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CC
AGREEMENT FOR 2021 HOTEL-MOTEL FUNDING FOR TOURISM SERVICES
CENTRUM
This Agreement is by and between JEFFERSON COUNTY(hereinafter known as
"COUNTY" and the CENTRUM(hereinafter known as"CENTRUM").
WHEREAS,the CENTRUM is a non-profit corporation of the State of Washington;and
WHEREAS,the COUNTY desires to promote tourism in unincorporated Jefferson County,
as authorized by Chapter 67.28 RCW and Jefferson County Code Chapter 3.25; and
WHEREAS,the Jefferson County Lodging Tax Advisory Committee reviewed and
recommended funding the lodging tax proposal by Centrum to implement a strategy for the
unincorporated area of Jefferson County to promote tourism activities;
IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the
parties as follows:
SECTION 1: SERVICES TO BE PERFORMED
CENTRUM shall use its capabilities and utilize up to$9,511 of funding provided under this
agreement to continue and update the ongoing performance of the tourism promotion services
consistent with the Itemized List of Promotion Services and Lodging Tax Budget,a copy of which
is incorporated herein and attached hereto as Exhibit A.
1. In recognition of the unavoidable disruption to tourism activities from the COVID-19
pandemic, CENTRUM may substitute other Promotion Services in 2021 in using the funding
provided this Agreement,upon prior presentation of an itemized list to the Lodging Tax
Advisory Committee(LTAC)and affirmative vote by the LTAC recommending that
CENTRUM proceed with the proposed substitution. In such case no amendment to this
Agreement shall be required and CENTRUM may use the funding to perform the substitute
Promotion Services in 2021.
SECTION 2: RESPONSIBILITIES OF CENTRUM:
1. On or before April 30;July 31; October 31,2021; and January 31,2022,provide to the
COUNTY:
• A quarterly report of the use, services,programs and activities of the CENTRUM under
for the prior quarter under this Agreement,and the 2020 Amendment No. 1 dated
December 7,2020;
• A quarterly financial statement detailing revenues, expenses and cash balances for the
prior quarter;and for the final quarter report,the financial statement shall also include a
detailed financial statement for all 2021.
Page: 1 of 9 Centrum
2. On or before January 31, 2021 OR upon execution of this agreement,whichever is later,
provide to the COUNTY:
• A billing statement requesting payment of Hotel-Motel Funding for the current year.
3. 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.
4. 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 31,2022.
5. By February 28th of each year provide the following information on Exhibit B,attached
hereto and incorporated by reference for the previous year.
a. Each festival,event,or tourism facility owned and/or operated by CENTRUM.
b. The amount of lodging tax revenue allocated for expenditure(whether actually
expended or not)by the CENTRUM on each festival,event or tourism facility.
c. Estimated number of tourists served at each festival,event or tourism facility. ("Tourist"
includes persons traveling more than 50 miles to the location of the event,festival or
facility and overnight stays in the area).
d. Estimated lodging stays. ("Lodging"refers to commercial lodging such as hotels,
motels,resorts,bed and breakfasts,or commercial campgrounds).
e. Measurements that demonstrate the impact of increased tourism attributable to the
event, festival or facility.
SECTION 3: RESPONSIBILITY OF JEFFERSON COUNTY
1. The COUNTY will provide the CENTRUM funding from Hotel-Motel Tax receipts to be
used in support of their responsibilities as defined under this agreement.
2. Said funding is in the sum of$9,511 for 2021. Payment is to be predicated on submittal of
reports defined in Section 2. Payment will be made by the COUNTY upon receipt of an
invoice on the next available billing cycle.
3. The County recognizes that the original allocation to the CENTRUM in Hotel-Motel funds
for promotional services in Jefferson County may be voluntarily reduced because of the
impacts of the COVID-19 pandemic.Any voluntary reduction from 2021 funding is
earmarked for potential use in 2022,contingent on a recommendation by the Lodging Tax
Advisory Committee to award those funds to the CENTRUM in 2022 and approval by the
Board of County Commissioners.
