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AG 13-129RGTURN TO: ����� EXT: � �{ 3 -7 CITY OF FEDERAL WAY LAW DEPARTMF_,NT ROUTING FORM 1. ORIGiNATING DEPTJDIV: 2. ORIGlNATINGSTAFFPERSON: vi� ('�P�.,�hnS EXT: ���% 3. DATEREQ.BY: � TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) o PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLiC WORKS CONTRACT ❑ PROF'ESSIONAL SERVICEAGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCLTMENT ❑ SECURITYDOCUMENT �E.G.BONDRELATEDDOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACTAMENDMENT(AG#): ❑ INTERLOCAL �,OTH ER 5. PROJECT 1 6. NAME OF CONTRACTOR: Pv;v,n � t�1 e s�- ADDRESS: I'lp 5 �_(����a� �_� 5�� C TELEPHONE $bo a32=�a E-MAIL: FAX: 3 60 5'� �- �-1►_5 SIGNATURE NAME: S 3 p,ic N a,r �nn D� TITLE (� v e s i c� r_ �} 7. EXHIBTTS AND ATTACHMENTS:(I�SCOPE, WORK OR SERVICES �COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN � REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENTDATE: T. G• D• C ��1 rfZ� COMPLETIONDATE: 12`31 jrh�7 � YyK\Hu1ke c�L' ; _ _ 9. TOTALCOMPENSATION$_�e�eYYV��� t�r" A E'�f� l SL°W1tVlt (INCLUDEEXPENSESANDSALES7'AX,IFANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTA SCHEDULES OF EMPLOYEES TI LES AND HOLIDAY RATES) REIMBURSA$LE$XPENSE: � YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED � YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR O CITY ❑ PURCHASING: PLEASE CHARGE TO; i0. DOCUMENT/CONTRACT REVIEW �(�I PROJECT MANAGER � DIRECTOR �[ LAW INITIAL /' AT RE IEl WED INITIAL / DATE APPROVED 2 'l lI fJ 12 7 I3 �P �a-a��• ►� P -l0-12 11. COUNCIL APPROVAL (�F ,�PL�C�t,E) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDORICONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS D LAW DEPARTMENT ❑ SIGIVATORY (MAYOR OR DIRECTOR) O CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: t��,�o��-�--� ��—��'� 1NITIAL / DATE SIGNED P ,` 0- f 4 1 Z- AG# - DATE SENT: - I1/9 irime � p � west J Qua�tY Targeted Adv�ertlsh�g Since 1987 Corporate Office: 1705 E College Way Suite C P.O Box 2609, Mount Vernon, WA 98273-7609 Phone: 1.800.932 6454 Fax: 360.542.4115 Actual Installation Date: NEWS & INFORMATION CENTER AGREEMENT THIS AGREEMENT made this 10th day of August, 2011, by and between Prime West of Washington, Incorporated (hereinafter referred to as "Corporation"), and Federal Way Community Center (hereinafter referred to as "EstabiishmenY') Address: 876 South 333r° Street Phone: (253) 835-6900 City: Federal Way State: WA Zip: 98003 Fax: (253) 835-6939 WHEREAS, the Corporation is in the business of advertising; WHEREAS, the Corporation agrees to place and monitor the News & Information Center described herein on the premises of the Establishment; WHEREAS, the Establishment agrees to allow the Corporation to have such News & Information Center on its premises and to allow the Corporation to sell advertising space on it; NOW THEREFORE, in consideration of the mutual promises contained herein, the parties hereto agree as follows: (1) The News & Information Center. The Corporation agrees to provide a News & Information Center ("Center") to the Establishment for its use, free of charge, to be installed and posted in the following location: Forest Lounge (Senior Lounge) In consideration for the use of the Center, the Establishment shall allow the Corporation to place advertisements on the Center. The Corporation shall install the Center on or about January 151, 2012, (the "Estimated Installation Date." The "Actual Installation Date" will be recorded at the top of this form). (2) Ownership. The Corporation shall own the Center at all times. (3) Maintenance. The Corporation, at its own expense, shall construct, maintain and service the Center, and shali repair at its own expense any loss or damage to the Center caused by accident, fire or theft, except that any damage caused by the fault or negligence of the Estabiishment shall be the responsibility of the Establishment. If the Corporation determines that the Center is severely damaged, it may elect to replace the Center with another substantially similar Center. The Corporation shall have the right to enter the EstablishmenYs premises during reasonable business hours for the purpose of perForming such maintenance or replacement. (4) Alterations. The Establishment shatl not alter the Center in any manner without obtaining prior written permission from the Corporation. (5) Term The initiat term of this Agreement shall be five years, commencing from the actual installation date of the Center. However, both parties shall have the right to terminate this Agreement at any time that it cannot setl sufficient advertisements for what it determines is an adequate price. The Establishment may also request termination of Agreement with a minimum 30 day notice. Upon expiration of the term of this Agreement or of any renewal term, without further renewal, the Corporation shall remove the Center from the Establishment within a reasonable time. (6) Miscellaneous. The Establishment has the right to have any ad they deem "inappropriate" removed immediately from the Center. This Agreement constitutes the entire Agreement between the parties hereto. There are no other agreements, representations or warranties not included in the Agreement. No supplements, modifications, or alterations to this Agreement shall be effective unless in writing and signed by the parties hereto. No waiver of any provisions of this Agreement shall be deemed a continuing waiver or a waiver of any other provisions of this Agreement. No waiver shall be binding unless it is in writing executed by the party making the waiver. (7) Annual Contribution. The Corporation shall accrue $50.00 per paid ad per year (or a propoRionate amount thereof if less than full payment is received from the advertiser) during the contribution period and shall pay the accrued amount to the Establishment at the end of the second year from the Actual Installation Date. There shall be no contribution accrued nor paid based on advertising revenue received the first year in order to partial�y offset the cost of installing the Center. Subsequently, this contribution shall continue annually until termination of this Agreement. PRI WEST, INC. � me of Cor b�ation) By: (Sig ature) Steve Harmon President FEDERAL WAY COMMUNITY CENTER (Name of Establishment By i�� (Signature) Cary M. Roe, P.E. Director of Parks, Public Works and Emergency Management (PRINT Name, Title) (PRINT Name, Title) Business Licensing Service:License Query Search • Contact us • Forms • About us • Home • Start your business • Change or uodate your business information • How to renew your license Search Business Licer�es License Information: Entlty NdMe: PRIME WEST OF WASHINGTON, INC. BuSin65S Ndme: PRIME WEST LiCense Type: Washington State Business Entitv Tvoe: Profit Corporation UBI: 601380989 Business ID:001 Location ID:0001 Status: To check the status of this company, go to Secretarv of State and Deoartment of Revenue. Location Address: 2203 OLD HWY 99 5 MOUNT VERNON, WA, 98273 Registered Trade Names: PRIME WEST OF WASHINGTON, INC. Governina Peoule: ]EWELL HARMON STEVEN HARMON Malling Address: 2203 OLD HWY 99 S MOUNT VERNON, WA, 98273 Status Expires Adive N/A Information Current as of 04/OS/2012 5:43AM Pacific Time New Search This site is limited to searching for business licenses issued through the Washington State Business Licensing Service. • Contad us • Forms • About us • Priv OZO11 Washin ton State Department of Revenue and its licensors. All rights reserved. First Issued 04/28/1992 Page 1 of 1 http://bls.dor.wa.gov/LicenseSearch/1qsLicenseDetail.aspx?RefID=512497 4/5/2012