HomeMy WebLinkAboutCONSENT HFB Dove House DV Shelter JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO: Jefferson County Board of Commissioners
FROM: Carolyn Gallaway, Clerk of the Board
DATE: /2 // c/2c
SUBJECT: AGREEMENT re: 2026 Affordable Housing/Homelessness
Grant Funding; Dove House—Emergency Temporary
Domestic Violence Shelter; in the amount of$189,000
STATEMENT OF ISSUE:
On October 29, 2025 and November 4, 2025 the Housing Fund Board met and reviewed the
RFPs received. On November 17, 2025,the Board of County Commissioners approved the
Housing Fund Board's 2026 funding recommendations for Affordable Housing Fund 148,
Homeless Housing Fund 149 (1590 and 5386 Funds). One of the recommendations was to fund
Dove House—Emergency Temporary Domestic Violence Shelter; in the amount of
$189,000.
ANALYSIS:
The attached Grant Agreement will provide $189,000 in funds approved by the Board of
County Commissioners on November 17, 2025.
FISCAL IMPACT:
$46,000 from Fund 148, and $143,000 from Fund 149 for a total of$189,000.
RECOMMENDATION:
Approve the attached Grant Agreement.
REVIEWED BY:
rrCrhAO ((}(fl7
Jo . Peters, County Administrator Date
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: DOVE HOUSE ADVOCACY SERVICES Contract No: DOVEHOUSE-DV-2026
Contract For: EMERGENCY TEMP DV SHELTER Term: January 1,2026 to December 31,2026
COUNTY DEPARTMENT: COUNTY ADMINISTRATOR'S OFFICE
Contact Person: CAROLYN GALLAWAY
Contact Phone: 360-385-9122
Contact email: CAROLYNQCO.JEFFERSON.WA.US
AMOUNT: $189,000($46,000148, $143,000 149) PROCESS: — Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds Vendor List Bid
Fund # ,� RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANC WITH J/ 3.55.080 AND CHAPTER/42.23 RCW.
■CERTIFIED: N/A: / ��'ck/ (2/h, /A-
ature Date
STEP 2: DEPARTMENT CERTIFIES THE RSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: ❑ N/A: p �,t �-€ e ram' ' �/� S.
Signature Date
STEP 3: RISK MANAGEMENT REVIEW( i be added electronically through Laserfiche):
Electronically approved by Risk Management on 12/12/2025.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 12/12/2025.
County grant template. Pre-approved by PAO.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
AGREEMENT FOR
2026 AFFORDABLE HOUSING/HOMELESSNESS SERVICES FUNDING FOR
DOVE HOUSE—EMERGENCY DV SHELTER
This Agreement is by and between Jefferson COUNTY, Washington (the COUNTY) and
DOVE HOUSE("RECIPIENT").
WHEREAS, RECIPIENT is a non-profit corporation registered with the Secretary of State
of the State of Washington under UBI number 601 141 377; and
WHEREAS, the COUNTY desires to support affordable housing and reduce or eliminate
homelessness in unincorporated Jefferson COUNTY, as authorized by Chapter 36.22 RCW,
Chapter 82.14 RCW,and Chapter 3.33 Jefferson COUNTY Code; and
WHEREAS, the COUNTY appointed the Jefferson COUNTY Housing Fund Board
("HFB") to review and recommend Affordable and Supportive Housing Fund (1590 FUNDS)
and/or Homeless Housing and Assistance Fund (5386 FUNDS) proposals submitted to the
COUNTY, as authorized by RCW 82.14.530, RCW 82.14.540 and Chapter 3.33 Jefferson
COUNTY Code;and
WHEREAS, RECIPIENT submitted a qualified Affordable and Supportive Housing Fund
(1590 FUNDS) and/or Homeless Housing and Assistance Fund (5386 FUNDS) proposal to the
HFB;
WHEREAS, the HFB reviewed and recommended funding all or part of RECIPIENT's
qualified Affordable and Supportive Housing Fund (1590 FUNDS) and/or Homeless Housing and
Assistance Fund(5386 FUNDS)proposal to the Jefferson County Board of Commissioners;
WHEREAS, the Jefferson County Board of Commissioners reviewed the HFB
recommendation for funding all or part of RECIPIENT's qualified Affordable and Supportive
Housing Fund (1590 FUNDS) and/or Homeless Housing and Assistance Fund (5386 FUNDS)
proposal and finalized an award of$46,000 from Fund 148 and$143,000 from Fund 149 for a total
of$189,000 for the purposes recommended by the HFB("Final HFB Award");
IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the
parties as follows:
1. SERVICES TO BE PERFORMED USING THE HFB AWARD
a. RECIPIENT shall use its capabilities and utilize up to the total amount of Final HFB Award
for the approved scope of work for the Project described in RECIPIENT's proposal for the
2026 fiscal year, a copy of which is attached as Exhibit A.
b. The budget for the Project is described in Exhibit B,attached.
2. RESPONSIBILITIES OF RECIPIENT
a. Reports. RECIPIENT shall submit a progress report no later than July 1, 2026, midway
through the grant cycle period. An annual report form will be due no later than January
31, 2027. The report form will be distributed before the end of the year. Non-compliance
may result in no funds awarded in the future. Reports shall include a comparison of
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 1
outcomes to date with those initially proposed, and the total number of individuals served
during the Agreement term.
b. Payment. Expenses incurred on the Project, as described in Section 1.b., by the Project's
consultants, contractors, suppliers, or RECIPIENT's staff shall be submitted to the
COUNTY Administrator's Office by RECIPIENT using a detailed invoice that includes
all of the following:
i. Each detailed invoice shall show individual items followed by the total amount
incurred and the amount eligible for reimbursement under this grant. RECIPIENT
may submit such invoices to the COUNTY once per month during the course of
the Project for work completed. All invoices shall be submitted no later than 30
days after project completion; and,
ii. The COUNTY shall review and approve invoice payments. Payments will be
limited to the monies that are available under the grant as described in Section 1.