Page: 2 of 9 Centrum
SECTION 4: TERM
This Agreement shall be for a term of one year,commencing on January 1,2021 and ending on
December 31,2021,except for the reports referenced in Section 2,due January 31,2022 and
February 28,2022.
SECTION 5:ASSIGNMENT
Either party to the agreement shall not assign this Agreement,except by signed amendment.
SECTION 6: MODIFICATION
This Agreement may be modified by mutual written agreement executed by both parties.
SECTION 7: TERMINATION
The 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 the Hotel-Motel Tax is reduced or limited in
any way,or for non-performance of duties under this Agreement, or for any reason. The
CENTRUM 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, CENTRUM 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.
SECTION 8: HOLD HARMLESS
The CENTRUM shall indemnify and hold the COUNTY, and its officers,employees, and agents
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 the CENTRUM's negligence or breach of any of its obligations
under this Agreement;provided that nothing herein shall require.the CENTRUM 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 and agents,and; provided
further that if the claims or suits are caused by or result from the concurrent negligence of: (a)the
CENTRUM's agents or employees; and, (b)the COUNTY, its officers, employees and agents,
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 the CENTRUM's negligence, or the negligence of the CENTRUM's agents
or employees.
The CENTRUM specifically assumes potential liability for actions brought against the COUNTY
by the CENTRUM's employees, or any other persons engaged in the performance of any work or
service required of the CENTRUM under this Agreement and, solely for the purpose of this
indemnification and defense, the Contractor specifically waives any immunity under the state
Page: 3 of 9 Centrum
industrial insurance law, Title 51 RCW. TheCENTRUM
C NTRUM recognizes that this waiver was �I
specifically entered into pursuant to provisions of RCW 4.24.115 and was subject of mutual
negotiation.
SECTION 9: INSURANCE
CENTRUM shall obtain and keep in force during the term of the Agreement,or as otherwise
required,the following insurance with companies or through sources approved by the State
Insurance Commissioner pursuant to RCW 48.
1. Worker's Compensation and Employer's Liability Insurance as required by the State of
Washington. CENTRUM shall maintain Workers' Compensation coverage as required
under the Washington State Industrial Insurance Act, RCW Title 51, for all CENTRUM
employees,agents and volunteers eligible for such coverage under the Industrial
Insurance Act.
2. Commercial Automobile Liability Insurance providing bodily injury and property damage
liability coverage for all owned and non-owned vehicles assigned to or used in the
performance of the work for a combined single limit of not less than$1,000,000 per
occurrence in connection with CENTRUM's performance of the contract, including:
a. Owned Automobiles;
b. Hired Automobiles; and
c. Non-owned Automobiles.
3. General Commercial Liability Insurance in an amount not less than a single limit of one
million dollars($1,000,000.00)per occurrence and an aggregate of not less than two(2)
times the occurrence amount($2,000,000.00 minimum)for bodily injury, including death
and property damage, unless a greater amount is specified in the contract specifications.
The insurance coverage shall contain no limitations on the scope of the protection
provided and include the following minimum coverage:
a. Broad Form Property Damage,with no employee exclusion;
b. Personal Injury Liability, including extended bodily injury;
c. Broad Form Contractual/Commercial Liability—including: completed operations;
d. Premises—Operations Liability(M&C);
e. Independent Contractors and subcontractors;
f. Blanket Contractual Liability.
Said commercial automobile liability policy and general commercial liability policy shall name
the County as an additional insured and shall include a provision prohibiting cancellation or
reduction of coverage of said policy except upon thirty(30)days prior written notice to the
County. Certificates of coverage as required by this Section shall be delivered to the County
within thirty(30) days of execution of this Agreement.
