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AG 18-017 RETURN TO: Mary i EXT: 69o1 CITY OF FEDERAL WAY LAW DEP ARTMLENT ROUTING FORM OR.IGTNArINGDEPT./DIV: P211111s ORIGINATING STAFF PERSON: Jason Gerwen EXT: 6912 3. DATE REQ.BY:—__._._.._ `TYPE OF DOCUMENT(CHECK ONE): 0 CONTRACTOR SELECTION DOCUMENT(E,G.,RFB,RFP,RF,) 0 PUBLIC WORKS CONTRACT E SMALL OR LIMITED PUBLIC WORKS CONTRACT 0 PROFESSIONAL SERVICE AGREEMENT LJ MAINTENANCE AGREEMENT Ej GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/CDBG L 17 REAL,ESTATE DOCUMENT 0 SECURITY DOCUMENT(E.G BOND RE.1-ATED DOCUMENTS) L1 ORDINANCE El RESOLUTION CONTRACTAMENDMENT(AG#): 18.017(B) El TNTERLOCAL 0 OTHER PROJECT NAME: Portable Toilet Service NAME OF CONTRACTOR: DBA Head Quarters,Inc-Temporary Storage of Washington ADDRESS: PC Box 995,auburn,WA 9807I TELEPHONE 253-833-3111 E-MAIL:To I let2gc com FAX: SIGNATURE NAME: .............. --_-___---- TITLE Owner EXHIBITS AND ATTACHMENTS: D SCOPE,WORK OR SERVICES 0 COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE 0 ALI-, OTHER REF12RENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS TERM: COMM ENCEMENT DATE: 1/18118 COMPLETION DATE: A�W3-14UO —------------- TOTAL COMPENSATION$$41,750+18,750=$60,600 (INCLUDE EXPENSES AND SALES TAX,IF ANY) (IF CALCULATED ON HOURLY I,ABOk'CHARGE AiTA,6j Sh4EDULES OF EMPLOYEES TITLES AND 1101-IDAY RATES) REIMBURSABLE EXPENSE:0 YES R NO IF YES,MAXIMUM DOLLAR AMOUNT: IS SALES TAX OWED OYES ONO IF YES, PAID BY:0 CONTRACTOR 0 CITY RETAINAGE: RETAINAOr.'AMOUNT: _O R.E"FAINAGE AGREEMENT(SEE CONTRACT) OR Fj RETAfNAciF,,BOND PROVIDE Fj PURCHASING: PLEASE CHARGE TO: 001-7100331-576-80-453 O DOCIUMENT/CONTRAcT REVIEW INITIAL DNEE.,RFYIEWL"D WITIA.11d,DATE APPROVED El PROJECT MANAGER 0 DIRECTOR o RISK MANAGEMENT (IF APPLICABLE) I LAW DK 9-17-2020,additional docs;on 9-21-2020 1, COUNCIL APPROVAL(IF APPLICABLE) COMMIT'-I'EEAPPROVAI.,I),AI'E: 10/13/2020 COUNCIL APPROVAL DATE: 10/20/2020 2, CONTRACT SIGNATURE ROUTING 0 SENTro VENDORJCO NTRZTOR DATE SENT: 10122/2020 DATE REC'D: 0 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS 0 CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE (Include dept.support staff if necessary and feel free to set notification snore than a month in advance if council approval is needed.) I N ITI AL,/DATI"SIGNED 0 LAW DEPARTMENT %.;KNATORY(MAYOR OR DIRECTOR) 0 4 CITY CLERK 11 ASSIGNED AG# Aw; 'OMMENTS: )K:Contract term currently set to expire end of 2020-needs to be extended in amendment. . ................ CITY OF CITY HALL ...., 33325 8th Avenue South Fe�d a ra I Way Federal Way.WA 98003-6325 (253) 835-7000 www clryoffederalway com AMENDMENT NO. 2 TO GOODS AND SERVICES AGREEEMENT FOR PORTABLE TOILETS This Amendment ("Amendment No. 2") is made between the City of Federal Way, a Washington municipal corporation("City"),and Temporary Storage of Washington,Inc.,dba Head Quarters a Washington corporation or ("Contractor"). The City,and Contractor(together"Parties"),for valuable consideration and by mutual consent of the Parties,agree to amend the original Agreement for Portable Toilets("Agreement")dated effective January 18,2018, as amended by Amendment No 1. 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, 2022 ("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(s)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 - 3/2017 CITY OF CITY HALL 4 33325, ...� Fe d e ra I Way Feder 13tn 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: ATTEST: By: (2ez . UA Jim Fe I , M yor S ephanie Courtney, CMC ity Clerk DATE: W149,0 APPROVED AS TO FORM: �� , J. Ryan Call, City Attorney TEMPORARY STORAGE OF WASHINGTON, INC. DBA HEAD QUARTERS: By: 11 Printed Name: n l Ve n Title: fre-S Date: I / (Z O-Z-C7 STATE OF WASHINGTON ) ) ss. COUNTY O� Oil this day personally appeared before me �,,ne�r���.�ex1_ to me known to be the ��s►r�.c+� of-T n r ,�rt o , P# ,Sh�� that executed the foregoing instrument,and acknowledged the said instrume t 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 ' —I D day of 2 r-. Notary's signature EILEEN GONZALEZ Notary Public , Notary's printed name State of Washington Notary Public in and for the State of Washington. Commission # 207613 L Comm. Expires Apr 11, 2023 My commission expires AMENDMENT - 2 - 3/2017 CITY OF CITY HALL 33325 Avenue South A Feder Federall Way,WA 98003-6325 Federal Way (253) 835-7000 www.cityoffederalway com EXHIBIT B-2 ADDITIONAL COMPENSATION 1. Total Compensation:In return for the Services,the City shall pay the Contractor an additional amount not to exceed Forty-Six Thousand Five Hundred and NO/100 Dollars($46,500.00).The total amount payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed Eighty-Seven Thousand Seven Hundred Fifty and NO/100 Dollars ($87,750.00). AMENDMENT 3 - 3/2017 CERTIFICATE OF LIABILITY INSURANCE DATE(YkVDOAYYYY) 111112020. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). — c;(AIACT PRODUCER nkmA SCOTT KIZER'S AGENCY r to"�o 253.398-2746 FAX 253-398-2748 STATE FARM INSURANCE E MAIL _ A1,7(YRE S�; 13106 SE 240TH ST SUITE 101 t1ns�^{�RfoROjMocC�(E1tac r KENT WA 98031 ,N;LIREk A Slate Farm Fire and Casually Garrifmny 25143 rMrA1D tNSLw4m a: State Farm Fire and Casualty Company 25143 TEMPORARY STORAGE OF WASHINGTON INSURER c. - DBA HEADQUATERS PORTABLE TOILETS INSURER D: PO BOX 995 INSURER E: AUBURN WA 9B071-0995 J INSURER F: COVERAGIES GI R B IE t(.)A I E NUM6Lfi REVISION NUMBER: ,. RTiFY 7"'- THE !'. ';ANCL LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A60VE FfJR I'HE POLICY Peklt_XO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEr,n WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONC. OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — 1td$,k nppt.'rt:;r1 Pt7 LILT Fri- TYPE OF NSUNA-4cF IitSD.:Y, v. I S ^` I I LIMITS X C.,,IMMERCIA1.4EWERAL LIABILITY V V :$1,000,000 CLAIMS-CIADE il OCCUR 155 8288-F23 47K 6/23/20 i 12/23/20 $ 187 4346-C20-47H 9120/20 13/20/21 i PERSONAL&ADV INJURY t rf.W`I ac F.r i LIMIT APPLIES PER GENERAL,• . 1 `+I�fFE}ilfil III 1•y)( j JJERa GT 7LOG FUTaxrTrl:, 1 ,:PAGG t 2,000,000 it AUTOMOBILE LIABILITY X X 155 8288•F23-47K I 6/23/20 12/23/20 GoA ood SINbGLE LIMI. j,000,000 . ANY AUTO BODY Y INJURY(Pe•Poo—) $ oNTIED SCHEDULED 187 4346-C20117H 9/20/20 3/20/21 { - B AUTOS ONLY .U?CIS HOD:L Y WJURY(pe•accdenl) $ HIRED NON-OWNED PRt7Ft.ERT'i 17rU34�iC- _ :g_- ..-_ AUTOS ONLY AUTOS ON(Y UM.:..:LALA LIAB t..._ O€'CLf7 I EACHOCCURRENCE i_QQn_000 E]II ESS L, _..{CLAIMS-MAtXr.. AGGREGATE RFTFNT!ON S i WORKERS COMPENSATION I I lTr C1i _.. 11 AND EMPLOYERS'LIABILITY YIN — --- -- ANY PROPRIF.TOWPARTNFRI@XFCU I IVE NIA F I EACH ACCIDFUT S i OFFICERJMEMnER EXCLLOCI57 - I(Mandatory In NH) E I. DISEASE II yea.dea Iw uwrx nr-:raIPTInN rIF OPFRATIONri hakwr E L DISEASE-v 71 r+"r;.MI' t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached H mom space is regiudredl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Federal Way ACCORDANCE WITH THE POLICY PROVISIONS. 33325 8th Ave S Federal Way,WA 98003-6325 AUTNORDED REPRESENTATIVE Completed by an authorized State Farm representative If signature is required, please contact a State Farm agent. 0 19 86-201 5 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD I f X)1486 I aM 9 12 17.E-1bJ01Ci RETURN TO: EXT: -s CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM ORIGINATING DEPT./DIV: PA9K=- ORIGINATING STAFF PERSON: JA�SD/J EXT: 6(� 3. DATE REQ.BY: 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 1ONTRACT AMENDMENT(AG#): t 9-0 I –A ❑ INTERLOCAL ❑ OTHER PROJECT NAME: foe-TAB''ffwi- T 1 G F T 5 f:A,(,cF� 4�� NAME OF CONTRACTOR*i7 -� UAPT941AJ6 . TQ or Sii Iuf ADDRESS: fo &K 22s AuE3yan1 S WA 2{'D?f —� _ TELEPFIO X53 - 3!P E-MAIL: 712 f Lf-T Z FAX: SIGNATURE NAME: C.sVI).1 TITLE DayAJf� 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 I E: OW S /e�AJA-1� COMPLETIONDATE: 4131 J/�a,av 15 �U uJ TOTAL COMPENSATION C� '��� (f�- ,1�s�"060,06 {'NW+1 T,-76V) (INCLUDE EXPENSES AND SALES TAX,IF ANY) (IF CALCULATED ON HOURLY LABOR CH GE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE:❑YES C N'O IF YES,MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑YES 6KO IF YES,$ PAID BY:❑CONTRACTOR❑CITY RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDE PURCHASING: PLEASE CHARGE TO: 001 -771 oD - 3 31 -5'7L - go - X5,3 0. DOCUMENT/CONTRACT REVIEW INI /DATE RE IE ED INIT L/DATE APPROVED X ROJECT MANAGER T 1 ?.ol 7 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW L 1 S ++I 1 1. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITTEE DATE:: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 2. CONTRACT SIGNATURE ROUTING C1 n E] SENT TO VENDOR/CONTRACTOR DATE SENT: /� DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I 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/DATE SIGNED ❑0� LAW DEPARTMENT 4 Q O 19 1�1-96NATORY(MAYOR OR DIRECTOR) C A ❑ CITY CLERK ❑ ASSIGNED AG# AG A ❑ SIGNED COPY RETURNED DATE SENT: 10fw .OMMENTS: voniR clry of CITY HALL 33325 8th Avenue South Federal Way Federal Way.WA 98003-6325 (253) 835-7000 www cityoffederalway.con) AMENDMENT NO. 1 TO GOODS AND SERVICES AGREEEMENT FOR PORTABLE TOILETS This Amendment ("Amendment No. I") is made between the City of Federal Way, a Washington municipal corporation("City"),and Temporary Storage of Washington,Inc.,dba Head Quarters a Washington corporation or ("Contractor").The City and Contractor(together"Parties"),for valuable consideration and by mutual consent of the Parties,agree to amend the original Agreement for Portable Toilets("Agreement")dated effective January 18,2018 as follows: 1. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or method of payment,as delineated in Exhibit B-1,attached hereto and incorporated by this reference.The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s)for the Term.Except as otherwise provided in an attached Exhibit,the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 2. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior amendments thereto,not modified by this Amendment, shall remain in full force and effect.Any and all acts done by 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 - 3/2017 Y OF � Federal way - IN WITNESS, the Parties execute this Agreement gr ement below,effective the last date written below CITY OF FEDERAL WAY: ATTEST. By: J i tell avor — f t" ha ie Courtney, CMC, City C ler DATE: APPROVED AS I 0 FORM: J. Ryan Cal I. Cv Attorney TEMPORARY STORAGE OF WASHINGTON, INC. DBA HEAD QUARTERS: By: Printe Name: Title: ow-4., T Date: ��f _V STATE OF WASHINGTON ) ss. COUNTY OF Uta this day personally appeared before me� � to me known to be the of -that executed the foregoing instrument=and acknowledged the said instrument to be the(�ee vol unt.ary act and deed of said corporation,for the uses and purposes therein mentioned,and on oath stated t P :Ise was authorized to execute said instrument and that the seal affixed, if any. is the corporate seal ()f said corporation. Z5 day of 20/-7 GLEN .X hand and official seal this _ ,�*SPY L!tfy �, Notarys signat .,« . fy' "�',r• ''vr . Notary's printed nam �?.41 ora °a'•.p NoU6 Lrblic in and fort e Sta�tc of Wa 0 ` W y My commission expires r� p'L� �on• 0 F y C, •��� 'y .�=+111�,�1''��1{0 ~�r♦+�� ' N fewSI AMENDMENT "2 - 3/2017 CITY OF CITY HALL .. South F�d e ra I Way Feder 8th Avenue 8003 Federal Way.WA 98003-6325 (253) 835-7000 wwwcityoffederalwaycam IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: ATTEST: By: Jim Ferrell, Mayor Stephanie Courtney, CMC, City Clerk DATE: APPROVED AS TO FORM: J. Ryan Call, City Attorney TEMPORARY STORAGE OF WASHINGTON, INC. DBA HEAD QUARTERS: By: Printe Name: , Title: Date:. STATE OF WASHINGTON ) ��- ss. COUNTY OF On this da personally appeared before me , `' �'� 7 to me known to be the p y pp _ - of O & ;�that executed the foregoing L. _ instrument,and acknowledged the said instrument to be the fi-cc anti voluntary act and deed of said corporation,for the uses and purposes therein mentioned, and on oath stated tlz � t� lie 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 Z� day of 520/-7 **+aarsrri ar+r++ --- r ,,* 4i,• gyp.AFq�•.9 +++ Notary's signat AoTA ty '- Notary's print�nanie s otaryPublic in and for tl e St to of as i on. —A 10 My;24 My commission expires P� OZi �t • AMENDMENT - 2 - 3/2017 ei r r OF CITY HALL &6, FWay �lw ,(253) 835-7000 www cityoffederalway.com EXHIBIT B-1 ADDITIONAL COMPENSATION 1. Total Compensation:In return for the Services,the City shall pay the Contractor an additional amount not to exceed Eighteen Thousand Seven Hundred Fifty and NO/100 Dollars ($18,750.00). The total amount payable to Contractor pursuant to the original Agreement,all previous Amendments,and this Amendment shall be an amount not to exceed Forty-One Thousand Seven Hundred Fifty and NO/100 Dollars ($41,750.00). AMENDMENT - 3 - 3/2017 DATE(MMIODIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/10/2019 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 pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and cenditlons of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the cortificato holder In lieu of such endorsementl6). PRODUCER Scott Kizer State Farm Insurance CONTACT NAME: 13106 SE 240th St, Suite 101 PH°"p FJSLI:253-398-z7as_ -- Fax 0.2 4 E-M IL Kent, WA 98031 ADDrxEss: INSURER(S) AFFORDING COVERAGE NAICY 5 INSURER A: INSURED Temporary Storage of Washington INSURER B.,State Farm Mutual Autorlloblle Insurance Company 25176 DBA HEADQUARTERS PORTABLE TOILETS INSURER C: PO BOX 895 INSURERO: AUBURN ,WA 98071-0995 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TH(S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERtOO 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. !NSR TYPEOFINSURANCE MiCYNUMBER DOL SU R POLICY EFF MWD rDIYYYY LTR EXP LIMITS GENERAL LUIBILr1Y EACH OCCURRENCE $ DAk" 'P— COMMERCIAL GENERAL LIABILITY ,PREMISES(Ea ocrxsrertce) _S CLAIMS-MADE F�OCCUR MED EXP( one raon S PERSONAL SADVINJURY S GENERAL AGGREGATE S GEN"1.AGGREGATE LIMIT APPLIES PER: kPROOLICTS-COMPIOP AGG S POLICv PR° LOC apB AUTOMOBILE LIABILITY �/ rien3 BINE D N t ITANY AUTO 155 8288-F23-47J 06/23/2019 1212312020 INJURY(Per person)XALL OWNED SCHEDULED INJURY(Per aodgent)AUTOS AUTOS187 4346-C20-47H 0912012019 03/20/2020 NON-0WNED AHIREOAUTOS AUTOS .Jdenl s 432 5819+13-47 06/13/2019 12/1312019 s UMRRELLALIAO OCCUR EACH OCCL"RRENCE S EXCESS LIAa CLAIMS-MADE AGGREGATE OC7 i RETE=NTICN S I _.