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AG 14-002RETURN TO: David Clemons EXT: 6949 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PARKS 2. ORIGINATING STAFF PERSON: DAVID CLEMONS EXT: 6949 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE X CONTRACT AMENDMENT (AG #): 14 - 0 0 2. ❑ OTHER ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: C- e 004 2et∎Ignm a tt - S v pr11 4v/4 S c r V i L. 6. NAME OF CONTRACTOR: C o. (e c a vA t° ADDRESS: TELEPHONE: E -MAIL: FAX: SIGNATURE NAME: TITLE: 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE )( 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: I' 1111 COMPLETION DATE: 2.t 3 t I a 9. TOTAL COMPENSATION: $ �°I1161,00 ('YsO NIA k) (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: 10. DOCUMENT / CONTRACT REVIEW ❑ PROJECT MANAGER ❑ SUPERVISOR ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) o LAW DEPT 11. COUNCIL APPROVAL (IF APPLICABLE) Ill- 7100 - 351- 515 -- - 3L12- INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ////4/ 1 le )0 4111i ?•(2Ci ll2t `V` COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 11 ZP 116 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPT ❑ SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG # ❑ SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: COUNCIL APPROVAL DATE: DATE REC' D: 11/9 aTr os Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffedera!way. com AMENDMENT NO. 4 TO GOODS AND SERVICES AGREEMENT FOR COFFEE AND EQUIPMENT SUPPLY AND SERVICE This Amendment ( "Amendment No. 4 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Cafe Fonte Coffee Company, a Washington 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 coffee and equipment supply and service ( "Agreement ") dated effective January 7, 2014, as amended by Amendment No. 1, Amendment No. 2, and Amendment No. 3, 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, 2018 ( "Amended Term "). 2. 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] AMENDMENT 1 - 1/2015 AL CITY OF 4N11■.- Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835 -7000 www atyoffederalway corn IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: Bye J. 'Hutton, Par - r erector DATE: 121/5/14 Title:./CVe /a r irriOrdet� DATE: STATE OF WASHINGTON ) ,� ) ss. COUNTY OFD. / I ATTEST: APPROVED AS TO FORM: City Attorney, 1.1/4.1Acottl On this day person Ily appeared before me P,--3 to me known to be the (na'. SLIK Fits 7,L=► signatory) at executed the foregoing instrument, (position or title) (corporation name) 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 day of 1 — , 2 / Notary's signsttu Notary PubtOr 0 State of Washi f W1ry's pri med ( JACQUELINE LEE VOSS SCHOTT I My Appointment Expires Apr 10, 2018 ' AMENDMENT . ��1�•�..- Notary Public in and for the State of Washington. My commission expires' — Jr) 2 e 1/2015 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PARKS 2. ORIGINATING STAFF PERSON: Om ■ C 1 e vk c to S 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE K CONTRACT AMENDMENT (AG #): Z{ - D O Z. ❑ OTHER EXT: b `111 3. DATE REQ. BY: ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: C.0 "c1.,ipvnntnl- SvP+P±i 0.114 Seru\ce 6. NAME OF CONTRACTOR: Ch }e Ft,Ak„ (bC4e6 ADDRESS: 514 2.. 61" AV S, 1 1r.1 A q$ 1 u 8 E -MAIL: SIGNATURE NAME: TELEPHONE: FAX: TITLE: 7. EXHIBITS AND ATTACHMENTS: p( SCOPE, WORK OR SERVICES ik COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ 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: U pout 'i 1 -11 A \-U C e COMPLETION DATE: I2 131 116 9. TOTAL COMPENSATION: $ i 1444 Gp (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: 1 i ( - 17_00- 35 (- 515 _ rjl - 314 Z 10. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED XJECT MANAGER UPERVISOR ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) xe LAW DEPT 11. COUNCIL APPROVAL (IF APPLICABLE) s tt hglIs C 14 J COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 13 115 ❑ 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 j2Z t Uo / /ts (�,..�I AG# ( -002 C DATE SENT: I -2(0- tlp COUNCIL APPROVAL DATE: DATE REC'D: 12_I 231 15 11/9 ,A. Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 88003 -8325 (253) 835 -7000 www.cityoffederatway.com AMENDMENT NO. 3 TO GOODS AND SERVICES AGREEMENT FOR COFFEE AND EQUIPMENT SUPPLY AND SERVICE This Amendment ( "Amendment No. 3 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Cafe Fonte Coffee Company, a Washington 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 coffee and equipment supply and service ( "Agreement ") dated effective January 7, 2014, as amended by Amendment No. 1 and No. 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, 2016 ( "Amended Term "). 2. 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. AMENDMENT [Signature page follows] 1 1/2015 CITY OF CITY HALL 466 Federal Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederahvay com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY By: John r s Director DATE: //2,S. //,� CAFE FONTE COFFEE COMPANY ATTEST: erk, Stephanie Court APPROVED AS TO FORM: .City Attorney, Amy Jo Pearsall Title: � ��'� /.mil DATE: 6 STATE OF WASHINGTON ) ) ss. On this day ersonally appeared b fore meor. f e, S t27I t , to me known to be the 2V r. LI �'i1'� ItG(of (p aot o that executed the foregoing instrument, and acknowledged the sai 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 l i Pday of ��%��-- , 20L5 Notary's signature `1,{1M744 s printed name U/ ('4 4t. m • 640a'VRrt2 Notary Public in and for the Ste of Washington. L0 My commission expires 1 a.( I 11 COUNTY OF KING MC WINDI M. EDWARDS Notary Public Stott of Washington •My Commission Expirts January 21, 2019 AMENDMENT 2 - 1/2015 ACORD CERTIFICATE OF LIABILITY INSURANCE ilki...„---- DATE(MM /DD/YYYY) 1/19/2016 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 Arthur J. Gallagher Risk Management Services, Inc. P.O. Box 2925 Tacoma WA 98401 -2925 CONTACT Janet Hite PHONE 253- 238 -1152 FAX (A/C NO Ext)• IA /C Not 253 - 572 -1430 ADDRESS: janet_hite @ajg.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Fireman's Fund Insurance Company 21873 INSURED Cafe Fonte Coffee Company 5501 - 6th Avenue South Seattle, WA 98108 INSURER B :National Surety Corporation 21881 INSURER C :American Insurance Company 21857 INSURER D : INSURER E : CLAIMS -MADE INSURER F : DAMAGE TO RENTED PREMISES(Ea occurrence) COVERAGES CERTIFICATE NUMBER: 1999917567 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD YYY) POLICY EXP (MMIDD/YYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY Y Y MXX80963350 6/1/2015 6/1/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT X PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO AUT OWNED HIRED AUTOS SCHEDULED NON -OWNED AUTOS MXX80963350 6/1/2015 6/1/2016 - — COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XAU32157380 6/1/2015 6/1/2016 EACH OCCURRENCE $8,000,000 AGGREGATE $8,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N / A WC81027981 6/1/2015 6/1/2016 PER STATUTE x OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 A Product Recall MXX80963350 6/1/2015 6/1/2016 Occurence $100,000 Aggregate $200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Federal Way and Federal Way Community Center are named as an Additional Insured as respects their interest may appear regarding the operations of the named insured per form CG7158 01/14. CERTIFICATE HOLDER 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RETURN TO: David Clemons EXT: 6922 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIv: 2. ORIGINATING STAFF PERSON: DAVID CLEMONS EXT: 6922 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/ CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION )(CONTRACT AMENDMENT (AG#):_[q - oQ ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: FWCC SPLASH CAFE COFFEE SERVICE AND EQUIPMENT_ 6. NAME OF CONTRACTOR: CAFE FONTE ADDRESS: 5412 6T" AVE S SEATTLE 98108 E -MAIL: JGAMBLE@FONTECOFFEE.COM SIGNATURE NAME: JENNIFER GAMBLE TELEPHONE: 206 - 762 -0760 FAX: 206 - 957 -0599 TITLE: 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE XALL 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: 12 -31 -13 COMPLETION DATE: 12 -31 -15 9. TOTAL COMPENSATION: $ 4=q#IANW \V O CrLIC-rst�- (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, $ ❑ PURCHASING: PLEASE CHARGE TO: 11- 7200 - 351 - 575 -51- 10. DOCUMENT/ CONTRACT REVIEW ,< PROJECT MANAGER SUPERVISOR ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW DEPT 11. COUNCIL APPROVAL (IF APPLICABLE) INITIAL / DATE REVIEWED 5 v 4 COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 17-11 b' ) A ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS LAW DEPT SIGNATORY (MAYOR OR DIRECTOR) CITY CLERK ❑ ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL/ DATE S GNED 7Ar-f- 1111,115- / /t i AG DATE SENT: I PAID BY. ❑ CONTRACTOR ❑ CITY INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: DATE REC'D: COMMENTS: � pod . jdjtj; -�A , �- nog+ 4-r akin( A45, 1/9 CITY OF CITY HALL fir deral Feder 8th Avenue South 33325 Federal Way, WA 98003 -6325 AV (253) 835 -7000 mm cityoirederalway corn AMENDMENT NO. 2 TO GOODS AND SERVICES AGREEMENT FOR COFFEE AND EQUIPMENT SUPPLY AND SERVICE This Amendment ( "Amendment No. 2 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Cafe Fonte Coffee Company, a Washington 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 coffee and equipment supply and service ( "Agreement ") as amended by Amendment No. 1 dated effective January 1St, 2014, 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 31St, 2015 ( "Amended Term "). 