The County may, upon the Contractor's failure to comply with any or all provisions of this
contract relating to insurance, withhold payment or compensation that would otherwise be due to
Page: 4 of 9 Centrum
the Contractor.
If the proof of insurance or certificate indicating the County is an"additional insured"to a policy
obtained by the Contractor refers to an endorsement(by number or name)but does not provide
the full text of that endorsement,then it shall be the obligation of the Contractor to obtain the full
text of that endorsement and forward that full text to the County.
All insurance policies obtained by CENTRUM in order to comply with this Section shall be
primary and non-contributory as against any coverage provided through any memorandum of
coverage for third party liability claims or actions obtained and retained by the County through a
Ch.48.62 RCW"Risk Pool."
It is agreed by the parties that 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 both parties and be primary coverage
for any and all losses covered by the above described insurance.
The insurance maintained by CENTRUM under this Agreement shall not in any manner limit or
qualify the liabilities or obligations of CENTRUM under this Agreement.
SECTION 10: INDEPENDENT CONTRACTOR
The CENTRUM and the COUNTY agree that the CENTRUM is an independent contractor with
respect to the services provided pursuant to this agreement. Nothing in this agreement shall be
considered to create the relationship of employer and employee between the parties hereto.
Neither the CENTRUM nor any employee of the CENTRUM shall be entitled to any benefits
accorded County employees by virtue of the services provided under this agreement. 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 the CENTRUM, or any employee,representative, agent
or contractor of the CENTRUM. The CENTRUM shall be responsible for all applicable
withholdings, deductions,state industrial insurance,tax reports,.business licenses,registrations,
and all other obligations of an independent organization.
SECTION 11: COMPLIANCE WITH LAWS
The CENTRUM shall comply with all Federal, State, and local laws and ordinances applicable to
the work to be done under this Agreement. This Agreement shall be interpreted and construed in
accord with the laws of the State of Washington and venue shall be in Jefferson County,
Washington.
SECTION 12: DISCRIMINATION PROHIBITED
The CENTRUM with regard to the project to be completed under this agreement, will not
discriminate on the grounds of age,sex,marital status, sexual orientation,race,creed, color,
Page: 5 of 9 Centrum
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, contractors or subcontractors.
SECTION 13: INTEGRATED AGREEMENT
This agreement together with attachments or addenda represents the entire and integrated
agreement between the County and the CENTRUM and supersedes all prior negotiations,
representations, or agreements written or oral. This agreement may be amended only by written
instrument signed by both the County and the CENTRUM.
APPROVED and signed this Z°31:day of P'. 4i�� 2021.
JEFFERSON COUNTY
Attest: BOARD OF COMMISSIONERS
Cfi (-;6Ge6avvec
Carolyn'Gallaway,CMC Kate Dean,Chair
Clerk of the Board
Approved as to Form: CENTRUM
c
February 16,2021
Philip Hunsucker, Robert Bi an,Executive Director
Chief Civil Deputy Prosecutor
Page: 6 of 9 Centrum
EXHIBIT A
Itemized List of Proposed Tourism Promotion Services and
CED4TRUM 2021 MARKI.1 lNG BUDGET
Total JCLTAC Request Centrum °
Print ads $20,000 $6,000 $14,000
Ditat, Radio,TV ads $30,000 $6,000 $24,000
Printir%costs $15,300 $15,300
Software subscrptions $2,000 $2,000
Brochure postager4.. m $2,000 4
$2,000
Total #
$69,300 t $12,000 $57,300
Page 7 of 9 Centrum
Exhibit B
Jurisdiction Lodging Tax Reporting Form — To Be Submitted to Jefferson
County Administrator's Office
No Later than February 28th of each Year
Lodging Tax Reporting Form
01pm/rano=recevms fac*1•ng to ix°mote fepavalx,Tema]'VOW and tourma-related actinne:through tour*mo-reLated&alines
nailed cn Ipraored by non-profit otgar 171nons or the local juraictton ire regulated to completo this form for EEC H activity
I Otrn•rao**Ns= Repanne Year
2 ••• • Type pod Om) 0 501.(X3) 0 501(co6) 0 laxal Pariadunixt 0011no eittoit)
3 Amin Nam
4 Amity Ttpe(Check Oc) 0 Event Tesolval' 0 Facity° 0 Merketag•
5 Arnms Start Dote'
4 Armary End Dare*
7 Taal Cost of Am:re S
I Amond kepi:sad) S
9 Amain Amided.
10 OtormlAttemistce• 13 Nizin,ero Anti...dee Who'keyed Oven:sex m Acrommadacccou'
a) Pewee' a) Projt:tee•
bj Actual* h) Acni4.•
••••• ,iCteck Om °Demo Come !ferbodong Check Onel• 0 Nor Count'
• Cour '-•J •.•n•re Surrea• Oldirect Coma' • aate Sow!'
41111donnal Stoney' ( • • •. Enunate• 4111/14=4 saiwr 0 Strectund Emmet*
0i emlatua
11 Munhet of Anendeto Who Tineted 5,2 We or Stoat' 14 Number of Anendeet Who Stayed Ought m P Au. •• •••• •
Peo,evaid• a) Projected'
bi Acme b pActua2'
;) p•ir_beci One 0 Dual Coax' c) Stenhodolor(Check Out 0 Dna:ow'
•bluer:Com- 0 Papresecearom Suivey* 2adtrect Color • .••••••••••• • Sam-
.Irfevir.I Sumer" 0 .Eme„ire 1.4xmal Stztr 0 StnItraill EktInlInt.
0 Other fa:plaza; 0 Other Cognitin.
12 Ntumber of Attendee Stba Tuveaal cee Another Stale co Cotov• Number of Pnd hatrof Nghtt•
Piagemed• al Projected'
b) /Saul* b) Amu:*
)detborlOor it-b.-1101:e 0 Direct Cow Meg' Chech Om). 0 Coot;coo
°Maw Cann' ORepresemarnsa Smola* 0 lultsecr Come 011epreseramve Surma-
Okal Mayo 0 Strummed E=tare• 0 atformel Sumer 0 icrucnoad Enrage
• _ et Other'vigilant
'See Lodging Tax Yearly Reporting,Definitions Instructions
Nome of Indmthal Who?tiptoed Report
?hole* E•Matl Mire
RETUR_N THIS FORM TO:
Jefferson C ratty Acknoustator Office
18.20 Jetfoil:on Street
P 0 Box 1220
Port TomarAnd.WA 98..S6S
effbocc co ieffer:ratta
DEADLINE:February 28r1t of Each Reporting Year
Page 8 of 9 Centrum
LTAC Yearly Reporting
Definitions/Instructions
Activity Type: Event/Festival:Short-term activity occurring between specific dates(e.g.,4th of July celebration,local marathon)
Facility:Municipally-owned facility that operates some or all of the year(e.g.,county historical museum,convention
center)
Marketing:Activity that provides information to encourage visitors to an area; is typically a year-round activity but
may also operate for less than a full year.
Activity Date: Activity beginning and ending dates.
Actual: Persons estimated to have actually participated in event/festival or visiting a facility.For marketing activity,enter
the number of persons estimated to have actually visited area as result of marketing activity.
Projected: Persons expected to participate in event/festival or visiting a facility.For marketing activity,enter the number of
persons expected to visit area as result of marketing activity.
Methodology: Select the methodology used to estimate the actual number of visitors/participants.
Direct Count:Actual count of visitors using methods such as paid admissions or registrations,clicker counts at
entry points,vehicle counts or number of chairs filled.A direct count may also include information collected directly
from businesses,such as hotels,restaurants or tour guides, likely to be affected by an event.
Indirect Count: Estimate based on information related to the number of visitors such as raffle tickets sold,redeemed
discount certificates,brochures handed out,police requirements for crowd control or visual estimates.
Representative Survey: Information collected directly from individual visitors/participants.A representative
survey is a highly structured data collection tool,based on a defined random sample of participants,and the results
can be reliably projected to the entire population attending an event and includes margin of error and confidence
level.
Informal Survey: Information collected directly from individual visitors or participants in a non-random manner
that is not representative of all visitors or participants. Informal survey results cannot be projected to the entire
visitor population and provide a limited indicator of attendance because not all participants had an equal chance of
being included in the survey.
Structured Estimate: Estimate produced by computing known information related to the event or location. For
example,one jurisdiction estimated attendance by dividing the square footage of the event area by the international
building code allowance for persons(3 square feet).
Other:(please describe)
Overall Attendance: Total projected and estimated actual attendance recorded for event,facility or resulting from marketing activity.
Total Attendees Traveling 50 miles or more:
Total: Total projected and estimated actual number of visitors traveling more than 50 miles to attend event or facility. For
marketing organizations,report visitors traveling more than 50 miles to visit area.
Of total,attendees who traveled from another state or country:Of the total projected and estimated actual number of
visitors traveling more than 50 miles to attend event or facility or visit area,report projected and estimated actual number of
visitors who traveled from another state or country.
Attendees who stayed overnight:
Paid Accommodations: Total projected and estimated actual number of visitors staying in paid lodging establishments such
as hotels,motels,bed and breakfasts,etc.
Unpaid Accommodations: Total projected and estimated actual number of visitors staying in unpaid accommodations such
as family and friends.
Paid Lodging Nights: Total projected and estimated actual number of paid lodging nights. One Lodging night=one or more persons
occupying one room for one night.
Page 9 of 9 Centrum
Consent Agenda
Commissioners Office
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Philip Morley, County Administrator
FROM: Adiel McKnight,Executive Assistant
DATE: February 22,2021
SUBJECT: AGREEMENT re: 2021 Hotel Motel (Lodging Tax) Giant Funding; In the
Amount of$9,511 Centrum
STATEMENT OF ISSUE:
This agreement provides grant funding for 2021 to certain non-profit agencies for the promotion of
tourism and ongoing preservation of Jefferson County's heritage. This funding has been budgeted from
the Hotel Motel (Lodging Tax) Fund, as recommended by the Lodging Tax Advisory Committee.
FISCAL IMPACT:
Centrum $9,511
RECOMMENDATION:
Approve and sign the agreement.
D Y:
2J/2r/2-i
clip orley, ounty minist or Date:
CONTRACT REVIEW FORM
CONTRACT WITH: Centrum TRACKING NO.: BOCC 2021-08
(Contractor/Consultant)
CONTRACT FOR: 2021 Lodging Tax Funding TERM: 12/31/21
COUNTY DEPARTMENT: County Administrator
RECEIVED
For More Information Contact: Philip Morley
Contact Phone #: Ext.383 { Eg 0 3 2021
RETURN TO: Leslie Locke RETURN BY: ASAP
(Person in Department) , EFF ON COUNTY
�SCIONGR
AMOUNT: $9,511 PROCESS: ❑ Exempt from Bid Process
❑ Consultant Selection Process
Revenue ❑ Cooperative Purchase
Expenditure ❑ Competitive Sealed Bid
Matching funds Required 0 Small Works Roster
Source(s)of Matching Funds 0 Vendor List Bid
❑ RFP or RFQ
❑ Other
1
Step 1 : REVIEW
vewb o :F,3
Date e
APPROVED FORM ❑ Returned for revision(See Comments)
Comments
Step 2: REVIEW BY PROSECUTING ATTORNEY
Review by: ' Philip C. Hunsucker
Date Reviewed: February 16,2021 Chief Civil Deputy Prosecuting Attorney
® APPROVED AS TO FORM ❑ Returned for revision(See Comments)
Comments
Step 3: (If required) DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK
MANAGEMENT AND PROSECUTING ATTORNEY
Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF
ORIGINALS
Step 5: SUBMIT TO BOCC FOR APPROVAL
Submit original Contract(s),Agenda Request,and Contract Review form. Also,please send 2 copies of
just the Contract(s)(with the originals)to the BOCC Office. Place"Sign Here"markers on all places the
BOCC needs to sign.
MUST be in BOCC Office by 4:30 p.m.TUESDAY for the following Monday's agenda.
(This form to stay with contract throughout the contract review process.)
CN���� Board of County Commissioners
roN coG ® 1820 Jefferson Street
m Lf'i ,-'i 5.1 PO Box 1220
Port Townsend, WA 98368
Kate Dean,District 1 Heidi Eisenhour,District 2 GregBrotherton,District 3
\ ; , ..,-, ,
�S�`II NG�
March 1, 2021
Centrum
Katya Kirsch
P.O. Box 1158
Port Townsend, WA 98368
Re: 2021 Lodging Tax Funding
Dear Katya Kirsch,
Enclosed for signature are two (2)original for Centrum re: 2021 Lodging Tax Funding. Please
sign both originals, keep one original for your records and return the second original to the
address listed above.
Thank you for your assistance.
Sincerely,
Adiel McKnight
Executive Assistant
Enclosure
Two (2) original copies for signature
Phone (360) 385-9100 Fax (360) 385-9382 jeffbocc@co.jefferson.wa.us
Issue Date 5/27/2021 Cert#:0000037564
Non Profit Insurance Program
Certificate of Coverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
Clear Risk Solutions GENERAL LIABILITY
451 Diamond Drive American Alternative Insurance Corporation,et al.
Ephrata,WA 98823
AUTOMOBILE LIABILITY
American Alternative Insurance Corporation,et al.
INSURED PROPERTY
American Alternative Insurance Corporation,et al.
Centrum Foundation
MISCELLANEOUS PROFESSIONAL LIABILITY
PO Box 1158 Princeton Excess and Surplus Lines Insurance Company
Port Townsend,WA 98368
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-12 6/1/2021 6/1/2022 PER OCCURRENCE $5,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
INCLUDES STOP GAP PRODUCT-COMP/OP $5,000,000
PERSONAL&ADV.INJURY $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1-A2-RL-0000013-12 6/1/2021 6/1/2022 COMBINED SINGLE LIMIT $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-0000013-12 6/1/2021 6/1/2022 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC Excluded
FLOOD PER OCC Excluded
(PROPERTY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-12 6/1/2021 6/1/2022 PER CLAIM $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Evidence of Coverage.
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.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
Jefferson County Lodging Tax Advisory Committee
PO Box 1220
Port Townsend,WA 98368
Lodging Tax Reporting Form
Organizations receiving funding to promote festivals,special events and tourism-related activities through tourism-related facilities
owned or sponsored by non-profit organizations or the local jurisdiction are required to complete this form for EACH activity.
