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AG 12-057RETURN TO: jr EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIv: PROS / 2. ORIGINATING STAFF PERSON: k i M �}fjit%�_ SVl a f 1W \ EXT: - (` -ct Z Z 3. DATE REQ. BY: 2 ^ l s� " 3 4. TYPE OF DOCUMENT (CHECK ONE): J ❑ 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 5. PROJECT NAME:_ Pee ,scn GU T(a i n i (10j ser v l Ce 3 6. NAME OF CONTRACTOR: I e I Ls be-ns G� ADDRESS: 02 3 W 3L TELEPHONE: Z��Sbf-`iS7„ol E -MAIL: CLan i e I el; Lf,n FAX: SIGNATURE NAME: 'TITLE: U.Ao e-r- 7. EXHIBITS AND ATTACHMENTS: C SCOPE, WORK OR SERVICES COMPENSATION OC INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES [ O PRIOR CONTRACT /AMENDMENTS CFW LICENSE #-10 "12-1011 40' QQBL, EXP. Y12L /31/ 13 UBI # !o03 I QS- = , EXP. 8. TERM: COMMENCEMENT DATE: r>� I / i 2— COMPLETION DATE: 1 Goo ` 4, &Q13 9. TOTAL COMPENSATION: $ I 1 , C7�J _ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ld NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES XNO IF YES, $ PAID BY' ❑ CONTRACTOR ❑ CITY ,a PURCHASING: PLEASE CHARGE TO: 1 I I 1 a-OU ' j'�;- /- 5l S _ �- l - Ll 10 10. DOCUME / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL /DATE APPROVED ROJECT MANAGER s i 1 olS 1 SUPERVISOR WIJ Z 0� DIRECTOR } \ ❑ RISK MANAGEMENT (IF APPLICABLE) LAw DEPT p I - • (3 bly 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT' REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL/ DATE SIGNED ❑ LAW DEPT 1 ❑ SIGNATORY AYO OR DIRECTOR) • CITY CLE I • fA • k • ASSIGNED AG# AG# 65:7 Fr • SIGNED COPY RETURNED DATE SENT: ❑ RETURN ONE ORIGINAL w 1 repeu�e d s tre bus . I L UtkSes a.� v� �fbUf W) C t kA Ivs 66 o 1 InS, )rte A <s neoc u-N 1 11/9 CITY Of CITY HALL 33325 '*..,., Federal Way Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cityoffederahvay.com AMENDMENT NO. 1 TO RECREATION AGREEMENT FOR PERSONAL TRAINING SERVICES This Amendment ( "Amendment No. 1") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Daniel Esbenshade, DBA Complete Body and Mind, a sole proprietor ( "Contractor "). The City and Contractor (together "Parties "), for valuable consideration and by mutual consent of the parties, agree to amend the original Agreement for Personal Training Services ( "Agreement ") dated effective May 1, 2012: 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 January 1, 2016 ( "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, is 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] AMENDMENT - 1 - 1/2010 CITY OF CITY HALL Federal Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY LE Jim F DATE: °f DANIEL ESBENSHADE By: 1� Printed Name: ! /4a *y -e i 4�Qoeklp 4C-1 Title: atN 0 t v DATE: 2 / 2-'7 / i --/ STATE OF WASHINGTON ) ss. COUNTY OF ) ATTEST: O-aAA Mo 0 City Clerk, Carol McNeill , C C AP ROVED AS FORM: ity Atto , Patricia A Richardson On this day personally appeared before me, Daniel Esbenshade, to me known to be the individual described in and who executed the foregoing instrument, and on oath swore that he /she /they executed the foregoing instrument as his/her /their free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN my hand and official seal this Ar*p 144A 4 s �►�yik'u� a � 6�•r �� yA '0' u���aa" & AMENDMENT day o6� rc 2016e (typed/printed name of notary) Notary Public in and for the State of Washington. My commission expires O 3 -2- 1/2010 CITY OF Federal Way EXHIBIT "B -1" COMPENSATION CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com 1. Total Compensation. In return for the Services, the City shall pay the Contractor an additional amount not to exceed Nineteen Thousand and 00/100 Dollars ($19,000.00). The total amount payable to the Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed Thirty Eight Thousand and 00 /100 Dollars ($38,000.00). 