2. 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 Alt Federal • CITY HALL 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 By: John Hug6jll, Director drParks DATE: % (I z lt;— CAFE FONTE COFFEE COMPANY By: Printed Name: yj_ Z Title:GP �T DATE: STATE OF WASHINGTON ) ss. COUNTY OF ATTEST: 6"W� �O&A/ - it Clerk, Stephanie Courtney MC APPROVED AS TO FORM: 'GYz C,%t City Attorney, Amy Jo Pearsall On this day personally appeared before me � , to me known to be the of N' that executed the foregoing instrument, and acknowledged the said instrument to be the free and voluntary adjand 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 day of`%An%{ �� —1206.7 Notary's Notary's Notary Public State of Washington JACQUELINE LEE VOSS SCHOTT My Appointment Expires Apr 10, 2018 Notary Public in and for the State of Washington. My commission expire s AMENDMENT - 2 - 1/2010 aC<? RV CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDNYYY) 6/6/2014 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 terns 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 Arthur J. Gallagher Risk Management Services, Inc. P.O. Box 2925 Tacoma WA 98401 -2925 NAME: Janet Hite PHONE 253- 238 -1152 F41t . 253 - 572 -1430 E-MAIL .Janet kite @ajg.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Surety Corporation 21881 /112014 INSURED INSURER B :American Insurance Company 21857 INSURER C : CLAIMS -MADE Fx_1 OCCUR Cafe Fonte Coffee Company 5412 - 6th Avenue South Seattle, WA 98108 INSURER D : INSURER E $1,000,000 INSURER F: MED EXP (Any one person) $10,000 r_nyFRAnFS r_FRTIFIr_ATF fJI1MRFR- 822746624 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 INSD WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP MM /DD LIMITS A X COMMERCIAL GENERAL LIABILITY MXX80956491 /112014 /1/2015 EACH OCCURRENCE $1,000,000 CLAIMS -MADE Fx_1 OCCUR DAMAGE RENTED PREMSES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY E PECT RO 7 LOC J ]OTHER: PRODUCTS - COMP /OP AGG $2,000,000 A AUTOMOBILE LIABILITY MXX80956491 /1/2014 /1/2015 Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO AUT OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR XAU24424343 /1/2014 /1/2015 EACH OCCURRENCE $8,000,000 AGGREGATE $8,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE WC81020616 /1/2014 /1/2015 PER X OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Product Recall MXX80956491 /1/2014 /112015 Occurence $100,000 Aggregate $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 003680 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. 33325 8th Ave S Federal Way WA 98003 -6325 USA AUTHORIZED REPRESENTATIVE @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 003680 MultiCove& - CG 71 58 01 14 Policy Amendment(s) Connnercial General Liability Coverage Fonn Your Commercial General Liability Coverage Form is occurred before you acquired or revised as follows: formed the orgalnization; and 1. Broadened Named Insured (3) Coverage B does not apply to per- sonal and advertising injury arising A. SECTION II - WHO IS AN INSURED, out of an offense committed before item 3., is deleted and replaced by the follow- you acquired or formed the organ - mg: ization. 3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the pol- icy period majority ownership or major- ity interest, will qualify as a Named Insured if a. There is no other similar insurance available to that organization; and b. The first Named Insured shown in the Declarations has the responsi- bility of placing insurance for that organization: and C. That organization is incorporated or organized under the lanes of the United States of America. However: (1) Coverage under this provision 3 is afforded only until the next occur- ring annual anniversary of the be- ginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier: and (2) Coverage A does not apply to bodily injury or property damage that B. SECTION II - WHO IS AN INSURED, the last paragraph, is deleted and replaced by the following: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not shown as a Named In- sured in the Declarations. However, this does not apply to a limited liability company that meets all of the conditions ui Section II - Who Is An Insured, item 3., above. 2. Additional Insured If an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 2. Additional Insured does not apply to such person or orgaluzation. SECTION II - WHO IS AN INSURED, sub- section 2.e_, is added as follows: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is legally obligated to pay for bodily injury, property damage or personal and advertising injury caused by your acts or omissions. With respect to the insur- ance afforded to such additional insured, all of the following additional provisions apply: This Form must be attached to Change Endorsement when issued after the policy is written. One of the Fireman's Farad Insurance CompaaiesO as named in the policy Secretary President CG7158 1-14 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Includes copyrighted material of Insurance Services Office. Inc., with its permission. Page 1 of 7 003680 (1) You have agreed in a written insured political subdivision, and are not in- contract that such person or organization cluded within the products - completed be added as an additional insured under operations hazard; or this policy; (f) Their liability as a grantor of a fran- (2) The bodily injury property damage or chise to you. personal and advertising injury for which said person or organization is legally ob- (6) This insurance does not apply to bodily ligated to pay occurs subsequent to the injury, property damage, personal and execution of such insured contract; advertising injury, occurrence or offense: (3) The most we will pay is the lesser of (a) Which takes place at a particular either the amount of insurance available premises after you cease to be a under the applicable Limits of Insurance tenant of that premises: shown in the Declarations or the limits of insurance required by the insured (b) Which takes place after all work, in- contract: eluding materials, parts or equip- ment famished in connection with (4) The insurance afforded to such additional such work to be performed by or on insured only applies to the extent per- behalf of the additional insured at mitted by law: the site of the covered operations, has been completed, (5) Such person or orgalzation is an addi- tional nisured only with respect to: (c) Which takes place after that portion of your work out of which the injury_ (a) Their ownership, maintenance, or or damage arises has been put to its use of that part of the premises, or intended use by any other person or land, owned by, rented to, or leased organization other than another to you, except such person or or- contractor or subcontractor engaged ganization is not an insured with re- in performing operations for a prui- spect to structural alterations, new cipal as part of the salve project, or construction or demolition oper- ations per formed by or on behalf of (d) Which takes place after the expira- such person or organization: tion of any equipment lease to which (4)(d) above applies: (b) Your ongoing operations performed for that insured; (7) With respect to architects, engineers or surveyors, coverage does not apply to (c) Their financial control of you, ex- bodily injury, property damage or per- cept such person or organization is sonal and advertising injury arising out not an insured with respect