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Trinity United Methodist Church - CA signed (ins. 090122) 080221
-41-4‘14 20-7 (pr►6.16 i kik1 Cr C-� GRANTEE A REEMENT WITH TRINITY UNITED METHODIST CHURCH FOR THEIR CORNERSTONE PROJECT This Grantee Agreement("Agreement") is by and between Jefferson County, a Washington political -� subdivision("County") and Trinity United Methodist Church, ("Grantee"). WHEREAS, on February 29, 2020, Governor Jay Inslee declared a State of Emergency • in all Counties in Washington State to due to the public health emergency caused by the COVID- 19 virus; and WHEREAS, on March 10, 2020, the Jefferson County Health Officer issued a Public Health Order to control and prevent the spread of the COVID-19 virus; and WHEREAS, on March 11, 2020, the World Health Organization declared the outbreak of COVID-19 to be a pandemic; and WHEREAS, on March 13, 2020, the President of the United States declared the COVID- 19 outbreak a national emergency; and WHEREAS, on March 16, 2020, the Jefferson County Board of Commissioners approved a Declaration of Emergency in Jefferson County due to the COVID-19 pandemic in Resolution 12-20, stating in part that"human life may be threatened and the local economy disrupted as a result of this unprecedented pandemic, and immediate extraordinary action must be taken to respond to this crisis and mitigate its impacts," and further stating"Jefferson County is authorized to exercise such other actions authorized by state law during a state of emergency as may be necessary to combat this emergency;" and WHEREAS, on March 19, 2020, the Port Townsend City Council approved a Declaration of Emergency due to the COVID-19 pandemic. WHEREAS, on March 23, 2020, Governor Jay Inslee signed Proclamation 20-25 declaring that a State of Emergency continues to exist in all Counties in Washington State due to COVID-19; and that his prior proclamations are amended and superseded by a Proclamation to impose a Stay Home- Stay Healthy Order throughout Washington State, which prohibits all people in Washington State from leaving their homes or participating in social, spiritual and recreational gatherings of any kind regardless of the number of participants, and all non-essential businesses in Washington State from conducting business, within the limitations provided in Proclamation 20-25; and WHEREAS, Proclamation 20-25 has been amended several times, most recently in Proclamation 20-25.7, issued on July 24, 2020, which makes clear that Proclamation 20-25 remain in effect until rescinded, and requires people to wear face masks both while at work and while not at work; 1 WHEREAS, as a result of the continued worldwide spread of COVID-19, its significant progression in Washington State, and the high risk it poses to our most vulnerable populations, Governor Jay Inslee subsequently issued amendatory Proclamations 20-06 through 20-53, 20-55 through 20-67, 20-69 through 20-71 and 20-74, and exercising his emergency powers under RCW 43.06.220 by prohibiting certain activities and waiving and suspending specified laws and regulations; and WHEREAS, Health professionals and epidemiological modeling experts advise that Washington is still in a state of COVID-19 outbreak; and WHEREAS, the COVID-19 pandemic is both a health emergency and a financial emergency, resulting in the worst global economic crisis since the Great Depression; and WHEREAS, as a result of the COVID-19 financial emergency, the largest economic stimulus legislation in American history, a$2 trillion package in Section 601(a) of the Social Security Act, as amended by Section 5001 of the Coronavirus Aid, Relief, and Economic Security Act, called the CARES Act, was signed into law on 27 March 2020; and WHEREAS, in May 2020, Governor Jay Inslee announced that the State of Washington would award $300 million of State's CARES Act Coronavirus Relief Fund (CRF) funding to reimburse local governments for eligible COVID-19 costs and economic support in connection with the COVID-19 public health emergency; and WHEREAS, on August 31, 2020, Governor Inslee announced that Washington State was awarding an additional $125 million of CARES Act CRF funding to local governments for the same purposes; and WHEREAS, the City of Port Townsend has been awarded up to $144,150 from the State's additional CRF award, which the City intends to receive by submitting an invoice to the State for the City's prior eligible expenditures, thereby freeing up City general fund moneys which the City wishes to deploy to address the COVID-19 public health emergency; and WHEREAS, Jefferson County has been awarded up to $638,000 from the State's additional CRF award, which the County intends to receive by submitting an invoice to the State for the County's prior eligible expenditures; and after combining those funds with available funds from the County's first CARES Act CRF award, and after reimbursing the County for its own direct eligible COVID-19 costs,makes available an estimated $633,515 of County general fund moneys which the County plans to deploy to address the COVID-19 public health emergency; and WHEREAS, the proposed uses will aid the economic recovery and public good of Jefferson County following the economic downturn caused by the COVID-19 pandemic. 2 WHEREAS, the Grantee desires to provide a variety of needed childcare and other services to a community with a paucity of such services and seeks funding assistance to cover costs associated with providing these services; and, WHEREAS, providing childcare and other services to the community will make the community more resilient and help support employment; and, WHEREAS, Jefferson County desires to provide funding for the needed services, as necessary to combat the COVID-19 pandemic and recession, protecting the health and safety of persons and property, providing emergency assistance to the victims of such disaster, making the community more resilient and supporting employment; and WHEREAS, RCW 38.52.070(2) grants to counties in which a disaster occurs, the power to enter into contracts and incur obligations necessary to combat such disaster, protecting the health and safety of persons and property, and providing emergency assistance to the victims of such disaster; and WHEREAS, the economic support provided to Grantee pursuant to this Agreement is necessary and appropriate given the Grantee's critical role and ability to provide services to community members in response to the COVID-19 public health emergency, and such assistance represents an eligible use of county funds consistent with RCW 38.52.070(2). WHEREAS, Jefferson County has an acute and chronic shortage of childcare and other services; and WHEREAS, the Jefferson County Board of Commissioners desires that sufficient resources be committed to provide such childcare and other services; and, NOW, THEREFORE, in consideration of the foregoing recitals, which are incorporated herein by reference, and the terms and conditions set forth below, the parties agree as follows: 1. Effective Date and Term. This Agreement shall commence on when last executed by the parties and remain in effect until September 30, 2021, unless terminated earlier by the County in writing. Eligible expenses incurred prior to contract execution but not prior to August 1, 2021 are hereby ratified. 