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HomeMy WebLinkAbout03/07/2012 AGENDA I • _J CITY COUNCIL 345 6th Street, Suite 600, Bremerton, WA 98337 ❑ Phone (360) 473 -5280 MARCH 7, 2012 Iff - CITY COUNCIL MEETING AGENDA 1 BRIEFING 5 00 — 5 30 P M in COUNCIL CONFERENCE ROOM 603 A General Council Business 2 CALL TO ORDER 5 30 P M in FIRST FLOOR CHAMBERS A Pledge of Allegiance B Invocation 3 MAYOR'S REPORT 4 PUBLIC RECOGNITION 5 CONSENT AGENDA A Claims & Check Register B Minutes of Meeting — February 15, 2012 C Minutes of Study Session — February 22, 2012 D Minutes of Special Meeting — February 28, 2012 E Minutes of Special Meeting — February 29, 2012 F KPS Rates and Underwriting Criteria G Installation of Service Beds on City Trucks purchased in 2011 H Purchase of 2 Chevrolet Caprice Police Pursuit Vehicles I Application to WSDOT for Safe Routes to Schools Grant Funding J Appointment of Harriette Bryant to the Bremerton Housing Authority Board of Commissioners K Appointment of Anita Albright to the Bremerton Planning Commission 6 GENERAL BUSINESS — There are no General Business items tonight 7 PUBLIC HEARINGS A Public Hearing and Release of Storm Water Easement for Bremerton Housing Authority B Public Hearing and Ordinance No 5180 to vacate Broadway Avenue from 13 to 16 Streets 8 COUNCIL MEMBER REPORTS 9 ADJOURNMENT OF CITY COUNCIL BUSINESS MEETING ® Americans with Disabilities Act (ADA) accommodations provided upon request Those requiring special accommodations please contact the City Clerk at (360) 473 -5323 by noon on the day preceding the Meeting CITY COUNCIL MEETING SPEAKERS LIST PLEASE PRINT YOUR NAME BELOW IF YOU PLAN TO SPEAK DURING THE COUNCIL MEETING TONIGHT 0 h pi [4,67 GiM1 l ea57 ;7 �r — CITY COUNCIL 345 6"' Street, Suite 600, Bremerton, WA 98337 0 Phone (360) 473 -5280 PRESS RELEASE Notice Issued March 5, 2012 Council Member Greg Wheeler has received a Certificate of Municipal Leadership (CML) from the Association of Washington Cities (AWC) Council Member Wheeler completed over 30 hours of training credits to earn this distinction The CML Program is designed to enhance the ability of elected officials by providing knowledge and skills to effectively operate within the law, plan for the future, secure and manage funds, and foster community and staff relationships Greg Wheeler represents Bremerton City Council District 5 which includes neighborhoods near downtown and Evergreen Park, as well as the area near Harrison Medical Center District 5 also shares boundaries with Districts 1 and 2 south of Sheridan Road near the Warren Avenue Bridge Greg was elected in 2010 to his first term and will serve through 2013 Currently, Greg is Council Vice - President, Chair of the Planning Committee, serves on the Public Works Committee, and is also part of the Cen -Corn Policy Board and Emergency Management Council He has also been recently reappointed to the Kitsap Community Resources Board of Directors Greg is also a representative for the City of Bremerton on the Kitsap Regional Coordinating Council (KRCC) Executive Board and Puget Sound Regional Council (PSRC) Growth Management Policy Board Greg is currently a member of the Bremerton Kiwarns and Bremerton Rotary clubs, and also serves on the Salvation Army Advisory Board as well as the Olympic College Organizational Leadership and Resource Management Advisory Committee A WC is a pnvate, non - profit, non-partisan corporation that represents Washington's cities and towns before the state legislature, the state executive branch, and with regulatory agencies Membership is voluntary, however, AWC maintains 100% participation form Washington's 281 cities and towns The goal of AWC is to create and maintain livable cities and towns throughout the state AWC Certificate of Municipal Leadership � The Association of Washington Cities recognizes the certification of Gr Wheeler Councilmember City o (Bremerton _ � for the successful completion of a AWC's Certificate of Municipal Leadership training program. v Presented on 10/20/2011 ` Nancy McLaughlin, AWC President a AGENDA BILL CITY OF BREMERTON CITY COUNCIL ......................................................... ............................... SUBJECT: Claims & Check Register Study Session Date COUNCIL MEETING Date March 7, 2012 Department Financial Services Presenter Cathy Johnson Phone 473 -5296 SUMMARY: Consent Agenda item Approval of checks and electronic fund transfers ATTACHMENTS: FISCAL IMPACTS (Include Budgeted Amount) APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: 1) Check #'s 347265 through 347534 and EFT's 11660 through 11700 in the amount of $2,011,369 56 2) Regular Payroll for the pay period ending February 15, 2012 in the amount of $718,281 38 3) Regular Payroll for the pay period ending February 29, 2012 in the amount of $689,776 80 4) Retiree Payroll for the pay period ending February 29, 2012 in the amount of $73,679 96 STUDY SESSION ACTION: ® Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT COUNCIL ACTION: [] Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 1/4/12 AGENDA BILL CITY OF BREMERTON CITY COUNCIL tse ■ eeeeeeeeaeeeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeee eeesee SUBJECT: City Council Minutes for COUNCIL MEETING Date. Marck 7, as ( - 3- Department City Council Presenter. Jim McDonald Council President Phone (360) 473 -5280 SUMMARY: Attached is a summary of the City Council Meeting ATTACHMENTS: Meeting Minutes FISCAL IMPACTS (Include Budgeted Amount) N/A APPROVALS: N/A RECOMMENDED MOTION: Move to approve the Consent Agenda as presented STUDY SESSION ACTION: ❑ Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT C 7 COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4/18/2011 DIGITAL RECORDING CITY COUNCIL MEETING MINUTES Wednesday, February 15, 2012 The weekly meeting of the City Council of the City of Bremerton was called to order Wednesday, February 15, 2012, at 5 00 PM in Council Conference Room 603 of the NORM DICKS GOVERNMENT CENTER, 345 6` Street, Bremerton, Washington, with Council President Jim McDonald presiding Council Members present were Nick Wofford, Eric Younger, Carol Arends, Faye Flemister, Greg Wheeler, Roy Runyon, Adam Brockus, and Leslie Daugs Also present were City Attorney Roger Lubovich, Interim City Clerk Shannon Conn, and Council Assistant Christine Grenier A COUNCIL BRIEFING was held to discuss General Council Business at 5 00 PM in the Council Conference Room At 5 30 PM the meeting moved to the Meeting Chambers The Pledge of Allegiance was led by Council Member Leslie Daugs followed by the invocation provided by Reverend David Malcom. Jr. of Ebenezer African Methodist Episcopal Church MAYOR'S REPORT Mayor Patty Lent • Proclaimed the Year 2012 as `International Year of the Cooperatives ", and the proclamation was received by Lorna Moynihan of Kitsap Community Co -Op, • Proclaimed March 2012 as `Brain Injury Awareness Month ", and the proclamation was received by Suzanne Griffin • Introduced Lieutenant Pete Fisher who reported on the ongoing Police investigation and encouraged anyone who may recognize the person of interest from the police sketch, to call the Police Hotline at (360) 473 -5481 immediately, • Encouraged residents to report light outages by calling the Public Works Hotline at (360) 473- 5920, and • Announced that there will be a Neighborhood Summit on Friday, March 5 in the Meeting Chambers President McDonald announced that the Executive Session has been moved from the Pre - Council Briefing to the end of the meeting PUBLIC RECOGNITION Robert Seibert announced the Kitsap Youth Expo on April 21st at the Kitsap County Fairgrounds, and for more information, please visit www kitsapyouthexpo com Gary Butterfield hoped the City would make streets and public safety the primary goals, expressed concerns about the vehicle tab fee being raised during a recession, and suggested that the City un- incorporate to eliminate bureaucracy Jim McDonald thanked his wife Judy and mother Dorothy McDonald for attending the meeting tonight CONSENT AGENDA 5A Check Numbers 347004 through 347264, and EFT -11615 through EFT -11659 in the amount of $2,464,915 64, and Regular Payroll for the pay period ending January 31, 2012 in the amount of $742,117 96 513 Minutes of Meeting — February 1, 2012 5C Minutes of Study Session — February 8, 2012 5D Extension of Inter -Local Agreement with Kitsap County Administrative Services for Court Security Services 5E Approve Conflict Waiver for the Bremerton Transportation Benefit District to utilize the City Attorney's Office for legal representation There were no comments from the public City Council Reg Mtg Minutes Wednesday, February 15, 2012 Page 2 of 3 05:54:08 M /S /C /U (Flemister/Wofford) Move to approve the CONSENT AGENDA as presented GENERAL BUSINESS 6A — ORDINANCE NO. 5179 TO ADOPT THE PROPOSAL TO MODIFY THE CITY COUNCIL DISTRICT BOUNDARIES FOR THE CITY OF BREMERTON FROM 9 TO 7 Bill Eley IT Manager, explained that each decade, the U S Government conducts a census of the nation's population Following the census, City district boundaries are changed to reflect the current population with a view to provide the public, as far as possible, with equal City Council representation Also at the November 2011 election, the citizens of Bremerton approved a charter change reducing the City's districts from nine to seven A public hearing was held on February 1, 2012 and the action before City Council is formal adoption of the ordinance setting the seven (7) district boundaries The new district boundaries information and maps are available on the City's website If the public has objections to the new boundaries, they have a 45 -day appeal process through Kitsap Superior Court Roger Lubovich City Attorney, clarified that the boundaries are set by current census data and any additional residents or Navy personnel who reside in a particular census block would be considered part of that Council District Becky Hasart Financial Services Director, emphasized that census blocks do not change and any changes in the Navy resident population would not be reflected until the next census There were no comments from the public 05:56:45 Motion was made by Wheeler, and seconded by Runyon, Comments and questions were then provided by Brockus, Runyon, Arends, and Daugs 06:01:54 M /S /C /U (Wheeler /Runyon) Move to approve Ordinance No 5179 adopting new City Council District boundaries for seven City Council Districts for the City of Bremerton based on the year 2010 census, and repealing Ordinance No 5162 relating to City Council Districts 613 — INTER -LOCAL AGREEMENT BETWEEN THE BREMERTON TRANSPORTATION BENEFIT DISTRICT (TBD) AND THE CITY OF BREMERTON TO PROVIDE STREET PRESERVATION AND MAINTENANCE SERVICES TO THE CITY ON BEHALF OF THE TBD Roger Lubovich City Attorney, explained that the City of Bremerton created a Transportation Benefit District (TBD) in February 2009 to address the fiscal needs of performing street preservation and maintenance activities within Bremerton City limits On December 7, 2011, the TBD enacted a $20 vehicle fee for this purpose Because the TBD is an independent agency separate from the City, an Interlocal Agreement is needed in order for the City to perform street related projects on behalf of the TBD There were no comments from the public 06:06 Motion was made by Runyon, and seconded by Brockus, Comments and questions were then provided by Runyon 06 M /S /C /U (Runyon / Brockus) Move to approve the Interlocal Agreement between the City of Bremerton and the Bremerton Transportation Benefit District, and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented COUNCIL MEMBER REPORTS Carol Arends explained that her constituents are concerned about safety, traffic, and parking issues, and have been meeting monthly to find ways to help City Council Reg Mtg Minutes Wednesday, February 15, 2012 Page 3of3 Faye Flemister announced that she and Council Member Arends will be hosting a Combined District 6 and 7 Neighborhood Meeting on Friday, February 24 beginning at 6 00 PM at Bremerton High School to present the "New Council District Boundaries ", and representatives from the Police Department will be available to answer questions and provide a "Public Safety Update ", encouraged people to attend the Salad Bowl Sunday event on February 26 beginning at 4 00 PM in the Presidents Hall at the Kitsap Sun Pavilion at the Kitsap County Fairgrounds, looked forward to attending a Black History Celebration on Friday, February 17 from 8 30 to 10 30 AM at Bremerton High School, and she will be hosting a Block Watch Meeting on February 29 at 7 00 PM at her residence located at 1931 Snyder Avenue Greg Wheeler encouraged the community to attend a District 5 and 6 Neighborhood Meeting on Thursday, February 23 from 6 30 to 8 00 PM in the basement of Community of Christ at Memorial Lutheran Church located at the corner of 10 Street & Veneta Avenue for a discussion on "Public Safety" with representatives from the Bremerton Police Department, and reported on his attendance at today's Ribbon Cutting Ceremony for Sally's Camp Homeless Shelter Roy Runyon announced that the next District 4 Community Meeting would be held on Monday, February 27 from 6 30 to 8 00 PM in the Meeting Chambers where the program will include the "Crosstown Pipeline Project" with Ned Lever, Engineering and "Public Safety Update" with Community Resource Officer Andy Oakley Adam Brockus announced that the next District 3 Community Meeting would be held on Tuesday, February 21 from 7 00 to 8 00 PM at the Bremerton Senior Center, and the program will include an update on "Public Works Projects for Manette "by Tom Knuckey, of the City's Public Works and Utilities Department, and members of the Police Department will be responding to concerns and providing a "Public Safety Update" Leslie Daugs announced that the next District 2 Community Meeting would be held on Tuesday, February 21 from 5 30 to 7 00 PM at View Ridge Elementary School located at 3520 Spruce Avenue The program will include presentations on "Council District Boundaries ", "Water - Wastewater- Stormwater Rates ", and Vehicle Tab Fees, and encouraged people to look out for your neighbors and stay safe Jim McDonald attended a Home Dedication Ceremony recently with Habitat for Humanity, and that the public was welcome to attend a TBD Special Meeting in the Meeting Chambers immediately following the Council Meeting tonight Council recessed from 6 17 to 6 45 PM for a 25 -Minute Executive Session to discuss "Potential and Pending Litigation" per RCW 42 30 110(1)(t) No action was taken With no further business, President McDonald adjourned the Council Meeting at 6 46 PM Prep r d and Submitted by CHRISTINE GRENIER Council Assistant Attest SHANNON CORK Interim City Clerk JIM McDONALD, City Council President JMSCIscg AGENDA BILL CITY OF BREMERTON CITY COUNCIL sco ■■ e � eeeeoeeee eeeeeeeeeeeeeeeeeeeeeeeeeeeee�e�eeeseeeeeeeeaee�eeeeeee�eeeeeeeeeeseeese�� e SUBJECT: City Council Minutes for COUNCIL MEETING Date MW-c k 7, 20 I 5+t,k j / Se_SSio n Department City Council I Presenter Jim McDonald Council President Phone (360) 473 -5280 SUMMARY: Attached is a summary of the City Council Meeting ATTACHMENTS: Meeting Minutes FISCAL IMPACTS (Include Budgeted Amount) N/A APPROVALS: N/A RECOMMENDED MOTION: Move to approve the Consent Agenda as presented STUDY SESSION ACTION: ❑ Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDEN COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4118/2011 DIGITAL RECORDING CITY COUNCIL STUDY SESSION MINUTES February 22, 2012 A Study Session of the City Council of the City of Bremerton was called to order in the City Council Conference Room 603, of the NORM DICKS GOVERNMENT CENTER, 345 6' Street, Bremerton, Washington, Wednesday, February 22, 2012, at 5 00 PM, with Council President Jim McDonald presiding Council Members present were Nick Wofford, Eric Younger, Carol Arends, Faye Flemister, Greg Wheeler, Roy Runyon, Adam Brockus, and Leslie Daugs Lori Smith, Legislative Assistant was present to provide staff support President McDonald emphasized that the Study Session was open to the public, however there would be no opportunities for input or participation, that no action will be taken, and the content of these items is subject to change The following items are budgeted items or have been reviewed by the appropriate Council Committee, and will be placed on the March 7, 2012 Council Meeting Agenda unless otherwise stated A NO PRESENTATION PROVIDED - The following items are budgeted items or have been reviewed by the appropriate Council Committee Only brief questions were asked and /or comments made 1 2012 KPS Rates and Underwriting Criteria — Becky Hasart, Finance Director, and Nick Wofford, Finance Committee Chair Consent Agenda 2 Installation of Service Beds on City Trucks purchased in 2011 — Jim Orton, Public Works Operations Manager, and Carol Arends, Public Works Committee Chair Consent Agenda 3 Purchase of 2 Chevrolet Caprice Police Pursuit Vehicles — Jim Orton, Public Works Operations Manager, and Carol Arends, Public Works Committee Chair Consent Agenda 4 Application to WSDOT for Safe Routes to Schools Grant Funding (Zero Match) — Tom Knuckey, Public Works & Utilities, and Carol Arends, Public Works Committee Chair Consent Agenda 5 Proposed public hearing and Release of Storm Water Easement for Bremerton Housing Authority — Gunnar Fridriksson, Public Works & Utilities, and Carol Arends, Public Works Committee Chair Public Hearing 6 Appointment of Harriette Bryant to the Bremerton Housing Authority Board of Commissioners — Mayor Patty Lent Consent Agenda B FULL DISCUSSION ITEMS 7 Proposed public hearing and ordinance to vacate Broadway Avenue from 13 to 16 Streets — Gunnar Fridriksson, Public Works & Utilities, and Carol Arends, Public Works Committee Chair Public Hearing C GENERAL COUNCIL BUSINESS Council Reports, and General Business President McDonald called a brief recess from 6 07 to 6 15 PM D EXECTIVE SESSION 6 15 to 6 35 PM 20- Minutes to provide an update on "Potential Litigation" per RCW 42 30 110(1)(i) No action City Council Study Session Minutes Wednesday, February 22, 2012 Page 2 of 2 President McDonald announced that the Council would be meeting with the Port of Bremerton Commissioners on Tuesday, February 28, 2012, and that a 5 Wednesday Study Session would be held in the Council Conference Room on February 29, 2012 With no further business, the Council Study Session was adjourned at 6 35 PM Prepared and Submitted by �w r LORI SMITH Legislative Assistant Attest SHANNON CORK Interim City Clerk JIM McDONALD, City Council President JMSCIscg AGENDA BILL CITY OF BREMERTON CITY COUNCIL N5 1) SUBJECT: City Council Minutes for COUNCIL MEETING Date. AAO-rC 7, ' 1 2 s Pte^ a1 Me e'6 n Department City Council Presenter Jim McDonald Pori o �- Z� VhE'r X1l Council President rk �� arY 2,9 .2-01 )— Phone (360) 473 -5280 SUMMARY: Attached is a summary of the City Council Meeting ATTACHMENTS: Meeting Minutes FISCAL IMPACTS (Include Budgeted Amount) N/A APPROVALS: N/A RECOMMENDED MOTION: Move to approve the Consent Agenda as presented STUDY SESSION ACTION: ❑ Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT: COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4118/2011 DIGITAL RECORDING CITY COUNCIL SPECIAL MEETING MINUTES February 28, 2012 A Special Meeting of the City Council of the City of Bremerton was called to order in the Bill Mahan Conference Room at the Bremerton Port Administration Offices in the terminal building at the Bremerton National Airport located at 8850 SW State Highway 3, Bremerton, Washington, Tuesday, February 28, 2012, at 4 50 PM, with Council President Jim McDonald presiding Council Members present were Eric Younger, Faye Flemister, Greg Wheeler, Roy Runyon, and Leslie Daugs Council Members Adam Brockus, Carol Arends, and Nick Wofford were absent President McDonald emphasized this was a Joint Meeting with Port of Bremerton Commissioners Roger Zabinski, Larry Stokes, and Axel Strakeljahn, that the meeting was open to the public, however there would be no opportunities for input or participation, and that no action will be taken The following items were discussed 1 Status and potential for Airport expansion 2 SKIA update 3 Washington State Department of Corrections proposed site /planning 4 Industrial activity at the Port and expansion plans /progress 5 Bremerton Marina & downtown property 6 Kitsap Harbor Festival update With no further business, the Council Study Session was adjourned at 6 00 PM Prepared and Submitted by LORI SMITH Legislative Assistant Attest SHANNON CORK Interim City Clerk JIM McDONALD, City Council President JMSCIscg AGENDA BILL CITY OF BREMERTON CITY COUNCIL . ........................................................ ............................... SUBJECT: City Council Minutes for COUNCIL MEETING Date March 7 , 20 1 2 S e l M C „ „� � V1 Department City Council z Presenter: Jim McDonald (5 , Weal vie ,S da - �vd SeS.51 o h � Council President ) Phone. (360) 473 -5280 "f -6ruzcry 2Q, 2 .o 12 SUMMARY: Attached is a summary of the City Council Meeting ATTACHMENTS: Meeting Minutes FISCAL IMPACTS (Include Budgeted Amount) N/A APPROVALS: N/A RECOMMENDED MOTION: Move to approve the Consent Agenda as presented STUDY SESSION ACTION: ❑ Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT- L` 7 COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4/18/2011 DIGITAL RECORDING CITY COUNCIL SPECIAL MEETING MINUTES February 29, 2012 A Special Meeting of the City Council of the City of Bremerton was called to order in the City Council Conference Room 603, of the NORM DICKS GOVERNMENT CENTER, 345 6 th Street, Bremerton, Washington, Wednesday, February 29, 2012, at 5 00 PM, with Council President Jim McDonald presiding Council Members present were Eric Younger, Carol Arends, Greg Wheeler, Roy Runyon, and Leslie Daugs Council Members Adam Brockus, Faye Flemister, and Nick Wofford were absent Lori Smith, Legislative Assistant was present to provide staff support President McDonald emphasized that the Study Session was open to the public, however there would be no opportunities for input or participation, that no action will be taken, and the content of these items is subject to change A MUNICIPAL BUDGETING 101 — Presentation was provided by Becky Hasart, Financial Services Director (Education and Information Only) No Action B GENERAL COUNCIL BUSINESS — Council Reports were provided, and General Business was discussed With no further business, the Council Study Session was adjourned at 7 10 PM Prepared and Submitted by LORI SMITH Legislative Assistant Attest SHANNON CORK Interim City Clerk JIM McDONALD, City Council President JMSCIscg AGENDA BILL CITY OF BREMERTON CITY COUNCIL SUBJECT: 2012 KPS Rates & Underwriting Study Session Date February 22, 2012 Criteria COUNCIL MEETING Date March 7, 2012 Department Finance Presenter Becky Hasart Phone 473 -5722 SUMMARY: Approval of KPS 2012 Rates and Underwriting Criteria and authorization of formal execution of the 2012 contracts between the City and KPS Health Plans for employee group health insurance coverage by the Mayor The new rates,which were negotiated on our behalf by our benefits consultants, Willis of Seattle, reflect an 5% rate increase above 2011 levels ATTACHMENTS: KPS 2012 Premium Rates & Underwriting Criteria FISCAL IMPACTS (Include Budgeted Amount) The 2012 Budget has adequate budgeted funds in personnel benefits for this rate increase APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: 1 move to approve the 2012 KPS Premium rates and Underwriting Criteria between the City and KPS, and authorize the Mayor to finalize and execute the contracts with substantially the same terms and conditions as presented STUDY SESSION ACTION: CLsent Agenda ❑ General usiness ❑ Public Hearing COUNCIL PRESIDENT COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 City of Bremerton January 1, 2012 Renewal Total Cost Outline PLAN A Active Current Renewal Negotiated Renewal LEOFF I Employees $84809 $91127 $89049 LEOFF Il & non - LEOFF Employees $61582 $661 70 $64661 Spouse $68265 $73351 $71678 1 st Child $30829 $33126 $32370 2nd Child+ $24813 $26662 $26054 LEOFF I Retirees (Under Age 65) Current Renewal Negotiated Renewal Subscriber $2,21932 $2,38466 $2,33029 Spouse $1,21581 $1,30639 $1,27660 1 st Child $30332 $32592 $31849 2nd Child+ $24242 $26048 $25454 PLAN B Active Current Renewal Negotiated Renewal LEOFF lI & non - LEOFF Employees $53250 $572 17 $55913 Spouse $59650 $64094 $62633 1 st Child $27137 $291 59 $28494 2nd Child+ $211 15 $22688 $221 71 LEOFF I Retirees (Under Age 65) Current Renewal Negotiated Renewal Subscriber N/A N/A N/A Spouse $1,00980 $1,08503 $1,06029 1 st Child $25666 $27578 $26949 2nd Child+ $20753 $22299 $21791 Renewal Adjustment: 7.45% 5.00% Assumes renewal as a grandfathered plan Prepared by ' fJ WIIS KPS Health Plans 400 Warren Avenue ` P O Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON — PLAN A COVERAGE CONTRACT Group Number: Active 21001, 21002, 21004, 21005 COBRA 21015 Effective Date: January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria KPS Health Plans (KPS) is a licensed health care services contractor (HCSC) in Washington State In its capacity as an HCSC, KPS agrees to underwrite and provide the benefits and services described in any Benefits Booklet that may be listed above (hereinafter collectively referred to as "Attachment A "), as applicable to the eligible Employees and their Eligible Dependents of the above -named Group, provided the Group, its eligible