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HomeMy WebLinkAboutForks Chamber of Commerce and Visitor Center re: LTAC Funding (ins ex 12-30-23) -121922Fe • WAGREEMENT FOR 0 HOTEL -MOTEL FUNDING FOR TOURISM SERVICES FORKS CHAMBER OF COMMERCE AND VISITOR CENTER This Agreement is by and between JEFFERSON COUNTY (hereinafter known as "COUNTY" and the FORKS CHAMBER OF COMMERCE (hereinafter known as "FCC"). WHEREAS, the FCC is a non-profit corporation of the State of Washington; and WHEREAS, the COUNTY desires to promote tourism by providing information to guests, support and staff to information centers in unincorporated West Jefferson County, as well as workshops, conferences and materials to enhance productivity of visitor information centers in the promotion of the tourism industry, 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 Forks Chamber of Commerce; IN CONSIDERATION of the mutual covenants and agreements herein it is agreed by the parties as follows: SECTION 1: SERVICES TO BE PERFORMED. The FCC shall use its capabilities and utilize up to $60,390 of funding provided under this agreement to continue and update the ongoing performance of the following tourism promotion services, as outlined below and consistent with the proposed FCC Lodging Tax budget, a copy of which are incorporated herein and attached hereto as Exhibit A: Provide for seasonal (May -September) Olympic National Park staffing at the Kalaloch Visitor Center to provide visitor information services there, consistent with a negotiated agreement with Olympic National Park. 2. Provide staffing at the Forks Visitor Information Center. 3. Tourism Marketing with the Washington State Visitor Guide and Co-op Marketing with Olympic Peninsula Tourism Commission, to include social media, print ads, television and bus ads. 4. Mailing of Rain Forest Country Adventure Map to individuals in visitor packets, to AAA and Visitor Information Centers around WA. Be the focal point for support of the West End participation in tourism promotional activities included but not limited to: web page update and web site hosting; distribution of Jefferson County tourism information and materials through the Kalaloch Visitor Center and the Forks Visitor Information Center; and participate in Joint Marketing and other tourism promotion activities. SECTION 2: RESPONSIBILITIES OF THE FORKS CHAMBER OF COMMERCE 1. On or before January 31; April 30; July 31; October 31, 2023; and January 31, 2024, provide to the COUNTY: see Exhibit C, attached hereto and incorporated; Page 1 of 12 Forks Chamber of Commerce • A quarterly report of the use, services, programs and activities of the FCC 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 2023. 2. On or before January 31, 2023 OR upon execution of this agreement, whichever is later, provide to the COUNTY: • A billing invoice requesting payment of Hotel -Motel Funding for the current year. 3. For a minimum of six (6) years, maintain documented proof of payments made, contracts executed, and other expenditures authorized under this Agreement. Upon reasonable notice, provide access to County or State representatives to audit those records. 4. Funding provided by this Agreement may only be expended on the services described in Section 1 of this Agreement. Any monies used for other services or purposes shall be refunded to Jefferson County. Any monies under -expended of the total funding allocated under this Agreement shall be refunded to Jefferson County by January 31, 2024. 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 FCC. b. The amount of lodging tax revenue allocated for expenditure (whether actually expended or not) by the FCC 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 The COUNTY will provide the FCC 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 $60,390 for 2023. Semi-annual payments of $30,195 will be made in the first and third quarter of 2023. 