to struc- of the rendering or failure to render any heal alterations, new construction professional services by or for you, 'n- or demolition operations performed eluding: by or on behalf of such person or organization: (a) The preparing, approving, or failing to prepare or approve, maps, shop (d) The maintenance, operation or use drawings, opinions, reports, surveys, by you of equipment leased to you field orders, change orders, or draw - by such person or organization, ings and specifications; or (e) Operations performed by you or on (b) Supervisory, inspection, architec- your behalf and for which a state or tural, or engineering services. political subdivision has issued a permit, provided such operations are These exclusions apply even if the claims not performed for such state or against an_y insured allege negligence or CG7158 1 -11 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Includes copyrighted material of Insurance Sen-ices Office. Inc., with its permission. Page 2 of 7 003680 other wrongdoing in the supervision, luring, employment, training or moni- toring of others by that insured, if the occurrence which caused the bodily, injury or property damage, or the offense which caused the personal or advertising injury involved the rendering of or the failure to render any professional services by or for you. 3. Additional Insured - Vendors If an Additional Insured Vendors endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 3. Additional Insured - Vendors does not apply to that person or organization. Unless the products - completed operations hazard is excluded from this policy, SECTION II - WHO IS AN INSURED, item 2.f is added as follows: f Any vendor of yours is included as an addi- tional insured, but only with respect to bodily injury or property damage caused by your products which are distributed or sold in the regular course of the vendor's busuiess, sub- ject to the following additional exclusions: (1) The insurance afforded such vendor does not apply to: (a) Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assump- tion of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the ab- sence of the contract or agreement: (b) Any express warranty unauthorized by you: (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, dem- onstration, testing, or the substi- tution of parts under instructions from the manufacturer, and then re- packaged in the original container; (e) Any failure to make such in- spections, adjustments, tests or ser- vicing as the vendor has agreed to ]rake or normally undertakes to make in the usual course of busi- ness, in connection with the distrib- ution or sale of the products; (f) Demonstration, installation, servic- ing or repair operations, except such operations performed by the vendor in full compliance with the man- ufacturer's written Instructions at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or Ingredient of any other thing or substance by or for the vendor: or (h) Bodily injury or property- damage arising out of the liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (2) This insurance does not apply to any in- sured person or organization from whom you have acquired such products or any ingredient, part or container, entering into, accompanying or containing such products: (3) The most we will pay is the lesser of ei- ther the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or agreement. and (4) The insurance afforded to such vendor olnly applies to the extent permitted by law_ 4. Additional Insured - Limited Primary and Non- contributory Provision CG7158 1 -14 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Inchu es copyrighted material of Insurance Services Office. Inc., with its Permission. The following is added as a second paragraph to Section IV Conditions, Condition 4. Other Insur- ance, following paragraph b.(2): However, if you have added any person, organiza- tion or vendor of yours as an additional insured to Page 3 of 7 003680 this policy by way of this MultiCover t endorse- ment and have agreed in a written insured contract that this insurance is primary and non- contribu- tory with other insurance available to that addi- tional insured, this insurance is primary and we will not seek contribution from such additional insured's other insurance, provided that the addi- tional insured is a Named Insured under such other insurance. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8., is deleted and replaced by the following: 8. Transfer of Rights of Recovery Against Oth- ers to Us and Blanket Waiver of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. b. If required by a written insured contract executed prior to the occurrence or of- fense, we waive any right of recovery we may have against any person or organ- ization named in such insured contract, because of payments we make for injury or damage arising out of your operations or your work for that person or organ- ization. 6. Cancellation - 90 Days Common Policy Conditions endorsement IL0017, A. Cancellation, item 2.b. is deleted and replaced by the following: b. 90 days before the effective date of cancella- tion if we cancel for any other reason. 7. Liberalization SECTION IV - COVIMERCLAJL GENERAL LIABILITY CONDITIONS , the following is ad- ded as an additional Condition: E:3 CG7158 1 -14 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Includes copyrighted material of Insurance Sen-tces Office. Inc., with its. permission. Liberalization If we adopt a change in our forms or riles which would broaden the coverage provided by any form that is a part of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. Fire, Explosion, Sprinkler Leakage, or Lightning Legal Liability- Coverage A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the last paragraph, is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while: 1. Rented to you: 2. Temporarily occupied by you with the permission of the owner: or 3. Managed by you under a written agree- ment with the owner. A separate limit of insurance applies to this coverage as described in Section III - LIMITS OF INSURANCE. B. SECTION III - LIMITS OF INSURANCE, item 6., is deleted and replaced by the follow- ing: 6. Subject to 5. above, the Damage to Premises Rented To You Limit shown in the Declarations, for property damage to any one premises while rented to you, or in the case of damage by fire, explo- sion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of a. $1,000,000 Any One Premises, or b. The Damage To Premises Rented To You Limit shown in the Decla- rations. Page 4 of 7 003680 C. SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS, 4. Other Insurance, b. Excess Insurance, (1)(a), items (1) and (iii), are deleted and replaced by the following: (i) That is Fire, Explosion, Sprinkler Leak- age, or Lightning insurance for premises while rented to you, temporarily occu- pied by you with permission of the owner, or managed by you under a writ- ten agreement with the owner: (iii) That is insurance purchased by you to cover your liability as a tenant for property, damage to premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner: or D. SECTION V - DEFINITIONS, 9. Insured Contract, item a., is deleted and replaced by the following: (a) A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with per- mission of the owner, or managed by you under a written agreement with the owner, is not an insured contract, 9. Damage to Invitees' Automobiles from Falling Trees or Tree Limbs - Limited Coverage This coverage applies to direct physical damage to automobiles owned by invitees subject to all of the following: 1. Provided such damage originates from trees on premises owned, managed, leased or rented by an insured; 2. Coverage applies only to invitees of an in- sured or an'insured's tenant, 3. Such damage is directly caused by wind -dri- ven falling trees or tree limbs: 4. The most we will pay for any one loss is the lowest of: a. the actual cash value of the damaged au- tomobile as of the time of the loss: or b. the cost of repairing the damaged auto- mobile: or c. the cost of replacing the damaged auto- mobile with another automobile of like kind and quality. Regardless of the number of occurrences, losses or claims, this coverage is subject to a limit of $25,000 ii any one policy period; 5. This coverage is not subject to the General Liability General Aggregate Limit: and 6. We will make payments under this coverage without regard to fault. 