Employees, and their Eligible Dependents meet and comply with the provisions of this Coverage Contract ( "Contract") C12BREMA TABLE OF CONTENTS f DEFINITIONS 1 CONTRACT EXAMINATION PERIOD 3 EFFECTIVE DATE, DURATION, AND RENEWAL 3 PREMIUM PAYMENT PROVISIONS 3 Payment Due Date /Grace Period 3 Premium Rate Adjustments 3 Premiums Paid by Subscribers /Dependents 4 Premium Refunds 4 ELIGIBILITY AND ENROLLMENT 4 Group Eligibility 4 Subscriber /Dependent Eligibility Requirements 4 Eligibility of Newborn and Adopted Child(ren) 4 Court- ordered Coverage for Eligible Dependent Children) 5 Enrollment Reporting Requirements 5 Enrollment Timeframes 5 When Coverage Begins 5 Coverage Waiting Periods g TERMINATION OF COVERAGE 7 Continuity of Coverage 7 Termination or Rescission of Contract 7 Termination or Rescission of Enrollee Coverage 7 COBRA (Consolidated Omnibus Budget Reconciliation Act - 1985) 8 Fraudulent Information 8 Re-Enrollment/Reinstatement 8 SUBSCRIBER /DEPENDENT LIABILITY AND RIGHTS 9 Subscriber /Dependent Liability 9 GENERAL TERMS AND CONDITIONS 9 Applicable Law 9 Assignment of Benefits 9 Binding Agreement 9 Confidentiality 9 Contract Modifications 10 Coverage Limits 10 Entire Agreement 10 Equity of Application 10 Force Majeure 10 Group Cooperation 10 Headings 10 Notices 11 Severabdity 11 Third Party Beneficiaries 11 Waiver of Breach 11 COVERAGE CONTRACT i DEFINITIONS Capitalized words found in the text of this Contract are defined below or may be found in Attachment A Child (or Children) (i) A natural child(ren), adopted child(ren), stepchild or other legally designated ward under the Limiting Age who is a dependent of the Subscriber or the Subscriber's Spouse (ii) A child(ren) under the Limiting Age who is legally entitled to receive medical coverage as a result of a court order binding either the Subscriber or the Subscriber's Spouse, regardless of whether or not the Subscriber or Subscriber's Spouse has legal custody of the child(ren) (iii) A child(ren) who has reached the Limiting Age, or is older than the Limiting Age, is incapable of self - sustaining employment due to developmental disability or physical handicap, and is dependent upon the Subscriber or the Subscriber's Spouse for total or partial support and maintenance (see the Continued Eligibility for a Disabled Dependent Child(ren) section of Attachment A) Contract this document and any other attachments, exhibits, Riders, or Endorsements listed on the title page or otherwise described herein, and any subsequent amendments or modifications to the Contract or its attachments, exhibits, Riders, or Endorsements Contract Renewal Month the calendar month specified on the title page of this Contract during which the Group may renew its coverage each year Covered Benefits and Services those Medically Necessary benefits and services described in Attachment A that an Enrollee is entitled to receive Eligible Dependent the legal Spouse and /or Child(ren) of a LEOFF I or LEOFF II law enforcement officer Employee + (a) LEOFF I employees who are full -time law enforcement officers or firefighters hired prior to October 1, 1977, and who are members of the LEOFF system as defined in Sections (3) and (4), CH 131, Law of 1972, 1 Ex Session, or (b) LEOFF II employees who are full -time law enforcement officers or firefighters hired on or after October 1, 1977, and who are not members of the LEOFF system as defined in Sections (3) and (4), CH 131, Law of 1972, 1 st Ex Session Endorsement an amendment to the conditions of coverage or the benefits provided by this Group Plan Enrollee a person enrolled in this Group Plan Group the employer entity, association, or other group that has entered into this Contract with KPS Group Master Application the application form completed by the Group and submitted to KPS prior to securing coverage under this Group Plan Group Plan: the Premium rates and benefits chosen by the Group as listed in Attachment A, any Riders and Endorsements, Attachment B — Premium Rates and Underwriting Criteria, plus other attachments that state the terms and conditions for eligibility and administration of Covered Benefits and Services Limiting Age the age at which a Child(ren) may no longer be covered under this Group Plan as an Eligible Dependent of the Subscriber The Limiting Age is specified in the Benefits Summary section of Attachment A Medical Director the licensed physician acting as chief medical advisor for KPS Open Enrollment Period the 31 -day period or some other period agreed to by both KPS and the Group, beginning one (1) month prior to the Group's Renewal Month or at some other mutually agreeable time but at least annually During the Open Enrollment Period, Subscribers may add or delete Eligible Dependents, and all eligible Employees and their Eligible Dependents have the opportunity to select from alternative health plans offered by the Group Coverage will be effective as of the renewal date Page 1 COVERAGE CONTRACT Participating Facility: an accredited facility, which has contracted with KPS, either directly or indirectly, to IN provide health care services to Enrollees Participating Facilities have agreed to accept the KPS allowance �- for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Participating Provider: a Provider who has contracted with KPS, either directly or indirectly, to provide health care services to Enrollees Participating Providers have agreed to accept the KPS allowance for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Premium the periodic payment made by, or on behalf of, the Enrollee as consideration for this Group Plan and in accordance with the terms of this Contract Premium Due Date the scheduled, periodic dates by which Premium payments must be received by KPS as a condition for continued enrollment in this Group Plan This date is typically the first day of each month of coverage Provider a licensed or certified health care practitioner acting within the scope of his /her license or certificate Rider an additional benefit over and above those listed in the Benefits Summary section of Attachment A Rider documents are attached at the back of Attachment A and provide detailed benefit information Spouse: (i) An individual who is living in a marital relationship with the Subscriber The marital relationship must be legally recognized by the state of Washington (u) An individual who is living with the Subscriber as a state registered domestic partner Subscriber an eligible employee who is enrolled in this Group Plan, or any other eligible person, who is the principal Enrollee in this Group Plan A� .. Page 2 COVERAGE CONTRACT CONTRACT EXAMINATION PERIOD If, after examination, the Group is not satisfied with this Contract for any reason, the Group may return the Contract to KPS within ten (10) days of the date it is received Upon receipt of the returned Contract, KPS will refund to the Group any pre -paid Premiums The Contract shall subsequently be deemed null and void EFFECTIVE DATE, DURATION, AND RENEWAL This Contract shall begin at 12 01 a m Pacific Time on the effective date (as indicated on the title page), and shall remain in effect until the Contract Renewal Month unless terminated according to the provisions set forth herein Thereafter, this Contract may be renewed automatically at 12 01 a m on the same date (month and day) in subsequent calendar years, unless otherwise terminated according to the provisions set forth herein PREMIUM PAYMENT PROVISIONS Payment Due Date /Grace Period The initial Premium payment is due and payable to KPS on or before the effective date of this Contract indicated on the title page Thereafter, Premium payments are due and payable on or before the first day of every month ( "Premium Due Date ") for which coverage is provided A roster of current enrollment and enrollment changes must accompany each Premium payment A ten (10) day grace period following the Premium Due Date is allowed, during which time this Contract shall not be terminated If payment is not received within the ten (10) day grace period, KPS may, at its sole discretion, elect to extend the grace period for up to 60 days from the Premium Due Date or terminate this Contract without notice to the Group If KPS elects to terminate this Contract due to non - payment of Premium, the effective date of termination will be retroactive to the last day of the month for which payment was received No further liability for claims will accrue to KPS Enrollees in this Group Plan shall not be entitled to benefits during any calendar month for which the Premium, on his /her behalf, was not received by KPS Premium payments, if applicable, must accompany all applications for coverage. Premium Rate Adjustments The Premium rates applicable to this Group Plan are defined in Attachment IS - Premium Rates and Underwriting Criteria Rates are guaranteed until the Contract Renewal Month each calendar year Notwithstanding the foregoing, KPS reserves the right to revise the rates as follows > As part of the annual Contract renewal process > As a result of any state or federal law or regulation that imposes an additional tax, new tax, or other assessment on KPS revenue In the event there is a material change in the basis upon which KPS assumed risk under this Contract Such changes may include inaccurate information presented by the Group, changes in the benefits, or other Contract terms required by statute or regulation, underwriting guidelines, or fluctuations of ten percent (10 %) or more in the number of enrolled Subscribers and /or Eligible Dependents KPS will give the Group 60 days prior written notice of any change in Premium rates not associated with the annual Contract renewal process KPS will give the Group 30 days prior written notice of rate increases associated with the annual Contract renewal process Page 3 COVERAGE CONTRACT Premiums Paid by Subscribers/Dependents In certain instances, Subscribers and their enrolled Eligible Dependents may be required to self -pay their Premiums in order to continue coverage Those instances include Strikes, lockouts, and other labor disputes that cause a disruption in Employee benefits ➢ When the Subscriber and /or Eligible Dependent(s) elects to continue coverage under a COBRA provision or other coverage continuation provision available under this Group Plan The Group is required to collect self -paid Premiums for continuation coverage and forward payments to KIPS on or before the Premium Due Date In the instance of strikes, lockouts, and labor disputes, the Enrollee may self -pay their Premium directly to the Group on or before the Premium Due Date Premium Refunds KPS will refund to the Group any Premium paid, in advance, for periods after the termination date of this Group Plan In the case of ineligible persons enrolled in this Group Plan, KIPS will refund to the Group any Premium paid, during a period of ineligibility, that is in excess of claim payments made on behalf of the ineligible person(s), during the period of ineligibility This refund will not exceed an amount equal to three (3) months of Premium payments ELIGIBILITY AND ENROLLMENT Group Eligibility In order to be eligible to participate in this Group Plan, the Group must continuously meet all eligibility, '4 participation, Group size, contribution, and other requirements specified in the Group Master Application form KIPS reserves the right to audit the Group's employment, payroll, and eligibility records to ensure that the Group continues to meet its participation requirements and to ensure that eligible Employees and their Eligible Dependents are properly enrolled in this Group Plan Subscriber /Dependent Eligibility Requirements Active, full -time LEOFF I and LEOFF II Employees, as defined in the Definitions section are eligible to enroll in this Group Plan Eligible Dependents of an active, full -time LEOFF I or LEOFF II law enforcement officer, as defined in the Definitions section, are also eligible to enroll in this Group Plan The chdd(ren) of an Eligible Dependent, other than the Child(ren) of the Spouse, is not eligible to enroll in this Group Plan Subscribers and their Eligible Dependents who do not enroll when they are initially eligible must wait until the next Open Enrollment Period, except in certain circumstances (see the Enrollment Under Special Circumstances section of Attachment A) Eligibility of Newborn and Adopted Child(ren) Newborn, adopted Child(ren), and Child(ren) placed for adoption are initially eligible for coverage as follows ➢ A natural newborn Child(ren) is eligible as of the date of birth and is covered automatically for a period of three (3) weeks In order for coverage to continue after the initial three (3) week period, the Child(ren) must qualify as an Eligible Dependent If additional Premium is required, the application and Premium for the Child(ren) must be received by KIPS within 60 days of birth Page 4 COVERAGE CONTRACT ➢ Adopted Children and Children placed for adoption are eligible (i) on the date of their adoption, (n) ' on the date the Subscriber or Spouse assumes legal obligation for total or partial support in anticipation of adoption, or (iii) on the date the Subscriber or Spouse acquires partial or complete legal custody If additional Premium is required, the application and Premium for coverage must be received by KPS within 60 days of the date of placement for adoption NOTE When additional Premium is not required, we encourage enrollment as soon as possible to prevent delays in claims processing Court- ordered Coverage for Eligible Dependent Child(ren) In the case of court- ordered coverage a dependent Child(ren) becomes initially eligible on the date the Subscriber or Spouse receives the order to provide medical coverage for the Child(ren), even if neither the Subscriber nor the Spouse is the custodial parent KPS requests that an application for coverage be submitted within 31 days of the date of the court order Coverage will become effective on the first day of the month, following the effective date of the court order Enrollment Reporting Requirements The Group will verify enrollment of all Employees and their dependents eligible for enrollment under this Contract and ensure that appropriate documentation is submitted to KPS for approval Enrollment Timeframes Current LEOFF I and LEOFF II Emplovees. including Eligible Dependents of active, full -time LEOFF I and LEOFF II law enforcement officers, are initially eligible to apply for coverage beginning on the effective date of this Group Plan Application for coverage must be received by KPS within 31 days of initial eligibility New LEOFF II Employees. including Eligible Dependents of active, full -time LEOFF I and LEOFF II law enforcement officers, may initially apply for coverage on the first day of the first full month following their first day of employment Application for coverage must be received by KPS within 31 days of initial eligibility Those Employees who do not enroll immediately following their probationary period(s) must wait until the next Open Enrollment Period A new Spouse and the Spouse's Child(ren) may initially apply for coverage as of the date of marriage Application for coverage must be received by KPS within 31 days of initial eligibility When Coverage Begins Coverage for new Enrollees begins on their date of initial eligibility provided they enrolled in this Group Plan within the specified time limits (see Enrollment Timeframes) and any applicable Premium amounts have been paid If the Employee enrolls during an Open Enrollment Period, coverage will begin on the first of the month, following the Open Enrollment Period A newborn Child(ren) who meets eligibility requirements is covered automatically for a period of three (3) weeks from the date of birth, provided either the female Subscriber, or male Subscriber's Spouse, is eligible for maternity coverage under this Group Plan at the time of the Child's (Children's) birth If additional Premium is required, coverage will not extend beyond the three- (3) week period unless the Child(ren) is enrolled within 60 days of the date of birth Any applicable Premium amount must accompany the enrollment application If additional Premium is required, coverage for an adopted Child(ren) is retroactive to the date the Child(ren) was adopted, legally placed for adoption, or when the Subscriber or Subscriber's Spouse assumes legal obligation for total or partial support of a Child(ren) in anticipation of adoption, provided that the application and applicable Premium for the Child(ren) are received by KPS within 60 days from the date of adoption, placement for adoption, or assumption of financial responsibility NOTE When additional Premium is not required, we encourage enrollment as soon as possible to prevent delays in claims processing Page 5 COVERAGE CONTRACT Coverage Waiting Periods s (This section does not apply to LEOFF I Employees) � Pre - existing Conditions Enrollees age 19 and older must be enrolled in this Group Plan for a period of three (3) consecutive months before KPS will provide benefits for a Pre - existing Condition A Pre - existing Condition is any condition for which you received medical advice during the three (3) month period immediately preceding your date of enrollment in this Group Plan or for which your Provider recommended or provided treatment Genetic information shall not be treated as a Pre - existing Condition, unless there has been a diagnosis of the condition related to the specific genetic information No Pre - existing Condition limitations apply to Enrollees under 19 years of age Transplant Procedures KIDS provides coverage for transplant procedures only after you have been continuously enrolled under this Group Plan for six (6) months This transplant waiting period applies to the transplant procedure, as well as any pre- and post - transplant care directly related to a transplant you receive while covered under this Group Plan Creditable Coverage If you were required to complete an employer imposed probationary period, the waiting periods begin on the first day of your probationary period The Pre - existing Condition and transplant procedures waiting periods may be reduced by the number of months of Creditable Coverage you have accrued under other health care programs prior to your enrollment in this Group Plan Creditable Coverage means periods of other health coverage an Enrollee may use to reduce Pre - existing Condition and transplant procedures waiting periods These include • Group health coverage r • Part A or Part B of Medicare o Medicaid • Military health coverage • Indian Health Service or tribal coverage • State High Risk Pool • Federal or Public Health Plans • Peace Corps Plan • State Children's Health Insurance Program • Other health insurance coverage The Enrollee will receive credit for prior Creditable Coverage if it was continuous and terminated not more than three (3) months immediately preceding enrollment in this Group Plan Health coverage will be considered continuous if there was not more than a three (3) month break between any Creditable Coverage No credit will be given if there was more than a three (3) month break between any coverage between the Enrollee's prior plan and their effective date of enrollment in this Group Plan Any Employer imposed probationary period will not be considered a break in coverage or creditable coverage To request a credit to the Pre - existing Condition waiting period, the Enrollee must submit a Certificate of Creditable Coverage from the prior health plan carrier with his /her enrollment application in lieu of a Certificate of Creditable Coverage, the Enrollee must provide all of the following information The name of the prior health plan carrier y The dates of coverage under the prior plan > Proof of coverage under the prior plan that documents the coverage penod(s) There are no waiting periods for > Pregnancy > Formulas necessary for the treatment of phenylketonuna (PKU) 'v Prescription drugs included in the Pharmacy Benefit y A newborn Chdd(ren) or an adopted Chdd(ren) Page 6 COVERAGE CONTRACT TERMINATION OF COVERAGE Continuity of Coverage Continuity of coverage under this Contract is guaranteed to all Enrollees provided the Group continues to meet eligibility requirements and continues to pay applicable Premium payments on a timely basis Termination or Rescission of Contract This Contract may be terminated as of the date on which any of the following occurs > The Group fads to make full Premium payments > The Group violates, or refuses to comply with, the terms and conditions of this Contract > The Group violates, or refuses to comply with, any published KPS policies and procedures that have been approved by the Insurance Commissioner > There is a change to, or implementation of, federal or state law that prohibits the continued offering of this Group Plan > KPS replaces this Group Plan In this case, the replacement plan will (i) include the services covered under the replaced Group Plan, (u) be offered to the Group's eligible Employees and their Eligible Dependents, and (iii) not significantly limit access to the kind of services covered under the replaced Group Plan In addition, the Group may terminate this Contract, at any time, by providing thirty (30) days written notice to KPS KPS may rescind or terminate this Contract upon thirty (30) days written notice in the event that intentional misrepresentation of material fact or fraud was used in order to obtain Group coverage In no event will coverage be terminated or rescinded solely on the basis of an Enrollee's physical or mental condition provided they meet all other eligibility requirements set forth by the Group The Group may appeal a termination or rescission decision through the KPS appeals process Either party may terminate this agreement in the event of intentional misrepresentation, fraud, or omission of information by the other party in performance of its responsibilities under this agreement If this Contract is terminated coverage for all Enrollees will end automatically on the effective date of termination, or on the last day of the last month for which the Group paid the Premium, whichever occurs first KPS will refund to the Group any Premium paid for periods after the termination date In the case of termination or non - renewal of this Contract, KPS shall be responsible for providing the effective date of termination of coverage to all affected Subscribers and their Eligible Dependents Termination or Rescission of Enrollee Coverage Coverage for an individual Enrollee under this Contract will end as of the date on which any one of the following events occurs Non - payment of any Premium amount, when Premium payment is the responsibility of the Enrollee > The Enrollee loses eligibility for coverage under this Contract > The Enrollee refuses to comply with the terms and conditions of this Group Plan as described in Attachment A > The Enrollee obtains coverage through intentional misrepresentation of material fact or fraud > The Enrollee voluntarily disenrolls from this Group Plan There is a change in either state or federal laws that no longer permit KPS from offering this Group Plan 'v This Contract is terminated Additionally, Eligible Dependent coverage ends if > The Subscriber is no longer employed or no longer meets eligibility requirements Page 7 COVERAGE CONTRACT The Subscriber dies v The Chdd(ren) reaches the Limiting Age i Coverage ends on the last day of the month in which the Enrollee was eligible for coverage, provided all applicable Premium amounts have been paid In the case of non - payment of Premium, coverage ends on the last day of the month for which KPS received a Premium payment KPS will be entitled to recover claims payments for services received by the Enrollee after the termination date, unless there was prior authorization for those services Upon termination of coverage either KPS or the Group shall issue a Certificate of Creditable Coverage certifying the period(s) during which the Enrollee was enrolled in this Group Plan An Enrollee who loses coverage under this Group Plan may be eligible to continue coverage or enroll in a KPS Conversion Plan (see the Continuation of Coverage section of Attachment A) A Subscriber who voluntarily disenrolls from this Group Plan will not be eligible to re- enroll in this Group Plan, until the next Open Enrollment Period See the Enrollment Under Special Circumstances section of Attachment A for exceptions to this policy COBRA (Consolidated Omnibus Budget Reconciliation Act -1985) If an Enrollee loses eligibility for coverage under this Group Plan, they may be eligible to continue their coverage for a period of time specified by federal law and regulations then in effect This continuation of coverage is referred to as COBRA and applies generally to groups of 20 or more employees KPS offers coverage gDly when ➢ Groups are required by law to provide COBRA coverage for their employees, and ➢ KPS is notified of a beneficiary's election of COBRA coverage within 31 days of that election being made Continuation of coverage under COBRA is not automatic Enrollees must apply for continuation of their Group coverage within 60 days of the date they receive a COBRA election notice from the Group KPS offers COBRA coverage to Groups only as required by law The Group Plan Administrator is required to notify KPS of an Enrollee's election of COBRA continuation coverage within 31 days of that election Failure on the Enrollee's part to make a timely election, or failure on the part of the Group Plan Administrator to provide KPS with timely notification of the election, will be interpreted by KPS as a waiver of the Enrollee's right to continue coverage under this provision Failure by the Group Plan Administrator to provide timely notification to KPS may not, in all cases, eliminate the Group's obligation to provide continuation coverage It will, however, eliminate any obligation on the part of KPS to provide the Enrollee with COBRA continuation coverage under this Group Plan Fraudulent Information In the event it is discovered that the Group has provided false or misleading information in connection with the provisions of this Contract for the purpose of defrauding KPS, KPS reserves the right to terminate or rescind coverage and shall inform the appropriate state and regulatory authorities, including, but not limited to, the Washington State Office of the Insurance Commissioner (OIC) for a determination of the Group's liability Re-Enrollment/Reinstatement If this Contract has been terminated by KPS due to non - payment of Premium, the Group automatically forfeits all rights to guaranteed renewal of coverage afforded under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Any decision to reinstate or re- enroll the Group is at the sole discretion of KPS y Page 8 COVERAGE CONTRACT SUBSCRIBER/DEPENDENT LIABILITY AND RIGHTS Subscriber /Dependent Liability Subscribers and their Eligible Dependents who are enrolled in this Group Plan are liable for the following costs ➢ Deductible (defined in Attachment A) ➢ Copayments (defined in Attachment A) ➢ Charges for non - Covered Benefits and Services Coinsurance, up to the Coinsurance Maximum limit (defined in Attachment A) ➢ Charges incurred after an annual or lifetime maximum benefit for a specific service or supply has been exhausted ➢ Charges in excess of the amount allowed by KPS for Non - Participating Providers If KPS fads to reimburse a Participating Provider for the cost of Medically Necessary Covered Benefits and Services provided in accordance with the terms of this Contract, neither the Enrollee nor the Group shall be required to compensate the Participating Provider for such services beyond the limit of Deductibles, Copayments, or Coinsurance amounts specified in Attachment A What happens if a Provider no longer participates with KPS? If a Participating Provider chooses to terminate their agreement with KPS, we will notify the affected Enrollees of the termination The notification will allow Enrollees at least 60 days to either (i) complete their course of treatment, or (u) appropriately transfer their care to another Participating Provider After the 60 days, services received from a Provider who has - terminated their agreement with KPS will be covered at the Non - Participating Provider benefit level s GENERAL TERMS AND CONDITIONS Applicable Law This Contract shall be governed by the laws of the state of Washington Venue for this Contract shall be Kitsap County Assignment of Benefits The benefits of this Contract shall accrue to Subscribers and their enrolled Eligible Dependents This Contract, payments, or Covered Benefits and Services are not assignable to a third party KPS reserves the right to make benefit payments to the Subscriber, their Provider(s), or jointly, as KPS deems necessary and appropriate, subject to federal and /or state laws Binding Agreement This Contract is binding on KPS and the Group, as well as their respective executors, administrators, successors, and /or assigns By election of coverage or payment of applicable Premiums, or if the Group's Subscribers or their enrolled Eligible Dependents seek the services provided under this Contract, all of the terms, covenants, and conditions contained herein shall become binding on the Group and its Subscribers and any enrolled Eligible Dependents, notwithstanding the failure of the Group to sign this Contract This Contract shall not bind KPS until (i) a person authorized by KPS signs it, and (n) a signed copy is delivered to the Group Confidentiality The underwriting and financial terms of this Contract are confidential and shall not be disclosed except as is necessary for the performance of this Contract or as required by law Page 9 COVERAGE CONTRACT Contract Modifications �^ r Except as set forth under the Premium Rate Adjustments section, KPS reserves the right to modify the provisions of this Contract, or the services described in Attachment A, upon 30 -days written notice to the Group The Group may elect to reject such modifications by providing KPS with 15 -days written notice However, rejection of a modification will result in the termination of this Contract as of the last day of the month for which Premium payment has been received Lack of notification of rejection by the Group shall be interpreted as acceptance of the modification, and this Contract will be renewed as modified No modification of the terms of this Contract shall be binding upon KPS unless endorsed, in writing, and signed by an authorized officer of KPS Such endorsement shall be deemed a part of this Contract, effective as of the effective date of the endorsement Any amendment or Contract modification required by law or regulation shall become effective as of the effective date required by such law or regulation Coverage Limits The Covered Benefits and Services offered under this Contract are subject to the coverage limits and maximums set forth in Attachment A Entire Agreement This Contract, together with Attachment A, any Riders and /or Endorsements attached hereto, and Attachment B — Premium Rates and Underwriting Criteria, constitutes the entire agreement This Contract supersedes all previous communications, representations, or agreements, whether verbal or written, between KPS and the Group Equity of Application This Contract is intended to apply equally to all Enrollees Force Majeure In the event KPS is unable to perform its obligations hereunder by reason of fire, casualty, lockout, strike, labor condition, riot, war, act of God, or by ordinance, law, order, or decree by any legal authority, the Contract may, at the option of KPS, be suspended During any period of suspension, KPS shall not be required to perform any service hereunder, nor shall KPS be liable for any damages arising from any event that precipitated the suspension If this Contract is suspended pursuant to this provision, any obligation by the Group and /or an Enrollee to make Premium payments also shall be suspended for the same period of time Group Cooperation The Group agrees to cooperate with KPS in the administration of this Contract by r> Advising Subscribers and their enrolled Eligible Dependents of policies and procedures applicable to this Group Plan ➢ Providing Subscribers and their enrolled Eligible Dependents with Attachment A, ID cards, and any applicable notices or other information regarding this Group Plan Providing information about Enrollees that is relevant to the determination of eligibility, claim reimbursement, coordination of benefits, or other information required for the administration of this Contract Making appropriate payroll deductions, if applicable, to facilitate Premium payment Headings _ The headings of sections and paragraphs in this Contract are for convenience and reference purposes only and do not affect in any way the meaning or interpretation of any provision of this Contract Page 10 COVERAGE CONTRACT Notices Any notice that may affect the provisions of this Contract shall be deemed delivered to the Group when deposited in the United States mad, with prepaid postage, addressed to the Group at the most recent address listed for the Group Any notice that may affect the provisions of this Contract shall be deemed delivered to KPS when deposited in the United States mad, with prepaid postage, addressed to KPS Health Plans P O Box 339 Bremerton, WA 98337 -0039 Any requirement of KPS to provide notice to Enrollees shall be fulfilled when the Group has received such notice It is the responsibility of the Group to disseminate notices to Enrollees within 31 days of receipt Severability If a court of competent jurisdiction deems any term, provision, Endorsement, or condition of this Contract invalid or unenforceable, the same shall be deemed severable from this Contract The remaining provisions of this Contract shall remain in full force and shall in no way be affected or invalidated as a result of such decision Third Party Beneficiaries There are no third party beneficiaries to this Contract Waiver of Breach Waiver of a breach of any provision of this Contract shall not be deemed to be a waiver of any other breach of the same or different provision The following topics are described in detail in Attachment A. Please refer to the Table of Contents in Attachment A to locate each section. ELIGIBILITY AND ENROLLMENT > Continuation of Inpatient Coverage > Continued Eligibility for a Disabled Dependent Child BENEFITS SUMMARY CONTINUATION OF COVERAGE > Coverage During a Labor Dispute > Continuation of Group Coverage > Conversion Coverage COORDINATION OF BENEFITS (COB) KPS'S RIGHT OF REIMBURSEMENT AND SUBROGATION COMPLAINTS AND APPEALS PROCESS ENROLLEES RIGHTS > KPS Privacy Policy > Statement of ERISA Rights Page 11 KPS Health Plans 400 Warren Avenue P 0 Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON — PLAN A COVERAGE CONTRACT Group Number: Active 21001, 21002, 21004, 21005 COBRA 21015 Effective Date. January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria This Contract is entered into and delivered in the state of Washington and is governed by Washington State laws, except to the extent state laws are preempted by federal law Signature by an authorized Group representative or payment of the Premium shall constitute acceptance of the terms and conditions set forth herein. FOR KPS: FOR GROUP: W James Page Jr, President Signature January 26, 2012 Date Print Name Title Date KPS Health Plans 400 Warren Avenue P O Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON - PLAN B COVERAGE CONTRACT Group Number: Active 21010, 21011, 21012 COBRA 21020 Effective Date: January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria KPS Health Plans (KPS) is a licensed health care services contractor (HCSC) in Washington State In its capacity as an HCSC, KPS agrees to underwrite and provide the benefits and services described in Attachment A any Benefits Booklet that may be listed above (hereinafter collectively referred to as "Attachment A "), as applicable to the eligible Employees and their Eligible Dependents of the above -named Group, provided the Group, its eligible Employees, and their Eligible Dependents meet and comply with the provisions of this Coverage Contract ( "Contract') C12BREMB TABLE OF CONTENTS i DEFINITIONS 1 CONTRACT EXAMINATION PERIOD 3 EFFECTIVE DATE, DURATION, AND RENEWAL 3 PREMIUM PAYMENT PROVISIONS 3 Payment Due Date /Grace Period 3 Premium Rate Adjustments 3 Premiums Paid by Subscribers /Dependents 4 Premium Refunds 4 ELIGIBILITY AND ENROLLMENT 4 Group Eligibility 4 Subscriber /Dependent Eligibility Requirements 4 Eligibility of Newborn and Adopted Child(ren) 5 Court- ordered Coverage for Eligible Dependent Chdd(ren) 5 Enrollment Reporting Requirements 5 Enrollment Timeframes 5 When Coverage Begins 5 Coverage Waiting Periods g TERMINATION OF COVERAGE 7 Continuity of Coverage 7 Termination or Rescission of Contract 7 Termination or Rescission of Enrollee Coverage 8 COBRA (Consolidated Omnibus Budget Reconciliation Act -1985) 8 Fraudulent Information g Re-Enrollment/Reinstatement g SUBSCRIBER /DEPENDENT LIABILITY AND RIGHTS 9 Subscriber /Dependent Liability g GENERAL TERMS AND CONDITIONS g Applicable Law g Assignment of Benefits g Binding Agreement 10 Confidentiality 10 Contract Modifications 10 Coverage Limits 10 Entire Agreement 10 Equity of Application 10 Force Majeure 10 Group Cooperation 11 Headings 11 Notices 11 Severabdity 11 Third Party Beneficiaries 11 Waiver of Breach 11 COVERAGE CONTRACT DEFINITIONS J Capitalized words found in the text of this Contract are defined below or may be found in Attachment A Child (or Children) (i) A natural child(ren), adopted child(ren), stepchild(ren), or other legally designated ward under the Limiting Age who is a dependent of the Subscriber or the Subscriber's Spouse (u) A chdd(ren) under the Limiting Age who is legally entitled to receive medical coverage as a result of a court order binding either the Subscriber or the Subscriber's Spouse, regardless of whether or not the Subscriber or Subscriber's Spouse has legal custody of the chdd(ren) (iii) A chdd(ren) who has reached the Limiting Ag, or is older than the Limiting Age, is incapable of self - sustaining employment due to developmental disability or physical handicap, and is dependent upon the Subscriber or the Subscriber's Spouse for total or partial support and maintenance (see the Continued Eligibility for a Disabled Dependent Chdd(ren) section of Attachment A) Contract: this document and any other attachments, exhibits, Riders, or Endorsements listed on the title page or otherwise described herein, and any subsequent amendments or modifications to this document, its attachments, exhibits, Riders or Endorsements Contract Renewal Month the calendar month specified on the title page of this Group Contract during which the Group may renew its coverage each year under this Group Plan Covered Benefits and Services those Medically Necessary benefits and services described in Attachment A that an Enrollee is entitled to receive Eligible Dependents the legal Spouse and /or Children) of an Eligible Employee, or the legal Spouse and /or Chdd(ren) of an active, full -time LEOFF I or LEOFF II firefighter Employee an active, full -time Employee who is not a LEOFF I or LEOFF II Employee Endorsement an amendment to the conditions of coverage or the benefits provided by this Group Plan Enrollee a person enrolled in this Group Plan Group the employer entity, association, or other group that has entered into this Contract with KPS Group Master Application the form completed by the Group and submitted to KPS prior to securing coverage under this Group Plan Group Plan the Premium rates and benefits chosen by the Group as listed in Attachment A, any Riders and Endorsements, Attachment B — Premium Rates and Underwriting Criteria, plus other attachments that state the terms and conditions for eligibility and administration of Covered Benefits and Services LEOFF I Employee an active, full -time law enforcement officer or firefighter hired prior to October 1, 1977, and who is a member of the LEOFF system as defined in Sections (3) and (4), CH 131, Law of 1972, 1 Ex Session LEOFF II Employee an active, full -time law enforcement officer or firefighter hired on or after October 1, 1977, and who is not a member of the LEOFF system as defined in Sections (3) and (4), CH 131, Law of 1972, 1 st Ex Session Limiting Age the age at which a Children) may no longer be covered under this Group Plan as an Eligible Dependent of the Subscriber The Limiting Age is specified in the Benefits Summary section of Attachment A Medical Director the licensed physician acting as chief medical advisor for KPS Open Enrollment Period the 31 -day period or some other period agreed to by both KPS and the Group, beginning one (1) month prior to the Group's Renewal Month or at some other mutually agreeable time but at least annually During the Open Enrollment Period, Subscribers may add or delete Eligible Dependents, and all eligible Employees and their Eligible Dependents have the opportunity to select from alternative health plans offered by the Group Coverage will be effective as of the renewal date Page 1 COVERAGE CONTRACT Participating Facility: an accredited facility, which has contracted with KPS, either directly or indirectly, to �- provide health care services to Enrollees Participating Facilities have agreed to accept the KPS allowance for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Participating Provider: a Provider who has contracted with KPS, either directly or indirectly, to provide health care services to Enrollees Participating Providers have agreed to accept the KPS allowance for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Premium the periodic payment made by, or on behalf of, the Enrollee as consideration for this Group Plan and in accordance with the terms of this Contract Premium Due Date the scheduled, periodic dates by which Premium payments must be received by KPS as a condition for continued enrollment in this Group Plan This date is the first day of each month of coverage Provider a licensed or certified health care practitioner acting within the scope of his /her license or certificate Rider an additional benefit over and above those listed in the Benefits Summary section of Attachment A Rider documents are attached at the back of Attachment A and provide detailed benefit information Spouse: (i) An individual who is living in a marital relationship with the Subscriber The marital relationship must be legally recognized by the state of Washington (u) An individual who is living with the Subscriber as a state registered domestic partner Subscriber an eligible employee who is enrolled in this Group Plan, or any other eligible person, who is the principal Enrollee in this Group Plan r �y r Page 2 COVERAGE CONTRACT CONTRACT EXAMINATION PERIOD If, after examination, the Group is not satisfied with this Contract for any reason, the Group may return the Contract to KPS within ten (10) days of the date it is received Upon receipt of the returned Contract, KPS will refund to the Group any pre -paid Premiums The Contract shall subsequently be deemed null and void EFFECTIVE DATE, DURATION. AND RENEWAL This Contract shall begin at 12 01 a m Pacific Time on the Effective Date (as indicated on the title page), and shall remain in effect until the Contract Renewal Month unless terminated according to the provisions set forth herein Thereafter, this Contract may be renewed automatically at 12 01 a m on the same date (month and day) in subsequent Calendar Years, unless otherwise terminated according to the provisions set forth herein PREMIUM PAYMENT PROVISIONS Payment Due Date/Grace Period The initial Premium payment is due and payable to KPS on or before the effective date of this Contract indicated on the title page Thereafter, Premium payments are due and payable on or before the first day of every month ( "Premium Due Date ") for which coverage is provided A roster of current enrollment and enrollment changes must accompany each Premium payment A ten (10) day grace period following the Premium Due Date is allowed, during which time this Contract shall not be terminated If payment is not received within the ten (10) day grace period, KPS may, at its sole discretion, elect to extend the grace period for up to 60 days from the Premium Due Date or terminate this Contract without notice to the Group If KPS elects to terminate this Contract due to non - payment of Premium, the effective date of termination will be retroactive to the last day of the month for which payment was received No further liability for claims will accrue to KPS Enrollees in this Group Plan shall not be entitled to benefits during any calendar month for which the Premium, on his /her behalf, was not received by KPS Premium payments, if applicable, must accompany all applications for coverage. Premium Rate Adjustments The Premium rates applicable to this Group Plan are defined in Attachment B - Premium Rates and Underwriting Criteria Rates are guaranteed until the Contract Renewal Month each Calendar Year Notwithstanding the foregoing, KPS reserves the right to revise the rates as follows As part of the annual Contract renewal process ➢ As a result of any state or federal law or regulation that imposes an additional tax, new tax or other assessment on KPS revenue D In the event there is a material change in the basis upon which KPS assumed risk under this Contract Such changes may include inaccurate information presented by the Group, changes in the benefits, or other Contract terms required by statute or regulation, underwriting guidelines, or fluctuations of ten percent (10 %) or more in the number of enrolled Subscribers and /or Eligible Dependents KPS will give the Group 60 days prior written notice of any change in Premium rates not associated with the annual Contract renewal process KPS will give the Group 30 days prior written notice of rate increases associated with the annual Contract renewal process Page 3 COVERAGE CONTRACT Premiums Paid by Subscribers/Dependents In certain instances, Subscribers and their enrolled Eligible Dependents may be required to self -pay their Premiums in order to continue coverage Those instances include ➢ Strikes, lockouts, and other labor disputes that cause a disruption in Employee benefits ➢ When the Subscriber and /or Eligible Dependent(s) elects to continue coverage under a COBRA provision or other coverage continuation provision available under this Group Plan The Group is required to collect self -paid Premiums for continuation coverage and forward payments to KPS on or before the Premium Due Date In the instance of strikes, lockouts, and labor disputes, the Enrollee may self -pay their Premium directly to the Group on or before the Premium Due Date Premium Refunds KPS will refund to the Group any Premium paid, in advance, for periods after the termination date of this Group Plan In the case of an ineligible person(s) enrolled in this Group Plan, KPS will refund to the Group any Premium paid, during a period of ineligibility, that is in excess of claim payments made on behalf of the ineligible person(s), during the period of ineligibility This refund will not exceed an amount equal to three (3) months of Premium payments ELIGIBILITY AND ENROLLMENT Group Eligibility In order to be eligible to participate in this Group Plan, the Group must continuously meet all eligibility, participation, Group size, contribution, and other requirements specified in the Group Master Application 1 form KPS reserves the right to audit the Group's employment, payroll, and eligibility records to ensure that the Group continues to meet its participation requirements and to ensure that eligible Employees and their Eligible Dependents are properly enrolled in this Group Plan Subscriber /Dependent Eligibility Requirements Active, full -time Employees, as defined in the Definitions section and their Eligible Dependents, are eligible to enroll in this Group Plan Eligible Dependents of active, full -time LEOFF I or LEOFF II firefighters, as defined in the Definitions section, are also eligible to enroll in this Group Plan The Chdd(ren) of an Eligible Dependent, other than the Chdd(ren) of the Spouse, is not eligible to enroll in this Group Plan Subscribers and their Eligible Dependents who do not enroll when they are initially eligible must wait until the next Open Enrollment Period, except in certain circumstances (see the Enrollment Under Special Circumstances section of Attachment A) Page 4 COVERAGE CONTRACT Eligibility of Newborn and Adopted Child(ren) Newborn, adopted Child(ren), and Child(ren) placed for adoption are initially eligible for coverage as follows ➢ A natural newborn Child(ren) is eligible as of the date of birth and is covered automatically for a period of three (3) weeks In order for coverage to continue after the initial three (3) week period, the Child(ren) must qualify as an Eligible Dependent If additional Premium is required, the application and Premium for the Child(ren) must be received by KPS within 60 days of birth ➢ Adopted Child(ren) and Child(ren) placed for adoption are eligible (i) on the date of their adoption, (u) on the date the Subscriber or Spouse assumes legal obligation for total or partial support in anticipation of adoption, or (m) on the date the Subscriber or Spouse acquires partial or complete legal custody If additional Premium is required, the application and Premium for coverage must be received by KPS within 60 days of the date of placement for adoption NOTE When additional Premium is not required, we encourage enrollment as soon as possible to prevent delays in claims processing Court- ordered Coverage for Eligible Dependent Child(ren) In the case of court- ordered coverage a dependent Child(ren) becomes initially eligible on the date the Subscriber or Spouse receives the order to provide medical coverage for the Child(ren), even if neither the Subscriber nor the Spouse is the custodial parent KPS requests that an application for coverage be submitted within 31 days of the date of the court order Coverage will become effective on the first day of the month, following the effective date of the court order Enrollment Reporting Requirements The Group will verify enrollment of all Employees and their dependents eligible for enrollment under this Contract and ensure that appropriate documentation is submitted to KPS for approval Enrollment Timeframes Employees and their Eligible Dependents including Eligible Dependents of active, full -time LEOFF I and LEOFF II firefighters, may initially apply for coverage in this Group Plan, beginning on the Group's effective date Application for coverage must be received by KPS within 31 days of initial eligibility New Employees and their Eligible Dependents including Eligible Dependents of active, full -time LEOFF I and LEOFF II firefighters, may initially apply for coverage on the first day of the first full month, following their first day of employment Application for coverage