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HomeMy WebLinkAboutQuilcene Historical Museum $62,935 (ins ex 072322) - 122021 e_ A-UD / AGREEMENT FOR 2022 HOTEL-MOTEL FUNDING FOR TOURISM SERVICES QUILCENE HISTORICAL MUSEUM _ This Agreement is by and between JEFFERSON COUNTY(hereinafter known as C, "COUNTY"and the QUILCENE HISTORICAL MUSEUM(hereinafter known as"MUSEUM"). WHEREAS,the MUSEUM 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; and WHEREAS,the Jefferson County Lodging Tax Advisory Committee reviewed and recommended funding the lodging tax proposal by the Quilcene Historical Museum to promote, operate and maintain the museum as a cultural resource and tourism destination,and to provide information to tourists and residents about the local area; IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the parties as follows: SECTION 1: SERVICES TO BE PERFORMED The MUSEUM shall use its capabilities and utilize up to$62,935 of funding provided under this agreement to continue and update the ongoing performance of the following tourism promotion services consistent with the Itemized List of Proposed Tourism Promotion Services and Lodging Tax Budget a copy of which is incorporated herein and attached hereto as Exhibit A: 1. Operation of the Quilcene Historical Museum and programs,including: a. Care of the collection for its long-term maintenance. b. Outreach to County residents through educational programs and Museum exhibits regarding cultural and natural heritage. c. Continued documentation of County heritage through collecting,oral history,research and other means. d. Advocacy of heritage preservation through all available means including the enhancement of Heritage based tourism for the economic development of the County. 2. Be a point of contact for the Jefferson County Tourism Coordinating Council for support and participation in tourism promotional activities;assist in developing regional promotional material in conjunction with other Chambers of Commerce and the Tourism Coordinating Council. 3. Respond to specific requests referred by the Olympic Peninsula Tourism Commission, the Jefferson County Tourism Coordinating Council and all other Jefferson County visitor's centers and Chambers of Commerce. Page: 1 of 13 Quilcene Historical Society 4. As vacancies occur,recommend potential representatives and alternates for inclusion with other candidates for consideration by the Board of County Commissioners for appointment to the Tourism Coordinating Council to represent the Quilcene region. SECTION 2: RESPONSIBILITIES OF THE QUILCENE HISTORICAL MUSEUM 1. On or before January 31;April 30;July 31;October 31,2022;and January 31,2023, provide to the COUNTY:see Exhibit C,attached hereto and incorporated; • A quarterly report of the use,services,programs and activities of the MUSEUM 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 2022. 2. On or before January 31,2022(OR upon execution of this agreement)and July 31,2022, provide to the COUNTY: • A billing statement requesting payment of Hotel-Motel Funding for the current half year. 3. For a minimum of six(6)years,maintain documented proof of payments made,contracts executed,and other expenditures authorized under this Agreement.Upon reasonable notice,provide access to County or State representatives to audit those records. 4. Funding provided by this Agreement may only be expended on the services described in Section 1 of this Agreement.Any monies used for other services or purposes shall be refunded to Jefferson County.Any monies under-expended of the total funding allocated under this Agreement shall be refunded to Jefferson County by January 31,2023. 5. By February 28th of each year provide the following information on Exhibit B,attached hereto and incorporated by reference for the previous year. a. Each festival,event,or tourism facility owned and/or operated by MUSEUM. b. The amount of lodging tax revenue allocated for expenditure(whether actually expended or not)by the MUSEUM on each festival,event or tourism facility. c. Estimated number of tourists served at each festival,event or tourism facility.("Tourist" includes persons traveling more than 50 miles to the location of the event,festival or facility and overnight stays in the area). d. Estimated lodging stays. ("Lodging"refers to commercial lodging such as hotels, motels,resorts,bed and breakfasts,or commercial campgrounds). e. Measurements that demonstrate the impact of increased tourism attributable to the event, festival or facility. SECTION 3: RESPONSIBILITY OF JEFFERSON COUNTY Page: 2 of 13 Quilcene Historical Society 1. The COUNTY will provide the MUSEUM 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$62,935 for 2022.Semi-annual payments of$31,468 will be made in the first and third quarter of 2022.