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AGREEMENT FOR 2022 HOTEL-MOTEL FUNDING FOR TOURISM SERVICES
CENTRUM
This Agreement is by and between JEFFERSON COUNTY(hereinafter known as
"COUNTY" and the CENTRUM(hereinafter known as "CENTRUM").
WHEREAS,the CENTRUM is a non-profit corporation of the State of Washington; and
WHEREAS,the COUNTY desires to promote tourism in unincorporated Jefferson County,
as authorized by Chapter 67.28 RCW and Jefferson County Code Chapter 3.25; and
WHEREAS,the Jefferson County Lodging Tax Advisory Committee reviewed and
recommended funding the lodging tax proposal by Centrum to implement a strategy for the
unincorporated area of Jefferson County to promote tourism activities;
IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the
parties as follows:
SECTION 1: SERVICES TO BE PERFORMED
The CENTRUM shall use its capabilities and utilize up to $40,000 of funding provided under this
agreement to continue and update the ongoing performance of the tourism promotion services
consistent with the Itemized List of Promotion Services and Lodging Tax Budget, a copy of which
is incorporated herein and attached hereto as Exhibit A.
SECTION 2: RESPONSIBILITIES OF CENTRUM:
1. On or before 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 CENTRUM 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, 2023 OR upon execution of this agreement, whichever is later,
provide to the COUNTY:
• A billing statement requesting payment of Hotel-Motel Funding for the current year.
3. For a minimum of six (6) years, maintain documented proof of payments made, contracts
executed, and other expenditures authorized under this Agreement. Upon reasonable
notice, provide access to County or State representatives to audit those records.
Page: 1 of 12 Centrum
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 CENTRUM.
b. The amount of lodging tax revenue allocated for expenditure (whether actually
expended or not)by the CENTRUM on each festival, event or tourism facility.
c. Estimated number of tourists served at each festival,event or tourism facility. ("Tourist"
includes persons traveling more than 50 miles to the location of the event, festival or
facility and overnight stays in the area).
d. Estimated lodging stays. ("Lodging"refers to commercial lodging such as hotels,
motels, resorts, bed and breakfasts,or commercial campgrounds).
e. Measurements that demonstrate the impact of increased tourism attributable to the event,
festival or facility.
SECTION 3: RESPONSIBILITY OF JEFFERSON COUNTY
1. The COUNTY will provide the CENTRUM funding from Hotel-Motel Tax receipts to be
used in support of their responsibilities as defined under this agreement.
2. Said funding is in the sum of$40,000 for 2022. Semi-annual payments of$20,000 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 31,2022, except for the reports referenced in Section 2, due January 31, 2023 and
February 28, 2023.
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.
Page: 2 of 12 Centrum
•
SECTION 7: TERMINATION
The Agreement may be terminated, in whole or in part, by the County upon thirty(30)days written
notice in the event expected or actual revenue from the Hotel-Motel Tax is reduced or limited in
any way, or for non-performance of duties under this Agreement, or for any reason. The
CENTRUM may terminate this Agreement upon thirty(30)days written notice to the COUNTY.
In the event of termination under this clause,the County shall be liable to pay only for services
rendered prior to the effective date of termination. If termination covers a period for which payment
has already been made, CENTRUM shall refund to the COUNTY a pro-rated share of the payment
based upon the balance of time remaining in the paid period, unless otherwise negotiated.
SECTION 8: HOLD HARMLESS
The CENTRUM shall indemnify and hold the COUNTY, and its officers, employees, and agents
harmless from and shall process and defend at its own expense, including all costs, attorney fees
and expenses relating thereto, all claims, demands, or suits at law or equity arising in whole or in
part, directly or indirectly, from the CENTRUM's negligence or breach of any of its obligations
under this Agreement; provided that nothing herein shall require the CENTRUM to indemnify
the COUNTY against and hold harmless the COUNTY from claims, demands or suits based
solely upon the conduct of the COUNTY, its officers, employees and agents, and; provided
further that if the claims or suits are caused by or result from the concurrent negligence of: (a)
the CENTRUM's agents or employees; and, (b)the COUNTY, its officers, employees and
agents, this indemnity provision with respect to claims or suits based upon such negligence,
and/or the costs to the COUNTY of defending such claims and suits, etc., shall be valid and
enforceable only to the extent of the CENTRUM's negligence, or the negligence of the
CENTRUM's agents or employees.