2. Method of Compensation: Contractor will invoice the City of Federal Way for 60% of total personal training services paid for by clients in a given month. This includes 60% of standard one -on -one training, small group training or designated time based programming. Invoice is due to the Fitness /Athletic Coordinator by the 5h of the month for training conducted in the previous month. Contractor is paid on the 15ffi of each month. AMENDMENT - 3 - 1/2010 CITY OF ;:k:� Federal Way BUSINESS REGISTRATION` License Number 20- 12- 101490 -MBL Home Occupation - Regular 1tegstered: COWLETE BODY AND MIND 2406 SW 342ND PL FEDERAL WAY, WA 98023 -7628 Expires: 12/3V2014 CglMory: 7200 - Personal Services Conditions: This license is non - transferable. Please notify the City Clerk's office of any change in your business such as a new location or business name ACC>R °r CERTIFICATE OF LIABILITY INSURANCE 1 /15� 014 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 W Insurance Group 1007 Pacific Ave Tacoma WA 98402 CONTACT David Wi.ita PHOPIE (800)362 -5220 FAl( (800)496 -6054 Nok EA .Dave @w- ins.com INSURERS AFFORDING COVERAGE NAIC # INSURER AAIDerican States Ins CO 19704 INSURED DANIEL E SBENSHAD Complete Body & Mind 2406 SW 342M PL FEDERAL WAY WA 98023 INSURER B /3/2013 INSURER C : EACH OCCURRENCE INSURER D: PREMISES Ea oawrrence ItSURERE: MED EXP (Any one person) INSURER F. PERSONAL & ADV INJURY COVERAGES CERTIFICATE NUMBER- CL1411519776 RFVISInN NUMRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUOR POLICY NUMBER POLICY EFF POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a OCCUR DIC159502720 /3/2013 /3/2014 EACH OCCURRENCE $ 1,000,000 PREMISES Ea oawrrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMPIOP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS CM48FINED SINGLE LIMIT Ea acMent BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accl $ s UMBRELLA LIAB EXCESS LIAR OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIAORM YIN ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? (may in I) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- 1 1011-1. E.L. EACH ACCIDENT s E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (Attach ACORD 101, AdeMomi Remarks Schedule if more space is required) Certificate holder is an additional insured, but only if required by written contract, agreement or permit per endorsement CG 76 35 02 07. Federal Way Community 876 S 33rd St Federal Way, WA 98003 ACORD 25 (2010105) 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 Wiit-a /DWI Z'�� ©1888 -2010 ACORD CORPORATION. All dahts neserved. INS025 (zmw5).m The ACORD name and logo are registered marks of ACORD ADVAN -5 OP ID: PA ACCORD` CERTIFICATE OF LIABILITY INSURANCE E (MM /DD/YYYY) 701/13/14 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 800 -803 -7000 Soundview Insurance Agency Inc 18927 33rd Ave W. Suite C 425- 712 -1058 CONTACT P FAX HONE N A/C No): E -MAIL ADDRESS: Lynnwood, WA 98036 -4726 Tony Conti INSURERS AFFORDING COVERAGE NAIC # INSURER A.. Travelers Indemnity Company $ 1,000,00 PREMISES Ea occurrence INSURED Advanced Pro Fitness Repair Inc INSURER B: $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 ID 474774 INSURER C : GENERAL AGGREGATE INSURER D : GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO cj LOC 9523 83rd Ave NE Marysville, WA 98270 INSURER E Emp Ben. INSURER F • AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS X HIRED AUTOS X NON-OWNED AUTOS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR LTR TYPE OF INSURANCE POLICY NUMBER P LI Y E F MM/DDN YYY POLICY EXP MM/DD LIMITS • GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx—] OCCUR X 80 -00OD701542 04/27/13 04/27/14 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 X WA STOP GAP GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO cj LOC PRODUCTS - COMP /OP AGG $ 2,000,00 Emp Ben. $ 1,000,00 • AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS X HIRED AUTOS X NON-OWNED AUTOS BA- OD743698 04127113 04127114 Ea accident 11000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ -1571UPYRIT DAMAGE Per ac cdent $ UM /UIM $ 1,000,00 A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CUP -001D023889 04127/13 04127114 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DIED I X I RETENTION $ 5,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 680- 000D701542 WASHINGTON STOP GAP 04/27113 04127/14 WC STATU• I X OTH- ITORY IMI ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) EXERCISE EQUIPMENT REPAIR City of Federal Way is included as an Additional Insured per Blanket AI Form C00105(04 -94). GLa1111:gV CITYFE1 City of Federal Way 876 S 333rd St 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 01988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Corporations: Registration Detail Corporations Division - Registration Data Search ADVANCED PRO FITNESS REPAIR, INC. Purchase Documents for this Corporation UBI Number 602784435 Category REG Profit/Nonprofit Profit Active/Inactive Active State Of Incorporation WA WA Filing Date 12/04/2007 Expiration Date 12/31/2014 Inactive Date Duration Perpetual Registered Agent Information Agent Name MICHAEL JELLISON Address 9523 -83RD AVENUE NE City MARYSVILLE State WA ZIP 98270 Special Address Information Address City State Zip Governing Persons Page 1 of 2 Title Name Address President JELLISON , MICHAEL MARYSVILLE , WA Purchase Documents for this Corporation http: / /www.sos.wa.gov /corps /search _ detail.aspx ?ubi = 602784435 12/9/2013 L 7 Y a L 5 p7 S A tv lit 0 __ 03 T. �R d M, Ln L Ln o� M 0 �O rl rl � � c A A "I H N 4 t0 (A M V 01 0! J cc .H .rl H H 3 7 CC p0 'O O1 •rl M- W 'c Z` V W Z m W W z H N LL LL ZzJ= z S F Z Z a IN °' zg o z¢aaa L N Q O A Z A A Z W> 3 +0 tN- ImzZEE 01 N A Q I- .CL a M 3 I.- Z QlAeNIry O 7 W M MQ N N W W W W OLJJJJ 0 O. W W HEEzF 2 OV -I Z m li ,a QH 01 i"IL w H(O. uL) V Y �.. O QOP� W Q W A V CO LL I- ce L 7 Y a L 5 p7 S A tv lit 0 __ 03 T. �R d M, RETURN TG: "IA�1 _. � / i. - , � EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: �� � 2. ORIGINATING STAFF PERSON: i EXT: �� 3. DATE REQ. BY: S �' / I� 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.c. sorm xEEi.nTEn Doc[nv¢rrrs� ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL ❑ OTHER PROJECT NAME: �e,►-s o a�.� �a1 t/l t✓l..Gi �' �-S 6. NAME OF CONTRACTOR: ADDRESS: �Z.�(�Ct � �TELEPHONE �S 3 �(0`1 Y57O C FAX: TITLE 7�t,v Ytp� SIGNATURE NAME: 7. EXHIBITS AND ATTACHMENTS: � SCOPE, WORK OR SERVICES �OMPENSATION �INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBTTS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: S'�� /� COMPLETION DATE: I' /�� 7 9. TOTAL COMPENSATION $ � b G O� � (INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LAB�R C�HARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES usUtvO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES �NO IF YES, $ PAID BY: � CONTRACTOR ❑ CITY ( � PURCHASING: PLEASE CHARGE TO: I� l' 1�--O I� '� S� ' �� S' S�` I D 10. DOCUMENT/CONTRACT REVIEW I1�iI /DATE VIEWED I1�TITIAL/DATEAPPROVED �PROJECTMANAGER aa I ❑ DIRECTOR ( Z ❑ RISK MANAGEMENT (� a�rrLicwsr,E) ❑ LAW l�P �Z�- � � .�' -Z�Q "I2 11. COUNCIL APPROVAL �IF APPLICABLE� COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING / ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: �f .3� ( 2 DATE REC'D: `� I) 2- ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPARTMENT ❑ SIGNATORY (cM oR nmECTOx) �CITY CLERK �ASSIGNED AG# �SIGNED COPY RETURNED II�iI IAL / DATE SIGNED s - b• �2 - ��" .►' � AG# �,�(2�j'� DATE SENT: Gj - �5 " I? �r1S�, r�d �. �►�o�' c:e.r-t .� �,nsv�an�e. SV�w� c:o Fw ao ccdo �fian�u �n a u.red . - fhv� (.ar.�At�r vs��� bc w��w, :�� ie 1 E sbans�r�'ade-, ��k Co�mpL,� Q� U� �i n � a�,c � � � . ► � rR;�" • � --� --�.r � � `•r' � . � �m. . r � � - rr, , � - , � CITY OF ,,'�... Federal CITY HA�L ��� 33325 8th Avenue South Federal Way, WA 98003-6325 {253) 835-700C1 �vw�v c�ryotfeder�hvay com RECREATION AGREEMENT FOR PERSONAL TRAINING SERVICES This Recreations Class Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Daniel Esbenshade, DBA Complete Body and Mind, a sole proprietor ("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: COMPLETE BODY AND MIND CITY OF FEDERAL WAY: Daniel Esbenshade Kimberl�y Shelton 2406 SW 342" Place 33325 8 Ave. S. Federal Way, WA 98023-7628 Federal Way, WA 98003-6325 (253) 835-6932 (telephone) (253) 569-4560 (telephone) (253) 835-6939 (facsimile) Danielesbenshade83 mail.com Kimberl .shelton ci offederalwa .com The Parties agree as follows: 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 January 1, 2014 ("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 are 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. 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 RECREATION AGREEMENT - 1 - 4/2011 � CITY �F ,,'�.. Federal CITY HALL ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 avww. crty�ffede.ral►vay com performance of the Work in accordance with this Agreement, notwithstanding the City's knowledge of defective ar non- complying performance, its substantiality ar the ease of its discovery. 2.4 Clean Up. 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 shall 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 ar 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 terminatc 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 m�imum 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 have been performed and within thirty (30) days a8er receipt and approval by the appropriate City representative of the voucher or invoice. If the Work do 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. 43 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, ar 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. 4.4 Non-Appro�riation 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 RECREATION AGREEMENT - 2 - 4/2011 ` CIfiY OF ,,'�..... Federal GTY HALL ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253} 835-7000 avww ciryofiieder�hvay com 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, ta�ces, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons ar 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 Contractar pursuant to this paragraph. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. 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 ar wark by the Contractor, their agents, representatives, 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 less than $1,000,000 for each occurrence and $1,000,000 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 Liabilitv. 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 RECREATION AGREEMENT - 3 - 4/2011 � CItY OF ,,�. Federal CITY HA�L ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 �vw�v ciryottede.r�lway com 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 ar 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. 8. 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. 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 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, ar other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR / 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 Safe . 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 OSHA/WISHA 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, RECREATION AGREEMENT - 4 - 4/2011 � CITY OF ,,�.... Federal CITY HA�L ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 4vww c�ryo�federalw�y com 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 Wark. 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 103 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, drafting, signing, administration, or evaluating the Contractor's performance. 12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Contractor or its subcontractors of any level, or any of those entities' employees, agents, subcontractors, or representatives against any person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply to, but not be limited to, the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Contractor shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non-discrimination. 13. GENERAL PROVISIONS. 13.1 Interpretation 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. RECREATION AGREEMENT - 5 - 4/2011 � CITY DF ,,�... Federal CITY HALL ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 tvtivw. cityoffaderal�v�ry com 133 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 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 daxe 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 - 6 - 4/2011 � CITY OF �."�._.. Federal Way CITY NALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 avww ciryoffederalway com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY � �� Cary M. Roe, P. ., Director, Parks, Public Works and Emergency Management ATTEST: City Clerk, Carol McN illy, M DATE: ���� COMPLETE BODY AND MIND B y : �� ��� - �� _� Printed Name: ��, e 1 G s�t�f�iCr �� Title: Qc</•-►�cvv� DATE: s��C Z. STATE OF WASHINGTON ) ) ss. COUNTY OF ��� ) APPROVED AS TO FORM: �� � City Att y, Patricia A Richardson On this day personally appeared before me,�v�� �, �4►��S �s b e��l�_ , to me known to be the individual described in and who executed the foregoing instrument, and on oath swore that he/she/they executed the foregoing instrument as his/her/their free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN my hand and official seal this � day of �o,v , 2012 NW�ry► P�Iic <�.a � ClMMiT1AN E �HlIMM1Eg Mr��a.oa.�rs �/�F7(/.�`✓�si'i� � r�� /4S !'l�R1�71p•✓ � �S1'R V �4 ��C (typed/printed name of notary) Notary Public in and for the State of Washington. My commission expires � w�,���� ZD I rj, RECREATION AGREEMENT - 7 - 4/2011 a�du4 Y�uoN nY�M�l�M 10 sltta a�ww�Z 3 N�r►a��� aros ,e o.t �� �n«+�► M►� � tITY OF CITY HALL �..... Federa I Way 33325 8th Avenue South • PO Box 9718 Federal Way, WA 98063-9718 (253) 835-7000 �+nvw crtyoffederalway com EXHIBIT "A" RECREATION SERVICES Contractor shall provide personal training services for the City of Federal Way. These services may include, but are not limited to: • Fitness Program Creation • Body Composition Testing and Analysis • Wellness Coaching • Fitness Equipment Instruction • Group Training • Wellness Lectures • Group Fitness Instruction • Marketing & Promotion of Services RECREATION AGREEMENT - 8 - 4/2011 CITY OF ,�., Federal CITY HALL W �� 33325 8th Avenue South • PO Box 9718 Federal Way, WA 98063-9718 (253) 835-7000 wtiv4v dtyoffederalway com EXHIBIT "B" COMPENSATION 1. Compensation. In consideration of the Contractor performing the Work, the City agrees to pay the Contractor an amount not to exceed Nineteen Thousand and No/100 Dollars ($19,000.00), calculated on the basis of 60% of each participant's registration fee that is paid and not refunded. The City makes no representation or warranty regarding class size and nothing in this Agreement obligates the City to pay more than 60% of the total of the registration fees paid and not refunded. 2. Method of Compensation: Contractor will invoice the City of Federal Way for 60% of total personal training services paid for by clients in a given month. This includes 60% of standard one-on-one training, small group training or designated time based programming. Invoice is due to the Fitness/Athletic Coordinator by the 5�' of the month for training conducted in the previous month. Contractor is paid on the 15�` of each month. RECREATION AGREEMENT - 9 - 4/2011 � Liberty Narth�i>�st. ����� AMERICAN STATES INSURANCE COMPANY NAMED INSURED AND MAILIN6 ADDRESS SEAITLE, WASHINGTON COMMERCIAL INSURANCE POLICY DANIEL ESBENSHAD DECLARATIONS DHA COMPLETE BODY & MIND 2406 SW 342ND PL FEDERAL WAY, WA 98023 POLICY PERIOD FROM 04-03-12 TO 04-03-13 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. POLICY NUMBER O1 RENEWAL OF NEW AcENr W INSURANCE GROUP A p 1007 PACIF'IC AVE ADDRESS TACOMA, WA 98402 04-12 4600152 (253) 382-2100 m � s = � � � C � � _ � � � � = � � THE TOTAL ESTIMATED PREMIUM FOR THE POLICY TERM IS �195 .00. YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACC�UNT #241 THIS POLICY IS SUBJECT TO A FINAL AUDIT. IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, TNE COMPANIES INDICATED ON THE SPECIFIC COVERAGE PART DECLARATIONS AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POUCY. COMMERCIAL GENERAL LIABILITY COVERAGE PART .............. $ 194.00 194.00 PREMIUM FOR CERTIFIED ACTS OF TERRORISM .............. $ 1.00 TOTAL POLICY PREMIUM .............. $ 195.00 COUNTERSIGNATURE BY (DAT� (AUTHORIZED REPRESENTATIV� 9-CC (0207) NORTHEAST COMPANY USE ONLY 25 (CHAFEL)CB INSURED COPY PREPARED 04-03-12 AGT * Page 1 — � N � � � � V r 0 � e � V � � W � o .� o ' F+ � � � DANIEL JAMES ESBENSHADE COMPLETE BODY AND MIND 2406 SW 342ND PL FEDERAL WAY WA 98023-7628 DETACH BEFORE POSTING 000743 �� s�rnT� o� o �, � � o $ �y �� ��' STATE OF WASHIWGTON. BUSINESS LICENSE Sole Proprietorship DANIEL JaMES ESBENSHADE CQMPLETE BODY AND MIND ` 876 S - 333ttD ST FEIIER�L WRY WA 98003 6343 TAX R�6I5TRATION REGIS'fERED TRADE NRMESe COMPLETE BODY AND MIND GOMPLETE BODY AND,MIND FITNESS COMPLETE MEND' AND `$ODY ` COMPLETE MIND AND BODY FITNESS Unified Business ID !�: 603 195 551 Business ID �: l Locatione 1 This documenf lisis the cegistrations, end+orsements, �ml licenses authorizecF for the busioess �t"L,. named'above. By accepting this document, the iicensee certifies the i�tformafion on the appiicadon was complete, true, and accura#e 3a !he best of his or Irer knowledge, and that business wilf be conducted in compliance with al1 appticable Washington state, county� and city regulations. Director; Departmeat of B n CITY OF ' - ,� � '��.. Federal V1�ay _, ������� ���������: y Lice�se 1rTumber 20-12-1tl14�f1-0aBL Home Uccup:�tian - It�gular Re�stered: CO�IPLETE BODY ANi? 11�1IND �4(�i SV�' 34�2NF3 PL FETJ�E�AL 'WA�, i�VA 98423-7628 ; E�nires: 22/3 U20i 2 Ca�e�a�'v: 7204 - Perso�ai Serc�ices ` Ctrgd�,�„inons; This license is n��t-transferable. ` �'Iease �it�tify t�e eity Clerk office of any c�a�ge in your business such as a new ' 1QCatian Qr busi�ess name. ��{itt{'tl� .'�'`�`� k ��� R ' 4,f � { '`� � p ,t � 1 �'•�. •' �ptipOR/tFt �' � � ,(j = C? :' , �... — ���"t� � - ��' �� .�E1�t.�o.' ` ���i�'�'��1ll+l����` Gity �lecic, City ofFederal Wa}r ; t '�ft f! K3 <<�� 'I`his cerUifres Ch� the above entity has been issued ttie registration or`license �isted. CQ�LETE $OD�'Y AND NIINU ��?AtrTIEL ES$�fiTSHAg� * 24U6 S� 34�1�I3 PL : F�IIER�LL �t�Y ?�A, 98Q23 N 5 CA -CERTIFIED PER.SQ � 1,�+ `The National Strength and Conditioning Association hereby certifies that i D nie C . �s6ensF�aaCe c� J :�� has earned the design�i��' c�� NSCA-Certified Personal Trainer ��� � as defined by the T�SCA Certification Committee. 