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 1,2022 and ending on December 3 I,2022,except for the reports referenced in Section 2,due January 31,2023 and February 28,2023.All activities performed pursuant to this Agreement within its term and prior to its execution are hereby ratified. 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 MUSEUM 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,MUSEUM 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 MUSEUM shall indemnify and hold the COUNTY,and its officers,employees,and agents harmless from and shall process and defend at its own expense, including all costs,attorney fees and expenses relating thereto,all claims,demands,or suits at law or equity arising in whole or in part,directly or indirectly,from the MUSEUM's negligence or breach of any of its obligations under this Agreement;provided that nothing herein shall require the MUSEUM 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 MUSEUM's agents or employees;and, (b)the COUNTY, its officers,employees and agents, this Page: 3 of 13 Quilcene Historical Society 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 MUSEUM's negligence,or the negligence of the MUSEUM's agents or employees. The MUSEUM specifically assumes potential liability for actions brought against the COUNTY by the MUSEUM's employees,or any other persons engaged in the performance of any work or service required of the MUSEUM 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 MUSEUM 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 MUSEUM shall obtain and keep in force during the tern 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 MUSEUM shall maintain Workers' Compensation coverage as required under the Washington State Industrial Insurance Act,RCW Title 51, for all MUSEUM 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 MUSEUM's performance of the contract,including: a. Owned Automobiles; b. Hired Automobiles;and c. Non-owned Automobiles. 3. General Commercial Liability Insurance in an amount not less than a single limit of one million dollars ($1,000,000.00)per occurrence and an aggregate of not less than two(2) times the occurrence amount($2,000,000.00 minimum)for bodily injury,including death and property damage,unless a greater amount is specified in the contract specifications. The insurance coverage shall contain no limitations on the scope of the protection provided and include the following minimum coverage: a. Broad Form Property Damage,with no employee exclusion; b. Personal Injury Liability, including extended bodily injury; c. Broad Form Contractual/Commercial Liability—including:completed operations; d. Premises—Operations Liability(M&C); e. Independent Contractors and subcontractors; f. Blanket Contractual Liability. Page: 4 of 13 Quilcene Historical Society 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 MUSEUM 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 MUSEUM under this Agreement shall not in any manner limit or qualify the liabilities or obligations of MUSEUM under this Agreement. SECTION 10: INDEPENDENT CONTRACTOR The MUSEUM and the COUNTY agree that the MUSEUM 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 MUSEUM nor any employee of the MUSEUM 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 MUSEUM,or any employee, representative,agent or contractor of the MUSEUM. The MUSEUM 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 MUSEUM 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 Page: 5 of 13 Quilcene Historical Society accord with the laws of the State of Washington and venue shall be in Jefferson County, Washington. SECTION 12: DISCRIMINATION PROHIBITED The MUSEUM 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 MUSEUM 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 MUSEUM. APPROVED and signed this day of ,2021 JEFFERSON COUNTY Attest: BO F COMMISSIONED t i' 6 - Carolyn Callaway, - Kate Dean,Chair Clerk of the Board l Sf r 2111 Approved as to Form: QUILCENE HISTORICAL 1 v1 '6, "AVM j Philip C. Hunsucker, December 7,2021 Authorized Offic I Chief Civil Deputy Prosecutor 1 i0. 