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05/01/2013 AGENDA
1 CITY COUNCIL 345 6th Street, Suite 600, Bremerton, WA 98337 ❑ Phone (360) 473 -5280 ** *AMENDED * ** MAY 1, 2013 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 INFORMATION BRIEFING — John Powers, Executive Director, Kitsap Economic Development Association (KEDA) Approx 10- minutes 5 PUBLIC RECOGNITION 6 CONSENT AGENDA A Claims & Check Register B Minutes of Meeting — April 17, 2013 C Minutes of Study Session — April 24, 2013 D Appointment of Annamane Lavien (Kitsap Historical Society & Museum) to the Lodging Tax Advisory Committee E Appointment of Nicole Vorthman (Hampton Inn & Suites) to the Lodging Tax Advisory Committee F Appointment of Jose Maldonado (Baymont Inn & Suites) to the Lodging Tax Advisory Committee G Amendment to the 2004 Kitsap County HOME Consortium (Project No KC- 360 -04) Interlocal Cooperation Agreement H 2013 KPS Premium Rates & Underwriting Criteria I Renewal of Service Agreement with CenturyLmk for Long Distance Services, and to provide Telecommunications Services at the Police Department and Gold Mountain Golf Complex J Appointment of Nicole Floyd as Senior Planner in the Community Development Department at a step higher than Rate 1 (Rate 5 in Pay Band 11) of the 2013 City of Bremerton "Management, Professional, Confidential & Fiduciary Salary Plan" 7 GENERAL BUSINESS A Amendment to prior Council Motion regarding the East Beach Sewer Main Replacement Project 8 COUNCIL MEMBER REPORTS 9 ADJOURNMENT OF CITY COUNCIL BUSINESS MEETING ® Amencans with Disabilities Act (ADA) accommodations provided upon request Those requinng special accommodations please contact the City Clerk at (360) 473 -5323 by noon on the day preceding the Meeting Prortamation WHEREAS, water is our most valuable natural resource, and WHEREAS, only tap water delivers public health protection, fire protection, support for our economy and the quality of life we enjoy, and WHEREAS, any measure of a successful society — health, economic growth and diversity, productivity, and public safety — are related to access to safe water, and WHEREAS, we are all stewards of the water infrastructure upon which future generations depend, and WHEREAS, each citizen of our community is called upon to help protect our source waters, to practice water wise habits, and to get involved in local water issues, NOW, THEREFORE, I, Patty Lent, Mayor of the City of Bremerton do hereby proclaim May 5 - 11, 2013 as Drinking Water Week Signed this 1" day of May 2013 Mayor Patty Lent Prodamatton WHEREAS, the Office of the Municipal Clerk, a time honored and vital part of local government exists throughout the world, and WHEREAS, the Office of the Municipal Clerk is the oldest among public servants, and WHEREAS, the Office of the Municipal Clerk provides the professional link between the citizens, the local governing bodies and agencies of government at other levels, and WHEREAS, Municipal Clerks have pledged to be ever mindful of their neutrality and impartiality, rendering equal service to all, and WHEREAS, the Municipal Clerk serves as the information center on functions of local government and community, and WHEREAS, Municipal Clerks continually strive to improve the administration of the affairs of the Office of the Municipal Clerk through participation in education programs, seminars, workshops and the annual meetings of their state, province, county and international professional organizations, and WHEREAS, it is most appropriate that we recognize the accomplishments of the Office of the Municipal Clerk, NOW, THEREFORE, I, Patty Lent, Mayor of the City of Bremerton do hereby recognize the week of May 5 through May 11, 2013, as Municipal Clerks Week, and further extend appreciation to our Municipal Clerk, Shannon Corm and to all Municipal Clerks for the vital services they perform and their exemplary dedication to the communities they represent Signed this 1" day of May 2013 Mayor Patty Lent ;Vrodamaction WHEREAS, service to others is fundamental to the character of citizens of the City of Bremerton and the current economic downturn means more citizens are facing difficulties, and WHEREAS, volunteering and community service are needed more than ever, and WHEREAS, the Senior Companion Program, part of the Senior Corps National Service Program, encourages citizens aged 55 and older to volunteer, and WHEREAS, 44 Senior Companion Volunteers of Pierce and Kitsap Counties served 124 clients in 2012, thereby assisting those clients in maintaining their independence while living in their own homes, and WHEREAS, the Senior Companions provided 36,897 hours of direct service, and WHEREAS, the Senior Companions provided transportation for 2,292 trips to doctor's appointments, grocery stores, pharmacies, parks and senior centers, and WHEREAS, these 44 Senior Companions directly served in eight non profit agencies, including the Asian Pacific Community Center, Catholic Community Services, Harbor View Manor, the Korean Women's Association, Lutheran Community Services, Mercy Housing, the Multicultural Self- sufficiency Movement and the Tacoma Area Coalition of Individuals with Disabilities, and WHEREAS, Senior Corps Week, May 6 through 10, is a time for the people of Bremerton to recognize Senior Corps and the Senior Companions for their service, to thank the Senior Companion partner agencies and to encourage more citizens to become involved in volunteering, NOW, THEREFORE, I, Patty Lent, Mayor of the City of Bremerton, do hereby proclaim May 6 — 10, 2013 to be Senior Corps Week in Bremerton and urge Bremerton citizens to thank the Senior Companion Volunteers for their service Signed this 10 day of April 2013 Mayor Patty Lent Proclamation WHEREAS, service to others is fundamental to the character of citizens of the City of Bremerton and the current economic downturn means more citizens are facing difficulties, and WHEREAS, volunteering and community service are needed more than ever, and WHEREAS, the Retired and Senior Volunteer Program, part of the Senior Corps National Service Program, encourages citizens aged 55 and older to volunteer, and WHEREAS, 479 unduplicated Retired and Senior Volunteer Program volunteers of Kitsap County served 34 stations 2012, thereby assisting those stations in serving the community, and WHEREAS, the Retired and Senior Volunteer Program provided 59,510 hours of direct service, and WHEREAS, the Retired and Senior Volunteer Program provided the monetary equivalent of $1,271,139 of Independent Sector Value of volunteer hours of service in Kitsap County, and WHEREAS, these 479 Retired and Senior Volunteer Program volunteers directly served in non - profit organizations exclusively ie food banks, schools, hospitals, museums, etc, and WHEREAS, Senior Corps Week, May 6 through 10, is a time for the people of Bremerton to recognize Retired and Senior Volunteer for their service, to thank the Retired and Senior Volunteer partner agencies and to encourage more citizens to become involved in volunteering, NOW, THEREFORE, 1, Patty Lent, Mayor of the City of Bremerton, do hereby proclaim May 6 — 10, 2013 to be Senior Corps Week in Bremerton and urge Bremerton citizens to thank the Retired and Senior Volunteer Program Volunteers for their service Signed this 10`" day of April 2013 Mayor Patty Lent Proclamation WHEREAS, the City of Bremerton supports the 5ch Annual Armed Forces Motorcycle Ride and Bike Show benefitting the Washington Youth Academy at 8 30 AM on Sunday, May 19 2013 beginning at Pendergast Park, 1099 Union Ave in Bremerton and sponsored by Brothers Powersports, the Armed Forces Festival and JR's Hideaway Grill, and WHEREAS, proceeds from this event go directly to the Washington Youth Academy Foundation whose mission is helping Washington at -risk youth succeed and supports the Armed Forces Hero Barbeque, and WHEREAS, the Washington Youth Academy (WYA) Foundation was established to support the students and mission of the WYA The WYA is part of the National Guard Youth Challenge Program and is a state -run residential and post - residential program for 16 -18 year old boys and girls who have dropped out of high school or are at risk of dropping out, and WHEREAS, during the rider registration, the Washington Youth Academy Cadets will march in to the park and the Cadet Drill Team will perform The Cadets will also pick their favorite motorcycle, NOW, THEREFORE, I, Patty Lent, Mayor of the City of Bremerton, do hereby proclaim Sunday, May 19, 2013 as 5 "' Annual Armed Forces Motorcycle Ride and Bike Show Day and we encourage riders and the general public to attend Signed this lth day of May, 2013 Patty Lent, Mayor BREMERTON CITY COUNCIL MEETING SPEAKERS LIST PLEASE PRINT YOUR NAME BELOW IF YOU PLAN TO COMMENT SO YOUR NAME CAN BE INCLUDED IN THE RECORD cl � S4 ry Lc (6eg 1� ka - ��Q � OC4 " eA MCA z K REQUESTS FOR INFORMATION MUST BE SUBMITTED IN WRITING TO THE CLERK THANK YOU F9 ,014 : `���� ,�► -,�2�. To , -� !3tz SvAs s b , p46 D od N �- ,.t F0,2 D A - y 1 u a r id s ve s L7 /AND P U A -0)50 ©36 rLJD )VO Y)I �, �G v �-►�� L< � s �'� `�� ��? N, �r��,e� l-�� Gds � s c�,ed' �� 50� .STj 7N« Gu2v�� is p SPOAD ��TS l�l :Z ' S i`'� l� p J /n/� 5 / R � ir/ � dryJ � )SA R�. � W,4 �o2,t� e�2 Any ► MAZI ` r ,� �rZ , o (Ze s7� E's D�w�/7b �r 1514 V, -7-th" yoo AGENDA BILL CITY OF BREMERTON CITY COUNCIL ■■ eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee SUBJECT. Claims & Check Register Study Session Date COUNCIL MEETING Date May 1, 2013 Department Financial Services Presenter Shannon Conn Phone 473 -5323 SUMMARY. Approval of the following checks and electronic fund transfers 1) Check #'s 353225 through 353402 and EFT's 12777 through 12809 in the amount of $1,048,112 62 2) Regular Payroll for the pay period ending April 15, 2013 in the amount of $712,439 52 3) Retiree Payroll for the pay period ending April 30, 2013 in the amount of $55,881 95 ATTACHMENTS. FISCAL IMPACTS (Include Budgeted Amount) STUDY SESSION AGENDA Nx No Discussion ❑ Full Presentation STUDY SESSION ACTION- Nx Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve consent agenda as presented COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 AGENDA BILL CITY OF BREMERTON lots CITY COUNCIL ■■ rs���������a�������������������������0EE0ENEa0000M000EaaMM SUBJECT COUNCIL MEETING Date May 1, 2013 Department City Council Minutes of Meeting Presenter Greg Wheeler April 17, 2013 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 STUDY SESSION AGENDA Nx No Presentation Planned ❑ Full Presentation STUDY SESSION ACTION N Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION* Move to approve the Consent Agenda as presented COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 DIGITAL RECORDING CITY COUNCIL MEETING MINUTES Wednesday, April 17, 2013 The weekly meeting of the City Council of the City of Bremerton was called to order Wednesday, April 17, 2013, at 5 00 PM in the Council Conference Room 603 of the NORM DICKS GOVERNMENT CENTER, 345 6 th Street, Bremerton, Washington, with Council President Greg Wheeler presiding Council Members present were Eric Younger, Carol Arends, Faye Flemister, Wendy Priest, Adam Brockus, Leslie Daugs, and Jim McDonald Council Member Nick Wofford was absent Also present were City Attorney Roger Lubovich, City Clerk Shannon Conn, and Legislative Assistant Lori Smith 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 and (due to technical difficulties) was convened five minutes later at 5 35 PM The Pledge of Allegiance was led by Council Member Jim McDonald followed by the invocation provided by Pastor Jerry Michaels of Voyage Community Church MAYOR'S REPORT — Mayor Patty Lent • Encouraged residents to take the Mayor's Conservation Challenge by visiting www mywaterpled eq com until April 30, • Introduced Caroline Stein Washington State Science and Engineering Fair (WSSEF), and David Ruble Bremerton School District Board Member, who accepted a Mayor's Award on behalf of the 37 students recognized for their exhibits, • Proclaimed April 25, 2013 as "Pay If Forward Day ", • Announced that the Bremerton Foodline will be hosting its Annual Empty Bowl fundraiser on Saturday, April 20 at 2 00 PM at Our Saviour's Lutheran Church, • Proclaimed April 24, 2013 as "Arbor Day ", • Proclaimed April 22, 2013 as "Earth Day ", • Announced that an Earth Day and Arbor Day Celebration would be held on Wednesday, April 24 beginning at 10 30 AM at Kiwanis Park, • Looked forward to the Annual Kids Fishing Day hosted by the Kitsap Poggie Club on Saturday, April 27 from 8 00 AM to 1 00 PM near Otto Jarstad Park, and • Announced that the Bremerton Farmers Market will be opening on May 2 at Evergreen Rotary Park and on May 5 near the Bremerton Ferry Terminal Police Chief Steve Strachan provided a briefing on the Bremerton Police Department PUBLIC RECOGNITION Mike Strube Bremerton Area Chamber of Commerce, announced the 22 Annual Pepsi Armed Forces Golf Tournament on May 10 and the deadline to sign -up to be part of the Armed Forces Day Parade is April 29 Todd Best welcomed the public to a Memorial Day Service at the Tomb of the Unknown Soldier on Monday, May 27 at 1 00 PM, and encouraged people to help with the next Forest Ridge Park Stewardship Day on Saturday, April 20 from 9 00 AM to Noon Scott Collett Bremerton School District, pointed out that after several latest Public Works street projects, Bremerton is not "bus friendly' and hoped that future engineering decisions would take busses (and other longer vehicles) into account City Council Reg Mtg Minutes Wednesday, April 17, 2013 Page 2 of 4 Robert Parker agreed that Public Works projects need to take into consideration the drivability on our streets for busses and even freight trucks, which is important to businesses who may want to locate to Bremerton He also expressed concern about the current location planned for electric vehicle charging stations that will take up valued parking spaces close to the downtown area because after researching their use in other Puget Sound areas, he learned they are more likely to be located in parking lots (not on the street) and are not really even being used very often Bob Dollar read a letter into the record to also express his concerns about the proposed location for electric vehicle charging stations Dino Davis Sustainable Bremerton, provided comment in favor of the charging stations Vern LaPrath was appreciative of open communication with Leslie Daugs, and was upset about a recent newspaper article about a lease agreement at Gold Mountain Golf Course Jerry McDonald asked that Council consider relocating the flowers currently in the Charleston area to downtown Jodette Parker emphasized that flowers are for Charleston and other areas besides downtown, and did not support charging stations which would remove four parking stalls CONSENT AGENDA 6A— Clams & Check Register Check Numbers 353011 through 353224 and EFT -12737 through EFT -12776 in the amount of $2,311,278 74 613— Minutes of Meeting — April 3, 2013 6C — Minutes of Study Session — April 10, 2013 6D — Bid Award to ROGNLIN'S, INC for the Eastside Beach Sewer Main Replacement Project 6E — Bid Award for Service Agreement with S VARICK MAINTENANCE for Landscape Maintenance and Service 6F — Ordinance No 5214 providing for the Issuance and Sale of two (2) Limited Tax General Obligation (LTGO) Bonds for the Parking System and Golf Course in the aggregate principal amount not to exceed $14,500,000, and delegating authority to Mayor or Director of Financial Services to approve the final terms of the Bonds 613 — Collective Bargaining Agreement between the City of Bremerton and International Association of Fire Fighters (IAFF) Local 437 Comments from the public were provided by Bob Dollar 06:37:00 Motion was made by Daugs, and seconded by Priest Comments on the Motion were provided by Daugs and Brockus, with a response was provided by Ms Hasart 06:40:00 M /S /C /U (Daugs /Priest) Move to approve the CONSENT AGENDA as presented GENERAL BUSINESS 7A— ORDINANCE NO. 5215 ESTABLISHING A NEW CHAPTER 6.10 OF THE BREMERTON MUNICIPAL CODE (BMC) ENTITLED "ABANDONED PROPERTY REGISTRATION AND MAINTENANCE "; AND RESOLUTION NO. 3191 AMENDING THE COMMUNITY DEVELOPMENT — RATE TABLE C ESTABLISHING FINES AND PENALTIES FOR FAILURE TO REGISTER AND MAINTAIN ABANDONED PROPERTIES Andrea Spencer Community City Council Reg Mtg Minutes Wednesday, April 17, 2013 Page 3 of 4 Development Director, explained that the City has numerous vacant properties, many of which are at some stage of foreclosure It has been shown that vacant abandoned properties lead to increased crime rates, and have a deleterious impact on adjacent properties The City Council has made it a priority to adopt regulations that aid in reducing the impact of these vacant abandoned properties, and to this end, staff has developed an ordinance that addresses abandoned properties It was emphasized that the proposed ordinance requires the following • Abandoned properties must be registered with the City (a property that is not legally occupied, and subject to foreclosure or in foreclosure status), • Registration must identify a local property manager (within Kitsap County) who can resolve issues on the site, • Property manager must conduct monthly inspections to ensure code compliance, and • Property manager's name and 24 -hour contact information must be posted on the site Comments and questions from the public were provided by Dino Davis Robert Parker Jerry McDonald and George Warrington with responses provided by Ms Spencer 06:56:00 Motion to pass Ordinance No 5215 was made by Brockus, and seconded by McDonald Comments and questions were provided by Brockus, Daugs, Wheeler, Priest, McDonald, and Arends, with responses provided by Ms Spencer 07:06:00 M /S /C /U (Brockus /McDonald) Move to pass Ordinance No 5215 establishing Chapter 6 10 of the Bremerton Municipal Code entitled "Abandoned Property Registration & Maintenance" 07:07:00 Motion to adopt Resolution No 3191 was made by McDonald, and seconded by Brockus Questions were asked by Brockus, with response provided by Ms Spencer 07:09:00 M /S /C /U (McDonald /Brockus) Move to adopt Resolution No 3191, amending the Community Development — Rate Table C fees to establish abandoned properties fines and penalties COUNCIL MEMBER REPORTS Eric Younger was excited about the passage of the abandoned property ordinance and hoped that a similar program for rentals would be next Carol Arends announced that ClayWerks will be hosting its last Girl's Night Out event prior to closing the shop at the Callow Avenue location on Thursday, April 18 from 6 00 to 8 00 PM, reported that a vintage clock is now working and on display in the Charleston area, and encouraged people to volunteer for the next Forest Ridge Park Stewardship Day on Saturday, April 20 from 9 00 AM to Noon Faye Flemister invited the community to attend the 35 Anniversary Celebration Banquet for Emmanuel Apostolic Church on Friday, April 19 at 7 00 PM at Olympic College in the Bremer Student Center Please contact (360) 479 -3674 to purchase tickets or for more information Wendy Priest also encouraged the public to attend the Empty Bowl event at 2 00 PM on Saturday, April 20 at Our Saviour's Lutheran Church, and added that she attended last year's fundraiser and the bowls made by art students as well as the soup were all fabulousl City Council Reg Mtg Minutes Wednesday, April 17, 2013 Page 4 of 4 Adam Brockus invited the public to attend the next District 3 Community Meeting on Tuesday, April 23 from 6 30 to 8 00 PM at the Bremerton Senior Center that would feature a program with Community Development Director Andrea Spencer and Code Enforcement Officer Janet Lunceford to discuss "Code Enforcement and the Abandoned Property Registration & Maintenance Program" He also responded to previous comments about the proposed electric vehicle charging stations as part of the Pacific Avenue project by clarifying 1) No Transportation Benefit District (TBD) funds would be used to install the charging stations, 2) Additional parking spots would be added across the street from the charging stations, and 3) He would rescind his current support for the charging stations if pending legislation was approved to issue $124 tickets to those without electric vehicles parking in the charging station spots Leslie Daugs thanked Fire Marshall Mike Six for a recent ride around during fire inspections, reiterated information about the Empty Bowl event that will benefit the Bremerton Foodline, and looked forward to attending the Habitat for Humanity Bay Vista "Home Dedication Ceremony' on Saturday, April 20 at 1 00 PM Jim McDonald responded to earlier comments regarding newspaper articles about a yearly lease of City property for $1 00 with Scott Alexander for a golf cart business at Gold Mountain Golf Course He stated the headline was misleading because he considers this a great contract for Bremerton that was carefully negotiated by City Attorney Roger Lubovich, and considers it a great deal because the City gets a 50% reduced rate on golf carts, which amounts to a $90,000 benefit to the City And also mentioned that as a City employee for 27- years, Scott Alexander successfully managed the golf course, so summarized this is a "win -win" contract Greg Wheeler also plans to support the Empty Bowl event and hopes members of the community will as well, and announced the opening of the Bremerton Farmers Market, which may be in its last year at Evergreen Rotary Park With no further business, President Wheeler adjourned the Council Meeting at 7 20 PM Prepared and Submitted by LORI SMITH Legislative Assistant Attest I SHANNON CORIN, City Clerk GREG WHEELER, City Council President GW SC Is cg i AGENDA BILL CITY OF BREMERTON CITY COUNCIL ■e 0 0 0 E M 0 0 E E 0 E M a M 0 M 0 a 0 0 0 0 0 0 a w 0 0 0 0 0 0 0 0 0 0 0 0 N a 0 w 0 E 0 a 0 0 0 M 0 0 0 0 E w 0 0 M 0 2 2 0 0 N 0 0 0 0 w M 0 M 0 a 0 K 0 0 E 0 0 0 M M 9 SUBJECT: COUNCIL MEETING Date May 1, 2013 Department City Council Minutes of Study Session Presenter Greg Wheeler April 24, 2013 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 STUDY SESSION AGENDA 0 No Presentation Planned ❑ Full Presentation STUDY SESSION ACTION Nx Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION. Move to approve the Consent Agenda as presented COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 DIGITAL RECORDING CITY COUNCIL STUDY SESSION MINUTES Wednesday, April 24, 2013 A Study Session of the City Council of the City of Bremerton was called to order in the Council Conference Room of the NOW DICKS GOVERNMENT CENTER, 345 6 th Street, Bremerton, Washington, Wednesday, April 24, 2013, at 5 00 PM, with Council President Greg Wheeler presiding Council Members present were Eric Younger, Carol Arends, Faye Flemister, Wendy Priest, Adam Brockus, Leslie Daugs, and Jim McDonald Council Member Nick Wofford was absent Lori Smith, Legislative Assistant, was present to provide staff support Mayor Lent introduced new IT employee Hans Nilsson and presented a Mayor's Award to Dave Buffington in recognition of his technical work, including the design and implementation of a program to report graffiti on -line and with smart phone applications President Wheeler emphasized that the Study Session was open to the public but there would be no opportunities for input or participation, and announced that approved items by Council will be placed on the May 1, 2013 Council Meeting Agenda or as indicated A NO PRESENTATION ITEMS 1 Appointments of Annamane Lavien (Kitsap Historical Society and Museum), Nicole Vorthman (Hampton Inn & Suites), and Jose Maldonado (Baymont Inn & Suites) to the Lodging Tax Advisory Committee Consent Agenda 2 Amendment to the 2004 Kitsap County HOME Consortium (Project No KC- 360 -04) Interlocal Cooperation Agreement Consent Agenda 3 2013 KPS Premium Rates and Underwriting Criteria Consent Agenda 4 Renewal of Service Agreement with CenturyLink for Long Distance Services, and to provide Telecommunications Services at the Police Department and Gold Mountain Golf Complex Consent Agenda B FULL PRESENTATION ITEM 5 Update of proposed changes to Chapter 18 02 of the Bremerton Municipal Code (BMC) entitled City Fire Code Information Only — Action proposed for June 19 C GENERAL COUNCIL BUSINESS 1 Finance and Investment Committee Briefing — Eric Younger, Chair 2 Brief Council Member reports were provided and other General Business discussed With no further business, President Wheeler adjourned the Council Study Session at 6 20 PM Prepared and Submitted by LORI SMITH Attest Legislative Assistant SHANNON CORIN, City Clerk GREG WHEELER, City Council President AGENDA BILL CITY OF BREMERTON 61 ) CITY COUNCIL SUBJECT COUNCIL MEETING Date April 24 & May 1, 2013 Appointment of Annamare Lavien to the Department Executive Bremerton Lodging Tax Advisory Committee Presenter Mayor Lent Phone (360) 473 -5266 SUMMARY: There is a vacancy on the Lodging Tax Advisory Committee Revised Code of Washington (RCW) Title 67 28 and Bremerton Municipal Code (BMC) Chapter 2 38 010 (b) both specify that two (2) representatives from businesses that are eligible to receive proceeds from the hotel /motel tax shall serve on the advisory committee It is recommended that Annamane Lavien, Kitsap