__ S WORKERSC'OMPENSAMN j I WC;TORY LII U- ER- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN NIA E.L.EACHACCIDENT 5 OFFICEIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE It yes,dasnrlbG under E E.L.LNSEASE-POLICY LIMIT S 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If mora space Is required) CERTIFICATE HOLDER CANCELLATION CITY OF FEDERAL WAY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 33325 8th Ave S ACCORDANCE WITH THE POLICY PROVISIONS. Federal Way,WA 98003-6325 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010106) The ACORD name and logo are registered marks of ACORD 100148e 132849.7 03-01-2012 Page 1 of 1 BUSINESS INFORMATION Business Name: TEMPORARY STORAGE OF WASHINGTON,INC. UBI Number: 601 434 061 Business Type: WA PROFIT CORPORATION Business Status: ACTIVE Principal Office Street Address: 10318 236TH AVE E,BUCKLEY,WA,98321-9724,UNITED STATES Principal Office Mailing Address: PO BOX 995,AUBURN,WA, 98071-0995,UNITED STATES Expiration Date: 12/31/2019 Jurisdiction: UNITED STATES, WASHINGTON Formation/Registration Date: 12/29/1992 Period of Duration: PERPETUAL Inactive Date: Nature of Business: OTHER SERVICES, PORTABLE TOILETS REGISTERED AGENT INFORMATION Registered Agent Name: JANSEN LEVEN Street Address: 10318 236TH AVE E, BUCKLEY,WA, 98321-9724,UNITED STATES Mailing Address: PO BOX 995,AUBURN,WA, 98071-0995,UNITED STATES GOVERNORS Title Governors Type Entity Name First Name Last Name GOVERNOR INDIVIDUAL JANSEN LEVEN GOVERNOR INDIVIDUAL CARLY SPENCE https:Hccfs.sos.wa.gov/ 10/22/2019 II RETURN TO: Mary Jaenicke EXT: 6901 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING 2. ORIGINATING 4. TYPE ❑ CONTRACTOR ❑ PUBLIC ❑ PROFESSIONAL A GOODS ❑ REAL ❑ ORDINANCE ❑ CONTRACT ❑ OTHER 5. PROJECT 6. NAME ADDRESS: E-MAIL: SIGNATURE 7. EXHIBITS OTHER 8. TERM: 9. TOTAL (IF REIMBURSABLE IS SALES RETAINAGE: O PURCHASING: 10. DOCUMENT/CONTRACT O PROJECT ❑ DIRECTOR ❑ RISK ❑ LAW 11. COUNCIL 12 ❑ONTSENTTTTO ❑ ATTACH: ❑ CREATE ❑ LA.....W e.WS7GNATORY ❑ CITY ❑ ASSIGNED ❑ SIGNED COMMENTS: DEPT./DIV: Parks Administration STAFF PERSON: Steve Ikerd EXT: 6911 3. DATE REQ. BY: OF DOCUMENT (CHECK ONE): SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION AMENDMENT (AG#): ❑ INTERLOCAL NAME: Portable Toilets OF CONTRACTOR: Head Quarters, Inc. -Ra e4 PU Y'S., a 1(J 5 1"\--1/4-X�'�.r 9 �✓•. I TELEPHONE 253-833-3111 Toilet2go@msn.com / FAX: NAME: V'jr 1,lCA__ La—kJ vt TITLE Owner AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS COMMENCEMENT DATE: upon Signature COMPLETION DATE: 12/31/2020 COMPENSATION $18,750.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY) CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) EXPENSE: ❑ YES A NO IF YES, MAXIMUM DOLLAR AMOUNT: $ TAX OWED OYES ONO IF YES, $ PAID BY: 0 CONTRACTOR ❑ CITY RETAINAGE AMOUNT: N/A 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED PLEASE CHARGE TO: 001-7100-331-576-80-453 REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED MANAGER 61 1I-2.17 MANAGEMENT (IF APPLICABLE) =` Z AJe v Zo V? APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: N/A COUNCIL APPROVAL DATE: N/A OUTING VEN OR/CONTCT SIGNATURERRACTOR DATE SENT: 1 DATE REC'D: �' / I / ) I I I " /� t J I SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS 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 / DATE SIGNED DEPARTMENT ) 4 )6..4 I g - (MAYOR OR DIRECTOR) Al CLERK ,' AG# AG# /13 -r3 7- COPY RETURNED DATE SENT: CI ;23 / e - 4r— 2/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 wwww crtyoffederalway corn GOODS AND SERVICES AGREEMENT FOR PORTABLE TOILETS This Goods and Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Temporary Storage of Washington, Inc., dba Head Quarters, a Washington corporation ("Contractor"). The City and Contractor (together "Parties") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: TEMPORARY STORAGE OF INC. DBA HEAD QUARTERS: Bruce Levin II, President PO Box 995 Auburn, WA 98071 253-833-3111 (telephone) Toilet2go@msn.com WASHINGTON CITY OF FEDERAL WAY: Steve Ikerd 33325 8th Ave. S. Federal Way, WA 98003-6325 (253) 835-6911 (telephone) (253) 835-6968 (facsimile) Steve.ikerd@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 until the completion of the Work, but in any event no later than December 31, 2020 ("Term"). This Agreement may be extended for additional periods of time upon the mutual written agreement of the City and the Contractor. 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. The Contractor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Contractor's representations to City. The Contractor shall, at its sole cost and expense, correct all Work performed which the City deems to have defects in workmanship and material discovered within one (1) year after the City's final acceptance of the Work. This Agreement is subject to all warranty provisions established under the Uniform Commercial Code, Title 62A RCW. In the event any part of the goods are repaired, only original replacement parts shall be used; rebuilt or used parts are not acceptable. When defects are corrected, the warranty for that portion of the work shall extend for one (1) year from the date such correction is completed and accepted by the City. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by GOODS AND SERVICES AGREEMENT - 1 - 9/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 t,wnv crtyoffederahvay corn the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. 2.3 Time, Documentation, and Inspection. Work shall begin immediately upon the effective date of this Agreement. Work shall be subject, at all times, to observation and inspection by and with approval of the City, but the making (or failure or delay in making) such inspection or approval shall not relieve Contractor of responsibility for performance of the Work in accordance with this Agreement, notwithstanding the City's knowledge of defective or non -complying performance, its substantiality or the ease of its discovery. 2.4 Clean Up. At any time ordered by the City and immediately after completion of the Work, the Contractor shall, at its own expense, clean up and remove all refuse and unused materials of any kind resulting from the Work. In the event the Contractor fails to perform the necessary clean up, the City may, but in no event is it obligated to, perform the necessary clean up and the costs thereof shall be immediately paid by the Contractor to the City and/or the City may deduct its costs from any remaining payments due to the Contractor. 