractor Damages owed Nad to an inrn ` injured co -"e° or or engaged In Performing operations for a nteer worker" will be reduced by any amount paid or available to the injuc+ad co - „ " co - Principal as apart of the same or "volunteer worker' under any other valid and collectible insurance. J. Any Grantor of Licenses to you, but only K HEALTH CARE SERVICE PROFESSIONALS AS INSUREDS - INCIDENTAL MALPRACTICE with respect to their liabirty as grantor of lice to you. Section If — Who is, an Para 2.a, 1 ( ) Their status as additional insured under (d) is amended as RAms: this enclorsement ends when: This provision does not apply to Nunes, Emergency 1. The tense granted to you by such Medical Technicians, or Paramedics who Provide Prd6ssional hems care services on your behalf, 1 (e) organization(s) expires; or 2. Your tense is terminated or revoked Hotianever tht exception does not apply f in y you are the business � of provWing any such by such p(s) or organization(s) peal prior to expiration of the license as stipulated by the contract or L NEWLY FORMED OR ACQUIRED agreement ORC;At�AZAT10N8 k. Any Grantor of Franchise, but only with Section II — Who Is An insured, Paragraph 3.& is respect to their liability as grantor of a replaced bythe folkyMng: franchise to you. 3.a. Coverage under this proviWn is afforded unfit I. Any Co-owner of Insured Premises, but the end ofthe policy period. only with resWt to their liability as co- This provision does not apply if newly formed or owner of any insured premises. acquired orgamations coverage is excluded either by M. Any Concessionaires Trading Under Your the provisions of the Coverage Foran or by Name. but only with respect to their liability as a concessionaire trading under your M. DAMAGE TO PREMISES RENTED TO YOU name' Section III — Lknits of Irourance, Paragraph S. is 3. Any insurance provided to any additional wed by the followira- insured does not apply to 'bodily injury°', "property damage or 'personal and advertising Std to &a. above, the Damage To Premises injury' arising out of the sole negligence or Rented To You Limit, or $500,000, wtkhever is higher, is the most we will Pay under Courage A for wul misconduct of the additional Insured or itsecause 'employees' o any to one arts. or any otter representative of the additional insured. promises, while rented } or in the case of damage by face, smoke � from automotic 4. With respect to the insurance afforded to these protection systems, while rented to you or terr>p edgy additional insureds, the following Is added to occupied by You with permission of the owner. Section III —Limits of insurances: N. MEDICAL PAYMENTS — INCREASED LIMITS If coverage provided to any additional insured is required by a contract or agreement, the Section III — Limits of Insurance, Paragraph 7. is most we will pay on behalf of the additional replaced by the following: insured is the amount of insurance: above, 7, eCt t0 h above, $10,000 is the a. Required by the contract or agreement; or Medical Expense Limit we will pay under Coverage C for all medical expenses because of b. Available under the ale Limits of 'bodily injury" sustained by any one person, Insurance shown in the Declarations; unless the amount shown on the Decimations of whichever is less. this Coverage Part for Medical Expense Limit states: CG7578{2-19) Includes nwWlal of 130 Propvtks, kc. Wtt b per *pion. Page 5 ct 6 (a) No Coverage; or (b) $1,000; or (c) $5,000; or (d) A limit higher than $10,000. O. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAN OR SUIT Section N — Commercial General Liabift Conditions Paragraph Z. is arrrerrded to add the Wig: e. The requirement in Condition 2.a. that you must see to A that we are notified as soon as practof an "occurrence' or an offense which may result in a claim, applies only when the "oaxtrrence or offense is known to: (1) You, ft you are an individual or a limited liability corra,ry, (2) A partner, if you are a partnership; (3) A member or manager, I you are a 6rnked liability company, (4) An "executive officer' or insurance manager, if you are a corporation; or (5) A trustft if you are a trust. f. The requirerreft in Condition 21x tied you must SM to it that we receive notice of a claim or "sub" as soon as will not be considered breached urt the breach occurs after such claim or "suir is known to: (1) You. if you are an individual or a limited liability company, (2) A partner, If you are a partnership; (3) A member or rr, agor, if you are a limited liability company; (4) An "executive officer" or insurance manager, if you are a corporation; or (5) A trustee, if you are a trust. PRIMMY AND NONCONTRIBUTORY ADDITIONAL INSURED EXTENSION Sewn iV — Cominercial General Liability Conditions Pah C Other Insurance is amended to add the This Wince is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that (1) That additional insured is a Named Insured under such oftw insurance, and (2) You have agreed in writing in a contact or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. However, y the additional insured has been added as an additional insured an other polies, whether perry, excess, contingent or on any other basis, this insurance is excess over any other insurance regardless of the written agreement between you and an additionM insured. Q. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES Section IV — Cornrfrercial General LiaNy Conditions Paragraph 6. Representations is amended to add the foWwing: If you uninte Abnaffy fait to discicee any exposures existing at the inception date of your policy, we ww not deny coverage under the Coverage Form so* because of such failure to disclose. However, this provision does not affect our right to Coliect addritmial premium or exercise our right of canceWon or non- renewal. This provision does not apply to any known injury or damage which is excluded under any other provision of this policy. R. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Section IV — COrnnwcW General Liability Condition. Paragraph sL Trorwer Of Rights Of Recovery Against Others To Us is amended to add the following: We waive any right of recovery we may have against any peen or organization because of payments we make for injury or damage arising out Of 1. Your ongoing operations; or 2. "Your work' included in the "pioducts- compkded operations hazard'. However, this waiver applies only when you have agreed in writing to waive such rights of recovery in a contract or agreement, and only if the contract or agreement- 1. greement1. Is in effect or becomes effective during the term of this policy; and 2. Was executed prior to loss. S. MENTAL ANGUISH Section V — Definition 3. is iced by the foil p: 'Bodily injury' means bodily injury, sickness or disease sustained by a person, inciudhg mental anguish or death r"Li ing from bodily injury, sickness or disease. T. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CG757t!{2--19) lndud" coPyrWftd of ISO Propwtin, tent. irate ftt pwrriasion. Page 6 d 6 PERFORMANCE BOND BOND TO THE CITY OF PASC O Bond No. 107368794 KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Fogle Pump & Supply, Inc. as principal, and Travelers Casualty and Suretv Company a corporation organized and existing under the laws of the State of C as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors, as surety, are jointly and severally held and firmly bound to the City of Pasco in the penal sum of ***Twentt� Three Thousand Three Hundred for the payment of which sum on demand we bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into a pursuance of the statutes of the State of Washington, and ordinances of the City of Pasco. Dated at Spokane. Washington, this 18th day of February. 2021. Nevertheless, the conditions of the above obligation are such that: WHEREAS, pursuant to action taken by the City Council of the City on _ 20____, the Mayor and City Clerk of the City of Pasco have let or are about to let to the said Fogle Pump & Supply, Inc. the above bounden principal, a certain contract, the same contract being numbered 21-007 and providing for Farm Well #2 Cleaning and Rehabilitation (which contract is referred to herein and is made a part hereof as though attached hereto.) WHEREAS, the said principal has accepted, or is about to accept the said contract, and undertake to perform the work wherein provided for in the manner and within the time set forth. NOW, THEREFORE, if the said ale Pump & Supply, Inc. shall faithfully perform all of the provisions of said contract in the manner and within the time therein set forth, or within such extensions of the time as may be granted under the contract, and shall pay all laborers, mechanics, subcontractors, and material men, and all persons who shall supply said principal or subcontractors with provisions and supplies for the carrying on of said work, and shall indemnify and hold said City of Pasco harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal, or any subcontractor in the performance of said work, and shall indemnify and hold the City of Pasco harmless from any damage or expense by reason or failure of performance as specified in said contract or from defects appearing or developing In the material or workmanship provided or performed under said contract after its acceptance thereof by the City of Pasco, then and in that event this obligations shall be void; but otherwise it shall be and remain in full force and effect. Approved as to Form: Travelers Casuafyand Surety Company Fogle Pump & Supply,, Inc. Surety ShefW Donovan, Attorney In Fact Contractor PB -1 PAYMENT BUND To City of Pasco, Washington Bond No. 107368794 The City of Pasco, Washington, City has awarded to Fogle Puma & Suyely. Inc. (Principal), a contract for the construction of the project designated as Farm Well #2 Cleaning and Rehabilitation, Project No. 21- 007 in Pasco, Washington (Contract), and said Principal is required under the terms of that Contract to furnish a payment bond in accord with Title 39.08 Revised Code of Washington (RCW). The principal, and Travelers Casualty and Surety Company (Surety), a corporation organized under the laws of the State of CT 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, in the sum of ***Twerity Three Thousand Three Hundred Eighty Two and No!100*** US Dollars (523.382.00). Total Contract Amount, subject to the provisions herein. This statutory paymerd 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 RCW Titles 39.08, and 39.12 including all workers, laborers, mechanics, subcontractors, and material suppliers for the carrying on of such work, and all taxes incurred on said Contract under Title 50 and 51 RCW an all taxes imposed on the Principal under Title 82 RCW; 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 (2) 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 Fogle Pump & Supply, Inc. I w l f! ' ,,rMI/�I TT7 11..E --02/18/2021 02/18/2021 Principal Signatures Date "41(� Ur -r ;1 Printed Name =` SURETY Travelers Casualty and Surety Company i.- 211 EU --021 Surety Sign re Date Shelly Donovan Printed Name Dirt, Uf OL Uim' S Attorney In Fact _ Title ITitle Name, address, and telephone of local office/agent of Surety Company is: A ai n I—ns uranG` ervices, inc. - 818 W. Riverside Ave., Ste. 800, Spokane, WA 99201, (509) 324-3025 Approved as to form: Signature Title PB -1 Date Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company ,TRAVELERS'J' SL Paul Fire and Marine Insurance Company POWER OF ATTORNEY -- KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St Pout Fre and Marine insurance Company are corporations duty organized under the laws of the State of Connecticut (harem coitectvety called the 'Companies"), and that the Companies do hereby make, constitute and appoint SHELLY DONOVAN of SPOKANE Washington , their true and iawNI Attorney -in -Fact to sign, execute, seat and acknowledge any and all bonds, recograzances, conditional undertakings and other wr€tings obligatory in the nature thereof on buff of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WifNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seats to be hereto affixed, this 17th day of January, 2015. NyCCM Noel State of Connecticut 'e BY- City of Hartford ss Robert L. Rana , aria' Vitae President On this the 17th day of January, 2018, before me personally appeared Robert L. Rang, who acknowledged himself to be the Senior lice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing Instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duty authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission expires the 30th day of June, 2021 loom �d !!tom � r pulm Anna P. Nowik, Notary Public This Power of Attorney is granted under and by the authority of the foibwing resolutions adopted by the Boards of DirectDrs of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full force and effect reading as follows: RESOLVED, that the Chairman, the Pres€dent, any Vice Chairman, any Executive Vice President, any Seng Vice President, any Vice President any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Atlomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of author may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizant es, contracts of Indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her, and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, arty Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation Is In writing and a copy thereof is fled in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vm President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duty attested and seated with the Company's seat by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attomeys4n-Fact and Agus pursuant to the power prescribed in his or her certfficate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: Presiderrt, any Executive Vice President, any Senior Vice President, any Vice PreskienL any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fad for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the mature thereof, and any such Power of Attorney or certificate tearing such facsenile signature or facsimile seat shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facalmile seal shall be valid and binding on the Company in the future with respect to an bond or understanding nding to which it is attached.. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St Paul Fire and Marine insurance Company, do hereby certify that the above and forging is a true and correct copy of the Pourer of Attorney executed by said Companies, which remains in full force and effect. Dated this lbtth day of February , 2021 -5✓A�r � ��.,a,;-. .tM°1t ad v� . eelVis, +_ � Kevin:E. Hughes, Assn :tent Secretary 7b WWMY the AUIUWW�ofthis Power ofAttormw, phmae CON as at 1-800-4n-3WV. Pmserefer fotheaborre-fla~Athmnna-rrfa�ctAad the 4thuft of theboad to whArh this Pbwar of)[Mrrw AratWdkgaL Change Order Quote Farm Well #3 Item No. Description Unit Unit, t_. Frio Quantity Extended Price 1 Well Development Labor (2 guys 20 hrs each) hrs 100.00 40 4000.00 2 Equipment use Cable tool/Frac Unit hrs 150.00 20 3000.00 Sub Total 7000.0 Tax Rate (8.6% / 8.0% Circle appropriate tax rate 560.00 Total S 7560.00 By: Alaina Fogle Date Director of Operations