2. Grant Amount and Grantee's Use of Grant Funds. The Grantee shall ensure that the any funds expended are eligible in accordance with the terms of the grant, to include the grant Scope of Work. The Grant amount is $20,000. 3. Termination. The County may terminate this Agreement, for convenience or otherwise and for no consideration or damages, upon prior notice to the Grantee. 4. Independent Grantee. Each party under this Agreement shall be for all purposes an independent Grantee. Nothing contained herein will be deemed to create an association, a partnership, a joint venture, or a relationship of principal and agent, or employer and employee 3 between the parties. The Grantee shall not be, or be deemed to be, or act or purport to act, as an employee, agent, or representative of the County for any purpose. 5. Indemnification. The Grantee agrees to defend, indemnify and hold the County, its officers,officials,employees,agents and volunteers harmless from and against any and all claims, injuries, damages, losses or expenses including without limitation personal injury, bodily injury, sickness, disease, or death, or damage to or destruction of property, which are alleged or proven to be caused in whole or in part by an act or omission of the Grantee, its officers, directors, employees, and/or agents relating to the Grantees' performance or failure to perform under this Agreement. The section shall survive the expiration or termination of this Agreement. 6. Insurance. Prior to commencing work, the Grantee shall obtain at its own cost and expense the following insurance coverage specified below and shall keep such coverage in force during the terms of the Agreement. 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 $500,000 each occurrence with the County named as an additional insured in connection with the Consultant's performance of his Agreement. This insurance shall indicate on the certificate of insurance the following coverage: (a) Owned automobiles; (b) Hired automobiles; and, (3) Non-owned automobiles. Commercial General Liability. Insurance in an amount not less than a single limit of $1,000,000 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 commercial general liability 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 coverage for products and completed operations; d. Premises —Operations Liability (M&C); e. Blanket Contractual Liability. The County shall be named as an"additional named insured"under all insurance policies required by this Agreement, except Professional Liability Insurance when not allowed by the insurer, and shall include a provision prohibiting cancellation of said policy except upon thirty (30) days prior written notice to the County. Such insurance coverage shall be evidenced by one of the following methods: (a) Certificate of Insurance; or, (b) Self-insurance through an irrevocable Letter of Credit from a qualified financial institution. 4 The Grantee shall furnish the County with properly executed certificates of insurance that, at a minimum, shall include: (a) The limits of overage; (b) The project name to which it applies; (c) The certificate holder as Jefferson. County, Washington and its elected officials, officers, and employees with the address of Jefferson County Risk Management, P.O. Box 1220, Port Townsend, WA 98368, and, (d) A statement that the insurance policy shall not be canceled or allowed to expire except on thirty (30) days prior written notice to the County. If the proof of insurance or certificate indicating the County is an "additional insured" to a policy obtained by the Consultant 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 Consultant to obtain the full text of that endorsement and forward that full text to the County. Certificates of coverage as required by this section shall be delivered to the County within fifteen (15) days of execution of this Agreement. Failure of the Grantee to take out or maintain any required insurance shall not relieve the Grantee 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. The Grantee'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, with the exception of Professional Liability Insurance, so affected shall protect all the parties and shall be primary coverage for all losses covered by the above described insurance. Insurance companies issuing the Grantee'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 the Grantee's insurance policies shall be assumed by and be at the sole risk of the Grantee. Any deductibles or self-insured retention 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 the Consultant shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. 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 the Grantee until the Grantee 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 the Grantee shall provide to comply with this Agreement. The County may, upon the Grantee's failure to comply with all provisions of this Agreement relating to insurance, withhold payment or compensation that would otherwise be due to the Grantee. The Grantee shall provide a copy of all insurance policies specified in this Agreement. 5 Written notice of cancellation or change in the Grantee'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. The Grantee's liability insurance provisions shall be primary and noncontributory with respect to any 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. The Grantee'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. The Grantee shall include all. Sub-Grantees as insured under its insurance policies or shall furnish separate certificates and endorsements for each Sub-Grantee. All insurance coverage for Sub- Grantees 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. The Grantee 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 shall be promptly replaced. All the insurance policies required by this Agreement shall provide that thirty (30) days prior to cancellation, suspension, reduction or material change in the policy, notice of same shall be given to the County Risk Manager by registered mail, return receipt requested. The Grantee shall place insurance with insurers licensed to do 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 placed with insurers or re-insurers licensed in the State of Washington. The County reserves the right to request additional insurance on an individual basis for extra hazardous contracts and specific service agreements. 7. Worker's Compensation (Industrial Insurance). If and only if the Consultant employs any person(s) in the status of employee or employees separate from or in addition to any equity owners, sole proprietor, partners, owners or shareholders of the Consultant, the Grantee 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. Worker's compensation insurance covering all employees with limits meeting all applicable state and federal laws. This coverage shall include Employer's Liability with limits meeting all applicable state and federal laws. 6 ` This oovc,ugc shall extend to any 8ub-(Icuotec that does not have their own "/o,kcr`o compensation and employer's liability insurance. The (]runtcu 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 o[any jurisdiction which would otherwise be applicable in the oosc o[such c|ciru. If the County incurs any costs to enforce the provisions of this subsection, all cost and fees shall hc recoverable from the Grantee. N. Compliance with Lov/a. Guidelines. The (]cmn1cc mbuU comply with all hrdcrul` state, and local |uv/a and all requirements (including certifications and audits), to the cstcut applicable, when seeking P|cinuhursenownL 9. Maintenance and Audit of Records. The Grantee shall maintain records, books, documents, and other materials relevant to its performance under this /\grccmncn\. These records shall be subject to inspection, review and audit by the County or its designee, the Washington State Auditor's (}0lco. If it is determined during the course of the audit that the Grantee was reimbursed for unoi|ovvab|c costs under this Agccconcut or any, the Grantee agrees to promptly reimburse the County for such payments upon request. 