The CENTRUM specifically assumes potential liability for actions brought against the
COUNTY by the CENTRUM's employees, or any other persons engaged in the performance of
any work or service required of the CENTRUM under this Agreement and, solely for the purpose
of this indemnification and defense, the Contractor specifically waives any immunity under the
state industrial insurance law, Title 51 RCW. The CENTRUM 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 CENTRUM shall obtain and keep in force during the term of the Agreement, or as otherwise
required,the following insurance with companies or through sources approved by the State
Insurance Commissioner pursuant to RCW 48.
The CENTRUM shall maintain Workers' Compensation coverage as required under the
Washington State Industrial Insurance Act, RCW Title 51, for all CENTRUM employees, agents
and volunteers eligible for such coverage under the Industrial Insurance Act.
SECTION 10: INDEPENDENT CONTRACTOR
Page: 3 of 12 Centrum
The CENTRUM and the COUNTY agree that the CENTRUM is an independent contractor with
respect to the services provided pursuant to this agreement. Nothing in this agreement shall be
considered to create the relationship of employer and employee between the parties hereto.
Neither the CENTRUM nor any employee of the CENTRUM shall be entitled to any benefits
accorded County employees by virtue of the services provided under this agreement. The
COUNTY shall not be responsible for withholding or otherwise deducting federal income tax or
social security or for contributing to the state industrial insurance program, otherwise assuming
the duties of an employer with respect to the CENTRUM, or any employee, representative, agent
or contractor of the CENTRUM. The CENTRUM shall be responsible for all applicable
withholdings, deductions, state industrial insurance, tax reports, business licenses, registrations,
and all other obligations of an independent organization.
SECTION 11: COMPLIANCE WITH LAWS
The CENTRUM shall comply with all Federal, State, and local laws and ordinances applicable to
the work to be done under this Agreement. This Agreement shall be interpreted and construed in
accord with the laws of the State of Washington and venue shall be in Jefferson County,
Washington.
SECTION 12: DISCRIMINATION PROHIBITED
The CENTRUM with regard to the project to be completed under this agreement, will not
discriminate on the grounds of age, sex, marital status, sexual orientation, race, creed, color,
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.
Page: 4 of 12 Centrum
SECTION 13: INTEGRATED AGREEMENT
This agreement together with attachments or addenda represents the entire and integrated
agreement between the County and the CENTRUM and supersedes all prior negotiations,
representations,or agreements written or oral. This agreement may be amended only by written
instrument signed by both the County and the CENTRUM.
APPROVED and signed this —day of bcp 4.-, 202
JEFFERSON COUNTY
Attest: BOARD OF COMMISSIONERS
Carolyn+Gallaway, Kateean,Chair
Clerk of the Board
Approved as to.Form: CENTRUM
4 December 7,2021
Philip C. Hunsucker, Authorized icial
Chief Civil Deputy Prosecutor
Page: 5 of 12 Centrum
EXHIBIT A
Itemized List of Proposed Tourism Promotion Services and
Centrum Itemized List of Proposed Tourism Promotion Services in 2022
National, International,and Regional Publications and Promotions
Jazz Times Magazine,Jan./Feb. and April 2022.Circulation 70,000 magazine readers. $1,950
Olympic Peninsula Getaway Guide,spring display ad edition.Circulation of 200,000 $800
including Washington State Ferries.
KUOW-FM,36 underwriting announcements,Spring/Summer 2022.445,200 listeners in $9,000
Washington each week. 57%of listener household's annual income over$75,000.
Seattle Medium,Metro Homemaker,Tacoma True Citizen and Portland Medium $5,000
promotion allowance to be negotiated employing print and digital advertising across
each platform(one ownership)
Poets and Writers Magazine,quarter page display ads,Jan./Feb.,March/April,and $2,580
May/June 2022.Circulation 100,000 people throughout the US.