3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days' written notice at its address set forth on the signature block of this Agreement. The City may terminate this Agreement immediately if the Contractor fails to maintain required insurance policies, breaches confidentiality, or materially violates Section 12 and such may result in ineligibility for further City agreements. 4. COMPENSATION. 4.1 Amount. In return for the Work, the City shall pay the Contractor an amount not to exceed a maximum amount and according to a rate or method as delineated in Exhibit "B," attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for the Term. Except as otherwise provided in Exhibit "B," the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 4.2 Method of Payment. On a monthly basis, the Contractor shall submit a voucher or invoice in the form specified by the City, including a description of what Work have been performed, the name of the personnel performing such Work, and any hourly labor charge rate for such personnel. The Contractor shall also submit a final bill upon completion of all Work. Payment shall be made on a monthly basis by the City only after the Work has been performed and within thirty (30) days after receipt and approval by the appropriate City representative of the voucher or invoice. If the Work does not meet the requirements of this Agreement, the Contractor will correct or modify the work to comply with the Agreement. The City may withhold payment for such work until the work meets the requirements of the Agreement. 4.3 Defective or Unauthorized Work. If any goods, materials, or services provided under this Agreement are either defective, unauthorized, or otherwise do not meet the requirements of this Agreement, the Contractor will correct or modify the work to comply with the Agreement and the City reserves the right to withhold payment from the Contractor until the goods, materials, or services are acceptable to the City. If Contractor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Contractor. GOODS AND SERVICES AGREEMENT - 2 - 9/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 www. cityoffederahvay.corn 4.4 Non -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the City will not be obligated to make payments for Work or amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Work for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. 4.5 Final Payment: Waiver of Claims. Contractor's acceptance of final payment shall constitute a waiver of any and all claims, except those previously and properly made and identified by Contractor as unsettled at the time request for final payment is made. 5. INDEMNIFICATION. 5.1 Contractor Indemnification. The Contractor agrees to release indemnify, defend, and hold the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims, 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 GOODS AND SERVICES AGREEMENT - 3 - 9/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 wtww. cityoffederalway corn with the performance of the services or work by the Contractor, their agents, representatives, employees or subcontractors for the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: 6.1. Minimum Limits. The Contractor agrees to carry as a minimum, the following insurance, in such forms and with such carriers who have a rating that is satisfactory to the City: a. Commercial general liability insurance covering liability arising from premises, operations, independent contractors, products -completed operations, stop gap liability, personal injury, bodily injury, death, property damage, products liability, advertising injury, and liability assumed under an insured contract with limits no less than $1,000,000 for each occurrence and $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 "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 GOODS AND SERVICES AGREEMENT - 4 - 9/2017 Fecferal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederal way corn or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR / EMPLOYEE CONDITIONS. 10.1 Independence. The Parties intend that the Contractor shall be an independent contractor and that the Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Contractor sick leave, vacation pay or any other benefit of employment, nor to pay any social security, income, or other tax which may arise as an incident of employment, except as specifically provided in Section 4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment contract. If the Contractor is a sole proprietorship or if this Agreement is with an individual, the Contractor agrees to notify the City and complete any required form if the Contractor retired under a State of Washington retirement system and agrees to indemnify any losses the City may sustain through the Contractor's failure to do so. 10.2 Safety. Contractor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors at the work site and in the performance of the contract work and shall utilize all protection necessary for that purpose. Contractor shall comply with all applicable provisions of federal, state and municipal safety and health laws and codes, including without limitation, all OSHA/WISHA requirements, Safety and Health Standards for Construction Work (Chapter 296-155 WAC), General Safety and Health Standards (Chapter 296-24 WAC), and General Occupational Health Standards (Chapter 296-62 WAC). Contractor shall erect and properly maintain, at all times, all necessary guards, barricades, signals and other safeguards at all unsafe places at or near the site for the protection of its employees and the public, safe passageways at all road crossings, crosswalks, street intersections, post danger signs warning against known or unusual hazards and do all other things necessary to prevent accident or loss of any kind. Contractor shall protect from damage all water, sewer, gas, steam or other pipes or conduits, and all hydrants and all other property that is likely to become displaced or damaged by the performance of the Work. The Contractor shall, at its own expense, secure and maintain a safe storage place for its materials and equipment and is solely responsible for the same 10.3 Risk of Work. All work shall be done at Contractor's own risk, and Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an employment contract. Even though Contractor is an independent contractor, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion 11. CONFLICT OF INTEREST. It is recognized that Contractor may or will be performing professional services during the Term for other parties; however, such performance of other services shall not conflict with or interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such conflicts of interest in favor of the City. Contractor confirms that Contractor does not have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the Contractor's selection, negotiation, drafting, signing, administration, or evaluating the Contractor's performance. 12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Contractor or its subcontractors of any level, or any of those entities' employees, agents, subcontractors, or representatives GOODS AND SERVICES AGREEMENT - 5 - 9/2017 Vecleral Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www crtyoffederalwa can against any person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply to, but not be limited to, the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Contractor shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non-discrimination. 13. GENERAL PROVISIONS. 13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of the Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement. Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect. Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. No provision of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly authorized representatives of the Parties. 13.2 Assignment and Beneficiaries. Neither the Contractor nor the City shall have the right to transfer or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non -assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. 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 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 GOODS AND SERVICES AGREEMENT - 6 - 9/2017 Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www citvoffederalway corn 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 maybe executed in any number of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. [Signature page follows] GOODS AND SERVICES AGREEMENT - 7 - 9/2017 4_, Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 www crtyoffederalway corn IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: Jim Fe ell; M.yor DATE: f -‹it( TEMPORARY STORAGE OF WASHINGTON, INC. DBA HEAD QUARTERS By: 'I Printed Name: �f\1�sc1 L -E Title: U t L� Q ; LA \ DATE: t2/if /11 STATE OF WASHINGTON ) ) ss. ATTEST: nie Courtney, CMC APPROVED AS TO FORM: ity Clerk On this day personally appeared before me ,)0,, Qy\ LeN SYN , to me known to be the \( ciz Of—\- of T2mP Am of LQ,p\ that executed the foregoing instrume t, and acknowledged the said instrument to 5e 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. GIVE?1B4 f8+4i official seal this 4.• • •• . •• ▪ • • NO• TARY PUBLIC 0,'�• COMM. EXPIRES • • Nov. 15, 2019 w sii,• •• • ••▪ ,Gf. •,�/,�'� OF'iW ASH`a `�� yt'N day o DraiLY Qf , 2011. Notary Public in and for the State of Washington. My commission expiresNuN M Notary's signature Notary's printed nam GOODS AND SERVICES AGREEMENT 8 9/2017 Federal Way EXHIBIT "A" SERVICES 1. The Contractor shall do or provide the following: CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway corn Contractor shall maintain, sanitize, and keep in a safe and good working condition, portable toilets for the City of Federal Way. Each monthly unit will be serviced once per week. Units for special events may be ordered directly by the City Division making the request. Each weekly unit cleaning shall include: A. Removing the waste from the toilet tank and refilling with clean solution. B. Supplying the unit with two rolls of toilet paper. C. Supplying the unit with hand sanitizer dispenser and refilling with solution. (optional bid) D. Removing debris and litter from the inside of the unit and disposing of the debris properly. E. Removing debris and litter from the exterior of the unit in a five foot radius around the unit. F. Cleaning of the interior and exterior of the unit to remove dirt, bio -hazards & graffiti. The holding tank shall be chemically deodorized with a biodegradable chemical additive and maintain a written, posted log on the unit indicating the dates of service. Environmentally friendly (non -pollutant and biodegradable) products shall be used for all cleaning, sanitizing and deodorizing functions. Copies of MSDS sheets will be provided for all products used. The contractor shall keep the unit in good working order which shall include a working door lock and handle, unbroken toilet seat, unbroken toilet paper holder, a door that opens and closes properly with the door spring in working order, screens in place and unbroken, no leaks in the tank, ramp properly affixed to the unit, and no holes in the unit. Minor, in field repairs include fixing a door lock, repairing or replacing a toilet seat, door handle, door spring, vent screens and toilet paper holder, and realigning the ramp shall be done on-site as needed or as directed by the City's Project Manager. The Parks & Facilities Manager, Deputy Park Director, or other designated representative shall be the final authority on whether standards have been met. Contractor shall respond to emergencies within 3 hours of a request for services. Contractor shall submit invoices in a timely manner based on the following rate schedule: Regular unit - $69.75 per month. No charge for delivery and pick up. Handicap unit - $120.00 per month. No charge for delivery and pick up. City owned handicap unit - $69.75 per month City owned regular unit mounted on a trailer $20.00 per service. GOODS AND SERVICES AGREEMENT - 9 - 9/2017 Federal Way Extra service - $20.00 per unit per service or $69.75 per month. Tipped over service - $20.00 per unit per service. Weekend service rate - $45.00 per unit per service Optional hand sanitizer - $10.00 per month per unit. Special event rates vary. CITY HALL 33325 8th Avenue South Federal Way. WA 98003-6325 (253) 835-7000 ivww cit yoffederalway com Extra insurance protection for vandalism will be charged at $5.00 per month per unit, which the City request on all provided units, except for the West Hylebos unit which the City owns. City staff will coordinate the number and location of units each month. GOODS AND SERVICES AGREEMENT - 10 - 9/2017 44, Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway corn EXHIBIT "B" COMPENSATION 1. Total Compensation: In return for the Services, the City shall pay the Contractor an amount not to exceed Twenty -Three Thousand and no/100 Dollars ($23,000.00). GOODS AND SERVICES AGREEMENT - 11 - 9/2017 BUSINESS REGISTRATION License Number 20 -17 -106090 -00 -BL Non -Resident Business Registered: TEMPORARY STORAGE OF WA DBA HEADQUARTERS PORTABLE TOILETS 3401 C ST NE SUITE B FEDERAL WAY WA 98002 Expires 12/31/2018 Category: Conditions: 4950 - Utilities- Sanitary Services 1. This license is non -transferable. 2. Please notify the City Clerk's office of any change in your business such as a new location or business name. ` `,O; This certifies that the above entity has been issued the registration or license listed. City of Federal Way - Licensing FEDERAL WAY WA 98003 NYianue) awtrmze City Clerk, City of Federal Way STAT'EWASHINGTON or ^-^-`^^"^_.