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HomeMy WebLinkAboutJefferson County Historical Society - 032221 - (ins) .1G fits Pdrf t( ioc e` / 3'? VctZ{fh 0.2'7 cc /WO AGREEMENT FOR 2021 HOTEL-MOTEL FUNDING FOR TOURISM SERVICES JEFFERSON COUNTY HISTORICAL SOCIETY This Agreement is by and between JEFFERSON COUNTY(hereinafter known as "COUNTY" and the JEFFERSON COUNTY HISTORICAL SOCIETY(hereinafter known as "HISTORICAL SOCIETY"). WHEREAS,the HISTORICAL SOCIETY is a non-profit corporation of the State of Washington; and WHEREAS,the COUNTY desires to promote tourism by documenting,preserving and displaying County heritage for the benefit of its residents and to encourage tourist interest in Jefferson County, as authorized by Chapter 67.28 RCW and Jefferson County Code Chapter 3.25; IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the parties as follows: SECTION 1: SERVICES TO BE PERFORMED The HISTORICAL SOCIETY shall use the Hotel-Motel Tax funding under this agreement to fund staff salaries to continue and update the ongoing performance of the following specific services: 1. Operation of the following tourism facilities in Jefferson County: • Jefferson Museum of Art&History • Rothschild House Museum • Commanding Officer's Quarters Museum • Historical Research Center 2. Operation of the County Museum and care of the collection for its long-term maintenance. 3. Outreach to County residents through educational programs and Museum exhibits regarding cultural and natural heritage. 4. Promotion of heritage awareness through countywide recognition programs and the establishment of new and traveling exhibits and publications. 5. Continued documentation of County heritage through collecting, oral history,research and other means. 6. Advocacy of heritage preservation through all available means including the enhancement of heritage based tourism for the economic development of the County. Page: 1 of 8 Jefferson County Historical Society 7. Assistance as requested to the Quilcene Historical Museum in development of its Museum, in implementation of basic museum practices and procedures and in promotion of the Museum as a local,public cultural and education organization. 8. Tourism promotion services provided by JCHS Staff and volunteers at each facility as follows: • Verbal information, displays and brochures; • Telephone communications during normal office hours (9:00 a.m.—5:00 p.m.)year round; • Website access to tourism information SECTION 2: RESPONSIBILITIES OF THE JEFFERSON COUNTY HISTORICAL SOCIETY 1. On or before January 31;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 HISTORICAL SOCIETY under this Agreement for the prior quarter; • 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. 2. On or before January 31 (OR upon execution of this agreement, whichever is later); April 30; July 31; and October 31, 2021,provide to the COUNTY: • A billing statement requesting payment of Hotel-Motel Funding for the current quarter. 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 A, attached hereto and incorporated by reference for the previous year. a. Each festival,event, or tourism facility owned and/or operated by HISTORICAL SOCIETY. b. The amount of lodging tax revenue allocated for expenditure (whether actually expended or not)by the HISTORICAL SOCIETY 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). Page: 2 of 8 Jefferson County Historical Society 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 HISTORICAL SOCIETY 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$48,440 for 2021. Quarterly payments of$12,110 will be made, beginning with the first quarter of 2021. Payments are 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. 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 HISTORICAL SOCIETY 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, HISTORICAL SOCIETY 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 HISTORICAL SOCIETY shall indemnify and hold the COUNTY, and its officers, employees, and agents harmless from and shall process and defend at its own expense, including Page: 3 of 8 Jefferson County Historical Society 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 HISTORICAL SOCIETY's negligence or breach of any of its obligations under this Agreement; provided that nothing herein shall require the HISTORICAL SOCIETY 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 HISTORICAL SOCIETY'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 HISTORICAL SOCIETY's negligence, or the negligence of the HISTORICAL SOCIETY's agents or employees. The HISTORICAL SOCIETY specifically assumes potential liability for actions brought against the COUNTY by the HISTORICAL SOCIETY's employees, or any other persons engaged in the performance of any work or service required of the HISTORICAL SOCIETY under this Agreement and, solely for the purpose of this indemnification and defense,the Contractor specifically waives any immunity under the state industrial insurance law, Title 51 RCW. The HISTORICAL SOCIETY recognizes that this waiver was specifically entered into pursuant to provisions of RCW 4.24.115 and was subject of mutual negotiation. SECTION 9: INSURANCE The HISTORICAL SOCIETY 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. The HISTORICAL SOCIETY shall maintain Workers' Compensation coverage as required under the Washington State Industrial Insurance Act, RCW Title 51, for all the HISTORICAL SOCIETY 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 the HISTORICAL SOCIETY'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($1,000,000.00 minimum) for bodily injury, including death and property damage, unless a greater amount is specified in the contract specifications. Page: 4 of 8 Jefferson County Historical Society 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 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 the HISTORICAL SOCIETY 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 the HISTORICAL SOCIETY under this Agreement shall not in any manner limit or qualify the liabilities or obligations of the HISTORICAL SOCIETY under this Agreement. SECTION 10: INDEPENDENT CONTRACTOR The HISTORICAL SOCIETY and the COUNTY agree that the HISTORICAL SOCIETY 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 HISTORICAL SOCIETY nor any employee of the Page: 5 of 8 Jefferson County Historical Society HISTORICAL SOCIETY 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 HISTORICAL SOCIETY, or any employee, representative, agent or contractor of the HISTORICAL SOCIETY. The HISTORICAL SOCIETY 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 HISTORICAL SOCIETY 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 HISTORICAL SOCIETY 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, 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 HISTORICAL SOCIETY 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 HISTORICAL SOCIETY. APPROVED and signed this ?� day of Ma YL ,2021. JEFFERSON COUNTY Attest: ������ BOARD OF COMMISSIONERS 6 c C'd Carolyn/Gallaway, CM Clerk of the Board Kate Dean, Chair Approved as Form: JEFFERSON COUNTY HISTORICAL 0( C./ � SOLI Y Philip Hunsucker, Chief Civil Deputy Prosecutor y Leave , Director Vg121 Page: 6 of 8 Jefferson County Historical Society Exhibit A Jurisdiction Lodging Tax Reporting Form - To Be Submitted to Jefferson County Administrator's Office Lodging Tax Reporting Form Organizations receiving filndinE to promote ftrvals,venial events and tourism-related activities through tourism-related facilities owned or sponsored by non-profit orgintaations or the local jurisdiction are required to complete this form for EACH acniity 1 Organiaation Name: Re wrung Yeas: Sponsor Type(Check Oce): 0 501(c;(3) 0 50106) 0 Local Turisdicrien °Other.sEviiic): 3 Activity Name 4 Ao.mity Tape(Cbeck Ow): 0 Eveuferaival* 0 Fry' 0 Mzuketing• 5 Amway Start Date*: 5 Activrry Ead Date*: Teal Cost of Activity S S AIDOUE/Reverted: S 9 Amain Avoided: $ 10 Osura]Auendmice• 13 Number of Artendeei Who Staved Overnight m Unpaid Arroctuacdacions" a) Pro:ecied* a) Projected' b) Acrar b) Arras c) Mettaocktiort(Check Om) ODiren Came cj Mehodthogy(1-31.th Coe): 0 Direct Come Oictitrea Coact" °Representative Suaw Olodirect Couur ORepresenache Suney4 8 Tr fruTrA Survey* 0 Suuctured Enamare+ raft Sumer 0 Strucrured Estimate* Other(mplain): Uct (e•splairac 1 1 Number of Attendees Who Traveled 50 Miles or More 14 Number of Attendees lace Stayed.OVESCiAl 131 Raid Acton:madam:mai" a) Pro:etre& a) Projerred• b) ACTIK. b) Acta& c) Mettodo:ogy(Check Ore) 0 Direct Core c) Zidettodnou(Check Om): 0 Mien CountQ + ludirwt Com' 0 Reprewmarrve Stuvey. 0:a:direct Ct'incr Represenathe Survey 0 In finny Survey* 0 S.:trump-3i Emmace° 0 iformal Survey' Strumnad Escictune* 0 Other tenpin*: 0 Other(eupdain): 1.2 Mother of Anendeei Who Traveled from Another Stare or Country If Number ad Paid r Mein!!Nighn' a) Proycied• at Projected` b) Atria:* Actor c) MethodOogy(Chedt One): 0 irert. Cnrrr c Melb2CII:Ogy Check Ogre): Cirect Come °Indirect Come' ORepresenrative Sway' :ndirecr Com:* ORepresentathe Surma. 0 ThintwAl Slimy° 0 Sinicturel Enialate" cmnil Sarver 0 Scrucruzed EiCiCIUDe °Other(thiplain): Othe(esplaint: 'See Lodging Tax Yearly Reporting Definition>Twitructions ame of lodradual Who Prepared Report: Phone tr: Aditesi: RETURN THIS FORM TO: Jefferson C orally Administrator's Office 1820 JefferLon Street P.O.Box 1220 Port Townsend.WA 98368 juffbocc4cojefferson.vra.us BEADED": February 28th of Each Reporting Year Page 7 of 8 Jefferson County Historical Society 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 8 of 8 Jefferson County Historical Society 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: March 22,2021 SUBJECT: AGREEMENT re: 2021 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of$48,440 JC Historical Society 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: JC Historical Society $48,440 RECOMMENDATION: Approve and sign the agreement. REVIEWS BY: <3/7/3- Philip Mor ey, mty Administrator Date: CONTRACT REVIEW FORM CONTRACT WITH: JC Historical Society TRACKING NO.: BOCC 2021-03 (Contractor/Consultant) CONTRACT FOR: 2021 Lodging Tax Funding TERM: 12/31/21 COUNTY DEPARTMENT: County Administrator RECEIVED For More Information Contact: Philip Morley JAN 2 6 2021 Contact Phone #: Ext.383 �EFFERS COUNTY RETURN TO: Leslie Locke RETURN BY: AS PCOMMISSI®N RS (Person in Department) (Date) AMOUNT: $48,440 PROCESS: ❑ Exempt from Bid Process E Consultant Selection Process Revenue ❑ Cooperative Purchase Expenditure ❑ Competitive Sealed Bid Matching funds Required ❑ Small Works Roster Source(s) of Matching Funds ❑ Vendor List Bid ❑ RFP or RFQ ❑ Other Step 1 : REVIEW BY-RISB:MANAG E Review by, ' / �.� ✓I/>/ Date Reviewed: APPROVED FORM ❑ Returned for revision(See Comments) Comments Step 2: REVIEW BY ROS U ING ATTORNEY Review by: . ('. Philip C. Hunsucker Date Reviewed: / Z Chief Civil Deputy Prosecuting Attorney APPROVED AS TO FORM eturned 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.) com1 ,0 Board of County Commissioners rs N c 1820 Jefferson Street O ti7t PO Box 1220 csip Port Townsend, WA 98368 Kate Dean,District 1 Heidi Eisenhour,District 2 Brotherton,District 3 kviING'S. Greg March 18, 2021 Jefferson County Historical Society Shelly Leavens 540 Water Street Port Townsend, WA 98368 Dear Ms. Leavens, 1.Enclosed for signature are two (2)originals for AGREEMENT re: 2021 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of$48,440; Jefferson County Historical Society. Please sign both, keep one and return the second to: Jefferson County Commissioner's Office Attn: Adiel McKnight P.O. Box 1220 Port Townsend, WA 98368 • Please remember that on or before April 30; July 31; October 31, 2021 and January 31, 2022 you are required to provide to the County: A quarterly report of the use, services, programs and activities under this agreement for the prior quarter. • 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 by February 28th of each year. • The JC Historical Society shall obtain insurance as outlined in the terms of the Agreement and provide a copy to this office. • Payment will be provided upon invoice, subject to the terms of the Agreement. Thank you for your assistance. Since y, Adie McKnight Executive Assistant Enclosure: Two (2) original copies for signature Issue Date 2/17/2021 Cert #:0000028453 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). PRODUCERCOMPANIES 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. PROPERTY INSURED American Alternative Insurance Corporation, et al. Jefferson County Historical Society MISCELLANEOUS PROFESSIONAL LIABILITY Princeton Excess and Surplus Lines Insurance Company 540 Water Street 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 INSURANCEPOLICY NUMBERPOLICY EFF POLICY EXP DESCRIPTIONLIMITS DATEDATE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITYN1-A2-RL-0000013-106/1/20206/1/2021PER OCCURRENCE$5,000,000 OCCURRENCE FORMPER MEMBER AGGREGATE$10,000,000 INCLUDES STOP GAPPRODUCT-COMP/OP$5,000,000 PERSONAL & ADV. INJURY$5,000,000 (LIABILITY IS SUBJECT TO A $100,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATE$50,000,000 AUTOMOBILE LIABILITY ANY AUTON1-A2-RL-0000013-106/1/20206/1/2021COMBINED SINGLE LIMIT$5,000,000 (LIABILITY IS SUBJECT TO A $100,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATENONE PROPERTY N1-A2-RL-0000013-106/1/20206/1/2021ALL RISK PER OCC EXCL EQ & FL$75,000,000 EARTHQUAKE PER OCCExcluded FLOOD PER OCCExcluded (PROPERTY IS SUBJECT TO A $100,000 SIR PAYABLE FROM PROGRAM FUNDS)ANNUAL POOL AGGREGATENONE MISCELLANEOUS PROFESSIONAL LIABILITY N1-A3-RL-0000060-106/1/20206/1/2021 PER CLAIM5,000,000.00 (LIABILITY IS SUBJECT TO A $100,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS Regarding scheduled events hosted by Jefferson County Historical Society throughout the year. City of Port Townsend is named as Additional Insured regarding this event only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached. 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 HOLDERAUTHORIZED REPRESENTATIVE City of Port Townsend 250 Madison Street, Suite 2 Port Townsend, WA 98368 3531900 AMERICAN ALTERNATIVE INSURANCE COMPANY ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION – (GENERAL LIABILITY) Named Insured Non Profit Insurance Program (NPIP) Policy NumberEndorsement Effective N1-A2-RL-0000013-106/1/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: GENERAL LIABILIT Y COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above. Schedule Person or Organization (Additional Insured):As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator City of Port Townsend 250 Madison Street, Suite 2 Port Townsend, WA 98368 Regarding scheduled events hosted by Jefferson County Historical Society throughout the year. City of Port Townsend is named as Additional Insured regarding this event only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached. A. With respects to the General Liability Coverage Part only, the definition of I nsured in the Liability Conditions, Definitions and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above Schedule. Such Person or Organization is an Insured only with respect to liability for Bodily Injury, Property Damage, or Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those acting on your behalf: 1.In performance of your ongoing operations; or 2.In connection with your premises owned or rented to you. B.The Limits of Insurance applicable to the additional Insured are those specified in either the: 1.Written contract or written agreement; or 2.Declarations for this policy, whichever is less. The se Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations. All other terms and conditions remain unchanged. Includes copyrighted material of the Insurance Services Office, Inc., with its permission 3531900 RECEIVED MAR 0 3 ?U22 JECO } MMIISSI ONERS 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: Jefferson County Historical Society Reporting Year: 2021 2 Sponsor Type(Check One): °501(c)(3) °501(c)(6) °Local Jurisdiction 0 Other(Explain): 3 Activity Name: Research Center Preservation and Access for Heritage Tourism Support 4 Activity Type(Check One): °Event/Festival* 0 Facility* °Marketing* 5 Activity Start Date*: 01/01/2021 6 Activity End Dates: 12/31/2021 7 Total Cost of Activity: $70,000 8 Amount Requested: $48,440 9 Amount Awarded: $48,440 10 Overall Attendance* 13 Number of Attendees Who Stayed Ovemight in Unpaid Accommodations* a) Projected* 1000 a) Projected* 0 b) Actual* 1632 b) Actual* 1 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):In-person attendance was 82-we mostly st °Other(explain): 11 Number of Attendees Who Traveled 50 Miles or More* 14 Number of Attendees Who Stayed Ovemight in Paid Accommodations* a) Projected* 0 a) Projected* 0 b) Actual* 5 b) Actual* 1 c) Methodology(Check One): 0 Direct Count* c) Methodology(Check One): 0 Direct Count* °Indirect Count* °Representative Survey* °Indirect Count* °Representative Survey* °Informal Survey* ()Structured Estimate* °Informal Survey* °Structured Estimate* °Other(explain):We were only open half of the year:pander °Other(explain): 12 Number of Attendees Who Traveled from Another State or Country* 15 Number of Paid Lodging Nights* a) Projected* 0 a) Projected* 0 b) Actual* 1 b) Actual* 5 c) Methodology(Check One): 0 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):Very little travel occurred due to COVID-1 °Other(explain):One out-of-state patron stayed 5 nights for *See Lodging Tax Yearly Reporting Definitions/Instructions Name of Individual Who Prepared Report: Shelly Leavens Phone#: 206-450-6214 E-Mail Address: shelly@jchsmuseum.com RETURN THIS FORM TO: Jefferson County Administrator's Office 1820 Jefferson Street P.O.Box 1220 Port Townsend,WA 98368 jeffbocc@co.jefferson.wa.us DEADLINE: February 28th of Each Reporting Year \A--- ' O 1-+ i-+ F, 1+ I-, F"' IO 00 V 01 U F+ pp N j n A w NJ I-, o .... 01 I r \\,S �, • ,,'C. 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