Historical Society and Museum, be appointed for the remainder of the unexpired term held previously by her predecessor Carolyn Neal ending June 13, 2014 ATTACHMENTS FISCAL IMPACTS (Include Budgeted Amount) N/A STUDY SESSION AGENDA ❑x No Presentation Planned ❑ Full Presentation STUDY SESSION ACTION ❑x Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION. Move to confirm the appointment of Annamane Lavien to the Lodging Tax Advisory Committee COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4/5/13 I i i AGENDA BILL CITY OF BREMERTON 616 CITY COUNCIL ■■ eeeeeeeseeeaseaeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee SUBJECT: COUNCIL MEETING Date April 24 & May 1, 2013 Appointment of Nicole Vorthman to the Department Executive Bremerton Lodging Tax Advisory Committee Presenter Mayor Lent Phone (360) 473 -5266 SUMMARY. There is a vacancy on the Lodging Tax Advisory Committee Revised Code of Washington (RCW) Title 67 28 and Bremerton Municipal Code (BMC) Chapter 2 38 010 (a) both specify that two (2) representatives from businesses that collect the hotel /motel tax shall serve on the advisory committee It is recommended that Nicole Vorthman, General Manager for the Hampton Inn and Suites, be appointed for the remainder of the unexpired term held previously by her predecessor Matthew Boeckman ending June 13, 2014 ATTACHMENTS FISCAL IMPACTS (Include Budgeted Amount) N/A STUDY SESSION AGENDA px No Presentation Planned ❑ Full Presentation STUDY SESSION ACTION ❑x Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to confirm the appointment of Nicole Vorthman to the Lodging Tax Advisory Committee COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4/5113 AGENDA BILL CITY OF BREMERTON to 1 CITY COUNCIL SUBJECT- COUNCIL MEETING Date April 24 & May 1, 2013 Appointment of Jose Maldonado to the Department Executive Bremerton Lodging Tax Advisory Committee Presenter Mayor Lent Phone (360) 473 -5266 SUMMARY: There is a vacancy on the Lodging Tax Advisory Committee Revised Code of Washington (RCW) Title 67 28 and Bremerton Municipal Code (BMC) Chapter 2 38 010 (a) both specify that two (2) representatives from businesses that collect the hotel /motel tax shall serve on the advisory committee It is recommended that Jose Maldonado, Baymont Inn, be appointed for the remainder of the unexpired term held previously by his predecessor Samantha Heinnchs ending April 4, 2015 ATTACHMENTS: FISCAL IMPACTS (Include Budgeted Amount) N/A STUDY SESSION AGENDA ❑x No Presentation Planned ❑ Full Presentation STUDY SESSION ACTION ❑x Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION Move to confirm the appointment of Jose Maldonado to the Lodging Tax Advisory Committee COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 4/5/13 AGENDA BILL CITY OF BREMERTON 4014 CITY COUNCIL SUBJECT: Amendment to KC- 360 -04 - Study Session Date April 24, 2013 Kitsap County HOME Consortium Interlocal COUNCIL MEETING Date May 1, 2013 Cooperation Agreement Department DCD — Block Grant Presenter Marie Vila Phone 360- 473 -5375 SUMMARY In 2004 the City of Bremerton entered into an Interlocal Agreement with Kitsap County for participation in the Kitsap County HOME Consortium This amendment modifies the Administrative portion of the agreement to cover administrative costs incurred by the County for additional Contract Management of City projects and reflect changes to Program Income ATTACHMENTS. Amendment 01 to City Interlocal KC- 360 -04A, Staff Memo FISCAL IMPACTS (Include Budgeted Amount) HOME allows 10% of total award to be used for adman costs (about $22,857) Kitsap previously retained 50% of that allowance (about $11,429) for its role as lead jurisdiction Under the amendment, Kitsap County will retain 85% of the allowance (about $19,429) and the City of Bremerton will retain 15% (about $3,429) to compensate Kitsap County for taking on grant management duties for City HOME projects STUDY SESSION AGENDA 0 No Presentation ❑ Full Presentation STUDY SESSION ACTION 0 Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION. Move to approve amendment to 2004 Kitsap County Consortium Interlocal Agreement, and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/25/13 AMENDMENT KC- 360 -04 INTERLOCAL AGREEMENT PROJECT NAME: Interlocal Cooperation Agreement Between Kitsap Urban County and the City of Bremerton to Form a HOME Consortium Under the National Affordable Housing Act for Program Years 2005 -2007 and as herein renewed PROJECT NUMBER. KC- 360 -04 AMENDMENT NUMBER: 01 WHEREAS, Kitsap County, hereinafter referred to as "County", and the City of Bremerton, hereinafter referred to as "City", have previously entered into an Interlocal Agreement, KC- 360 -04, dated August 9, 2004 by which the City agrees to participate in a HOME Consortium to allow Kitsap County to receive HOME Investment Partnership Program funds WHEREAS, Amendment 01 to KC- 360 -04 between Kitsap County and the City modifies the Administrative portion of the agreement to cover administrative costs incurred by the County for additional Contract Management of City projects and reflect changes to Program Income WHEREAS, it is necessary to implement certain required changes to activities described in this Contract, and WHEREAS, the County and City desire to modify such Contract NOW THEREFORE, Contract Number KC- 360 -04 is hereby modified as follows: IV. ADMINISTRATION Delete I Funds received by the Kitsap County HOME Consortium will be allocated between the COUNTY and the CITY based on a proration of the HOME allocation as established by the Federal allocation formula for the year or the most recent formula if a current year formula has not been established The percentage of distribution between the COUNTY and the CITY shall be as determined in HUD's HOME Consortia Participating Members Percentage Report for each federal fiscal year Provided, however, that if the federal allocation is reduced due solely to one Party's program activities, the Party that caused the reduction in funds shall have its allocation reduced accordingly 1 CITY agrees to set aside up to 5% of CITY's allocation for reimbursement to COUNTY of COUNTY's actual costs for administration of the CITY's portion of the HOME Program 2 CITY will retain and control program income generated from its HOMEproration to utilize for HOME projects in accordance with applicable federal regulations. 1 Chanae To- 1. Funds received by the Kitsap County HOME Consortium will be allocated between the COUNTY and the CITY based on a proration of the HOME allocation as established by the Federal allocation formula for the year or the most recent formula if a current year formula has not been established. The percentage of distribution between the COUNTY and the CITY shall be as determined in HUD's HOME Consortia Participating Members Percentage Report for each federal fiscal year. Provided, however, that if the federal allocation is reduced due solely to one Party's program activities, the Party that caused the reduction in funds shall have its allocation reduced accordingly. 1 CITY agrees to set aside 85% of CITY's administrative allocation for reimbursement to COUNTY of COUNTY's actual costs for administration of the CITY's portion of the HOME Program. 2 CITY will remit Program Income to the COUNTY for reporting to HUD but will retain control of program income generated from its HOME proration to utilize for HOME projects in accordance with applicable federal regulations 2 THIS AMENDMENT constitutes the entire amendment to the Contract between the County and the City All other terms and conditions of this Contract remain in effect. THIS AMENDMENT is effective when signed by all parties CITY OF BREMERTON BOARD OF COUNTY COMMISSIONERS KITSAP COUNTY, WASHINGTON By Patty Lent, Mayor Josh Brown, Chair Date Charlotte Garrido, Commissioner Approves As to Form City Attorney Robert Gelder, Commissioner Date ATTEST ATTEST Shannon Corin, City Clerk Dana Daniels, Clerk of the Board G \DAS\DATA \CDBG \CONTRACnCONTRACT FORMS\INTERLOCAL AND PERSONNEL CONTRACTS INTERLOCAL HOME \ CONSORTIUM PROCESS\2014.2016 \\AMENDMENT TO CITY IN VMOCAL\Amendment 01 to City Interloul KC -360-04 dm 3 DEPARTMENT OF COMMUNITY DEVELOPMENT MEMORANDUM To: Bremerton City Council From: Mane Vila, CDBG /HOME Administrator Date: April 24, 2013 Re , Amendment to 2004 Kitsap HOME Consortium Interlocal Agreement with City of Bremerton In 2004 the City of Bremerton entered into an Interlocal Agreement with Kitsap County for participation in the Kitsap County HOME Consortium This mterlocal agreement is required by HUD for the City's membership in the HOME Consortium, and allows the City to receive HOME funds This amendment makes two changes 1 Assigns a greater portion of the HOME Administrative allocation to Kitsap County to cover administrative costs incurred by the County for additional Contract Management of City projects, and 2 Changes administration of HOME program income to streamline duties under Kitsap County Previously, the City had retained and performed all accounting for program income generated from our grant Under the amended procedure, the City collects program income and remits it to Kitsap County, who handles all accounting, HUD reporting and expenditures The City still retains credit for the funds, which are used for City projects only BACKGROUND HUD passed the Cranston - Gonzalez National Affordable Housing Act in 1990, thereby launching the HOME housing block grant The City of Bremerton, already a CDBG Block Grant entitlement grant recipient, worked together with Kitsap County to achieve county -wide entitlement eligibility for the CDBG and HOME programs In 1997, the City of Bremerton and Kitsap County entered into their first Interlocal Agreement outlining point participation in the HOME program as the "Kitsap County HOME Consortium" The interlocal agreement outlines several basic items 1 Kitsap County is the lead jurisdiction in the Consortium, and as such is the direct HUD grantee for HOME funds 2 Kitsap County enters into a separate agreement with Bainbridge Island, Poulsbo and Port Orchard to form the Kitsap "Urban County", which shares in Kitsap County's CDBG and HOME allocation 3 City of Bremerton is a HUD designated "Metropolitan City" and receives its own CDBG and HOME allocation, its CDBG allocation comes directly from HUD, and its HOME allocation comes through the Kitsap County HOME Consortium, the amount of which is determined annually by HUD as a percent of the total Kitsap County Consortium HOME allocation 4. The City of Bremerton has full decision - making discretion over its portion of the HOME allocation Bremerton City Council is the governing body for use of all HUD block grant funds awarded to the City Should you have any questions or concerns regarding any of these items please do not hesitate to contact Mane ViIt at (360) 473 -5375 AGENDA BILL CITY OF BREMERTON CITY COUNCIL ■■ eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee SUBJECT: 2013 KPS Rates & Underwriting Study Session Date April 24, 2013 Criteria COUNCIL MEETING Date May 1, 2013 Department Human Resources Presenter Charlotte Belmore Phone 360- 473 -5926 SUMMARY Approval of the KPS 2013 Rates and Underwriting Criteria and authorization of formal execution of the 2013 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 a 10 97% rate increase above the 2012 levels ATTACHMENTS KPS 2013 Premium Rates & Underwriting Criteria FISCAL IMPACTS (Include Budgeted Amount) This increase was accounted for in the 2013 adopted budget, therefore, no amendment is needed STUDY SESSION AGENDA ❑x No Discussion ❑ Full Presentation STUDY SESSION ACTION: ❑x Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION Move to approve the 2013 KPS Premium Rates and Underwriting Criteria between the City and KPS, and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 City of Bremerton January 1, 2013 Renewal Rates 10.97% Increase over 2012 PLAN A Active LEOFF I Employees $ 988.18 LEOFF 118 non - LEOFF Employees $ 717 54 Spouse $ 795.41 1st Child $ 359.21 2nd Child+ $ 289.12 LEOFF I Refines (Under 60 65) Subscnber $2,585.92 PLAN 8 Acthm Non - LEOFF Employees $ 620 47 Spouse $ 695.04 1 st Child $ 316.20 2nd Child+ $ 246.03 KPS Health Plans Business Address Mailing Address 400 Warren Avenue P O Box 34803 Bremerton, WA 98337 Seattle, WA 98124 -1803 CITY OF BREMERTON — PLAN A COVERAGE CONTRACT Group Number: 1000780 Effective Date: January 1, 2013 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 heir Eligible Dependents meet and comply with the provisions of this Coverage Contract ( °Contract°) C13BREMA TABLE OF CONTENTS 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 Newbom and Adopted Children 4 Court- ordered Coverage for Eligible Dependent Children. .. 5 Enrollment Reporting Requirements 5 Enrollment Timeframes .. .. ........ .. ...... ..... . ......... . ... 5 When Coverage Begins .. .. 5 Coverage Warting Periods 6 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 10 Contract Modifications ... . .... 10 Coverage Limits 10 Entire Agreement .. .. 10 Equity of Application .. 10 Force Majeure 10 Group Cooperation .. .. ... .. ... .. 10 Headings .. 11 Notices ....... .... .. .... 11 Severability 11 Third Party Beneficiaries .. 11 Waiver of Breach ... .... .. 11 COVERAGE CONTRACT DEFINRIONS Capitalized words found In the text of this Contract are defined below or may be found in Attachment A. Child or Children (i) Natural children, adopted children, stepchildren or other legally designated ward under the Limiting Age who Is a dependent of the Subscriber or the Subscribers Spouse (it) Children under the Limiting Age who are 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) Children who have reached the Limiting Age, or are older than the Limiting Age, are incapable of self - sustaining employment due to developmental disability or physical handicap, and are dependent upon the Subscriber or the Subscribers Spouse for total or partial support and maintenance (see the Continued Eligibility for Disabled Dependent Children section of Attachment A) Contract: this document and any other attachments, exhibits, Riders, or Endorsements listed on the title page or otherwise descnbed 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 btle page of this Contract dunng 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 Children of a LEOFF I or LEOFF it law enforcement officer Employee (a) LEOFF I employees who are full -time law enforcement officers or firefighters hired pnor 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 at 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" 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 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 KIPS, 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 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 infomration 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 (11) 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 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 btle 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 KIDS on or before the effective date of this Contract Indicated on the We 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 bate 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, K 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 terns 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 SubscriberslDependents 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 overage 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 overage and forward payments to KIDS 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, 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. KIDS 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. Subscribed0opendent Eligibility Requirements Active, full -time LEOFF I and LEOFF 11 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 enforoement officer, as defined in the Definitions section, are also eligible to enroll in this Group Plan. The children of an Eligible Dependent, other than the Children of the Spouse, are 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 Children Newborn, adopted Children, and Children placed for adoption are initially eligible for overage as follows Natural newbom Children are eligible as of the date of birth and are covered automatically for a period of three (3) weeks In order for overage to continue after the initial three (3) week period, the Children must qualify as an Eligible Dependent. If additional Premium is required, the application and Premium for the Children must be received by KIDS 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; (ii) 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 overage 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 Children In the case of court- ordered coverage, dependent Children become initially eligible on the date the Subscriber or Spouse receives the order to provide medical coverage for the Child, 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 11 Employees, including Eligible Dependents of active, full -time LEOFF I and LEOFF 11 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 11 Employees. including Eligible Dependents of active, full -time LEOFF I and LEOFF II law enforcement officers, may inibally 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 Children 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 Tlmeframes) 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 Newbom Children who meet eligibility requirements are 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 birth If additional Premium is required, coverage will not extend beyond the three- (3) week period unless the Child 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 adopted Children is retroactive to the date the Children were adopted, legally placed for adoption, or when the Subscriber or Subscriber's Spouse assumes legal obligation for total or partial support of the Children in anticipation of adoption, provided that the application and applicable Premium for the Children are received by KPS within 60 days from the date of adoption, placement for adoption, or assumption of financial responsibility I Premium i not required, we encourage enrollment as soon as possible to NOTE. When additions s req g pons prevent p delays in claims processing Page 5 COVERAGE CONTRACT Coverage Waiting Periods (This section does not apply to LEOFF I Employees) Pre - existing Condfdons 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 Ph 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- exisbng 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. CrediftWe 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 • 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 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 d 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 camer 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 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 phenylketonurta (PKU) Prescription drugs included in the Pharmacy Benefit Newborn Children or adopted Children 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 D 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, (n) 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 D The Enrollee refuses to comply with the terns 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 D This Contract is terminated Page 7 COVERAGE CONTRACT Additionally, Eligible Dependent coverage ends it The Subscriber a no longer employed or no longer meets eligibility requirements. ➢ The Subscriber dies. The Children reach 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 KIPS 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 periods) 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 -1988) 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 conbnuabon 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 Re- EnrollmeMlReinstatement 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. 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 N 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) appropnately 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 and is entered into in Bremerton Washington. Any controversy or claim ansing out of or relating to this Contract shall be resolved in a court of competent jurisdiction in Kitsap County, Washington or the U S. District for the Western District of Washington. 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 Contrail This Contract shall not bind KPS until. (i) a person authorized by KPS signs d, and (ii) a signed copy is delivered to the Group. Page 9 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 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 8 — Prem lum 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, not 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 ansing 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 and their enrolled Eligible Dependents of polies 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 detemunabon of eligibility, claim reimbursement, coordination of benefits, or other information required for the administration of this Contract Malang appropriate payroll deductions, if applicable, to balitate Premium payment Page: 10 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 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 34803 Seattle, WA 98124 -1803 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 SeverabiUty 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 4 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 Disabled Dependent Children BENEFITS SUMMARY CONTINUATION OF COVERAGE Coverage During a Labor Dispute Continuation ofrGroup 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 Business Address* Mailing Address: 400 Warren Avenue P O Box 34803 Bremerton, WA 98337 Seattle, WA 98124 -1803 CITY OF BREMERTON — PLAN A COVERAGE CONTRACT Group Number: 1000780 Effective Date: January 1, 2013 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Underwnbng Cntena 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 terns and conditions set forth herein. FOR KPS: FOR GROUP: W James Page Jr, President Signature April 10, 2013 Date Print Name Title Date KPS Health Plans Business Address Mailing Address 400 Warren Avenue P O Box 34803 Bremerton, WA 98337 Seattle, WA 98124 -1803 CITY OF BREMERTON — PLAN B COVERAGE CONTRACT Group Number. 1000780 Effective Date: January 1, 2013 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 KIDS 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 X), 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 (° ContracN) C13BREMB TABLE OF CONTENTS 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 Children) 5 Court- ordered Coverage for Eligible Dependent Children) 5 Enrollment Reporting Requirements 5 Enrollment Timeframes .. 5 When Coverage Begins 5 Coverage Waiting Periods .. ... ... 6 TERMINATION OF COVERAGE ........... ............................... .... . .... ... 7 Continuity of Coverage... .7 Termination or Rescission of Contrail 7 Termination or Rescission of Enrollee Coverage.. .. .. 8 COBRA (Consolidated Omnibus Budget Reconciliation Act -1985) 8 Fraudulent Information ... .... 9 Re- Enmllment/Reinstatement 9 SUBSCRIBER/DEPENDENT LIABILITY AND RIGHTS .... .. ................... 9 Subscriber/Dependent Liability 9 GENERAL TERMS AND CONDITIONS. .. ...................... .... ......... ......9 Applicable Law 9 Assignment of Benefits . 10 Binding Agreement .. 10 Confidentiality 10 Contract Modifications 10 Coverage Limits .. 10 Entire Agreement ... .. .10 Equity of Application .. .. .. ... 10 Force Majeure ..... ........ .. 11 Group Cooperation ..... .. ... ..11 Headings 11 Notices Severability. . 11 Thins Party Beneficiaries .. ..... 11 Waiver of Breach .. .. ...... 11 COVERAGE CONTRACT DEFINITIONS Capdal¢ed words found in the text of this Contract are defined below or may be found In Attachment A. Child or Children. (i) Natural children, adopted children, stepchildren, or other legally designated ward under the Limiting Age who is a dependent of the Subscriber or the Subscribers Spouse. (ii) Children under the Limiting Age who are legally entitled to receive medical coverage as a result of a court order binding either the Subscriber or the Subscribers Spouse, regardless of whether or not the Subscriber or Subscribers Spouse has legal custody of the children. (iii) Children who have reached the Limiting Ag, or are older than the Limiting Age, are incapable of self- sustaining employment due to developmental disability or physical handicap, and are dependent upon the Subscriber or the Subscribers Spouse for total or partial support and maintenance (see the Continued Eligibility for Disabled Dependent Children 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 Children 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 11 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 Ex. Session. Limiting Age' the age at which 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 KIPS, either directly or indirectly, to provide health care services to Enrollees Participating Facilities have agreed to accept the KIDS 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 Lensed or certified health care practitioner acting within the scope of his/her license or cerbficate Rider an additional benefit over and above those listed