-."/./ " .`^_G/_/^/`/^/.O'v TEMPORARY STORAGE OF WASHINGTON, INC. 200 S NARWHAL LP SW OCEAN SHORES, VVAQ8569 Domestic Profit Corporation Renewed by Authority of Secretary of State By accepting this document the recipient certifies that information provided v"the annual report was complete, true, and accurate to the best of hs or her knowledge, and that the company will stay in compliance with all applicable Washington State „.3cretary of State Office of the Secretary of State Corporations Division Unified Business ID #: 601434061 Expiration: Dec -31-2017 State Farm Mutual Automobile Insurance Company PO Box 853922 Richardson, TX 75085-3922 AT1 A-2911 A TEMPORARY STORAGE OF WASHINGTON DBA HEADQUATERS PORTABLE TOILETS PO BOX 995 AUBURN WA 98071-0995 Policy Number: 187 4346 -C20 -47F Policy Period: September 20, 2017 to March 20, 2018 Vehicle: 2001 INTERNATNL FL60 00 State Farm AUTO RENEWAL PREMIUM PAID: $1,068.79 DO NOT PAY. Your premium is billed through the State Farm Payment Plan State Farm Payment Plan Number: 1122280615 Your State Farm Agent SCOTT KIZER Office: 253-398-2746 Address: 13106 SE 240TH ST STE 101 KENT, WA 98031-9211 If you have a new or different car, have added any drivers, or have moved, please contact your agent. Location used to determine rate charged -200 S NARWHAL LOOP SW, OCEAN SHORES WA 98569. Your premium has increased by $117.56. When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to Policy Number: 187 4346 -C20 -47F Prepared August 16, 2017 1004583 process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution. Page number 1 of 3 143562 201 11-12-2014 It's What You Know. Your auto insurance premium is $1,068.79. Did you know you may qualify for a discount? Call State Farm® Agent SCOTT KIZER at 253-398-2746 to see how much you can save! 'Not all discounts are available in every stateand discount amounts may vary by state. �.. StateFarm VEHICLE INFORMATION Review your policy information carefully. If anything is incorrect, or if there are any changes, please let us know right away. How is this vehicle normally used? National average: 12,000 miles driven Vehicle Description Number (VIN) Who principally drives this vehicle? annually per vehicle Vehicle Identification 2001 INTER.NATNL FL60 1 FVABPBV61 HH68589 For this commercial vehicle, contact your agent for a full review of drivers. Vehicle Body Type: Tank Truck, Vehicle Use: Hauling of Waste or Refuse, Business Description: Septic Tank Systems and Sewer Cleaning, Radius of Operation: 20 miles, Annual Distance Driven: 7500 miles, Gross Vehicle Weight, Manufacturer's Suggested Retail Price, Year Business established: 1999 Premium Adjustment Each year, we review our medical payments and personal injury protection coverages claim experience to determine the vehicle safety discount that is applied to each make and model. In addition, we review the comprehensive, collision, bodily injury and property damage claim experience annually to determine which makes and models have earned decreases or increases from State Farm's standard rates. If any changes result from our reviews, adjustments are reflected in the rates shown on this renewal notice. COVERAGE AND LIMITS See your policy for an explanation of these coverages. A Liability Bodily Injury 1,000,000/1,000,000 D G Total Premium Property Damage 1,000,000 1000 Ded Comprehensive 1000 Deductible Collision $715.58 $75.28 $277.93 $1,068.79 If any coverage you carry is changed to give broader protection with no additional premium charge, we will give SURCHARGES AND DISCOUNTS AUTOMOBILE RATING PLAN - Applies to private passenger cars only. Accident -Free Discount Once your policy has been in force for at least three years with no chargeable accidents, you may qualify for our Accident -Free Discount. Once you qualify, this discount applies as long as there are no chargeable accidents, and may even increase over time. Good Driving Discount - Newer policyholders who do not yet qualify for our Accident -Free Discount (available after three years with no chargeable accidents) may already be receiving a Good Driving Discount. This discount continues Policy Number: 187 4346 -C20 -47F Prepared August 16, 2017 you the broader protection without issuing a new policy, starting on the date we adopt the broader protection. to apply until your policy qualifies for the Accident -Free Discount as long as there are no chargeable accidents and no new drivers. If you add new drivers, they must also qualify in order for your Good Driving Discount to continue. Chargeable Accidents - For new business rating, an accident is chargeable if it results in $750 or more of damage to any property. For renewal business, an accident is chargeable as of the date State Farm pays at least $750 (for accidents occurring on or after April 1, 1999) under property damage liability and collision coverages for an at -fault accident. (continued on next page) Page number 2 of 3 6018CK COMMERCIAL VEHICLE This endorsement is a part of the policy. Except for the changes this endorsement makes, all other provisions of the policy remain the same and apply to this endorsement. 1. DEFINITIONS a. Trailer is changed to read: Trailer means: 1. a trailer: a. designed to be pulled by a pri- vate passenger car; b. not designed to carry persons; c. while not used as premises for office, store, or display pur- poses; and d. while used for pleasure; or 2. a farm implement or farm wagon while pulled on public roads by a car. b. The following definitions are added: (a) Collision means: (i) a vehicle hitting or being hit by another vehicle or another ob- ject; or (ii) the overturning of a vehicle. (b) Pollutants means any solid, liquid or gaseous irritant or contaminant, toxic substance, hazardous sub- stance, or oil in any form. (c) Work means any work or operations performed by or on behalf of an in- sured including: (i) any materials, parts, or equip- ment furnished in connection with such work or operations; and (ii) any warranties or representa- tions made at any time with re- spect to the fitness, quality, durability, or performance of such work or operations of the items described in i. above. 2. LIABILITY COVERAGE a. Additional Definition Item 1.b.