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AG 23-087 - I'M HOOKED, INC.RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: FWCC 2. ORIGINATING STAFF PERSON: Trisha Plucknett EXT: 6921 3. DATE REQ. B 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#):. ❑ INTERLOCAL © OTHER MOU 5. PROJECT NAME: Memorandum of Understanding - City of Federal Way and I'm Hooked Inc. 6. NAME OF CONTRACTOR: I'm Hooked, Inc. ADDRESS: 3564 NE 26TH AVE, PORTLAND OR TELEPHONE E-MAIL: FAX: SIGNATURE NAME: TITLE 7. EXHIBITS AND ATTACHMENTS: LIP SCOPE, WORK OR SERVICES N COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: upon execution COMPLETION DATE: May 31, 2023 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 9 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ®YES ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ❑ PROJECT MANAGER CS 02/15/23 ❑ DIRECTOR �� a ❑ RISK MANAGEMENT (IF APPLICABLE) vJE LAW 2122/23 JE 3116123 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION 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 council approval is needed.) INITIAL / DATE SIGNED WLAW DEPARTMENT Z ❑ SIGNATORY (MAYOR OR DIRECTOR) p ❑ CITY CLERK ❑ ASSIGNED AG# AG# - O COMMENTS: Can you please review the attached MOU? We are partnering with I'm Hooked this year instead of having a separate fishing derby put on by the Recreation Department. JE 2/2H23 - There are lots of questions and clarifiers in the document. Please feel free to let us know if you have questions or send it back through for another review once adjusted. 2/2017 Memorandum of Understanding City of Federal Way and I'm Hooked, Inc. THIS MEMORANDUM OF UNDERSTANDING (MOU), date effective upon mutual execution by all parties, defines the respective responsibilities of the City of Federal Way, Washington ("City"), I'm Hooked, Inc., an Oregon non-profit corporation in regards to the I'm Hooked Family Fishing Experience planned for Saturday, May 6, 2023. Background: For the past three years, the Oregon -based nonprofit I'm Hooked, Inc. has partnered with local agencies and individuals in Federal Way to support a family fishing activity. The City generally also holds a separate fishing event each year. To maximize impact and opportunity for Federal Way residents, the City and I'm Hooked plan to join together for a single larger event in 2023. Planned Event: The I'm Hooked Family Fishing Experience is scheduled for Saturday, May 6, 2023 from 7:00 a.m. to 2:00 p.m. The event will be held rain or shine at Steel Lake Park, located at 2410 S. 312th St. in Federal Way, Washington. The event is recommended for children ages 6 and up and youth are free. Participants 15 years old and up must have a valid fishing license to participate. I'm Hooked provides life vests, rods and reels, bait and tackles, bags, and ice. Attendees should wear weather -appropriate clothing, sturdy shoes, and a hat, and bring a cooler to store fish. Lifeguards will not be present at this event. Participants will only be fishing from the shoreline during the event. NOW, THEREFORE, the parties agree as follows: I. City Responsibilities. The City agrees to provide the following: • City shall waive Steel Lake Park rental fee for I'm Hooked; • Federal Way Parks Activity Booth for the event; • Surface Water Public Education Booth for the event; • City will advertise the event via the Recreation Catalog and City Social Media pages; • City will provide Parks support in notifying the public; • of the event via signage a couple weeks in advance of event and closing the dock the night before the event. City will advertise the event via the Recreation Catalog and City Social Media pages; • City will provide trash receptacles. II. I'm Ilooked, Inc. Responsibilities. I'm Hooked agrees to the following: • Coordination of Family Outdoor Fishing Experience on May 6h, 2023; • Partner with Department of Fish and Wildlife to supply fish for the event the day before; • Provide staffing and volunteers to sufficiently run fishing and other activities; • Process FREE registration online through Imhooked.org; • Provide rods and reels, bait and tackle, bags and ice; ■ Personal floatation device PFD Lifejackets and basic water safety to be provided by I'm Hooked; • Provide completed City Special Event Permit Application. [Signature page follows] IN WITNESS, the