Such invoices, once approved, will be paid using the COUNTY's normal bill
paying process and cycle.
c. For a minimum of six (6) years, maintain documented proof of payments made, contracts
executed, and other expenditures authorized under this Agreement. Upon reasonable
notice,provide access to COUNTY or State representatives to audit those records.
d. Funding provided by this Agreement may only be expended on the services described in
Section 1 of this Agreement. Any monies used for other services or purposes shall be
refunded to Jefferson COUNTY. Any monies under-expended of the total funding
allocated under this Agreement shall be refunded to Jefferson COUNTY by January 31,
2027.
3. RESPONSIBILITY OF JEFFERSON COUNTY
a. The COUNTY shall provide RECIPIENT funding from the Affordable and Supportive
Housing Fund (1590 FUNDS) and/or Homeless Housing and Assistance Fund (5386
FUNDS) to be used in support of their responsibilities as defined under this Agreement.
b. Said funding is in the amount of the Final HFB Award for the 2026 fiscal year. Payment is
conditioned on full compliance with this Agreement, including but not limited to, the
submittal of the reports required by Section 2.
c. Payment shall be made by the COUNTY upon receipt of an invoice on the next available
billing cycle.
4. TERM
This Agreement shall be for a term of one year, commencing on January 1, 2026 and ending on
December 31,2026,except for the reports required in Section 2,which are due January 31,2027.
5. ASSIGNMENT
A party's interests in this in this Agreement may not be assigned to any other person.
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 2
6. TERMINATION
a. This Agreement may be terminated, in whole or in part, by the COUNTY upon thirty (30)
days written notice in the event expected or actual revenue from Fund 148 and/or 149 is
reduced or limited in any way, or for non-performance of duties under this Agreement, or
for any reason.
b. RECIPIENT may terminate this Agreement upon thirty (30) days written notice to the
COUNTY. In the event of termination under this clause, the COUNTY shall be liable to
pay only for services rendered prior to the effective date of termination. If termination
covers a period for which payment has already been made, RECIPIENT shall refund to the
COUNTY a pro-rated share of the payment based upon the balance of time remaining in the
paid period,unless otherwise negotiated.
7. HOLD HARMLESS
a. RECIPIENT shall indemnify and hold the COUNTY, and its officers, employees, agents
and volunteers (and their marital communities) harmless from and shall process and
defend at its own expense, including all costs, attorney fees and expenses relating thereto,
all claims, demands, or suits at law or equity arising in whole or in part, directly or
indirectly, from RECIPIENT's negligence or breach of an of its obligations under this
Agreement; provided that nothing herein shall require RECIPIENT to indemnify the
COUNTY against and hold harmless the COUNTY from claims, demands or suits based
solely upon the conduct of the COUNTY, its officers, employees, agents and volunteers
(and their marital communities), and; provided further that if the claims or suits are
caused by or result from the concurrent negligence of: (a) RECIPIENT's agents or
employees; and, (b) the COUNTY, its officers, employees agents and volunteers (and
their marital communities), this indemnity provision with respect to claims or suits based
upon such negligence, and or the costs to the COUNTY of defending such claims and
suits, etc., shall be valid and enforceable only to the extent of RECIPIENT's negligence,
or the negligence of RECIPIENT's agents or employees.
b. RECIPIENT specifically assumes potential liability for actions brought against the
COUNTY by RECIPIENT's employees, including all other persons engaged in the
performance of any work or service required of RECIPIENT under this Agreement and,
solely for the purpose of this indemnification and defense, RECIPIENT specifically
waives any immunity under the state industrial insurance law, Title 51 RCW.
RECIPIENT recognize that this waiver was specifically entered into pursuant to
provisions of RCW 4.24.115 and was subject of mutual negotiation.
8. INSURANCE
RECIPIENT shall obtain and keep in force during the term of this Agreement, or as otherwise
required, the following insurance:
a. Commercial General Liability Insurance. RECIPIENT shall maintain commercial general
liability coverage on a form acceptable to Jefferson COUNTY Risk Management for
bodily injury, personal injury, and property damage, with a limits of not less than in the
amount of at least $1 million per occurrence, for bodily injury, including death, and
property damage; and
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 3
b. Worker's Compensation (Industrial Insurance). RECIPIENT shall maintain workers'
compensation insurance at its own expense, as required by Title 51 RCW, for the term of
this Agreement and shall provide evidence of coverage to Jefferson COUNTY Risk
Management, upon request.
9. INDEPENDENT CONTRACTOR
a. RECIPIENT and the COUNTY agree that RECIPIENT is an independent contractor with
respect to the services provided pursuant to this Agreement.
b. Nothing in this Agreement shall be considered to create the relationship of employer and
employee between the parties hereto.
c. Neither RECIPIENT nor any employee of RECIPIENT shall be entitled to any benefits
accorded COUNTY employees by virtue of the services provided under this Agreement.
d. The COUNTY shall not be responsible for withholding or otherwise deducting federal
income tax or social security or for contributing to the state industrial insurance program,
otherwise assuming the duties of an employer with respect to RECIPIENT, or any
employee, representative, agent or subcontractor of RECIPIENT.
e. RECIPIENT shall be responsible for all applicable withholdings, deductions, state
industrial insurance, tax reports, business licenses, registrations, and all other obligations
of an independent organization.
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 4
10. SUBCONTRACTING REQUIREMENTS
a. RECIPIENT Owns Contract Performance. RECIPIENT is responsible for meeting all
terms and conditions of this Agreement including standards of service, quality of
materials and workmanship, costs and schedules. Failure of a subcontractor to perform is
no defense to a breach of this Agreement. Recipient assumes responsibility for all
liability for the actions and quality of services performed by any subcontractor.
b. Subcontractor Disputes. Any dispute arising between RECIPIENT and any
subcontractors or between subcontractors must be resolved with involvement of any kind
on the part of the COUNTY and without detrimental impact on the delivery of contracted
goods and services.
11. LEGAL AND REGULATORY COMPLIANCE
While performing under this Agreement, RECIPIENT, subcontractors, and their employees are
required to comply with all applicable local, state and federal laws, codes, ordinances and
regulations, including but not limited to:
a. Applicable regulations of the Washington State Department of Labor and Industries,
including WA-DOSH Safety Regulation; and
b. State and Federal Anti-Discrimination Laws.
12. COMPLIANCE WITH LAWS
RECIPIENT shall comply with all Federal, State, and local laws and ordinances applicable to the
work to be done under this Agreement.
13. CHOICE OF LAW
The parties agree that this Agreement is entered into in the State of Washington. This Agreement
shall be governed by and construed under the laws of the United States, the State of Washington
and the County of Jefferson, as if applied to transactions entered into and to be performed wholly
within Jefferson County, Washington between Jefferson County residents. No party shall argue
or assert that any state law other than Washington law applies to the governance or construction
of this Agreement.
14. DISPUTES
a. The parties agree to use their best efforts to prevent and resolve disputes before they
escalate into claims or legal actions. Any disputed issue not resolved under this
Agreement shall be submitted in writing within 10 days to the County Risk Manager,
whose decision in the matter shall be final, but shall be subject to judicial review.
b. If either party deem it necessary to institute legal action or proceeding to enforce any
right or obligation under this Agreement, each party in such action shall pay for its own
attorney's fees and court costs.
c. Any legal action shall be initiated in the Superior Court of the State of Washington for
Jefferson County, subject to the venue provisions for actions against counties in RCW
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 5
36.01.050. The parties agree that the parties have the right of appeal from such decisions
of the Superior Court under the laws of the State of Washington.
d. RECIPIENT consents to the personal jurisdiction of the courts of the State of
Washington.
15. DISCRIMINATION PROHIBITED
RECIPIENT with regard to the project to be completed under this Agreement, shall not
discriminate on the grounds of age, sex, marital status, sexual orientation, race, creed, color,
national origin, honorably discharged veteran or military status, or the presence of any sensory,
mental, or physical disability or the use of a trained dog guide or service animal by a person with
a disability, unless based upon a bona fide occupational qualification in the selection and
retention of employees, materials, supplies, or subcontractors.
16. INTEGRATED AGREEMENT
This agreement together with attachments or addenda represents the entire and integrated
agreement between the COUNTY and RECIPIENT and supersedes all prior negotiations,
representations, or agreements written or oral.
17. PUBLIC RECORDS ACT
This Agreement and any reports submitted by RECIPIENT are subject to disclosure as a public
record under the Public Records Act, RCW Chapter 42.56.
18. RECORDS RETENTION AND AUDIT AUTHORIZATION
a. A minimum of six years, RECIPIENT shall maintain documented proof of payments
made, contracts executed and other expenditures authorized under your Agreement with
Jefferson COUNTY.
b. Upon reasonable notice, RECIPIENT shall provide access to COUNTY or State
representatives to audit records related to the funds provided to RECIPIENT under this
Agreement.
19. NO SEVERABILITY
The terms of this Agreement are not severable. If any provision of this Agreement or the
application of this Agreement to any person or circumstance shall be invalid, illegal, or
unenforceable to any extent, the remainder of this Agreement and the application this Agreement
shall not be enforceable.
20. SURVIVAL
Those provisions of this Agreement that by their sense and purpose should survive the term of
this Agreement shall survive the term of this Agreement for a period equal to any and all relevant
statutes of limitation, plus the time necessary to fully resolve any claims, matters or actions
begun within that period.. Without limiting the generality of the preceding sentence, and for the
avoidance of doubt, the provisions that survive the term of this agreement include: (a)controlling
law; (b) insurance; and, (c) indemnification.
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 6
21. AMENDMENT, MODIFICATION AND WAIVER
a. This Agreement may be not be amended or modified to change the approved scope of
services in the Final HFB Award.
b. Only the Jefferson County Board of Commissioners or their delegate by writing
(delegation to be made prior to action) shall have the expressed, implied, or apparent
authority to sign, alter, amend, modify, or waive any clause or condition of this
Agreement.
c. Any alteration, amendment, modification, or waiver of any clause or condition of this
Agreement is not effective or binding unless made in writing and signed by the Jefferson
County Board of Commissioners or their delegate.
SIGNATURES ARE ON THE FOLLOWING PAGE
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 7
JEFFERSON COUNTY WASHINGTON DOVE HOUSE
Board of COUNTY Commissioners
Jefferson COUNTY, Washington
By: By:
Heidi Eisenhour,Chair Date Signature
By: Name:
Greg Brotherton, Member Date
Title:
By: Date:
Heather Dudley-Nollette, Member Date
SEAL:
ATTEST:
Carolyn Gallaway,CMC Date
Clerk of the Board
Approved as to form only:
for 12/12/20.25
Philip C. Hunsucker. Date
Chief Civil Deputy Prosecuting Attorney
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 8
EXHIBIT A- SCOPE OF WORK
RECIPIENT has been awarded $189,000(the "Final HFB Award"), after recommendation by the
Housing Fund Board ("HFB"). Recipient shall use the Final HFB Award consistently with its
response to the request for proposal submitted to the HFB during the 2026 cycle.
A true and correct copy of the RECIPIENT's response to the request for proposal is attached as
Exhibit C.
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 9
EXHIBIT B—BUDGET
RECIPIENT has been awarded$189,0000(the"Final HFB Award"), after recommendation by
the Housing Fund Board ("HFB"). Recipient shall use the Final HFB Award consistently with its
response to the request for proposal submitted to the HFB during the 2026 cycle.
A true and correct copy of the RECIPIENT's response to the request for proposal is attached as
Exhibit C.
Applicant: Dove House Advocacy Services
Contact: Beulah Kingsolver, Executive Director
Address: 1045 10th Street, Port Townsend, WA 98368
Phone: 360-385-5292
Email: beulahkAdovehousejc.org
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 10
Exhibit C
RECIPIENT'S PROPOSAL
Request for Proposal(RFP) starts after this page
HFB Grant Award Agreement for Dove House—Emergency DV Shelter Page 1 l
Application
AFFORDABLE AND SUPPORTIVE
HOUSING & HOMELESS HOUSING
AND ASSISTANCE FUNDS
For use from January 1, 2026 to December 31, 2026
GENERAL INFORMATION —It is understood that if awarded funding for this period, there is no guarantee of
future funding beyond this award.
We estimate the available funding for this period to be approximately $160,000 for 5386 Homeless Housing and
Assistance(operating) funds; $780,000 for 1590 Affordable and Supportive Housing development funds; and first
year operating funds; and $520,000 for 1590 Affordable and Supportive Housing operating funds. Note that 1590
operating funds may be used for all housing-related services.
Name of Project or Program Emergency Temporary Domestic Violence Shelter& Services
Requested total amount for this application: $210,254.00
Area of the County to be served: Jefferson County,WA
Name of Applicant/Agency: Dove House Advocacy Federal Tax ID#: 91-119187
Services
Contact Person: Beulah Kingsolver Title: Executive Director
Address: 1045 10th Street City: Port Townsend
State: WA Zip: 98368
Phone Number: 360-385-5292 Fax Number: 360-379-5395
E-mail: beulahk@dovehousejc.org
CERTIFICATION by Authorized Agency Representative(Board President,CEO,or another person authorized to
bind the agency in a contract).
Name of Authorized Agency Representative(print):_Beulah Kingsolver
Title: Executive Director
• Applicant certifies that these funds will be used as described in this application unless a change has been
mutually agreed upon between Contractor and Jefferson County Board of County Commissioners. Substantive
amendment requests will also require the approval of the Housing Fund Board ("HFB").
• Applicant certifies that the information in this application is true and correct.
• Applic certifies that it has no outstanding obligations to the County with respect to housing funds.
S-Qo .S.—
Signature of lzed Agency Representative Date
SPECIFIC INFORMATION
Please separately tab each section of the application submission as to Project or Program Description, Capacity,
Alignment,Approach, Impact of Funds,Budget.
PROJECT DESCRIPTION
• Name of Project or Program (please include HMIS name/number if applicable): _Emergency Temporary
Domestic Violence Shelter& Services HMIS Project Names(DOHEmergency Shelter,DOHHotel Vouchers)
• Amount requested: $210,254.00
• Provide a brief description of the Project or Program: (LIMIT 200 WORDS)
The provision of emergency housing and advocacy serves approximately 115 heads of households who are fleeing
domestic violence and experiencing homelessness. Support is provided with emergency temporary shelter and
emergency temporary hotel room stays with trauma-informed,person-centered,wrap-around advocacy services.
Services are confidential and free of charge.
Our service model is designed to support survivors in obtaining long-term affordable housing,strengthen their
ability to keep the housing they obtain and move people out of our temporary emergency shelter as soon as
possible so that other victims who are experiencing homelessness may come into the shelter. All shelter guests are
entered into the HMIS system.
Our advocates serve the whole family and use a Housing First model adapted for serving victims. Each guest is
matched with an advocate who offers emotional and practical support beginning with safety planning. Advocates
meet with each guest at least once each week to support healing,assist them in identifying needs,barriers,and
goals, and connect and refer them to services and resources in our community. Our program reduces or eliminates
homelessness in Jefferson County by providing domestic violence survivors with an immediate safe roof over their
heads and 24-hour access to facilities and resources.
• Specify the Project or Program goals and expected outcomes. Specify the measures of success by which the
Project or Program will be assessed. (LIMIT 300 WORDS)
1. Emergency Temporary Shelter for Victims of Domestic Violence
Outcomes: Approximately 115 heads of households(and their approved pets)who lack safe shelter and are fleeing
domestic violence will find a welcoming place to stay in our temporary emergency shelter.
Measure: Infonet reports showing the number of people/families who enter our shelter.
Outcome: Approximately 115 head of households(and their approved pets)will be offered our full spectrum of
wrap-around services and complete Action Plans toward the goals of long-term safety and affordable housing,
financial stability, and healthy lives.
Measure: Infonet reports showing how many guests received which services. Review of client Action Plans and
goals reached.
Outcome:Keep shelter stays as short as possible.
Measure: Compare the average number of days in shelter during the grant period to same periods in the two
previous Fiscal Years.
Outcome:Shelter guests move directly from shelter to affordable long-term or transitional housing.
Measure: Infonet reports
Outcome:Increase self-sufficiency, financial stability, and well-being
Measure: Review of clients'Action Plans/goals reached. Client feedback about whether or not/how much their
confidence and ability to plan for their safety has increased;whether or not/how much their knowledge of
community resources has expanded;whether or not/how much their feeling of hopefulness about their future has
improved; whether or not/how much they feel more comfortable about asking for help; and whether or not/how
much they feel more comfortable in their decision making.
3. Coordinated Entry
Outcome:All shelter guests entered into HMIS.
Measure: Compare the number of clients entered into HMIS to the number of people who stayed in the shelter
during the grant period.
• Specify the number of units of housing to be created or number of individuals who will be served by the Project
or Program.
Approximately 115 heads of households and approved pets will be served by the program.
Threshold Requirements:
• Identify the specific eligible use(s) under 5386 and/or 1590 for which the Project or Program qualifies, as
listed on pages two through four of the RFP. If you are submitting for both operating and development
funds,please submit separate budgets for each.
5386 Operating Funds:
Quoting directly from page 3 of the RFP:"Persons fleeing domestic or family violence with no subsequent safe
residence identified and lacking the resources needed to obtain such housing. Persons living on the streets or in
emergency shelter but are spending a short time(up to 30 consecutive days)in a hospital or other institution.
Person who would otherwise be living on the streets on in an emergency shelter." And "m. Operating costs for
emergency shelters and licensed overnight youth shelters."
1590 Development Funds:
None
1590 Operating Funds:
• Provide a brief description of recent,relevant and successful experiences in delivering similar programs
and/or projects.
DHAS has been providing crime victim advocacy services in Jefferson County for 40+years. Our Emergency
Shelter,where we began accepting approved pets accompanying their owners in 2017,has been operating for 24
years. DHAS is the only agency in Jefferson County specifically trained to serve current and past victims of trauma
including domestic violence (DV),sexual assault (SA),and other types of crime. We are also the only organization
in Jefferson County offering a Recovery Café with its unique services.
In CalYr 2024, DHAS served 377 clients victimized by domestic violence, sexual assault, or other crimes. 64
individuals/21 families were guests in our Shelter; 4980 bed nights. For CalYr 2025 through 10/10/25,we've had
47individuals/15 families as Shelter guests(3380 bed nights);51 individuals/17 families in hotel rooms. Average
length of stay was 62 last year to 78 nights this year. Unmeetable requests for emergency shelter were at least 340
in 2024 and 277 thus far in 2025.
Of the 52 individuals/26 families who were Shelter guests in FY 2024-2025, 12 moved directly to affordable
permanent or transitional housing; 4 returned to shelter or haven't yet exited the shelter; 6 returned to their abusers.
4 found temporary solutions through family/friends. As of 10/15/25, 14 individuals/6 families are Shelter guests.
A mom of high-risk pregnancy and her young son who were fleeing domestic violence moved into our confidential
shelter. They moved into a safe,comfortable,beautiful environment to start a new chapter of life. At weekly
advocacy appointments housing was one of the many things worked on. She filled out applications for apartments
for low-income affordable housing and connected with apartment managers.
The Dove House Confidential Shelter offered a place for her son to get on regular routine with school and
transition into a safe community. Mom was able to connect with local agencies to get ready for the arrival of her
newborn.Her and the newborn came back into the shelter and were able to stay until they found permanent
housing. Mom and her two kids moved into a beautiful apartment with support from the Dove House staff and the
community providing furniture and household necessities. The journey had some bumps in the road, but through
perseverance and strength support in her advocacy appointments she succeeded moving forward into safe housing.
The Dove House Confidential Shelter played a major role as the first steppingstone for this mom and her family to
stay safe and obtain safe,affordable,permanent housing.
• Briefly describe how the project aligns with the priorities and objectives of the Five-Year Homeless
Housing Plan and the community outreach conducted for the project or program. (LIMIT 400 WORDS)
#1,Quickly identify and engage people experiencing homelessness. DHAS participates in the HMIS system. In
addition,our 24/7 crisis line provides a way for victims of violence who are homeless to connect with emergency
shelter, including our shelter. #2, Prioritize Homeless Housing For People With The Highest Needs.The 5-Year
Plan states: "Unsheltered entries are people living without safe shelter or are fleeing violence." And, "Fortunately,
Jefferson County also has Dove House Advocacy Services which operates an emergency shelter for victims fleeing
domestic violence . . . ". (pg. 26). Our program is for people living without safe shelter and fleeing violence. #3,
Operate an effective and efficient homeless crisis response system that swiftly moves people into stable and
permanent housing while providing services." Housing advocacy helps survivors remain safe and able to continue
building independent, self-sufficient,and fulfilling lives. DHAS uses the Housing First/Rapid Re-Housing models
to support and inspire clients, create materials, train advocates,work with landlords. We dedicate fundraising
efforts to maximize clients' success. We place priority on preventing homelessness, keeping families in their
existing housing(when safe/feasible) and ensuring that guests can move directly to permanent affordable housing
as soon as it can be obtained.#5,Address Racial,Ethnic and Gender Disparities Among People Experiencing
Homelessness. We take substantial steps to ensure inclusivity: translating intake and shelter-related documents into
Spanish; using the Language Line when people whose first language is not English call our Crisis Line and during
meetings with Advocates;respecting all gender expression among our clients; partnering with community groups
such as JCIRA and the LGBTQ++Equity Task Force at JHC:and more. #6 Supportive Efforts Aimed At Ending
Homelessness. We are active partners with community groups evaluating the nature/scope of and potential
solutions to homelessness in Jefferson County. We serve on the Housing Fund Board Needs Assessment
Committee.We participate in HMIS and current efforts to improve data.Case Management is core to our service
model. Our Recovery Café(RC)regularly hosts local housing providers and other agencies serving people
experiencing homelessness who meet with clients and connect them with services. Free meals and human warmth
at the RC create a welcome entry to services where people can build trust. We are continuing to work with
Washington State Coalition Against Domestic Violence for training to help local housing providers better
understand domestic violence and housing barriers unique to victims.
A. APPROACH-Completeness of Proposal and Readiness(5 Points) (LIMIT 400 WORDS)
This program provides emergency/temporary shelter to individuals/families (and approved pets)fleeing domestic
violence who lack safe shelter. Each guest is matched with an Advocate who offers options for emotional healing
and practical problem solving. Shelter guests have 24-hour access to their private room/fully stocked bathroom;
fully stocked/equipped kitchen;common areas; internet access). We provide 100%of basic needs during their
shelter/hotel stay and offer them the full spectrum of DHAS services/resources. Clients meet at least once/week
with their Advocate and may enroll in our classes/support groups(including financial management and trauma-
informed yoga). Our staff conduct ongoing case management and provide connection/referrals to community
resources (including therapy)as well as support in accessing them such as transportation and childcare assistance.
Our Recovery Café provides unique resources and connections to community services for victims.
Our housing advocacy is designed to help survivors remain safe and able to continue building independent, self-
sufficient, and fulfilling lives. We use the Housing First and Rapid Re-housing models to support and inspire
clients, create materials, train advocates, work with landlords. Includes addressing prior evictions;identifying
affordable rentals;encouraging property owners to work with us(e.g. educating them about trauma,how financial
abuse is often part of the cycle of violence, how rent subsidy programs work, and what support is available from
DHAS);helping clients with application; tracking applications; providing financial assistance for first/last rents and
security deposits;sourcing move-in resources; and continuing to support clients after they have moved into their
dwelling. Landlords often express interest in working with us when they learn of our ability to provide the client
with move-in costs in a timely manner and our commitment to continued support services. We prioritize helping all
guests to obtain their best next step for housing,whether it be permanent or transitional, after they leave the
shelter/hotel.