must be received by KPS within 31 days of initial eligibility Those Employees who do not enroll immediately following their probationary penod(s) must wait until the next Open Enrollment Period A new Spouse and the Spouse's Child(ren) may initially apply for coverage as of the date of marriage Application for coverage must be received by KPS within 31 days of initial eligibility When Coverage Begins Coverage for new Enrollees begins on their date of initial eligibility, provided they enrolled in this Group Plan within the specified time limits (see Enrollment Timeframes) and any applicable Premium amounts have been paid If the Employee enrolls during an Open Enrollment Period, coverage will begin on the first of the month following the Open Enrollment Period A newborn Child(ren) who meets eligibility requirements is covered automatically for a period of three (3) weeks from the date of birth, provided either the female Subscriber, or male Subscriber's Spouse, is eligible for maternity coverage under this Group Plan at the time of the Child's (Children's) birth If additional Premium is required, coverage will not extend beyond the three- (3) week period unless the Child(ren) is enrolled within 60 days of the date of birth Any applicable Premium amount must accompany the enrollment application Page 5 COVERAGE CONTRACT If additional Premium is required, coverage for an adopted Child(ren) is retroactive to the date the Children) was adopted, legally placed for adoption, or when the Subscriber or Subscriber's Spouse assumes legal obligation for total or partial support of a Chdd(ren) in anticipation of adoption, provided that the application and applicable Premium for the Chdd(ren) are received by KPS within 60 days from the date of adoption, placement for adoption, or assumption of financial responsibility NOTE When additional Premium is not required, we encourage enrollment as soon as possible to prevent delays in claims processing Coverage Waiting Periods Pre - existing Conditions Enrollees age 19 and older must be enrolled in this Group Plan for a period of three (3) consecutive months before KPS will provide benefits for a Pre - existing Condition A Pre - existing Condition is any condition for which you received medical advice during the three (3) month period immediately preceding your date of enrollment in this Group Plan or for which your Provider recommended or provided treatment Genetic information shall not be treated as a Pre - existing Condition, unless there has been a diagnosis of the condition related to the specific genetic information No Pre - existing Condition limitations apply to Enrollees under 19 years of age Transplant Procedures KPS provides coverage for transplant procedures only after you have been continuously enrolled under this Group Plan for six (6) months This transplant waiting period applies to the transplant procedure, as well as any pre- and post - transplant care directly related to a transplant you receive while covered under this Group Plan Creditable Coverage If you were required to complete an employer imposed probationary period, the waiting periods begin on the l first day of your probationary period The Pre - existing Condition and transplant procedures waiting periods may be reduced by the number of months of Creditable Coverage you have accrued under other health care programs prior to your enrollment in this Group Plan Creditable Coverage means periods of other health coverage an Enrollee may use to reduce Pre - existing Condition and transplant procedures waiting periods These include > Group health coverage > Part A or Part B of Medicare > Medicaid > Military health coverage > Indian Health Service or tribal coverage > State High Risk Pool > Federal or Public Health Plans > Peace Corps Plan > State Children's Insurance Program > Other health insurance coverage The Enrollee will receive credit for prior Creditable Coverage if it was continuous and terminated not more than three (3) months immediately preceding their date of enrollment in this Group Plan Health coverage will be considered continuous if there was not more than a three (3) month break in Creditable Coverage No credit will be given if there was more than a three (3) month break in coverage between the Enrollee's prior plan and their effective date of enrollment in this Group Plan Any employer imposed probationary period will not be considered a break in coverage or Creditable Coverage Page 6 COVERAGE CONTRACT To request a credit to the Pre - existing Condition waiting period, the Enrollee must submit a Certificate of Creditable Coverage from the prior health plan carrier with his /her enrollment application In lieu of a Certificate of Creditable Coverage, the Enrollee must provide all of the following information Y The name of the prior health plan carrier ➢ The dates of coverage under the prior plan ➢ Proof of coverage under the prior plan that documents the coverage period(s) There are no waiting periods for ➢ Pregnancy ➢ Formulas necessary for the treatment of phenylketonuna (PKU) ➢ Prescription drugs included in Pharmacy Benefits Y A newborn Chdd(ren) or an adopted Chdd(ren) TERMINATION OF COVERAGE Continuity of Coverage Continuity of coverage under this Contract is guaranteed to all Enrollees provided the Group continues to meet eligibility requirements and continues to pay applicable Premium payments on a timely basis Termination or Rescission of Contract This Contract may be terminated as of the date on which any of the following occurs ➢ The Group fads to make full Premium payments The Group violates, or refuses to comply with, the terms and conditions of this Contract ➢ The Group violates, or refuses to comply with, any published KPS policies and procedures that have been approved by the Insurance Commissioner ➢ There is a change to, or implementation of, federal or state law that prohibits the continued offering of this Group Plan KPS replaces this Group Plan In this case, the replacement plan will (i) include the services covered under the replaced Group Plan, (ii) be offered to the Group's eligible Employees and their Eligible Dependents, and (iii) not significantly limit access to the kind of services covered under the replaced Group Plan In addition, the Group may terminate this Contract, at any time, by providing thirty (30) days written notice to KPS KPS may rescind or terminate this Contract upon thirty (30) days written notice in the event that intentional misrepresentation of material fact or fraud was used in order to obtain Group coverage In no event will coverage be terminated or rescinded solely on the basis of an Enrollee's physical or mental condition provided they meet all other eligibility requirements set forth by the Group The Group may appeal a termination or rescission decision through the KPS appeals process Either party may terminate this agreement in the event of intentional misrepresentation, fraud, or omission of information by the other party in performance of its responsibilities under this agreement If this Contract is terminated coverage for all Enrollees will end automatically on the effective date of termination, or on the last day of the last month for which the Group paid the Premium, whichever occurs first KPS will refund to the Group any Premium paid for periods after the termination date In the case of termination or non - renewal of this Contract, KPS shall be responsible for providing the effective date of termination of coverage to all affected Subscribers and their Eligible Dependents Page 7 COVERAGE CONTRACT Termination or Rescission of Enrollee Coverage Coverage for an individual Enrollee under this Contract will end as of the date on which any one of the '0 following events occurs > Non - payment of any Premium amount, when Premium payment is the responsibility of the Enrollee > The Enrollee loses eligibility for coverage under this Contract > The Enrollee refuses to comply with the terms and conditions of this Group Plan as described in Attachment A > The Enrollee obtains coverage through intentional misrepresentation of material fact or fraud > The Enrollee voluntarily disenrolls from this Group Plan > There is a change in either state or federal laws that no longer permit KPS from offering this Group Plan > This Contract is terminated Additionally, Eligible Dependent coverage ends if > The Subscriber is no longer employed or no longer meets eligibility requirements > The Subscriber dies > The Chdd(ren) reaches the Limiting Age Coverage ends on the last day of the month in which the Enrollee was eligible for coverage, provided all applicable Premium amounts have been paid In the case of non - payment of Premium, coverage ends on the last day of the month for which KPS received a Premium payment KPS will be entitled to recover claims payments for services received by the Enrollee after the termination date, unless there was prior authorization for those services Upon termination of coverage either KPS or the Group shall issue a Certificate of Creditable Coverage certifying the period(s) during which the Enrollee was enrolled in this Group Plan ' 4 ° An Enrollee who loses coverage under this Group Plan may be eligible to continue coverage or enroll in a KPS Conversion Plan (see the Continuation of Coverage section of Attachment A) A Subscriber who voluntarily disenrolls from this Group Plan will not be eligible to re- enroll in this Group Plan, until the next Open Enrollment Period See the Enrollment Under Special Circumstances section of Attachment A for exceptions to this policy COBRA (Consolidated Omnibus Budget Reconciliation Act -1985) If an Enrollee loses eligibility for coverage under this Group Plan, they may be eligible to continue their coverage for a period of time specified by federal law and regulations then in effect This continuation of coverage is referred to as COBRA and applies generally to groups of 20 or more employees KPS offers coverage onl when > Groups are required by law to provide COBRA coverage for their employees, and KPS is notified of a beneficiary's election of COBRA coverage within 31 days of that election being made Continuation of coverage under COBRA is not automatic Enrollees must apply for continuation of their Group coverage within 60 days of the date they receive a COBRA election notice from the Group KPS offers COBRA coverage to Groups only as required by law The Group Plan Administrator is required to notify KPS of an Enrollee's election of COBRA continuation coverage within 31 days of that election Failure on the Enrollee's part to make a timely election, or failure on the part of the Group Plan Administrator to provide KPS with timely notification of the election, will be interpreted by KPS as a waiver of the Enrollee's right to continue coverage under this provision Failure by the Group Plan Administrator to provide timely notification to KPS may not, in all cases, eliminate the Group's obligation to provide continuation coverage It will, however, eliminate any obligation on the part of KPS to provide the Enrollee with COBRA continuation coverage under this Group Plan Page 8 COVERAGE CONTRACT Fraudulent Information In the event it is discovered that the Group has provided false or misleading information in connection with the provisions of this Contract for the purpose of defrauding KPS, KPS reserves the right to terminate or rescind coverage and shall inform the appropriate state and regulatory authorities, including, but not limited to, the Washington State Office of the Insurance Commissioner (OIC) for a determination of the Group's liability Re- Enrollment/Reinstatement If this Contract has been terminated by KPS due to non - payment of Premium, the Group automatically forfeits all rights to guaranteed renewal of coverage afforded under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Any decision to reinstate or re- enroll the Group is at the sole discretion of KPS SUBSCRIBER/DEPENDENT LIABILITY AND RIGHTS Subscriber /Dependent Liability Subscribers and their Eligible Dependents who are enrolled in this Group Plan are liable for the following costs Deductible (defined in Attachment A) Copayments (defined in Attachment A) Charges for non - Covered Benefits and Services ➢ Coinsurance, up to the Coinsurance Maximum limit (defined in Attachment A) Charges incurred after an annual or lifetime maximum benefit for a specific service or supply has been exhausted (e g , the annual maximum benefit for medical equipment and supplies) ➢ Charges in excess of the amount allowed by KPS for Non - Participating Providers If KPS fads to reimburse a Participating Provider for the cost of Medically Necessary Covered Benefits and Services provided in accordance with the terms of this Contract, neither the Enrollee nor the Group shall be required to compensate the Participating Provider for such services beyond the limit of Deductibles, Copayments, or Coinsurance amounts specified in Attachment A What happens if a Provider no longer participates with KPS? If a Participating Provider chooses to terminate their agreement with KPS, we will notify the affected Enrollees of the termination The notification will allow Enrollees at least 60 days to either (i) complete their course of treatment, or (n) appropriately transfer their care to another Participating Provider After the 60 days, services received from a Provider who has terminated their agreement with KPS will be covered at the Non - Participating Provider benefit level GENERAL TERMS AND CONDITIONS Applicable Law This Contract shall be governed by the laws of the state of Washington Venue for this Contract shall be Kitsap County Assignment of Benefits The benefits of this Contract shall accrue to Subscribers and their enrolled Eligible Dependents This Contract, payments, or Covered Benefits and Services are not assignable to a third party KPS reserves the right to make benefit payments to the Subscriber, their Provider(s), or jointly, as KPS deems necessary and appropriate, subject to federal and /or state laws Page 9 COVERAGE CONTRACT Binding Agreement ' This Contract is binding on KPS and the Group, as well as their respective executors, administrators, successors, and/or assigns By election of coverage or payment of applicable Premiums, or if the Group's Subscribers or their enrolled Eligible Dependents seek the services provided under this Contract, all of the terms, covenants, and conditions contained herein shall become binding on the Group and its Subscribers and any enrolled Eligible Dependents, notwithstanding the failure of the Group to sign this Contract This Contract shall not bind KPS until (i) a person authorized by KPS signs it, and (u) a signed copy is delivered to the Group Confidentiality The underwriting and financial terms of this Contract are confidential and shall not be disclosed except as is necessary for the performance of this Contract or as required by law Contract Modifications Except as set forth under the Premium Rate Adjustments section, KPS reserves the right to modify the provisions of this Contract, or the services described in Attachment A, upon 30 -days written notice to the Group The Group may elect to reject such modifications by providing KPS with 15 -days written notice However, refection of a modification will result in the termination of this Contract as of the last day of the month for which Premium payment has been received Lack of notification of refection by the Group shall be interpreted as acceptance of the modification, and this Contract will be renewed as modified No modification of the terms of this Contract shall be binding upon KPS unless endorsed, in writing, and signed by an authorized officer of KPS Such endorsement shall be deemed a part of this Contract, effective as of the effective date of the endorsement Any amendment or Contract modification required by law or regulation shall become effective as of the effective date required by such law or regulation Coverage Limits The Covered Benefits and Services offered under this Contract are subject to the coverage limits and maximums set forth in Attachment A Entire Agreement This Contract, together with Attachment A, any Riders and /or Endorsements attached hereto, and Attachment B - Premium Rates and Underwriting Criteria, constitutes the entire agreement This Contract supersedes all previous communications, representations, or agreements, whether verbal or written, between KPS and the Group Equity of Application This Contract is intended to apply equally to all Enrollees Force Majeure In the event KPS is unable to perform its obligations hereunder by reason of fire, casualty, lockout, strike, labor condition, riot, war, act of God, or by ordinance, law, order, or decree by any legal authority, the Contract may, at the option of KPS, be suspended During any period of suspension, KPS shall not be required to perform any service hereunder, nor shall KPS be liable for any damages arising from any event that precipitated the suspension if this Contract is suspended pursuant to this provision, any obligation by the Group and/or an Enrollee to make Premium payments also shall be suspended for the same period of time Page 10 COVERAGE CONTRACT Group Cooperation The Group agrees to cooperate with KPS in the administration of this Contract by ➢ Advising Subscribers and their enrolled Eligible Dependents of policies and procedures applicable to this Group Plan ➢ Providing Subscribers and their enrolled Eligible Dependents with Attachment A, ID cards and any applicable notices or other information regarding this Group Plan ➢ Providing information about Enrollees that is relevant to the determination of eligibility, claim reimbursement, coordination of benefits, or other information required for the administration of this Contract ➢ Making appropriate payroll deductions, if applicable, to facilitate Premium payment Headings The headings of sections and paragraphs in this Contract are for convenience and reference purposes only and do not affect in any way the meaning or interpretation of any provision of this Contract Notices Any notice that may affect the provisions of this Contract shall be deemed delivered to the Group when deposited in the United States mail, with prepaid postage, addressed to the Group at the most recent address listed for the Group Any notice that may affect the provisions of this Contract shall be deemed delivered to KPS when deposited in the United States mad, with prepaid postage, addressed to KPS Health Plans P O Box 339 Bremerton, WA 98337 -0039 Any requirement of KPS to provide notice to Enrollees shall be fulfilled when the Group has received such notice It is the responsibility of the Group to disseminate notices to Enrollees within 31 days of receipt Severabi4ty If a court of competent jurisdiction deems any term, provision, Endorsement, or condition of this Contract invalid or unenforceable, the same shall be deemed severable from this Contract The remaining provisions of this Contract shall remain in full force and shall in no way be affected or invalidated as a result of such decision Third Party Beneficiaries There are no third party beneficiaries to this Contract Waiver of Breach Waiver of a breach of any provision of this Contract shall not be deemed to be a waiver of any other breach of the same or different provision 1 Page 11 COVERAGE CONTRACT The following topics are described in detail in Attachment A Please refer to the Table of Contents in Attachment A to locate each section JV ELIGIBILITY AND ENROLLMENT ➢ Continuation of Inpatient Coverage ➢ Continued Eligibility for a Disabled Dependent Child BENEFITS SUMMARY CONTINUATION OF COVERAGE Coverage During a Labor Dispute ➢ Continuation of Group Coverage ➢ Conversion Coverage COORDINATION OF BENEFITS (COB) KPS'S RIGHT OF REIMBURSEMENT AND SUBROGATION COMPLAINTS AND APPEALS PROCESS ENROLLEE RIGHTS ➢ KPS Privacy Policy ➢ Statement of ERISA Rights Page 12 KPS Health Plans 400 Warren Avenue P O Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON — PLAN B COVERAGE CONTRACT Group Number: Active 21010, 21011, 21012 COBRA 21020 Effective Date: January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria This Contract is entered into and delivered in the state of Washington and is governed by Washington State laws, except to the extent state laws are preempted by federal law Signature by an authorized Group representative or payment of the Premium shall constitute acceptance of the terms and conditions set forth herein FOR KPS: FOR GROUP: W James Page, Jr, President Signature January 26, 2012 Date Print Name Title Date KPS Health Plans 400 Warren Avenue { P O Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON — UNDER 65 LEOFF I RETIREES COVERAGE CONTRACT Group Number: 21003 Effective Date: January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December ?� This Coverage Contract includes the following �► Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria KPS Health Plans (KPS) is a licensed health care services contractor (HCSC) in Washington State In its capacity as an HCSC, KPS agrees to underwrite and provide the benefits and services described in any Benefits Booklet that may be listed above (hereinafter collectively referred to as "Attachment A "), as applicable to the eligible Employees of the above -named Group, provided the Group, its eligible Employees meet and comply with the provisions of this Coverage Contract ( "Contract ") C12BREMR TABLE OF CONTENTS DEFINITIONS 1 CONTRACT EXAMINATION PERIOD 2 EFFECTIVE DATE, DURATION, AND RENEWAL 2 PREMIUM PAYMENT PROVISIONS 2 Payment Due Date /Grace Period 2 Premium Rate Adjustments 2 Premiums Paid by Subscribers 3 Premium Refunds 3 ELIGIBILITY AND ENROLLMENT 3 Group Eligibility 3 Subscriber Eligibility Requirements 3 Enrollment Reporting Requirements 3 Enrollment Timeframes 3 Enrollment Under Special Circumstances 4 When Coverage Begins 4 TERMINATION OF COVERAGE 4 Continuity of Coverage 4 Termination or Rescission of Contract 4 Termination or Rescission of Enrollee Coverage 5 COBRA (Consolidated Omnibus Budget Reconciliation Act - 1985) 5 Fraudulent Information 5 Re-Enrollment/Reinstatement 6 SUBSCRIBER LIABILITY AND RIGHTS 6 Subscriber Liability 6 GENERAL TERMS AND CONDITIONS 6 Applicable Law 6 Assignment of Benefits 6 Binding Agreement 6 Confidentiality 7 Contract Modifications 7 Coverage Limits 7 Entire Agreement 7 Equity of Application 7 Force Majeure 7 Group Cooperation 7 Headings 8 Notices 8 Severabdity 8 Third Party Beneficiaries 8 Waiver of Breach 8 COVERAGE CONTRACT DEFINITIONS Capitalized words found in the text of this Contract are defined below or may be found in Attachment A. Contract: this document and any other attachments, exhibits, Riders, or Endorsements listed on the title page or otherwise described herein, and any subsequent amendments or modifications to this document, its attachments, exhibits, Riders or Endorsements Contract Renewal Month: the calendar month specified on the title page of this Group Contract during which the Group may renew its coverage each year under this Group Plan Covered Benefits and Services: those Medically Necessary benefits and services described in Attachment A that an Enrollee is entitled to receive Employee: a retired LEOFF I Employee who is under the age 65 and who is eligible for a Premium contribution by his /her payroll office Endorsement* an amendment to the conditions of coverage or the benefits provided by this Group Plan Enrollee: a person enrolled in this Group Plan Group: the employer entity, association, or other group that has entered into this Contract with KPS Group Master Application: the form completed by the Group and submitted to KPS prior to securing coverage under this Group Plan Group Plan: the Premium rates and benefits chosen by the Group as listed in Attachment A, any Riders and Endorsements, Attachment B — Premium Rates and Underwriting Criteria, plus other attachments that state the terms and conditions for eligibility and administration of Covered Benefits and Services LEOFF I Employee: a full -time law enforcement officer or firefighter hired prior to October 1, 1977, and who is a member of the LEOFF system as defined in Sections (3) and (4), CH 131, Law of 1972, 1 st Ex Session Medical Director: the licensed physician acting as chief medical advisor for KPS Open Enrollment Period: the 31 -day period or some other period agreed to by both KPS and the Group, beginning one (1) month prior to the Group's Renewal Month or at some other mutually agreeable time but at least annually Coverage will be effective as of the renewal date Participating Facility: an accredited facility which has contracted with KPS, either directly or indirectly, to provide health care services to Enrollees Participating Facilities have agreed to accept the KPS allowance for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Participating Provider: a Provider who has contracted with KPS, either directly or indirectly, to provide health care services to Enrollees Participating Providers have agreed to accept the KPS allowance for Covered Benefits and Services as payment in full, except for Deductible, Copayment, and Coinsurance amounts, which are the responsibility of the Enrollee Premium: the periodic payment made by, or on behalf of the Enrollee, as consideration for this Group Plan and in accordance with the terms of this Contract Premium Due Date: the scheduled, periodic dates by which Premium payments must be received by KPS as a condition for continued enrollment in this Group Plan