10. Non-0-timed or Chartered Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY, 2. Exclusions, item g. Aircraft, Auto, or Watercraft, item (2), is deleted and re- placed by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used for public transportation or as a common carrier: 11. Chartered Aircraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, item (6), is added as follows: (6) An aircraft in which you have no ownership interest and that you have chartered with crew. 12. Coverage Territory - Broadened CG7158 1-14 Copyright 2013. Fireman's Fund Insurance Company, Novato. CA. All rights resen-ed. Includes copyrighted material of Insurance Sen•ices Office. Inc., with iti permission. SECTION V - DEFINITIONS, item 4.a., is de- leted and replaced by the following: a. The United States of America (including its territories and possessions), Puerto Rico, Canada, Bermuda, the Bahamas, The Cayman Islands, and the British Virgin Islands; Page 5 of 7 003680 13. Personal and Advertising Injury - Contractual Unless personal and advertising injury is excluded from this policy the following applies: SECTION I - COVERAGES, COVERAGE B, 2. Exclusions, item e., is deleted. 14_ Fellow Employee Coverage SECTION II - WHO IS AN INSURED, 2.a., item (1) is deleted and replaced by the following: (1) Personal and advertising injury: However, subsections (a), (b), (c) and (d) of item (1) remain unchanged. 15. Bodily Injury Definition - Broadened SECTION V - DEFINITIONS, 3. Bodily Injury is deleted and replaced by the following: Bodily injury means bodily injury, sickness or dis- ease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. 16. Expected or Intended Injury - Amendment to Ex- clusion SECTION I. Coverage A Bodily Injury and Pro- perty Damage Liability, 2. EXCLUSIONS, a. Ex- pected or Intended Injury, is deleted and replaced by the following: a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or prop- erty. 17. Unintentional Failure to Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 6. Representa- tions, the following is added: d. If you unintentionally fail to disclose any ha- zards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. 18. Supplementary Payments - Increased Limits SECTION I - COVERAGES, SUPPLEMEN- TARY PAYMENTS - COVERAGES A AND B, items Lb. and l.d., are deleted and replaced by the following: b. The cost of bail bonds 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. d. All reasonable expenses incurred by the in- sured at our request to assist us in the inves- tigation or defense of the claim or suit, including substantiated loss of earnings up to $500 a day because of time off from work. 19. Duties in the Event of an Occurrence, Offense, Claim or Suit - Amended CG7158 1 -14 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights resened. Includes copyrighted material of Insurance Sen•ices Office. Inc., with iti permission SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 2.a. is deleted and replaced by the following: (1) You must see to it that we or any licensed agent of ours are notified of a General Liability occurrence or offense which may re- sult in a claim as soon as practicable after it becomes known to: (a) You, if you are an individual: (b) Your partner or member, if you are a partnership or joint venture; (c) Your member, if you are a limited liabil- ity company; (d) Your executive officer if you are an or- ganization other than a partnership, joint venture or limited liability company, or (e) Your authorized representative or insur- ance manager. Knowledge of an occurrence or offense by persons other than those listed above does not imply that those listed above also have such knowledge. Page 6 of 7 003680 El (2) To the extent possible, notice should include: (a) How, when and where the occurrence or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the occurrence or offense. 20. lion Employment Discrimination Liability Unless personal and advertising injury is excluded from this policy the following applies: A. SECTION V - DEFINITIONS, 14. Personal and advertising injury, item h. is added as fol- lows: h. Discrimination. B. SECTION V - DEFINITIONS, item 23. is added as follows: 23. Discrimination means the unlawful treat- ment of a person or class of persons be- cause of their specific race, color, religion, gender, age, or national origin in com- parison to one or more persons who are not members of the specified class. C. SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions, the following are added: q. Discrimination directly or indirectly re- lated to the past employment, employ- ment or prospective employment of any person or class of persons by any insured; r. Discrimination directly or indirectly re- lated to the sale, rental, lease or sublease or prospective sale, rental, lease or sub- lease of any dwelling or permanent lodg- ing by or at the direction of any insured; s. Discrimination, if insurance thereof is prohibited by law-. or t. Fines, penalties, specific performance, or injunctions levied or imposed by a gov- ernmental entity, governmental code, law, or statute because of discrimination. 21. Medical Payments Unless COVERAGE C MEDICAL PAY- MENTS, or the products- completed operations hazard has been excluded from this policy the fol- lowing applies: A. SECTION I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, 2. Exclusions, item f., is deleted and replaced by the follow- ing: f. Products - Completed Operations Hazard Included within the products - completed operations hazard. However, this exclu- sion does not apply to expenses for den- tal services. B. Section I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, is amended to in- clude item 3. as follows: 3. Limit of Insurance The Medical Expense Limit of Insurance shall be the greater of: a. $20,000 Any One Person: or b. The amount shown in the Declara- tions. All other terms and conditions of the policy apply. CG7158 1 -14 Copyright 2013. Fireman's Fund Insurance Company. Novato. CA. All rights reserved. Includes copyrighted material of Insurance Sen-ices Office. Inc., with it4 permission. Page 7 of 7 003680 Arthur J. Gallagher Risk Management Services, Inc. P.O. Box 2925 Tacoma WA 98402 USA City of Federal Way 33325 8th Ave S Federal Way WA 98003 -6325 Corporations: Registration Detail Corporations Division - Registration Data Search CAFE FONTE COFFEE COMPANY Purchase Documents for this Corporation n UBI Number 601506001 Category REG Profit/Nonprofit Profit Active /Inactive Active State Of Incorporation WA WA Filing Date 1 1/17/1993 Expiration Date 11/30/2014 Inactive Date Duration Perpetual Registered Agent Information Agent Name SHANE SKINNER Address - 5412 6TH AVE S City SEATTLE State WA ZIP 98108 Special Address Information Address 5501 6TH AVE S City SEATTLE State WA Zip 981082503 Governing Persons Page 1 of 1 Title Name Address President Treasurer,Chairman ODOM ,PAUL 2566 NOB HILL AVE N SEATTLE , WA 98109 Vice President Secretary SMITH ,STEVE 7337 23RD AVE BE SEATTLE , WA 98115 Purchase Documents for this Corporation http: / /www.sos.wa.gov /corps /search _ detaii.aspx ?ubi = 601506001 12/17/2013 RETURN TO: EXT: L� G CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PROS/ 2. ORIGINATING STAFF PERSON: �rnvjc� C 1,- v✓iny�� EXT: (a 3 7 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/ CDBG • REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) • ORDINANCE ❑ RESOLUTION )<CONTRACTAMENDMENT (AG #): -oo ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: 15,ek,5�A Lg, n e. e S c y- y � c ,� 6. NAME OF CONTRACTOR: - Pgyl�c ADDRESS: wk 12 C. AvP s- 81 o 2 TELEPHONE: 7-06 - -I G2 - 0-160 E -MAIL: FAX: SIGNATURE NAME: GAC"y-nlo[e- TITLE: 7. EXHIBITS AND ATTACHMENTS: VSCOPE, WORK OR SERVICES XCOMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ 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:_ 1431113 COMPLETION DATE: 1? (. � -L f IA 9. TOTAL COMPENSATION: $ Vlk , !I q q . p p (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: l i t - "I Zo O - 351 - 5-lb- -13i - 3 N Z 10. DOCUMENT/ CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ❑ PROJECT MANAGER !V / y ❑ SUPERVISOR >0 DIRECTOR 1 ❑ RISK MANAGEMENT (IF APPLICABLE) LAW DEPT I I a 7} 3 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: IS ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS • LAW DEPT • SIGNATORY (MAYOR OR DIRECTOR) Cl CITY CLERK ❑ ASSIGNED AG # 1� SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: INITIAL / DATE SIGNED 1/9 CITY OF CITY HALL �.. Fe d e ra I Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www ciryoffederahvay. com • AMENDMENT NO.1 TO GOODS AND SERVICES AGREEMENT FOR COFFEE AND EQUIPMENT SUPPLY AND SERVICE This Amendment ( "Amendment No. I") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Cafe Fonte Coffee Company, a Washington 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 coffee and equipment supply and service ( "Agreement ") dated effective December 31 ", 2013 as follows: 1. 