Emergency shelters are vital for domestic violence victims. When not spending most of their energy/time simply
meeting basic needs,their stress/anxiety are reduced and they can focus on emotional healing, identifying and
addressing barriers toward increased self-sufficiency, and accessing the resources needed to obtain,and retain,
permanent affordable housing.
B. IMPACT OF FUNDS-Leverage of Other Funds and Number of Persons Assisted
(10 Points) (LIMIT 400 WORDS)
• Our Emergency Domestic Violence Shelter and Services program is exclusively for unsheltered homeless
individual/families victimized by domestic violence. Youth ages 18-24 are directly eligible for/served by
these services. Those younger than 18 may receive these services when accompanied by a parent or when
their parent agrees to allow them to access the services unchaperoned.
Increasing exits to permanent housing; Reducing the length of time homeless; Reducing returns to
homelessness
• Our program provides 100% of basic needs to shelter/hotel guests. When they are not spending most of
their energy/time simply meeting basic needs,their stress and anxiety are reduced and they can focus on
emotional healing, identifying/addressing barriers toward increased self-sufficiency, and accessing the
resources needed to achieve their goals including permanent affordable housing.
• We engage every available avenue to assist clients in acquiring skills and resources to avoid
remaining/returning to homeless(ness) and to find and keep affordable,permanent housing. This includes
teaching housing search strategies; addressing prior evictions; supporting clients in job and childcare
searches; identifying all subsidy and low-income housing options and other affordable options;encouraging
property owners to work with us;helping clients with applications; tracking applications; providing move-
in assistance; and continuing to support clients after they have moved into their dwelling.
■ We dedicate fundraising efforts to maximize clients' success. We place priority on preventing homelessness
and keeping families in their existing housing, when safe and feasible and ensuring that guests in our
emergency shelter can move directly to permanent affordable housing(if they wish)as soon as it can be
obtained,rather than remaining homeless.
• Clients in this program meet with their Advocate at least once a week and actively work toward obtaining
permanent or transitional housing. While the realities of the severe housing emergency in Jefferson County
make it challenging, we prioritize helping all guests to obtain their best next step for housing as quickly as
possible in order to make emergency/temporary shelter available for other victims in need.
We participate in the HMIS System.
C. PROJECT OR PROGRAM BUDGET—A Feasible Financial Plan (5 Points)
BUDGET FORMS
Funding period begins January 1, 2025, and ends December 31,2025. Please use the attached budget
templates. If you need additional space,you may insert rows. "Proposal"refers to the funds requested from
these funds that will be applied to this specific Project or Program. Blank spaces are provided for additional
categories. Justification for budget items must be specific,and that same specificity should be reflected in
subsequent billings. A maximum 10%Administration fee is allowed for projects if needed,however,
Administration fees are not allowed for Capital Projects.
CAPITAL BUDGET FOR REAL ESTATE DEVELOPMENT USES
Financing Categories Estimate Basis of Estimate
Total Acquisition Costs $
Construction $
Construction Fees $
Financing Fees and $
Charges
Guarantees and Reserves $
Developers Fee $
Subtotal $
TOTAL $
SOURCES
Financing Categories Estimator Indicate if Committed or Application has been made. If not made
indicate date application is to be submitted
Private Loan $
Jefferson County Funds $
Public Sources(State or $
Federal Funds)
Foundations
Donations
Low Income Housing $
Tax Credits(indicate 9%
or 4%)
Historic Tax Credits $
New Market Tax Credits $
Gap(if any) $
TOTAL $
Please include any budget narrative that is descriptive or helpful to explain any part of your proposed expenditures
in your capital budget(s). (LIMIT 300 WORDS)
PROGRAM OPERATING BUDGET
[DATES]
Budget Categories Program Proposal Justification Priority
Salaries $105,915.00 $79,375.00 Salaries 1.50 FTE 1
Benefits $40,098.00 $31,920.00 Benefits & taxes for 1.50 FTE 1
Utilities $13,163.00 $13,821.00 Utilities to run shelter(5% increase 2
Insurance $6,431.00 $6,624.00 Insurance for shelter(5% increase) 2
Food/Supplies S45,000.00 $5,000.00 Food & supplies for clients 2
Furnishings/Equipment S 10,000.00 $5,000.00 Furnishing& Equipment for sheltei 3
Facilities $30,400.00 $24,400.00 Maintenance/Janitorial/Landscapin; 1
Emergency Hotel Stay $10,000.00 $5,000.00 Hotels for when Shelter is full 3
Therapy $28,600.00 $20,000.00 Therapy once a week for 5 clients 2
Subtotal $289,607.00 $191,140.00
Administration(lo%max.) $28,961.00 $19,114.00
TOTAL $318,568.00 $210,254.00
If your Project or Program includes salaries and benefits, please list position(s) and FTE to be paid by these funds
(FTE should be that percentage of time the employee is dedicated to this Project or Program):
Position Salary Benefits FTE
Program Manager $17,500.00 $5,485.00 0.25
Advocate/Shelter $50,500.00 $21,148.00 1.00
Manager
Maintenance $11,375.00 $5,287.00 0.25
FUNDING SOURCES FOR THE PROGRAM in 2025
Funding Sources Awards Awards Indicate if Committed or
2024-25 2025-26 Application has been made.