1244150312 Certification Number March 30, 20� Date of Certification � Detember 31� ZQ14 Date Certifieation E�cpit�, ThecSCSandNS[a<vT �� ceniflcailonsereaccr2�IitMby . theNatlonalCpmmisslonWr � Cerofyln9Aplel�les. . •■ e v'� �! e . .�TA��, TRAIN ER� � � � �� � � ` w��' U'' /L�--�— 1e� BJ�e4 P� 111�I� IIS, PT, SCS, ATC, CSCS,#D NSCA Certlflutlon Com�itbe C�dr � �e� �. �, �o, cscs,�u, �, F�, �scc�o NSCA 6oera ot �ara Pr�d�ot � i ��TION �a�: �+�, rp ��� � `;� W '�,�:, Business Licensing Service:License Query Search • Contact us • Forms • About us • Home • Start your business • Change or update your business information • How to renew your license Search Business Lioenses License Information: Entity Name: Business Name: License Type: Entitv Tvue: UBI: Status: DANIEL]AMESESBENSHADE COMPLETE BODY AND MIND Washington State Business Sole Proprietor 603195551 Business ID:001 Location ID:0001 To check the status of this business, go to Department of Revenue. Location Address: 876 5 333RD ST FEDERAL WAY, WA, 98003-6343 Mailing Address: 2406 SW 342ND PL FEDERAL WAY, WA, 98023-7628 Status Registered Trade Names: COMPLETE BODY AND MIND COMPLETE BODY AND MIND FITNESS COMPLETE MIND AND BODY COMPLETE MIND AND BODY FITNESS Governing Peoule: DANIELJAMESESBENSHADE Active Active Active Active Expires N/A N/A N/A N/A Information Current as of 04/24/2012 5:41AM Pacific Time New Search Page 1 of 1 First Issued 04/02/2012 04/02/2012 04/02/2012 04/02/2012 This site is limited to searching for business licenses issued through the Washington State Business Licensing Service. • Contact us • Forms • About us • Privacv c0201�� State Department of Revenue and its licensors. All rights reserved. http://bls.dor.wa.gov/LicenseSearch/1qsLicenseDetail.aspx?RefID=30568 4/24/2012 AMERICAN STATES INSURANCE COMPANY SEATTLE, WASHINGTON COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS PAGE CG 1 NAMED INSURED: DANIEL ESBENSHAD POLICY NUMBER: O1-CI FORM OF BU5INE5S: INDIVIDUAL L I M I T S 0 F I N S U R A N C E --------------------------------------------------------------------- COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS OPERATIONS) PRODUCTS OPERATIONS AGGREGATE LIMIT PERSONAL AND ADVERTISING INJURY LIMIT EACH OCCURRENCE LIMIT DAMAGE TO PREMISES RENTED TO YOU (ANY ONE PREMISES) MEDICAL EXPENSE LIMIT (ANY ONE PERSON) STOP GAP - EMPLOYERS LIABILITY DISFASE AGGREGATE LIMIT �ACH ACCID�NT LIMIT �t�CS EMPLO�YEE LIMIT CODE CLASS�FICI�TION-PREMIUM BASIS ----------------------------------- ULTRA SPECIA�.TY �FRVICES PREHISES NA 00494 IiOME BASED BUSINESS - PERSONAL TRAINER/YO GA INSTRUCTOR PRODUCTS-COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT (PER NUMBER OF FULL TIME EMPLOYEES) TO HEET POLICY WRITING MINIMUM ���t��*�r*��*,���u�t�����k �� PREMIUM ADJUSTMENTS: CERTIFIED ACTS OF TERRORISM COMMERCIAL GENERAL LIABILITY TOTAL EXPOSURE RATE 2,000,000 a,000,000 i,000,oao 1,000,000 1,000,000 10,000 � 2,000,000 1,000,000 1,000,000 �REMIiTM 1 187.0000 $ 187.00 7.00 $ 1.00 $ 195.00 9-CC (GL) (0207) NORTHEAST (CHAFE) :� PREPARED 04-03-12 CMD40 SEQ.0001 w �u .w ne.u+w�� .wa. �n e v ..��IY'!/i5!'il& �'3,��� J� �.� f 'il .�� �. 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Centet ��'rhePauct��ltv�:: = ' �76 8 333rd 3t , � � � ���mE � , � _.. . , � �� �"�al _�'ay.. 1�a _ .�$Q:1�$ > .... .. : 4 „ .. , ,. _„ � � � wf� �iir.a/D6�z � ���:�`✓'�`. ��.t�i� ,. , ,. , . . . ACQtt� ��) '" , � 1988-2010 A�R'D AI� rigfrts reaerved. r lNSO1S.�2oanosj:a� � ''Ctie A�ORD name and bgo ace regf�ered ma�'ks of ACORQ � ,. ;.. . _ , �: � . , . . .. ,; -.. .. ,: ,. , �`:. . � . . . �..; . .. ..,� . STATE OF WASHINGTON UBI NO. EXPIRATION DATE 603 195 551 1 1 DANIEL JAMES ESBENSHADE COMPLETE BODY AND MIND 876 S 333RD ST FEDERAL WAY WA 98003 6343 TAX REGISTRATION FOLD HEP.E � � �::.. . . .:. ... FOID HERE �� Directoq Depar6nent of Revenu ' DETACH THIS SECTION FOR YOUR WALLET