Parties execute this MOU below, effective the last date written below. CITY OF FEDERAL WAY: John Hatt , arks Dif czar DATE: ( 36 I'M HOOKED, INC.: By: Printed Name: va,, Nae vJ Title: "�, C►�d DATE: 3 t 2.0 1� STATE OF OREGON ) )Ss. COUNTY OF Lu )Anr ) ATTEST: A AAA Aa/f lay/F , (�W" y Ocrk, Stepbanic Courtlicu CMC APPROVED AS TO FORM: .1. Rya Call, City.A I�tomey On this day personally appeared before meD. l>L7Q+fT.V1 _ , to me known to be the d"A C E of I`M �4 ) EA 1►4(-- 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 aflimed, if any, is the corporate seal of said corporation. GIVEN my hand and official seal this2 rat tQ day of _ "Cir&, 202-'� Notary's signature y- OFFICIAL STAMP Notary's printed n CAMRYN DEANN OSBORNE Now u6l is in and for the State of Ore on. NOTARY PUBLIC OREGON �' g COMMISSION N0.10175a1 My commission c�}�ircfi �{pbtr 2�l 2.ms MY COMMISSION EXPIRES OCT013 24, 2025 CIWOF , �- SPECIAL EVENT PERMIT Federal Way Name of Organization (Applicant): IM HOOi{ED !NG Main contact: Wilbert Warren t liter ►.tu Address: 3300 NW 185th AVE City: Portland State: Oregon Zip: 97229 Phone: 503-453-0521 Email address: wiOmhookedinc.oEg Park/Area requested: Picnic #1, Beach House - front patio space. Swimming.area Requested date: Ma '6th 2023 Arrival time including set-up: 6:30 AM Departure time including take -down: 4:00 PM Expected attendance: 230 Type of activity planned:, Youth and Families Fishing and other Outdoor Recreational Acitivities What type of equipment will be used?: Fishing Rods Reels, L'de Vests, Angler Education Equipment, Musical Drums, Art Material Cooking Equip ment Services requested of City (additional tables, trash bins, electricity, etc.): N/A Will admission be charged?: No If yes, how much?: Is this event, or any part thereof, revenue generating? If so, describe fully: N/A The above named organization (Applicant), hereby requests the use of the above described park area and/or outdoor facility and agrees to abide by City Park Regulations and all other applicable laws or rules relating to park area/outdoor facility use. Applicant agrees to keep the area in a clean and orderly condition, and assumes responsibility for any damages incurred by Applicant's activities. In consideration of the City authorizing Applicant's use of the described facility/park area, Applicant agrees to indemnify and hold the City, its elected officials, officers, employees, agents, and volunteers harmless from any and all claims, demands, losses, actions and liabilities (including costs and all attorney fees) to or by any and all persons or entities including without limitation, their respective agents, licenses, or representative, and event participants, arising from, resulting from or connected with .applicant's use of the faciliiylpark area_ I also understand that the City of Federal Way reserves the right to change or cancel any part of this use agreement as related to the scheduled activity. Additional information may be required before permit approval is granted. **COVID RISK** I acknowledge that use of City facilities may result in exposure to COVID-19 (novel coronavirus) and other contagious diseases and that the risk of exposure cannot be entirely eliminated for me, my organization, and event participants. I agree to abide by, and require event participants to abide by, all applicable public health guidelines to reduce the risk of COVID exposure. please review the Special Event Application Procedure, Rates, General Information, and the Park Reservation Guidelines. Authorized Agent's Signature: Date: 3/10/2023 � o OFFICE USE ONLY v u • --7m Rental # 1 o ■ Total Price 2° � a • FWCC: Date: • Parks Maintenance: Date: d� o ° • 2 ❑ Parks Director: Date: ° • 9 logo 006*000 00099*0000900000*o on 2/21/23, 11:43AM New Search Business Registry Business Name Search Business Registry Business Name Search Business Entity Data 02-211:433 Registry Nbr Entity_ Entity_ Jurisdiction Registry Date Next Renewal Date Renewal Due? �Pe Status 634766-92 DNP ACT OREGON 10-02-2009 10-02-2023 Entity Name VM HOOKED INC. Foreign Name Non Profit PUBLIC BENEFIT Type New Search Associated Names Please click here, for general inforination about registered agerzts and service afPr acess. 