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 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. 2. 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 Other 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 33325 8th Avenue South Federal Way Federal Way, WA 98003 -6325 (253) 835 -7000 www atyoffederaiway. com &N WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY L-Ofi ��, (\-�i Ken Miller, Interim Parks Director DATE: 4—� \S` �L,-- CAFE FONTE COFFEE COMPANY Y' Printed Name: •Title: DATE: STATE OF WASHINGTON ) ) ss. COUNTY OFA::2 � ) ATTEST: �c -hln� City Clerk, G=ffal MeNcilir, ehfe APPROVED AS TO FORM: y R, la L Interim City Attorney, Amy Jo Pearsall On this day personally appeared before me to me known to be the >�✓ id 1 , of yr- _� w hat 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. n U GIVEN my hand and official seal thisaE-fn day of ,Gy�3 "/ , 2014 IF Notary's Notary's ft" ftft sto of wa JACQUELM tff Voss My ANONIIIIIIN111 AIM» hr 10. M1 AMENDMENT Notary Public in and for the State of Washington. EMy commission expires (:�3/4- /Q-« -2- 1/2010 ` CITY OF CITY HALL 33325 8th Avenue South Federal Way Federal Way, WA 98003 -6325 (253) 835 -7000 www crtyoffedera way. com • 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 FIFTEEN THOUSAND NINE HUNDRED NINETY NINE and NO /100 Dollars ($15,999.00). The total amount payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed NINETEEN THOUSAND NINE HUNDRED NINETY NINE and NO /100 Dollars ($19,999.00). C] AMENDMENT -3 - 1/2010 RETURN TO: L ExT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIv: PRCS /< 61) L c' 2. ORIGINATING STAFF PERSON: S u s a ✓x L- ,eC' O o,- EXT: LY C) 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 O 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: J b Las h c' f 2 6. NAME OF CONTRACTOR: O ✓� i 2. ADDRESS: fh a .c A TELEPHONE: 266 - 76.�! -O ?6,d E -MAIL: i ciGLw�l�(? `n _ GU {yep_ „ f+� -,�.�_ FAX: 201 - 5s 7 -of'99 SIGNATURE NAME: me- 4 )iZf- G►a TITLE: 7. EXHIBITS AND ATTACHMENTS SCOPE, WORK OR SERVICES,)d COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE WALL&% OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS CFW LICENSE # BL, EXP. 12/31/_ UBI # (go 1..5 O(o bo i , EXP. tj_ >3I_Lj 8. TERM: COMMENCEMENT DATE: / / 3 / �� COMPLETION DATE: 2- 9. TOTAL COMPENSATION: $ q OOO `e9- (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 [TYURCHASING: PLEASE CHARGE TO: t i I - -7 200 - 3 10. DOCUM NT / CONTRACT REVIEW OJECT MANAGER SUPERVISOR ADIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) LAW DEPT 11. COUNCIL APPROVAL (IF APPLICABLE) INITIAL / DATE REVIEWED ra � INITIAL / DATE APPROVED SL �3 mQ Z 11 - 121 -sa- 6A L7_0A & to COMMITTEE APPROVAL DATE: t = 11 12. CON CT SIGNATURE ROUTING SENT TO VENDOR/CONTRACTOR DATE SENT: ZO 113 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS LAW DEPT SIGNATORY (MAYOR OR DIRECTOR CITY CLERK ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL INITIAL / DATE SIGNED .1 AG# DATE SENT: COUNCIL APPROVAL DATE: DATE REC'D: / Z !Iffi l3 COMMENTS: 11/9 CITY OF CITY HALL '�.... Fe d e ra I Way Federal 8th Avenue South deral Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com GOODS AND SERVICES AGREEMENT FOR COFFEE AND EQUIPMENT SUPPLY AND SERVICE This Goods and Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Cafe Fonte Coffee Company, a Washington 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: FONTE COFFEE COMPANY Paul Odom 5412 6`" Avenue South Seattle, WA 98108 (206) 762 -0766 (telephone) (206) 957 -0599 (facsimile) com The Parties agree as follows: CITY OF FEDERAL WAY: Susan Leddon 33325 80' Ave. S. Federal Way, WA 98003 -6325 (253) 835 -6940 (telephone) (253) 835 -6929 (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, 2014 ( "Term "). This Agreement may be extended for additional periods of time upon the mutual written agreement of the City and the Contractor. 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 performance of the Work in accordance with this Agreement, notwithstanding the City's knowledge of defective or non - complying performance, its GOODS AND SERVICES AGREEMENT - 1 - 4/2011 CITY OF CITY HALL 33325 8th Avenue South Federal Way Federal Way. WA 98003 -6325 (253) 835 -7000 www cityoffederalway com substantiality or 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 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 have been performed and within thirty (30) days after 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. 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. 4.4 Non - Appropriation 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, GOODS AND SERVICES AGREEMENT - 2 - 4/2011 ciry of CITY HALL Federal Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses,'attomey'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 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 or work 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 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 GOODS AND SERVICES AGREEMENT - 3 - 4/2011 CITY OF CITY HALL '�.._. 33325 Federal Way Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www crtyoffederalway com 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. 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, or 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 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 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, 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 GOODS AND SERVICES AGREEMENT - 4 - 4/2011 ` CITY OF CITY HALL Federal Way 33325 8th Avenue South AN Federal Way, WA 98003 -6325 (253) 835 -7000 www otyoffederahvay com 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, 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. GOODS AND SERVICES AGREEMENT - 5 - 4/2011 CITY OF ti Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com 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 ofthis 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 ofthe 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 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] GOODS AND SERVICES AGREEMENT - 6 - 4/2011 Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www otyoffederahvay com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY Cary M. Roe,, ., Director, Parks, Public Works & Emergency Management DATE: CAF NTE COFFEE COMPANY B �L.� Printed Name: c_LZ) llb�l�l Title: DATE: STATE OF WASHINGTON) ss. COUNTY OF ATTEST: P.&W mn I D City Clerk, Carol McNeilly, A MC APPROVED AS TO FORM: On th' ay personally appeared before me l0 "�- to me known to be the of 0,, f e � -- 4 c 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 day of &Q_LVVJ11,, 20 t? City Att y, Patricia A Richardson Nobq Public State of Washington MW A Zuocadni Commlaaion F*lm 114o.17 Notary's signature Notary's printed name -;� orcrr:t, Notary Public in and for the State of Washington. My commission expires 11'jo - 17 GOODS AND SERVICES AGREEMENT - 7 - 4/2011 CITY Of CITY HALL A 33325 4% Federal Way Feder 8th Avenue South Federal Way. WA 98003 -6325 (253) 835 -7000 www a yoffederahvay com EXHIBIT "A" SERVICES 1. Exclusive Supply. Contractor agrees to be the City's exclusive supplier of Coffee at the Splash Cafe at the Federal Way Community Center. Contractor will supply to City, and City will purchase, an average of 30 pounds of coffee each month. 