(1) of the definition of insured is deleted. b. Exclusions The following are added: (1) THERE IS NO COVERAGE FOR AN INSURED FOR DAMAGES ARISING OUT OF THE OPERA- TION, MAINTENANCE, OR USE OF ANY EQUIPMENT THAT IS TOWED BY, MOUNTED ON, OR CARRIED ON ANY VEHICLE. This exclusion does not apply to equipment: (a) mounted on the vehicle and de- signed solely for the loading or unloading of the vehicle; or (b) designed for: (i) snow removal; (ii) street cleaning; or (iii) road maintenance, other than construction or resur- facing. (2) THERE IS NO COVERAGE FOR AN INSURED FOR DAMAGES ARISING OUT OF WORK AFTER IT IS CONSIDERED COM- PLETED. WORK IS CONSID- ERED COMPLETED: (a) IF IT HAS BEEN ABAN- DONED; OR Page 1 of 7 6018CK ©, Copyright, State Farm Mutual Automobile Insurance Company, 2016 (b) IF IT HAS NOT BEEN ABAN- DONED, THEN AT THE EAR- LIEST OF THE FOLLOWING TIMES: (i) WHEN THAT PART OF THE WORK DONE AT A JOB SITE HAS BEEN PUT TO ITS INTENDED USE BY ANY PERSON OR OR- GANIZATION OTHER THAN ANOTHER CON- TRACTOR OR SUBCON- TRACTOR WORKING ON THE SAME PROJECT; (ii) WHEN ALL OF THE WORK TO BE DONE AT THE LOCATION WHERE THE DAMAGES AROSE HAS BEEN FINISHED; OR (iii) WHEN ALL OF THE WORK CALLED FOR IN YOUR CONTRACT HAS BEEN FINISHED. WORK IS CONSIDERED COMPLETED REGARDLESS OF WHETHER ADDITIONAL SERVICING, MAINTENANCE, CORRECTION, REPAIR, OR REPLACEMENT IS RE- QUIRED. (3) THERE IS NO COVERAGE FOR AN INSURED FOR DAMAGES RESULTING FROM: (a) THE HANDLING OF PROP- ERTY BEFORE IT IS MOVED FROM THE PLACE WHERE IT IS ACCEPTED BY THE IN- SURED FOR MOVEMENT INTO OR ONTO A VEHICLE FOR WHICH THE INSURED IS PROVIDED LIABILITY COVERAGE BY THIS POL- ICY; (b) THE HANDLING OF PROP- ERTY AFTER IT IS MOVED FROM THE VEHICLE DE- SCRIBED IN (a) ABOVE TO THE PLACE WHERE IT IS FI- NALLY DELIVERED BY THE INSURED; OR (c) THE MOVEMENT OF PROP- ERTY BY MEANS OF A ME- CHANICAL DEVICE, OTHER THAN A HAND TRUCK, THAT IS NOT ATTACHED TO THE VEHICLE DESCRIBED IN (a) ABOVE. (4) THERE IS NO COVERAGE FOR AN INSURED FOR BODILY IN- JURY OR DAMAGE TO PROP- ERTY CAUSED BY POLLUTANTS THAT: (a) ARE TRANSPORTED BY; (b) ARE CARRIED IN OR UPON; (c) ARE RELEASED, DIS- CHARGED, OR REMOVED FROM; OR (d) ESCAPE OR LEAK FROM ANY VEHICLE. This exclusion does not apply if the bodily itt'ury or damage to property is the direct, ac- cidental, and instantaneous re suit of pollutants caused by a collision which arises out of the use pf any vehicle as a vehicle for which that insured is provided Liability Cover- age by this policy. THERE IS NO COVERAGE FOR AN INSURED FOR ANY CLAIM MADE OR LAWSUIT FILED BY ANY PERSON, ORGANIZA- TION, OR GOVERNMENTAL BODY AGAINST THAT INSURED FOR DAMAGES, RESPONSE COSTS, OR SIMILAR COSTS, OR (5) Page 2 of 7 6018CK 0, Copyright, State Farm Mutual Automobile Insurance Company, 2016 ANY RELATED REMEDIAL AC- TION THAT ARE: (a) THE REAL OR ALLEGED RESULT OF THE EFFECTS OF POLLUTANTS; OR (b) IN ANY WAY ASSOCIATED WITH THE COST OF: (i) CLEANUP; (ii) REMOVAL; (iii) CONTAINMENT; OR (iv) NEUTRALIZATION THE EFFECTS OF POLLUTANTS. This exclusion does not apply if such damages, costs, or remedial ac- tion is the direct, accidental, and in- stantaneous result of pollutants caused by a collision which arises out of the use of any vehicle as a ve- hicle for which that insured is pro- vided Liability Coverage by this policy. (6) THERE IS NO COVERAGE FOR AN INSURED FOR DAMAGES ARISING OUT OF THE: (a) HANDLING OR USE OF, OR (b) EXISTENCE OF ANY CON- DITION IN OR WARRANTY OF ANY PRODUCT MANUFAC- TURED, SOLD, OR DISTRIB- UTED BY AN INSURED IF THE BODILY INJURY OR DAMAGE TO PROPERTY OCCURS AFTER THE INSURED RELINQUISHES POSSESSION OF THE PRODUCT. THERE IS NO COVERAGE FOR AN INSURED FOR BODILY IN- JURY TO ANY PERSON OR DAMAGE TO ANY PROPERTY WHICH ARISES OUT OF ANY VEHICLE WHILE PARKE FUNCTIONING AS AN 0 OR BUSINESS PREMISES. exclusion does not apply: (a) to the loading and unloa equipment or supplies; or (b) if such vehicle is mai primarily to transport pe cargo. 3. PERSONAL INJURY PROTEC and MEDICAL PAYMENTS COVE OF Exclusions The following are added: (7) (1) THERE IS NO COVERAGE F INSURED WHOSE BODILYI RESULTS FROM THE OPE MAINTENANCE, OR USE OF EQUIPMENT THAT IS TOWE MOUNTED ON, OR CARRIE ANY VEHICLE. This exclusio not apply to equipment: AND FICE This ing of ained ns or ION GE R AN URY ION, ANY BY, ON does (a) mounted on the vehicle a d de- signed solely for the loading •r un- loading of the vehicle; or (b) designed for: (i) snow removal; (ii) street cleaning; or (iii) road maintenance, othe than construction or resurfacin (2) THERE IS NO COVERAGE F I R AN INSURED FOR BODILY I URY ARISING OUT OF WORK AFT R IT IS CONSIDERED COMPL TED. WORK IS CONSIDERED OM- PLETED: (a) IF IT HAS BEEN ABAND I NED; OR (b) IF IT HAS NOT BEEN I: AN- DONED, THEN AT THE E RLI - EST OF THE FOLLO ING TIMES: Page 3 of 7 601: CK ©, Copyright, State Farm Mutual Automobile Insurance Company, 2016 (i) WHEN THAT PART OF THE WORK DONE AT A JOB SITE HAS BEEN PUT TO ITS IN- TENDED USE BY ANY PER- SON OR ORGANIZATION OTHER THAN ANOTHER CONTRACTOR OR SUB- CONTRACTOR WORKING ON THE SAME PROJECT; (ii) WHEN ALL OF THE WORK TO BE DONE AT THE LOCA- TION WHERE THE DAM- AGES AROSE HAS BEEN FINISHED; OR (iii) WHEN ALL OF THE WORK CALLED FOR IN YOUR CONTRACT HAS BEEN FIN- ISHED. WORK IS CONSIDERED COM- PLETED REGARDLESS OF WHETHER ADDITIONAL SER- VICING, MAINTENANCE, COR- RECTION, REPAIR, OR REPLACEMENT IS REQUIRED. (3) THERE IS NO COVERAGE FOR AN INSURED FOR BODILY INJURY RE- SULTING FROM: (a) THE HANDLING OF PROPERTY BEFORE IT IS MOVED FROM THE PLACE WHERE IT IS AC- CEPTED BY THE INSURED FOR MOVEMENT INTO OR ONTO A VEHICLE FOR WHICH THE IN- SURED IS PROVIDED MEDICAL PAYMENTS COVERAGE BY THIS POLICY; (b) THE HANDLING OF PROPERTY AFTER IT IS MOVED FROM THE VEHICLE DESCRIBED IN (a) ABOVE TO THE PLACE WHERE IT IS FINALLY DELIVERED BY THE INSURED; OR (c) THE MOVEMENT OF PROPERTY BY MEANS OF A MECHANICAL Page 4 of 7 0, Copyright, State Farm Mutual Automobile Insurance Company, 2016 DEVICE, OTHER THAN A HAND TRUCK, THAT IS NOT AT- TACHED TTACHED TO THE VEHICLE DE- SCRIBED IN (a) ABOVE. (4) THERE IS NO COVERAGE FC R AN INSURED FOR BODILY INJURY CAUSED BY POLLUTANTS THAT: (a) ARE TRANSPORTED BY; (b) ARE CARRIED IN OR UPON; (c) ARE RELEASED, DISCHARGED, OR REMOVED FROM; OR (d) ESCAPE OR LEAK FROM ANY VEHICLE. This exclusion does not apply if the bodily injury is he di- rect, accidental, and instantaneouE result of pollutants caused by a collision which arises out of the use of any vehicle as a vehicle for which that insured is provided Medical Payments Coverage by this policy. THERE IS NO COVERAGE FOR AN INSURED FOR BODILY INJURY ARISING OUT OF THE: (a) HANDLING OR USE OF, O-1 (b) EXISTENCE OF ANY CONDI- TION IN OR WARRANTY OF ANY PRODUCT MANUFACTL RED, SOLD, OR DISTRIBUTED BY AN INSURED IF THE BODILY INJURY OCCURS AFTER THE INSURED RE- LINQUISHES POSSESSION OF THE PRODUCT. (6) THERE IS NO COVERAGE FOR AN INSURED FOR BODILY INJURY WHICH ARISES OUT OF ANY VEHI- CLE WHILE PARKED AND FUNC- TIONING AS AN OFFICE OR BUSINESS PREMISES. This exclu- sion does not apply: (a) to the loading and unloading of equipment or supplies; or (5) 6018CK (b) if such vehicle is maintained primar- ily to transport persons or cargo. 4. MEDICAL PAYMENTS COVERAGE Additional Definitions Item 1.a.(4) of the definition of insured is deleted. 5. PHYSICAL DAMAGE COVERAGES a. Additional Definitions (1) Covered Vehicle is changed to mean: 1. your car; 2. a newly acquired car; 3. a temporary substitute car; and 4. a camper that is designed to be mounted on a pickup truck and shown on the Declarations Page; including its parts and its equipment that are common to the use of the ve- hicle as a vehicle and its special equipment. However, parts and equipment of trailers and campers must be securely fixed as a permanent part of the camper. (2) The following is added: Special equipment means: 1. parts and equipment not common to the use of the vehicle as a vehicle that are: a. securely fixed as a per- manent part of the cov- ered vehicle; or b. designed to be: (1) pushed by a cov- ered vehicle; or (2) towed by a covered vehicle but only if a description of the towed equipment is Page 5 of 7 ©, Copyright, State Farm Mutual Automobile b. shown immediately following the title "Special 3quip- ment" on the Dec- larations Page; 2. parts and accessories de- signed to be attached to the equipment described in 1.a. and l.b. above; and 3. tools that are provided by the manufacturer and are specifically designed to op- erate and maintain the equipment described in l.a. and 1.b. above. Limits and Loss Settlement — Com- prehensive Coverage and Collision Coverage The following are added: (1) You agree with us that if special equipment is either: (a) not damaged, or (b) damaged and we offer to pay the cost to repair it, subject to (2) below, then we may pay the cost to remove the special equipment from the cov- ered vehicle and install it in a re- placement vehicle. If we chcose to remove special equipment, tr en the amount of our payment for tl',e cov- ered vehicle will not include tie dol- lar value of the special equipment. (2) Special Equipment — Replacement Cost If there is a dollar amount she wn on the Declarations Page for special equipment, then item 1. uncle Lim- its and Loss Settlement — Compre- hensive Coverage and Collision Coverage applies to determine the amount that we will pay for the cov- ered vehicle, except to determine 6018CK Insurance Company, 2016 the amount we will pay for the repair or replacement of that special equipment. We have the right to choose to pay either the cost to re- pair or the cost to replace that spe- cial equipment. However, the most we will pay to repair or to replace special equipment, including re- moval and installation costs, is the dollar amount shown on the Decla- rations Page for that special equip- ment. (a) The cost to repair will be deter- mined by: i. the cost agreed to by both you and us; or ii. a bid or repair estimate ap- proved by us. The cost to repair such special equipment does not include any reduction in the value of the special equipment after it has been repaired, as com- pared to its value before it was damaged. (b) The cost to replace will be deter- mined by the replacement cost of the same or of similar special equipment agreed to by both you and us. If there is disagreement as to the replacement cost of the spe- cial equipment, then the disa- greement will be resolved by appraisal upon written request of the owner or us, using the proce- dures described in 1.b.(1) under Limits and Loss Settlement — Comprehensive Coverage and Collision Coverage. If we choose to replace special equipment, then we will pay the 1 actual cash value of that special equipment until it is replaced. If the special equipment is re- placed, then we will also pay the lesser of: i. the cost incurred to replace that special equipment less the amount we already paid for that special equipment; or ii. the replacement cost agreed to by both you and us less the amount we already paid for that special equipment. The damaged special equipment must be given to us in exchange for our payment, unless we agree that you or the owner may keep it. If you or the owner keeps the special equip- ment, then our payment will be re- duced by the dollar value of the special equipment after the loss. c. Financed Vehicle The second paragraph of item 1. is de- leted. 6. GENERAL TERMS a. Nonrenewal is changed to read: 7. Nonrenewal If we decide not to renew this policy, then, at least 45 days be- fore the end of the current policy period, we will mail or deliver a nonrenewal notice which will include the reason for our re- fusal to renew to the most recent policy address that we have on record for the named insured who is shown on the Declara- tions Page. Page 6 of 7 6018CK ©, Copyright, State Farm Mutual Automobile Insurance Company, 2016 We will also mail or deliver at the same time like notice to each mortgagee, pledgee, or other per- son shown by the policy to have an interest in any loss which may occur thereunder. The mailing of the notice will be sufficient proof of notice. b. Cancellation (1) Item a. How You May Cancel is changed to read: a. How You May Cancel You may cancel this policy by providing notice to us in one of the following ways: (1) written notice by mail, fax, or e-mail; (2) surrender the policy or binder; or (3) verbal notice. Upon receipt of such notice, we will cancel this policy including any binder issued as evidence of coverage. The date cancellation is ef- fective will be the later of the following: (1) the date such notice is received; or (2) the date of cancellation requested by you. (2) Item b. How and When We May Cancel is changed to read: b. How and When We May Cancel We may cancel this policy by mailing or delivering a written notice to the most recent policy address that we have on record for the named insured who is shown on the Declarations Page. The notice will pro- vide both the reason for the cancellation and the date cancellation is effective. The date cancellation is ef- fective will be at least: (1) 10 days after we mail or deliver the cancellation notice if the cancella- tion is because you did not pay the premium; or (2) 45 days after we mail or deliver the cancellation notice if the cancella- tion is because of any other reason. We will also mail or deliver at the same time like notice to each mortgagee, pledgee, or other person shown by the policy to have an interest in any loss which may occur thereunder. The mailing of the notice will be sufficient proof of notice. Page7of7 6018CK ©, Copyright, State Farm Mutual Automobile Insurance Company, 2016 Corporations: Registration Detail - WA Secretary of State Page 1 of 1 TEMPORARY STORAGE OF WASHINGTON, INC UBI Number 601434061 Category REG Profit/Nonprofit Profit Active/Inactive Active State Of Incorporation WA WA Filing Date 12/29/1992 Expiration Date 12/31/2017 Duration Perpetual Registered Agent Information Agent Name BRUCE JOHN LEVEN II Address 200 S NARWHAL LP SW City OCEAN SHORES State WA ZIP 985690000 Special Address Information Address PO BOX 995 City AUBURN State WA Zip 980710000 Governing Persons (as defined in RCW 23.95.105(12)(htipY/app.legwages/Rcw/supderautaspt?atE=73.95.105)) Title Name Governor LEVEN JANSEN Governor LEVEN , MORGAN Governor LEVEN II , BRUCE Governor LEVEN , MELINDA https://www.sos.wa.gov//corps/search_detail.aspx?ubi=601434061 10/31/2017