0f�, / �rj��CU1 CL) CP Page: 6 of 13 Quilcene Historical Society EXHIBIT A Itemized List of Proposed Tourism Promotion Services and Lodging Tax Budget 1. Itemized List of Proposed Tourism Promotion Services Organization(or Event)Name: Quilcene Historical Museum-Worthington Park 2019 2022 10-26-2021 1.Visitor Event Support& Information Museum Expense Code#66112 $11.040 36,845$17,33,0 signage exhibits newsletters invitations brochures conveniences event materials COVID/PPE supplies 2. Co-operative Partnerships&Collaborations Museum Expense Code#66116 $2500 "' $1,470 FAM tours,Culinary Loop,101 Brewery,CMIQ,Quilcene Fair,Quilcene Alumni OPTC(Olympic Peninsula Tourism Council),OPVB(Olympic Peninsula Visitors Bureau) State,Regional,&National memberships,Chambers of Commerce,Lions'Club,Boy Scouts Quilcene/Brinnon Garden Club,educational&scholarship programs,Quilcene Booster Club Children programs&events,Local Farms&Seafood producers Farmer Markets,Car&RV group tours.Victoriana tours&education 3. Museum web-sites&Social Media, ISP, Phone Museum Expense Code#66118 $6000 <r;,= $8880 domains,upgrades&maintenance,enhancement with links to JeffCo lodging,dining and events.video teleconferencing 4. Special Events, Promotions,Marketing Museum Expense Code#66120 $7850 i $19,.t15() Museum Season Openers(April) Quilcene Festival Weekend(Sept) Easter Egg Hunt(April) Quilcene Oyster Run(Sept) Worthington Park Grand Opening(May) Worthington Park/QSO"Harvest Festival"(Oct) QHS Alumni Reunion exhibits(June) Appreciation Dinner(Nov) Gravel Unravel Bike Race(June) "Polar Express Festival"(Nov/Dec) Worthington Park"Country Picnic"(June) Sheep to Shawl Festival(Nov/Dec) Worthington Park Outdoor Movie Night(June) Community Lighting Festival(Dec) Worthington Mansion open house tours(June,July,Sept) Welcome to the Holidays Gala(Dec) Wine&Spirits Tasting Gala(Aug) Marketing Media I Ads&Promotion Rental Portfolio Packet 5. Professional Services,Projects Museum Expense Code#66122 $50550 $13,055 Accessioning input Document Storage Project Oral History Project professional services History!culture publications facilities maintenance 6.Travel I conferences,postage,copies,office Conference/Convention/Meeting Museum Expense Code#66130 $2400 ; $700 Office Expenses&Postage,Program Expense Code#66171 &#66173 $400 $"4.50 Travel Museum Expense Code#66195 $300 WC, Office Expense,Administration Museum Expense Code#66265 $500 =' G Postage Administrator. Printing Museum Expense Code#66267 $700 $600 and Copying,Admix Museum Expense Code#66269 S3€0 )' TOTAL LTAC 2019• „,:,request for Museum!ours§m promotion!facility Page 7 of 13 Quilcene Historical Society Exhibit B Jurisdiction Lodging Tax Reporting Form — To Be Submitted to Jefferson County Administrator's Office No Later than February 28th of each Year Lodging Tax Reporting Form Os delons reeving tlimekm•to promote fosural: special event and zdirilSin-teLiseU actrane:.thiough 23-I e:a red facilities owned os lacinsm ed by non-profit Orp111.7.3n011:or the local prischgtion are leisured so complete du:form for EAC H acnairy 1 Otisicaraaec Name leporaq Yer 2 Sponia Type Mack Ode 501(c1,3i (J 51:,1..c it3) 0 Loca.1MI/11MM 0 Crid E7.1.11C, ;ArCar:NIZTA Actr p :heck Ott 0 iron Terivel• Faertry• 0Marisag• 5&miry Stm Date Acirtua End;re "Total.:oil of 3 A.C2CUCt Recl•-cali Amoxm Merle 5 ; 13 Nambes of Amt.:tee 7:ho;rased Zr.1zIm=1:cnaxi Arrectaiodairons• • Pio:ec:ed* a, Pregame' bi Acnia' Methadonav Chet Om 0:arert C.es.-• c Methodologa Ciseci One,. 0 CIIECI Zwarr• azdatcs Cam:- Oltepresecarne Sure licirecs Ccr,i=" Of..ewesec:rays Sum' 0 313-g7L-ed ar-wnri:.• Okfontal Satyr 0 5micarrel Emmert* 0153cr-li °Gibe ethtm °Cite explain 11 Nei of Azahatie to T:-Ireled!:Min;=Man' Niumb•.i of ArredeerWto Stare Cr. Paid.3.ccrer•roo..-aer' • Pro:+=ed• a Projered• ALmaC• Acta' Metocon cMetodo.ogy Checi Oaf 0Cone C)Peomecitain a;ix...r* 0;ekes': 1* ()Le/31€513.13ZV iir.er WI.Klzed Emir li r-re 0"frierl Sortler• 0 lauctre Lamm' 0 Ot.w o Otes ;:iircser of AriamirA,,Who Isn'a:ed to=Amt.& :ourzs-• if number of Pixt' Mem' • Pueced• a Projected' A..-rat• : Metodo:ory :Lk Ora 0 Direct:c c Methodony `21secii One. 0:tract"....r=s• 0.-xdres Corm* 013.garerearat e Onct"..trar ORepresliZt* :e0i1C21:SW:er. 0 WWII:7*d Exna.r.e• 3izqv 03cr.accid;irM.XM. °Other es5== CI)Gther -5e*Lodging Tam Yearly Reporting Definitions In:trnerion: Name of a±v.ext:Who?wired Ke,ao. ?•-cce kidteis RETURN TH15 FORM TO' effes son C ouu Achnunstrator:Office 325 Jeffer.on Scree P 0 3ox:"C Port Tostadencl W. 952 58 :efacce;4 CO effer:on na.us DEADLINE Februtr, :8111 of Each Repornng Year Page 8 of 13 Quilcene 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 toot,based on a defined random sample of participants,and the results can be reliably projected to the entire population attending an event and includes margin of error and confidence level. Informal Survey: Information collected directly from individual visitors or participants in a non-random manner that is not representative of all visitors or participants.Informal survey results cannot be projected to the entire visitor population and provide a limited indicator of attendance because not all participants had an equal chance of being included in the survey. Structured Estimate:Estimate produced by computing known information related to the event or location.For example,one jurisdiction estimated attendance by dividing the square footage of the event area by the international building code allowance for persons(3 square feet). Other:(please describe) Overall Attendance: Total projected and estimated actual attendance recorded for event,facility or resulting from marketing activity. Total Attendees Traveling 50 miles or more: Total: Total projected and estimated actual number of visitors traveling more than 50 miles to attend event or facility.For marketing organizations,report visitors traveling more than 50 miles to visit area. Of total,attendees who traveled from another state or country:Of the total projected and estimated actual number of visitors traveling more than 50 miles to attend event or facility or visit area,report projected and estimated actual number of visitors who traveled from another state or country. Attendees who stayed overnight: Paid Accommodations: Total projected and estimated actual number of visitors staying in paid lodging establishments such as hotels,motels,bed and breakfasts,etc. Unpaid Accommodations: Total projected and estimated actual number of visitors staying in unpaid accommodations such as family and friends. Paid Lodging Nights: Total projected and estimated actual number of paid lodging nights.One Lodging night=one or more persons occupying one room for one night. Page 9 of 13 Quilcene Historical Society EXHIBIT C 1st OUARTER Due by April 30th to afmcknight(caco.jefferson,wa.us Organization: Contact person: Mailing Address: Phone Number/Email: STARTING BALANCE + REVENUE THIS _ EXPENSES THIS _ ENDING BALANCE PREVIOUS QUARTER QUARTER QUARTER "" ' THIS QUARTER Please attach supportive documents.Any attachments may be subject to disclosure as a public record under the Public Records Act,RCW Chapter 42.56. 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. Please provide your reports of the revenue,marketing,services,programs and activities of the prior quarter. JANUARY Incoming Revenue Outgoing Expenses Total • • FEBRUARY Incoming Revenue Outgoing Expenses Total • • • • MARCH Incoming Revenue Outgoing Expenses Total • • • • • • Page 10 of 13 Quilcene Historical Society EXHIBIT C 2"d QUARTER Due by July 31"to afmcknight@co.jefferson.wa.us Organization: Contact person: Mailing Address: Phone Number/Email : STARTING BALANCE + REVENUE THIS - EXPENSES THIS ENDING BALANCE PREVIOUS QUARTER QUARTER QUARTER — THIS QUARTER Please attach supportive documents. Any attachments may be subject to disclosure as a public record under the Public Records Act,RCW Chapter 42.56. 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. Please provide your reports of the revenue,marketing,services,programs and activities of the prior quarter. APRIL Incoming Revenue Outgoing Expenses Total • • • • • • MAY Incoming Revenue Outgoing Expenses Total • • • • • • JUNE Incoming Revenue Outgoing Expenses Total • • • • • • Page 11 of 13 Quilcene Historical Society EXHIBIT C 3rd OUARTER Due by October 31"to afmcknight@,co jcfferson,wa.us Organization: Contact person: Mailing Address: Phone Number/Email: STARTING BALANCE REVENUE THIS EXPENSES THIS _ ENDING BALANCE PREVIOUS QUARTER + QUARTER QUARTER — THIS QUARTER � l Please attach supportive documents.Any attachments may be subject to disclosure as a public record under the Public Records Act, RCW Chapter 42.56. 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. Please provide your reports of the revenue,marketing,services,programs and activities of the prior quarter. JULY Incoming Revenue Outgoing Expenses Total AUGUST Incoming Revenue Outgoing Expenses Total • • • • • • SEPTEMBER Incoming Revenue Outgoing Expenses Total • • • • EXHIBIT C 4th OUARTER Due by January 31"to afmcknight@co.jefferson.wa.us Page 12 of 13 Quilcene Historical Society Organization: Contact person: Mailing Address: Phone Number/Email: STARTING BALANCE + REVENUE THIS _ EXPENSES THIS _ ENDING BALANCE PREVIOUS QUARTER QUARTER QUARTER — THIS QUARTER Please attach supportive documents.Any attachments may be subject to disclosure as a public record under the Public Records Act,RCW Chapter 42.56. 