10. Notices. Any notice desired or required to be given hereunder abn|| be in writing, and shall be deemed received five (5)days after deposit with the U.S. Postal Service, postage fully prepaid, oonificd mail, return receipt requested, and addressed hm the party to which it is intended at its \usi known address, or to such other person or address as either party ahu|| designate to the other from time Um time in writing forwarded iolike nauoocc hmntcr JcfficyD. &zidu, Cornerstone Committee 49|4 Cape George QLd Port Townsend, V98 98368 (206) 200-7297 jkdda(�4enoui|.co/?l Jefferson County Mark McCauley Central Services Director Jefferson County Courthouse 1820 ]cffersoo Street Port Townsend, WA 98360 11. Improper Influence. Each party vvununtx that it did not and will not employ, retain, or contract with any person or entity on u contingent compensation basis for the purpose of seeking, obtuining, maintaining, or extending this /\g,ccnucu\. Each party agrees, vvunrunto, and represents that no gratuity whatsoever has been or will offered or conferred with uview towards obtaining, 12. Conflict ofInterest. The elected and appointed officials and employees of the parties nbuU not have any personal interest, direct orindirect, vvhiob givesrise to a conflict o[interest. \I ]lnze. Time is of the cxncucc in this Auzrccoocnt. 14. Survival. The provisions nfthis Agreement that by their sense and purpose should survive expiration or termination ofthis Agreement shall so survive. Those provisions include n/dbou1 limitation Indemnification and Maintenance and Audit of Records. 15. Amcodrncni. No amendment or modification to this Auznccnocn< will be effective without the priorwritten consent of the authorized representatives o[the parties. |h. Governing Law. Venue. This Agreement will be governed in all respects by the |uvvo of Washington state, both ox to interpretation and performance, without regard io conflicts oflaw or choice of law provisions. Any action arising out of or in connection with this Agreement may be instituted and maintained only in o court of competent jurisdiction in Jefferson County, Washington orus provided hY RCn/ 3b.U1.O5V. 17. Non-Waiver. No failure on the part of the County to exercise, and no delay in exercising, any right hereunder shall operate as o wavier thereof-, nor shall any single or partial exercise by the County of any right hereunder preclude any other or further exercise thereof or the exercise of any other right. The remedies herein provided arc Cumulative and not exclusive n[any remedy available to the County at law or in equity. ]8. Binding Eff'ect. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors. 19. f\xoigncncnL Neither party shall assign or transfer any of its interests inorobligations under this Agreement without the prior written consent o[the other party. 20. Eo\irc Agreement. This /\gmorcucni constitutes the entire agreement bctvvccn the County and the (}nyo\eo for the use of funds received under this /\grocnocni and it supersedes all prior orcontemporaneous uonornunicoions and proposals, whether electronic, oral, or v/dttcu between the parties with respect to this Agreement. 21. No Third Party Beneficiaries. Nothing herein nhuU or be deemed to create nrconfer any right, uohoo, or benefit in, to, or on the part of any person or entity that is not uparty to this Agreement. This provision shaUnot|irnirany ob|igadnn which either party has to the WashingtonSbuk: [3cpurtmcn{ of Commerce of these gran/ funds, including the obligation tnprovide access to records and cooperate with audits ox provided io this Agreement. 22. 8cncoobi|ity.Tnthe event that one ocroore provisions n[this Agreement shall bcdetcnnincd to be invalid by any court of competent J urisdiction or agency having J urisdiction thereof,the remainder of this Agreementahu| remain in full force and effect and the invalid provisions abuU be deemed deleted. 23. Counterparts. This Agreement may bc executed incounterparts, any ofwhich shall be dccnnod an original but all of which together sha|| constitute one and the yuoocina\runncnL 24. Authorization. Each party vvonunto to the other party, that the person executing this 8 Agreement on its behalf has the full power and authority to do so. 25. Public Records Act. Notwithstanding any provisions of this Agreement to the contrary, to the extent any record, including any electronic, audio, paper or other media, is required to be kept or indexed as a public record in accordance with the Washington Public Records Act, Chapter 42.56 RCW (as may be amended), the Grantee agrees to maintain all records constituting public records and to produce or assist the County in producing such records, within the time frames and parameters set forth in state law. The Grantee also agrees that upon receipt of any written public record request, Grantee shall, within two business days, notify the County by providing a copy of the request per the notice provisions of this Agreement. (SIGNATURES APPEAR ON THE NEXT PAGE) 9 IN WITNESS WHEREOF, this Agreement is executed and shall become effective as of the last date signed below. BY THE AUTHORITY GRANTED TO THE INTERIM TRINITY UNI D MF,TIOP T CHURCH COUNTY ADMINISTRATOR BY THE BOARD OF � COUNTY COMMISSIONERS OF JEFFERSON COUNTY, By: _ WASHINGTON ON JULY 26,2021: Name: DATE g/il By: i� /J/jam/ Mark cCa DATE Interim Cou Administrator SEALs, ` s3"`� r+ it . 4 1: it ! ATTEST: ,`,F. : ed47,,t g/ v g/2/.2 Carolyn GLlloway DAG Clerk of the Board Approved as to form only: August 1, 2021 Philip C.Hunsucker DATE Chief Civil Deputy Prosecuting Attorney ATTACHMENT A SCOPE OF WORK The Board of County Commissioners is directing up to $20,000 to provide funding to Grantee to help fund the construction of their Cornerstone project. Project details follow: "Cornerstone" Project Trinity United Methodist Church, Port Townsend, WA The "Cornerstone"project at Trinity is a$340K reconstruction of public use spaces in the 150-year-old historic building located at 609 Taylor Street in Port Townsend, to bring the various public use and meeting spaces (for all from local seniors to toddlers) up to safe ADA standards. The project converts all lavatories to ADA, adds bathrooms for public use,replaces an old dangerous stairway, and adds an elevator for incapacitated building users, plus wheelchair ramps and other public safety features). Many local charitable organizations and public needs programs use this old building regularly, at low or no cost, or they generate revenues that are primarily used to fund other countywide charities and public service programs (sample list below). The construction, which will be completed by mid-August, has been funded approximately 82% to date by donations from members of the congregation and other community residents, along with generous grants from both: First Federal Foundation (with recommendation letters from: Mayor Sandoval, School Superintendent David Engle, and Firefly Preschool Director Laura Faber), and from the Jefferson County Foundation. Community user organizations that use, or after construction will be using these spaces either gratis or at far below market rate, include: • NAMI National Alliance on Mental Illness: Support groups for mentally ill and their friends and family. • J C Mash: drop-in medical clinic (low-income medical needs, doctor exams, acupuncture, records storage, waiting rooms. • Refuge Recovery: support group for addiction • ALS Support Group • Firefly Academy; a multi-age Montessori preschool program serving more than 30 county families • Candlelight Concert series, which for 17 years has been financially supporting local charity needs including: Dove House, Recovery Cafe, Bayside Housing, Habitat, Jefferson County Food Bank, Jumping Mouse, OlyCap, Toys for Tots, St. Vincent De Paul, Olympic Angels, Gathering Place, and more. • "Lil' Ducklings, a regional drop off infant care (see below description of this planned program) "Lil' Ducklings planned program outline: There is a need in the County for drop-off infant care. Trinity will now have the safe and inspected spaces to offer this program, and at no or low cost, as needed. It was launched in 2020 and discontinued for need of certified staff, then discontinued by Covid-19. Trinity will staff and re-launch the program by complying with regulations allowing for one parent of an attending child to qualify as certification for all. Trinity will manage the volunteer and paid staff to qualify under regulatory rules and make this needed program happen in our community. Trinity seeks to raise the remaining $50K needed to meet increased Covid-19 related construction materials costs. Volunteers already have supplemented contractor's labor and additional fundraising will ensue. A grant of$20K from Jefferson County, added to this project, will go a long way toward meeting the myriad needs of people and groups in our county. Below is a project financing summary supporting the grant request: Trinity UMC Cornerstone Campaign ADA Building Project Amount Description Comment Improvements for ADA Access Including April 1,2020 $370,000 ADA Project Total Estimate Elevator and New Ramp Entrance June 1,2020 $93,568 Previous Cornerstone Campaign Funds Balance Balance from 1st Cornerstone Campaign June 30,2020 $50,000 First Federal Grant October 31,2020 $143,980 CBB Campaign Pledged thru 12/31/2023 New Pledges Committed April 30,2021 $5,000 Jefferson Community Foundation Grant June 30,2021 $49,194 Non-Pledge Donations thru 07/01/2021 Cash and Non-Pledge Donations $341,742 Total Pledges&Cash thru 12/31/2023 $28,258 ADA Project Shortfall These funds are available immediately upon the execution of this agreement and the submission of an invoice to the County. Eligible Costs and Expenditures The Grantee MAY NOT use the funding for any activity or cost not directly related to their Cornerstone project. Program Funding and Award Amount The Board of County Commissioners is directing up to $20,000 to provide funding to Grantee to help fund the construction of their Cornerstone project. 3_ 1'� THE PACIFIC NORTHWEST CONFERENCE of The United Methodist Church Brant Henshaw Assistant Treasurer Conference Treasurer Assistant Benefits Officer Director Administrative Services ramieson@pnwumc.org bhenshaw@pnwumc.org Rik Jamieson January 2021 To: Church Trustees From: Brant Henshaw bhenshaw(i pnwumc.org and Rik Jamieson riamieson(alpnwumc.org 2021 INSURANCE RENEWAL Please review the Summary of Coverage enclosed for specifics by line of coverage.This year,the church deductible reduces to$5,000 per each property claim.The commercial insurance industry continues to move to requirements for higher deductibles coupled with double digit rate increases.However,in our case these changes were negotiated favorably with the expectation that each local church will provide updated property information. Soon you will receive a document to complete.If you do not respond it's likely your premium will increase significantly and the deductible will also be significantly higher. We do not issue an individual policy for each of the churches. The enclosed documents serve as the policy for your church.This year our insurance company has changed to GuideOne Insurance for all lines of insurance. WHAT YOU NEED TO DO NEXT: • Provide a copy of this letter and enclosures to the appropriate staff.(Trustee Chair,Treasurer, Pastor,office/building manager). • Review and update values per the discussion below in the Property Data section.This is a Trustees responsibility.Of high importance is to review the Statement of Values(SOV)by each listed property as well as contents.Coverage is limited to 125%of the value per specific property, with a$1,000,000 cap. • If your church has a vehicle insured through the conference plan or uses member's autos for church business,we recommend that you run a Motor Vehicle Record Search(MVR)for each driver.These reports should be retained at the church.You can process these through Ministry Safe by performing a Level TWO background search.New this year,we will need to provide a drivers list to the broker. Please provide a listing with name,license#,date of birth and state of license. • If your church operates a preschool or daycare,(must be operated and sponsored by the church) please provide the Treasurers' office with the number of students enrolled as well as the number of adult helpers and teachers.Without this information you may not have coverage. 816 South 216th St.#2, Des Moines,WA 98198 I Mail to:P.O.Box 13650,Des Moines,WA 98198 1-800-755-77101 FAX 1-206-870-6839 I www.pnwumc.org • If outside parties use your facilities,revise any agreement to assure there is an indemnity(hold harmless)statement.Also,the insurance company requires the outside user to provide your church with a certificate of insurance that includes the church as an additional insured on their policy and a minimum of$1 million of liability coverage per occurrence and$2 million general aggregate. If you need a sample agreement,contact us.You can find templates on the Conference website. • Make sure you are paying L&I Workers Compensation Insurance for all paid employees including clergy. Also remember to incorporate the new Paid/Family leave law in Washington. FIRE&LIABILITY INSURANCE BILLING: Enclosed you will find the billing statement with the 2021 charge. It is an annual charge for all premiums and all coverages found on the Certificate of Participation. The policy period is January 1 through December 31. We no longer receive interest free financing from the insurance companies.As such, the Conference requires each church to make payment in full by September 30th. Interest will be charged at the rate of 1%per month on any remaining balance due after September 30th as a late fee. You can elect to pay the entire premium in January,or any combination of monthly payments so long as the total is paid by September 30.Please forward the enclosed billing statement to your church treasurer along with a copy of this letter for payment so they know the payment options. PROPERTY DATA—THIS REOUIRES YOUR CLOSE REVIEW: The attached Statement of Values(SOV)is the basis for coverage limits.For all churches the property details are the responsibility of your Trustees. 