DownBeat Magazine,display ads March 2022 Jazz Camp Guide and May 2020 Summer $1,900
Festival Guide.Circulation 68,000 people throughout the US who love jazz.
Writer's Chronicle,quarter page display ad,spring 2022.Circulation 35,000 copies with $700
an estimated readership of 54,000 people throughout the U.S.
Victoria Jazz Festival program guide, half page display ad,Audience:43,000 people. $1,400
Acoustic Guitar Magazine,two display ads,April 2022, including website. 54,000 readers $1,700
throughout the US who like blues and other guitars styles.
Living Blues Magazine,display ad,April 2022. Circulation of 16,000 throughout US. $1,200
JazzED Magazine, 1/3-page display ad, Mar. 2022.Circulation 13,000 jazz educators. $800
Printing of 8,000 season brochures promoting all Centrum programs for direct mail $9,000
throughout Washington and U.S. Distribution starting April 2022 at Jefferson County
Visitor Information Center, Port Townsend Visitor Information Center, B&Bs and hotels
in Jefferson County,and more.
Earshot Jazz Magazine,two 2/3-page ads June/July 2022.Circulation 6,000 Seattle. $750
JEN Conference, (Jazz Education Network), 1/3-page ad in program guide,circulation $500
5,000,conference held January 5-8,2022 in Dallas,Texas.
Old-time Herald Magazine,full page inside cover color ad(fiddle tunes)and half page $1,300
color ad(Voice Works), May 2022. Readership:4,000 people throughout the US.
Fiddler Magazine, Full page ad,spring 2020. Readership:3,000 people in the US. $400
Wintergrass Music Festival program guide,full page ad,3,000 people in Bellevue, $450
Washington February 24-27,2022.
Face book targeted digital ads to areas beyond Jefferson County. Estimated annual reach: $8,000
100 million viPwc
The Facts,weekly newspaper for Black communities in Seattle.Circulation 80,000.3
$810
column inch ad for three months.
Northwest Asian Weekly,weekly newspaper for Asian communities in Seattle. $1,226
Circulation 9,500.
KNKX-FM,42 underwriting announcements,April/May 2020. 330,000 listeners $9,000
throughout western Washington each week.
Total expenses(out-of-county marketing) $58,466
I Total requested from JCLTAC $40,000
This budget only includes promotions outside of Jefferson County
Page 6 of 12 Centrum
Exhibit B
Jurisdiction Lodging Tax Reporting Form - To Be Submitted to Jefferson
County Administrator's Office
No Later than February 28th of each Year
Lodging Tax Reporting Form
Orgamzations receiving finning to promote f-tivals,special ewerits and tourism-related activities through tourixtu-seIated
owned or sponsored by non-profit organmanond or the local jurisdiction are required to complete thiz form for EAC H acn.nry-
1 Orpniztion Name:
Repertng Year
2 Spemor Type;Check One) 0 501(cX3( 0 501(cX6) I oral funsclicrion °Other
3 Art-.7.ry Name
4 Amifry Type(Check One) 0 Evenaestival• Facility* °Marketing'
5 Activity Start Date':
6 Activity End Dare•-
Total COST of Acavity: $
S AC10013 ileczared
9 Amcor!Amisied:
10 Oven Aiteraince• 13 Nuoil,er. of Anendeesio St ay-ed Over:right M 1r4x.,1 Accocermodanoni•
a) Pro..ened• a' Pmenerl•
A.ctual* bAzrua:'
c) Methodnegy ICheck O ()Direct Cana* c; Metbodokrgy(ask One): 0 l'Arect Cow'
01r.dt Calm OKepreseinarive SUIVEy. Idireci Court' °Rept-mummy Sumer
Ofr..formal Survey' (3 Strum:red Estimate" IP:dermal Survey' 0 Structured Estimate"
00ther(explain):
410' *Plain):
11 Number of Arter4oei V. Traveled f,3 Miles or More' 14 Number of Arrendeei Who Stayed Os.errughr Paid Accommodations•
a) Proiecred• a) Projected"
b) Acme? b) Actiaa?