This date is the first day of each month of coverage , Provider: a licensed or certified health care practitioner acting within the scope of his /her license or certificate Rider: an additional benefit over and above those listed in the Benefits Summary section of Attachment A Rider documents are attached at the back of Attachment A and provide detailed benefit information Subscriber: the primary person, generally the Employee, enrolled in this Group Plan Page 1 COVERAGE CONTRACT CONTRACT EXAMINATION PERIOD If, after examination, the Group is not satisfied with this Contract for any reason, the Group may return the Contract to KPS within ten (10) days of the date it is received Upon receipt of the returned Contract, KPS will refund to the Group any pre -paid Premiums The Contract shall subsequently be deemed null and void EFFECTIVE DATE, DURATION, AND RENEWAL This Contract shall begin at 12 01 a m Pacific Time on the effective date (as indicated on the title page), and shall remain in effect until the Contract Renewal Month unless terminated according to the provisions set forth herein Thereafter, this Contract may be renewed automatically at 12 01 a m on the same date (month and day) in subsequent Calendar Years, unless otherwise terminated according to the provisions set forth herein PREMIUM PAYMENT PROVISIONS Payment Due Date/Grace Period The initial Premium payment is due and payable to KPS on or before the effective date of this Contract indicated on the title page Thereafter, Premium payments are due and payable on or before the first day of every month ( "Premium Due Date ") for which coverage is provided A roster of current enrollment and enrollment changes must accompany each Premium payment A ten (10) day grace period following the Premium Due Date is allowed, during which time this Contract shall not be terminated If payment is not received within the ten (10) day grace period, KPS may, at its sole discretion, elect to extend the grace period for up to 60 days from the Premium Due Date or terminate this Contract without notice to the Group If KPS elects to terminate this Contract due to non - payment of Premium, the effective date of termination will be retroactive to the last day of the month for which payment was received No further liability for claims will accrue to KPS Enrollees in this Group Plan shall not be entitled to benefits during any calendar month for which the Premium, on his /her behalf, was not received by KPS Premium payments, if applicable, must accompany all applications for coverage. Premium Rate Adjustments The Premium rates applicable to this Group Plan are defined in Attachment B - Premium Rates and Underwriting Criteria Rates are guaranteed until the Contract Renewal Month each Calendar Year Notwithstanding the foregoing, KPS reserves the right to revise the rates as follows > As part of the annual Contract renewal process > As a result of any state or federal law or regulation that imposes an additional tax, new tax or other assessment on KPS revenue > In the event there is a material change in the basis upon which KPS assumed risk under this Contract Such changes may include inaccurate information presented by the Group, changes in the benefits, or other Contract terms required by statute or regulation, underwriting guidelines, or fluctuations of ten percent (10 %) or more in the number of enrolled Subscribers KPS will give the Group 60 days prior written notice of any change in Premium rates not associated with the annual Contract renewal process KPS will give the Group 30 days prior written notice of rate increases associated with the annual Contract renewal process Page 2 COVERAGE CONTRACT { Premiums Paid by Subscribers In certain instances, Subscribers may be required to self -pay their Premiums in order to continue coverage Those instances include ➢ Strikes, lockouts, and other labor disputes that cause a disruption in Employee benefits When the Subscriber elects to continue coverage under a COBRA provision or other coverage continuation provision available under this Group Plan The Group is required to collect self -paid Premiums for continuation coverage and forward payments to KPS on or before the Premium Due Date In the instance of strikes, lockouts, and labor disputes, the Enrollee may self -pay their Premium directly to the group on or before the Premium Due Date Premium Refunds KPS will refund to the Group any Premium paid, in advance, for periods after the termination date of this Group Plan In the case of an ineligible person(s) enrolled in this Group Plan, KPS will refund to the Group any Premium paid during a period of ineligibility that is in excess of claim payments made on behalf of the ineligible person(s) during the period of ineligibility This refund will not exceed an amount equal to three (3) months of Premium payments ELIGIBILITY AND ENROLLMENT Group Eligibility In order to be eligible to participate in this Group Plan, the Group must continuously meet all eligibility, participation, Group size, contribution, and other requirements specified in the Group Master Application form KPS reserves the right to audit the Group's employment, payroll, and eligibility records to ensure that the Group continues to meet its participation requirements and to ensure that eligible Employees are properly enrolled in this Group Plan Subscriber Eligibility Requirements Retired LEOFF I Employees, as defined in the Definitions section, are eligible to enroll in this Group Plan As of March 1, 2001, Eligible Dependents of retired LEOFF i Employees are no longer eligible to enroll in this Group Plan Retired LEOFF I Employees who do not enroll when they are initially eligible may not apply for coverage at a later date except in certain circumstances (see the Enrollment Under Special Circumstances section of Attachment A) Enrollment Reporting Requirements The Group will verify enrollment of all Employees eligible for enrollment under this Contract and ensure that appropriate documentation is submitted to KPS for approval Enrollment Timeframes Currently retired LEOFF I Emplovees are initially eligible to apply for coverage beginning on the effective date of this Group Plan Application for coverage must be received by KPS within 31 days of initial eligibility Newly retired LEOFF I Employees may initially apply for coverage on their effective date of retirement Application for coverage must be received by KPS. within 31 days of initial eligibility Page 3 COVERAGE CONTRACT Enrollment Under Special Circumstances Retired LEOFF I Employees who, when they were initially eligible to enroll, declined coverage in this Group Plan, based on existing coverage under another health plan, may apply for coverage under this Group Plan if they lose eligibility for coverage under their other health plan, or if the other health plan terminates Retired LEOFF I Employees must apply for coverage within 31 days of losing coverage under their prior plan When Coverage Begins Coverage for new Enrollees begins on their date of initial eligibility provided they enrolled in this Group Plan within the specified time limits (see Enrollment Timeframes) and any applicable Premium amounts have been paid TERMINATION OF COVERAGE Continuity of Coverage Continuity of coverage under this Contract is guaranteed to all Enrollees provided the Group continues to meet eligibility requirements and continues to pay applicable Premium payments on a timely basis Termination or Rescission of Contract This Contract may be terminated as of the date on which any of the following occurs > The Group fads to make full Premium payments > The Group violates, or refuses to comply with, the terms and conditions of this Contract > The Group violates, or refuses to comply with, any published KIPS policies and procedures that have been approved by the Insurance Commissioner > There is a change to, or implementation of, federal or state law that prohibits the continued offering of this Group Plan > KIPS replaces this Group Plan In this case, the replacement plan will (i) include the services covered under the replaced Group Plan, (n) be offered to the Group's eligible Employees, and (m) not significantly limit access to the kind of services covered under the replaced Group Plan In addition, the Group may terminate this Contract, at any time, by providing thirty (30) days written notice to KIPS KIPS may rescind or terminate this Contract upon thirty (30) days written notice in the event that intentional misrepresentation of material fact or fraud was used in order to obtain Group coverage In no event will coverage be terminated or rescinded solely on the basis of an Enrollee's physical or mental condition provided they meet all other eligibility requirements set forth by the Group The Group may appeal a termination or rescission decision through the KIDS appeals process Either party may terminate this agreement in the event of intentional misrepresentation, fraud, or omission of information by the other party in performance of its responsibilities under this agreement If this Contract is terminated coverage for all Enrollees will end automatically on the effective date of termination, or on the last day of the last month for which the Group paid the Premium, whichever occurs first KPS will refund to the Group any Premium paid for periods after the termination date In the case of termination or non - renewal of this Contract, KIPS shall be responsible for providing the effective date of termination of coverage to all affected Subscribers Page 4 COVERAGE CONTRACT Termination or Rescission of Enrollee Coverage Coverage for an individual Enrollee under this Contract will end as of the date on which any one of the following events occurs Non - payment of any Premium amount, when Premium payment is the responsibility of the Enrollee ➢ The Enrollee loses eligibility for coverage under this Contract �o The Enrollee refuses to comply with the terms and conditions of this Group Plan as described in Attachment A Y The Enrollee obtains coverage through intentional misrepresentation of material fact or fraud ➢ The Enrollee voluntarily disenrolls from this Group Plan There is a change in either state or federal laws that no longer permit KPS from offering this Group Plan v This Contract is terminated Coverage ends on the last day of the month in which the Enrollee was eligible for coverage, provided all applicable Premium amounts have been paid In the case of non - payment of Premium, coverage ends on the last day of the month for which KPS received a Premium payment KPS will be entitled to recover claims payments for services received by the Enrollee after the termination date, unless there was prior authorization for those services Upon termination of coverage either KPS or the Group shall issue a Certificate of Creditable Coverage certifying the period(s) during which the Enrollee was enrolled in this Group Plan An Enrollee who loses coverage under this Group Plan may be eligible to continue coverage or enroll in a KPS Conversion Plan (see the Continuation of Coverage section of Attachment A) A Subscriber who voluntarily disenrolls from this Group Plan will not be eligible to re- enroll in this Group Plan, until the next Open Enrollment Period See the Enrollment Under Special Circumstances section of Attachment A for exceptions to this policy COBRA (Consolidated Omnibus Budget Reconciliation Act - 1985) If an Enrollee loses eligibility for coverage under this Group Plan, they may be eligible to continue their coverage for a period of time specified by federal law and regulations then in effect This continuation of coverage is referred to as COBRA and applies generally to groups of 20 or more employees KPS offers coverage only when Groups are required by law to provide COBRA coverage for their employees, and > KPS is notified of a beneficiary's election of COBRA coverage within 31 days of that election being made Continuation of coverage under COBRA is not automatic Enrollees must apply for continuation of their Group coverage within 60 days of the date they receive a COBRA election notice from the Group KPS offers COBRA coverage to Groups only as required by law The Group Plan Administrator is required to notify KPS of an Enrollee's election of COBRA continuation coverage within 31 days of that election Failure on the Enrollee's part to make a timely election, or failure on the part of the Group Plan Administrator to provide KPS with timely notification of the election, will be interpreted by KPS as a waiver of the Enrollee's right to continue coverage under this provision Failure by the Group Plan Administrator to provide timely notification to KPS may not, in all cases, eliminate the Group's obligation to provide continuation coverage It will, however, eliminate any obligation on the part of KPS to provide the Enrollee with COBRA continuation coverage under this Group Plan Fraudulent Information In the event it is discovered that the Group has provided false or misleading information in connection with the provisions of this Contract for the purpose of defrauding KPS, KPS reserves the right to terminate or rescind coverage and shall inform the appropriate state and regulatory authorities, including, but not limited to, the Washington State Office of the Insurance Commissioner (OIC) for a determination of the Group's liability Page 5 COVERAGE CONTRACT Re Enrollment/Reinstatement �¢ If this Contract has been terminated by KPS due to non - payment of Premium, the Group automatically forfeits all rights to guaranteed renewal of coverage afforded under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Any decision to reinstate or re- enroll the Group is at the sole discretion of KPS SUBSCRIBER LIABILITY AND RIGHTS Subscriber Liability Subscribers who are enrolled in this Group Plan are liable for the following costs > Deductible (defined in Attachment A) > Copayments (defined in Attachment A) > Charges for non - Covered Benefits and Services > Coinsurance, up to the Coinsurance Maximum limit (defined in Attachment A) > Charges incurred after an annual or lifetime maximum benefit for a specific service or supply has been exhausted (e g , the annual maximum benefit for medical equipment and supplies) > Charges in excess of the amount allowed by KPS for Non - Participating Providers If KPS fads to reimburse a Participating Provider for the cost of Medically Necessary Covered Benefits and Services provided in accordance with the terms of this Contract, neither the Enrollee nor the Group shall be required to compensate the Participating Provider for such services beyond the limit of Deductibles, Copayments, or Coinsurance amounts specified in Attachment A What happens if a Provider no longer participates with KPS? If a Participating Provider chooses to terminate their agreement with KPS, we will notify the affected Enrollees of the termination The notification will allow Enrollees at least 60 days to either (i) complete their course of treatment, or (u) appropriately transfer their care to another Participating Provider After the 60 days, services received from a Provider who has terminated their agreement with KPS will be covered at the Non - Participating Provider benefit level GENERAL TERMS AND CONDITIONS Applicable Law This Contract shall be governed by the laws of the state of Washington Venue for this Contract shall be Kitsap County Assignment of Benefits The benefits of this Contract shall accrue to Subscribers This Contract, payments, or Covered Benefits and Services are not assignable to a third party KPS reserves the right to make benefit payments to the Subscriber, their Provider(s), or jointly, as KPS deems necessary and appropriate, subject to federal and/or state laws Binding Agreement This Contract is binding on KPS and the Group, as well as their respective executors, administrators, successors, and /or assigns By election of coverage or payment of applicable Premiums, or if the Group's Subscribers seek the services provided under this Contract, all of the terms, covenants, and conditions contained herein shall become binding on the Group and its Subscribers, notwithstanding the failure of the Group to sign this Contract ' This Contract shall not bind KPS until (i) a person.Zuthornze4 by KPS signs it, and (u) a signed copy is delivered to the Group Page 6 COVERAGE CONTRACT Confidentiality The underwriting and financial terms of this Contract are confidential and shall not be disclosed except as is necessary for the performance of this Contract or as required by law Contract Modifications Except as set forth under the Premium Rate Adjustments section, KPS reserves the right to modify the provisions of this Contract, or the services described in Attachment A, upon 30 -days written notice to the Group The Group may elect to reject such modifications by providing KPS with 15 -days written notice However, refection of a modification will result in the termination of this Contract as of the last day of the month for which Premium payment has been received Lack of notification of refection by the Group shall be interpreted as acceptance of the modification, and this Contract will be renewed as modified No modification of the terms of this Contract shall be binding upon KPS unless endorsed, in writing, and signed by an authorized officer of KPS Such Endorsement shall be deemed a part of this Contract, effective as of the effective date of the Endorsement Any amendment or Contract modification required by law or regulation shall become effective as of the effective date required by such law or regulation Coverage Limits The Covered Benefits and Services offered under this Contract are subject to the coverage limits and maximums set forth in Attachment A Entire Agreement This Contract, together with Attachment A, any Riders and /or Endorsements attached hereto, and Attachment B — Premium Rates and Underwriting Criteria, constitutes the entire agreement This Contract supersedes all previous communications, representations, or agreements, whether verbal or written, between KPS and the Group Equity of Application This Contract is intended to apply equally to all Enrollees Force Majeure In the event KPS is unable to perform its obligations hereunder by reason of fire, casualty, lockout, strike, labor condition, riot, war, act of God, or by ordinance, law, order, or decree by any legal authority, the Contract may, at the option of KPS, be suspended During any period of suspension, KPS shall not be required to perform any service hereunder, nor shall KPS be liable for any damages arising from any event that precipitated the suspension If this Contract is suspended pursuant to this provision, any obligation by the Group and /or an Enrollee to make Premium payments also shall be suspended for the same period of time Group Cooperation The Group agrees to cooperate with KPS in the administration of this Contract by > Advising Subscribers of policies and procedures applicable to this Group Plan > Providing Subscribers with Attachment A, ID cards, and any applicable notices or other information regarding this Group Plan > Providing information about Enrollees that is relevant to the determination of eligibility, claim reimbursement, coordination of benefits, or other information required for the administration of this Contract y Making appropriate payroll deductions, if applicable, to facilitate Premium payment Page 7 COVERAGE CONTRACT Headings The headings of sections and paragraphs in this Contract are for convenience and reference purposes only and do not affect in any way the meaning or interpretation of any provision of this Contract Notices Any notice that may affect the provisions of this Contract shall be deemed delivered to the Group when deposited in the United States mail, with prepaid postage, addressed to the Group at the most recent address listed for the Group Any notice that may affect the provisions of this Contract shall be deemed delivered to KPS when deposited in the United States mad, with prepaid postage, addressed to KPS Health Plans P O Box 339 Bremerton, WA 98337 -0039 Any requirement of KPS to provide notice to Enrollees shall be fulfilled when the Group has received such notice It is the responsibility of the Group to disseminate notices to Enrollees within 31 days of receipt Severability If a court of competent jurisdiction deems any term, provision, Endorsement, or condition of this Contract invalid or unenforceable, the same shall be deemed severable from this Contract The remaining provisions of this Contract shall remain in full force and shall in no way be affected or invalidated as a result of such decision Third Party Beneficiaries There are no third party beneficiaries to this Contract Waiver of Breach Waiver of a breach of any provision of this Contract shall not be deemed to be a waiver of any other breach of the same or different provision Page 8 COVERAGE CONTRACT The following topics are described in detail in Attachment A Please refer to the Table of Contents in ° Attachment A to locate each section ELIGIBILITY AND ENROLLMENT ➢ Continuation of Inpatient Coverage BENEFITS SUMMARY CONTINUATION OF COVERAGE Coverage During a Labor Dispute ➢ Continuation of Group Coverage Ir Conversion Coverage COORDINATION OF BENEFITS (COB) KPS's RIGHT OF REIMBURSEMENT AND SUBROGATION COMPLAINTS AND APPEALS PROCESS ENROLLEE RIGHTS ➢ KIPS Privacy Policy ➢ Statement of ERISA Rights Page 9 KPS Health Plans 400 Warren Avenue P O Box 339 Bremerton, WA 98337 -0039 CITY OF BREMERTON UNDER 65 LEOFF I RETIREES COVERAGE CONTRACT Group Number. 21003 Effective Date January 1, 2012 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwriting Criteria This Contract is entered into and delivered in the state of Washington and is governed by Washington State laws, except to the extent state laws are preempted by federal law Signature by an authorized Group representative or payment of the Premium shall constitute acceptance of the terms and conditions set forth herein. FOR KPS• FOR GROUP. W James Page Jr, President Signature January 26, 2012 Date Print Name Title Date AGENDA BILL CITY OF BREMERTON CITY COUNCIL 56m ■■ eeeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeee SUBJECT: Installation of services beds on Study Session Date February 22, 2012 trucks purchased in 2011 COUNCIL MEETING Date March 7, 2012 Department ERR Presenter Jim Orton Phone 473 -5359 SUMMARY: In budget year 2011, two replacement trucks were purchased that services boxes were required Due to the uncertainties of the 2011 budget it was decided to hold off on the installations until 2012 The first truck we utilized an existing service body and transferred it to the new truck chassis The total cost for this installation is $7,028 05 including Washington State sales tax The second truck will have a new service body installed at a total cost of $19,997 06 including Washington State sales tax The authorized dealer is Allied Body of Seattle Washington for a total cost of $27,025 11 ATTACHMENTS: Copies of quote from Allied Body of Seattle Washington FISCAL IMPACTS (Include Budgeted Amount) Funding is available thru the 510 but this will require a budget adjustment due to the expenditure was authorized in the 2011 budget APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR *74 MAYOR RECOMMENDED MOTION: That City Council authorizes the expenditure of $27,025 11 including Washington State sales tax STUDY SESSION ACTION: Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT i ,°! /" COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No ction Form Updated 11/02/2011 ALLIED Allied Body Works, I c Estimate BODY Sea South 96th Street Seattle, WA 98108 Date Estimate No 1/30/2012 11740 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TEW ITEM DESCRIPTION QTY LOCATION TOTAL MATERIALS LED ROPE LIGHTING, BRIGHT WHITE, 1/2",120V 60 32520 PRICE PER FOOT (INCLUDES ROPE & SPLICES WRAP) TRU 4050 LMP- S /T /T,LED,4 ",12V 2 4000 TRU 94993 PIG TAIL -PL 3, S /T /T RED WHITE BILK 2 300 TRU 40700 GROMMET -MDL 40 6 930 MATERIALS SUPER SPRINGS SSA7 HEAVY DUTY SUSPENSION 1 39900 ENHANCEMENT KIT MATERIALS MISC SHOP MATERIALS & STEEL PLATING FOR 1 5000 ANGLE BRACKET OFF FRONT OF BOX CENTERED, FOR BREMERTON TO MOUNT GO -LITE, AND TO WELD CLIPS FOR MOUNTING LED ROPE LIGHTING IN COMPARTMENTS AND INTERIOR ROOF RIBS LABOR HOURS OF SHOP LABOR FOR ALL ABOVE LISTED 40 3,200 00 LINE ITEMS PLUS TRANSFER OF BODY FROM S -10 PICKUP TO 2012 CHEVROLET COLORADO W/ SAME CA MEASUREMENT PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) TOTAL Page 1 ALLIED Allied Body Works, I c Estimate BODY 625 South 96th Street Seattle, WA 98108 Date Estimate No 1/30/2012 11740 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TE W ITEM DESCRIPTION QTY LOCATION TOTAL SUBLET REFURBISHMENT OF BODY AND REPAINT - 1 2,44500 INCLUDES SMALL PARTS /BRACKETS SAND BLASTED (AS NEEDED), SEAM SEALING, PATCHING OF ANY OBVIOUS HOLES (REAR COMPARTMENTS IN PARTICULAR) FIXING OF ANY OBVIOUS DENTS - EPDXY PRIMER FOLLOWED W/ (2) COTES POLYEUROTHANE (IMRON AVAILABLE IF REQUESTED) - PRICE IS FOR fNTERIOR AND EXTERIOR OF BODY SUBTOTAL 6,471 50 * TRANSFER EXISTING BODY FROM S -10 TO 2012 CHEVROLET COLORADO W/ SAME C A MEASUREMENT ESTIMATE ALSO INCLUDES 1 ADDING LED ROPE LIGHTING TO ALL COMPARTMENTS AS WELL AS ACROSS THE THREE REAR -MOST ROOF BOWS (BACKSIDE) WITH ALL WIRING LOOSE IN BACK CURB SIDE CORNER (FOR CUSTOMER TO DEAL WITH IN TERMS OF WIRING TO ANY SWITCH) 2 REPLACING LIGHT GROMMETS WHILE MOVING BACKUP LIGHTS INTO BUMPER AND PUTTING TURN SIGNAL LED LIGHTS IN THEIR VACATED POSITION PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) TOTAL Page 2 ALLIED Allied Body Works, Inc Estimate BODY Sea South 96th Street Seattle, WA 98108 08 Date Estimate No 1/30/2012 11740 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TEW ITEM DESCRIPTION QTY LOCATION TOTAL 3 ADD T' BRACKET TO FRONT OF BODY, CENTERED, FOR CUSTOMER TO INSTALL GO -LITE 4 REMOVE ALL TOP MOUNTED LIGHTS IN REAR AND PATCH HOLES 5 ADD SUPER SPRINGS TO REAR SUSPENSION (3000+ LBS ) 6 REPLACE DOOR CHAINS ON REAR DOORS W/ SPRING LOADED 7 REFURBISH INTERIOR AND EXTERIOR OF BODY INCLUDES PAINT PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal $6,471 50 ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) S55655 TOTAL S7,02805 Page 3 ALLIED Allied Body Works, I c Estimate BODY 625 South 96th Stree Seattle, WA 98108 Date Estimate No 2/1/2012 11748 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TEW ITEM DESCRIPTION CITY LOCATION TOTAL MATERIALS READING CLASSIC 11 SPACEMAKER SERVICE 1 9,07400 BODY, US108ADW 33503022 - INCLUDES EZ SLIDE DRAWERS IN BOTH HORIZONTAL COMPARTMENTS, GNG 3- DRAWER UNIT IN CURBSIDE FRONT VERTICAL COMPARTMENT, MASTERLOCKING W/ SAFETY SHIELD ALL POWDER COATED WHITE TRU 97231 FLASHER - NON AUDIBLE ULTRAFLASH 1 5200 TRU 15220 LAMP LIC, LED, 12V, NEW FLYER 1 2500 TRU 3005OR LMP KIT -MDL 30 LED, 12V 7 8400 TRU 6005OR LMP KIT - S /T /T, LED GRMT MNT 4 16000 TRU 60075Y LMP KIT -T /S, LED GRMT MNT 2 10400 BUY BA0972 BACK UP ALARM 97DBA l 4000 MATERIALS MISC WIRING MATERIALS 1 750 UNI M6325 SILAPRENE M6325,10 I OZ, GREY A/S 2 1900 BUY B38 D -RING, 1/2" FORGED W/2 HOLE BRKT 2 2000 BUY RT25812 RECEIVER TUBE 2 "ID X 12 ", 5/8" PH 3 8400 BUY TC1007 TRAILER CONNECTOR,TRUC KEND, METAL, 7P IN 1 1300 RD BUY HP6253WC 5/8" HITCH PIN W/H P COTTER PIN 2 700 BUY B901 H D 360' SWIVEL, 5000 LB CAP 4 10000 BUY PM87 PINTLE HOOK MOUNTING PLATE l 5000 BUY BH82516 COMBINATION HITCH W/2- 5/16" BALL 1 10400 MATERIALS CUSTOM STEEL BUMPER (NORTHPARK) 188 x 10" 1 60000 x 14" x 96" LONG STEEL TREADPLATE ANGLE & 4" x 8" a 4" x 96" LONG CHANNEL 1 I GAUGE STEEL PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) TOTAL Page 1 ALLIED Allied Body Works,l ic Estimate BODY 625 South 96th Street Seattle, WA 98108 Date Estimate No 2/1/2012 11748 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TEW ITEM DESCRIPTION QTY LOCATION TOTAL MATERIALS MISC MATERIALS, STEEL, ALUMINUM PAINT, 1 95000 ECT SUBLET LINE -X FLOOR, SIDE WALLS, BACK OF TAILGATE 1 1,00000 AND BUMPER LABOR HOURS OF SHOP LABOR 65 5 200 00 SUBLET PAINT "BREMERTON SHELF" WHITE 5 40000 SUBLET PAINT REAR BUMPER PRIOR TO LINE -X 4 32000 SUBTOTAL 18 413 50 • ESTIMATE TO FURNISH & INSTALL ALL ABOVE LISTED MATERIALS FOR 2011 FORD F -350 CHASSIS W/ 60" C A AND DUAL REAR WHEELS INCLUDES READING CLASSIC II 108" SERVICE BODY W/ SPACEMAKER LIDS - ALSO INCLUDES THE FOLLOWING 1 CUSTOM BUMPER W/ RECEIVER TUBES OUT REAR AND EACH SIDE (INCLUDES D- RINGS, COMBINATION HITCH & SPECIALTY LED LIGHTING W/ FLASHER CAPABILITIES TIED TO UPFITTER SWITCHES) 2 LINE -X CARGO AREA INCLUDING SIDE WALLS BACK OF TAILGATE AND BUMPER 3 BACKUP ALARM PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) TOTAL Page 2 ALLIED Allied Body Works, I ic Estimate BODY 625 South 96th Street Seattle, WA 98108 Date Estimate No 2/1/2012 11748 ALLIED BODY WORKS INC Name /Address CITY OF BREMERTON EQUIPMENT SERVICES DIVISION 100 OYSTER BAY AVE N BREMERTON, WA 98312 Vehicle # VIN # PO No Terms REP Project Net 30 TEW ITEM DESCRIPTION QTY LOCATION TOTAL 4 CUSTOM 'BREMERTON SHELF" INCORPORATED INTO HEADACHE RACK - INCLUDES 6" BRACKET ON EACH CORNER OF HEADACHE RACK AND HALF -MOON SHAPED ANTENNA BRACKET ON FRONT EACH SIDE OF BREMERTON SHELF 5 TAMPER HOLDER - PINNED CHANNEL AT TOP FOR HANDLE, SQUARE ANGLE AT BOTTOM TO REST BASE 6 CUSTOM CHANNEL KEY HOLDER DOWN FULL LENGTH OF BODY DOWN CURBSIDE, ALUMINUM 7 GRIP N GLIDE 3- DRAWER UNIT IN CURBSIDE FRONT COMPARTMENT, EZ SLIDE SHELVES IN BOTH HORIZONTAL COMPATMENTS PLEASE SIGN & DATE TO ACCEPT ESTIMATE Subtotal $18413 50 ESTIMATE VALID FOR 30 DAYS FROM DATE ABOVE Sales Tax (8.6 %) $1,583 56 TOTAL $19 997 06 Page 3 AGENDA BILL CITY OF BREMERTON CITY COUNCIL SUBJECT: Purchase of 2 Chevrolet Study Session Date February 22, 2012 Caprice Police Pursuits vehicles COUNCIL MEETING Date March 7, 2012 Department ERR Presenter Jim Orton Phone 473 -5359 SUMMARY: The 2012 approved budget reflects the replacement of two (2) Ford Crown Victoria police interceptors The standard for police cars in Bremerton's fleet is the Crown Victoria but 2011 was the last year of production It has been decided between Fleet and the Police Department that we will purchase 2012 Chevrolet Caprice Police Interceptors I am requesting Council authorize the purchase of two (2) 2012 Chevrolet Caprice's utilizing State Contract 03611 The State Contract dealer is Bud Clary Chevrolet of Longview Washington Total cost for the 2 cars is $60,898 21 including Washington State sales tax This is for the cars only, police equipment installation will be brought forward at a later date ATTACHMENTS: Copy of State Contract 03611 FISCAL IMPACTS (Include Budgeted Amount) Funds are available in the ERR fund 510 APPROVALS: DEPARTMENT DIRECTOR rL AV--o� CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: That City Council authorizes the purchase of 2 Chevrolet Caprice police interceptors using State Contract 03611 for a total cost (cars only) of $60,898 21 including sales tax STUDY SESSION ACTION: Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT i oe p COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 Current Contract Information Contract No 03611, Police Pursuit Vehicles Price Sheet Order Form Page 7 ONLINE ORDERS MAY BE PLACED AT httysh1fortress. iva.govl des /ittet/velirea/velinienti.lrhn TO MINIMIZE PRODUCTION DELA YS ORDER AS EARLY AS POSSIBLE, BEFORE MARCH 31, 2012. POLICE VEHICLE —FULL SIZE RWD POLICE PURSUIT VEHICLE TYPE 4 DOOR SEDAN MAKE/MODEL CHEVROLET CAPRICE EQUIPMENT INCLUDED IN NET PRICE - 6 0 Liter, 8 cylinder Gas Engine (350 HP) (380 Lb Ft - Daytime Running Lights Torque) - AM /FM Stereo with Digital Clock & CD/MP3 - Automatic Transmission w /First Gear, Lockout and - Cigarette Lighter/ Auialiary Power Source Highest Capacity Cooler - Certified Police Speedometer 0 -160 MPH HD Engine Cooling, Engine Oil Cooler - Hubcap Wheel Covers P235/60HR18 BSW Speed Rated All Season Radial - HD Power Brakes, Anti -Lock Braking System Tires, Firestone(]) - Power Windows With Passenger Lockout Switch - Matching Full Size Spare Tire & Wheel - Power Door Locks - Molding Front Doors Installed - Electric Trunk Release, Battery Operated (no key req ) - Air Bags, Driver & Front Passenger, Frontal & Side - Inside Hood Release Impact - Intemuttent Wipers - Power Steering w /external cooler - Police Equipment Mounting Bracket Between Front Seats (No - Power Driver's Seat, 8 Way w /Manual Center Console) - HD Power Brakes, 4 -Wheel Anti -Lock System - Radio Suppression Package 700 CCA Battery - Trunk, Glove Box, Dome and Engine Compartment Lights - 170 AMP Alternator - All Factory Standard Police Package 29AEquipment including - HD Police Suspension Package Tire Pressure Monitoring System - HD Front Bucket Seats, Rear Bench Seat w /HD Seat Lamp Cushions Police Prep Package - Light Tinted Glass, All Around HD Cooling, Coolant Recovery System - Rubber Floor Cover Cruise Control - Power Heated Mirrors Inside Tiunk Emergency Release Air Conditioning w/higli speed cutout Headlamps On Warning, Buzzer /Chime - Electric Rear Window Defroster Roof Reinforcement - Tilt Steering Wheel Police Power Pigtail - Engine Oil Cooler 2 65 l Rear Axle Ratio - Random code, Single Key System. Dour Keys, 8 36/36 Mile Bumper to Bumper Warranty, intergated Keys 5 Yr /100,000 Extended Warranty (PPV660) Mercury Free Vehicle VEHICLE MELTS CALIFORNIA EMISSION STANDARDS Zinc/Steel Wheel Weights DEALER Bud Clary Auto Dealerships (W262) DEALER CONTACT John Slater or Jim Scott PO Box 127 PHONE 1- 800 - 899 -1926 Longview WA 98632 EMAIL islater @budelary con. FEDERAL TAX ID NO 91- 0699054 DELIVERY 160 -180 Days After Receipt of Order PAYMENT TERMS Discount $200 /20 Days (per vehicle) Net 30 Days (l) Not Tire Chain Compatibility POLICE VEHICLE —FULL SIZE RWD POLICE PURSUIT VEHICLE TYPE 4 DOOR SEDAN MAK E /MODEL CHEVROLET CAPRICE NET PRICE (Vehicle equipped as above, delivered to any point within the State of Washington, exclusive of Federal Excise and before 8.2% State Sales Tax including a 3% vehicle tax) Current Contract Information Contract No. 03611, Police Pursuit Vehicles Price Sheet Order Form Page 9 ORDER CODE VEHICLE DESCRIPTION ORDER On PRICE EACH PRICE EXTENSION 2312- 081 -001 Automobile, Full -Size Police Pursuit RWD, 4 Door Sedan 2012 Chevrolet Caprice 2 ea $26,050 00* $52,100 (1EW19) NO COST EXTERIOR COLORS INDICATE QUANTITYOF COLOR(S) SELECTED White Mirage , Silver , Red , Black — 2 . Karma , Grey ORDER CODE OPTION DESCRIPTION ORDER PRICE EACH PRICE TY EX7ENSION 2312 -081 -010 Credit for pickup from selling Dealer (Orders for Eastern $(100.00) $ WA ) (DLR) * (EPO) (Deduct) 2312 - 081 -011 Credit for pickup from selling Dealer (Orders for Western 'x(100.00) WA) (DLR):' (WPU) (Deduct) 2312 - 081 -012 Alternative Engine, 3 6L V6, E85 (50 state emissions) (LFX) 2 $000 OAO 2312 - 081 -013 Dual Batteries (K45) 2 S22000 440 2312 -081 -014 Detective Car, No Offset Console (90) $000 2312- 081 -015 Door Panel, Ballistic Drivers Side (KTBDP -L) $1,79700 Door Panel, Ballistic Driver and Front Passenger Side $3,59500 2312- 081 -016 (KTBDP -R &L) 2312- 081 -017 Door Panels, High Strength Aluminum Rear Doors (Kdoor) S29500 Differential Limited Slip(Included wN8with 6 Cylinder S16600 2312- 081 -018 (G80) 2 1 332 Delayed Warranty Start email dealer VIN, adjusted in- service $000 date and brief reason for delay (Dealer to provide form to Fax) 2312- 081 -019 (DLR)x Fire Extinguisher, 2 5# Dry Chemical ABC rated w/Mounung $35.00 2312 -081 -020 Bracket, Delivered wNehicle, Uninstalled (DLR)' Flare Kit, 3 Piece Triangle w /Storage Box for Roadside $3500 2312- 081 -021 Emergency use, Delivered wNelucle, Umnstalled (DLR)II 2312- 081 -022 Flasher, Wig Wag, Headlamp System (6J7) $33000 2312- 081 -023 Fuse Box, Auxiliary (six 20Am s) (KPDIST) 5410 00 2312 -081 -024 Gas Cap Locking (DLR) $3500 2312 -081 -025 Inoperative Door Jam Light Switches on Dome Light (7Y6) 2 $2200 44 2312 -081 -026 Keys Set of 2 instead of 4 (T53) (Deduct) $(120.00) 2312 -081 -027 Lamp Prewire Group (Package Tray, Inner Decklid) (T53) S36200 2312 -081 -028 Mirrors, Power Heated, Foldawa (GUK) $5300 Manufacturer to Dealer Order Acknowledgement Document $000 2312 -081 -029 Faxed or E- nailed to Customer (DLR) k 2312 -081 -030 Mud Flaps (Set of 4) (DLR) r $13500 2312- 081 -031 Rear Door Locks & Handles Inoperable (6N6) 2 $5900 118 2312- 081 -037 Remote vehicle Starter System (BTV) $26000 ORDER CODE OPTION DESCRIPTION ORDER PRICE EACH PRICE 12 TY EXTENSION Current Contract Information Contract No 03611, Police Pursuit Vehicles Price Sheet Order Form Page 9 Carpet Floor Covering, HD, instead of vinyl (includes cloth rear $(90.00) $ 2312- 081 -033 seat) (AEH) (Deduct) 2312- 081 -034 Spotlight Pre Package (7X8) $25000 Seat, "Laguna 3P Prisoner Transport" (Factory Seat & Seat $65000 2312- 081 -035 Belts Loose in Trunk) (add 30 days) (DLR) Spare Wheel, No Tire in addition to standard tull size tire and $295,00 2312. 081 -036 wheel (SWO) Spotlight, 6 inch Halogen, Clear Lens, Pillar Mounted Left S39500 2312 -081 -037 (Black) (LNF) 2 790 Spotlight, 6 inch Halogen, Clear Lens, Right, to match Lett S72200 2312- 081 -038 Spotlight (LNA) Stock Vehicle Upcharge (Call dealer or SPO for availability) S25000 2312- 081 -039 Delive within 7 days when available (STK)* 2312. 081 -040 Undercoann (DLR) r 2 $19500 390 2312 -081 -041 Universal Keyed Fleet (All vehicles keyed alike) (6E3/634) 2 $2200 44 Vehicle Partition, Horizontal Sliding Center Section w /Lexan $91900 (Include Full Lower Extension Panel) (Installed) (SetinalOS) 2312 - 081 -042 (KPCS) Vertical Partition, Double Vertical Weapon System ( Horizontal $1,34800 Sliding Center Section w /Lexan, Full Lower Extension Panel, One Standard Shotgun lock, One Adjustable Universal Lock including Key Override and Timer)(Includes Recessed Panel) 2312- 081 -043 (Installed) (SetinalORP) (KVETR/KRCSP Vehicle Push Bumpers 12" HD Aluminum, Set 2 (Installed) $39500 2312 -081 -044 (Setina P13200) Vehicle Push Bumpers 16" HD Aluminum, Set 2 (Installed) $395.00 2312 -081 -045 (Setina PB200) Vehicle Push Bumpers HD w /Welded Oval Cross Support $35400 2312- 081 -046 (Setina PB400) (KPush) Vehicle Push Bumpers Upgrade Fender Protectors S4,006-0 2312 -081 -047 (Setina P135) (when ordered with one PB 200, 300 or 400) Vehicle Push Bumpers, HD w /Bolted Oval Upper Cross S44500 2312 -081 -048 Su ort (Setina PB300) Window Barrier, HD Steel, Rear Doors (Installed) (Setina) $29000 2312- 081 -049 (KWBAR) 2312 -081 -050 Wiring, Auxiliary Speaker (WX7) $7500 2312 - 081 -051 Wiring, Harness, Root (Center hole) (6137) S17200 2312- 081 -052 Wiring Harness, Root No hole) (6l5) $17200 2312 -081 -053 Wiring. .Horn/Siren Circuit (674) 2 $5600 112 Wiring Package for Connection of Grille Lamp Siren & S14500 2312- 081 -054 Speakers (6.13) 2 290 2312 -081 -055 Wheel Covers, Hubcaps instead of Full (set 4) (W2P) $3500 2312- 081 -056 Rear window switches inoperative (6N5) 2 61.50 I23 White vinyl top and 4 doors 2 750 1500 SUBTOTAL 56,283 +8.2% 4615.21 SST TOTAL 60 898.21 AGENDA BILL CITY OF BREMERTON CITY COUNCIL 53: SUBJECT: Study Session Date February 22, 2012 Application to WSDOT for Safe Routes to COUNCIL MEETING Date March 7, 2012 Schools Grant Funding Department PW &U Presenter Knuckey Phone 473 -2376 SUMMARY: The Washington State Department of Transportation has announced a call for projects to be funded under the Safe Routes to School Program The purpose of these grants is to address pedestrian and bicycle mobility and safety near schools This program does not require matching funds for 2012, applications are due May 4th The requested action before City Council is approval for City Staff to submit a zero match grant application not to exceed $500,000 for the next phase of pedestrian improvements at Armin Jahr Elementary School ATTACHMENTS: Council Summary, Site Plan FISCAL IMPACTS None APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY r FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: Move to authorize the City to submit a zero match grant application not to exceed $500,000 for pedestrian improvements near Armin Jahr Elementary School STUDY SESSION ACTION: X Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT 41! (� � COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 2012 SAFE ROUTES TO SCHOOLS GRANT APPLICATION COUNCIL SUMMARY Contract Summary In 2010 the City submitted an application and was funded to construct the first phase of sidewalk improvements on McClain Avenue near Armin Jahr Elementary School with grant funding from the Safe Routes to Schools Program This work is scheduled for construction this summer In January 2012, the Washington State Department of Transportation announced a call for projects to be funded under the same program, this grant cycle no matching funds are required Staff reviewed the non - motorized transportation plan and recommend that an application for funding for the next phase of this project be pursued The scope of this application would construct missing sidewalks immediately south of the school on 31s street, Stewart Road and McClain Avenue Fiscal Summary Staff will develop a pre - design cost estimate during development of the grant application The application will be submitted showing zero contribution from other sources of funding — 100% grant funded project City of Bremerton Page I of 1 February 2012 �r� T } ,�yrr T° y r 4 'nTIT r � ( M �i j�rlt �, jJ..erlRr ry rflu ff., \a ., ^� �'�Ltf�TJIIO yD�f ![r ` �+a Y"—. _ i • "".` r s k5� A ;G`" t �r ,a �J f , w t Y °icy Sw I I t, t y� �. ~. 15 t� r .�° r , tt � "��' .� n S' ! } r� � f Win, G- *z * 4 <� r r _ I y tr � ' siaµ+ p; aP i f _ Dl STREET- .� $TR E f J � 'r '� '�'' � - ( ��� F e � � T1�+ � • . � : � �r�' ��l a 1 -rl<r� �'��mdY�.�>> ��C `�� i �{.- *�'j�rF ' n ti " 31 t STREE r = ��^ n "E 31st STREET _ tttt t _ #✓.+, v F/+ � C u '�r�° t P �� *F _ , y�y. ^a'n ! - y ` ,�_"` (� � "''�^ d '•' ^ P , ; � � r � oG; , ^�� � c J rs 6jJ "�' tea. 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KITSAP, COUNTY CITY OF BREMERTON AGENDA BILL CITY OF BREMERTON CITY COUNCIL ■■ eeeereeeeeeerreereeeeereerrreereeseeseeeeeeeeeeeeereeerrreereeeeeeereerereeeeeeeee SUBJECT: Appointment to the Bremerton Study Session Date February 22, 2012 Housing Authority Board of Commissioners COUNCIL MEETING Date March 7, 2012 Department Executive Presenter Mayor Patty Lent Phone 473 -5266 SUMMARY: There is a vacancy on the Bremerton Housing Authority Board of Commissioners due to the resignation of Larry Robertson It is recommended Harriette Bryant be appointed to fill the vacancy ATTACHMENTS: Application available for viewing in the Mayor's office FISCAL IMPACTS (Include Budgeted Amount) N/A APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION - Motion to confirm the appointment of Harriette Bryant to the Bremerton Housing Authority Board of Commissioners STUDY SESSION ACTION: Consent Agenda ❑ G Business F] Public Hearing �7 COUNCIL PRESIDENT COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 AGENDA BILL CITY OF BREMERTON CITY COUNCIL v5K ■■ eeeeeeeeeeeeeeeeeeeeeee eeeseeeeeeeeeeeeeeeseeeeeeeeeeeeereeeeeeeeeeaeeeeeeeeeeeeeeeeee SUBJECT: Appointment to the Planning Study Session Date February 29, 2012 Commission COUNCIL MEETING Date March 7, 2012 Department Executive Presenter Mayor Lent Phone 4735266 SUMMARY: Anita Albright has been selected to serve on the Planning Commission, with a term that will expire on December 31, 2015 ATTACHMENTS: Mrs Albright's application for appointment is available in the Department of Community Development FISCAL IMPACTS (Include Budgeted Amount) No Fiscal Impacts APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: Move to a of t Anita Albright to the Planning Commission with a term that will end December 31, 2015 V III STUDY SESSION ACTION: IR Consent Agenda ❑ General Business ❑ Public Hearing COUNCIL PRESIDENT COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action j Form Updated 11/02/2011 i AGENDA BILL CITY OF BREMERTON CITY COUNCIL 7A ■■ mmmmmmmmmememmeemmmemmmmmeemmmmeeemmmmmeeemmmeemmmmmememmeeeemmmeeemmmemeeeasmeememee SUBJECT: Public Hearing and Release of Study Session Date February 22, 2012 Storm Water Easement for Bremerton COUNCIL MEETING Date March 7, 2012 Housing Authority Department PW&U Presenter Fndnksson Phone 473 -2354 SUMMARY: The Bremerton Housing Authority has requested the City to release a portion of a storm water easement which crosses diagonally across Lot 1 of the plat of Bay Vista — Phase 3 The easement was created with the plat of Bay Vista — Phase 2 The lot configuration between the two phases has changed and eliminated the need for this portion of the easement ATTACHMENTS: 1 Council Summary, 2 Release of Easement, 3 Exhibit FISCAL IMPACTS (Include Budgeted Amount) None APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: Move to approve the Release of Easement and authorize the Mayor to finalize and execute the Release of Easement with substantially the same terms and conditions as presented STUDY SESSION ACTION: Consent Agenda ❑ General Business Xpublic Hearing COUNCIL PRESIDENT D` COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 Return Address. City Clerk City of Bremerton 345 6` Street, Ste 600 Bremerton, WA 98337 AUDITOR/RECORDER'S INDEXING FORM Document Titles) I Release of Easement Reference Number(s) of Documents assigned or released Grantor(s) 1 The City of Bremerton ❑ Additional names on page of document Grantees) I Bremerton Housing Authority 0 Additional names on page of document Legal Description Lot I, plat of Bay Vista — Phase 3, Vol 33 of plats, Pages 94 -98, records of Kitsap County, (abbreviated) WA, portion of the NW 1 /4 of the SE 1 /4 of S 16, T 24 N, R 1 E, W M, Kitsap County, WA ❑ Additional legal is on page of document Assessor's Property Tax Parcel /Account Number 5583 -000 -001 -00 Project Name N/A RELEASE OF EASEMENT (City of Bremerton Grantor) THIS INSTRUMENT made this day of , 2012, by and between the CITY OF BREMERTON, a Washington municipal corporation of Kitsap County, State of Washington (hereinafter "Grantor ") and Bremerton Housing Authority (hereinafter "Grantee ") Grantor for and in consideration of mutual benefits derived and/or other valuable consideration, receipt of which is hereby acknowledged by Grantor, does by these presents grant, convey, release and quit claim forever unto Grantee, its successors and/or assigns, all its right, title and interest in and to a portion of the storm water easement as shown on, under and upon Lot 1, of the recorded plat for Bay Vista — Phase 3, as recorded in Volume 33 of the book of plats, Page 94- 98, records of Kitsap County, Washington, and as created in the recorded plat for Bay Vista — Phase 2, as recorded in Volume 33 of the book of plats, Page 74 -90, records of Kitsap County, Washington, which is further described as shown in Exhibit A, and a drawing for the same as Exhibit B RELEASE OF EASEMENT- Page I of 2 GRANTOR CITY OF BREMERTON By Patty Lent Its Mayor DATE STATE OF WASHINGTON ) ) ss COUNTY OF KITSAP ) On this - day of , 2012, before me a Notary Public in and for the State of Washington, personally appeared Patty Lent to me known to be the Mayor of the City of Bremerton, a municipal corporation that executed the foregoing instrument, and acknowledged it to be the free and voluntary act and deed of the municipal corporation, for the uses and purposes mentioned in this instrument, and on oath stated that he was authorized to execute said instrument -Notary Seal Must Appear Withm This Box - IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written NOTARY PUBLIC, in and for the State of Washington, residing at My appointment expires APPROVED AS TO FORM ROGER A LUBOVICH City Attorney R \LEGAL \Forms\Easements\Release of Easement (recorded easement) doe RELEASE OF EASEMENT- Page 2 of 2 F XHlBl C AN ui IIIt tit)liiIit v -I OL1, \KIl K \11 \N 11 II ?Ht(c \tl SH �3 Y 11 IA I PUIt 1 It )N t ri f111 VX II I AN-1 f l l, �0ImL, R \NC,t= I 1 11 \\ ASt11NG fO RI 1'012 I JON O -\ til it I 13KFMbKION KITS' \1 Cul'N 1)RI I) IINOFK I IL 1S SI IOW v UN 1 PLA I (-)I BAN \'1tiT,\ t I I \ L ASl MFN 1 AU DI i OK S 1 ILL Nl \'t13LK '1)1 I Ob l UuUS \Nf) \S Sl l0 \ \N ( I I tl c )i iNI \' \t C)I I ( tK KI 1 ( OI IN \ IS f`\ PLAI ( BAN PL1, '> I l )1 � I UI O \ \�I \! III I NI "kinCK 3(11 in3 "OU t) ti \It) PL \l OF \l l OM�1FN( INC A I illf ��U� \VhS 1 LKLY �UK\LR ( � I LO1'1 I\� I \NC I V I S I A PH; \fit ' NUtZ 1 H t1 ()� ALU'�( -� ►1iL I INI C)F � �lU l OI I IHtN(t �n l i I i It) Ilif 17 93 I LL I ! I It I lit l POIN I Ol 111 - fNN1NG I)I', J ANl l 01 1 - \�h IIIt NCt CON NON INC, NOtZ1H 17 LA 01 U8 S1 ti L ;F, \RS � N(it N l C UKVL l ON( -\ \ 1 NUK IV IN ► `1 LK1 N _l til c�INNIN(� C)F rt �N (� `� un FFFl K'\I)Il'S t- �� � \ND t K( >tii wFll c I I Pt tIN ! l It K \I)ll I HLN(- F No1ZT 11F \� I I KI \ At t\N)1�11H N(F t )C 7 (,III ► 1 I I ILN( I NOIZ 111 46 37 ;, \\ L� 1 f\ l)t� I \Nt- L ( ) I ► 2 8 y l 1 1 t I 1 I NOIL I 1 t h� I t I`) LAS ( >1 ' -' _ I I IFNCF , t 1 1 AS 1\ 1)Iti f, \NCF OF 3(1 110 1 1 1 3 t, I l II I IWL POIN I 1111 N(E SOl i 111 _4 4. t 3 t 7 I l l l l 1111-N(I ,O1 it 161 \Nl l I OI Bi UNNIN(l Kt 10 \NI) 11l I ! IIti Itl I I IZI N \I I AS SH ) \1 \C)I \ PAR I III Iil-01• Ljw /_1 nt w EXHIBIT 'B' ; / PORTION OF \S !y EASEMENT I TO REMAIN / LOT 1 PLAT OF BAY VISTA — PHASE 2 / J �v j PLAT OF BAY VISTA AFN 20110615 // HAS P� � AFN 200E � 029 OGO 10 /L3 \ QOR C 1 TRUE POINT OF i L2 BEGINNING POINT OF L1 �i� / COMMENCEMENT / PLAT OF BAY VISTA PHASE 2 / AFN 201 1 06 1 50008 \ // t LINE TABLE. CURVE TABLE- LINE REARING DISTANCE CURVE RADIUS RC - DELTA L1 N 01 08'47" E 17 92' C1 627 00' 7 61' 00'41'42" L2 N 01'08'47" E 1 20' L3 N 46'27'35" W 17 38' T L4 S 24'45'41 " E 20 00' �, S ►CENti T GRAPHIC SCALE 1" =100' 0 100 200 s� e go ��L L ►� B CRA M IN THE SE } OF SEC 16, ■ 2106 PACIFIC AVE, SUITE 300 ■ TOWNSHIP 24 N. RANGE 1 E. W M ■TACOMA, WASHINGTON 98402 ■ KITSAP COUNTY, WASHINGTON ■ PHONE (253) 627-4367 ■ DATE OCTOBER 28. 2011 SHEET 2 OF 4 Vacation of Easement in Lot 1 - Plat of Bay Vista Phase 3 COUNCIL SUMMARY SUMMARY The Bremerton Housing Authority has asked the City to vacate a portion of a twenty foot easement for storm which crosses Lot 1 diagonally The easement is depicted on the face of the plat of Bay Vista — Phase 3 (Volume 33 of the book of plats, Pages 94 -98) The easement was created with the plat of Bay Vista — Phase 2 (Volume 33 of the book of plats, Pages 74 -90) With the Phase 3 recording, the design of the plat was changed so as this portion of the easement is no longer needed Storm water infrastructure will be placed into the roadways and alley As such, staff supports the request to vacate this portion of the easement Easement Vacation — Bay Vista Phase 3 Council Summary January 2012 AGENDA BILL CITY OF BREMERTON CITY COUNCIL 78 ■■ eeeeeeseeeeeeeeeeeeeeeeeeeeeeeeseeeeeeereeeeereeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeesee SUBJECT: Public Hearing and Ordinance Study Session Date February 22, 2012 No �LLO to vacate Broadway Avenue from COUNCIL MEETING Date March 7, 2012 13 to 16 Streets Department PW &U Presenter Gunnar Fndnksson Phone 473 -2354 SUMMARY: Olympic College has initiated the vacation of Broadway Avenue from 13 Street to 16 Street The City requested a traffic analysis from the College to evaluate the area, and to determine what improvement needed to be made to Broadway Avenue to reduce non - college vehicles using the area This study was performed by Parametnx, Inc in April 2010 The suggested improvement is to vacate Broadway Avenue and construct a new signal at 13th and Warren for access to Warren Avenue ATTACHMENTS: Proposed Ordinance No 51 150, Engineering Staff Report, Exhibit and Interlocal Agreement FISCAL IMPACTS (Include Budgeted Amount) The vacation of Broadway will remove approximately 900 feet of roadway from City maintenance requirements This savings will be offset by the maintenance requirements for the new signal at 13 Street Also see compensation section of attached staff report APPROVALS: DEPARTMENT DIRECTOR CITY ATTORNEY FINANCE DIRECTOR MAYOR RECOMMENDED MOTION: Move to pass Ordinance No s vacate Broadway Avenue between 13 and 16 Streets STUDY SESSION ACTION: ❑ Consent Agenda ❑ General Business X Public Hearing COUNCIL PRESIDENT ' COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/2011 ORDINANCE NO. 5106 AN ORDINANCE of the City Council of the City of Bremerton, Washington, relating to the vacation of Broadway Avenue from 13` Street to 16 Street in the City of Bremerton. WHEREAS, Olympic College has petitioned the City to vacate Broadway Avenue from 13` Street to 16 Street in order to implement its long range development plans, and WHEREAS, the City passed Resolution No 3157 setting a hearing date to consider the vacation of Broadway Avenue from 13`" Street to 16 Street, to take public comment or consider written objections to the vacation; and WHEREAS, fewer than fifty percent of the property owners abutting said right - of -way filed written objections to this action prior to the time set for public hearing herein, and WHEREAS, a public hearing was held with proper notice on January 18, 2012, in the City Council Chambers of the Bremerton City Hall to take public comment or consider written objections to the vacation, and WHEREAS, the City Council has determined that it is in the best interest of the public to proceed with the vacation, and WHEREAS, this is a Class 1, Class II and Class III right of way and compensation is required in accordance with BMC 11 20 140, and WHEREAS, Olympic College, has proposed compensation through right -of -way dedication to the City along 17 Street between Warren Avenue and Elizabeth Avenue, a portion of the value of right -of -way dedicated by Olympic College to the City along 13` Street and Warren Avenue, under Ordinance No 5149, and payment for a traffic signal at 13` Street and Warren Avenue, and, to the extent such compensation does not fully cover the value of the vacated right -of -way, Olympic College has requested, as a government entity, a partial waiver of compensation and fees under BMC 1120 140(E), and WHEREAS, the City Council has determined that the proposed compensation and a partial waiver of compensation as proposed by Olympic College is in the public's interest and advantage, and WHEREAS, the City Council finds it appropriate to reserve certain easements within the area to be vacated until such time as new easements are granted by Olympic College to replace the City's reserved easements, NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF BREMERTON, WASHINGTON, DOES HEREBY ORDAIN AS FOLLOWS 1 Vacation — Broadway from 1P to 16 Street SECTION 1. Recitals The foregoing recitals are incorporated as if fully set forth herein j (b rt SECTION 2. Vacation Broadway Avenue from 13` Street to 16 StreeYn th ,�r��' City of Bremerton, as described in Exhibit A, which is attached and incorporated herein by this ti/ ` reference, is hereby vacated to the abutting property owners subject to the following conditions. (a) Compensation for this vacation as set forth in Section 3 below (b) Reservation of easements as set forth in Section 4 below SECTION 3. Compensation (a) Compensation for this vacation, calculated to be $637,688 00, shall be paid to the City by Olympic College, as follows (i) Olympic College shall dedicate to the City right -of -way along 17 Street between Warren Avenue and Elizabeth Avenue, which has a value of $32,352 (ii) The City shall apply the remaining value of the excess right -of -way previously dedicated by Olympic College to the City by Olympic College along 13` Street and Warren Avenue, under Ordinance No 5149, which has a value of $229,630 (iii) Olympic College shall pay for the construction of the traffic signal at 13` Street and Warren Avenue, which has an estimated value of $350,000. The parties shall enter into an agreement for construction of the traffic signal project and the City shall not be responsible for any of the costs of construction of the project (b) Compensation to the City for this street vacation shall be fully satisfied upon completion of the items listed in Section 3(a) above and upon such completion, any remaining compensation to the City 0(w �lv� maccordance yMith, BMC110 140(,E) � G r KA il" hove Q � "' o� 'ICY 4:f 1kcc SECTION 4. Reservation of Easements (a) An easement is reserved to serve the single family property at 1338 Broadway for ingress and egress over that portion of the area vacated pursuant to this ordinance that, by operation of law, is owned by Olympic College as abutting property owner (b) An easement is reserved to serve Olympic College for ingress and egress over that portion of the area vacated pursuant to this ordinance that, by operation of law, is owned by the owner of the property at 1338 Broadway as abutting property owner (c) An easement is reserved for Comcast for operation, maintenance and repair of services within the area vacated pursuant to this ordinance (d) An easement is reserved for Puget Sound Energy for operation, maintenance and repair of existing services and appurtenances within the area vacated pursuant to this ordinance (e) An easement is reserved for CenturyLmk for operation, maintenance and repair of existing services and appurtenances within the area vacated pursuant to this ordinance (f) An easement is reserved for Cascade Natural Gas for operation, maintenance and repair of existing services and appurtenances within the area vacated pursuant to this ordinance (g) An easement is reserved for Kitsap Public Utility District for operation, maintenance and repair of existing services and appurtenances within the area vacated pursuant to this ordinance 2 Vacation — Broadway from I? to le Street (h) An easement is reserved for Convergence Technologies for operation, maintenance and repair of existing services and appurtenances within the area vacated pursuant to this ordinance (i) An easement is reserved for the City of Bremerton for construction, operation, maintenance and repair of water, sanitary and storm sewer mains over, under and upon the entire area vacated pursuant to this ordinance 0) Olympic College intends to enter into a cross easement agreement with the owner of the single family property at 1338 Broadway for ingress and egress by that single family owner across that portion of the vacated Broadway right -of -way owned by Olympic College and for ingress and egress by the College across that portion of the vacated Broadway right -of -way owned by that single family owner (the "Substitute Residential Cross Access Easements ") that will replace the access easements reserved above Upon recording of the Substitute Residential Cross Access Easements, the easements reserved in Section 4, paragraph (a) and paragraph (b) shall be automatically terminated with no further action required by the City or any other party (k) Olympic College intends to grant utility easements to Comcast, Puget Sound Energy, CenturyLmk, Cascade Natural Gas, Kitsap Public Utility District and to Convergence Technologies for operation, maintenance and repair of services within the area vacated pursuant to this ordinance (the "Substitute Utility Easements ") Upon recording of the Substitute Utility Easements, the easements reserved in this Section 4, paragraphs (c) and (d) shall be automatically terminated with no further action required by the City or any other party. SECTION 5. Vested Rights No vested rights shall be affected by the provisions of this ordinance SECTION 6. Severability If any one or more section, subsections, or sentences of this Ordinance are held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portion of this ordinance and the same shall remain in full force and effect SECTION 7. Effective Date This ordinance shall take effect and be in force ten (10) days from and after its passage, approval and publication as provided by law PASSED by the City Council the day of , 2012 Jim McDonald, Council President Approved this day of , 2012 PATTY LENT, Mayor 3 Vacation — Broadway from 13` to 16 Street ATTEST APPROVED AS TO FORM - SHANNON L CORIN, Interim City Clerk ROGER A LUBOVICH, City Attorney PUBLISHED the day of 9 2012 EFFECTIVE the day of , 2012 ORDINANCE NO R \Legal \Legal \Ordmances\Pubhc Works & Utilities \Olympic College Broadway Street Vacation - Clean doc I I 4 Vacation — Broadway from 13` to 16` Street _ -' 16t St _ $ 8 I 3 AFN 8012180088 8 I � 7 2 1 6 3 f 9 I' 5 2 4 TRACT 6 10 UNKNOWN AFN 8012180088 1 ` AFN 8012050082 1 1 15th St. " 801 7 6 i [WARREN SMITH'S ACRE I TRACTS DEDICATION I I 5 I I U Class 1 Area = 31,583 sf 7 ® Class 0 Area = 5,065 sf Class m Area = 21AN s E _ m i 8 to �Q �t r TRACT 7 ORDUVANCE M, 1911 3 m � s I 2 I i 10 AFN 8012180088 1 I EXHIBIT — _ Portions of the SE 1/4 of the NE 1/4 13th St Section 14, T 24 N, R 1 E, W M City of Bremerton, Kitsap County, Washington STREET VACATION REQUEST BROADWAY AVENUE FROM 13 TO 16 STREET ENGINEERING STAFF REPORT CITY COUNCIL HEARING DATE: March 7, 2012 PREPARED BY: Gunnar Fridnksson SUMMARY Applicant Olympic College c/o David C Mitchell 1600 Chester Avenue Bremerton, WA 98337 Location Broadway Avenue from 13 to 16 Street, lying in the Plat of Warren Smith's Acre Tracts as recorded in Volume 2, of the book of plats, Page 51, records of Kitsap County, Washington BACKGROUND The current master plan for the College has identified 13 Street as the south boundary, Ohio Avenue as the west, Warren Avenue as the primary east boundary and Port Washington Narrows on the north This plan was completed in September of 2008 In discussions with the City for new replacement parking lots between Broadway and Warren Avenues, and 13 and 15 Streets, the City requested a traffic analysis from the College to evaluate the area, and in particular what improvements needed to be made to Broadway to reduce non - college vehicles using the area The study was completed by Parametrix, Inc, in April of 2010 and found the best alternative would be to vacate Broadway with a new signal at 13 and Warren constructed for access to Warren Avenue This would allow the existing roadway to become internal to the campus, promoting connectivity and safety for the students The new signal would be coordinated with others in the corridor and would not deteriorate the current level of service on Warren Avenue The City of Bremerton created this portion of Broadway Avenue in March of 1911 with Ordinance 382 The alignment of the street was previously vacated in 1962 between 15 and 16 Streets for building construction The roadway in this section was moved easterly to its current position sometime after the vacation, but the right of way was not dedicated until 1980 Broadway between 13 and 15 was purchased by the City from the individual property owners under threat of condemnation in the 1910's and is Class I right of way The portion of Broadway between 15 and 16 was deeded to the City by the State of Washington in 1980 at no cost to the City, and improvements paid for by the College November 2011 Broadway Vacation —13 to 16 Street Page 1 of 5 Staff supports having this section treated as Class III right of way The plat dedicated 15 Street and as such, this is Class II right of way RIGHT OF WAY CONDITIONS • Functional Classification Local Access • Existing R -O -W Width Varies — mostly 50 feet • Proposed R -O -W Width N/A • Pavement Width 22 foot • Surface Type Asphalt and concrete • Curb and Gutter Yes • Sidewalks Yes HEARING CONSIDERATIONS BMC 1120 120 sets forth issues that the City Council needs to determine at the conclusion of the Vacation Hearing These issues and the staff position are 1. Whether the street, alley or portion thereof is no longer required for public use and vacation of the described portion will better serve the public good. Staff Position With construction of a new signal at 13 and Warren, traffic will be able to access Warren Avenue and the current roadway revert to usage by the campus 2. Whether the vacation is consistent with the City Comprehensive Plan. Staff Position The proposed vacation does not conflict with the Comprehensive Plan 3. Whether continued use of the proposed vacation as a public way is not of such public benefit as to justify the costs of maintenance. Staff Position The improvements will reduce the City's maintenance responsibility in this area as the existing roadway, sidewalks, curb and gutter would become the responsibility of the college 4. Whether substitution of a new and different thoroughfare would be more useful to the public. Staff Position Circulation through this area will use 13 Street and the new signal at Warren Avenue to access the SR 303 corridor 5. Whether conditions may so change in the future as to provide a greater public use or need than presently exists. November 2011 Broadway Vacation —13 to 16 Street Page 2 of 5 Staff Position No — property will remain vested with the College and be incorporated into the campus per the master plan 6. Whether objections to the proposed vacation are made by owners of private property abutting the same. Staff Position No objections have been received by staff There is one remaining residential property along the roadway and Olympic College is retaining an easement for them for access SHORELINE ACCESS This portion of right -of -way does not provide shoreline access UTILITIES All private utility companies were contacted Comcast and PSE will retain an easement for servicing the remaining residence The City of Bremerton will also retain an easement for water and sanitary sewer mains Catch basins and the storm system shall become the responsibility of the College Easements may be released upon arrangements made for utility relocations SUFFICIENCY OF SIGNATURES Olympic college owns all adjacent properties with the exception of the one residence COMPENSATION This vacation a mixture of Class I, Class II and Class III right -of -way No compensation is owing for Class III right of way Total compensation using 2011 Kitsap County value assessments from the adjacent parcels will be Class I Right of Way 37,323 sq ft x $16 /sq ft = $597,168 Class II Right of Way 5,065 sq ft x (0 5) x $16 /sq ft =$40,520 Sub -Total $637,688 Monies owed for the vacation will be reduced by the dedication of right of way at 17 and Warren Avenue, construction of the signal, and right of way dedicated by the College for 13 Street and Warren Avenue in conjunction with the new parking lot These amounts are 17 and Warren Avenue ROW 2,022 sq ft x$16 /sq ft = $32,352 Signal construction (estimated) = $350,000 13 h and Warren Avenue ROW credit(remainder from Ord #5149) =$229,630 Sub -Total ($) GRAND TOTAL $25,706 November 2011 Broadway Vacation — 13 to 16 Street Page 3 of 5 No compensation will be required by the City to the College The College has requested any remaining costs owed be forgiven in accordance with BMC 1120 140(E) Resolution of compensation will be at completion of the signal installation construction This will be when all construction costs are actual and known STAFF RECOMMENDATION City Attorney, Police, Fire, Engineering and Community Development staff notes no objections to the proposal Staff recommends that this Street Vacation be approved as requested •ti � r - o Looking northerly from 13 Street up Broadway Avenue November 2011 Broadway Vacation — 13"' to 16"' Street Page 4 of 5 a Lookin g northerly on Broadwa at str eetjog - 15 Street I i I �l 1 v ,, Fx oGL,� tTu3, , w Looking northerly from 15 Street up to 16 th Street on Broadway November 2011 Broadway Vacation —13 to 16 Street Page 5 of 5 Parametrix ENGINEERING . PLANNING . ENVIRONMENTAL SCIENCES 411 108th AVENUE NE, SUITE 1800 BELLEVUE, WA 98004 -5571 T 425 458 6200 F. 425 458 6363 www parametrix com DRAFT TECHNICAL MEMORANDUM Date April 21, 2010 To Schacht I Aslani Architects From John Pencc, PE and Ryan Abbotts, AICP Subject Olympic College Parking Study — Traffic Operations Evaluation cc Project Number 554 - 5720 -003 Project Name Olympic College Parking Study OVERVIEW The purpose of this Memorandum is to summarize the transportation and traffic operations analysis for a new surface parking lot for the Olympic College campus in Bremerton located between 13th Street and 16th Street, immediately west of Warren Avenue (State Route 303) to accommodate existing and future parking needs of students and staff The new surface parking area would include 551 spaces and replace an existing 238 spaces resulting in a net increase of 313 new surface parking spaces to the campus This project is an initial phase of the recently updated Olympic College Campus Master Plan, Appendix A shows the location of the new parking spaces in relation to campus The College currently experiences a significant amount of non - college vehicles traveling through campus on Broadway Avenue between 13th Street and 16th Street Broadway Avenue is currently classified as a collector arterial in the City of Bremerton As part of the Master Planning efforts, the College proposes to change the functional classification or pursue a right -of -way vacation of Broadway Avenue to reduce non - campus traffic traveling through campus Reducing traffic volumes on campus would improve the safety of pedestrians crossing Broadway Avenue from these new surface parking areas to campus The function of Broadway Avenue would change to a local campus access roadway since the new surface parking areas expand the campus boundary to encompass the existing street right -of -way Reconfiguring Broadway Avenue is likely to cause the existing non - campus traffic to seek an alternate route —it is likely these vehicles would use 11 th Street to reach Warren Avenue instead of traveling through campus to the 16th Street /Warren Avenue intersection This would potentially create out -of- direction travel, safety concerns from vehicles making left turns onto 11 th Street, and a sigruficant traffic volume increase at the 11th Street /Warren Avenue intersection To minimize the impacts of increased traffic at the 11th Street /Warren Avenue intersection, a new traffic signal at the 13th Street /Warren Avenue intersection would be needed to accommodate these movements The impact of a new signal at this intersection on level of service and vehicle queue lengths is evaluated in this memorandum DRAFT - TECHNICAL MEMORANDUM (CONTINUED) STUDY INTERSECTIONS The traffic operations analysis included the following intersections (listed from north to south) ■ 16th Street and Warren Avenue (SR 303) ■ 13th Street and Warren Avenue ■ 11 th Street and Warren Avenue EXISTING CONDITIONS Two common measurements of traffic performance and operation are reported for the scenarios analyzed and are summarized in Appendix B—this includes the level of service (LOS), which is represented by a letter A through F, and the 95th percentile queue length The significance of these two measurements is the LOS provides a representation of the average delay vehicles experience when passing through an intersection (except for at stop controlled intersection where the worst approach is reported) As conditions degrade and congestion increases, the scale slides towards F, which generally represents stop- and -go or heavily congested conditions The Bremerton Transportation Plan's standard for allowable intersection LOS is E or better, with a volume /capacity ratio of less than or equal to 10 in the SR 303 corridor The 95th percentile queue length shows the extent vehicles on the critical movement spillback from the intersection The operations analyses was performed using Trafficware's Synchro version 7, build 773, revision 8 Data Collection Turning movement counts were collected on November 10, 2009 from 2 30 PM to 6 30 PM —the PM peak hour was calculated as 3 45 PM to 4 45 PM and is illustrated in Appendix C (complete peak period traffic counts are also included in Appendix C for the 16th Street /Warren Avenue and 11th Street /Warren Avenue intersections) Conditions were considered normal Pedestrian crossing volumes and heavy vehicle composition was also collected Peak hour factors were used for each movement and not averaged by approach or by intersection All lane widths were assumed to be 11 feet 16th Street and Warren Avenue This signalized T- intersection provides access to Olympic College to the west of Warren Avenue along 16th Street Warren Avenue is a 4/5 lane principal arterial providing a left -turn lane and 2 through lanes northbound and a right -turn lane and 2 through lanes southbound 16th Street provides an exclusive left -turn and shared left /right -turn lane for the eastbound approach The speed limit on Warren Avenue is 30 miles per hour (mph) and 25 mph on 16th Street This intersection is currently experiencing low to moderate congestion as drivers experience approximately 16 seconds of delay when passing through this intersection, on average during the PM peak period This is represented by a level of service (LOS) of B, as shown in Appendix A Schacht I Adam Architects 554 5720 003 Olympic College Parking Study - Traffic Operations Evaluation 2 April 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) 13th Street and Warren Avenue This stop- controlled (eastbound and westbound only) intersection provides access to the south end of Olympic College and connects to the east and west of Warren Avenue Warren Avenue provides 2 through lanes for the northbound and southbound directions— southbound and northbound left -turns to 13th Street are prohibited 13th Street provides one right -turn only lane for eastbound and westbound approaching vehicles Left turns from 13th Street to Warren Avenue are also prohibited in both directions The speed limit on Warren Avenue is 30 mph and 25 mph on 13th Street Traffic on Warren Avenue experiences almost no delay as only movements from 13th Street are required to stop at this intersection Due to low volumes on the side streets, little to no delay is experience by vehicles turning right -only onto Warren Avenue from 13th Street, as shown in Appendix A 11th Street and Warren Avenue This signalized intersection is a major intersection in downtown Bremerton, with high volume eastbound left -turn and southbound right -turn movements Warren Avenue northbound provides a left -turn lane, a through lane, and a shared through /right -turn lane and southbound provides a left -turn lane, 2 through lanes, and an exclusive right -turn lane The right -turn lane is approximately 100 feet long —the City of Bremerton is scheduled to construct an additional 200 feet of storage capacity for this right -turn lane in 2010 11th Street eastbound provides 2 left -turn lanes and a shared through /right -turn lane and westbound provides a through lane and shared through /right -turn lane with a left -turn prohibition This intersection experiences moderate to high delay on most of the left -turn movements and moderate congestion on the remaining movements Drivers experience approximately 39 seconds of delay when passing through this intersection during the PM peak period, on average This is represented by a LOS of D, as shown in Appendix A FUTURE CONDITIONS Anticipated Campus Growth Future growth in student enrollment, staff and supportive services will add traffic to the surrounding street network in addition to anticipated background growth The 2007 Olympic College Campus Master Plan reports enrollment at 4,514 full time equivalent students for 2005 -2006 The enrollment trend at the college is projected to increase to 5,169 full time equivalent students for 2015 - 2016 —the compounded annual growth rate for student growth is 137 percent Anticipated Traffic Growth Traffic volumes in the study area are anticipated to experience an increase of 1 percent per year for the next 6 years to reach the target year of 2015 —this is based on historical trend data from 2002 to 2009 and the recent slow -down in the economy This growth rate was applied to all intersection turning movement volumes at study area intersections except a conservatively high 137 percent growth rate consistent with the estimated student population growth was applied to turning movements to and from 13th Street and 16th Street Historical growth rates were calculated by comparing previous 2002 (Existing 2002 PM Peak 10 -11 Synchro model) to recent counts collected in November 2009 The 16th Street and Warren Avenue intersection Schacht I Aslam Architects 554 5720 003 Olympic College Parking Study - Traffic operations Evaluation 3 April 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) experienced an increase in traffic volumes of less than 1 percent per year from 2002 to 2009 The 11th Street and Warren Avenue intersection experienced an increase of approximately 1 1 percent per year in traffic volumes from 2002 to 2009 Planned and Funded Area Improvements The City of Bremerton has recently completed design improvements for the 11th Street /Warren Avenue intersection, which is anticipated to begin construction in early 2011 Improvements will include extending the southbound left -turn and right -turn lanes by approximately 200 feet and include new controller and signal equipment Westbound left -turn restrictions are assumed to be retained Olympic College Campus Master Plan Improvements Olympic College is implementing their Plan to construct safe and convenient access ways to serve a revised parking strategy Parking will be expanded and provided immediately west of Warren Avenue between 16th Street and 13th Street This Plan is examining ways to reconfigure Broadway Avenue as it passes through campus to reduce vehicle speeds, volumes, and the amount of non - campus traffic currently using this roadway The purpose of these improvements is to provide for greater safety and comfort for pedestrian and automobile users on campus In addition, the function of Broadway Avenue would change to a local campus access roadway since the new surface parking areas expand the campus boundary to encompass the existing street right -of -way The Campus Plan Improvement options examine ways to decrease the amount and speed vehicles travel when passing through campus on Broadway Avenue It is anticipated these changes will cause vehicles to choose a different path — signalizing the 13th Street /Warren Avenue intersection is proposed to provide further safety and incentive for these vehicles to choose a route that is not through campus Safety Benefits from Changes to the Pedestrian Environment The proposed campus parking location improvements would result in Broadway Avenue being disconnected between 13th Street and 16th Street, as shown in Appendix A The safety benefits of the proposed improvements include the following • The attractiveness of Broadway Avenue to cut - through traffic would be reduced and traffic volumes traveling through campus would decrease substantially • Safer pedestrian access to campus is achieved from the new surface parking lot and other areas to the east with the reduction of vehicular volumes on Broadway Avenue, due to a significant reduction in pedestrian- vehicle conflicts • Vehicles arriving and leaving campus would be directed to enter and exit the surface parking lot from 16th Street in the proposed configuration, reducing the congestion and existing pedestrian /vehicle conflicts at the 16th Street/ Broadway Avenue intersection • The parking lot area concept provides dedicated pedestrian accessways through the parking lot and directs pedestrians to marked crosswalks • Installing a signal at the 13th Street/ Broadway Avenue intersection would provide a safer crossing for pedestrians at this location -- currently, signalized pedestrian crossings of Warren Avenue are only provided at 11 th Street and 16th Street Schacht I Aslam Architects 554 5720 003 Olympic College Parking Study - Traffic Operations Evaluation 4 April 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) OPERATIONAL ANALYSES The objective of the operational analyses is to present modifications to traffic patterns and intersection operations that maintain the operability and ability of the Bremerton street system to move traffic and provide safe access for pedestrians Traffic analyses were conducted for the PM peak hour from 3 45 PM to 4 45 PM Four 2015 scenarios were exanuned for comparative purposes • No Build: Assumes a 1 percent annual growth in traffic volumes, except for campus related movements, which have a 137 percent annual growth rate, intersection signal timings were optimized to future traffic volumes, and, improvements to the 11 th Street /Warren Avenue intersection are constructed • Campus Plan Improvements: Same growth in traffic volumes as the 2015 No Build scenario and intersection signals are optimized, but assumes modified traffic patterns as follows (unless noted in scenarios below) two- thirds of Warren Avenue southbound traffic would turn right at 16th Street and the remaining one -third would turn right at 13th Street, and, two- thirds of the eastbound left - turning traffic at the 16th Street /Warren Avenue intersection would shift to the new left -turn movement at the 13th Street /Warren Avenue intersection o Stop Controlled at 13th Street: No changes to intersection control type, eastbound left -turns are permitted at the 13th Street /Warren Avenue intersection, and signal timings are optimized Assumed traffic from Olympic College and from the east would use 13th Street to access Warren Avenue o Signal at 13th Street: Includes signalizing the 13th Street /Warren Avenue intersection and providing actuated - coordinated signals along Warren Avenue at its intersections with 11th Street, 13th Street, and 16th Street o Stop Controlled at 13th Street (Some Diversion to 11th Street): No changes to intersection control type, eastbound left -turns are not permitted at the 13th Street /Warren Avenue intersection, and signal timings are optimized This scenario assumes two- thirds of the eastbound left - turning traffic at the 16th Street /Warren Avenue intersection would divert to 11 th Street to turn left onto northbound Warren Avenue Appendix D through F present the future 2015 PM peak hour turning movement volumes for the scenarios described above Queue lengths and intersection LOS are graphically depicted in Appendix G OPENING YEAR FINDINGS: 2015 PM PEAK No Build Scenario The 2015 No Build conditions are estimated to be perforrmng adequately with intersections operating at or above acceptable conditions (LOS of D or better), as shown in Figure 1 Also, queue lengths are not anticipated to impact the operations of downstream intersections The estimated average travel time for vehicles traveling northbound and southbound on Warren Avenue between south of 11 th Street and north of 16th Street is 18 minutes, as shown in Exhibit A Schacht I Astam Architects 554 5720 003 Olympic College Parking Study Traffic Operations Evaluation 5 April 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) Campus Plan Improvement: Stop Controlled at 13th Street The 2015 Campus Plan Improvements (stop controlled at 13th Street) estimates an improvement in the operations of the 16th Street /Warren Avenue intersection (from LOS C to A) —this is due to a reduction in the volume of traffic turning at this location as it diverts to 13th Street and passes through the 16th Street intersection as through movements The 13th Street intersection is estimated to provide smooth operations for northbound and southbound Warren Avenue through traffic as they are not required to stop However, the eastbound left- turrung traffic experiences significant delay Traffic volumes on Warren Avenue provide a steady stream of vehicles and likely do not provide enough gaps in traffic (space for vehicles from 13th Street to complete their left -turn onto Warren Avenue to travel north) This would result in a high accident potential for vehicles turning left onto Warren Avenue because drivers could become impatient and attempt to turn with less than acceptable gaps in traffic flow Stop sign control of the 13th Street/ Warren Avenue intersection is not recommended because of the sigruficant queuing, delay, and potential for accidents The 11th Street /Warren Avenue intersection is operating at an acceptable level (LOS of D) and is not adversely impacted by anticipated changes in traffic flows resulting from campus improvements The estimated average travel time for vehicles traveling on Warren Avenue between south of 11th Street and north of 16th Street is 16 nunutes in the northbound direction and 18 minutes in the southbound direction, as shown in Exhibit A The improvement in the northbound travel time, compared to the 2015 No Build scenario, results from a reduction in eastbound turning vehicles at the 16th Street /Warren Avenue intersection This allows for more green time to be given to the northbound and southbound movements Also, the significant delay for eastbound vehicles making the eastbound to northbound left -turn onto Warren Avenue from 13th Street is likely reducing vehicle volumes on Warren Avenue, which contributes to improved operations Exhibit A Travel Time Summary for Warren Avenue Travel Time Campus Plan Improvements: Alternative Northbound Southbound 2015 No Build 1 8 minutes 18 minutes 2015 Stop Controlled at 13th Street 16 minutes 18 minutes 2015 Signal at 13th Street 16 minutes 16 minutes 2015 Stop Controlled at 13th Street 2 1 minutes 16 minutes (traffic diverted to 11 th Street) Campus Plan Improvement: Signal at 13th Street The 2015 Campus Plan Improvements (signal at 13th Street) is estimated to accommodate background growth and planned campus growth under the proposed reconfiguration of Broadway Avenue with the signahzation of the 13th Street /Warren Avenue intersection Maintaining adequate traffic operations and flow along Warren Avenue could be achieved with a coordinated signal system —this means the 11 th Street, 13th Street, and 16th Street intersections with Warren Avenue operate together to manage traffic flow through the area based on a system wide signal timing scheme The 16th Street /Warren Avenue intersection is estimated to operate better than No Build conditions resulting from the diversion of some traffic to 13th Street The intersection of 13th Street and Warren Avenue is estimate to operate with little to no delay for through movements on Warren Avenue —this was accomplished by timing the eastbound movements of both the 13th Street and 11 th Street intersection with Warren Avenue to be green at approximately the Schacht I Aslam Architects 554 5720 003 Olympic College Parking Study - Traffic Operations Evaluation 6 Apnl 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) same time The 11th Street /Warren Avenue intersection is not adversely impacted and operates at an acceptable LOS of D, as illustrated in Figure 1 The estimated average travel time for vehicles traveling on Warren Avenue between south of 11th Street and north of 16th Street is 16 minutes for both the northbound and southbound directions, as shown in Exhibit A The improvement in travel time results from the greater efficiency in vehicle flow from multiple signalized access points onto Warren Avenue (accesses at 13th Street and 16th Street) This allows vehicle movements to be accommodated with less green time given to side streets, which can be reallocated to the prioritized northbound and southbound directions Signal coordination of 11 th Street, 13th Street, and 16th Street also contributes to the travel time savings Campus Plan Improvement: Stop Controlled at 13th Street (Traffic Diverted to 11th Street) If a traffic signal is not installed at the 13th Street /Warren Avenue intersection, it is anticipated the reconfiguration of Broadway Avenue would cause eastbound traffic to divert to 11 th Street–referred to as the 2015 Campus Plan Improvement (signal at 13th Street, some diversion to 11 th Street) This diverted traffic was assumed to make the eastbound left -turn from 11th Street to Warren Avenue and continue north The traffic analysis demonstrates the overall intersection LOS is E with the eastbound left -turn, northbound through, and southbound left -turn movements operating at LOS E or F The volume to capacity ratio is higher than 10 for the eastbound left -turn and the 95th percentile queue length is likely underrepresented in the LOS analysis This redistribution of traffic is also predicted to increase the northbound average travel time by 0 3 minutes on Warren Avenue, as shown in Exhibit A This increase is the result of more green time being required at the 11 th Street /Warren Avenue intersection to accommodate the increase in eastbound to northbound left - turns (the green time would be taken from the northbound through movement) The improvement in southbound travel time is likely the result of increased time for vehicles at the 11th Street /Warren Avenue intersection to make the southbound to westbound right-turn resulting from the additional green time given to the eastbound left -turn movement SIGNAL WARRANT ANALYSIS A signal warrant analysis is conducted for an intersection to determine if installing a signal is an appropriate improvement based on operating conditions —these conditions include vehicle volumes by time of day, pedestrian volume, and safety The warrant process is described in the Federal Highway Administration's (FHWA) Manual on Uniform Traffic Control Devices ( MUTCD) The installation of a traffic signal must improve the overall safety and /or operation of the intersection Satisfying one or more warrants alone does not in itself provide concrete justification to consider a signal A thorough analysis that considers crash history, field conditions such as sight distances and speed limits, and good engineering judgment must all be considered before the installation of a traffic signal is proposed This signal warrant analysis evaluates the intersections of 13th Street and 16th Street with Warren Avenue to evaluate whether they meet signal warrant criteria established in the MUTCD in the 2015 Campus Improvements (signal at 13th Street) scenario The 13th Street /Warren Avenue intersection is being assessed as the intersection is currently a stop - controlled intersection and the scenario provides for this intersection to be signalized. The 16th Street /Warren Avenue intersection is included in this analysis due to Schacht I Aslani Architects 554 5720 003 Olympic College Parking Study Traffic Operations Evaluation 7 Apnl 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) the reduction in vehicle volumes at this location due to the reconfiguration of Broadway Avenue —a number of signal warrants evaluate aspects of vehicle volume during specific time frames As shown in Exhibit B, the 13th Street /Warren Avenue intersection meets the peak hour and school crossing warrants The peak hour warrant would not be met in the No Build scenario at this intersection, but the diversion of vehicles from 16th Street to 13th Street increases the side street (13th Street) traffic volume enough to meet the peak hour signal warrant (combined with the corresponding traffic volumes of Warren Avenue) The school crossing warrant was also met at 13th Street as signalizing this intersection would provide Olympic College students living east of Warren Avenue a safe and convenient point to cross Warren Avenue — today, students must walk to 16th Street or 11th Street to cross Warren Avenue at designated signalized crosswalks Exhibit B: Summary of Signal Warrant Analysis for the 13th Street/Warren Avenue Intersection Signal Warrant Status Reason 3: Peak Hour Vehicular Met The Warren Avenue (mayor street) two -way average traffic volume for one hour of Volume an average day is 3,145 vph and the average volume on the minor street is 250 vph which is above the MUTCD threshold 4: Pedestrian Volume Not Met The pedestrian threshold of 100 or more pedestrians for each of any 4 hours during a day or 190 or more pedestrians during any 1 hour of a day is not met 5: School Crossing Met This intersection would provide additional access to Olympic College from east of Warren Avenue if signalized Students would cross unprotected at this location today or else walk to 16th Street or 11 th Street to cross Warren Avenue The following warrants were not evaluated 1 Eight -Hour Vehicular Volume, 2 Four -Hour Vehicular Volume, 6 Coordinated Signal System, 7 Crash Experience, 8 Roadway Network As shown in Exhibit C, the 16th Street /Warren Avenue intersection continues to meet signal warrants —the peak hour vehicular volume and school crossing warrants are met The peak hour warrant is met even with the reduction in traffic volume on 16th Street resulting from the campus improvements This intersection functions a school crossing for Olympic College students to cross Warren Avenue to access the neighborhood to the east and the existing bus stop Exhibit C Summary of Signal Warrant Analysis for the 16th Street/Warren Avenue Intersection Signal Warrant Status Reason 3: Peak Hour Vehicular Met The Warren Avenue (mayor street) two -way average traffic volume for one hour of Volume an average day is 3400 vph and the average volume on the minor street is 140 vph which is above the MUTCD threshold 4: Pedestrian Volume Not Met The pedestrian threshold of 100 or more pedestrians for each of any 4 hours during a day or 190 or more pedestrians during any 1 hour of a day is not met 5: School Crossing Met This intersection is a school crossing location It provides the main crossing location for students from Olympic College to access the northbound bus stop on Warren Avenue The following warrants were not evaluated 1 Eight -Hour Vehicular Volume, 2 Four -Hour Vehicular Volume, 6 Coordinated Signal System, 7 Crash Experience, 8 Roadway Network Schacht I Adam Architects 554 5720 003 Olympic College Parking Study - Traffic Operations Evaluation 8 April 21, 2010 DRAFT - TECHNICAL MEMORANDUM (CONTINUED) CONCLUSIONS The modifications to Broadway Avenue to reduce on- campus traffic flows and increase pedestrian safety can be achieved without significantly or adversely impacting traffic operations on Warren Avenue — provided the 13th Street /Warren Avenue intersection is signalized and the signal system on Warren Avenue from 16th Street to 11 th Street is coordinated With this alternative, the 11 th Street /Warren Avenue intersection would operate at LOS D If the 13th Street /Warren Avenue intersection is not signalized, traffic would likely divert to the 11th Street /Warren Avenue intersection and degrade the operating conditions of this intersection Drivers would experience longer queues and delays and the overall intersection would worsen to LOS E Installing a signal at the 13th Street /Warren Avenue intersection would improve northbound and southbound travel times on Warren Avenue The anticipated result is an improvement in the efficiency of vehicles being able to turn onto Warren Avenue from additional access points providing greater priority in signal timing (green time) to be given to the northbound and southbound movements on Warren Avenue Also, the 13th Street /Warren Avenue (new signal) and 16th Street /Warren Avenue (change in traffic volumes at existing signal) intersections meet two of the warrants used by traffic engineers to assist in determining the appropriateness of installing a traffic signal Based on this analysis, adding a new signal at the 13th Street /Warren Avenue intersection appears to be the best solution for maintaining traffic flow on Warren Avenue if through traffic is restricted on Broadway Avenue Schacht I Adam Architects 554 5720 003 Olympic College Parking Study - Traffic Operations Evaluation 9 Apnl 21, 2010 Appendix A: Proposed Campus Parking Location 16th Street -- p J I I I ` I I I I \\ I I ^ I� M N 7y J L- -j tilt I I — I a' J � L 1 r � f 13th Stree I APPENDIX B: Operational Analyses Summary 16th Street @ Warren Ave Traffic to 13th Street Traffic to 13th Street Traffic to 11th Street 1 2009 2015 - No Build 2015 - Campus (Stop Sign) 201S - Campus (Signal) 2015 - Campus (Signal) Approach Turn LOS 95th Queue LOS 95t Q LOS 95th Queue LOS 95th Queue LOS 95th Queue Eastbound Left /Right D 192 D 223 D 86 D 84 C 57 Right -- Northbound Left D 79 E 90 C 23 D 81 C 24 Thru A 328 A 397 A 336 A 134 A 312 Southbound Thru B 470 B 535 A 202 B 461 A 183 Right A 8 A 6 A 3 A 8 A 5 Control Type Actd Uncrd Actd Uncrd Actd Uncrd Actd Coord Actd Uncrd Cycle Length 120 130 130 120 130 Intersection LOS B 163 B 17 9 A 6 9 A 9 9 A 6 8 Recall Mode Min N/S Min N/S Min N/S C Max N/S Min N/ 11 3th Street 8 Warren Ave Traffic to 13th Street Traffic to 13th Street Traffic to 11th Street 2009 2015 - No Build 2015 - Campus (Stop Sign) 2015 - Campus (Signal) 2015 - Campus (Stop Sign) Approach Turn LOS 95th Queue LOS 95th Queue LOS 9Sth Queue LOS 95th Queue LOS 95th Queue Eastbound Left F exceed v/c E 280 Right A 1 B 2 F exceed v/c B 2 Westbound Right B 2 B 4 B 4 B 24 B 5 Northbound Thru A 0 A 0 A 0 A 98 A 0 Right A 0 A 0 A 0 A 0 Southbound Thru A 0 A 0 A 0 A 126 A 0 Right A 0 A 0 A 0 A 0 Control Type Stop Controlled Stop Controlled Stop Controlled Actd Coord Stop Controlled Cycle Length n/a n/a n/a 120 n/a Intersection LOS B B F A 8 5 B Recall Mode n/a n/a n/a C Max N/S n /a 11th Street @ Warren Ave Traffic to 13th Street Traffic to 13th Street Traffic to 11th Street 2009 2015 No Build 2015 Campus (Stop Sign) 2015 - Campus (Signal) 2015 - Campus (Signal) Approach Turn LOS 95th Queue LOS 95th Queue LOS 95th Queue LOS 95th Queue LOS 95th Queue Eastbound Left D 401 D 482 D 482 E 496 F 522 Thru B 213 C 239 C 239 C 247 B 156 Westbound Thru E 244 E 280 E 180 E 293 D 188 Right C 132 C 136 C 136 C 148 C 126 Northbound Left E 57 E 65 E 65 E 61 D 51 Thru D 412 D 516 D 516 D 421 E 439 Southbound Left E 90 E 99 E 99 E 88 F 75 Thru D 454 D 575 D 575 C 371 D 481 Right A 113 A 125 A 125 A 5 A 134 Control Type Actd Uncrd Add Uncrd Actd Uncrd Actd Coord Actd Coord Cycle Length 120 130 130 120 130 Intersection LOS D 38 8 D 448 D 448 D 40 8 E 59 0 Recall Mode Min N/S Min N/S Min N/S C Max N/S Min N/S Appendix C: Peak Period Turning Movement Counts Warren Ave & 16th St Tuesday, November 10, 2009 2 :30 PM to 5:30 PM 15- Minute Interval Summary 2 30 PM to 5 30 PM Interval Northbound Southbound Eastbound Westbound Pedestrians Start Warren Ave Warren Ave 16th St 16th St Interval Crosswalk Time L T HV T R HV L R HV Total North South East West 2 30 PM 5 271 9 326 37 6 71 8 0 718 0 3 0 0 2 45 PM 14 310 5 331 46 12 91 9 0 801 0 3 0 2 3 00 PM 7 252 4 357 58 8 70 11 0 755 0 5 0 4 315 PM 5 317 11 349 47 12 104 11 3 833 0 13 0 0 3 30 PM 8 321 2 339 42 9 86 10 2 806 0 5 0 1 3 45 PM 11 349 5 318 45 9 82 7 0 812 0 3 0 0 k445 7 321 7 318 50 11 75 6 1 777 0 3 0 0 PM 12 346 12 320 38 12 82 6 5 804 0 6 0 0 PM 31 343 4 351 72 8 84 4 1 885 0 3 0 0 PM 45 322 4 334 101 8 82 1 0 885 0 2 0 0 PM 11 291 3 419 58 6 79 6 0 864 0 3 0 0 PM 5 299 2 359 42 2 73 5 2 783 0 1 0 0 Total Survey 161 3 742 68 4 121 636 103 979 84 14 9 723 0 50 0 7 Warren Ave & 11 th St Tuesday, November 10, 2009 2:30 PM to 5:30 PM 15- Minute Interval Summary 2 30 PM to 5 30 PM Interval Northbound Southbound Eastbound Westbound Pedestrians Start Warren Ave Warren Ave 11th St 11th St Interval Crosswalk Time L T R HV L T R HV L T R HV L T R HV Total North South East West 2 30 PM 7 160 4 4 16 156 138 7 166 54 3 6 2 59 20 2 785 0 0 0 1 2 45 PM 8 147 2 1 13 139 134 11 166 47 8 2 0 60 34 5 758 1 0 1 0 3 00 PM 4 143 5 2 8 152 122 9 142 42 9 7 1 76 33 11 737 2 0 0 3 315 PM 3 192 5 2 16 199 135 10 187 73 7 6 1 66 18 0 904 1 3 0 1 3 30 PM 7 145 3 0 8 160 110 10 173 61 7 1 1 77 35 2 787 0 2 0 0 3 45 PM 6 207 5 3 26 186 139 9 200 68 12 3 0 86 39 1 1 974 2 0 1 1 4 00 PM 9 222 3 1 14 169 108 8 164 63 7 5 0 111 51 4 921 0 0 0 1 4 15 PM 1 10 1 212 5 3 16 159 143 10 213 55 a 5 1 1 100 57 6 979 6 0 0 2 4 30 PM 6 209 5 2 6 171 133 1 10 1 192 64 7 2 0 95 51 2 939 0 0 0 1 4 45 PM 7 211 5 2 12 150 95 7 151 58 7 2 0 55 32 1 783 0 0 0 0 5 00 PM 7 210 4 6 12 203 134 4 148 55 2 4 0 75 42 0 892 1 0 0 0 515 PM 5 232 1 2 8 168 124 2 1 55 4 1 0 65 31 3 875 0 1 0 0 T otal Survey 79 2290 47 28 155 2,012 1 515 97 2084 895 81 44 B 927 443 37 10 334 13 8 1 2 1 10 Total Vehicle Summary M�_ Ctoe�aiowo Appendix C: 2009 Volumes PM Peak Hour from 3:45 PM to 4:45 PM Warren Ave 1512 b 4 1682 1512 61 205 1307 16th Street a 0 b a 323 & 4�h 4 346 1 346 1 23 � 61 11359 1420 0 � 0 a 0 0 13th Street a a 0 0 b MEW 1 0 F l - 27 - 0 - 1 198 946 523 1 685 1 62 a 392 591 591 11th Street a 40 b q� If 1 a b 769 & 41 A 4 b 1053 1053 250 b 31 1 850 1 18 330 34 899 720 a 4 899 Warren Ave Appendix D: 2015 - No Build Volumes PM Peak Hour from 3:45 PM to 4:45 PM Warren Ave 1605 b 4 2060 1605 65 220 1385 16th Street a 40 a b 350 & 4 375 375 25 65 11710 1775 1375 25 35 35 11340 a 25� 25 13th Street a di b W a a 4 b 15 15 b 1805 65 65 15 11870 1345 210 1005 1 555 1 725 1 65 a 415 625 625 11th Street a ry b W a b 815 & 4 a 1115 1115 265 a 35 900 20 350 35 % 955 760 b 4 955 Warren Ave Appendix E: 2015 - Traffic Diverts to 13th Street PM Peak Hour from 3:45 PM to 4:45 PM Warren Ave 1605 4 2295 ME] 65 145 1460 16th Street a 40 a b 115 xk qo 4 140 1 140 25 xt , 65 1945 2010 1450 25 110 110 1340 a 25 25 13th Street a 40 a W a a 235 J* 4 d b 250 250 b %/, 1805 65 65 15 1870 l 3 210 1005 1 555 1 725 65 a 415 625 625 11th Street a 4 b W I a a 815 & 1% 4 0 b 1115 1115 265 b 35 900 20 j 350 35 % 955 760 b 4 955 Warren Ave Appendix F: 2015 - Traffic Diverts to 11 th Street PM Peak Hour from 3:45 PM to 4:45 PM Warren Ave 1605 b 4 2295 1605 65 145 1460 16th Street a 40 b 115 J* 4 h 4 140 140 25 65 11945 2010 1450 25 110 110 1340 a ME E 25 13th Street a �' W a b 41h 4 0 a 15 15 a 2040 65 65 15 xt 2105 1345 210 1005 1 555 1 725 65 a 415 625 625 11th Street G 4 q> a b 1050 & 41 A 4 0 b 1350 1350 265 b 35 900 20 350 35 955 760 b 4 955 Warren Ave Appendix G: Results of 2015 Operation Analysis No Build Campus Plan Improvements Stop Controlled at 13th Street Signal at 13th Street Traffic Diversion to 11th Street 16th Street B 16th Street A 16th Stree 16th Street A L L M I O M M a a a a I 3 3 3 3 13th Street B 1 3th St reet F 13th Street A 13th Street B J i 11th Street - - -, 11th Street —F 11th Street -- — 11th Street - -, D D D E I 1 LEGEND i Queue Length (200 feet) O D Signalized Intersection a O q Stop - Controlled Intersection