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Home My WebLink AboutAG 18-009 - South King County Soccer Referees AssociationRETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: CITY OF FEDERAL WAY PARKS & RECREATION 2. ORIGINATING STAFF PERSON: ASHRIYA GUPTAR EXT: 6950 3. DATE REQ. BY. 11/20/23 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ® CONTRACT AMENDMENT (AG#): 16-009 ❑ WTERLOCAL ❑ OTHER 5. PROJECTNAME: SOCCER REFEREES -AMENDMENT NO.2 6. NAME OF CONTRACTOR: SOUTH KING COUNTY REFEREES ASSOCIATION ADDRESS: 5565 NE 17TH ST RENTON, WA 96059 E-MAIL: SIGNATURE NAME: RICHARD MEEK TELEPHONE FAX: V PRESIDENT 7. EXHIBITS AND ATTACHMENTS: A SCOPE, WORK OR SERVICES A COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS 11 PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS E:�I � �.�u ICK�]u lu lJ�Cy � � l �1�II U7•� �'+snlnrxrx.Irar� �r•1a COMPLETION DATE: 12/31/26 9. TOTAL COMPENSATION $ $189,000.00 ($75,000.00 additional) (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ©NO IF YES, MAXIMUM DOLLAR AMOUNT: S IS SALES TAX OWED i0YES ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED 0 PURCHASING: PLEASE CHARGE TO: 001-7200-351-573-63-410 10. DOCUMENT/CONTRACT REVIEW ® PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) A LAW 11. COUNCIL APPROVAL (IF APPLICABLE) INITIAL / DATE REVIEWED KH 11/15/23 JE 11/16/23 INITIAL / DATE APPROVED COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATEREC'D: I'Lf ,♦q IZ3 ,❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS I❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) R<' pw_ DEPARTMENT 1@09IGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# COMMENTS: Comments and changes within the document. JE 11/16/23 DATE SIGAIED F!�r.�1fi 2/2017 CITY of CITY HALL Federal � FederWay Feder l Avenue South al Way, WA 98003-6325 (253) 835-7000 www. Myoffederalway. com AMENDMENT NO.2 TO RECREATION AGREEMENT FOR SOCCER REFEREES This Amendment ("Amendment No. 2") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Northwest Soccer Officals, a Washington non-profit corporation ("Contractor"). The City and Contractor (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree to amend the original Agreement for Recreation Agreement for Soccer Referees ("Agreement") dated effective January 9, 2018, as amended by Amendment Nos. 1 and 2, as follows: 1. AMENDED TERM. The term of the Agreement, as referenced by Section 1 of the Agreement and any prior amendments thereto, shall be amended and shall continue until the completion of the Services, but in any event no later than December 31, 2024 ("Amended Term"). 2. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or method of payment, as delineated in Exhibit B-2, attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for the Amended Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 3. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done by either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after the previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment. The provisions of Section 13 of the Agreement shall apply to and govern this Amendment. The Parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. [Signature page follows] I AMENDMENT - 1 - 4/2023 CITY OF CITY HALL Federal WayFeder 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wwwcrtyoffadern4vay com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: *10000 By: Jim F 11, Mayor DATE:t / - / V 7 NORTHWEST SOCCER OFFICALS: By: Printed Name: Richard Meeks Title: Executive Director Date: IZ %/5)93 STATE OF WASHINGTON ) ss. COUNTY OF ATTEST: W Ami 14 "At 0 v I p anie Courtney, CM , ity Clerk APPROVED AS TO FORM: J. R in Call, Ci Attorney On this day personally appeared before me Richard Meeks, to me known to be the Executive Director of Northwest Soccer Officals that executed the within and foregoing instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he or she was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. GIVEN under my hand and official seal this day of i3�E% 207S. Notary's signature C r r Notary Public State of Washington ]ACOS K00MNEN LICENSE # 21026808 MY COMMISSION FxPIRES AGLIST 4, 2025 s printed name izp a& Notary Public in and for the State of Washington. My commission expires .Li 4,6,G U , 2&15--� AMENDMENT - 2 - 4/2023 CITY OF ,. Federal way EXHIBIT B-2 ADDITIONAL COMPENSATION CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. otyoffederafway. com 1. Total Compensation: In return for the Additional Services, the City shall pay the Contractor an additional amount not to exceed Seventy -Five Thousand and NO/100 Dollars ($25,000.00). The total amount payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed One Hundred Eighty -Nine Thousand and NO/100 Dollars ($139,000.00). 2. Method of Compensation: a. A "Match Fee" will be paid for each game played amounting to Ninety -Two and NO/100 Dollars ($92.00) AMENDMENT - 3 - 4/2023 12/11/23, 9:35 AM Corporations and Charities System BUSINESS INFORMATION Business Name: NORTHWEST SOCCER OFFICIALS UBI Number: 601 631 506 Business Type: WA NONPROFIT CORPORATION Business Status: ACTIVE Principal Office Street Address: 5565 NE 17TH ST, RENTON, WA, 98059-4379, UNITED STATES Principal Office Mailing Address: PO BOX 2291, RENTON, WA, 98056-0291, UNITED STATES Expiration Date: 05/31/2024 Jurisdiction: UNITED STATES, WASHINGTON Formation/ Registration Date: 05/23/1995 Period of Duration: PERPETUAL Inactive Date: Nature of Business: ATHLETIC, SPORTS OFFICIALS Charitable Corporation: R Nonprofit EIN: 80-0793430 Most Recent Gross Revenue is less than $500,000: Has Members: R Public Benefit Designation: Rr Host Home: El REGISTERED AGENT INFORMATION Registered Agent Name: RYAN MEEKS Street Address: 5565 NE 17TH ST, RENTON, WA, 98059-4379, UNITED STATES Mailing Address: 5565 NE 17TH ST, RENTON, WA, 98059-4379, UNITED STATES https://ccfs.sos.wa.gov/#/BusinessSearch/Businesslnformation 1/2 12/11/23, 9:35AM Corporations and Charities System GOVERNORS Title Governors Type GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL Entity Name First Name Last Name RYAN P MEEKS JEREMY P GERKING CRAIG ALLEN JONATHAN R. SIMMONS ALEX WOLBERT COLLIN CHRISTOPHER NISCO ETHAN DRISCOLL CAMERON ZIPP BRUCE SUGIYAMA PETER F STRAUGHAN RICHARD A MEEKS ELMER L OLNEY https://cefs.sos.wa.gov/#/BusinessSearch/Business Information 2/2 12/11/23, 9:36 AM Washington State Department of Revenue Wa hinriton State Department Of Revenue < Business Lookup License Information: Entity name: NORTHWEST SOCCER OFFICIALS I New search Back to results Business SOUTH KING COUNTY SOCCER REFEREES ASSOICATION name: Entity type: Nonprofit Corporation U BI #: 601-631-506 Business ID: 001 Location ID: 0001 Location: Active Location address: Mailing address: 5565 NE 17TH ST RENTON WA 98059-4379 5565 NE 17TH ST RENTON WA 98059-4379 Excise tax and reseller permit status: Click here Secretary of State status: Click here https://secure.dor.wa.gov/gteunauth/—/#2 1/3 12/11/23, 9:36AM Governing people ALLEN, CRAIG DRISCOLL, ETHAN GERKING, JEREMY P MEEKS, RICHARD A MEEKS, RYAN P NISCO, COLLIN CHRISTOPHER OLNEY, ELMER L Washington State Department of Revenue Title SIMMONS, JONATHAN R Governing People May include governing people not registered with Secretary of State Filter Governing people Title WOLBERT, ALEX ZIPP, CAMERON Registered Trade Names Registered trade names Status First issued NORTHWEST SOCCER Active Aug-05-2020 OFFICIALS NSO Active Jun-07-2021 NW SOCCER OFFICIALS Active Aug-05-2020 hftps://secure.dor.wa.gov/gteunauth/—,/#2 2/3 12111 /23. 