c) gy(Check One) (3 'ect Cour" c) Mettodo`ogy(Check One). 0 Direct 7.ormt•
Indirect Count' 0 Repreiesaanve Survey.' Idrect Collor •ReprEomtatroe Survey*
*Trferte.)Sincry• 0 Saructrued Emulate' llama'Stayer •Sri-accused Emulate*
0 Other Adam): 0 Other lainc
12 Number of Artencteei'AU Traveled from Another Stale or Country- 15 Number of Paid Jar-Lyme Nigliv•
Pira;ected• a) Proleced•
b) Arno:* b)
Methadorogy(Check Orel )Direct Come c) Meteor:kip.(Check One): 0 Direct omt•
0 1117111.Kr,C cow ORcaresentarwe Sumer 0 Ichrect Count' OR2presentarne Saner
0 MfArmll Surtey* QStrucntred E urr,lte• 0 Infonnal Sumer 0 Structured Estimate"
00tber,e•cplath )Other fesplam):
-See Lodging Tax Yearh.Reporting Definition:In-.n-uctions
Name of Indivithaal Rio?reci:ed Repor:
Phone m: E-MajjAddress
RETIRN 111.IS FORM TO:
Jefferson Comity Administrator%Office
1820 Jefferson Street
P.O.Box 1220
Port Townsend&WA 98368
jeffbocc:el co effer son Ara.tic
DEADLINE:February 28th of Each Reporting Year
Page 7 of 12 Centrum
LTAC Yearly Reporting
Definitions/Instructions
Activity Type: Event/Festival: Short-term activity occurring between specific dates(e.g.,4th of July celebration,local marathon)
Facility:Municipally-owned facility that operates some or all of the year(e.g.,county historical museum,
convention center)
Marketing:Activity that provides information to encourage visitors to an area;is typically a year-round activity but
may also operate for less than a full year.
Activity Date: Activity beginning and ending dates.
Actual: Persons estimated to have actually participated in event/festival or visiting a facility.For marketing
activity,enter the number of persons estimated to have actually visited area as result of marketing activity.
Projected: Persons expected to participate in event/festival or visiting a facility.For marketing activity,enter the number of
persons expected to visit area as result of marketing activity.
Methodology: Select the methodology used to estimate the actual number of visitors/participants.
Direct Count:Actual count of visitors using methods such as paid admissions or registrations,clicker counts at
entry points,vehicle counts or number of chairs filled.A direct count may also include information collected
directly from businesses,such as hotels,restaurants or tour guides,likely to be affected by an event.
Indirect Count:Estimate based on information related to the number of visitors such as raffle tickets sold,
redeemed discount certificates,brochures handed out,police requirements for crowd control or visual estimates.
Representative Survey: Information collected directly from individual visitors/participants.A representative
survey is a highly structured data collection tool,based on a defined random sample of participants,and the results
can be reliably projected to the entire population attending an event and includes margin of error and confidence
level.
Informal Survey: Information collected directly from individual visitors or participants in a non-random manner
that is not representative of all visitors or participants.Informal survey results cannot be projected to the entire
visitor population and provide a limited indicator of attendance because not all participants had an equal chance of
being included in the survey.
Structured Estimate:Estimate produced by computing known information related to the event or location.For
example,one jurisdiction estimated attendance by dividing the square footage of the event area by the international
building code allowance for persons(3 square feet).
Other:(please describe)
Overall Attendance: Total projected and estimated actual attendance recorded for event,facility or resulting from marketing activity.
Total Attendees Traveling 50 miles or more:
Total: Total projected and estimated actual number of visitors traveling more than 50 miles to attend event or facility. For
marketing organizations,report visitors traveling more than 50 miles to visit area.
Of total,attendees who traveled from another state or country:Of the total projected and estimated actual number of
visitors traveling more than 50 miles to attend event or facility or visit area,report projected and estimated actual number of
visitors who traveled from another state or country.
Attendees who stayed overnight:
Paid Accommodations: Total projected and estimated actual number of visitors staying in paid lodging establishments such
as hotels,motels,bed and breakfasts,etc.
Unpaid Accommodations: Total projected and estimated actual number of visitors staying in unpaid accommodations such
as family and friends.
Paid Lodging Nights: Total projected and estimated actual number of paid lodging nights.One Lodging night=one or more persons
occupying one room for one night.
Page 8 of 12 Centrum
EXHIBIT C 1st OUARTER Due by April 30th to afmcknight@co.jefferson.wa.us
IOrganization:
IContact person:
Mailing Address :
1 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 9 of 12 Centrum
EXHIBIT C 2nd OUARTER Due by July 31s`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 10 of 12 Centrum
EXHIBIT C 3rd OUARTER Due by October 31 St to afmcknight(a,co jefferson.wa.us
Organization:
Contact person:
Mailing Address :
IPhone 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.
JULY
Incoming Revenue Outgoing Expenses Total
AUGUST
Incoming Revenue Outgoing Expenses Total
SEPTEMBER
Incoming Revenue Outgoing Expenses Total
EXHIBIT C 4t' OUARTER Due by January 31 St to afmcknight@cojefferson.wa.us
Page 11 of 12 Centrum
•
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 Outgoing Expenses Total
DECEMBER
Incoming Revenue Outgoing Expenses Total
Page 12 of 12 Centrum
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$40,000; Centrum
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:
Centrum $40,000
RECOMMENDATION:
Approve and sign the agreement.
REVIEWED BY:
/2-// 7/-/
Mark McCain , Interim County Administr Dade:
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Centrum 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: $40,000 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 12555730/410901 Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES CO LIAN E WITH4C 3.55.080 D CHAPTER 42.23 RCW.
CERTIFIED: ri
N/A: ■
tL i.7 �,2
ure Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEE D ARRED Y ANY FEDERAL, STATE, OR LOCAL
AGENCY. `'
CERTIFIED: C N/A: C G� /.2 ` 3
Signs u Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electron' ly through Laserfiche):
Electronically approved by Risk Management on 12/8/2021.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 12/7/2021.
Corrrections.
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
F
1 ''
roN
. CoMtitss Board of County Commissioners
oor0Q 6� 1820 Jefferson Street
,a PO Box 1220
= -' Port Townsend, WA 98368
/s III NG(SO Kate Dean,District 1 Heidi Eisenhour,District 2 Greg Brotherton,District 3
December 20, 2021
Centrum
Katya Kirsch
P.O. Box 1158
Port Townsend,WA 98368
Dear Katya Kirsch,
Enclosed for signature are two (2) originals for AGREEMENT re: 2022 Hotel Motel (Lodging
Tax) Grant Funding; In the Amount of$40,000; Centrum
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
Issue Date 5/27/2021 Cert#:0000037564
Non Profit Insurance Program
Certificate of Coverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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Clear Risk Solutions GENERAL LIABILITY
451 Diamond Drive American Altemative Insurance Corporation,et al.
Ephrata,WA 98823
AUTOMOBILE LIABILITY
American Altemative Insurance Corporation,et al.
PROPERTY
American Altemative Insurance Corporation,et aI.
Centrum Foundation
MISCELLANEOUS PROFESSIONAL LIABILITY
PO Box 1158
Princeton Excess and Surplus Lines Insurance Company
Port Townsend,WA 98368
S
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-12 6/1/2021 6/1/2022 PER OCCURRENCE $5,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
INCLUDES STOP GAP PRODUCT-COMP/OP $5,000,000
PERSONAL&ADV.INJURY $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
x x. LIABILITY
ANY AUTO N1-A2-RL-0000013-12 6/1/2021 6/1/2022 COMBINED SINGLE LIMIT $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-0000013-12 6/1/2021 6/1/2022 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC Excluded
FLOOD PER OCC Excluded
(PROPERTY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-12 6/1/2021 6/1/2022 PER CLAIM $5,000,000
(LIABILITY IS SUBJECT TO A$150,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Evidence of Coverage.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLICY PROVISIONS
CERTIFICATE HOLDER yf ;; AUTHORIZED REPRESENTATIVE
Jefferson County Lodging Tax Advisory Committee
PO Box 1220
Port Townsend,WA 98368