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, 2023 and ending on December 31, 2023, except for the reports referenced in Section 2, due January 31, 2024 and February 28, 2024. Page 2 of 12 Forks Chamber of Commerce 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 FCC 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, FCC 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. FCC shall indemnify and hold the COUNTY, and its officers, employees, agents and volunteers (and their marital communities) 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 FCC's negligence or breach of an of its obligations under this Agreement; provided that nothing herein shall require FCC 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, agents and volunteers (and their marital communities), and; provided further that if the claims or suits are caused by or result from the concurrent negligence of. (a) FCC's agents or employees; and, (b) the COUNTY, its officers, employees agents and volunteers (and their marital communities), 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 FCC's negligence, or the negligence of FCC's agents or employees. FCC specifically assumes potential liability for actions brought against the COUNTY by FCC's employees, including all other persons engaged in the performance of any work or service required of FCC under this Agreement and, solely for the purpose of this indemnification and defense, FCC specifically waives any immunity under the state industrial insurance law, Title 51 RCW. FCC recognize that this waiver was specifically entered into pursuant to provisions of RCW 4.24.115 and was subject of mutual negotiation. SECTION 9: INSURANCE. FCC shall obtain and keep in force during the term of the Agreement, or as otherwise required, the following insurance: Page 3 of 12 Forks Chamber of Commerce A. Commercial General Liability Insurance. FCC shall maintain commercial general liability coverage on a form acceptable to Jefferson County Risk Management for bodily injury, personal injury, and property damage, with a limits of not less than in the amount of at least $1 million per occurrence, for bodily injury, including death, and property damage. B. Worker's Compensation (Industrial Insurance). FCC 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. SECTION 10: INDEPENDENT CONTRACTOR. The FCC and the COUNTY agree that the FCC 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 FCC nor any employee of the FCC 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 FCC, or any employee, representative, agent or contractor of the FCC. The FCC 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 FCC 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 FCC 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 Forks Chamber of Commerce SECTION 13: INTEGRATED AGREEMENT. This agreement together with attachments or addenda represents the entire and integrated agreement between the County and the FCC 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 FCC. APPROVED and signed this /�t day of 2022. Attest: /� `, ca P4, CMG Carolyn Gallaway, CMC Clerk of the Board Approved as to Form: r dip C. Hunsucker, December 14, 2022 Chief Civil Deputy Prosecutor tiEis N COUNTY COMMISSIONERS our, Chair S CHAMBER OF COMMERCE JA7uo cial Page 5 of 12 Forks Chamber of Commerce EXHIBIT A Itemized List of Proposed Tourism Promotion Services 2023 FUNDS REOUESTED by Forks Charriber of Commerce We anticipate that Kalsloch Ranger Station " be 9WW 5 daysMeek beginning 5/1112023, ♦, ♦.`; t is Yi -'.a -. •. w ♦ :. • :.":. t s to kx*40 $ociqW numM. print ads, lelevWon, bus ads, other .Aaft a of Forest Country • s To Ox"usis in v*ibx packsts, and to AAAMC around WA • ! •' ! states Total,4 OO Page 6 of 12 Forks Chamber of Commerce 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 org=zatiams receiving fuadiag to prcmote fes�m-al-, special ev+ uA tatrrisrnmlated activities duough taon uat-f elated facdtbes owned at ePamsared by non pwfit organaawns or the local jumsdwton we required to coaWlete the farm for ULCH amvity. 1 0WnLMWNMW. Hepacmag Ti ew: Spaaset Type (cbecit tlee): 0 so1(e)(3) 0 50406) Q local x � � ) 3 AcmatyNmw T.yte (Cbed lane): 0 ramtFeml* ram Mad�etimg s Ammy 5tat Date*: 6 At ttity End D&e* Taal cost of Atxi Vy, S S Aamm : S 9 Amoms Aw sled: $ 16 Cleecam Aundonce* i,, PM)Kud* 1r) Acne? c,l Me6aidou (awa one) ODicea Cant* Obdirect Coact* oR ht .- S.,.v. ()kf=d Sr mM- 0Sattva nvd Eotmm- (spimn): 11 NumberadAnmidees Who Tnnmled 54 !clues ar Mea* a,, Pnp aed* ire Acwal* 0 MR643bu (Cbed lane). Tatted Cow* bdna Ca=* 0Rq..nme SwsaeY" khmud Savvy- 0 Eet®ate* 0 04bW ( ): 13 Nmmber of Atmedaes %1w Traveled fmm,Anotw Sate or Comu "' a,, Ptegected* Yr) Acwta3• c), MabodWar (CbKk Same): V 1 uva Caw Obdirea Calm' ORqnsewm SLi w* bhemipi Sa3M- 0 Ems* 0dw (MIAM): *See Lodgimg Tax Yearly Reporting DePmifiew; Iastructioae Nam afb&ndad Who AWared Reparc: Pb me*: E-mai] Address RETL'KK`+ THIS FOR -At TO: lef ierson County Admiuistratais office 1920 Jefferson Street P.O. Box 1220 Poet Townsend, WA 98369 jefibocci4vo jeer -son a.u> 13 Nmber tid A wdm Who Saved Orazqft a unpaid AccommodawasO al Pavyet* b) Acanacl* i7MM , * + Soo — a) Poajet tx1* b) At t g* ;) Pg* DE.ADUNEe Februans !9tit of Each Reporting Year Page 7 of 12 Forks Chamber of Commerce 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 Forks Chamber of Commerce EXHIBIT C 1 st QUARTER Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 1st QTR: Due by April 30th to afmcknight@cojeftrson.wa.us 2. LTAC funds spent by your organization 1st QTR (include 200 word limit regarding activities and funds spent with supporting documentation ie: reports outlining LTAC funds,): 3. LTAC funds balance remaining 11 QTR: 4. Please attach your organization's report for all revenue, marketing, services, programs and activities of the prior quarter. This report and any attachments may be subject to disclosure as a public record under the Public Records Act, RCW Chapter 42.56. A minimum of six years, you must maintain documented proof of payments made, contracts executed and other expenditures authorized under your Agreement with Jefferson County. Upon reasonable notice, you must be able to provide access to County or State representatives to audit those records. Page 9 of 12 Forks Chamber of Commerce EXHIBIT C 2na QUARTER Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 1st QTR: Due by July 315t to afmckni hg t@co.jefferspp.wams LTAC funds spent by your organization V QTR (include 200 word limit regarding activities and funds spent with supporting documentation ie: reports outlining LTAC funds,): 2. LTAC funds balance remaining V QTR: 3. Please attach your organization's report for all revenue, marketing, services, programs and activities of the prior quarter. This report and any attachments may be subject to disclosure as a public record under the Public Records Act, RCW Chapter 42.56. A minimum of six years, you must maintain documented proof of payments made, contracts executed and other expenditures authorized under your Agreement with Jefferson County. Upon reasonable notice, you must be able to provide access to County or State representatives to audit those records. Page 10 of 12 Forks Chamber of Commerce EXHIBIT C P QUARTER Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 111 QTR: Due by October 31s' to afmcknight@co.jeffgrson.wa.us 2. LTAC funds spent by your organization 11t QTR (include 200 word limit regarding activities and funds spent with supporting documentation ie: reports outlining LTAC funds,): 3. LTAC funds balance remaining 15L QTR: 4. Please attach your organization's report for all revenue, marketing, services, programs and activities of the prior quarter. This report and any attachments may be subject to disclosure as a public record under the Public Records Act, RCW Chapter 42.56. A minimum of six years, you must maintain documented proof of payments made, contracts executed and other expenditures authorized under your Agreement with Jefferson County. Upon reasonable notice, you must be able to provide access to County or State representatives to audit those records. Page 11 of 12 Forks Chamber of Commerce EXHIBIT C 4 h QUARTER Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 1st QTR: Due by January 31st to afmcknight co.jefferson wa us LTAC funds spent by your organization 11t QTR (include 200 word limit regarding activities and funds spent with supporting documentation ie: reports outlining LTAC funds,): 3. LTAC funds balance remaining 15t QTR: 4. Please attach your organization's report for all revenue, marketing, services, programs and activities of the prior quarter. This report and any attachments may be subject to disclosure as a public record under the Public Records Act, RCW Chapter 42.56. A minimum of six years, you must maintain documented proof of payments made, contracts executed and other expenditures authorized under your Agreement with Jefferson County. Upon reasonable notice, you must be able to provide access to County or State representatives to audit.those records. Page 12 of 12 Forks Chamber of Commerce Consent Agenda Commissioners Office JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners FROM: Adiel McKnight, Executive Assistant DATE: December 19, 2022 SUBJECT: AGREEMENT re: 2023 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of $60,390; Forks Chamber of Commerce STATEMENT OF ISSUE: This agreement provides grant funding for 2023 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 October 28, 2022 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 21, 2022. FISCAL IMPACT: Forks Chamber of Commerce $60,390 RECOMMENDATION: Approve and sign the agreement. REVIEWED BY: 2 /� Date CONTRACT REVIEW FORM clear Form J (MMUCH ONS ARE ON THE NEXT PAGE) CONTRACT WITH: Forks Chamber of Commerce Contract No: LTAC FCC Contract For: Lodging Tax Term: January through December 2023 COUNTY DEPARTMENT: County Administrator Contact Person: Adiei McKnight Contact Phone: xlin Contact email: atmdmight@oo.jefierson.wa.us AMOUNT: $60,390 Revenue: Expenditure: $60,390 Matching Funds Required: Sources(s) of Matching Funds Fund # 125 Munis Org/Obj 12555730/411106 APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES IT JCC 30.080 AND CHAPTER 42.23 RCW. CERTIFIED: C L E © N/A: -- -S gnature 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: ❑ N/A: Q-jw ignature Date STEP 3: RISK MANAGEMENT REVIEW (will be added elec nically through Laserfiche): PROCESS: Exempt from Bid Process Cooperative Purchase Competitive Sealed Bid Small Works Roster Vendor List Bid RFP or RFQ Other: Electronically approved by Risk Management on 12/14/2022. STEP 4: PROSECUTING ATTORNEY REVIEW (will be added electronically through Laserriche): Electronically approved as to form by PAO on 12/14/2022. 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 o& coNfS �4Soly December 19, 2022 Board of County Commissioners 1820 Jefferson Street PO Box 1220 Port Townsend, WA 98368 Kate Dean, District 1 Heidi Eisenhour, District 2 Greg Brotherton, District 3 Forks Chamber of Commerce Lissy Andros P.O. Box 1249 Forks, WA 98331 Dear Lissy Andros, Enclosed for signature are two (2) originals for AGREEMENT re: 2023 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of $60,390; Forks Chamber of Commerce 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 28t' 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. Cordially, Adiel McKnight Executive Assistant Phone (360) 385-9100 Fax (360) 385-9382 jeffbocc@co.jefferson.wa.us AC40 V CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YVYY) s/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. YA 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), AUTHORaff 2 9 2022 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the pol)cy(ies) must have ADDITIONAL INSURED provisions or bppp"tj'� COUNT If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statdtReg4OgpgSIONFRS this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: Kayla Furford Callis &Associates, Inc. a/c° No Ext ; (360) 452-2314 IAC Nr, : (360) 452-1701 E-MAIL ADDRESS: certificate@callisinsurance.com 802 East First Street, Suite 3 INSURER(S) AFFORDING COVERAGE NAIC N INSURERA: Sentinel Insurance Company. LTD Port Angeles WA 98362 INSURED INSURER B : Continental Divide Insuuance Company INSURER C : United States Liability Insurance Company Forks Chamber Of Commerce, Inc INSURER D : PO BOX 1249 INSURER E : INSURER F : Forks WA 98331 COVERAGES CERTIFICATE NUMBER: CL22122908674 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DID MMDD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 7 OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 A Y 52SBAAE0730 12/30/2022 12/30/2023 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOSHIRED Y 05APM015573-06 12/30/2022 12/30/2023 BODILY INJURY(Per accident) $ PROPERTY DAMAGE Per aaident $ NON -OWNED AUTOS ONLY AUTOS ONLY rx X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 C EXCESS LIAB CLAIMS -MADE CUP1564786B 12/28/2022 12/28/2023 DED I X RETENTION $ 101000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 52SBAAE0730 12/30/2022 12/30/2023 SPER OTH- I TXATUTE ER WA State Stop Gap E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space is required) Evidence Only. Refer to policy(s) for all applicable terms, conditions, endorsements and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Jefferson County ACCORDANCE WITH THE POLICY PROVISIONS. 615 Sheridan AUTHORIZED REPRESENTATIVE Port Townsend WA 98368 01988-2015 ACORD CORPORATION. All rights reserve ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD