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AG 15-130 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIV: PARKS 2. ORIGINATING STAFF PERSON: h rX v ■A c(P W►p�n 43 EXT: 6941 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#): ❑ INTERLOCAL X OTHER Lc VI LL 5 S 1 is j1(i.kV C 5. PROJECT NAME: Po Roc% 6. NAME OF CONTRACTOR: 12,c O,A r r a r Prk■A.- 01 ADDRESS: 1'6 4 3 11511' ICU(- N E ( t-Ile V ,F `l' cc l-1 TELEPHONE: E-MAIL: eV,' cr Q rte. FAX: SIGNATURE NAME: 3 pA., t K St r TITLE: 7. EXHIBITS AND ATTACHMENTS: SCOPE,WORK OR SERVICES MCOMPENSATION -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: 1 ' a L I S COMPLETION DATE: 1 .-t I I S 9. TOTAL COMPENSATION:$ N l A (INCLUDE EXPENSES AND SALES TAX,IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑YES ❑NO IF YES,MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑YES ❑NO IF YES,$ PAID BY: ❑CONTRACTOR ❑CITY ❑ PURCHASING: PLEASE CHARGE To: C a v\ c.c a v e 10. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL/DATE APPROVED ❑ 3ROJECT MANAGER SUPERVISOR 4(.. � �I�1 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW DEPT h?.0 ‘11'6115 11. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 5 121 1115 DATE REC'D: (a SIC S ❑ ATTACH: SIGNATURE AUTHORITY,INSURANCE CERTIFICATE,LICENSES,EXHIBITS INITIAL/DAT, SIGNED ❑ LAW DEPT C Mir ❑ SIGNATORY(MAYOR OR DIRECTOR) / ❑ CITY CLERK /4 111PTI 7f ❑ ASSIGNED AG# AG ❑ SIGNED COPY RETURNED DATE SENT: 0 man .2-OtLs ❑RETURN ONE ORIGINAL COMMENTS: c/iM/l J 5-peArm6 I Go V w►ti 11/9 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www otyoffederalway.com CONCESSIONAIRE AGREEMENT FOR PAINTBALL BOOTH AT RED, WHITE AND BLUES FESTIVAL This Concessionaire Agreement("Agreement")is made between the City of Federal Way,a Washington municipal corporation("City"),and Road Warrior Paintball,LLC.,a Washington limited liability company("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: ROAD WARRIOR PAINTBALL,LLC: CITY OF FEDERAL WAY: John E Kiser Kevin Hutchinson 1843 115th Ave NE 876 South 333rd Street Bellevue, WA 98004 Federal Way, WA 98003-6325 206-406-0880 (telephone) 253-835-6927 (telephone) ekiser @comcast.net kevin.hutchinson@cityoffederalway.com The Parties agree as follows: 1. TERM.The term of this Agreement shall commence upon the effective date of this Agreement,which shall be the date of mutual execution, and shall continue through the clean-up of the City's 4th of July Red, White and Blues Festival (the "Event")located at Celebration Park, 1095 South 324th Street,Federal Way,WA on July 4th, 2015 ("Term"). 2. WORK. 2.1 Work. The Contractor shall provide goods, materials or services and otherwise perform the work more specifically described in Exhibit "A," attached hereto and incorporated by this reference("Work"), performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. 2.2 Warranties.The Contractor warrants that it has the requisite training,skill,and experience necessary to provide the Work and is appropriately accredited and licensed by all applicable agencies and governmental entities,including but not limited to obtaining a City of Federal Way business registration. The Contractor warrants it will provide services in a manner consistent with the accepted practices for other similar services within the Puget Sound region in effect at the time those services are performed 2.3 Clean Up.At any time ordered by the City and no later thank 11:59pm on July 4,2012,the Contractor shall,at its own expense, clean up and remove from Celebration Park 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. CONCESSIONAIRE AGREEMENT -paintball - 1 - 1/2015 CITY OF CITY HALL Federal Way 33325 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www atyoffederalway.corn 4. COMPENSATION. 4.1 Flat Rate Payment.The Contractor agrees to pay the City a one-time flat rate of Two Hundred Fifty and No/100 Dollars($250.00). 4.2 Method of Payment.The Flat Rate Payment to the City is due from the Contractor at the time this Agreement is executed. 4.3 Contractor Responsible for Taxes. 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. 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 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 CONCESSIONAIRE AGREEMENT - paintball - 2 - 1/2015 CITY OF CITY HALL ; Federal Way 3e3e5 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www crtyo/%deralway.corn liability, advertising injury, and liability assumed under an insured contract with limits no less than $1,000,000 for each occurrence and$2,000,000 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 insurance for all commercial general liability policies attached hereto as Exhibit"B"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. INDEPENDENT CONTRACTOR/EMPLOYEE CONDITIONS. 8.1 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. 8.2 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 CONCESSIONAIRE AGREEMENT -paintball - 3 - 1/2015 CITY OF CITY HALL iii& Federal VVay Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www ciryoffederalway.corn and equipment and is solely responsible for the same 8.3 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 9. 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. 10. GENERAL PROVISIONS. 10.1 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. 10.2. Non-Exclusive Right. This Agreement does not grant the Contractor an exclusive right to distribute its products. The City reserves the right to grant to other persons or entities any of the rights contained herein or otherwise. Assignment nor the City shall have the right to transfer or assign,10.3 ssigmnent and Beneficiaries.Neither the Contractor no t e C y g gn, 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. 10.4 Compliance with Laws. The Contractor shall comply with and perform the Services in accordance with all applicable federal,state,local,and city laws including,without limitation,all City codes,ordinances,resolutions,regulations, rules,standards and policies,as now existing or hereafter amended,adopted,or made effective.If a violation of the City's Ethics Resolution No. 91-54,as amended,occurs as a result of the formation or performance of this Agreement,this Agreement may be rendered null and void, at the City's option. CONCESSIONAIRE AGREEMENT -paintball - 4 - 1/2015 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway.com 10.5 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] CONCESSIONAIRE AGREEMENT - paintball - 5 - 1/2015 CITY OF CITY HALL 33325 Feder 8th Avenue South 4„. . Federal Nay Federal Way,WA 98003-6325 (253) 835-7000 www.cityoffederalwey.com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY ATTEST: By: 4 - -" A11111 1 John Hutto ;Director o : s 11 C erk, Stephanie Court MC APPROVED AS TO FORM: DATE: 7/2--/ -PO City Attorney, Amy Jo Pearsall ROAD WARRIOR PAINTBALL, LLC. By: ...//4 Printed !me: e Title: n L/01,1 - .r DATE: 6 - STATE OF WASHINGTON ) ) ss. COUNTY OF k jal ) On this day personally appear d efore me 11 . A , to me known to be the Cent( of k V arrear Usti W li , CL L.-, that executed the foregoing instrument,and 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 m tt tglficial seal this day of JW1t , 2 1 (b,.--40‘‘5%°" 74‘��i,, Notary's signature . J +„ Notary's printed name -�, E , Notary Publ. in and for the State of Washington. q My commission expires s� r t,„%m,*� ff1l't�t WASH` Z' CONCESSIONAIRE AGREEMENT - paintball - 6 - 1/2015 CITY OF CITY HALL IA, 33325 Fed era I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www ciryoffederaIway.com EXHIBIT "A" PAINTBALL BOOTH SERVICES 1. Contractor shall provide a paintball target shooting booth("Paintball Booth")in a designated area during the City's 4th of July Red,White and Blues Festival ("Event")located at Celebration Park in a manner consistent with the accepted practices for other similar services, 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. Hours of Operation. Equipment can be set up between 2:00pm and 5:00pm on July 4th, and Contractor will have staff on site ready for event by 5:30pm.Paintball booth will be open to the public from 6:00pm until 10:00pm. 3. Products and Pricing. The Contractor shall provide the following: • Trailer with moving target. • Paintball guns and all paintball ammunition needed. • All protective equipment to protect participants and spectators. Contractor will provide supervisor and staff to operate the equipment and collect all money.The Contractor's staff shall be responsible for setup and take down of equipment,shall remain at the Event to oversee that all equipment is in safe working order, and shall provide all necessary extension cords. The City shall be responsible for providing adequate electrical power to run the equipment. 4. Customer Service. Contractor and all of its employees, agents, or representatives shall provide the highest quality of customer service and shall treat all customers with courtesy and respect. Contractor shall honor all reasonable requests for refunds including requests from customers that are dissatisfied with any product sold by Contractor. 5. Employee Appearance.All of Contractor's employees,agents,representatives or licensees shall have a neat, clean and sanitary personal appearance and those who come in direct contact with the public shall wear clothing or identification, which distinguishes them as employees of Contractor. 6. Employee Training.Contractor shall provide a training program for its employees,agents,or representatives for the development of the skills and techniques necessary to perform its obligations under this Agreement including but not limited to promoting customer service,product and service presentation, cleanliness,positive attitude and promoting the City Parks and Recreation Department's philosophy and policy. 7. Staffing. Paintball Booth shall be properly staffed in order to prevent undue delay to the public. Contractor shall plan its staffing in advance and anticipate to the best of its ability any events,such as holidays or special events, which may require additional staffing. In the event the City determines in its sole discretion that Contractor is not adequately staffing the Concession Stands, it may notify Contractor of that fact and Contractor shall immediately increase its staffing to meet the City's recommendation. CONCESSIONAIRE AGREEMENT -paintball - 7 - 1/2015 Aco°® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/24/2015 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 CONTACT Annette Halko NAME: Shoff Darby Companies (A/C. o. Ext): (203)354-6200 (ac No:(203)354-6480 488 Main Avenue ADDRESS:halkoa @shoffdarby.com 3rd Floor INSURER(S)AFFORDING COVERAGE NAIC# Norwalk CT 06851 INsuRERANationwide Mutual Insurance Co INSURED INSURER B: Road Warrior Paintball LLC INSURER C: 1843 115th Ave., NE INSURERD: Bellevue, WA 98004-3002 INSURERE: A member of the SLE RPG INSURER F: COVERAGES CERTIFICATE NUMBER:04/08/15 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYY) x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO A CLAIMS-MADE x OCCUR PREMISES(EaEoccurrence) $ 300,000 6BRPG57059 4/8/2015 10/8/2015 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 POLICY PRO 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _AUTOS (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Equipment and Contents 6BRPG57059 4/8/2015 10/8/2015 $10,000Iimil$250 deductible Premium DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: 10x10 booth operations Date: July 4, 2015 Event: Red, White & Blue Festival The City of Federal Way is listed as additional insured as owner/lessor of premises. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Federal Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN PO Box 9718 ACCORDANCE WITH THE POLICY PROVISIONS. Federal Way, WA 98063 AUTHORIZED REPRESENTATIVE Allison Steeves/ROSEM©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I NS025(701401/