2. Coffee Equipment. Contractor will loan to City the coffee brewing equipment listed below ( "Equipment"). City assumes the full risk of loss of the Equipment. City acknowledges that it is receiving a limited license to use the Equipment and agrees that it will only use the equipment in connection with Fonte Coffee. At the expiration or termination of this Agreement, City agrees to return all Equipment promptly to or provide reasonable access to its premises for Contractor to remove the Equipment. City will reimburse Contractor for the reasonable costs associated with loss or damaged equipment. Equipment: uantit Model /Type 1 FETCO Coffee brewer 4 1.85 L pour pots 1 2 group espresso machine 1 Mini Mazzer espresso grinder 1 Decaf Espresso Grinder 1 3 Gal Tea Brewer GOODS AND SERVICES AGREEMENT - 8 - 4/2011 CITY OF CITY HALL 'N•.... Federal Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www ci"ffederalway com EXHIBIT "B" COMPENSATION In return for the Services, the City shall pay the Contractor an amount not to exceed four thousand and 00 /100 Dollars ($4000.00), based on monthly orders of coffee from the following price list: First Avenue Blend $8.85 per lb Decaf Blend $9.10 per lb Cerrado (brewed) $8.00 per lb Decaf Fonte (brewed) $8.55 per lb Contractor will guarantee this pricing for 12 months. GOODS AND SERVICES AGREEMENT - 9 - 4/2011 AcoR°® CERTIFICATE OF LIABILITY INSURANCE 6/23 1 DATE 12/ 16 /2 1 /Y013 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. 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 1- 253 - 627 -7183 CONTACT Janet Hite NAME: Arthur J. Gallagher Risk Management Services, Inc. ONE FAX PH 253 253- 238 -1152 -572 -1430 N t • A/C No E -MAIL Janet hite@ajg.com ADDRESS: J jg• P.O. Box 2925 INSURERS AFFORDING COVERAGE NAIC# Tacoma, WA 98401 -2925 INSURERA: NATIONAL SURETY CORP 21881 Darin Puryear INSURED INSURER B: Cafe Fonts Coffee Company $1,000,000 MED EXP (Any one person ) $10,000 INSURER C: $1,000,000 INSURER D: 5412 - 6th Avenue South INSURERE: Seattle, WA 98108 INSURER F: $ 2,000,000 COVERAGES CERTIFICATE NUMBER: 37367364 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 INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDD POLICY EXP MMID LIMITS • GENERAL LIABILITY MZX80949100 06/01/1 06/01/14 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1-il OCCUR NI DAMAGE PREM SES EaEoccurren $1,000,000 MED EXP (Any one person ) $10,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 $ POLICY PRO- X LOC • AUTOMOBILE LIABILITY MZX80949100 0 C MBINED SINGLE LIMIT Ea accident) 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per aocident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED HIRED AUTOS AUTOS 1 PROPERTY DAMAGE (Pr ..d ent $ • X UMBRELLA LIAIB X OCCUR XAU48704803 06/01/1 06/01/14 EACH OCCURRENCE $ 8,000,000 AGGREGATE $8,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE MZX80949100 06/01/1 06/01/14 WCSTIMIT X ER E.L. EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N /A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Product Recall MZX80949100 06/01/1 06/01/14 Occurence 100,000 Aggregate 200,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space is required) Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty of Federal Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 33325 8th Ave S AUTHORIZED REPRESENTATIVE e� Federal Way, WA 98003 -6325 i USA ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD jhite 37367364 n S F u 0 m W a i N fm0 MultiCover® - CG 7158 12 07 Policy Amendment(s) Commercial General Liability Coverage Form Your Commercial General Liability Coverage Form is revised as follows: 1. Broadened Named Lsnred A. SECTION II - WHO IS AN INSURED, item 3., is deleted and replaced by the follow- ing; 3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the pol- icy period majority ownership or major- - ity- _interest, -. -will ..qualify_as_ a_ Insured ila (3) Coverage B does not apply to per- sonal and advertising iMJWY arising out of an offense committed before you acquired or formed the organ- ization. B. SECTION II - WHO IS AN INSURED, the last paragraph, is deleted and replaced by the followin& No person or organization is an insured with respect to the conduct of any current or past partnersEp, joint venture, or limited liability ! company that is not shown as a Named In . sired in the Declarations. However, this does ._.. -.- not - apply" to•- a-limited_liabfty.company that..... _.._..._.._.._ meets all of the conditions in Section II - a. There is no other similar insurance • Who Is An Insvred. item -2 available -to -that- organization; - and. -- _ -- - - -- _- - 2. b. The first Named Insured shown in SECTION II - • WHO IS AN INSURED, sub - the Declarations has the respond- section 2.e., is added as follows: bifity of placing insurance for that organization; and e. Any. person or organization is included as an additional insured, but only to the extent such c. That organization is incorporated or person or organizabon is held liable for organized under the laws of the bodily injury, property damage or personal and United States of America. advertising injury caused by your acts or omissions. With respect to the insurance of- However. forded. to such insured, all of the follovring additionalprovtsions apply: (1) Coverage- under this provision 3 is afforded only until the next occur- (1). Ypu and such person or organization ring annual anniversary bf the be- have agreed in a written insured contract ginning of the policy period shown that such person or organization be in the Declarations, or the end of the added as an additional insured under this policy period, whichever is earlier•, policy; and (2) The bodily injury, property dmuage or (2) Coverage A does not apply to bodily personal and advertising injury fpr which injury or property damage that oc- said person or organization is held liable curer before you acquired or occurs subsequent to the execution of formed the organization; and such insured contract; This Form must be attached to Change Endorsement when issued after the policy is written. one of the Fireman's Fend insurance Companies® as named in the policy r Sy President CCr7151 IM Copyright 21W. Fireman's Fund Insurance Company, Novato, CA. All rights reserved. includes copyrighted material of Lnvrance services oaioe, rue., with its pcmdsdon. Page 1 of 7 (3) The most we will pay is the lesser of either the Limits of Insurance shown in the Declarations or the limits of insur- ance required by the insured contract; (4) Such person or organization is an insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or or- ganization-is not an insured with re- spdct to structural alterations, new construction or demolition- oper- ations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) -- Their - financial control of you, ex- ......._......... cept such person or organization is not an insured with respect to struc- -tural alterations, new construction or demolition alperations performed by or on behalf of such person or organization; (d) The maintenance, operation or use 'by. you of equipment leased to. you by such person or organization; (e) 'Operations performed by you or on your behalf and for which a state. or political subdivision has issued a pewit, provided such operations are not performed for such state or pol- itical subdivision, and are not in- chided within the products- completed operations hazard; (5) This insurance does not apply to bodily injury, property damage, personal and advertising injury, occurrence or offense: (a) Which takes place at a particular premises after you cease to be a tenant of that premises; (b) Which takes place after all work, in- cluding materials, parts or equip- ment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of your work out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a prin- cipal. as part of the same project; (d)• Which takes place after the expira- tion of Any equipment lease to which (4)(d) above applies; (6) With respect to architects, engineers or surveyors, coverage does not apply to bodily injury, property damage or per - soul -and advertising injury arising out __._o# the rendering.or faure to render. any .'..._... - -. - - -.. _.- .-- . -_ - -- professional services by or for you, in- cluding: (a) The preparing, approving, or Ming to prepare or approve, claps, shop drawings, opinions, reports, surveys, field orders, change orders, or draw- ings and specifications; (b) Supervisory, inspection, architec- tural, or engineering services. -However, if an Additional insured endorsement is attached to- this policy that specifically names a person or organization as an. insured, - then this subsection 2.e. does not apply to such person or organization. 3. Additional Insured - Vendors Unless the products - completed operations hazard is excluded from this policy, SECTION II - WHO IS AN INSURED, item 21 is added as follows: i Any vendor of yours is included as an addi- tional insured, but only with respect to bodily injury or property damage caused by your products which are distributed or sold in the regular course of the vendor's business, sub- ject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: CG7158 12-07 Copyright 2007, Ffremao's Rind Insurance Company, Novato, CA. All rights rcnrm& P 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (a) Bodily injury or property damage-for which the vendor is obligated to pay damages by reason of the assump- tion of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the ab- sence of the contract or agreement; (b) Any express warranty unauthorized by you; into, accompanying or containing such products. However, if an Additional insured - Vendors endorsement is attached to this policy that specifically manes a person or organization as an insured, then this subsection 21 does not apply to that person or organization. 4. Additional Insured - Lignited Prima y .and Non- . contrMutory Pravision (c) Any physical or chemical change in The following is added as 'a second paragraph . to the product made intentionally by Section IV Conditions, Condition 4. Other b ur- the vendor, ante, following paragraph b.(2): However, if you have added any person, organiza- tion or vendor of yours as an additional insured to tliis polig . byway. of this Mu%CoveA endorse- .. merit and have agreed in a written h>snre c o»Orad that • this insurance is primary and non- contribu- tory with other mmance.available to that addi- - tional -- insured,- this - insurance -is primary ..and..we_ .......:....... .___ -. Will not seek contribution ftom such additional m ured's other insurance. This provision does not . apply to other insurance to which such additional insured has been added as an additional insured. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GBNERAL LIABILITY CONDITIONS, item 8., is -deleted and replaced by the following: 8.. Transfer of Rights of Recovery Against Oth- ers to Us and Blanket Waiver of Subrogation a. If the insured has rights to •recover all or part of any payment we have made under this Coverage Part, those. rights' are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. (h) Bodily injury or property damage b. If required by a written insured contract arising out of the liability of the vendor for its own acts or omissions executed prior to the occurrence or of- m or those of its employees or anyone fence, we waive any right of recovery we w n else acting on its behalf may have against any person or orga ization named in such insured contract, '(2) This insurance does not apply to any in- because of payments we make for injury cured person or organization from whom or damage arising out of your operations you have acquired such products or any or your work for that person or organ N ingredient, part or container, entering ization. U CG7158 12.07 Copyright 2007, sirmaffs Fund lmwwm CompaihY, Novara. CA. All rights rererved. Page 3 of 7 mIncludes copyrighted niataid Of Insorance Servloes Office, Inc., with its pern6don. , m o (d) Repackaging, unless unpacked solely �..:_._..._ for the purpose of inspection, dem- __ -- tution of parts under instructions from the manufacturer, and then re- packaged in the original container; . (e) Any failure to make such in- spections, adjustments, tests or ser- vicing as the vendor has agreed to make or normally undertakes to o make m the usual course of busi- ness, in eormeetion with the distn'b- g ution.or sale of the products; (f) • Demonstration, installation, servic- ing or repair operations, except such operations performed by the vendor in fall compliance with the man ufacromes written instructions at the vendor's premises in connection with the sale of the product; ' (g) Products which, after distribution or sal6 by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or _ substance by or for the vendor, or However, if you have added any person, organiza- tion or vendor of yours as an additional insured to tliis polig . byway. of this Mu%CoveA endorse- .. merit and have agreed in a written h>snre c o»Orad that • this insurance is primary and non- contribu- tory with other mmance.available to that addi- - tional -- insured,- this - insurance -is primary ..and..we_ .......:....... .___ -. Will not seek contribution ftom such additional m ured's other insurance. This provision does not . apply to other insurance to which such additional insured has been added as an additional insured. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GBNERAL LIABILITY CONDITIONS, item 8., is -deleted and replaced by the following: 8.. Transfer of Rights of Recovery Against Oth- ers to Us and Blanket Waiver of Subrogation a. If the insured has rights to •recover all or part of any payment we have made under this Coverage Part, those. rights' are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. (h) Bodily injury or property damage b. If required by a written insured contract arising out of the liability of the vendor for its own acts or omissions executed prior to the occurrence or of- m or those of its employees or anyone fence, we waive any right of recovery we w n else acting on its behalf may have against any person or orga ization named in such insured contract, '(2) This insurance does not apply to any in- because of payments we make for injury cured person or organization from whom or damage arising out of your operations you have acquired such products or any or your work for that person or organ N ingredient, part or container, entering ization. U CG7158 12.07 Copyright 2007, sirmaffs Fund lmwwm CompaihY, Novara. CA. All rights rererved. Page 3 of 7 mIncludes copyrighted niataid Of Insorance Servloes Office, Inc., with its pern6don. , m o 6. Cancellation - 120 Days Common Policy Conditions endorsement IL0017, A. Cancellation, item 2.b. is' deleted and replaced by the following: b. 120 days before the effective date of cancella- tion if we cancel for any other reason. 7. Liberalization SECTION IV - COMMERCIAL GENERAL WJiMM CONDMONS, the following is ad- ded as'an additional Condition: Liberalization If we- adopt a change in our forms or rules which - - -- woukl.bmaden the_coyerage- providedby- any -£ors- - - - - -- that is a part of this policy without an extra premium charge, the broader.coverage will apply to this policy. This extension is effective upon the — 'approval of such - broader coverage -in your —state—.-- 8. Fire, Explosion, Sprinkler Leakage, or lightning Legal Liability Coverage A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the last paragraph, is deleted and replaced by the following: Bxchusions c. through A. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while: ' 1. Rented to you; 2. Temporarily occupied by you with the permission of the owner, or 3. Managed by you under a written agree - meet with the owner. A separate limit of insurance applies to this coverage as described in Section III - LIMITS OF INSURANCE. B. SECTION III - LIMITS. OF INSURANCE, item 6., is deleted and replaced by the follow- Ing 6. Subject to 5. above, the Damage to Premises Rented To You Limit shown C07158 12 -07 Copyright 2007, Fireman's Fund insurance Company, Novato, CA. All rlgktts reserved. Includes copyrighted material of Insurance Services office, Inc., with its permission . in the Declarations, for property damage to any one premises while rented to you, or in the case of damage by fire, explo- sion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you. with the permission of the owner, or managed by you under a written agreement with the owner, is the greater o£ a. $1,000,000 Any One Premises; or b. The Damage To Premises Rented To You Limit shown in the Decla- rations. C. SECTION -IV - COMMERCIAL GEN- _..... —ERAL -- LIABILITY - CONDITIONS, .4.-_.__... - -. Other Insurance, b. Excess Insurance, (1), items (b) and (c), are deleted and replaced by the following: (b) That is Fire, Explosion, Sprinkler Leak- age; or Iigghtning insurance for premises while -rented to you, temporarily occu- pied by you with permission of the owner, or'managed by you under a writ- ten agreement with the owner; (c) That is insurance purchased by you to cover your liability as a• tenant for property damage to *premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, or D. SECTION V - DEFINITIONS, 9. - Insured Contract, item a., is deleted and replaced by the following: , (a) A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire; explosion, sprinkler leakage, or Lightning to premises while rented to you, temporarily occupied by you with per- mission of the owner, or managed by you under a written agreement with the owner, is not an insured contract;' Page 4 of 7 9. • Damage to Invitees' Automobiles from Falling Trees or Tree Limbs - Limited Coverage This coverage applies to direct physical damage to automobiles owned by invitees subject to all of the following: 11. Charged Aircraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, item (6), is added as follows: ' 1. `Provided such damage originates from trees (6) An aircraft in which you have no ownership interest and that you have chartered with on premises owned, managed, leased or rented crew. � by as insured; 12. Coverage Territory - Broadened --- -2. Coverage applies only to invitees of an in- sured or an insured's tenant; SECTION V - DEFINITIONS, item 4.a., is de-. feted and replaced by the following: 3. Such damage is directly caused by wind -dri- ven falling trees or tree limbs; a. The United States of America. (including its . territories and possessions), Puerto Rico, '� Me most we will pay for any one loss is the Canada, Bermuda, the Bahamas, The Cayman _........ . _4, . lowest Of, Islands- and- %eBritisl>,V islands; I a. the actual cash value of the damaged au 13. Personal and Advertising Injury - Contractual 1omobile as of-the .time..of the loss;. or.. .. _ .._. Uiiless and- advertusl -- _ir aiy .ffi - b. the cost of repairing the damaged auto- from this policy the following applies: mobile; or SECTION I - COVERAGES, COVERAGE B, "— c. the cost of replacing the damaged auto- 2. Exclusions, item e., is deleted. b mobile with mother automobile of like 14. Fellow Employee Coverage dad and qty. SECTION II -WHO IS AN INSURED, 2.a., Regardless of the. " number • of occurrences, item (1) is deleted and replaced by the following: losses or claims, this coverage is subject to a • limit of $25,000 in any one policy period; (1) Pexsomal and advertising Wow- i' m m h W d N V W 5. This coverage is not subject to the General Liability General Aggregate Limit; and 6. We- will make payments under this coverage without regard to fault. 10. Non -Owned or Chartered Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAM- AGE LIABILITY, 2. Exclusions, item g. -Aircraft, Auto, or Watercraft, item (2), is deleted. and re- placed by the following. (2) A'watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used for public transportation . or as a common carrier, However, subsections (a), (b), (c) and (d) of item (1) remain unchanged. 15. Bodily Injury Definition - Broadened SECTION V - DEFINITIONS, 3. Bodily Injury is deleted and replaced by the following: Bodily injury means bodily injury, sickness or dis- ease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. 16. Expected or Intended Injury - Amendment to-Ex- clusion CG715812 -07 Copyright 2W7, Fireman s Furui'rnsuranee Company. Novato, CA All rights reserved. includes copyrighted material of Insurance Services Once, Inc ,with its permission. SECTION I. Coverage A Bodily Injury and Pro- perty Damage Liability, 2. EXCLUSIONS, a. Ex- pected or Intended Injury, is deleted and replaced by the following Page 5 of•7 a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or prop - erty. 17. Unintentimai Failure to Disclose Hazards SECTION IV - -COMMERCIAL GENERAL LIABILITY CONDITIONS, item 6. Represents (a) You, if you are an individual; (b) Your partner or, member, if you are a partnership or joint venture; (c) Your member, if you are a limited liabil- . ity company, (d) Your executive officer if you are an or- ganization other than a partnership, joint venture or limited liability company; or (e) Your authorized representative or msur- ance manager. tions, the following is added: Knowledge of an occurrence or offense by ns other than those listed above does not d. If you unintentionally fail to disclose any hs �y that those listed above also have such -- zards- existing -• at 'the. inception .date . of-- alts.: -.._- .. _.. _ .... - k'nowledge: . policy, we will not deny coverage under this Coverage Form because of such failure. (2) To the extent possible, notice should include: However, this provision does not affect . our nght to collcc additional premium or-exercise _ .._.._.._ -- -(a.)----How; when and. -where occurrence or- . -.... our right of cancellation or non renewal. offense took place; 18. - Supplementary Payments - Increased Limits SECTION I - COVERAGES, SUPPLEMEN- T TARY PAYMENTS - COVERAGES A AND B, items l.b. and l.d., are deleted and replaced by the following: b. • The cost of bail bonds 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. d. All reasonable expenses incurred by the in- sured at our request to assist us in the inves- tigation or defense of the claim or suit, including substantiated loss of earnings up to $500 a day because of time off from work. 19. Duties in the Event of an Occurrence, offense,. Claim or Suit - Amended SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 2.a. is deleted. and replaced by the following. (1) You must see to it that we or any licensed agent of ours are notified of a General Liability occurrence or offense which may re- sWi is a claim as soon as practicable after it becomes known to: (b) The names and addresses of any injured perms and witnesses; and (c) The nature and location of any injury or damage arising out of the occurrence or offense. 20. Non Employment Discrimination Liability- Unless personal and advertising injury is excluded from this policy this following applies: A. SECTION V - DEFINITIONS, 14. Personal and advertising injury, item IL is added as fol- lows: CG715B 12.07 Copyright 2M)7, Fireman's Fund Iasaraxe Company, Novam, CA Aa dghtt tautvsd Indudes copydg$ted material or Insurance Services Office, Inc., with its permission. h. Discrimination. B. SECTION V - DEFINITIONS, item 23. is added as follows: 23. Discrimination means the unlawful treat- . meat of a person or class of persons be- cause of their specific race, color, religion, gender, age, or national origin in com- parison to one or more person's who are. not members of the specified class. C• c. . SECTION I -COVERAGES, COVERAGE r •B. -PERSONAL AND ADVERTISING INJURY LIABILITY,' 2 Exclusions, the following are added: 'Page 6 of 7 p. Discrimination .directly or in� re- A. SECTION I - COVERAGES, COVERAGE i� ]sled to the past employment, employ- C MEDICAL PAYMENTS, 2. Emb ions, ment or prospective employment of any item f., is deleted and replaced by the follow person or class of persons by any insured; ing. i q. Discrimination directly . or indirectly re- L Products - Completed Operations Hazard fated to the sale, rental, lease or sublease or prospective sale, rental, lease or. sub- Included within the eted � lease of any dwelling or permanent lodg opernfidus Lazard. However, this exclu ing by or at the direction of any insured; lion does not to for den- apply � E� tal services.' r. Dation, if insurance thereof is prohibited by law; or B. Section I - COVERAGES, COVERAGE C MEDICAL PAYMENTS, is amended to in s. Fines, penalties, specific pedonnance, or chide item 3. as follows. >o inlutu bons Ievled or imposed by a govr ernmental entity, governmental code, law, or statute because of &wAnination. 3. Limit of Insurance The Medical Expense Limit of Insurance _..._. - -- ._ ......... ...._ .._ . _ -. ---- _:....._ - -._ ... 21. Medical Payments shall be The greater ofi Unless COVERAGE C MEDICAL PAY - a. $20,000 Any One Person; or ..... - -.. - MENTS,._or_ ihe..products-completed operations... - - -._ .....:....._ . Lazard has been excluded from this policy the fol- b. The amount shown in the Declare lowing applies. Lions. m o c' 8 ' m v �r s m m w d W N V C0115912-0 Copyright 2W, Phleman's Fund Irsttrance Company, Nmbq CA. All rights reserved. , P % of 7 W Indudgs e6pyrighted material of insurance services Office, Inc., with its pertoission. � o Corporations: Registration Detail Corporations Division - Registration Data Search CAFE FONTE COFFEE COMPANY Purchase Documents for this Corporation » UBI Number 601506001 Category REG Profit/Nonprofit Profit Active/Inactive Active State Of Incorporation WA WA Filing Date 11/17/1993 Expiration Date 11/30/2014 Inactive Date Duration Perpetual Registered Agent Information Agent Name SHANE SKINNER Address 5412 6TH AVE S City SEATTLE State WA ZIP 98108 Special Address Information Address 5501 6TH AVE S City SEATTLE State WA Zip 981082503 Governing Persons Page 1 of 1 Title Name Address President,Treasurer,Chairman ODOM , PAUL 2566 NOB HILL AVE N SEATTLE, WA 98109 Vice President, Secretary SMITH, STEVE 7337 23RD AVE BE SEATTLE, WA 98115 Purchase Documents for this Corporation » http: / /www.sos.wa.gov /corps /search _ detail.aspx ?ubi = 601506001 12/17/2013