08-2 1- Type AGT REGISTERED AGENT Start Date 08-2 Resign Date Name IWILBERT ID WARREN Ar 2ddr 1 .3564 NE 26TH AVE Add CSZ PORTLAND OR 97212 Country UNITED STATES OF AMERICA Type MAL MAILING ADDRESS Addr i .3564 NE 26TH AVE Addr 2 PORTLAND OR 97212 CSZ Type 1PRE PRESIDENT Name JDONNA 11 Addr i 3564 NE 26TII AVE Addr 2 PORTLAND OR 97212 CSZ Type SEC ISECRETARY Name HERRELL 1 Addr i f11OBOX55442 Addr 2 PORTLAND JOR 197238 CSZ �SLII~; WARDS -EL Country JUNITED STATES OF AMERICA Resign Date Country JUNITED STATES OF AMERICA Resign Date Country JiUNITED STATES OF AMERICA https://egov.sos.state.or.us/brlpkg_web_name_srch_inq.show_deti?p_be_rsn=1416l27&p_srce=BR_INQ&p_print=TRUE 1/2 2/21/23, 11:43AM New Scarch M HOOKED INC. L Business Registry Business Name Search Name History Business Entity Name Please read before ordering Copies. Name j Name ! Start Date I End Date EN I CUR 1 10-02-2009 New Search Summary History Image Action 'Transaction Effective Status Name/Agent Dissolved By Change Available Date Date AMENDED ANNUAL 08-31-2022 FI REPORT MENDED ANNUAL 09-02-2021 FI PORT AMENDED ANNUAL 08-21-2020 FI Agent REPORT REINSTATEMENT 12-31-2019 FI MENDED ADMINISTRATIVE 11-27-2019 SYS DISSOLUTION AMENDED ANNUAL 08-25-2018 FI REPORT AMENDED ANNUAL 08-27-2017 FI REPORT AMENDED ANNUAL 09-25-2016 FI REPORT ENDED ANNUAL 09-26-2015 FI REPORT AMENDED ANNUAL 09-30-2014 FI REPORT MENDED ANNUAL 09-07-2013 FI REPORT = RESTATED ARTICLES 10-12-2012 FI AMENDED ANNUAL 10-12-2012 FI REPORT aMNDMT TO ANNUAL 05-15-2012 FI RPT/INFO STATEMENT ANNUAL REPORT 08-23-2011 FI AMENDED ANNUAL 10-07-2010 FI - REPORT TICLES OF 10-02-2009 FI Agent INCORPORATION © 2023 Oregon Secretary of State. All Rights Reserved. https:l/egov.sos.state.or.us/brlpkg_web_name_srch_inq.show_detl?p be_rsn=1416127&p_srce=BR_INQ&p_print=TRUE 2/2 AC R" CERTIFICATE OF LIABILITY INSURANCE DATE9/7/2 DIYYYY) mzo2z 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 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 certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Kim Hutchinson NAME! JD Fulwiler & Co., Insurance PHONE 503-977-585t3 FAX o 5Q3 977-5850 5727 S Macadam Ave I: �.— 6 6-Iu1AlL ktg!ghlnsan dfutwiler.com Portland OR 97239 Ems-.___._.-...�� -- INSURED I'm Hooked Inc. 3300 NW 185th #333 Portland OR 97229 IM INSURERS AFFORDING COVERAGE I NAICN _ INSURER A: Great American Insurance Co 16690 INSURERS : Alliance of NonProfts for Ins INSURER C INSURER E : ^MmvlchA A TQ &4"Amm=n.'0'nnA(%-2A RFlll Clr]N AIIIMFIFl7• 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. 4j `�._D➢L St1HR POLICY OLICY P TYPE OF INSURANCE I pOIJCY NUMBER MNUO mr DmYY LIMITS A X I COMMERCIAL GENERAL LIABILITY Y 202269422 9/9/2022 9/9/2023 EACH OCCURRENCE $1,000,000 CLAIMS -MADE .� OCCUR p7SAMI$E d14oAL� R�MkSES IEBt�,cW!•BnCe $100,000 fTiABUSE-SEE MED EXP (Any one Person) _ _. S 5,FYD0 BELOW PERSONALLADVINJURY I S11.000,000 �GENERALAGGREGATE I AGGREGATE LIMIT APPLIES PER: 62,000.000 GE_N'L i %( POLICY L—JERCTT f _ J LOC ` V 1 jI ` PRODUCTS • COMPIOP AGG I $2,000,000 _ OTHER: V f LIQUORLIABILITY $1,000,000 B AUTOMOBILE LIABILITY Y 202269422 9/9/2022 9/9/2023 1 0 4 Cti}S NWE UNIT E 1,00G,000 BODILY INJURY (Per person) s ANY AUTO OWNED BODILY INJURY (Per accidenS() AUTOS ONLYN.SCHEDULED AUTOS HIRED NON -OWNED AUTOS ONLYAUTOS ONLY y �4-- �F s I1 i S B X UMBRELLA ' X I 9/9/2022 9/912023 EACH OCCURRENCE S1.000.000 OCCUR I 12022-69422-UMB EXCESS LIAB CLAIMS -MACE 1 I ! AGGREGATE $1.000000 - - `1j DED I RFTENTIO1,15 I IIII"-�- s WORKERS COMPENSATION ! S A7UTE ER' AND EMPLOYERS' LIABILITY Y / N , ANYPROPRIETORIPARTNERIEXECUTIVE E L EACH ACCIDENT_ $ -_ E.L DISEASE - EA EMPLOYEE OFFICERIMEM BER EXCLUDED? a I N I A (Mandatory In NH) 5 ' E.L DISEASE -POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is reyulred) `Improper Sexual Conduct and Physical Abuse Coverage included in General Liability; Each Claim Limit: $1,000,000 Aggregate Limit $2,000,000 re: Event May 7, 2022 City of Federal Way, its officers, agents and employees are included as Additional Insureds as respects operations of the Named Insured subject to policy terms, condltlans, and exclusions per attached form CG 20 26. CFRTIFICATF Hni.nFR CANCELLATION City of Federal Way 33325 8th Ave S Federal Way WA 98003 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1tt5tf-ZU10 AL:UKU GUKNUKA I IUrv, Ali rignts reserveu, ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD