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HomeMy WebLinkAboutQuilcene Fair and Parade $10,000 no ins - 102323 er;) 01' 1(1- ano AGREEMENT FOR 20 HOTEL-MOTEL FUNDING FOR TOURISM SERVICES QUILCENE FAIR& PARADE ASSOCIATION This Agreement is by and between JEFFERSON COUNTY(hereinafter known as "COUNTY" and the QUILCENE FAIR& PARADE ASSOCIATION(hereinafter known as "QUILCENE FAIR"). _ WHEREAS, the QUILCENE FAIR 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 the Quilcene Fair and Parade Association 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 QUILCENE FAIR shall use its capabilities and utilize the funding provided under this agreement to continue and update the ongoing performance of the following tourism promotion services, as outlined below: 1. QUILCENE FAIR shall use its capabilities and utilize up to $10,000 of funding provided under this agreement to promote the Quilcene Fair and Parade, restricted to any of the eligible items in the itemized list of proposed tourism promotion services, a copy of which is incorporated herein as Exhibit A, as may be reduced on a prorated basis to match the actual funding amount. SECTION 2: RESPONSIBILITIES OF THE QUILCENE FAIR: 1. On or before January 31; April 30;July 31; October 31, 2024; and January 31, 2025, provide to the COUNTY: see Exhibit C, attached hereto and incorporated; • A quarterly report of the use, services,programs and activities of the QUILCENE FAIR 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 2024. 2. On or before January 31, 2024,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 13 Quilcene Fair& Parade 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, 2025. 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 QUILCENE FAIR. b. The amount of lodging tax revenue allocated for expenditure(whether actually expended or not) by the QUILCENE FAIR 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 QUILCENE FAIR 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$10,00 for 2024. Payment is 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, 2024 and ending on December 31,2024, except for the reports referenced in Section 2, due January 31, 2025 and February 28, 2025. 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 QUILCENE FAIR 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 Page: 2 of 13 Quilcene Fair& Parade services rendered prior to the effective date of termination. If termination covers a period for which payment has already been made, QUILCENE FAIR 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 QUILCENE FAIR 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 QUILCENE FAIR's negligence or breach of an of its obligations under this Agreement; provided that nothing herein shall require QUILCENE FAIR 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)QUILCENE FAIR'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 QUILCENE FAIR's negligence, or the negligence of QUILCENE FAIR's agents or employees. QUILCENE FAIR specifically assumes potential liability for actions brought against the COUNTY by QUILCENE FAIR's employees, including all other persons engaged in the performance of any work or service required of QUILCENE FAIR under this Agreement and, solely for the purpose of this indemnification and defense, QUILCENE FAIR specifically waives any immunity under the state industrial insurance law,Title 51 RCW.QUILCENE FAIR 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 QUILCENE FAIR shall obtain and keep in force during the term of the Agreement,or as otherwise required, the following insurance: A. Commercial General Liability Insurance. QUILCENE FAIR 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). QUILCENE FAIR 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. Page: 3 of 13 Quilcene Fair& Parade SECTION 10: INDEPENDENT CONTRACTOR The QUILCENE FAIR and the COUNTY agree that the QUILCENE FAIR 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 QUILCENE FAIR nor any employee of the QUILCENE FAIR 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 QUILCENE FAIR, or any employee, representative, agent or contractor of the QUILCENE FAIR. The QUILCENE FAIR 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 QUILCENE FAIR 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 QUILCENE FAIR 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 QUILCENE FAIR 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 QUILCENE FAIR. SIGNATURES ON THE FOLLOWING PAGE Page: 4 of 13 Quilcene Fair & Parade APPROVED and signed this � `d y of 2023. JEFFE N COUNTY Attest: """��� eii,4, BOARD COMMISSIONERS 6 �'�� REF FERS,1'h. ,,,, , c ,, .....6,,,„,;;,....0.4, „ Carolyn Callaway. CMC m 4 j mo. g t on,Chair Clerk of the Board S p:, �e9), Approved as to Form: •,6,hsti�NG�O'. UILCENE FAIR& PARADE ASSOCIATION MIIII/NU���` C 10/18/2023 �hili C. Hunsucker. A o e icia " �Le l(12N < L____ 1' Chief Civil Deputy Prosecutor 1 1 Page: 5 of 13 Quilcene Fair& Parade EXHIBIT A Itemized List of Proposed Tourism Promotion Services 1. Itemized List of Proposed Tourism Promotion Services Organization (or Event) Name: Quilcane Fair& Parade, plus Car Show In the following space or on a separate sheet of paper, please specify each proposed tourism promotion, facility, event or activity, including quantities and costs (see examples at bottom of page). Tourism Promotion from Jan 2023 -Sept 2023 ■ 113,050 • Pnnt Advertising • S10,050 Mason, Chiltern & Jefferson County Publications • To include Tracing the Fjord, Jefferson County Farm Tour Brochure, Getaway Guide and Olympic Peninsula Visitors Guide • Facebook Advertising = $1,000 • Physical & Direct Advertising = $2,000 Banners I Posters/Signs in Jefferson, Kitaap, Mason & Clallam Counties Postcards and Letters to • Sponsors • Raffle Sponsors a Target Audience for Car Show Parade & Vendors Entertainment for Day of Event • $4,000 • Bands 1 Live Music • Performers for Kids & Car Snow Physical Items (Purchase & Rental) for Day of Event - $8,340 • Restroom& Handwashing Station Rental Good Man Sanitation $2,540 • Tent Rental for Kids Area The Production Alliance = $1 800 • Supplies (zip ties, trash bags pens tags/signs_ etc) = $500 Includes grass cutting of additional parking lots • Rodc Climbing Wall rental National Event PTOS. Seattle = $2,500 • Strart Up Foam Fun foam party rental, Port Angeles = $1,000 Kids Carnival $2,100 • Prizes& New Games • $1,500 • Que Lines &other day of supplies = 5600 Participants &Support for Day of Event = $6,300 • Vendors = $500 Gift bags Page 6 of 13 Quilcene Fair & Parade Day Of Supplies • Exhibit Hall = $1000 Pnzes Day of Supplies Print promotional materials • Parade = $300 Day of Supplies • Raffle = $300 Mailings and Day of Supplies • Sponsors $200 Mailings arid sponsor banner for day of • Car Show= $1,500 Prizes, trophies & dash plaques Day of Supplies Print Promotional rriatenals • 'Volunteers = $2,500 T-shirts for all Lunch. Drinks Day of Suppries Expenses to Support Event= $3020 • Insurance for Day of Event = $700 • Janitors Day Of = $600 • Website Hosting (annuailyi = $300 • Meeting Rental to Quilcene Community Center for Meetings = $420 • General Administrative costs throughout the year = $1000 - PO Box, Postage. SOS Annual Fees Chamber dues, supplies Page 7 of 13 Quilcene Fair & Parade 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 Organizations receiving finalinE to promote festival-,special event and tourism-related activiti through tourism-related facilities owned or sponsored by non-profit orgy trations or the local jurisdiction are required to complete this form for EACH activity. 1 Organization Nate: Reporting Year 2 Sponsor Type(Check One): 501 c;3) 0 501(c)(6) 0 J 1r41 Junsditnan °Other(EsPlam): 3 Activity Name 4 Activity Type(Check One): 0 Event Festival* 0 Foci itr` Ma:keting. i Activity Start Date*: 6 Activity End Date*: 7 Total Cost of Activity: S 8 Amount Requested: S 9 Amount Awarded: S 10 Overall Attendance' 13 Number of Attendees WIn Staved Overnight in Unpaid.Accommodations* a) Projected' a) Project* b) Actual* b) Actual* c) Methodology(Check One): °Direct Cant" c) Methodology(Check One): Iq`i Direct COME" Chtdirect Cowen* f Representative Survey' °ndirect Count* ()Representative Sun'ey' °Informal Survey' C)Stntcnured Estimate* 0 Iformal Survey* 0 Stormed F;rmare' C)0ther(enPlain): ClOthff(esPlain): 11 Number of Attendees Who Traveled 50 Miles or More* 14 Number of Attendees Who Stayed Ove hr in Paid Accommodations* a) Projected' a) Projected* b) Actual* b) Actual* c) Methodology(Check One): 0 Direct Coma' c) Methodoloev(Check One): 0 Direct Coimr• aIndirect Count' 0 Representative Survey' 0 Indirect Count* Representative Survey 0 Informal Survey* 0 Snuct red Estimate* 0 Informal Snrey" 0 Structured Estimate* Ot1ter(explain): 0 Other;explain): 12 Number of Attendees Who Traveled from AnotherState or Country' 15 Number of Paid J Mgjn'Nights• a) Projected* a) Projected* b) Actual* b) Actual* c) Methodology(Check One): �, 0 Direct Count* c) Methodology(Check One): 0 Dired Count' 0 Indirect Cams' OReprese reatire Survey* 0 Indirect Count* ORepresentariw Survey' 8 Informal Srvey' 0 Structured Estimate* Infexmal Survey* Structured Estimate Other(explain): i Other(explain): *See Lodging Tax Yearly Reporting Definitions'Instrucnons Name of Individual 8L'ho Prepared Report Phone Or. E-Mail Address RETURN THIS FORM TO: Jefferson County Administrator's Office 1820 Jefferson Street P.O.Boar 1220 Port Townsend,WA 98368 jeflbocc a co_jefferon.wa.us DEADLINE:February 28th of Each Reporting Year Page 8 of 13 Quilcene Fair & Parade 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 9 of 13 Quilcene Fair& Parade EXHIBIT C 1st QUARTER Due by April 30th to afmcknight@ico.jefferson.wa.us Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 1st QTR: ORGANIZATION Amount Received Overspent Refund TOTAL Ut Awarded From (+) Required QTR by JeffCo JeffCo Underspent LTAC (-)of LTAC FUNDS funds SPENT 2. LTAC funds spent by your organization 15t QTR (include 200 word limit regarding activities and funds spent with an itemized statement and supporting documentation ie: invoices paid, receipts from payment,): 3. LTAC funds balance remaining 1st 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 10 of 13 Quilcene Fair & Parade EXHIBIT C 2nd QUARTER Due by July 31st to afmcknight@co.jefferson.wa.us Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 2nd QTR: ORGANIZATION Total Total Overspent Refund TOTAL TOTAL 2"d Amount Received (+) Required I'QTR QTR Awarded From Underspent LTAC LTAC by JeffCo JeffCo (-)of LTAC FUNDS FUNDS funds SPENT SPENT 2. LTAC funds spent by your organization 2"d QTR (include 200 word limit regarding activities and funds spent with an itemized statement and supporting documentation ie: invoices paid, receipts from payment,): 1. LTAC funds balance remaining 2"d QTR: 2. 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 13 Quilcene Fair & Parade EXHIBIT C 3rd QUARTER Due by October 31st to afmcknightPco.jefferson.wa.us Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 3rd QTR: ORGANIZATION Total Total Overspent Refund TOTAL TOTAL 2nd TOTAL Amount Received (+) Required 1st QTR QTR 3rd QTR Awarded From Underspent LTAC LTAC LTAC by JeffCo JeffCo (-)of LTAC FUNDS FUNDS FUNDS funds SPENT SPENT SPENT 2. LTAC funds spent by your organization 3rd QTR(include 200 word limit regarding activities and funds spent with an itemized statement and supporting documentation ie: invoices paid, receipts from payment,): 2. LTAC funds balance remaining 3rd 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 12 of 13 Quilcene Fair & Parade EXHIBIT C 4th QUARTER Due by January 31St to afmcknight@co.jefferson.wa.us Organization: Contact person: Mailing Address: Phone Number/Email: 1. LTAC Funds received from the County 4th QTR: ORGANIZATION Total Total Overspent Refund TOTAL TOTAL TOTAL TOTAL Amount Received (+) Required 1'QTR 2"d QTR 3rd QTR 4th QTR Awarded From Underspent LTAC LTAC LTAC LTAC by JeffCo From (-)of LTAC FUNDS FUNDS FUNDS FUNDS JeffCo funds SPENT SPENT SPENT SPENT 2. LTAC funds spent by your organization 4th QTR (include 200 word limit regarding activities and funds spent with an itemized statement and supporting documentation ie: invoices paid, receipts from payment,): 3. LTAC funds balance remaining 4th 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 13 of 13 Quilcene Fair& Parade \I /0/ Quilcene Fair & Parade Association r fT PO Box 761 Quilcene, WA 98376/QuilceneFair.Org/quilcenefair@gmail.com Members of the Board November 13th, 2023 Bill Stephens President Jefferson County Commissioner's Office Kristin Deverin Attn: Adiel McKnight Vice President PO Box 1220 Linda Lindquist Port Townsend, WA 98368 Secretary Shonna Wilkerson Hello Adiel - Treasurer Please find the enclosed: • 2024 Signed LTAC Agreement • Invoice for 2024 Amount • Copy of 2023 Insurance Policy o please note we will obtain a new policy a few months before the 2024 event and I will be sure to email that to you Thank you for all your continued assistance! And please pass along our appreciation to the Lodging Tax Advisory Committee and the Board of County Commissioners. Cordially, Vika C honna Wilkerson Treasurer 360-990-3665 A ® CERTIFICATE OF LIABILITY INSURANCE DATE( 023m 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 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 CONTANAME: Maggie Maggie Merritt Homer Smith Insurance, Inc. PHONE E-MAIL maggOe a�homersmith com FAX PO Box 591 Port Townsend,WA 98368 (AID,ESS:Est): 38511 t ,No ,_ INSURER()AFFORDING COVERAGE _ NAIC# INSURER A: Scottsdale Insurance Company INSURED INSURER 8: Quilcene Fair& Parade Association INSURER C: PO Box 761 Quilcene,WA 98376 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 INSRA SUBRWVD POLICY NUMBER (M POUCYD(YYYY) (M POLICY EXP iY) LIMITS LTR GENERAL LIABILITY X CPS7846536 9/16/2023 9/17/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREMISES(EaENTED occurrence) $ 100,000 Al CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 I GENERAL AGGREGATE $ 2,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 j X POLICY PRO- i JECT I LOC $ AUTOMOBILE LIABILITY CO BINEDaccidentSINGLE LIMITI (Ea $ I ANY AUTO BODILY INJURY(Per person) $ I ALL OWNED — SCHEDULED — AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) I $ — UMBRELLA LIAB __ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE {___r AGGREGATE $ _ _— DED 1 {RETENTION$ $ 1 WORKERS COMPENSATION WC STATU- OTH- i AND EMPLOYERS'LIABILITY TORY LIMITS ER i ANY PROPRIETOR/PARTNERJEXECUTIVE Y N OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 1(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under — I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Certificate holder is listed as an additional insured. CERTIFICATE HOLDER CANCELLATION Washington Department of Transportation, Dana Brewer- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Traffic Operations MS 47344, 310 Maple Park Ave SE, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 47344, Olympia WA 98504-7344 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE OW, ‘,1424"44""""""'"' i ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Consent Agenda Commissioners Office JEFFERSON COUNTY BOARD OF COUNTY COMMISSIONERS AGENDA REQUEST TO: Board of County Commissioners FROM: Adiel McKnight,Executive Assistant DATE: Qeh kr 23 , 2023 SUBJECT: AGREEMENT re: 2024 Hotel Motel (Lodging Tax) Grant Funding; In the Amount of$10,000; Quilcene Fair and Parade STATEMENT OF ISSUE: This agreement provides grant funding for 2024 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 September 19, 2023 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 October 2, 2023. FISCAL IMPACT: Quilcene Fair and Parade $10,000 RECOMMENDATION: Approve and sign the agreement. REVIEWED BY: -li 1 , Vt.g....-Z---> ------ Mark McCaul County Administrator çDate: 1 CONTRACT REVIEW FORM Clear Form (INSTRUCTIONS ARE ON THE NEXT PAGE) CONTRACT WITH: Quilcene Fair and Parade Associaton Contract No: LTAC QF&P Contract For: Quilcene Fair and Parade l erm: 2024 COUNTY DEPARTMENT: County Administrator Contact Person: Adiel McKnight Contact Phone: 102 Contact email: afmcknight@co.jefferson.wa.us AMOUNT: $10,000 PROCESS: Exempt from Bid Process Revenue: _ Cooperative Purchase Expenditure: $10,000 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 12555730/411111 ✓ Other: APPROVAL STEPS: STEP 1: DEPARTMENT CERTIFIES COM I NC H JC 5. AND CHAPTER 42.23 RCW. CERTIFIED: El N/A: /6/✓? - Sign re Date STEP 2: DEPARTMENT CERTIFIES T PERS OPOSED FOR CONTRACTING WITH THE COUNTY (CONTRACTOR) HAS NOT EN D D ANY EDERAL, STATE, OR LOCAL AGENCY. CERTIFIED: ❑ N/A: a 7 • /Q, f 3•�3 Sign ure Date STEP 3: RISK MANAGEMENT REVIEW(will be added electronica through Laserfiche): Electronically approved by Risk Management on 10/17/2023. STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche): Electronically approved as to form by PAO on 10/18/2023. County standard LTAC grant language. 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