Public Sources $238,000.00 $269,000.00 Committed/Applied
(State or Federal
Funds)
Private Donations $29,000.00 $30,000.00 Estimated for 2025-26
Foundation Grants $9,000.00 $10,000.00 Applied/Estimated for 2025-
26
Fundraising Events $7.000.00 $9,000.00 Estimated for 2025-26
Other $ $
Other $ $
TOTAL $283,000.00 $318,000.00
Please include any budget narrative that is descriptive or helpful, to explain any part of your proposed
expenditures. For instance, if you are requesting furnishings or appliances specifically for housing included in your
Project or Program, what are the items you are requesting? (LIMIT 300 WORDS)
The requested funds from this RFP will cover 1.50 of the Salary and Benefits of the staff required to provide
services.The utilities include water/sewer,electricity,garbage removal,and telephone. Insurance,supplies&
furnishings/equipment,maintenance/janitorial/landscaping are needed to run the shelter.Program services include
hotels,therapy,and client financial support.
ATTACHMENT A
Required Insurance Coverages
1. Commercial General Liability.
• Recipient shall maintain commercial general liability coverage on a form acceptable to
Jefferson County Risk Management for bodily injury, personal injury, and property damage, in
an amount not less than two million dollars per occurrence ($2,000,000)and an aggregate of
not less than four million dollars ($4,000,000), for bodily injury, including death, and property
damage.
• The commercial general liability insurance coverage shall contain no limitations on the scope
of the protection provided and include the following minimum coverage:
o Broad form property damage, with no employee exclusion;
o Person injury liability, including extended bodily injury;
o Broad form contractual/commercial liability, including completed operations and
product liability coverage;
o Premises —operations liability (M&C);
o Independent contractors and subcontractors;and,
o Blanket contractual liability.
• Recipient's commercial general liability policy shall include employer's liability coverage.
• The County and its elected officials, officers and employees shall be named as an additional
insured party under this insurance policy.
2. Automobile Liability.
• Recipient shall maintain business automobile Liability insurance on a form acceptable to
Jefferson County Risk Management with a limit of not less than a combined single limit of
$1,000,000 each occurrence. Coverage shall include owned, hired,and non-owned
automobiles.
3. Workers' Compensation (Industrial Insurance). Recipient shall maintain workers' compensation
insurance at its own expense,as required by Title 51 RCW, for the term of this Agreement and
shall provide evidence of coverage to Jefferson County Risk Management,upon request. If the
County incurs any cost to enforce the provisions of this subsection,all costs and fees shall be
recoverable from Recipient.
o Recipient shall provide Workers' Compensation and Employer's Liability on a state
approved policy form providing benefits as required by law with employer's liability limits
no less than$1,000,000 per accident or disease.
o This coverage shall extend to any contractor or subcontractor that does not have their own
workers' compensation and employer's liability insurance.
o Recipient expressly waives by mutual negotiation all immunity and limitations on liability,
with respect to the County,under any industrial insurance act,disability benefit act,or
other employee benefit act of any jurisdiction, which would otherwise be applicable in case
of such claim.
4. General Insurance Requirements.
• Insurance coverage shall be evidenced by one of the following methods:
o Certificate of insurance; or,
o Self-insurance through an irrevocable Letter of Credit from a qualified financial institution.
• Any deductibles or self-insured shall be declared to and approved by the County prior to the
approval of this Agreement by the County.At the option of the County, the insurer shall reduce
or eliminate deductibles or self-insured retention,or Recipient shall procure a bond
guaranteeing payment of losses and related investigations,claim administration and defense
expenses.
• Failure of Recipient to take out or maintain any required insurance shall not relieve Recipient
from any liability under this agreement,nor shall the insurance requirements be construed to
conflict with or otherwise limit the obligations concerning indemnification of the County.
• Recipient's insurers shall have no right of recovery or subrogation against the County
(including its employees and other agents and agencies),it being the intention of the parties
that the insurance policies so affected shall protect all the parties and shall be primary coverage
for all losses covered by the above described insurance.
• Insurance companies issuing Recipient's insurance policy or policies shall have no recourse
against the County(including its employees and other agents and agencies)for payment of any
premiums or for assessments under any form of insurance policy.
• All deductibles in Recipient's insurance policies shall be assumed by and be at the sole risk of
Recipient.
• Any judgments for which the County may be liable, in excess of insured amounts required by this
agreement, or any portion thereof, may be withheld from payment due, or to become due,to
Recipient until Recipient shall furnish additional security covering such judgment as may be
determined by the County.
• Any coverage for third party liability claims provided to the County by a"Risk Pool"created
pursuant to Ch.48.62 RCW shall be non-contributory with respect to any insurance policy
Recipient shall provide to comply with this Agreement.
• The County may,upon Recipient's failure to comply with all provisions of this Agreement
relating to insurance, withhold payment or compensation that would otherwise be due to
Recipient.
• Recipient shall provide a copy of all insurance policies specified in this Agreement.
• Written notice of cancellation or change in Recipient's insurance required by this Agreement shall
reference the project name and agreement number and shall be mailed to the County at the
following address:Jefferson County Risk Management,P.O. Box 1220, Port Townsend,WA
98368.
• Recipient's liability insurance provisions shall be primary and noncontributory with respect to
any insurance or self-insurance or self-insurance programs covering the County,its elected and
appointed officers,officials, employees and agents.
• Any failure to comply with reporting provisions of the insurance policies shall not affect coverage
provided to the County, its officers, officials, employees or agents.
• Recipient's insurance shall apply separately to each insured against whom claim is made or suit is
brought, except with respect to the limits of the insurer's liability.
• Recipient shall include all subcontractors as insured under its insurance policies or shall furnish
separate certificates and endorsements for each subcontractor.All insurance coverage for
subcontractors shall be subject to all the requirements stated in this Agreement. The insurance
limits mandated for any insurance coverage required by this Agreement are not intended to be an
indication of exposure nor are they limitations on indemnification.
• Recipient shall maintain all required insurance policies in force from the time services commence
until services are completed. Certificates,insurance policies, and endorsements expiring before
completion of services will be promptly replaced.
• Recipient shall place insurance with insurers listed to business in the State of Washington and
having A.M. Best Company ratings of no less than A-,with the exception that excess and
umbrella coverage used to meet the requirements for limits of liability or gaps in coverage need
not be place with insurers or re-insurers licensed in the State of Washington.
• Certificates of insurance as required by this Agreement shall be delivered to the County within
fifteen (15)days of execution of the Agreement.To the extent a certificate lists or refers to any
endorsements solely by name. description or number it shall be the responsibility of Recipient to
obtain and provide to Jefferson County Risk Management a full and complete copy of the texts of
such endorsements.
• The County shall be named as an"additional insured"on all insurance policies required by this
Agreement.
• Recipient shall furnish the County with properly executed certificates of insurance that,at a
minimum, shall include:
o The limits of coverage;
o The project name and agreement number to which it applies;
o The certificate holder as Jefferson County,Washington and its elected officials,
officers, employees and agents with the address of Jefferson County Risk Management,
P.O.Box 1220,Port Townsend, WA 98368;and
o A statement that the insurance policy shall not be cancelled or allowed to expire except
on thirty(30)days prior written notice to the County.
Dove House Advocacy Services
Budget
July 2025 through June 2026
July-June
Ordinary Income/Expense
Income
FEDERAL & STATE GRANTS 993,287.00
OTHER GRANTS 594,289.00
PROGRAM INCOME 62,900.00
INDIVIDUAL CONTRIBUTIONS 172.542.00
MISCELLANEOUS INCOME 19,000.00
Total Income 1.842.018.00
Expense
ADMINISTRATIVE 64.370.00
FACILITIES 46,094.00
FUNDRAISING 14.000.00
INSURANCE 27.530.00
MARKETING & PUBLIC OUTREACH 9.350.00
PROFESSIONAL SERVICES 28,650.00
PROGRAM SUPPORT 122.150.00
SALARIES BENEFITS & TAXES 1,411,344.00
SUPPLIES & EQUIPMENT 28.900.00
TRAINING & TRAVEL 27.000.00
UTILITIES 62.630.00
Total Expense 1,842,018.00
Net Ordinary Income 0.00
DATE IMMVOIYYYYI I
ACOR/7 CERTIFICATE OF LIABILITY INSURANCE
1'Y 14'2025
`r--
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 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 endorsements)
CONTACT
PRODUCER
NAME Cathy 14WaFflsten
Highstreet Insurance&Financial Services PRONE 425 775.644E FAX 425 84o-S225
500 Main Street,Suite A Nd,c•rt lam,Noe
Edmonds WA 98020 Ammo
INSURERISI AFFORDING COVERAGE MAIC•
INSURER A Philadelphia Indemnity Insurance Company 18058
INSURED -... �- ---1• INSURER 13 _ _ ._
Dove House Advocacy Services INSURER C
INSURER
1045 10th Street
Port Townsend WA 98368-2933 : . I
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER:391277188 REVISION NUMBER.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMtO ABOVE FOR THE PCoGY 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
NSA ADDL SUVA POLICY EFF POLICY EXP
TYPE OF INSURANCE
LTR MD WVD POLICY NUMBER IMM.CC1 YYVY1 IMMINGYYYYI LAES
+ X COMMERCIAL GENERAL LIABILITY PHPK2586C61-024 4,1&2C25 5'13.2026 FACiOCCURRE-NCE Si 000.000
. •L-- ADE X OCCUR PEMISSESO� rtNITEencel 3100.000 _.
MEo EXP!Arty me person} _35.000
_ PERSONAL 0 ADV'HAIRY I S 1 ODD 000
:=4'.A:-eECIsT5_:,•IIIAPPlIESPER---- GENERAL AGGREGATE S2 ODD 000 _--
O.
POLICY JECT LOC pitOOUCTS•COMP/OP AGO S 2 COO ODD_
OCTIER. S
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AIJTpYp6.LE LtAR1 BTY PHPK2566D81-024 9:18'2025 9 t&'2•�25 lEaMaiNED arndmrttSINGLE OMIT S 1°De 000
AHY Atr0 acre Y INJURY(Per priori S
OWNE7 X SCHEDULED Aurcis BODILY INJURY(Per ecad-- S
X IRE OS ONLY x NON-OWNED Pfi& SRTY t
AUTOS ONLY .Ames(Ayr, IPM tI arf Mi 5
s
UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MA..7E I AGGREGATE I -
i =E PE'EN 7ICN1 .5
A l WORKERS COMPENSATION atiPK258F06'-2:4 919/2025 9.'18r2t126 ^ $TTATJTE I ERH i WA STOP GAP
AND EMPLOYERS'UABILI Y T.
ANYPROPRIE'ORY'AR-NER,EXEC:UTT+E 7 N,A E L.EACH ACCIDENT ;ENT S 1.OD0.000
OFFICER•MEMBERE'CL�JDE07 --- .
(Slyacnd.tary In CHI E L.DISEASE-EA EMPLOYEE $1,C00.000 _.
l JESCRIPPON OF PERATIONS bale. ` E L DISEASE-POLICY LIMIT S 1,000,000
s (4'Olessacrui-atilt!. PHP1(2586061-024 9+16r2025 I 9:1812026 F-t4!Alb A,g 2.000.000
x I:r,ectersS:"'rr PHS7'P111i58-C22 9,16r2025 ; 9i18•'2o26 PlcL,ebOCr 1,000.000
DAD:_aIVEPu 1.000.000
DESCRIPTION OF OPERATIONS.LOCATIONS,VEHICLES CACORO 101.Additional Remarks Schedule.may be attached it man apace is regwndl
Any person or or.poccurrence anlzation where required by a written contract executed prior to toe of a loss.Such person or organization is an additional insured
for'bodily injury. property damage-or`personal and advertising injury"but only for liability arising out of the negligence of the named insured.The limits nl
insurance applicable to these additional insureds are the lesser of the policy krruts or those limits specified in a contract or agreement These I.rr=ts are induced
within and not in addrtion to the limits of insurance shown in the Declarations Per torn PI-GLD-HS(10111).
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
City of Port Townsend. John Mauro/Thomas Olson
250 Madison Street Ste 101 AUTHORIZED REPRESENTATIVE
Port Townsend WA 98368 ? --. `
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