125%of that value per each specific listed property and contents is accepted as complete and accurate.Note this is different than assessed property value used for taxation or fair market value used for purposes of selling the property. It should be an estimate of the cost to rebuild a similar type of property(with like kind and quality that existed)in the event of a total loss. The summary result is that many of our church properties have insured values that are below full replacement value.That means in the event of a total loss the insurance company would only provide funds to rebuild up to the stated value per listed asset as reported by the church Trustees plus 25%,subject to a maximum additional benefit of$1 M in value. We are pleased to report that the insurance company continues to allow each church to use up to the entire amount of the stated value plus 25%in the event of a partial loss. Please have the Trustees review the Statement of Values(SOV)for accuracy and discuss: 1. Comfort level with the stated value as it relates to estimated replacement value—knowing that the maximum amount of insurance proceeds the church receives in the event of a total loss is the stated value plus 25%.This would also be a good time to discuss what kind of building/facility the congregation needs to continue its ministry,perhaps a different kind of venue or smaller facility could serve more effectively and efficiently? 2. Stained Glass and Fine Arts Coverage. Stained Glass is included within the total insured limit per each church,while Fine Arts has a sublimit of$25,000. The insurer can increase this limit and in order to do so requires information on the market value and each item description.Please share this with the Conference office. 3. A decision to increase coverage to a higher value using$175 per$100,000 of value as an estimate of the increase in premium cost.This can be done at any time of the policy year,not just once per year at renewal. To further understand the ramifications of these discussions,contact the Treasurer's office. Also,GuideOne Insurance offers their services regarding loss control and safety issues. If a loss control specialist visits your church and makes recommendations,please follow-up to rectify the issue as soon as possible.Any Boiler Jurisdictional inspections will be performed by Travelers via GuideOne Insurance Company. HOW TO REPORT A CLAIM: Post and share copies of the claims reporting card in a prominent area in the church office so others will know what to do in reporting a claim. It is also posted on the Conference website under digital downloads. We have learned through experience that whenever there is a situation that may create legal or insurance ramifications(i.e. serious injury,allegations of abuse, legal complaints); it is imperative that we receive communication of such instances immediately, in order to have the best insurance response. Auto Accident,Other Incidents and Injury Claims Please report all claims involving a church owned auto within 24 hours to GuideOne Mutual at(888-748-4326). This number is available 24 hours a day.Or email at clu(_tuguideone.com Provide the name of your church and address or reference the Pacific Northwest Conference. Please have available our auto master policy# 01832015. For all other auto claims,please contact the Conference Office or our insurance brokers Mark Landwehr 206-465-7627 mark.landwehnii.marsh.com or Van Vong of Marsh at 206-605-9491 or email at van.h.vong@marsh.com marsh.com for additional information. Property Damage Claims If you have a property claim,please call Shannon Madison at Marsh to report the incident at(206-214-3086;or toll free at 877-613-2200 ext. 2062143086 or email at shannon.madisonvmarsh.com). OTHER ITEMS Certificate of Participation This document provides your policy number,stated values of property by asset,limits of liability and premium amounts by type of coverage. Safe Church Background Check-noncompliance If your church is charged with a"Safe Church"surcharge as detailed on the Certificate of Participation that means your church did not complete the required number of national background checks and/or training in 2020. To avoid an Insurance Surcharge on your 2022 insurance bill please complete the following requirements during the 2021 calendar year. Each church needs to complete background checks on the MinistrySafe dashboard:under 75 Average worship attendance must complete at least 3 background checks,over 75 Average worship attendance must complete at least 5 background checks.Complete"Awareness Trainings"available on the MinistrySafe Dashboard:under 75 Average worship attendance must complete at least 3 awareness trainings,over 75 Average worship attendance must complete at least 5 awareness trainings.To avoid a surcharge next year,please complete your checks and trainings no later than November 30,2021. Bridge Loan for Property Claims Deductible Portion The Conference will continue to offer short term Ioans to local churches with claims as follows: 1. The maximum loan amount will be$4,000 after the local church pays the first$1,000. • 2. Repayment in full is required within 9 months of disbursement. During the 9 months there will be no interest charged:.. 3. To qualify and apply for this loan the local church must be current on apportionment payments,health and benefit payments,and fire&liability premium payments. No exceptions. 4. The application can be found on the Conference website at wwc .pn -umc.org We also suggest that each church should already have or should begin a designated fund for buildings and property issues.The fund would be designated for deductible payments(you should expect the deductible to continue to increase)as well as known and unknown future repair and maintenance issues.Trustees should determine an amount as a goal based on known issues as well as the probability of occasional future claim deductibles. RENEWAL PREMIUM IUM - This year's renewal was challenging as usual. With the combination of industry losses related to natural disasters which effects all policies;and the fact that churches fall in the category of public places which has seen increased active shooter risks;we were initially told to expect a 30%increase.With great effort by our broker we have ended up with an increase less than 5%before any surcharge related to background checks for 2020 changes your church may have had. Our group program continues to provide the broadest terms and limits available to any one church compared to a stand-alone insurance basis_Therefore,we continue to choose a group master plan approach. Churches who wish to evaluate their individual stand-alone options are asked to obtain comparable coverages and limits. We appreciate your feedback if this is considered. Here are some summary comments about the renewal process: 1. The largest portion of the insurance premium at most churches relates to the property coverage. Each property in the group plan is risk rated by zip code of the property location.We do not assign premiums based on an average for the Conference over all geographic areas. 2. Your church will have an auto policy charge only if the church owns vehicles. Vehicles are priced individually,and premiums are based on garaged locations. Insurance ID cards were issued earlier in January to each church that reports owned vehicles.These should be retained in the vehicle. 3. Please watch your email!mail in the coming weekslmonths for additional data request by the insurance broker to complete the insurer's files(as we have a new insurer this year). We continue to challenge the market every year for the best risk management solution for your church property and operations. This year we continue to retain Marsh USA, Inc.as our insurance broker for their assistance in managing claims and expertise in procuring insurance coverage.Questions as always are welcome. Sincerely, Brant Henshaw Rik Jamieson PNW Conference Treasurer PNW Conference Assistant Treasurer 206-870-6832 206-870-6818 bhenshaw�upnwumc.org rjamieson(u),pmAwumc.org E PACIFIC NORTHWEST ANNUAL CONFERENCE I THE UNITED METHODIST CHURCH I CERTIFICATE OF PARTICIPATION Effective January 1, 2021 to January 1, 2022 IN REFERENCE TO POLICIES(contact Conference office for policy numbers): I Insurers: GuideOne Insurance; Lloyds of London, Excess Liability(RSUI and Great American) t 1. THE FOLLOWING IS INCLUDED AS NAMED INSURED AMOUNT PREMIUM Port Townsend: Trinity United Methodist Church WITH RESPECT TO PROPERTY SITUATED AT: SEE ATTACHED 2. ALL REAL& PERSONAL PROPERTY AGAINST RISKS $ 2,058,630 $ INCL. OF DIRECT PHYSICAL LOSS, EXCEPT AS 11 EXCLUDED, SUBJECT TO A$5,000 PER LOSS I! DEDUCTIBLE 'N 11 SPECIFIC LIMIT APPLIES FOR EACH STRUCTURE See next See next page page I 3. GLASS INCLUDING PLATE, STAINED & LEADED INCL. $ INCL. $5,000 DEDUCTIBLE II 4. EMPLOYEE DISHONESTY LIMIT(1,000 deductible) $ 100,000 $ INCL. 5. MONEY AND/OR SECURITIES $ 100,000 $ INCL. 6. LIABILITY TO THIRD PARTIES, PERSONAL INJURY, $ 26,000,000 $ INCL. tl AND PROPERTY DAMAGE- Sq.Ft.(See Location list) 1 7. PASTORAL PROFESSIONAL LIABILITY $ 11,000,000 $ INCL. li 8. DAY CARE OPERATION LIABILITY (if'incl'is shown) $ 11,000,000 $ I I 9. AUTOMOBILE LIABILITY $ 26,000,000 $ PHYSICAL DAMAGE(included if elected) Actual Cash ,':. Value 10. DIRECTORS AND OFFICERS LIABILITY, shared $ 1,000,000 $ INCL. I' 10.a. EMPLOYMENT PRACTICES LIABILITY, shared $ 1,000,000 $ INCL. 11. ABUSIVE CONDUCT LIABILITY $ 3,000,000 $ INCL. 12. BOILER& MACHINERY Incl. in $ INCL. I Property , I SUB-Total $ 6,517 13. SAFE CHURCH— BACKGROUND CHECK NONCOMPLIANCE Surcharge (applies if an amount is shown) - Declaration Number: #30 Total Annual Premium: $ 6,517 I I GCFA Number: #921423 L Prepared by: This Certificate of Participation is a summary of coverages only.Please I 1 MARSH USA INC_ refer to the policy for complete limits,terms,conditions and exclusions. at Seattle,WA The policy shall prevail. The Conference Office has a complete copy of the policy available,please call with any questions. i l I (I !' : » �- �����, �± % e & K \$ Z.;. -; #\ }- © . . . . . . . -4 \� \ - ES. } � @ / ƒ � � m g ) a i J » . � \ $ § § § 0 • . \ ta 4. \ ) {3 /( IR RR a | � a , 2 E. a. i i £ s , § § & - ` . • f E • \ § k ~ \ B o o 7 \ , ¥ -41 ) ) } ) ? . / K E � . a I tv $ k k \ $5. $ % k 4c.. « /j \ / et 0 / PACIFIC NORTHWEST ANNUAL CONFERENCE THE UNITED METHODIST CHURCH SUMMARY OF COVERAGE Group Property& Liability Insurance Program Underwritten by GuideOne Mutual Insurance Company, Great American Insurance Company of NY and RSUI Indemnity Company As in effect January 1, 2021 PROPERTY DAMAGE: 1. Fire Insurance a. Provides replacement cost coverage on a church basis for direct physical loss of or damage to covered property, except as excluded. The total values reported for each church building/ property type plus 25% (twenty five)( is the total limit available for damages per claim per church building or property type, subject to a maximum of $1,000,000 applies.--Coverage includes protection from (but not limited to) loss due to fire, lightning, windstorm hail, explosion, riot, aircraft, vehicles, smoke, falling objects, vandalism, malicious mischief, collapse,water damage from overflowing appliances and breaking of pipes (premises must be heated). Coverage applies to buildings (including permanently affixed organs and pews), contents, outdoor signs, fences, boilers (if applicable)and property while in the care and custody of the church.The per-occurrence deductible is $5,000. b. Coverage extends to loss from burglary or theft, including damage to the building. c. Coverage is provided for church contents while off church premises temporarily, while in domestic and Personal Property of Others in your care, custody or control, these are subject to sub-limits and deductibles. d. Coverage applies to personal property of the pastor or employees located in the church building, such as books, office equipment, etc., which is customarily used in the performance of one's duties. Personal property of employees at the church are covered up to a $25,000 limit. e. Major coverage exclusions are earthquake(except as noted below),water(flood:except as noted below), loss due to wear and tear, deterioration, defects, settling or cracking, nuclear hazard, governmental action, war, mud slide, and power failure away from premises. This policy does not cover losses to valuables of volunteers when the valuables are not in the care and custody of the church. An example would be a stolen purse, vehicles in the parking lot. f. Damage to building or contents due to Sewer Back-Up, meaning water or sewage which backs up from a sewer or drain located within a building,and waterborne material carried or otherwise moved by such water or sewage is subject to the church building limit on file with the insurer. There is no coverage for other water damage (except as noted in Flood). Water means: flood, surface water, waves, tidal waves, overflow of any body of water,or their spray,all whether driven by wind or not;mudslide or mudflow,water under the ground surface pressing on, or flowing or seeping through foundations, walls, floors or paved surfaces, basements, or doors, windows or other openings. Flood Coverage — Coverage is included at a limit of $5,000,000 shared among the churches.A$100,000 deductible applies. Flood coverage is intended to be a catastrophic insurance coverage, hence the higher deductible. If flood is of concern to your church, please contact Marsh for a quote through the National Flood Insurance Program. Coverage through this program based on actual The information provided in this Summary is for reference only. It should not be construed as an exact copy of the policy form,nor as legal evidence of insurance. In case of any claim questions with regard thereto, the provisions of the policy form will prevail. SUMMARY OF COVERAGE, 2021 (Continued) -2- cash value (accounts for depreciation)and the maximum limit available is$500,000 per building and $500,000 contents per building. g. Coverage to shrubs, plants and trees is provided up to a limit of$25,000 per occurrence for any one shrub, plant, or tree(subject to$2,500 per item)resulting from fire, lightning, aircraft, explosion, or riot. A$500 deductible applies. h. Property is insured for replacement cost (without deduction for depreciation), but payment will not be made until 1.) the lost or damaged property is actually repaired or replaced; and 2.) unless repairs/replacement are made as soon as reasonably possible after loss or damage. Replacement cost does not apply to manuscripts, works of art, antiques or rare articles, including etchings, pictures, statuary, marbles, bronzes, porcelains and bric-a=brae these are subject to a sub-limit of $25,000. Furthermore, valuation is "market value' at the time of loss. Losses are subject to $5,000 per occurrence deductible. i. Coverage includes increased cost to repair, rebuild, or construct the property, by enforcement of building, zoning or land use law. 2. Miscellaneous Coverages: a. Valuable Papers and Records- $50,000 per church limit. Cost to research, replace, or restore the lost information or lost or damaged valuable papers and records. b. Newly acquired locations -$2,000,000 limit, report within 180 days. c. Builder's Risk- Provides coverage during construction for new or major renovations. Builders Risk provides for property damage to the church under construction. Please request for a liability certificate of insurance from the contractor/builder evidencing a minimum of $1,000,000 per occurrence and name the church and Conference as additional insured. Individual churches are required to notify Conference Treasurer's Office of construction projects. This coverage is not automatically included and needs to be requested. A separate premium will be charged for this coverage during construction. d. Lock Recalibration- Covers expense to repair or replace exterior or interior door locks if keys are stolen in a covered theft loss, or when property is damaged and door keys are stolen by burglars, subject to a $10,000 limitation, no deductible applies to this extension of coverage. e. Fine Arts incl Stained Glass and Musical Instruments—A sub-limit of$25,000 applies for fine arts at a church premises unless values are declared separately to the insurer. Fine arts also includes stained glass, musical instruments, manuscripts, works of art, antiques or rare articles, including etchings,pictures, statuary, marbles, bronzes, porcelains and bric-a-brac. If this limit is not sufficient for your fine arts, please notify the Conference Treasurer's office and provide a listing and values per item. No coverage for marring, scratching, or breakage unless caused by a covered cause of loss. Valuation is the"market value"at the time of loss. All the above subject to$5,000 per loss deductible. 3. EmployeesNolunteers Theft Coverage-$100,000 per loss. Provides for losses of money and securities due to employee or volunteer dishonesty. $1,000 per occurrence deductible applies. The information provided in this Summwy is for reference only. It should not he construed as an exact copy of the policvforrn, nor as legal evidence of insurance. In case of any claim questions with regard thereto, the provisions of the policy form will prevail. SUMMARY OF COVERAGE, 2021 (Continued)-3- 4. a. Loss of Money or Securities — $100,000 per loss of cash, check, or other securities by actual destruction, disappearance, or wrongful extraction thereof within the premise. $1,000 per loss deductible. b. Forgery or alteration - $100,000 coverage for forgery or alteration of any check draft, promissory note, or any similar written promise drawn upon the church's accounts. $1,000 deductible. 5. Earthquake Coverage—Coverage is included at a limit of$1,000,000 for shared limit for all churches. In the event of loss, the deductible will be 10%`of the location's building - per building and contents values applied separately. Exclusions to coverage include: Property under construction, newly acquired(unless reported),or those locations not scheduled to the policy. Earthquake coverage is intended to be a catastrophic insurance coverage, hence the higher deductible. Earthquake Sprinkler Leakage is included at the earthquake shared limit of$1,000,000 with an additional$10,000 per location extension. If your church has particular concerns regarding the shared limit for aU churches in the event of an earthquake, please contact the Conference office. 6. Vacancy Restrictions—Vacant property needs to be reviewed by the Insurance Company. If insured property is vacant and a loss occurs, recovery may be limited. If any of your properties become vacant, please notify the Conference Treasurer's office within a reasonable timeframe. Exclusions to coverage include but not limited to animals, wear and tear, landslide, volcanic eruption. COMMERCIAL LIABILITY: 7. Provides broad form commercial general liability protection, including but not limited • to, the following: Bodily injury and property damage to third parties where you are legally liable arising out of your premises or operations, products, contractual obligations and personal or advertising injury. Also included are Stop Gap Employer's liability and Employee Benefits administration liability. Liability is extended to owned watercraft and non-owned watercraft less than 58 feet long, not being used to carry person or property for a charge. Limits provided are $1,000,000 per occurrence and $3,000,000 Aggregate per church. . There is a $25,000,000 excess limit shared among the conference. This commercial liability coverage applies to the church,its trustees,and clergy,and all other employees or volunteers while engaged in their capacity or scope of duties at any location within coverage territory. The coverage territory only includes the United States (including its territories and possessions), Puerto Rico, and Canada. A separate international coverage would have to be written for exposures(trips)outside the coverage territory. Liability arising out of pollution or contamination; asbestos or lead; employment related practices; fungi/bacteria; war; and abuse or molestation, drones are excluded from coverage under policy. (This is not a complete list of exclusions). a. Medical Payments—I.minimal sub-limit for Medical Payments applies of$15,000 per person. Medical Payments are goodwill payments made to an injured party without establishing liability on the part of the church/Conference. This coverage extension does not apply on a primary basis to camps or day cares, however medical payments may be available in excess of what might be covered by other insurance. 8. Day Care Liability— Coverage is included under General Liability for church sponsored day care operations at specified churches. Excess Medical Payments for children enrolled in day care are available (pays in excess of what the daycare/child/parent may have in place outside the SUMMARY OF COVERAGE, 2021 (Continued) -4- conference program). Coverage is not provided for "schools" (engagement in regular teaching curriculum, grades K-12), unless on file. Please notify the conference Treasurer's office if your church has a daycare operation currently not insured. 9. Damage to Premises Rented To You - Provides coverage for property damage to structures or portions thereof rented to or leased to you up to $1,000,000 limit. WHENEVER YOU RENT OR LEASE OTHER BUILDINGS,OR PEOPLE!ORGANIZATIONS LEASE FROM YOU OR USE YOUR CHURCH FACILITIES, BE SURE TO HAVE YOUR LEASE AGREEMENTS CHECKED TO MAKE CERTAIN THAT YOU HAVE A SUBROGATION WAIVER AND A HOLD HARMLESS AGREEMENT IN THE LEASE. IN ADDITION, PLEASE SEE TO IT THAT THE CHURCH AND CONFERENCE OFFICE ARE ADDED AS ADDITIONAL INSUREDS TO THE THIRD PARTY'S INSURANCE. This is to protect the church. Without a hold harmless agreement or subrogation waiver, the building or contents owner's insurance company, upon paying the loss, could then come against you to recover the payment. Conversely, if people/organizations use your church and cause bodily injury or property damage to third parties,that organization's insurance would respond on your behalf. - 10.Pastoral Professional Counseling-This coverage extends to ordained persons while acting within the scope of rendering professional services such as counseling in the capacity as a religious organization. Limits under this coverage are included in the General Liability Limit at $1,000,000 per occurrence and $3,000,000 aggregate per church with Excess limits up to $10,000,000 annual aggregate shared among the conference. Coverage does not apply to counseling with respect to personal need or lack of need for medical or psychiatric services, or as respects any organized professional counseling service. This coverage also provides defense and settlement costs and will respond to claims brought within the United States, its Territories, or Possessions. This does not provide coverage for any dishonest, fraudulent, or criminal act or omission by the insured/pastor, and does not apply to licentious, immoral, or sexual behavior intended to lead to or culminating in any sexual act. 11. Directors and Officers Liability and Employment Practices Liability - Covers directors and officers, Trustees, or Clergy who become legally obligated to pay damages because of wrongful acts committed, there is no specific prior acts date, and prior to the policy expiration date. Directors and Officers Liability of$1,000,000 per claim I$3,000,000 limit per church with an excess limit of$10,000,000 shared among the conference. Insurance applies only if a claim for damages is first made against you during the policy term. (A'Wrongful Act" is any negligent act, error, or omission or breach of duty of directors, officers, or trustees while acting in their capacity as such). Coverage includes Employment Practices Liability, which includes wrongful termination, harassment, and discrimination for $1,000,000 per claim / $1,000,000 aggregate. Allegations by third parties relating to discrimination or harassment are also included. Defense and settlement costs are within the limits. A retention of$2,500 applies per claim for Directors & Officers and $5,000 applies per claim for Employment Practices Liability. 12. Sexual Misconduct/Abuse Liability — Covers acts of sexual misconduct/abuse by an insured (as defined by the policy, but including volunteers and employees). Coverage is provided at limits of$1,000,000 per occurrence and $3,000,000 aggregate per church. If additional limits are a concern, please contact the Conference office. No deductible applies to this coverage. No coverage is provided for any individual insured who intentionally caused the harm alleged to have arisen out of an insured event; however, defense will be provided until the individual is judicially determined to have intentionally caused alleged harm. AUTO Liability is provided for owned and rented vehicles, and coverage applies for the use of them The information provided in this Summary is for reference only. It should not be construed as an exact copy of the policy form, nor as legal evidence of insurance. In case of any claim questions with regard thereto, the provisions of the policy form will prevail. SUMMARY OF COVERAGE, 2021 (Continued)-5- only within the U.S. and Canada. If member-owned vehicles are used for church business, the member's personal insurance is primary. Physical damage to the church owned vehicle (comprehensive or collision coverage) applies to scheduled vehicles only(if deletion of coverage has not been requested or previously requested). Physical Damage coverage can be deleted upon request. For any autos rented for church business in the U.S.A., you may decline the insurance offered by the rental company. The Conference program provides hired/rented auto Liability and includes physical damage, subject to exclusions/limitations. If you rent an auto of greater value (such as a bus), please contact the Conference Treasurer's office or Marsh immediately. For those churches that have vehicles) insured through the conference policy, limits apply as follows: - Coverage Limit of Liability Deductible Liability $1,000,000 $0 Underinsured/Uninsured $1,000,000 $300 hit/run—WA only Motorist Auto Medical Payments $5,000 per person Comprehensive Lesser of ACV or repair cost $500 Collision Lesser of ACV or repair cost $1,000 CYBER t NETWORK SECURITY& PRIVACY Please note, the Conference program does not offer Cyber/Network security or Privacy Liability coverage. This coverage would provide media liability and can extend to claims arising out of your website and publications, regulatory defense, and PCI (credit card) compliance liability, breach notification costs, data restoration costs and cyber extortion are excluded. If this is of concern to your church, please contact the Conference office. OTHER CONSIDERATIONS Insured status extends to any 501(cX3) organization over which you (the church) maintain majority rule of board membership and fulfills the mission of the church/Conference. Any new 501 c3 formation, please notify the Conference immediately with particulars. For any questions that may arise about the Conference insurance program,contact: Brant Renshaw,Conference office (206)870-6832 bhenshawc@pnwumc.orq Rik Jamieson,Conference office(206)870-6818 rjamieson@pnwumc.org Marsh - Van Vong at 206 605 9491, van.h.vonq(&marsh.com or Mark Landwehr 206 465 7627 mark.landwehr{a marsh.com or Jeneile May 206 214 3082 jenelle.may( marsh.com The descriptions of coverage provided herein are from a limited review of an insurance proposal and are intended solely for information purposes. This information is based on certain assumptions and is subject to change. insurability, including without limitation the premium and the terms of any coverage, am determined by the underwriting insurance company or companies evaluating your submission. This information is not an offer of insurance, binder, insurance policy, or any other evidence of insurance placed on behalf of any party. Any coverage ultimately placed or bound will be documented by a separate communication to the named insured(s) or its representative. Coverage will be determined by the terms of any issued policy as well any applicable laws or regulations,which shall govern in the event of a conflict with the information provided herein. CONTRACT REVIEW FORM (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: Trinity United Methodist Church-CARES Act Grant Cornerstone 2021 (Name of Contractor/Consultant) Contract No. COUNTY DEPARTMENT: Contact Person: Mark McCauley Contact Phone: 360-385-9130 Contact email: mmccaulevaco.iefferson.wa.us AMOUNT: $20,000 PROCESS: 111 Exempt from Bid Process Revenue: N/A _ Cooperative Purchase Expenditure: N/A _ Competitive Sealed Bid Matching Funds Required: N/A _ Small Works Roster Sources(s) of Matching Funds N/A _ Vendor List Bid _ RFP or RFQ Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW. CERTIFIED: N/A:E Mark McCauley Ote.'202907tl30y15.4 n,',00Y 7-30-21 Signature Date STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL AGENCY. CERTIFIED: 1I1 N/A: � Mark McCauley Dae.I20210Z3015.4751 0700y 7-30-21 Signature Date STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche): Electronically approved by Risk Management on 7/30/2021. STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche): Electronically approved as to form by PAO on 8/1/2021. 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