Document Moscow_doc_ada0695cdc

CONSTRUCTION CONTRACT THIS AGREEMENT, dated this 24th day of March, 1998, by and between the City of Moscow, Idaho, a municipal corporation of the State of Idaho (hereinafter, "City") and Leone & Keeble, Inc., (hereinafter, "Contractor"): WITNESSETH: WHEREAS, pursuant to the invitation of the City, extended through an officially published "Advertisement for Bids", the Contractor did, in accordance therewith file with the City a proposal containing an offer which was invited by said notice; and WHEREAS, the City has determined that said offer was the lowest and best submitted: NOW THEREFORE, the parties to this Contract, in consideration of the mutual covenants and stipulations set out, agree as follows: ARTICLE 1. CONTRACT DOCUMENTS The Contract Documents which comprise the entire agreement between the City and the Contractor concerning the work to be performed are this Contract, pages one through and the following: 1. Advertisement for Bids; 2. Project Specifications titled : Wastewater Treatment Facilities Headworks; 3. Bid/Proposal of the Contractor, dated February 18'", 1998, to be physically attached to this Contract; 4. The Engineering Plans; 5. Performance and Payment Bonds and Insurance Certificates, to be physically attached to this Contract; 6. Change Orders which may be delivered or issued after the effective date of this Agreement; 7. Addenda issued prior to opening of bids. There are no Contract Documents other than those listed in Article 1 . This Contract may only be amended by change order as provided in the General Conditions. ARTICLE2. WORK The Contractor shall complete the entire work as specified, indicated and required under the Contract Documents. ARTICLE3. CONTRACT TIME/SUBSTANTIAL COMPLETION The work to be performed pursuant to this Contract shall be substantially complete within 210 calendar days from the issuance of the Notice to Proceed, unless adjustment of the contract time is made in accordance with the provisions of the Contract Documents. The Contractor shall begin work in conformance with the Contract Documents and shall complete the work prior to the date of completion. CONSTRUCTION CONTRACT PAGE 98-11 ---PAGE BREAK--- ARTICLE4. CONTRACT SUM The City shall pay the Contractor for completion of the Work in accordance with the Contract Documents in current funds the amount of seven hundred forty-six thousand six hundred fifty-one DOLLARS ($746,651.00). Said Contract Sum shall be paid in accordance with the Contract Documents. ARTICLES. INDEPENDENT CONTRACTOR The parties warrant by their signature that no employer-employee relationship is established between the Contractor and the City by the terms of this contract. It is understood by the parties hereto that the Contractor is an independent contractor and as such neither it nor its employees, agents, representatives or subcontractors, if any, are employees of the City for purposes of tax, retirement system, or social security (FICA) withholding. ARTICLE 6. SCOPE OF SERVICES The Contractor shall perform all services required by the Contract Documents. All work shall be completed in accordance with the specifications and plans established for this project. ARTICLE 7. HOLD HARMLESS/INDEMNIFICATION In addition to other rights granted the City by the Contract Documents, the Contractor shall indemnify and save harmless the Engineer and the City, its officers and employees, from all suits, actions, or claims of any character brought because of any injuries or damages received or sustained by any person, persons, or property on account of the operations of the Contractor or his subcontractors; or on account of or in consequence of any neglect in safeguarding the work; or through use of unacceptable materials in constructing the work; or because of any act or omission, neglect, or misconduct of the Contractor or his subcontractors; or because of any claims or amounts recovered from any infringements of patent, trademark or copyright; or from any claims or amounts arising or recovered under the Workmen's Compensation Act or any other law, ordinance, order or decree. ARTICLES. CONFLICT OF INTEREST The Contractor covenants that it presently has no interest and will not acquire any interest, direct or indirect, in the project which would conflict in any manner or degree with the performance of its services hereunder. The Contractor further covenants that, in performing this Contract, it will employ no person who has any such interest. Should any conflict of interest arise during the performance of this Contract, Contractor shall immediately disclose such conflict to the Project Engineer/Engineer and the City. CONSTRUCTION CONTRACT PAGE2 ---PAGE BREAK--- ARTICLE 9. ENTIRE AGREEMENT, MODIFICATION AND ASSIGNABILITY This Contract and the exhibits hereto contain the entire agreement between the parties, and no statements, promises, or inducements made by either party, or agents of either party are valid or binding unless contained herein. This contract may not be enlarged, modified or altered except upon written agreement signed by the parties hereto. The Contractor may not subcontract or assign its rights (including the right to compensation) or duties arising hereunder other than as contemplated by the Contract Documents, without the prior written consent and express authorization of the City of Moscow. ARTICLE 10. ADHERENCE TO LAW REQUIRED All applicable local, state and federal statutes and regulations are hereby made a part of this contract and shall be adhered to at all times. Violation of any of these statutes or regulations by the Contractor shall be deemed material and shall subject the Contractor to termination of this contract for cause. No pleas of misunderstanding or ignorance on the part of the Contractor will in any way serve to modify the provisions of this requirement. The Contractor and his surety shall indemnify and save harmless the City and its employees, agents and representatives against any claim or liability arising from or based on the violation of any such laws, codes, ordinances, or regulations, whether by himself, his employees, or his subcontractors. ARTICLE 1 1. LEGAL FEES In the event either party incurs legal expenses to enforce the terms and conditions of this contract, the prevailing party is entitled to recover reasonable attorney's fees and other costs and expenses, whether the same are incurred with or without suit. ARTICLE 12. SPECIAL WARRANTY The Contractor warrants that nothing of monetary value has been given, promised or implied as remuneration or inducement to enter into this Contract. The Contractor further declares that no improper personal, political or social activities have been used or attempted in an effort to influence the outcome of the competition, discussion, or negotiation leading to the award of this Contract. Any such activity by the Contractor shall make this Contract null and void. CONSTRUCTION CONTRACT PAGE 3 ---PAGE BREAK--- ARTICLE 13. COMMUNICATIONS Such communications as are required by this contract shall be satisfied by mailing or by personal delivery to the parties at the following address: Contractor: City: Leone & Keeble, Inc. P.O. Box 2747 Spokane, WA 99220-2747 City of Moscow 122 E. 4th Street P.O. Box 9203 Moscow, Idaho 83843 IN WITNESS WHEREOF, said Contractor and the City have caused this Contract to be executed on the day and year first above written. Contractor: CONSTRUCTION CONTRACT PAGE4 ---PAGE BREAK--- ACKNOWLEDGMENT State of WASHINGTON )ss County of On this 1ST State of WASHINGTON personally appeared PAU L A. KEEBLE and CR_ A_I_G_ M _ L_ E_O _N _E in their official capacity as president and secretary of Leone & Keeble, Inc., known to me to be the persons described in the above document and acknowledged to me they executed the same. [sea!] Notary Public residing at DEER PARK, WA My commission expires: MARCH 3, 2002 CONSTRUCTION CONTRACT PAGE5 ---PAGE BREAK--- PROPOSAL TO CITY OF MOSCOW PROPOSAL OF À Á L EÂOÃNÄE Å&ÆKEÇEÈB LÉEÊËINÌCÍ·-- (hereinafter called "Bidder"). organii'.cd and existing under the laws of the State of WASHINGTON, doing business as a(n) CORPORATION 1, to the City of Moscow, Idaho, (hereinafter called "Owner"). BIDDER'S DECLARATION AND UNDERSTANDING. In compliance with your Invitation to Bid, the undersigned Bidder hereby proposes to furnish all plant, labor, services, materials, equipment, tools, supplies. transportation, utilities, and all other items and facilities necessary to perform all work required under the Bid Schedule of the Owner's Contract Documents and Specifications entitled "City of Moscow, Idaho, Wastewater Treatment Facilities - Headworks", in accordance with the intent of the Contract Documents. including, but not limited to, the Specifications, Drawings, and all Addenda issued hy said Owner prior to opening of the Proposals. Said Bidder agrees that, within ten (10) calendar days after receipt of Notice of Award from said Owner, he will execute a Omtract in the required form. of which the Invitation to Bid, Instructions to Bidders. Proposal, Information Required of Bidder, Specifications, Drawings, and all addenda issued hy said Owner prior to the opening of Proposals, are a part, and will secure the required insurance and bonds and furnish the required insurance certificates; and that upon failure to do so within said time, then the Proposal Guarantee furnished by said Bidder shall he forfeited to said Owner as liquidated damages for such failure; provided, that if said Bidder shall execute the Contract, _secure the required insurance and bonds, and furnish the required insurance certificates within said time, his check, if furnished, shall he returned to him within five days thereafter, and the hid hond, if furnished, shall become void. It is further understood that this Proposal may not he withdrawn for a period of thirty (30) days after the date set for the opening thereof. The Owner reserves the right to reject any or all Proposals or to accept the Proposal deemed to he in the best interest of the Owner. This hid offer is accompanied hy a Proposal Guarantee (Certified Check, Cashier's Check. or Bid Bond) in the amount of five percent of the Base Bid, as a guarantee that the Bidder, if successful, will enter into a contract and execute the necessary contractual documents or forms as stipulated in these Contract Documents; and then, if awarded the contract, agrees to obtain the materials, arrange the work, and prosecute the same to ·Insert "Corporation", "Partnership", or "Individual", as applicable. c- 1 January 6. 1998 (2:26pm) ---PAGE BREAK--- PROPOSAL TO CITY OF MOSCOW to ontain and resell components of other manufacturers to form a complete installation; the length of time the equipment offered has hcen in successful, regular operation under comparahle conditions; the efficiency of the equipment's operation; and the anility of the supplier or manufacturer to service and maintain the equipment. 4. The Bidder understands that cjuipment of a proposed alternate manufacturer must meet or exceed the rcljujrcments of the Contract Documents and Specifications. be of c\jual or hetter \juality. and he of e\jual function to the base bjd C\luipment. 5. After the 1'-ecw:e.Qetlv:er otl'tmJ'1art,of-·ʟ--:Corp:piifiY. ̽ I recognʠaooast·contra.ca !Jf il'!demÝtr _an4 Qther writings ot»!Gat*ri jo JhiJ' thetooC-Thll' Cj)fPQ:fill̿ seal is rwr n5ary''foUtii,l vaUdlW of •Wi(·-ʡ::ʢ-iʣʤg$, contra-Cu. ot :llf!<:l t-Wr writings the natvre -tl)lori:iݔL- , ' ' ' 3. ʥttnmeyis_J.¢-Faʦ shan Œavœ Þet>ßnà : - exeeutd--˅{l/rii˜ ,-rʧred to be .ittachlid,Ot? oo'n&, tʨ¢6gniim'\C$S;-::-:ʩQi;tiʪcU:·.ʫ'f:)ncterrmit{ or Ȧliet':—dJtiŐaJ\, :obiŕ;-,,: afld theY shall also nave power and auihorltv to-certify th:e financial stateme'nt-ot the Company ct the By-taws of th!f comPanY -or any a rtldi! Qr sʬ'theteof. ' ' - : _ ' ' ' , ' _ , , - , ' - ' ' ʭ' ' This Po;i...er of Attorney :is ·$Jgned and :ʯealed b't. and by, Buthorltá _llf:t;hˆ'" fcllowing resdlution-adot)ted'tt( the Exacutive 'a!Jd- ʰ?fiCʱ;-ʲbm_mittees c6f-tna.5oartts,:of_btr7ors, o(Retlanf;e Jnsurance Company, I.JnlteQ Pacmc Jnsânct CO(D.p:aftY' and, 'Reliance Nationaun®tn_m'ty , Company by tJʳn!mous Consent datetfiils Qf 1994, and by thſl, l;8_e, and :ftnanc:ial C.t.mmitte:e of the Board of Olre.ctMs of ReliancJ:r.$Utl>tY,'COfnp:ͅ;ny, by Vnann:m;ruS-'CO,MWlt d at˃d -a:s of Maret ݒ1, :1994,' ' ʵResolved_ ʶat t_ll- signatvres Of _sŏ 4ʷecttary oll'!EUANC€ SURETY COMPAIIIV, RELIANCE IIIISURAIIICE COMP!\IIIV, .VNITEO PACIFIC INSURAN(:E. COMP; ANY, end RELIANCE foŌ""'--ō- Ȝ Signature JO/Ann Mikkelsen, At orney- in- Fact (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY) END OF SECTION 1 All Sureties sha.il use this Bid Bond form. Other forms are not acceptable. D - 1 SECD.mlS ---PAGE BREAK--- INFORMATION REQUIRED OF BIDDER GENERAL INFORMATION The Bidder shall furnish the following information. Failure of the Bidder to furnish this information may cause rejection of the Bid. Additional sheets shall be attached as required. 1. Contractor's name and address LEONE & KEEBLE, INC. 108 W. BOONE AVE. (P.O. BOX 2747) SPOKANE, WA 99201 (99220) 2. Contractor's telephone number: 9ª-«3¬2­7- 4¯ 3. Contractor • s license: Primary classification TYPE 3 State License No . 8"'-2 Supplemental classification held, if any: TYPE 4 (1,2,5,6,8,9,10, 12,15,16,17,18,19,20,21, 4. Number of years as a Contractor in construction work of 22,23,24 this type: 6 YEARS 25,26,27 29,30,31 5. Names and titles of all officers of Contractor's firm: 34,35,36 37,40,41 PAUL KEEBLE PRESIDENT 44,46) CRAIG LEONE SECRETARY-TREASURER 6. Name of person who inspected site of proposed work for your firm: Name: GARY SCHI M MELS, JR. Date of Inspection: 2/5/98 7. Name, address and telephone number of Surety Company and agent who will provide the required bonds on this Contract: RELIANCE SURETY CO MPANY 421 W. RIVERSIDE #820 SPOKANE, WA 99201 [PHONE REDACTED] E - l SEC::.M:S December 9, 1996 ---PAGE BREAK--- LIST OF SUBCONTRACTORS A. The Bidder shall list below the name, business address, Idaho Public Works Contractor's License, and description of work for Ȗ subcontractor who will perform work if the Bidder is awarded the Contract. After the opening of Proposals, no changes or substitutions will be allowed without the written approval of the owner. The listing of more than one subcontractor for each item of work to be performed with the word "or" will not be permitted. B. The Bidder's attention is directed to the provisions of the Idaho Naming Law for Mechanical and Electrical Subcontractors (Idaho Code Section 67-2310). The Contractor shall not name any more than one subcontractor for each work item. If the Contractor intends to perform mechanical and/or electrical work under the provisions of his own license. he shall name himself. as appropriate. C. The Bidder's attention is directed to the provisions of Article 3.10 of the General Conditions which requires that not less than twenty percent (20%) of the work shall be performed with the Bidder's own forces. D. Failure to comply with the above requirements may render the Bid non-responsive and may cause its rejection. DESCRIPTION OF WORK 1 2 3 4 5 6 Mechanical Electrical HVAC yª:;,rn f'r'lv{\ \1 h1Ll-s o ŢJr 1/ I A t, ol-, LJ/r LICENSE NUMBER II 5 4A' lf (.:rs 3'+3r• t?spl,.ti/1 t. . . ŋ . t. I a. . 4. NOTE: Attach additional sheets if required. END OF SECTION E - 3 SE:CE.M::S Jecembe.z: 9, :99€ ' i ---PAGE BREAK--- , , DESCRIPTION OF WORK LICENSE SUBCONTRACTOR'/" NAME & ADDRESS ' NUMBER /lb"/1-Aȕ 0V€rL.C4o Dt>t>i" 7 "v fi' rl, Ho Ou'i l.f-{t/7) U,v, lv .:J:tfJI\Lt: 8 PA.:rN"' 9 u 10 11 12 J j 'Yt·t-PDŊ t( I '-I'J 'V a..k L vrp - J & LcJ ( c:/o I. NOTE: Attach additional sheets if required. END OF SECTION E - 4 SEC:_ t1l6 TrP{lLo ---PAGE BREAK--- CONTRACTOR'S NON-COLLUSION AFFIDAVIT (TO BE SUBMITTED WITH THE BID) State of WASHINGTON county of SPOKANE ss Bid for CITY OF MOSCOW, IDAHO, WASTEWATER TREAT MENT FACILITIES-HEADWORKS A¶ U· L¸A¹·º K»E¼E½B¾ L¿E , being first duly sworn, deposes and says that he is PRESIDENT of LEONE & KEEBLE, INC. the party making the foregoing Bid; that such Bid is not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation; that such Bid is genuine and not collusive or sham; that said Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham Bid and has not directly or indirectly colluded, conspired, connived or agreed with any Bidder or anyone else to put in a sham Bid, nor that anyone shall refrain from bidding; that said Bidder has not in any manner, directly or indirectly, sought by agreement, communication or conference with anyone to fix the Bid Price of said Bidder or of any other Bidder, nor to fix any overhead, profit or cost element of such Bid Price, nor of that of any other Bidder, nor to secure any advantage against the public body awarding the Contract or anyone interested in the proposed Contract; that all statements contained in such Bid are true; and, further, that said Bidder has not directly or indirectly submitted his Bid Price or any breakdown thereof, nor the contents thereof, nor divulged information or data relative thereto, nor paid and will not pay any fee in connection therewith to any corporation, partnership, company, association, organization, bid depository, nor to any member or agent thereof, nor to any other individual except to such person(s) as has/have a partnership or other financial interest with e : dusiness. PAUL A. KEEBLE SECF .Ml& Title: _ _ (5BAL) Not My Commission Expires END OF SECTION 1/nsert sole owner, a partner, president, secretary, etc. F - 1 to before me this day 1998. ---PAGE BREAK--- PERFORMANCE BONO Bond No. B2814952 KNOW ALL MEN BY THESE PRESENTS: That Leone & Keeble, Inc. as Contractor, and Reliance Insurance Company as Surety, are held and firmly bound unto the City of Moscow, Idaho, hereinafter called "Owner," 1n the sum of Seven Hundred Forty Six Thousand Six Hundred Fifty .