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. Please provide your reports of the revenue,marketing,services,programs and activities of the prior quarter. OCTOBER Incoming Revenue Outgoing Expenses Total • • • • NOVEMBER -------_ _____ ----- --Incoming Revenue Revenue Outgoing Expenses Total • • • • DECEMBER Incoming Revenue Outgoing Expenses Total • • • • • • Page 13 of 13 Quilcene Historical Society ACCPREP DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/27/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Ryan Smith NAME: Homer Smith Insurance Inc. (plc No,Extl: (360)385-3711 (AA/c,No): (360)385-3726 PO Box 591 E-MAIL ryan@homersmith.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Port Townsend WA 98368 INSURER A: West American Ins Co 44393 INSURED INSURER B Quilcene Historical Museum INSURER C: PO Box 574 INSURER D: INSURER E: Quilcene WA 98376 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2182709801 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/Y LIMITS LTR INSD WVD POLICY NUMBER (MMIDDYYY) (MM/DDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 A BKW57216373 07/23/2021 07/23/2022 PERSONAL 8,ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X. POLICY PRO 20 , 00000 JECT LOC PRODUCTS-COMP/OP AGG $ , OTHER: Expense Mod Factor 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS_ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD December 24, 2021 Dear Adiel McKnight, Enclosed is the signed 2022 Hotel Motel (Lodging Tax) Grant Agreement for the Quilcene Historical Museum. Also attached is a copy of our 2021-2022 Evidence of Insurance document. Please let me know if you need anything else or if you have questions. Thank you for all that you do! Marty McCullough Treasurer Quilcene Historical Museum 360-765-3420 Consent Agenda Commissioners Office JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners FROM: Adiel McKnight, Executive Assistant DATE: December 20,2021 SUBJECT: AGREEMENT re: 2022 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of$62,935; Quilcene Historical Museum STATEMENT OF ISSUE: This agreement provides grant funding for 2022 to certain non-profit agencies for the promotion of tourism and ongoing preservation of Jefferson County's heritage. The Lodging Tax Advisory Committee met on November 2, 2021 and reviewed request for proposals. This funding has been budgeted from the Hotel Motel (Lodging Tax) Fund, and approved by the Board of County Commissioners on November 15, 2021. FISCAL IMPACT: Quilcene Historical Museum $62,935 RECOMMENDATION: Approve and sign the agreement. REVIEWED BY: ziavie// / f 4 Mark McCaule /nterim County Administrator Date: CONTRACT REVIEW FORM Clear Form (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: Quilcene Historical Museum Contract No: N/A Contract For: Lodging Tax Term: 1 yr COUNTY DEPARTMENT: County Administrator Contact Person: Mark McCauley Contact Phone: Ext.383 Contact email: mmccauley@co.jefferson.wa.us AMOUNT: $62,935 PROCESS: Exempt from Bid Process Revenue: Cooperative Purchase Expenditure: — Competitive Sealed Bid Matching Funds Required: ^ Small Works Roster Sources(s)of Matching Funds Vendor List Bid Fund # 125 RFP or RFQ Munis Org/Obj 12555730/411103 _ Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFI PLI CE T ,JCC .55.080 AND CHAPTER 42.23 RCW. CERTIFIED: f N/A:t' I _.) ignature Date STEP 2: DEPARTMENT CERTIFIES TH PERSON P POSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NQT EN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL AGENCY. , CERTIFIED: 11 N/A: I ignature Date STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche): Electronically approved by Risk Management on 12/6/2021. STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche): Electronically approved as to form by PAO on 12/7/2021. Standard county grant contract. 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 roNC4�f�f Board of County Commissioners ,� „o6, O 1820 Jefferson Street pq` PO Box 1220 m '-' Port Townsend, WA 98368 -is NG't Kate Dean,District 1 Heidi Eisenhour,District 2 Greg Brotherton, District 3 December 20, 2021 Quilcene Historical Museum Brian Cullin P.O. Box 574 Quilcene,WA 98376 Dear Bill Cullin, Enclosed for signature are two (2) originals for AGREEMENT re: 2022 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of$62,935; Quilcene Historical Museum 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 along with Exhibit B attached to your contract. • Insurance shall be obtained 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. Sincerely, Adiel McKnight Executive Assistant Phone(360) 385-9100 Fax (360) 385-9382 jeffbocc@co.jefferson.wa.us