9:36 AM Registered trade names SKCSRA SOUTH KING COUNTY SOCCER REFEREES ASSOCIATION Washington State Department of Revenue Status First issued Active Mar-10-2014 Active Mar-10-2014 View Additional Locations The Business Lookup information is updated nightly. Search date and time: 12/11/2023 9:36:13 AM Contact us How are we doing? Take our survey! Don't see what you expected? Check if your browser is supported https://secure.dor.wa.gov/gteunauth/_/#2 3/3 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT.IDIV: �--Kc 2. ORIGINATING STAFF PERSON: EXT: 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES I CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION �4,CONTRACTAMENDMENT (AG#)JI ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: 6. NAME OF CONTRACTOR: , ADDRESS: TELEPHONE E-MAIL: FAX: SIGNATURE NAME: l' $j TITLE:B _� 7. EXHIBITS AND ATTACHMENTS.)I,SCOPE, WORK OR SERVICES C OMPENSATION ❑ INSURANCE REQUIREMENTSICERTIFICATE XALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS �J 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: 9. TOTAL COMPENSATION $� �� 1 (INCLUDE EXPENSES AND SALES TAX, IF ANY) {IF CALCULATED ON HOURLY L OR CHARGE - AT A H SCHEDULES OF MPLOYEES T1TLE5 ANT] HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: ElCONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ElRETAINAGE AGREEMENT (SEE CONTRACT) OR EIRETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: {]�}:�� IU -141 10. DOCUMENT/CONTRACT REVIEW INITIAL/DATE UVIEWED INITIAL /DATE APPROVED ❑ PROJECT MANAGER • DIRECTOR ❑ RISKMANAGEMENT (TAPPLICABLE) ❑ LAW to 0'> Ze 1 l 11. COUNCILAPPROVAL(IFAPPLICABLE) SCHEDULED CpMM1TTEEDATE: COMM ITTEEAPPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE ACUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDERINOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if eouncil approval is needed.) INITIAL I DATE SIGNED ❑ LAW DEPARTMENT �� f ❑ SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# AG ❑ SIGNED COPY RETURNED DATE SENT: COMMENTS: CITY OF 3 3F FALL e d e ra [Way Fede2 8th r 8th Avenue, WASouthFe�feralllVayWA 98003�325 �253) 835-7000 www_ cf"ff8eeraiway com AMENDMENT NO. I TO RECREATION AGREEMENT FOR SOCCER REFEREES This Amendment {"Amendment No. 1") is made between the City of Federal Way, a Washington municipal corporation ("City"), and South King County Soccer Referees Association, a Washington non-profit corporation ("Contractor"). The City and Contractor (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree to amend the original Agreement for Soccer Referees ("Agreement") dated effective January 9, 2018 as follows: L AMENDED TERM. The term of the Agreement, as referenced by Section 1 of the Agreement and any prior amendments thereto, shall be amended and shall continue until the completion of the Services, but in any event no later than December 31, 2023 ("Amended Term"). 2. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or method of payment, as delineated in Exhibit B-1, attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for the Amended Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 3. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done by either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after the previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment. The provisions of Section 13 of the Agreement shall apply to and govern this Amendment_ The Parties whose names appear below swear under penalty ofperjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. [Signature page follows] AMENDMENT - 1 - 312017 CIYY OF Federal Way CITY HALL 33325 8th Avenue South Federal Way WA 98003-6325 (253) 835-7000 www. city nftederal way ciom IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: By;ik; ks Director •, DATE: ATTEST: APPROVED TO FORM: pr J. Ryan Cal, City Attorney SOUTH KING COUNTY SOCCER REFEREES ASSOCIATION: 4 By: Richard M eeks, President J Date: 'S- l t STATE OF WASHINGTON ) ) ss. COUNTY OF On this day personally appeared before me Richard Meeks tome known to be the President of South King Coup ty Soccer Referees Association that executed the foregoing instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. GIVEN my hand and official seal this ank day of _ a'c. enn be-(- , 2011• Notary's signature Notary's printed name DEBORA L. SANDONA NOTARY PUBLIC #174979 STATE OF WASHINGTON COMMISSION EXPIRES OCTOBER 8, 2022 oEBb,KA SAIpDofoh Notary Public in and for the State of Washington. My commission expires - S . AMENDMENT - 2 - 3/2017 crrr OF CITY HALL ,� Feder Fe �! a ra 1!1lay 8th Avenue South Federal Way. WA 9$003-6325 (253) 835-7000 WWWCI"ffederalu aycorn EXHIBIT B-1 ADDITIONAL COMPENSATION 1. Total Compensation: In return for the Services, the City shall pay the Contractor an additional amount not to exceed Seventy -Six Thousand and NO1100 Dollars ($76,000.00). The total amount payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed One Hundred Fourteen Thousand and NO1100 Dollars ($114,000.00) based on the following fees for service. 2. Method of Compensation: a. A "Match Fee" will be paid for each game played. The Match Fee is an inclusive rate and is comprised of the Official fee ($66.00), Assignor fee (10%), and Administration fee (5%). b. The total Match fee will be Seventy -Five and 901100 Dollars ($75.90). AMENDMENT - 3 - 312017 A � o0 CERTIFICATE OF LIABILITY INSURANCE °�'0 aalv/111/2F'"Y'"' zals THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies} must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the ccrttflcate hoIdor in lieu of such endorsements}. PRODUCER CONTACT NAME, Leanne Pearson McDcnaid Insurance Group, AMember of The Partners Group I1C E� : (425) 897-5964 FAX {425} 691-5228 1?225 SE 6th S€., Suite 110 ADDE-MAIL leanne@modonaldins.com INSURER{SI AFFORDING COVERAGE NAIL* Bellevue INSURED WA 98004 TNSURERA: Great American Assurance Co. INSURER B South King County Soccer Referees AssocIatlon INSURERC: PO Box 2291 INSURERO: IN SURER E : Renton VVA 98056 INSURER F: r COTIrre-ATM u1INAoco- 19I20 GL RFAn_g1nM MIINIRFRI THIS IS TO CERTIFY THAT THE POLIC{ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER POUCYS" MMIDLJIYYYY POLICY P MMIODIYYYY LJMITS A x COMMERCiRLGENERALLIASILRY CLAIV"ADE © OCCUR Y PAC0484825 05/15/2019 05/15/2020 EACH OCCURRENCE S 1,000,000 DAMAGE r01ZMT= m PREMISES ERorxuance y 100,000 MED E%P (AW one parson] S 5.000 PERSONAL aADVINJURY g 1,0D0,000 GEN'LAGGREGATE LIMIT APPLJES PER: POLICY PRO LOC JECT OTHER: GENERAL AGGREGATE g 2,000.000 PRODUCTS - COMPIOP AGG S 2.000,000 S AUTOMOBILE UABILJTY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NONOWNED AUTOS ONLY AUTOS ONLY E6M�6cNd SINGLE LIMIT S BODILY INJURY (Per Person) 5 BODILY INJURY {Par accident} $ PROPERTY DAMAGE Per acddara S 3 UMBRELLA LIAR EXCESS LIAB OCCUR HCLAIMSMADE EACH OCCURRENCE S AGGREGATE 5 DEC I I RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' LIAR1L ITY Y I N ANY PROPRIETOMPARTNERIEXECUTiVE ❑ OFFICERIMEMBER EXCLUDED? IMandstory In NH] IT yes, describe unoor DESCRIPTION OF OPERATIONS below NIA $7 7UTE EOTI E L. EACH ACCIDENT L E L DISEASE - EA EMPLOYEE S E.L DISEASE -POLICY LIMIT S OESCRWTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddltlonaI Remarks Schedule, "y be attichod If more spare Is re"Ired) Certificate Holder is an Additional Insured for General Liability coverage as required by written contract or written agreement pef Form CG8970, attached. l A krrCI I Avin" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Federal Way ACCORDANCE WITH THE POLICY PROVISIONS. 876 S 333fd ST AUTHORIZED REPRESENTATIVE Federal Way WA 98003-6325 � W Iaoa-ICU I M%.,V r[61 4.v rcr-VRMI wM. nn Iynu ,W...I u. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC" & CERTIFICATE OF LIABILITY INSURANCE DAT41111IMWD7YYYYI 0 4f1112019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certkflcate holder in lieu of such endorsement(sy. PRODUCER McDonald Insurance Group, A Member of The Partners Group 11225 SE Bth 5t., Suite Zia Bellevue WA 98004 NAME Leanne Pearson P N Ext : {425) 897-5964 FAXNu : (425) 691-5228 E-MAIL leanneQmcdonaldins.Com ADDRESS: I NSU RER;S) AFFORD! NG COVERAGE NAIL d INSURERA: Great American Assurance Co. 26344 INSUREr7 South King County Soccer Referees Association PO Box 2291 Renton VM 98056 FNSURER B INSURER C INSURER D : I NSURSR E : INSURERF: n=oyic!le'ATM LH IU12r-o• 19120 GL P5VISION NLIMIRER- . THIS IS TO CERTIFY THAT'THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTA TYPE OF INSURANCE �gO yyyp POLICY NUMBER EFF M O YY LIM►fS X CCMAMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'OD0 CLAIMS -MADE � OCCUR DAMAGE TO RENT EO PREMISES Esoowrenoe S 7Ud,ODO MED EXP VM one person] S 5,000 A PACO4B4825 05/15/2019 0511WZD20 PERSONALBAOVINJURY S 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,011D PRODUCTS -CAMPIOYAGG $ 2,000.000 C POLICYEJ PRO- LOC OTHER: AUTOMOBILE LLABFLLTY EaaacodeOl ! L IMIT 5 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident] E OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OYMED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Par acddem $ E UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLWMS-MADE DED RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETCRIPARTNERIEXECUrNE ❑ OFFICERIMEAIHER EXCLUDED? (Mandatory W NH) NIA PER STATUTE I I ERA E.LEACHAOClDENT b E.L DISEASE - EA EMPLOYEE S E.L DISEASE - P011GY LIMIT $ If yes, describe under DE8CRIP71ON OF OPERATIONS below OESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 1e1, AddHlonal Remarks Schedule, may be alttachad N more space Is required] Certificate Holder is an Additional Insured as respects General Liability coverage as required by written agreement per farm CG897U attached e'AW'Cl I ATlnu SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Issaquah School District ACCORDANCE WTH THE POLICY PROVISIONS. 555 MW Holly St AUTHORIZED REPRES ENTATIVE Issaquah WA 98027-2899 �17 W TM a-:LUT0 MLVKU 1wUMI'VSV% I IV r7. Mu rrPjlIW MUM raw. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT.IDIV: /1-1 B )CL 2. ORIGINATING STAFF PERSON: ilY EXT: 3. DATE REQ. BY. I 114 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RF13, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRA T AMEAG#}: ❑ INTERLOCAL *OTHER S. PROJECT NAME: Sn cc e)c C&we!�. b. NAME OF CONTRACTOR: ` ADDRESS: TELEPHONE E-MAIL: FAX: SIGNATURE NAME: TITLEfPSj Vt�t- 7. EXHIBITS AND ATTACHMENTS COPE, WORK OR SERVICES)4,COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRAC�T.,/A�MENDMEN�T}S,� 8. TERM: COMMENCEMENT DATE: '0-(10Cj OW COMPLETION DATE: 9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ElCITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: eae - 7Zoo - S'7 3 —Co 3 - V/O 10. DOCUMENT/CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW IL COUNCIL APPROVAL (IF APPLICABLE) 12. CONTRACT SIGNATURE ROUTING INITIAL/ DATE REVIEWED INITIAL/ DATE APPROVED #t1 7 E Z I3 n". zoI 3 COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) ❑ LAW DEPARTMENT ❑ SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERIC ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: INITIAL / DATE SIGNED D 11 IU1 i�' AG# DATE SENT: D d CITY OF CITY HALL ,�. Feder 8Avenue South Federal Way W Federal Way. lh'A 98003-6325 (253) 835-7000 tti�rzar cr�valfedea3ltvaiY. ��r►� RECREATION AGREEMENT FOR SOCCER REFEREES This Recreation Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and South King County Soccer Referees Association, a Washington non-profit corporation ("Contractor"). The City and Contractor (together "Parties") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: SOUTH KING COUNTY SOCCER REFEREES I CITY OF FEDERAL WAY: ASSOCIATION: Richard Meeks PO Box 2291 Renton, WA 98056 (206) 200-8145 (telephone) .net The Parties agree as follows: Cody Geddes 876 S. 333' St Federal Way, WA 98003-6323 (253) 835-6926 (telephone) (253) 835-6939 (facsimile) .com 1. TERM. The term of this Agreement shall commence upon the effective date of this Agreement, which shall be the date of mutual execution, and shall continue until the completion of the Work, but in any event no later than December 31, 2019 ("Term"). This Agreement may be extended for additional periods of time upon the mutual written agreement of the City and the Contractor. 2. WORK. 2.1 Work. The Contractor shall provide goods, materials or services and otherwise perform the work more specifically described in Exhibit "A," attached hereto and incorporated by this reference ("Work"), performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. 2.2 Warranties. The Contractor warrants that it has the requisite training, skill, and experience necessary to provide the Work and is appropriately accredited and licensed by all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business registration. The Contractor warrants it will provide services in a manner consistent with the accepted practices for other similar services within the Puget Sound region in effect at the time those services are performed. The Contractor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Contractor's representations to City. The Contractor shall, at its sole cost and expense, correct all Work performed which the City deems to have defects in workmanship and material discovered within one (1) year after the City's final acceptance of the Work. This Agreement is subject to all warranty provisions established under the Uniform Commercial Code, Title 62A RCW. in the event any part of the goods is repaired, only original replacement parts shall be used; rebuilt or used parts are not acceptable. When defects are corrected, the warranty for that portion of the work shall extend for one (1) year from the date such correction is completed and accepted by the City. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. RECREATION AGREEMENT - 1 - 312017 CITY OF CITY HALL South Federal 'Way Feder l Wh Avenue 8003 Federal Way. WA 98043-6325 .253) 835-7000 �snnv c+fYoliedernlwrry ev+i+ 2.3 Time Documentation and Inspection. Work shall begin immediately upon the effective date of this Agreement. Work shall be subject, at all times, to observation and inspection by and with approval of the City, but the making (or failure or delay in making) such inspection or approval shall not relieve Contractor of responsibility for performance of the Work in accordance with this Agreement, notwithstanding the City's knowledge of defective or non -complying performance, its substantiality or the ease of its discovery. 2.4 Clean Utz. At any time ordered by the City and immediately after completion of the Work, the Contractor shall, at its own expense, clean up and remove all refuse and unused materials of any kind resulting from the Work. In the event the Contractor fails to perform the necessary clean up, the City may, but in no event is it obligated to, perform the necessary clean up and the costs thereof shalt be immediately paid by the Contractor to the City and/or the City may deduct its costs from any remaining payments due to the Contractor. 3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days' written notice at its address set forth on the signature block of this Agreement. The City may terminate this Agreement immediately if the Contractor fails to maintain required insurance policies, breaches confidentiality, or materially violates Section 12 and such may result in ineligibility for further City agreements. 4. COMPENSATION. 4.1 Amount. In return for the Work, the City shall pay the Contractor an amount not to exceed a maximum amount and according to a rate or method as delineated in Exhibit "B," attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for the Term. Except as otherwise provided in Exhibit "B," the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 4.2 Method of Payment. On a monthly basis, the Contractor shall submit a voucher or invoice in the form specified by the City, including a description of what Work have been performed, the name of the personnel performing such Work, and any hourly labor charge rate for such personnel. The Contractor shall also submit a final bill upon completion of all Work. Payment shall be made on a monthly basis by the City only after the Work has been performed and within thirty (30) days after receipt and approval by the appropriate City representative of the voucher or invoice. If the Work does not meet the requirements of this Agreement, the Contractor will correct or modify the work to comply with the Agreement. The City may withhold payment for such work until the work meets the requirements of the Agreement. 4.3 Defective or Unauthorized Work. If any goods, materials, or services provided under this Agreement are either defective, unauthorized, or otherwise do not meet the requirements of this Agreement, the Contractor will correct or modify the work to comply with the Agreement and the City reserves the right to withhold payment from the Contractor until the goods, materials, or services are acceptable to the City. If Contractor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Contractor. RECREATION AGREEMENT - 2 - 3/201 7 CITY OF CITY HALL Federal Wa Feder l Avenue South -! Y Federal Way. "A 98DD3�325 (253)835-7300 mewls• c#Yoffederals•,)_v corm 4.4 Non-AppMpriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the City will not be obligated to make payments for Work or amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Work for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. 4.5 Final Payment: Waiver of Claims. Contractor's acceptance of final payment shall constitute a waiver of any and all claims, except those previously and properly made and identified by Contractor as unsettled at the time request for final payment is made. 5. INDEMNIFICATION. 5.1 Contractor Indemnification. The Contractor agrees to release indemnify, defend, and hold the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives, arising from, resulting from, or in connection with this Agreement or the performance of this Agreement, except for that portion of the claims caused by the City's sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24-115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. Contractor shall ensure that each sub -contractor shall agree to defend and indemnify the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent and on the same terms and conditions as the Contractor pursuant to this paragraph. The City's inspection or acceptance of any of Contractor's work wben completed shall not be grounds to avoid any of these covenants of inderrimfication. 5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Contractor waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the purposes of this indemnification. Contractor's indemnification shall not be limited in any way by any limitation on the amount of damages, compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further acknowledge that they have mutually negotiated this waiver. 5.3 City Indemnification. The City agrees to release, indemnify, defend and hold the Contractor, its officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent solely caused by the negligent acts, errors, or omissions of the City. 5.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement with respect to any event occurring prior to such expiration or termination. 6. INSURANCE. The Contractor agrees to carry insurance for liability which may arise from or in connection with the performance of the services or work by the Contractor, their agents, representatives, RECREATION AGREEMENT - 3 - 3/2017 CITY OF CITY HALL Sih Avenue South 4S Federal Way Feder 8003 Federal Way. WA 98o03-S325 T (253) 835-7000 .tM1YIY ary®11ede+WtV41y Con) employees or subcontractors for the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: 6.1. Minimum Limits_ The Contractor agrees to carry as a minimum, the following insurance, in such forms and with such carriers who have a rating that is satisfactory to the City: a. Commercial general liability insurance covering liability arising from premises, operations, independent contractors, products -completed operations, stop gap liability, personal injury, bodily injury, death, property damage, products liability, advertising injury, and liability assumed under an insured contract with limits no Iess than $1,000,000 for each occurrence and $2,000,000 general aggregate- b. Workers' compensation and employer's liability insurance in amounts sufficient pursuant to the laws of the State of Washington; C. Automobile liability insurance covering all owned, non -owned, hired and leased vehicles with a minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily injury, including personal injury or death, and property damage. 6.2. No Limit of Liability. Contractor's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. The Contractor's insurance coverage shall be primary insurance as respect 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. Additional Insured Verification. The City shall be named as additional insured on all commercial general liability insurance policies. Concurrent with the execution of this Agreement, Contractor shall provide certificates of insurance for all commercial general liability policies attached hereto as Exhibit "C" and incorporated by this reference. At City's request, Contractor shall furnish the City with copies of all insurance policies and with evidence of payment of premiums or fees of such policies. If Contractor's insurance policies are "claims made," Contractor shall be required to maintain tail coverage for a minimum period of three (3) years from the date this Agreement is actually terminated or upon project completion and acceptance by the City. 6.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement. 7. CONFIDENTIALITY. All information regarding the City obtained by Contractor in performance of this Agreement shall be considered confidential subject to applicable laws. Breach of confidentiality by the Contractor may be grounds for immediate termination. All records submitted by the City to the Contractor will be safeguarded by the Contractor. The Contractor will fully cooperate with the City in identifying, assembling, and providing records in case of any public records disclosure request. S. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design specifications, records, files, computer disks, magnetic media or material which may be produced or modified by Contractor while performing the Work shall belong to the City upon delivery. The Contractor shall make such data, documents, and files available to the City and shall deliver all needed or contracted for work product upon the City's request. At the expiration or termination of this Agreement, all originals and copies of any such work product remaining in the possession of Contractor shall be delivered to the City. w 9. BOOKS AND RECORDS. The Contractor agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of the Work and RECREATION AGREEMENT - 4 - 312017 CITY OF CITY HALL Federal Way Feder 8th Avenue South Federal Way. VVA 9$003-6325 (253) 835-7000 :`rMi' C+iJ•Oe?[i@r e 111 Y�1 v coil) maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be subject, at all reasonable times, to inspection, review or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR 1 EMPLOYEE CONDITIONS. 10.1 Independence. The Parties intend that the Contractor shall be an independent contractor and that the Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Contractor sick leave, vacation pay or any other benefit of employment, nor to pay any social security, income, or other tax which may arise as an incident of employment, except as specifically provided in Section 4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment contract. If the Contractor is a sole proprietorship or if this Agreement is with an individual, the Contractor agrees to notify the City and complete any required form if the Contractor retired under a State of Washington retirement system and agrees to indemnify any losses the City may sustain through the Contractor's failure to do so. 10.2 Safety. Contractor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors at the work site and in the performance of the contract work and shall utilize all protection necessary for that purpose. Contractor shall comply with all applicable provisions of federal, state and municipal safety and health laws and codes, including without limitation, all ❑SHAIWISHA requirements, Safety and Health Standards for Construction Work (Chapter 296-155 WAC}, General Safety and Health Standards (Chapter 296-24 WAC), and General Occupational Health Standards (Chapter 296-62 WAC). Contractor shall erect and properly maintain, at all times, all necessary guards, barricades, signals and other safeguards at all unsafe places at or near the site for the protection of its employees and the public, safe passageways at all road crossings, crosswalks, street intersections, post danger signs warning against known or unusual hazards and do all other things necessary to prevent accident or loss of any kind. Contractor shall protect from damage all water, sewer, gas, steam or other pipes or conduits, and all hydrants and all other property that is likely to become displaced or damaged by the performance of the Work. The Contractor shall, at its own expense, secure and maintain a safe storage place for its materials and equipment and is solely responsible for the same 10.3 Risk of Work. All work shall be done at Contractor's own risk, and Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment contract. Even though Contractor is an independent contractor, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion 11. CONFLICT OF INTEREST. It is recognized that Contractor may or will be performing professional services during the Term for other parties; however, such performance of other services shall not conflict with or interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such conflicts of interest in favor of the City. Contractor confirms that Contractor does not have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the Contractor's selection, negotiation, draping, signing, administration, or evaluating the Contractor's performance. RECREATION AGREEMENT - 5 - 312017 �AkCITY OF Federal Way 0 S7, I-1 I 5 C { 13. GENERAL PROVISIONS. CMY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253)835-7000 t��tav CrtVofle[iFre�hY7y corn PLOVER. In all services, programs, activities, hiring, and employment s Agreement or any subcontract, there shall be no discrimination by level, or any of those entities' employees, agents, subcontractors, or use of sex, age (except minimum age and retirement provisions), race, antal status, or the presence of any disability, including sensory, mental Dn a bona fide occupational qualification in relationship to hiring and ,ply to, but not be limited to, the following: employment, advertising, other forms of compensation, and selection for training, including with and shall not violate any of terms of Chapter 49.60 RCW, Title Americans With Disabilities Act, Section 504 of the Rehabilitation Act T any other applicable federal, state, or local law or regulation regarding I3.1 Intemretation and Modification. This Agreement, together with any attached Exhibits, contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of the Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement. Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect. Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. No provision of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly authorized representatives of the Parties. 13.2 Assignment and Beneficiaries. Neither the Contractor nor the City shall have the right to transfer or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non -assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. 13.3 Compliance with Laws. The Contractor shall comply with and perform the Services in accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics Resolution No. 91-54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the City's option. 13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is RECREATION AGREEMENT - 6 - 312017 CITY OF CITY HALL. Federal WayFeder 8th Avenue South Federal Way. WAA9$003 5325 (253) 835-7000 mvw ca wffeaeraflvos. corn essential to the Contractor's performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all other remedies available to the City at law, in equity or by statute. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. Failure or delay of the City to declare any breach or default immediately upon occurrence shall not waive such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law, provided, however, however nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section 5 of this Agreement. 13.5 Execution. Each individual executing this Agreement on behalf of the City and Contractor represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. [Signature page follows] RECREATION AGREEMENT - 7 - 312017 cirr of Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 Ittisai•. C;Wfredere3t�v?t+. cm7i IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: Z►9 Hutton,L ■ i ATTEST: S h ie Courtney, CMC ity Clerk DATE: 611k APPROVED AS TO FORM: �PLJ,.. r O r. J. Ryan Call, City Attorney SOUTH KING COUNTY SOCCER REFEREES ASSOCIATION: By: "/- Richard Meeks, President 12- DATE: 1, �v ! STATE OF WASHINGTON j ss. COUNTY OF ti 3 On this day personally appeared before me Richard Meeks, to me known to be the President of South King County Soccer Referees Association that executed the foregoing instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. GIVEN my hand and official seal this ;dnd day of (DEBORA L.SANDONA NOTARY PUBLIC STATE OF wo�sH�NGTON COMMISSION EXPIRES OCTOBER s, 2018 D e c&w, bar 20L� Notary's signature Notary's printed name D E SO A A 5 A IUDD AJ Notary Public in and for the State of Washington. My commission expires 10 - 3 1 t RECREATION AGREEMENT - 8 - 312017 CITY 4F CITY HALL A%*!Fe ra W+ Feder l Avenue 8003 (7+1 Federal Way. WA 98003-6325 �•� (253) 835-7000 i�m1v c:groffedaral�v?vrpm EXHIBIT "A" RECREATION SERVICES The Contractor shall do or provide the following: Contractor will: 1. Collaborate with the City to identify a USSF certified assignor 2. Allow the selected assignor access to the areas on the Contractor web site necessary to properly assign qualified referees to the league matches and manage all matches 3. Provide payment to the assignor and officials monthly a. For previous months' matches where the City pre -pays b. For all paid invoices that month for City not prepaying 4. The Contractor will keep the assignor apprised as to the status (received or still pending) of all invoices, keeping in mind the guidelines below 5. The Contractor will submit the invoice to the City, with a copy to the assignor, within seven (7) business days of the first of the month 6. Register for business licenses in jurisdictions where the business operates 7. Contractor will meet with Assignor and City to review the fee schedule at least bi-annually 8. Work with the City to promote opportunities for City's players to become Referees and referee games to cover the cost of their club player fees 9. Work with the City's Referee coordinator to recruit, retain and ensure coverage for City's games posted on the Contractor website The Contractor will provide or engage an Assignor who will: l . Provide an email address and phone number to the City and Contractor 2. Post all matches to the Contractor web site within three (3) days of receipt from the City 3. Post all changes to the Contractor web site within 24 hours of receipt from the City 4. Advise the City when all postings are completed 5. Assign qualified referees to all matches under their authority 6. Work to confirm assignments when match changes are posted 7. Attempt to have 1 Da% coverage no later than 24 hours prior to the scheduled match 8. Confirm coverage when match changes are made within 72 hours of the match's originally scheduled date and time 9. Hold the referee crew accountable for their actions, including, but not limited to, following the guidelines under United States Soccer Federation (USSF) Policy 531-10 Misconduct Of Game Officials 10. Follow up with the City the status of all outstanding invoices upon notification from the Contractor treasurer that an invoice is not paid promptly 11. Process all Officials match report comments within 48 hours of being filed. 12. Follow up with officials and ensure all match reports are filed within 48 hours of the match 13. Validate Invoices being sent to City for payment 14- Maintain Assignor Insurance 15. Assignor will meet with City and Contractor to review the fee schedule at least bi-annually The City agrees to the following: i. Provide an email address and phone number of at least two (2) points of contact to the assignor 2. Provide to the Contractor Treasurer an email address, physical address and phone number of the primary point of contact for financial matters RECREATION AGREEMENT .9- 3/2017 ,sSCITY OF ,� Federal Way 3. 4. 5. b. 7. 8. U 10. CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 kannv. cuyoffedRrnlw )y coin Provide the assignor a complete list of all match requirements for the league season no later than 7 days prior to the season start. (It is recommended that City submit no later than 21 days to increase probability for coverage) Provide the assignor any changes to match information, including, but not limited to, team changes, date changes, time changes, field changes and/or referee requirements within 24 hours of becoming aware of the changes Agree to pay the full match fee for any matches cancelled the day of the match Agree to pay the full match fee for any match where the referee is present but the match has been moved, changed or cancelled without notice to the assignor Acknowledge receipt of the invoice within 2 days if submitted electronically Hold all personnel accountable for any actions taken against the referee crew under the guidelines under USSF Policy 531-9 Misconduct Toward Game Officials plus any applicable league, association and/or state guidelines Validate match detail within 3 days of receipt and notify the Contractor Treasurer and assignor of any conflicts in the invoice. The disputed amount (and only the disputed amount) is exempt from the time line for payment of the invoice City will meet with Assignor and Contractor to review the fee schedule at least bi-annually Work with Contractor to promote opportunities for City players to become Referees and referee games to cover the cost of their club player fees Provide Contractor the City's Referee coordinator contact information RECREATION AGREEMENT - 1 tI - 3/2017 Crzr OF CITY HALL Federal Wa Feder Sth Avenue South Federal Way. WA 98003-66325 ..f (253 P 835-7000 alm..:1fV-0#P1er,7rWny coin EXHIBIT "B" COMPENSATION 1. Total Compensation: In return for the Services, the City shalt pay the Contractor a total amount not to exceed Thirty -Eight Thousand and NOI100 Dollars ($38,000.00) based on the following fees for service. 2. Method of Compensation: a. A "Match Fee" will be paid for each game played. The Match Fee is an inclusive rate and is comprised of the Official fee ($65.00), Assignor fee (10%), and Administration fee (5%). c. The total Match fee will be Seventy -Four and 75/100 Dollars ($74.75). RECREATION AGREEMENT - 11 - 312017 AC. �0, DATE (MWDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12127/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Leanne Pearson NAME: McDonald Insurance Group, Inc. PHONE Ed)• (425)827-7400 Fax Ro:(425)027-T402 PO Box 3089 ADDRIESS:leanne@modonaldins.com 620 Kirkland Way, Ste 100 INSURE S AFFORDING COVERAGE NAIC4 Kirkland WA 9OD83-3089 INSURERA:Great American Assurance Co 26344 INSURED INSURER B - South King County Soccer Referees Association SURERC PO Box 2291 �uIN!.M n. Renton WA 98055 1 INSURER F: 1"fI�/GRAC_GC r`PPTIGIr'ATP All IRARF-P-1 711 R C_T. RFVISI nN NI IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN_ MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUOR .,_ POLICY EFF POLICY EXP LTR POLICY NUMBER MID LIMITS TYPE OF INSURANCE % I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE I X7 OCCUR PREMISES fpEms"WNXIiatmuffmal $ 100,000 MEDEXP(A one person) S 5,000 7L PAC0484825 5/15/2017 5/15/2018 PERSONAL BADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY ❑ jE O- LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED NGLETMir— Ea aoDdent I S BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Perawdent) S ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per amdenl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAB CLAIMS -MADE DEO ! . RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIARILITY YIN ANY PROPRiETORIPARTNERIEXECUnVE TH" STATUT ER E.L. EACH ACCIDENT $ OFFICERNEMBER EXCLUDED? F-11NIA (Mandatory in NH) - E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ R rs, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 7 LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an Additional Insured for General Liability coverage as required by written contract or written agreement per Form CG8970, attached. CERTIFICATE HOLDER CANCELLATION City of Federal Cady Geddes 876 S 333rd ST Federal Way, WA 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 98003- 632 5 I AUTHORIZED REPRESENTATIVE Keith Bean-NPILEANNE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101 ) The ACORD name and Iogo are registered marks of ACORD INSD2r, •^r•nr• , C S1*04/11/17'PAC0484825-04 795991809 'DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO CG 89 70 (Ed. 11/14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SIGNATURE GENERAL LIABILITY BROADENING ENDORSEMENT This Endorsement modifies and is subject to the insurance provided under the fallowing form: COMMERCIAL GENERAL LIABILITY COVERAGE PART The fallowing extension only applies in the event that n❑ other specific coverage for the indicated loss exposure is provided under this Policy. If other specific coverage applies, the terms, conditions and limits of that Coverage are the exclusive coverage applicable under this Policy, unless otherwise noted in this Endorsement. This is a summary of the various additional coverages and coverage modifications provided by this Endorsement. For complete details on specific coverages, consult the actual policy wording. Coverage Description Limit of Insurance Page Non -Owned Aircraft Included 2 Non -Owned Watercraft Included 2 Bodily Injury - Mental Injury, Mental Anguish, Humiliation ❑r Shock Included 3 Medical Payments $ 20,000 3 ❑amage to Premises Rented to You $ 1,000,000 3 Supplementary Payments - Bail Bonds $ 3,000 4 Supplementary Payments - Loss ❑f Earnings $ 1 ,000 per day 4 Newly Formed or Acquired Organizations Included 4 Unintentional Failure to Disclose Hazards Included 5 Knowledge of ❑ccurrence, Claim or Suit Included 5 Property Damage Liability - Elevators Included 5 Property Damage Liability - Borrowed Equipment Included 5 Liberalization Clause Included 6 Amendment of Pollution Exclusion (Premises) Included 6 Limited Property Damage to Property of Others $ 5,000 6 Additional Insured - Manager or Lessor of Premises Included 7 CG 89 70 (Ed. 11114) (Page 1 of 12) C S1*04/11/17'PAC0484825-04 795991809 'DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO Coverage Description Limit of Insurance Page Additional Insured - Funding Sources Included 7 Additional Insured - By Contract Included 8 Primary and Non -Contributory Additional Insured Extension Included 10 Additional Insureds - Protection of Your Limits Included 10 Blanket Waiver of Transfer of Rights ❑f Recovery Against Others to Us (Subrogation) Included 11 Property Damage Extension With Voluntary Payments $ 1,0001$ 5,000 11 Wh❑ Is An Insured - Fellow Employee Extension - Management Employees Included 12 Broadened Personal and Advertising Injury Included 12 A. Non -Owned Aircraft Under paragraph 2. Exclusions of SECTION i - COVERAGE A - Bodily Injury and Property Damage Liability, exclusion g. Aircraft, Auto or Watercraft does not apply to an aircraft provided: 1. it is not owned by any insured; 2. it is hired, chartered ❑r loaned with a trained paid crew; 3. the pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating him or her a commercial ❑r airline pilot; and 4. it is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this Policy), contingent or ❑n any ❑ther basis, that would also apply to the loss covered under this provision. B. Non -Owned Watercraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (2) of exclusion g- Aircraft, Auto or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) less than 60 feet long; and CG 89 70 (Ed. 11114) (Page 2 of 12) C S1*04/11/17*PAC0484825-04 795991809 'DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO [b] not being used t❑ carry persons or property for a charge. C. Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Under SECTION V - DEFINITIONS, ❑efinition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness, or disease, including death of a person. "Bodily Injury" also means mental injury, mental anguish, humiliation, or shock if directly resulting from physical injury, sickness, or disease to that person. D. Medical Payments If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this Policy are amended as follows: The Medical Expense Limit in paragraph 7. of SECTION III - LIMITS ❑F INSURANCE is replaced by the following Medical expense Limit: The Medical Expense Limit provided by this Policy shall be the greater ❑f: a. $ 20,000; or b. the amount shown in the Declarations for Medical Expense Limit This provision 7. is subject to all the terms of SECTION III - LIMITS OF INSURANCE. E. Damage to Premises Rented to You If Damage to Premises Rented to You is not otherwise excluded from this Coverage Part: 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: 3. The last paragraph of paragraph 2. Exclusions is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. However, this insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, caused by: I. rupture, bursting, or operation of pressure relief devices; li. rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by ❑r resulting from water; ill. explosion of steam boilers, steam pipes, steam engines, or steam turbines; or iv. flood 2. Paragraph 6. Under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: CG 89 70 (Ed. 11114) (Page 3 of 12) C S 1 *04/1 1 /1 7'PAC0484825-04 795991 809 * D/B ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO 6. Subject to paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection system or water while rented to you or temporarily occupied by you with the permission of the owner, for all such damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water or any combination of the six, is the higher of $ 1,000,000 or the amount shown in the Declarations for the Damage to Premises Rented to You Limit. 3. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, subsection 4. Other Insurance, paragraph b. Excess Insurance where the words "Fire insurance" appear they are changed to "insurance for fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water." 4. As regards coverage provided by this provision I. Damage to Premises Rented to You - paragraph 9.a. of Definitions is replaced with the following: 9. a. a contract for a lease of premises. However, that portion ❑f the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract'; F. Supplementary Payments 1. In the Supplementary Payments - Coverages A and B provision, paragraph i.b. is replaced with: b. Up to $ 3,000 for the cost of bail fonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $ 1,000 a day because of time off work. G. Newly Formed or Acquired organizations Paragraph 3. of SECTION II - WHO IS AN INSURED is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a named insured if there is no other similar insurance available to that organization. However: a. coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired ❑r formed by you; b. coverage A does not apply to "bodily injury" or property damage that occurred before you acquired or formed the organization; and c. coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. CG 89 70 (Ed. 11114) (Page 4 of 12) C S1*04/11117'PAC0484825-04 795991809 'DIB ❑RIG IMAGE COPY ❑178116 GREAT AMERICAN ASSURANCE CO d. records and descriptions of operations must be maintained by the first named insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture ❑r limited liability company that is not shown as a named insured in the Declarations or qualifies as an insured under this provision. H. Unintentional Failure to Disclose Hazards Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 6. Representations: Failure of the Insured to disclose all hazards existing as of the inception date of this Policy shall not prejudice the insurance with respect to the coverage afforded by this Policy, provided such failure or omission is not intentional ❑n the part of the Insured. I. Knowledge of occurrence, Claim or Suit Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Knowledge of any occurrence, claim, or suit by any agent, servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such injury, claim or suit shall have been received by: a. you, if you are an individual; b. a partner, if you are a partnership c. an executive officer or insurance manager, if you are a corporation. J. Property Damage Liability - Elevators 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraphs (3), (4) and (6) of exclusion j. Damage to Property do not apply if such property damage results from the use of elevators. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. K. Property Damage Liability - Borrowed Equipment 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (4) of exclusion j. Damage to Property does not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY Conditions, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. CG 89 70 (Ed. 11114) (Page 5 of 12) C S1 `04111117'PAC0484825-04 795991809 `DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO L. Liberalization Clause If we revise this Signature General Liability Broadening Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the date the revision is effective in your state. M. Amendment of Pollution Exclusion (Premises) 1. The following is added to paragraph (1Xa) of Exclusion f. of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: (iv) "Bodily injury" or "property damage" arising out of the actual discharge, dispersal, seepage, migration, release or escape of "pollutants." As used in this Endorsement, the actual discharge, dispersal, seepage, migration, release or escape of pollutants must: (aa) commence on a clearly identifiable day during the policy period; and (bb) end, in its entirety, within seventy-two (72) hours of the commencement ❑f the discharge, dispersal, seepage, migration, release ❑r escape of "pollutants"; and (cc) be discovered and reported to us within fifteen (15) days of the clearly identifiable day that the discharge, dispersal, seepage, migration, release ❑r escape of "pollutants" commences; and (dd) be neither expected nor intended from the standpoint of any insured; and (ee) be unrelated to any previous discharge, dispersal, seepage, migration, release or escape; and (ff) not originate at or from a storage tank or other container, duct or piping which: a. is below the surface of the ground or water; or b. at any time has been buried under the surface of the ground or water and then is subsequently exposed. 2. For the purposes of this coverage, the following is added to the definition of "property damage" of SECTION V - DEFINITIONS and applies ❑nly as respects this coverage: Land or water, whether below ground level or not, is not tangible property. 3. Coverage provided hereunder does not apply to any discharge, dispersal, seepage, migration, release or escape that is merely threatened or alleged rather than shown to have actually occurred. N. Limited Property Damage to Property of Others The following is added under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A and B: 3. We will pay up to $ 5,000 for loss to personal property of others while in the temporary care, custody ❑r control of an insured caused by any person participating in your organized activities. For the purpose of this supplementary payment, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event ❑f a theft, a police report must be filed. This supplementary payment does not apply if: a. coverage is otherwise provided by the Property Coverage part (if any) of this Policy; or CG 89 70 (Ed. 11114) (Page 6 of 12) C S1 *04/11 /17'PAC0484825-04 795991809 'DIB ORIG IMAGE COPY 017811E GREAT AMERICAN ASSURANCE CO b. the loss is covered by any other insurance you have or by any insurance of such person who causes such loss. These payments will not reduce the Limits of Insurance. O. Additional Insured - Manager or Lessor of Premises 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an additional insured on this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an additional insured has been issued; but the written or oral contract or agreement must be an "insured contract," and, (1) currently in effect or become effective during the term of this Policy; and (i1) executed prior to the "bodily injury," "property damage," "personal and advertising injury." 2. With respect to the insurance afforded to the Additional Insured identified in paragraph 1. above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the Additional Insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (e) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to. (a) Any "occurrence" or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Insured. P. Additional Insured - Funding Sources 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding Source as an additional insured but only with respect to liability arising out of: CG 89 70 (Ed. 11114) (Page 7 of 12) C S1 *04/11117'PAC0484825-04 795991809 "❑IB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of "your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract ❑r agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the Additional Insured only applies t❑ the extent permitted by law c. If coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement t❑ provide for such additional insured. d. In no event shall the coverages or Limits ❑f Insurance in this Coverage Form be increased by such contract. 0. Additional Insureds - By Contract 1. SECTION it - WH❑ IS AN INSURED is amended to include as an insured any person or organization whom you have agreed t❑ add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of: a. your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the Additional Insured that are subject of the written contract or written agreement provided that the "bodily injury" or "property damage ❑ccurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. the maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. the Additional Insureds financial control of you; or d. operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by contract or agreement, the insurance afforded t❑ such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status as an additional insured under this Endorsement ends when: CG 89 70 (Ed. 11114) (Page 8 of 12) C S1 `0411111 7`PAC0484825-04 795991809 `DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) t❑ be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to paragraph 1.b. above, this insurance does not apply t❑ any "occurrence" which takes place after the equipment rental or lease agreement has expired ❑r you have returned such equipment to the lessor. The insurance provided by this Endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage." We have no duty t❑ defend an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured as required in paragraph b. of Condition 2. Duties in the Event of Occurrence, ❑ffense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITION. 2. With respect to the insurance provided by this Endorsement, the following are added to paragraph 2. Exclusions under SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) the preparing, approving, or failing to prepare ❑r approve, maps, shop drawings, ❑pinions, reports, surveys, field ❑rders, change orders or drawings and specifications; or (2) supervisory, inspection, architectural or engineering activities. 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 damage," or the ❑ffense which caused the "personal and advertising injury," involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. c "Bodily injury" or "property damage" occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 89 70 (Ed. 11114) (Page 9 of 12) C S1 *04/11117'PAC0484825-04 795991809 *D/13 ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO d. Any person or organization specifically designated as an additional insured for ongoing operations by a separate additional insured endorsement issued by us and made part of this Policy. 3. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided t❑ the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount ❑f insurance: a. required by the contract or agreement; or b. available under the applicable Limits of Insurance shown in the ❑eclarations; whichever is less. This Endorsement shall not increase the applicable Limits ❑f Insurance shown in the ❑eclarations. R. Primary and Non -Contributory Additional Insured Extension This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to paragraph a. Primary Insurance: This insurance is primary to and will not seek contribution from any other insurance available t❑ an additional insured under your policy provided that: (1) the Additional Insured is a named insured under such other insurance; and (2) you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. b. The following is added to paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract ❑r agreement, an equipment rental or lease contract or agreement or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the Additional Insured is designated as a named insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the Additional Insured has been added as an additional insured on other policies. S. Additional Insureds - Protection of Your Limits This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: An additional insured under this Endorsement will as soon as practicable: CG 89 70 (Ed. 11114) (Page 10 of 12) C S1*04/11/17*PAC 0484825-04 795991809 'DIB ORIG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO a. give written notice of an "occurrence" ❑r an offense that may result in a claim or "suit" under this insurance to us; b. tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the Additional Insured; and c. agree to make available any other insurance which the Additional Insured has for a loss we cover under this Coverage Part. d. we have no duty to defend or indemnify an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured. 2. The Limits of Insurance applicable to the Additional Insured are those specified in a written contract or written agreement ❑r the Limits of Insurance stated in the Declarations of this Policy and defined in SECTION III - LIMITS OF INSURANCE of this Policy, whichever are less. These limits are inclusive of and not in addition to the Limits of Insurance available under this Policy. T. Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Linder SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition S. Transfer of Rights of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising ❑ut of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products -completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. U. Property Damage Extension with Voluntary Payments 1. The following is added to paragraph 1. Insuring Agreement of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: At your request we will pay for "loss" to property of others caused by your business operations for which this Policy provides liability insurance. Such payment will be made without regard to your legal obligation to d❑ so. The "loss" must occur during the policy period and must take place in the "coverage territory." 2. With respect t❑ the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of SECTION I - COVERAGES A - Bodily Injury and Property Damage Liability is amended as follows: Exclusions j.(3), j.(4), j.(5) and 1.(6) are deleted. 3. As respects coverage afforded by this coverage, SECTION III - LIMITS OF INSURANCE is replaced by the following: Regardless of the number of insureds, claims made or "suits" brought or persons or organizations making claims or bring "suits": 1. Subject to 2. Below, the most we will pay for one or more "loss" arising out of any one "occurrence" is $ 1,000. 2. The aggregate amount we will pay for the sum of all "loss" in an annual period is $ 5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described in paragraph 2. ❑f SECTION III - LIMITS OF INSURANCE. CG 89 70 (Ed. 11114) (Page 11 of 12) C S1"04/11/17*PACO484825-04 795991809 "13113 ORiG IMAGE COPY 0178116 GREAT AMERICAN ASSURANCE CO V. Who Is an Insured - Fellow Employee Extension - Management Employees 1. The following is added to paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, including the direct supervision of other "employee" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury," caused in whole or in part by their intoxication by liquor or controlled substances. This coverage is excess over any other valid and collectable insurance available to your "employee." W. Broadened Personal and Advertising Injury 1. Unless "Personal and Advertising Injury" is excluded from this Policy, the following is added to SECTION V - DEFINITIONS Item 14.: h. mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.a. through 14.e. CG 89 70 (Ed. 11114) (Page 12 of 12) McDonald Insurance Group, Inc. P.0 Box 3089 Kirkland, OVA 98033 Applicable to ACORD 25 - Certificate of Liability This certificate of liability insurance does not necessarily imply that primary coverage or other additional insured requirements are provided for the additional insured(s) unless an endorsement is attached specifying these coverages. This certificate does not necessarily comply with all contract requirements between the named insured and the additional insured(s). All involved parties should have their attorney review the policy for actual coverage and compliance with their written agreement or contract. Applicable to ACORD 25, 27, 28, and 24 This certificate is the "latest" ACORD 25 (January 2014) Certificate of Liability Insurance, or ACORD 27 (December, 2009) Evidence of Property Insurance or ACORD 28 (December 2009) Evidence of Commercial Property Insurance or ACORD 24 (September 2009) Certificate of Property Insurance . In order to issue certificates from our agency, these revisions listed above must be used. If you previously received an ACORD 25, 27, 28 or 24 with an earlier revision date, there are notable changes between the forms. Please note the following significant characteristics of the new ACORD forms. ❖ The cancellation clause refers back to the policy terms. ❖ The ACORD form is copyrighted. Permission to alter it is not available. ❖ As Insurance Agents we receive authority from the insurance carriers that we represent to issue certificates. Carriers do not authorize us to include special language or alter the form even without the copyright concerns. The carriers also do not authorize us to complete special coverage forms provided by the certificate holder. McDonald Insurance Group, Inc — Po Box 3089 Kirkland, WA 98083