-Dna-a dollars { S 7 46,651.00 for the pay ment of which sum, well and truly to be made, we bind ourselves, our heirs, eŠecutors, administrators, su c cessors I and assigns, jointly and severally, firmly by these presents. WHEREAS, said Contractor has been awarded and is about to enter into the annexed Agreement with said owner to perform the wor:k as specified or indlcated in the Bid Schedule of the Contract Documents entit led "Citv of Moscow, Idaho , Wastewater Treatment Facilities - Headworks.•( NOW THEREFORE if said Contractor fails to perform all the requirements of said Contract Documents required to be performed on its part, at the times and in the manner specified tfierein , said Suretl;' will pay for same in an amount not exceeding the sum specicied above, and in the event suit is brought upon th is bond , a re a sonab le attorney's fee to be fixed by the court. This bond shall inure to the benefit of any persons, co mpanies or corporations entitled to file claims under applicable State law. PROVIDED, that any alterations in the work to be done or the materials to be furnished, or changes in the time of completion, which may be made pursuant to the terms of said Contract Documents, shall not in any way release said Contractor o r said Surety thereunder, nor shall any extensions of time granted under the provisions of said Contract Documents, release either said Cant ractor or said Surety, and notice of such alterations or extensions of the Agreement is hereby waived by said Surety . SIGNED AND SEALED, this 19 25th (SEAL) day of March (SEAL) RELIANCE INSURANCE COMPANY (Surety) By: ž e, President (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY) PERFORMANCE BOND SHALL MEET REQUIREMENTS OF IDÍlO CODE - SECTION 54-1926. END OF SECTION I - 1 ---PAGE BREAK--- PAYMENT BOND Bond No. B2814952 KNOW AI.L Mr:N BY THESE !?RESENTS: That ‡ope & Keeble, Inc. Contractor 1 and Reliance Insurance Company as Sure ty , arc held and firmly bound unto the in City the Idaho, hereinafter Seven Hundred Forty Six Fifty One and No/100 called Thousand Six UQwner,11 Hundred dollars 7 46,651.00 as of Moscow, swn of ) for the payment of which sum, well and truly to be made, we bind ourselves, our hei rs, executors, administrat:ors1 successors, and assigns, jointly ond severally, firmly by these presents. WHEREAS, sai d Contractor has been awarded and is about to enter into the anne.X.f:!'d Agreement with said owner to perfortn the work as specified or indic ated in the Bid Schedule of the Contract Documents entitled "Ci tv of Moscow, Idaho, wastewater Treatment Facilities - Headworks.'r NOW THEREFORE, if said contractor, or subcontractor, fails to pa¥ for any materials, equipment or other supplies, or for rental o same, used in connect:oon with the performance of work contracted to be done, or for amounts due under applicable State law for any work or labor thereon , said surety wili P.ay for same in an amount not exceeding the sum specified aoove , ana •n the event suit is brought upon this bond, a reasonable attorney's fee to be fixed by the court. This cond shall inure to tne benefit of any persons, companies, or corporations entitled to file claims under appl icab le State law. PROVIDED, t:hat any a lterations in the work to be done Ot" the materials to be furnished , or changes in the time of completion, which may bEt made pursuant to the terms of said Contract Documents, shall not in any way release said Contractor or said Surety thereunder, nor shall any extensions of time granted under the provisions of said Contract Documents, release either said Contractor or said Surety, and notice of such al t.erations or extensions o! the Agreement is hereby waived by said Surety. SIGNED AND SEALED, this 25th day of March 19̹. (SEAL) L!WNE & KEEBLE_,_.=I!.!.NC"-' _ t-contʼnr MligatQzy 1tlldenakings ݃ they thall :alsp bliV¢ power and to«nify tire financial statement of the Company and w eQpies of the: By-Laws of the §Y or any article M ܰ '1')ri{ -'P&ww {)f-Attnmey U :slpied IIJJd SOOkd by l'acsimiie IUl:der and by Of the,foJkrWing moh¢un ܺby' !hi Executive and-finl!t'l(;e Cotoriti!U:es uf !he &ards: of of Reliance Cmn¨y, Utrite4 twurarn.:e Crunpany and Rclܴ-ݕationalllidlmulity Company by Uܳ C4V ܐ t-\ttel1ty ܑ c I \J l /1 8/01/98 10/0i/?J 10/01/98 Ż;L y INJ!Jtf? P£1i1&J HHS lilt • zܠܡoooo • ZQO \iOO 1 a a o e o a • liluUilOO 500illl scco ' I 0 ' • AlJfQ CNL Y - tA ACCK"NT $ Ofi if:ܕ T!tN•l AVTV ON! Y e_..;t;J!M,.żi'H Ź AUCH/,_:fdL $ ܛݗNCC AGs11V-.:r-.,;Jc , 4liOOGOC $ ܜlJ0\7 IJ All ISK, Qij K£ & fLOOD, ̪1,000. 0[0. $Ȓ 4!_•_ȓ0D._ f'RUJfC! ܬ flii¥ or mr ź ܗ:tm.o t12 ܙUJ:D ܚ'!HE fJiifil¥'>1¥*# vt.ft tnti{ltJf, 'HܦܧCCNif'YfitWUܨܩIDW"Jt ---PAGE BREAK--- ADDITIONAL INSURED • PRIMARY COVERAGE I N S U R lEONE I KEEBLE, INC . I S E N D O R S E N T C H A NG E S T H E I C Y . P L £ t. R EAD l T C H U l l Y . COMMERCIAL GENERAL liABIUlY COVERAGE FORM N ame o f P e r s o n o r Qrga n i l a t l o n : C I IY OF IJ K IMBA L L E I 5 7 9 W YDtN YOEN LA I!E : t h e r·e s o r 9203 C I U 83843 - 1 7 T E ll T R [ N T f l l l T ! E S H E I S I NSU 0 ( s ec t i on I I ) i s ame n d ¹·u; i z a t i on s h vwn i n t h e i t y a r i s i n g cut o f 1.1 u ' t o i nc l u a s a n i n s u s c h u l c , b u t on l y w i t h w u r k f u r a t n s u by r t h ¸ r!1f o r e U I U T Y l l cw i n o i s a d d t o S E C T I I V I l l 5 p a - r h 4 , e t h e r i n s u r a n c e : I A !i 4 . Ot he r I n s u rance d) T h i s i n s u r a n c e i s f o r t h e p e r s o n o r o an l z a t l on s h ow n i n t h e s t h e u l e , a t on l y w i t h r e s ect t o l i a b i l i t y a r i s i n g o u t o f y o u r wo r t h ct t i n s u r o r f o r you . h e r l n s u a n t e a f f o rd ed t u t h a t l n s u w l 1 p l y a s e x c e s s 1 n a t c o t r i bute 1 5 p r i m a t o t h e i 5 u r a n c e a f f o r d t h i s e n d o r s e•en l . A l l o t h e r t e rms a d c an d i l o n s o f t h i s p o l i c y rema i n u n du n g ܏R-06-1998 ( : 24 ---PAGE BREAK--- ̓!!lUlU: C l TV Of IIOSCOW ATTN : DEAN WEYEN P . O . II()Jt ')203 X()SCOW, 1 0 8)843̩1 IDAHO STATE INSUilANCE FUND 1:t:a w n-Att nun ܂ BOX om - 'OO!U. lDA.OO li'MONE (ZMJ )34-l311J Sl44Z'1tl All[llf: 311 YORTH I DAHO I YSURANCE I NC PO SOX 248 SANDPOI NT, 1 0 [PHONE REDACTED] 263Z 2 1 94 CERTIFICATE OF WO+ COMPE"',ATION INSURANCE The State lnsur•nte fund nereby certifl܍s th&t the lnsuraoce pol hereunder described ls ln full fore܅ and eff̨t on the date of this certiflC$te •nd tnat It r܆ins in ful l forte and •ffect until tancelled • • l܋SU܌fO! LEONE & KEEBlE !WC PO SOl 2747 OR!Gl܊L OAT<: Polley ln f<>rc• f'ro!ll l!l/01/l!l!ll 12:01 a.m., ""'mt.lr Stand•l'd Tll!ll!, •t the addN!ss of t!le lrsum above or the jon slte in ldahPlles to -loyees of tlll! a!Jove-!lll!ntionmd company ,ywrere in the state of Idaho and also to any ܉loyees !datto but in a stat܇܈ !n addition to the covel"agf! j the ܁ 1 ectoo c-overage a 1 so app 1 i es: This certificate is valid for one ye&r from date tif crrtificate܎ Irt th€ eveflt of cam:eHat'irm of said POlley, toe State fulld wi l l end@av<>r to tn+ to this certificate is issued by teo (10) dey's advance ootll:e, oot the State Insurance fund sh•11 not be Hi!ll e in iiny way for Brian lane tXT. 314 !l!l