1 Organization Name: Centrum Reporting Year: 2021
2 Sponsor Type(Check One): 501(c)(3) °501(c)(6) O Local Jurisdiction °Other(Explain):
3 Activity Name: Centrum Tourist Promotion Program
4 Activity Type(Check One): °Event/Festival* ° Facility* °Marketing*
5 Activity Start Date*: 01/01/2021
6 Activity End Date*: 12/31/2021
7 Total Cost of Activity: $20,580.00
8 Amount Requested: $12,000.00
9 Amount Awarded: $11,999.00
10 Overall Attendance* 13 Number of Attendees Who Stayed Overnight in Unpaid Accommodations*
a) Projected* a) Projected* 0
b) Actual* 66,156 b) Actual*
c) Methodology(Check One): ()Direct Count* c) Methodology(Check One): O Direct Count*
°Indirect Count* °Representative Survey* °Indirect Count* °Representative Survey*
°Informal Survey* °Structured Estimate* °Informal Survey* °Structured Estimate*
()Other(explain): °Other(explain):
I I Number of Attendees Who Traveled 50 Miles or More* 14 Number of Attendees Who Stayed Overnight in Paid Accommodations*
a) Projected* a) Projected* 58
b) Actual* 68 b) Actual*
c) Methodology(Check One): °Direct Count* c) Methodology(Check One): °Direct Count*
°Indirect Count* °Representative Survey* °Indirect Count* °Representative Survey*
°Informal Survey* °Structured Estimate* °Informal Survey* °Structured Estimate*
°Other(explain): Faculty/artist residents only due to COVID °Other(explain):
12 Number of Attendees Who Traveled from Another State or Country* 15 Number of Paid Lodging Nights*
a) Projected* a) Projected* 476
b) Actual* 68 b) Actual*
c) Methodology(Check One): °Direct Count* c) Methodology(Check One): °Direct Count*
0 Indirect Count* °Representative Survey* °Indirect Count* °Representative Survey*
°Informal Survey* °Structured Estimate* °Informal Survey* °Structured Estimate*
Other(explain): °Other(explain):
*See Lodging Tax Yearly Reporting Definitions/Instructions
Name of Individual Who Prepared Report: Katya Kirsch
Phone#: (360)385-3102 E-Mail Address: kkirsch@centrum.org
RETURN THIS FORM TO:
Jefferson County Administrator's Office
1820 Jefferson Street
P.O.Box 1220
Port Townsend,WA 98368
j effbocc@co.j efferson.wa.us
DEADLINE: February 28th of Each Reporting Year
I.
Adiel F. McKnight
From: Katya Kirsch <kkirsch@centrum.org>
Sent: Wednesday, February 9, 2022 11:31 AM
To: Adiel F. McKnight
Subject: Re: Centrum State Reporting Form
ALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you
are not expecting them.
Hi Adiel,
Yes, the blank lines equal 0. Do you want me to resubmit the form with those zeros? Or is what I sent you
okay?
Thanks, Katya
From:Adiel F. McKnight<AFMcKnight@co.jefferson.wa.us>
Sent:Wednesday, February 9, 2022 11:28 AM
To: Katya Kirsch <kkirsch@centrum.org>
Subject: RE: Centrum State Reporting Form
Good morning Katya,
Thank you for this report.
There are blanks, do those equal 0?
Example:
10. projected—blank
Actual—66,156
Others have projected numbers and no actual.
Thank you for clarifying for me.
A Biel
74di-eJ,1cKneght
Executive Assistant
Jefferson County Administrator's Office
1820 Jefferson Street/P.O. Box 1220
Port Townsend, WA 98368
afmcknight@co.jefferson.wa.us
360-385-9102
1
L �
This is a reminder that all email to or from this email address may be subject to the Public Records Act contained in RCW
42.56. Additionally, all email to and from the county is captured and archived by Information Services.
From: Katya Kirsch <kkirsch@centrum.org>
Sent:Wednesday, February 9, 2022 10:20 AM
To:jeffbocc<jeffbocc@co.jefferson.wa.us>; Adiel F. McKnight<AFMcKnight@co.jefferson.wa.us>
Subject:Centrum State Reporting Form
ALERT:BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you
are not expecting them.
Hi Adiel and Jeff,
Attached is Centrum's State Reporting Form for 2021, related to marketing support from JCLTAC. Please
confirm receipt.
Note on the form in response to#11: due to the pandemic, Centrum had no in-person participants in Jefferson
County in 2021, but we did have a limited number of artist faculty and artist residents in-person; this accounts
for the small lodging numbers.
Thanks, Katya
Katya Kirsch
Development Officer
CENTRUM
P.O. Box 1158, Port Townsend, WA 98368
Phone: 360-385-3102 X 140
CENTRUM.ORG
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