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AG 13-179RETURN TO: 'k-;6' CW— EXT: 'x"10\ CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIv: PROS / 2. ORIGINATING STAFF PERSON: DA yey EXT: b41 3 7 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT Cl 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 lnA;mnifie.& -4•iOn / lv►<urar.ce Al. 5. PROJECT NAME: 5 6. NAME OF CONTRACTOR: Mu cI�IA�e B B Q ADDRESS: PO BOX 166 euuesluo 41$3-1 l TELEPHONE: L53 9SS $LOB E- MAIL: FAX: SIGNATURE NAME: &If" M urfk TITLE: e, Z' 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE 'K ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS CFW LICENSE # BL, EXP. 12/31 / UBI # , EXP. 8. TERM: COMMENCEMENT DATE: 412-1 ( 13 COMPLETION DATE: -t 9. TOTAL COMPENSATION: $ N I A (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 ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: j�l Ac 10. DOCUMENT/ CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ❑ PROJECT MANAGER • SUPERVISOR • DIRECTOR • RISK MANAGEMENT (IF APPLICABLE) • LAW DEPT I - q . 13 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 9 1 1 O 113 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES; EXHIBITS • LAW DEPT • SIGNATORY (MAYOR OR DIRECTOR) • CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED . ❑ RETURN ONE ORIGINAL COMMENTS: INITIAL / DATE SIGNED 1.(Q. K o AG# DATE SENT: - COUNCIL APPROVAL DATE: DATE REC'D: n I Is 113 1/9 INDEMNIFICATION AND INSURANCE AGREEMENT This Indemnification and Insurance Agreement ( "Agreement ") is dated effective this 21" day of September, 2013. The parties ( "Parties ") to this Agreement are the City of Federal Way, a Washington municipal corporation ( "City ") and Greg Murphy, DBA Murph's BBQ, a sole proprietor ( "Murph's BBQ "). A. Murph's BBQ wishes to provide concession services on September 21 st, 2013 ( "K -9 Karnival Event "); and B. The City wishes to cooperate by allowing Murph's BBQ to set up a temporary concession stand in conjunction with the K -9 Karnival Event at Steel Lake Park, which is located at 2410 S 312' ST ( "Steel Lake Park "). NOW, THEREFORE, the Parties agree as follows: 1. Indemnification. In consideration of the City authorizing a temporary concession stand in conjunction with the K -9 Karnival Event at Steel Lake Park, Murph's BBQ 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, licensees, or representatives, arising from, resulting from, or connected with this Agreement or the use of the Steel Lake Park Facility or relating to the K -9 Karnival Event to the extent caused by the acts, errors or omissions of the Murph's BBQ, its partners, shareholders, agents, employees, invitees or by Murph's BBQ's breach of this Agreement. 2. Insurance. Murph's BBQ agree to carry as a minimum, commercial general liability insurance with combined single limits of liability not less than $2,000,000.00 for bodily injury, including personal injury or death, products liability and property damage liability for all damage arising out of injury to or destruction of property in such forms and with such carriers as are satisfactory to the City. The City shall be named as additional insured on all such insurance policies. Murph's BBQ shall provide a certificate of insurance evidencing such coverage and, at the City's request, furnish the City with copies of all insurance policies and with evidence of payment of premiums or fees of such policies. Murph's BBQ's failure to maintain such insurance policies shall be grounds for the City's immediate termination of this Agreement. 3. General Provision. This Agreement contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement. No provision of this Agreement may be amended or modified except by written agreement signed by the Parties. This Agreement shall be binding upon and inure to the benefit of the Parties' successors in interest, heirs and assigns. Any provision of this Agreement which is declared invalid or illegal shall in no way affect or invalidate any other provision. In the event either of the Parties defaults on the performance of any terms of this Agreement or either Party places the enforcement of this Agreement in the hands of -1- an attorney, or files a lawsuit, each Party shall pay all its own attorneys' fees, costs and expenses. The venue for any dispute related to this Agreement shall be King County, Washington. Failure of the City to declare any breach or default immediately upon the occurrence thereof, or delay in taking any action in connection with, shall not waive such breach or default. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. DATED the day and year set forth above. CITY OF FEDERAL WAY By: / Cary M. Roe, PE, Director of Parks Public Works & Emergency Management Date: It o 117 MURPH' S BBO 0 (Phone) STATE OF WASHINGTON ) ) ss. COUNTY OF P144-CA---' ) ATTEST: City Clerk, Carol McNeilly, EM APPROVED AS TO FORM: OAWLOff r City Attorney, Patricia AJ tichardson (Address) On this day personally appeared before me, Greg Murphy, 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 1'7 A day of �*� 2013. Notary Public State of Washington JILL M SCHWAB MY COMMISSION EXPIRES November 12,2015 (typed/printed name of notary) Notary Public in and for the State of Washington. My commission expires l l / 1 x-11 '6— MURPH -1 OP ID: PM ACORO- CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) F 09/1712013 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 Phone: 609-922-2937 Wheat & Associates Insurance P.O. Box 3548 Fax: 509- 922 -4103 Spokane, WA 99220 -3548 Commercial House Accounts CONTACT NAME: A / ONE E A/C No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Ins Co. 19046 INSURED Murph's BBQ PO Box 165 Puyallup, WA 98371 INSURER B: 09125/2012 INSURERC: EACH OCCURRENCE INSURER D: PREMISES Ea occurrence INSURER E: MED EXP (Any one person) INSURER F: PERSONAL & ADV INJURY CAVFROrFR CFRTIFICOTF NIIMRFR 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MMID POLICY EXP MMID LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCU2 X 68016660666 09125/2012 0912512013 EACH OCCURRENCE $ 1,000,0 PREMISES Ea occurrence $ 300,0 MED EXP (Any one person) $ 5,0 PERSONAL & ADV INJURY $ 1,000, GENERAL AGGREGATE $ 2,000. GEN %AGGREGATELIMITAPPLIESPER: POLICY PROT F1 LOC - COMP/OPAGG $ 2,000, -PRODUCTS $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -0WNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Es accident BODILY INJURY (Per person) $ BODILY INJURY (Per accideM) $ PR TY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED) (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A I I WC STATU- OTH- I EEL E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace is required) Certificate Holder is included as an Additional Insured per endorsement CGD186 in respect to the operations of the named insured performed on their half. RE: K9 Carnival City of Federal Way 3200 SW Dash Point Rd Federal Way, WA 98023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIIZZEEDREPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD