AG 14-010 RETURN TO: Jennifer Marshall EXT:2542
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV:CITY CLERK'S OFFICE,,,,, ....,.
2. ORIGINATING STAFF PERSON::STEPHANIE COURTNEY CMC EXT: 2540 3. DATE REQ.BY: ASAP
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#): 14-010 D ❑ INTERLOCAL
❑ OTHER................................. _....... .....................................
5. PROJECT NAME:HFARINCAEXAmTNFR S—F VTC,..IES'
6. NAME OF CONTRACTOR:OLBRECHTS AND ASSOCIATES,PLLC
2 H
ADDRESS: 18833 NE 74T"STRI L➢�,�sI°wANITI mm��:�i,L.S 9825'. ...,��� TELEPHONE:206 650-7268
E-MAIL 0.113 R1EVIl"I'SLA "�s�I��MAIL.COM wFAX:N/4 �.....-�•
SIGNATURE NAME: Pti.u,A.OLBR EC',ffI'S .......... .�. TITLE:MEMBER/MANAGER
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
8. TERM: COMMENCEMENT DATE:„0,1,/,0„1,/2„0„18,AeOeee1 ,, COMPLETION DATE: 12/31/2019
9. TOTAL COMPENSATION NO I TO LXCI I I)..��$75,000 (INCLUDE EXPENSES AND SALES TAX,IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE:❑YES ❑NO IF YES,MAXIMUM DOLLAR AMOUNT: S ._...........-__
IS SALES TAX OWED ❑YES ❑NO IF YES,$ ,._....„ PAID BY:❑CONTRACTOR❑CITY
RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDED
■ PURCHASING: PLEASE CHARGE TO: 001-1200-044-514-30-4 1
D /
10. DOCUMENT/CONTRACT REVIEW II�IiT �.
DA �; UINITIAL DATE APPROVED
N PROJECT MANAGER f t'
11DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE) �m
0 LAW L �... .. _ ........ ... ....
11. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE:N/A COUNCIL APPROVAL DATE: 11/19/2013
12. CONTRACT SIGNATURE ROUTING
■ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D;
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,
. LICENSES,EXHIBITS
• CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept.support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.)
INITIAL/DAI'Iw';SI JNED
• LAW DEPARTMENT
• SIGNATORY(MAYOR OR DIRECTOR) ...
• CITY CLERK
G#
• SIGNED COPY RETURNED D
ATE"aIa1�14”:
COMMENTS:
2/2017
9
I
CITY OF CITY HALL
33325 8th Avenue South E
Federal Way
Federal Way,WA 98003-6325
(283)'835-700t3
MVWrat ff0d0raNVVY.rnm
AMENDMENT NO. 4
TO C
PROFESSIONAL SERVICE AGREEMENT
FOR
HEARING EXAMINER SERVICES
This Amendment ("Amendment No. 4") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Olbrechts and Associates, PLLC, a Washington professional limited liability
company, ("Contractor"). The City and Contractor (together "Parties"), for valuable consideration and by
mutual consent of the Parties, agree to amend the original Agreement for Hearing Examiner Services
("Agreement")dated effective January 1, 2014, as amended by Amendment No. 1,2, 3, and as follows:
1. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the 4
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-4, 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 for the Amended Term. Except as otherwise provided in an attached Exhibit, the
Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a
result of the performance and payment of this Agreement.
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 J
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. V
[Signature page follows] i
i
AMENDMENT - 1 - Rev. 9/2019
CITY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way,WA 98003-6325
(253)835-'000
www
s e
crC <°° r$bvay.com
IN WITNESS,the Parties execute this Agreement below,effective the last date written below.
CITY OF FEDERAL WAY: ATTEST:
Y
lim F m, r laoaneCourtney,CMC, i1 Cl.erl
DATE: APPROVED AS TO FORM:
J. Ryan Call, City Attorney _..._.___ _...._.__......._.
OLBRECHTS AND ASSOCIATES,PLLC:
i
By �P
Printed Name: Phil Olbrechts
Title: Mang 'na Partner
DATE;
STATEOI" k �
ss.
COUNTY OFC(e �7)N" >
On this day personally appeared before rae ,
to me known to be the
of
-,-JIthat executed the foregoing
instruni®t, rad acknowledged the said instrument to be the free and voluntary act and deed of said limited
liability company,for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to
execute said instrument.
GIVEN tray hand farad official al this day of
„ ..
Notary's signature
Notary's printed namet,
Public in and for the State o
Notary f Weshingtdn.Vis'°)
SAMANDEEP t4AUR f7 1 My commission expires
MAxy Pjo-State of Nevada
County of Clark
APP7 N0,19-1891-1
My APA.Bow JW.9.2023
AMENDMENT -2- Rev. 9/2019
CITY of CITY HALL
33325 8th Avenue South
Federal Way Federal Way,WA 98003-6325
(253)836-7000
wwwri"Ifederalmlay,tom
EXHIBIT B-4
ADDITIONAL COMPENSATION
1. Total Compensation: In return for the Hearing Examiner Services, the City shall pay the Contractor an
additional amount not to exceed Twenty-Five Thousand and No/100 Dollars ($25,000.00). The total amount
payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall
be an amount not to exceed Seventy-Five Thousand and No/100 Dollars($75,000.00).
2. Method of Compensation:
HOURLY RATE
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount
calculated on the basis of the hourly labor charge rate schedule for Contractor's personnel as shown below:
Hearing Exaiminer Services: $150 hourly rate(minimum of one hour for hearing date)
Contract Decision Writers: Cost plus 10%(not to exceed$65/hour)
Clerical Services: $30 hourly rate(minimum of one hour for hearing date)
RE IMBl:USABLE EXPENSES
The following expenses are permitted:
Copy and postage expenses: Actual Cost
Beyond postage and copy costs, decisions will be distributed as required by state law at no cost to the City.
AMENDMENT -3 - Rev. 9/2019
RETURN TO: Jennifer Marshall EXT: 242
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV:CITY CLERK'S OFFICE
ORIGINATING STAFF PERSON:STEPHANIE COURTNEY.CMC EXT: 2540 3. DATE REQ.BY: ASAP
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#): 14-010C ❑ INTERLOCAL
❑ OTHER
PROJECT NAME:HEARING EXAMINER SERVICES
NAME OF CONTRACTOR:OLBRECHTS AND ASSOCIATES.PLLC
ADDRESS: 18833 NE 74'STRLET.GRANITE FALLS 98252 TELEPHONE:206 650-7268
E-MAIL:OI_BRFCHTSLAW(&GMAIL.COM FAX:N/A
SIGNATURE NAME:PHIL A.OLBRECHTS TITLE:MEMBER/MANAGER
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
TERM: COMMENCEMENT DATE: 01/01/2018 COMPLETION DATE: 12/31/2019
TOTAL COMPENSATION'?#}-H? [=1IE_ �{�1 hall l 11\ 'I f'l� ��la_]fl{} (INCLUDE EXPENSES AND SALES TAX,IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE:❑YES LINO IF YES,MAXIMUM DOLLAR AMOUNT: $
1S SALES TAX OWED ❑YES ❑NO IF YES,$ PAID BY:❑CONTRACTOR❑CITY
RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDED
■ PURCHASING: PLEASE CHARGE TO: 001-1200-044-514-30-410
0. DOCUMENT/CONTRACT REVIEW INITI k DATE REVIEWED INITIAL/DATE APPROVED
■ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
■ LAW It I f
1. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE:N/A COUNCIL APPROVAL DATE: 11/19/2013
2. CONTRACT SIGNATURE ROUTING
■ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
■ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES, EXHIBITS
■ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept.support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.)
Il TIALI DA'Z'E SIGNED
LAW DEPARTMENT p�,
SIGNATORY(MAYOR OR DIRECTOR)
CITY CLERK
ASSIGNED AG# AG# I - OC ,
SIGNED COPY RETURNED DATE SENT:
C]M N`I" :
� lA +jAft4 "17 f .rh
ni-.
X017 --
CITY or CITY HALL
Federal Wa 33325 8th Avenue South
Federal Way,WA 98003-6325
(253) 835-7000
www cilyoffederalway.con)
AMENDMENT NO. 3
TO
PROFESSIONAL SERVICE AGREEMENT
FOR
HEARING EXAMINER SERVICES
This Amendment ("Amendment No. 3") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Olbrechts and Associates, PLLC, a Washington professional limited liability company,
("Contractor"). The City and Contractor(together"Parties"), for valuable consideration and by mutual consent of
the Parties,agree to amend the original Agreement for Hearing Examiner Services("Agreement")dated effective
January 1, 2014, as amended by Amendment Nos. 1 and 2, 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-3,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 for the Amended Term.Except as otherwise provided in an attached Exhibit,the Contractor shall be
solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance
and payment of this Agreement.
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 I - Rev. 9/2019
CITY OF CITY HALL
Federal Way■ay Feder 8th Avenue South
■YL1Y■ Federal Way,WA 98003-6325
(253) 835-7000
www.cityoffederalway.corn
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OFF DERAL WAY: ATTEST:
By.
YMEOW W_
Ji er• [, M
ay ayS hanie Courtney, CMC, CiVj Clerk
DATE: APPROVED AS TO f ORM:
J. Ryan Call, City Attorney
OLBRECHTS AND ASSOCIATES,PLLC:
By:
Printed Name: Phil Olbrechts
Title: Managing Partner
DATE: 7/Z f—ZIZ��t
STATE OF WASHINGTON )
) ss.
COUNTY OF KJ
On this day personally appeared before me 'NA D1 �frc�+5 -, to me known to be the
" M P"tMe of 06WA4s aced f646cItteS PLL--, that executed the foregoing
instrument,and acknowledged the said instrument to be the l vc Luid voluntary act and deed of said limited liability
company,for the uses and purposes therein mentioned,and �in (,,,idi Mated tha 1e was authorized to execute said
instrument. ��II
GIVEN my hand and official seal this day of . 20
.•�IoklE p Go
q „�,,,,,,,,, � �i�i Notary's signature % �
s _ o�" '•y�����r Notary's printed name
Q �' +, Notary Public in and for the State f�k'ashington.
My commission expires
a , veL%Q r2
fI1,0101tiWA5N` �•�'
AMENDMENT -2 - Rev. 9/2019
CITY of CITY HALL
J*%� Federal Way Feder 8th Avenue South
Federal Way,"iA 98003-6325
(253) 835-7000
tmw.cityoffederalway corn
EXHIBIT B-3
ADDITIONAL COMPENSATION
1. Total Compensation: In return for the Hearing Examiner Services, the City shall pay the Contractor an
additional amount not to exceed Twenty-Four Thousand and No/100 Dollars ($24,000.00). The total amount
payable to Contractor pursuant to the original Agreement,all previous Amendments,and this Amendment shall be
an amount not to exceed Fifty Thousand and No/100 Dollars ($50,000.00).
2. Method of Compensation:
HOURLY RATE
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount
calculated on the basis of the hourly labor charge rate schedule for Contractor's personnel as shown below:
Hearing Examiner Services: $150 hourly rate (minimum of one hour for hearing date)
Contract Decision Writers: Cost plus 10% (not to exceed $65/hour)
Clerical Services: $30 hourly rate (minimum of one hour for hearing date)
REIMBURSABLE EXPENSES
The following expenses are permitted:
Copy and postage expenses: Actual Cost
Beyond postage and copy costs, decisions will be distributed as required by state law at no cost to the City.
AMENDMENT - 3 - Rev. 9/2019
RETURN TO: Jennifer Marshall EXT: 2542
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT. /DIV: CITY CLERK'S OFFICE
2. ORIGINATING STAFF PERSON: STEPHANIE COURTNEY, CMC
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
• CONTRACT AMENDMENT (AG #): 14 -010 A
❑ OTHER
5. PROJECT NAME: HEARING EXAMINER SERVICES
EXT: 2540 3. DATE REQ. BY: 12/01/2017
❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ MAINTENANCE AGREEMENT
❑ HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
6. NAME OF CONTRACTOR: OLBRECHTS AND ASSOCIATES, PLLC
ADDRESS: 18833 NE 74Th STREET, GRANITE FALLS 98252 . TELEPHONE: 206 650 -7268
E -MAIL: OLBRECHTSLAW @GMAIL.COM . FAX: N/A
SIGNATURE NAME: PHIL A. OLBRECHTS . TITLE: MEMBER/MANAGER
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
8. TERM: COMMENCEMENT DATE: 01/01/20118, OW COMPLETION DATE: 12/31/2019
9. TOTAL COMPENSATION NOT TO EXCEED $11.(i I OW (INCLUDE EXPENSES AND SALES TAX)
(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 ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR 0 RETAINAGE BOND
PROVIDED
• PURCHASING: PLEASE CHARGE TO: 001 -1200- 044 - 514 -30 -410
10. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
• DIRECTOR/CITY CLERK
❑ RISK MANAGEMENT (IF APPLICABLE)
• LAW
11. COUNCIL APPROVAL (IF APPLICABLE)
1 ve.e Zo 11
COMMITTEE APPROVAL DATE: N/A COUNCIL APPROVAL DATE: 11/19/2013 .
12. CONTRACT SIGNATURE ROUTING
• SENT TO VENDOR/CONTRACTOR DATE SENT: ill 011 t t'1 DATE REC'D: 17,-1'04 ('1/1)1'1
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
• CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.)
• LAW DEPARTMENT
• SIGNATORY (MAYOR OR DIRECTOR)
• CITY CLERK
• ASSIGNED AG#
• SIGNED COPY RETURNED
INIT AL / I ATE SI NE I►
Y
W 7 L
✓7_ k!I%✓
AG#
DATE SENT:
COMMENTS:
Y�.0 . cmittruitt �\s- c -L a c {, & &k tl t .2)o !?4Qt1
2/2017
Vecferal Way
CITY HALL
33325 8th Avenue South
Federal Way. WA 98003 -6325
(253) 835 -7000
www cityoffederatway corn
AMENDMENT NO. 2
TO
PROFESSIONAL SERVICE AGREEMENT
FOR
HEARING EXAMINER SERVICES
This Amendment ( "Amendment No. 2 ") is made between the City of Federal Way, a Washington municipal
corporation ( "City "), and Olbrechts and Associates, PLLC, a Washington professional limited liability company,
( "Contractor "). The City and Contractor (together "Parties "), for valuable consideration and by mutual consent of the
Parties, agree to amend the original Agreement for Hearing Examiner Services ( "Agreement ") dated effective
January 1, 2014, as amended by Amendment No. 1, and 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, 2019 ( "Amended Term ").
2. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the
Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or
method of payment, as delineated in Exhibit B -2, 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 for the Amended Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be
solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and
payment of this Agreement.
3. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior
amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done by
either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after the
previous expiration date and prior to the effective date of this Amendment, 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 Rev. 3/2017
Vecferal Way
CITY HALL
33325 8th Avenue South
Federal Way. WA 98003 -6325
(253) 835 -7000
www c,tyoffederalway com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
By:
DATE:
OLBRECHTS AND ASSOCIATES, PLLC:
Printed Name: Phil Olbrechts
Title: Managing Partner
DATE: 12..-/y.
2..- y/ 7
ATTEST:
' l%1W
S ph.nie Courtney, CMC, C ty C
APPROVED AS TO FORM:
Lerk
J. Ryan Call, City Attorney
STATE OF WASHINGTON )
) ss.
COUNTY OF y- t (� )
On this day personally appeared beforte me Y Vt i t 4 , (, 0 • CCIA' , to me known to be the
(i+A011AC ilk c e,dkY' enr" of 0(k.tciArC it A " At (, , , ft(.. that executed the foregoing
instrumdit,.and acknowledged the said instrument to be the free and volhntary act and deed of said limited liability
company, for the uses and purposes therein mentioned, and on oath stated that he /she was authorized to execute said
instrument.
GIVEN wtkd and official seal this
E• MAR,VIt%
115 .
u>. 3.i9 4'
OF VI
AMENDMENT
day of De tiA/61/ 2011.
Notary's signature
Notary's printed name
in and for the Slate of Washington.
mission expires ViA (4) I Pv
2 Rev. 3/2017
Federal Way
EXHIBIT B -2
ADDITIONAL COMPENSATION
CITY HALL
33325 8th Avenue South
Federal Way. WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
1. Total Compensation: In return for the Hearing Examiner Services, the City shall pay the Contractor an
additional amount not to exceed Ten Thousand and No /100 Dollars ($10,000.00). The total amount payable to
Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount
not to exceed Twenty -Six Thousand and No /100 Dollars ($26,000.00).
2. Method of Compensation:
HOURLY RATE
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount
calculated on the basis of the hourly labor charge rate schedule for Contractor's personnel as shown below:
Hearing Examiner Services:
Contract Decision Writers:
Clerical Services:
REIMBURSABLE EXPENSES
The following expenses are permitted:
Copy and postage expenses:
$150 hourly rate (minimum of one hour for hearing date)
Cost plus 10% (not to exceed $65/hour)
$30 hourly rate (minimum of one hour for hearing date)
Actual Cost
Beyond postage and copy costs, decisions will be distributed as required by state law at no cost to the City.
AMENDMENT 3 Rev. 3/2017
ACGRIJ®
PRODUCER
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
11/29/2017
Moranco & Associates
9631 N. Nevada, #309
Spokane, WA 99218
(509) 324-0640
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Olbrechts & Associates, PLLC
18833 74th St. NE.
Granite Falls, WA 98252
(206) 650 -7268
COVERAGES
INSURER A: The Hanover Insurance Group
INSURER B:
INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM /DD/YYYYI
POLICY EXPIRATION
DATE /MMIOO/YYYY)
LIMITS
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES (Ea occurence)
$
CLAIMS MADE OCCUR
MED EXP (Any one person)
$
PERSONAL 8 ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
RO-
-1 POLICY jT LOC
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS/
UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER /MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
SPECIAL PROVISIONS below
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E . DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
Lawyers Professional
Liability Insurance
#LH2 A772755
10/29/17
10/29/18
$1,000,000 ^' Per Claim
$1,000,000 — Aggregate
$2,500 — Deductible
DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
City of Federal Way; Federal Way City Hall
33325 8th Ave S.
Federal Way, WA 98003 -6325
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2009/01)
r-t��
f /- f
1988 -2009 ACORD CORPORATION All rights reserved.
The ACORD name and logo are registered rc,rks of ACORD
11
RETURN TO: STEPHANIE COURTNEY EXT: 2540
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT. /DIV: LAW/CITY CLERK
2. ORIGINATING STAFF PERSON: STEPHANIE COURTNEY, CITY CLERK
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.
❑ PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT
❑ REAL ESTATE DOCUMENT
❑ ORDINANCE
X CONTRACT AMENDMENT (AG #): 14 -010
❑ OTHER
EXT: 2540 3. DATE REQ. BY: 12/31/2015
G., RFB, RFP, RFQ)
❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ MAINTENANCE AGREEMENT
❑ HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
5. PROJECT NAME: HEARING EXAMINER SERVICES
6. NAME OF CONTRACTOR: OLBRECHTS AND ASSOCIATES
ADDRESS: 18833 NE 74Th STREET, GRANITE FALLS, WA 98252 TELEPHONE 206 650 -7268
E -MAIL: OLBRECHTSLAW @GMAIL.COM FAX:
SIGNATURE NAME: PHIL A. OLBRECHTS TITLE: MEMBER/MANAGER
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
8. TERM: COMMENCEMENT DATE: 01/01/2016 COMPLETION DATE: 12/31/2017
9. TOTAL COMPENSATION $ PER FEE SCHEDULE (NOT TO EXCEED $16,000.00) (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES X NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
t4 PURCHASING: PLEASE CHARGE TO:
001 -1200- 044 - 514 -30 -410
10. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
A LAW
11. COUNCIL APPROVAL OF APPLICABLE)
COMMITTEE APPROVAL DATE: N/A COUNCIL APPROVAL DATE: 11/19/2013
12. CONTRACT SIGNATURE ROUTING `r
SENT TO VENDOR/CONTRACTOR DATE SENT: t\ 1 u Cl l 7 l`� DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
• LAW DEPARTMENT
CHIEF OF ST
SIGNATOR
A CITY CLERK
A ASSIGNED AG#
A SIGNED COPY RETURNED
R DIRECTOR)
COMMENTS:
INITIAL / DATE IGNED
DATE SENT: /2- 7 - /5
t&i,t7I)/ots--
11/9
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
AMENDMENT NO. 1
TO
PROFESSIONAL SERVICE AGREEMENT
FOR
HEARING EXAMINER SERVICES
This Amendment ( "Amendment No. 1") is made between the City of Federal Way, a Washington municipal
corporation ( "City "), and Olbrechts and Associates, PLLC, ( "Contractor "). The City and Contractor (together
"Parties "), for valuable consideration and by mutual consent of the parties, agree to amend the original Agreement
for Hearing Examiner Services ( "Agreement ") dated effective January 1, 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 31, 2017 ( "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 -
AG #14 -010
Vecleral Way
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:
Jim
ayor
DATE: /-- f 5
OLBRECHTS AND ASSOCIATES, PLLC
By:
Phil A. Olbrechts, Member /Manager
DATE: /7/7
STATE OF WASHINGTON )
/ ) ss.
COUNTY O� Lei CS A )
ATTEST:
erk, Stephanie Cou
APPROVED AS TO FORM:
y, CMC
p v K C
t''5 City Attorney, Amy Jo Pearsall
On this day personally appeared before me Phil A. Olbrechts, to me known/proven to be the member / manager of
Olbrechts and Associates, PLLC. 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 G' d �ay of /.: G - , 2O/ f -
�Q,. 1;4 qq Notary's signature
= �Oy1)* SSIOFA�° Notary's printed name
?�i �oT�r9N2=
=* ••� *_
3N ..y AUB% ,N _,�
'l%`F';BER222����'
e /e� %AWASH``; HI i
AMENDMENT
tary Public in and for the State of Washington.
My commission expires NJ v 22 2" 17
- 2 - AG #14-010
F[ T RETURN TO: Carol McNeilly, City Clerk EXT: 2540
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
I. ORIGINATING DEPT. /DIV: Law /City Clerk
2. ORIGINATING STAFF PERSON: Carol McNeill/, CitV Clerk EXT: 2541 3. DATE REQ. BY: 12 -27 -2013
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
• GOODS AND SERVICE AGREEMENT
• REAL ESTATE DOCUMENT
• ORDINANCE
• CONTRACT AMENDMENT (AG #):
❑OTHER
5. PROJECT NAME: Hearing Examiner Services
❑ MAINTENANCE AGREEMENT
❑ HUMAN SERVICES/ CDBG
• SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
• RESOLUTION
❑ INTERLOCAL
6. NAME OF CONTRACTOR: Olbrechts and Associates
ADDRESS: 18833 NE 74th Street, Granite Falls, WA 98252 TELEPHONE 206- 650 -7268
E -MAIL: Olbrechtslaw@-qmaii.com FAX:
SIGNATURE NAME: Phil A. Olbrechts TITLE Member /Manager
7. EXHIBITS AND ATTACHMENTS: E SCOPE, WORK OR SERVICES E COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑
ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
8. TERM: COMMENCEMENT DATE: 01 -01 -2014 COMPLETION DATE: 12 -31 -2015
9. TOTAL COMPENSATION $ See Fee Schedule A 1(L _ = ; - (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES E NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES E NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
E PURCHASING: PLEASE CHARGE TO: 001 -1200 -044- 514 -30 -410
10. DOCUMENT /CONTRACT REVIEW
E PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
Z LAW
11. COUNCIL APPROVAL (IF APPLICABLE)
INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
SFo t-?-- ?--5 - t
COMMITTEE APPROVAL DATE: N/A COUNCIL APPROVAL DATE: 11 -19 -2013
12. CONTRACT SIGNATURE ROUTING
® SENT TO VENDOR/CONTRACTOR DATE SENT: I Z' Z1 'l;5 DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
E LAW DEPARTMENT
E SIGNATORY (MAYOR OR DIRECTOR)
® CITY CLERK
E ASSIGNED AG#
E SIGNED COPY RETURNED
COMMENTS:
INITIAL / DATE SIGNED
-71 r ,2 '- 1
•Iry 1L1
LIAG# -j9t0
DATE SENT:
CITY O�
Federal Way
CITY OF FEDERAL WAY
33325 F.ighth Avenue South • Federal Way, WA 98003
253- 835 -7000 • www.cityoffederalway.com
PROFESSIONAL SERVICES AGREEMENT
FOR
HEARING EXAMINER SERVICES
This Professional Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal
corporation ( "City "), and Olbrechts & Associates, PLLC ( "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:
'S
Olbrechts and Associates, PLLC
Phil A. Olbrechts
18833 NE 74'' Street
Granite Falls, WA 98252
(206) 650 -7268 (telephone)
Olbrechtslaw@gmail.com
The Parties agree as follows:
CITY OF FEDERAL WAY:
Carol McNeilly, City Clerk
33325 8`h Ave. S.
Federal Way, WA 98003 -6325
(253) 835 -2540 (telephone)
(253) 835 -2509 (facsimile)
Caro l.mcneiIly@ciiyoffederalway com
1. TERM. The term of this Agreement shall commence January 1, 2014 (the effective date of this Agreement) and
shall continue through December 31, 2015 ( "Terin "). This Agreement may be extended for additional periods of time
upon the mutual written agreement of the City and the Contractor.
2. SERVICES. The Contractor shall perform the services more specifically described in Exhibit "A ", attached
hereto and incorporated by this reference ( "Services "), in a manner consistent with the accepted professional practices for
other similar services within the Puget Sound region in effect at the time those services are performed, 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. The Contractor warrants that it has the requisite training, skill, and experience necessary to provide the Services
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. Services shall begin immediately upon the effective date of this
Agreement. Services shall be subject, at all times, to inspection by and 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 Services
in accordance with this Agreement, notwithstanding the City's knowledge of defective or non - complying performance, its
substantiality or the ease of its discovery.
3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other
parry thirty (30) days written notice at its address set forth above. 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 Services, 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 Services have been performed, the name of the personnel
performing such Services, and any hourly labor charge rate for such personnel. The Contractor shall also submit a final
bill upon completion of all Services. Payment shall be made on a monthly basis by the City only after the Services have
PROFESSIONAL SERVICES AGREEMENT - 1 - 9/2012
CH Y Of CITY OF FEDERAL WAY
Federal Wavir 3332,E Avenue -South • Federal Way, 1VA 98003
253 83 ?000 • w.t:ityoffederalway . com
been performed and within thirty (30) days after receipt and approval by the appropriate City representative of the
voucher or invoice. If the Services 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 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 Services or amounts incurred
after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services
for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies.
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, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries,
damages, liabilities, taxes, 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 in connection with this Agreement or the acts, errors or omissions of the Contractor in
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, including the duty and cost to defend, 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 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:
PROFESSIONAL SERVICES AGREEMENT -2- 9/2012
cif` tar CfTY OF FEDERAL WAY
Fedel +' 33325 Eighth Avenue South • Federal Way, WA 98003
253 -835 -7000 • www.c;tyoffederniw(�v.com
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.
d. Professional liability insurance with limits no less than $1,000,000 per claim and $1,000,000
policy aggregate for damages sustained by reason of or in the course of operation under this Agreement, whether
occurring by reason of acts, errors or omissions of the Contractor.
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 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. 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 or other tax which
may arise as an incident of employment. Contractor shall take all necessary precautions and shall be responsible for the
safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection
PROFESSIONAL SERVICES AGREEMENT - 3 - 9/2012
CITFederal Yof ,��ag�{ CITY OF FEDERAL WAY
iA p' 3 a ,5 EighV'.. Avg i u(_ 'oulh edeial vC.�f; ��'V,' 121S,5 -8,115- 70 wr.iy,carn
necessary for that purpose. 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. The Contractor
shall pay all income and other taxes due 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.
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, 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.
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 of this
PROFESSIONAL SERVICES AGREEMENT - 4 - 9/2012
CITY OF CITY OF FEDERAL WAY
Federal 333225 Eighth Avenue South • Federal Way, WA 98003
253- 835 -7000 • www.cityoffederaifway.corn
Agreement, this Agreement may be rendered null and void, at the City's option.
13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which
performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the
Contractor's performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the
addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the
notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted
in the United States mail shall be deemed received three (3) days after the 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]
PROFESSIONAL SERVICES AGREEMENT -5- 9/2012
0
CITY OF
Federal Way
CITY OF FEDERAL WAY
33325 Eighth Avenue South • Federal Way, WA 98003
253 -835 -7000 • www.cityoffederalway.com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
DATE: S
OLBRECHTS AND ASSOCIATES, PLLC
Printed Name: Phil A. Olbrechts
Title: Member/Manager
DATE:
STATE OF WASHINGTON )
ss.
COUNTY OF
ATTEST:
m
i Clerk, Carol McNeilly, CM
APPROVED AS TO FORM:
ity Attorney, Patricia A Richardson
On this day personally appeared before meth tlexecuOd the foregoing be the
acknowledged the said of
Mbac}�5.+- !'�sSQ�— P��,�' g g g strument
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 1D I" day oflc� 204
Notary's signature
���••�� "� �h Notary's printed name ' 11 mcf)PLQ; 91�
sr� V A ft ���� , t
,�1�,�� Notary Public in and for the State of Washington.
3i Gs_ *O rg1t°j`, �� My commission expires- �. - 2 ^ 20
t G90
ro of
PROFESSIONAL SERVICES AGREEMENT - 6 - 9/2012
CITY OF
Federal s
EXHIBIT "A"
SERVICES
CITY OF FEDERAL WA`r
:333'.) Avenue S ;moth * Fe' ercil Vk v. ,',r J; MC-0
253 -335 /100 tNVVVJ.0 f`v'CitfE C9eYC11VJC:V,CO "Y
FEDERAL WAY REVISED CODE: The Hearing Examiner shall perform all duties described in and pursuant to the
jurisdiction, power and authority established in the Federal Way Revised Code (FWRC) Chapter 2.95 for the Hearing
Examiner as now existing or hereafter adopted or amended, together with such other or further Hearing Examiner services as
may be required by the Federal Way Revised Code.
CITY DIRECTION: All duties shall be perfonned pursuant to the direction of the Mayor or his or her designee.
COMPLIANCE WITH LAWS: All duties shall be performed in accordance with all applicable federal, state and City laws,
including but not limited to King County and the City of Federal Way Land Use laws, State Environmental Act (SEPA),
Shoreline Management Act, Open Public Meetings Act, Rules of Evidence, and all city codes, ordinances, resolutions,
standards or policies as now existing or hereafter adopted or amended, including the Hearing Examiner Rules of Procedure.
RULES OF PROCEDURE: The Hearing Examiner shall establish rules of procedure for the efficient and fair conduct of
matters that come before the Hearing Examiner. These rules must be consistent with state and city law. A copy of these rules
of procedure should be made available for inspection and copying in the department of 'Economic & Community
Development during regular business hours.
CLERICAL SERVICES: The Hearing Examiner shall furnish clerical services including, but not limited to, the typing of
decisions, mailing decisions to parties of record, typing decisions on requests for reconsideration, furnish qualified personnel
to mark exhibits, list names and address of parties of record, and record public hearings.
TIMELINESS: Decisions shall be rendered within the time period prescribed by the applicable statue or FWRC provision. If
the Hearing Examiner is unable to render a decision within the required time period, he shall follow the protocol set forth in
the FWRC. Failure to do so will be considered a material breach of contract.
PERFORMANCE STANDARD: All duties shall be performed in a manner consistent with the accepted practices for other
similar services, performed to the City's satisfaction, including, but not limited to conducting orderly and impartial hearings,
creating a 'professional and courteous environment for applicants, citizen and staff; and the preparation of findings and
conclusions which are understandable and based upon sound reasoning and all applicable laws. When deemed appropriate,
the Hearing Examiner will make site visits to familiarize him or herself with the site of the proposed land use and the
surrounding area.
DESIGNATED HEARING EXAMINER: Unless otherwise approved to in writing by the City, the City hereby designates
Phil A. Olbrechts, as the City's Hearing Examiner. Pro Tern Examiners shall be appointed by the City.
PROFESSIONAL SERVICES AGREEMENT - 7 - 9/2012
.,
CITY OF
Federal w
CITY OF FEDERAL WAY
i i315 t' �fl fl
Aveznue )C:uih • Federal 'yVay, W/,i 98003
2,5,3 -835 -7000 . www.cityoffeder(,jiw(Dy.corr
EXHIBIT "B"
COMPENSATION
Total Compensation: In return for the Services, the City shall pay the Contractor an amount not to exceed
$16,000.00
HOOLY RATE
In consideration of the Contractor performing the Services, the City agrees to pay the Contractor an amount calculated on the
basis of the hourly labor charge rate schedule for Contractor's personnel as shown below:
Hearing Examiner Services: $150 hourly rate (minimum of one hour for hearing date)
Contract Decision Writers: Cost plus 10% (not to exceed $651hour)
Clerical Services: $30 hourly rate (minimum of one hour for hearing date)
REIMBURSABLE EXPENSES
The following expenses are permitted:
Copy and postage expenses: Actual cost
Beyond postage and copy costs, decisions will be distributed as required by state law at no cost to the City.
PROFESSIONAL SERVICES AGREEMENT - 8 - 9/2012
Corporations: Registration Detail
Corporations Division - Registration Data Search
OLBRECHTS AND ASSOCIATES, PLLC
Purchase Documents for this Corporation »
UBI Number
603060102
Category
PLC
Profit/Nonprofit
Profit
Active/Inactive
Insetive
State Of Incorporation
WA
WA Filing Date
10131/2010
Expiration Date
10/31/2011
Inactive Date
O1/2012
Duration
Perpetual
Registered Agent Information
Agent Name
PHIL OLBRECHTS
Address
13833 NE 74TH ST
City
GRANITE FALLS
State
WA
ZIP
98252
Special Address Information
Address
City
State
Zip
w�,��SK Per�oe
Page 1 of 2
Title _
Name
Address
h(etnber
01brecthts, Phil
18833 NE 74th St NE
GRANITE FALLS, WA 98252
Member J01brechts,
Kristen
18$33 NE 74th St
GRANITE FALLS, WA 98252
http: / /www.sos.wa.gov /corps /search_ detail.aspOubi= 603060102 M _l i t113
Page 1 of 1
Back to search results
If "Non- revenue" appears after Tax Registration Number, the account is not registered
with the Department of Revenue. However, it may be registered with other agencies in the
state.
Washington State Department of Revenue
State Business Records Database Detail
TAX REGISTRATION NO: 603060102 ACCOUNT OPENED: 10/01/2010
UBI: 603060102 ACCOUNT CLOSED: 'OPEN.
ENTITY NAME OLBRECHTS &'ASSOCIATES PLLC
BUSINESS NAME:
MAILING ADDRESS:
BUSINESS LOCATION':
18833 74TH ST NE
18833 74TH ST NE
GRANITE FALLS, WA 98252 -9011
GRANITE FALLS, WA 98252 - 9011;
ENTITY; TYPE: LIMITED LIABILITY
RESELLER PERMIT NO
N/A'
PERMIT EFFECTIVE
K /Ai
NAICS CODE: S41110
PERMIT EXPIRES:
N /A`
NAICS DEFINITION': OFFICES OF LAWYERS
FOR NON-COM 'MERCIA►L USE ONLY
12/03/2013 3:21 PM
http: / /dor.wa.gov/ content/ doingbusiness/ registermybusiness /brd/Default.aspx '
`A'
ACCVlrrc3 CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DDIYYYY)
-
12/18/2013
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 policytios) 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 endorsemont(s).
PRODUCER Midiakes Insurance, Inc.
2AM __ Putt Hendricks
1700 Westlake Ave N #724
Pq/C,Nq F�t11206-269 520p �i%±JHe,;206-269-5220
Seattle WA 98109
pRless: patty @robinson- Ins.com
INSURER(S) AFFORDING COVERAGE _
NAIC A
$ 1,000,000
A: Ohio Security
01-110S
PERSONAL & ADV INJURY
INSURED
Olbrechts and Associates, PLLC
_INSURER . _._....� _ _ ,_».........�.�
INSURER B.
GENERAL AGGREGATE
S 2,OW.000
18833 74th Street NE
PRODUCTS - COMPIOP AGG
$ 1,000'000
1114SURER0:
NSURERD:
S
INSURER E:
LIABILITY
ANY AUTO
ALL
AUTOED AUTOS SCHEDULED
NON -OWNED
HIREDAUTOS AUTOS
Granite Falls WA 98252
`CCfVFRArP!A CFRTIFICATF NI IMRFR• RFVIFIr7N NtIMIRFR?:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN SR
TYPE OF INSURANCE
DDL
SUN
P CY NUMBER
POLICY EFF
POLICY EXP
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE XOCCUR
Y
N
BZS55768632
09/24/2013
09/24/2014
EACH OCCURRENCE'
$ 1,000,000
$ 1,000,000
MEOEXP An we^persa
S 15,000
PERSONAL & ADV INJURY
S 1,000,000
GENERAL AGGREGATE
S 2,OW.000
GEN'L AGGREGATE LIMIT APPLIES PER:
X I POLICY LOC
PRODUCTS - COMPIOP AGG
$ 1,000'000
Fire Le al Liabili
S
AUTOMOBILE
LIABILITY
ANY AUTO
ALL
AUTOED AUTOS SCHEDULED
NON -OWNED
HIREDAUTOS AUTOS
BODILY INJURY (Per person)
$
BODILY INJURY(Per acdderA)
S`
S
E
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
—PEP E ENT
; _
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNF_RIEXECUTIVE M;
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
If yyes, describe eY
DE urM
DESCRIPTION PERATI NS below
NIA
I I
WC STATU- C1T H
O
E.L. EACH ACCIDENT
$
E.L DISEASE - EA EMPLOYEE
S
,...:
E,L DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ~h ACORD 101, Addleonal Remarks Schedule, If more apace b required)
Certificate Holder is Additional Insured as respects General Liability if required by written contract.
I�GIKiII'IVA -LC OVLUCR GANGCLLA IiVN
Federal Way City Hall SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
33325 8th Avenue South ACCORDANCE WITH THE POLICY PROVISIONS.
Federal Way WA 98003 -6325
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
reserved.