in the BenetRts Summary section of Attachment A. Rider documents are attached at the back of Attachment A and provide detailed benefit information Spouse: (1) An individual who Is living in a mantal relationship with the Subscriber The mantel relationship must be legally recognized by the state of Washington. (ii) An individual who is Irving 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 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 DatsfGrace 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 fast 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, It 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 Criterla 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 overage under a COBRA provision or other overage 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 terrnrnabon 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 and their Eligible Dependents are properly enrolled in this Group Plan SubscrlbedDependent 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 If firefighters, as defined in the Definitions section, are also eligible to enroll in this Group Plan. The Children of an Eligible Dependent, other than the Children of the Spouse, are 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 Children Newborn, adopted Children, and Children placed for adoption are initially eligible for coverage as follows• ➢ Natural newbom Children are 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 Children must qualify as an Eligible Dependent If additional Premium is required, the application and Premium for the Children must be received by KPS within 60 days of birth Adopted Children and Children 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 (iu) 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 Children In the case of court- ordered coverage dependent Children b ecomes initially eligible on the date the Subscriber or Spouse receives the order to provide medical coverage for the Children, 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 verity 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 11 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 11 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 wad until the next Open Enrollment Penod A new Spouse and the Spouse's Children may initially apply for coverage as of the date of manage 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 Newborn Children 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 birth If additional Premium is required, coverage will not extend beyond the three- (3) week period unless the Child is enrolled within 60 days of the date of birth Any applicable Premium amount must accompany the enrollment application Page 6 COVERAGE CONTRACT If additional Premium Is required, coverage for adopted Children is retroactive to the date the Children were adopted, legally placed for adoption, or when the Subscriber or Subscriber's Spouse assumes legal obligation for total or partial support of Children in anticipation of adoption, provided that the application and applicable Premium for the Children 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 Pm-exl&ng CondlBons Enrollees age 19 and older must be enrolled in this Group Plan for a period of three (3) consecutive months before KIPS will provide benefits for a Pre-ewsbng Condition A Pre- existing Condvdon 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- ewsbng 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 sic (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 penods begin on the first day of your probabonary 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 penods 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 overage 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 Mill 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 pnor health plan camer with hWher enrollment application In lieu of a Certificate of Creditable Coverage, the Enrollee must provide all of the following informabon. 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 periods) There are no waiting periods for Pregnancy Formulas necessary for the treatment of phenylketonuria (PKU) Prescription drugs included in Pharmacy Benefits Newborn Children or adopted Childrep 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 D 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 (1) 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 thinly (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 penods 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 Subscnbers 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 following events occurs Non - payment of any Prerritum 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 KIDS from offering this Group Plan. This Contract is terminated. Additionally, Eligible Dependent coverage ends it ➢ The Subscriber is no longer employed or no longer meets eligibility requirements The Subscriber dies The Children reach 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 KIDS 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 temvnation of coverage either KPS or the Group shall issue a Certificate of Creditable Coverage certifying the perlod(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. KIDS offer; coverage obi y when 9 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 electron 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 electron 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 KIPS 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- Enroilment/Relnstatement 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 SubscribedDependent 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 fails 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. Whet happens N a Provider no longer pardclpates 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 (h) 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 and is entered into in Bremerton Washington Any controversy or or claim ansing out of or relating to this Contract shall be resolved in a court of competent jurisdiction in Kitsap County, Washington or the U S District for the Western District of Washington. Page 9 COVERAGE CONTRACT 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 (ii) 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, 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 Page 10 COVERAGE CONTRACT Force Majeure In the event KPS is unable to perform its obligations hereunder by reason of fire, casualty, lockout strike, labor condition, not 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 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 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 34803 Seattle, WA 98124 -1803 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 Severabiiity 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 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. EUGIBILITYAND ENROLLMENT Continuation of inpatient Coverage ➢ Continued Eligibility for Disabled Dependent Children BENEFITS SUMMARY CONTINUATION OF COVERAGE ➢ Coverage During a Labor Dispute Continuation of Group Coverage D Conversion Coverage COORDINATION OF BENEFITS (COB) KPS'S RIGHT OF REIMBURSEMENT AND SUBROGATION COMPLAINTS AND APPEALS PROCESS ENROLLEE RIGHTS ➢ KIDS Privacy Policy Statement of ERISA Rights Page 12 KPS Health Plans Business Address Mailing Address - 400 Warren Avenue P O. Box 34803 Bremerton, WA 98337 Seattle, WA 98124 -1803 CITY OF BREMERTON — PLAN B COVERAGE CONTRACT Group Number. 1000780 Effective Date: January 1, 2013 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 consdb to acceptance of the terms and conditions set forth herein. FOR K FOR GROUP: 4 'C— , W James Page Jr, President Signature Apd110, 2013 Date Print Name Tide Date KPS Health Plans Business Address Mailing Address: 400 Warren Avenue P O Box 34803 Bremerton, WA 98337 Seattle. WA 98124 -1803 CITY OF BREMERTON — UNDER 66 LEOFF I RETIREES COVERAGE CONTRACT Group Number: 1000780 Effective Date: January 1, 2013 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 X), 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') C13BREMR TABLE OF CONTENTS DEFINITIONS .............. ............. ............................................................ ..............................1 CONTRACT EXAMINATION PERIOD ..... .... ... ....... ....... ... .............................2 EFFECTIVE DATE, DURATION, AND RENEWAL ................ ............................... ........ ... . .....2 PREMIUM PAYMENT PROVISIONS ......... .... . ................. . ........ ......... . ......... 2 Payment Due Date/Grace Penod 2 Prern ium Rate Adjustments ...... ..... .... .. 2 Premiums Paid by Subscnbers 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- Enmilment/Remstatement ... .. ..... 6 SUBSCRIBER LIABILITY AND RIGHTS ............... ............................... ......... .... ......6 Subscriber Liability.. 6 s 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 Severabtlity ........ 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 tide 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 reeve 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, l 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 terns 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, KIDS 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 foilowing 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 histher 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. >a In the event there is a material change in the basis upon which KPS assumed risk under this Contract. Such changes may include inaccurate infbrmabon 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°x6) 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 penods 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 EUGIBIUTY 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 Currency retired LEOFF 1 Employees, 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 terminate 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 terns and conditions of this Contract. The Group violates, or refuses to comply with, any published KIDS 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 KIDS 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 (W) not significantly limit access to the land 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 inforination 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 why 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 temunabon 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. 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 KIDS from offering this Group Plan 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 penod(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 them 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 A Groups are required by law to provide COBRA coverage for their employees; and A 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 conbnuabon 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- Enrolhnent/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 Subscnbers who are enrolled in this Group Plan are liable for the following costs ➢ Deductible (defined in Attachment A). 9 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 Seances 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 and is entered into in Bremerton Washington Any controversy or claim ansing out of or relating to this Contract shall be resolved in a court of competent jurisdiction in Kitsap County, Washington or the U S District for the Wester District of Washington. Assignment of Benefits The benefits of this Contract shall a=ue 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 deem 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 Premium, 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 ifs Subscribers, notwithstanding the failure of the Group to sign this Contract Page 6 COVERAGE CONTRACT This Contract shall not bind KIDS until (i) a person authorized by KPS signs it and (ii) 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, KIDS 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 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 — Prem ium 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, not, 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 some 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 Page 7 COVERAGE CONTRACT 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 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 mail, with prepaid postage, addressed to KIDS Health Plans P O Box 34803 Seattle, WA 98124 -1803 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 SeveraWi ty 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 Conversion Coverage COORDINATION OF BENEFITS (COB) KPS's RIGHT OF REIMBURSEMENT AND SUBROGATION COMPLAINTS AND APPEALS PROCESS ENROLLEE RIGHTS ➢ KIDS Privacy Policy ➢ Statement of ERISA Rights Page 9 KPS Health Plans Business Address Mailing Address - 400 Warren Avenue P.O Box 34803 Bremerton, WA 98337 Seattle, WA 98124 -1803 CITY OF BREMERTON UNDER 65 LEOFF I RETIREES COVERAGE CONTRACT Group Number. 1000780 Effective Date: January 1, 2013 Contract Renewal Month: January Open Enrollment Period: December This Coverage Contract includes the following Attachment A: Benefits Booklet Attachment B: Premium Rates and Under vnbng 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 teams and conditions set forth herein. FOR KPS: FoR GROUP: G� W James Page Jr, President Signature April 10, 2013 Date Print Name Title Date AGENDA BILL CITY OF BREMERTON 4r CITY COUNCIL 0M00N0000000EMa0MEM0NEEN00o0n00EEa0aEa00Wa0000N0E SUBJECT. Service Agreement with Study Session Date April 24, 2013 CenturyLink to provide Telecommunications COUNCIL MEETING Date May 1, 2013 services to listed City facilities and to provide Department Finance Long Distance services Presenter Kevin Matthew Phone 473 -5473 SUMMARY Staff recommends renewal of the existing service agreements with CenturyLink for Long Distance services and for T1 PRI circuits located at 1025 Burwell (BPD) and to 7268 W Belfair Valley Rd (Golf Course) The current 5 year agreements have expired and are being replaced with more competitively priced agreements The value of this 2 year agreement, excluding Long Distance Services, is $25,200 00 over 2 years Recently expired contracts were at higher rates than is currently being offered reducing the recurring telecommunications costs by $330 00 per month for a total savings of $7,920 00 over the life of this agreement The renegotiated long distance rates are expected to save the City about $100 00 per month for a 2 year savings of $2,400 00 ATTACHMENTS Service Agreement FISCAL IMPACTS (Include Budgeted Amount) None This expenditure is a monthly O &M cost and is included in the yearly departments operating budget STUDY SESSION AGENDA Fx No Discussion ❑ Full Presentation STUDY SESSION ACTION N Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve service agreements with CenturyLink and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented COUNCIL ACTION ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT This CenturyLink Loyal Advantage Agreement ( "Agreement ") is between Qwest Communications Company, LLC d/b /a CenturyLink QCC, its Affiliates including, Qwest Corporation d/b /a CenturyLink QC ( "CenturyLink ") and City of Bremerton ( "Customer") and is effective on the date the last party signs it ( "Effective Date ") CenturyLink QCC is signing on behalf of its Affiliate for the Affiliate Services identified in this Agreement CenturyLink reserves the right to withdraw this offer if Customer does not execute and deliver the Agreement to CenturyLink before May 31, 2013 Using Centuryl-ink's electronic signature process for the Agreement is acceptable CITY OF BREMERTON QWEST COMMUNICATIONS COMPANY, LLC DIB /A CENTURYLINK QCC Authorized Signature Authorized Signature Name Typed or Printed Name Typed or Printed Title Title Date Date Customer's address for notices Customer's facsimile number Person designated for notices 1 Services Customer may purchase the products and services ( "Services ") in the service exhibits ( "Service Exhibits ") attached to the Agreement Centurylink QC may be required to submit this Agreement, Service Exhibits, Pricing Attachments, and any subsequent addenda for Service to certain regulatory agencies for approval because the Rates or certain other terms are being offered on an individual case basis ( "ICB ") Although the general terms and conditions of this Agreement are effective on the Agreement Effective Date, those service- specific Rates and /or terms, and conditions that require filing with or approval by regulatory agencies ( "ICB Terms ") will not become effective for a given jurisdiction until the filing and approval requirements for that jurisdiction are fulfilled Service will be offered in accordance with the applicable Tariff until the ICB terms become effective If Customer receives reduced pricing under a Pricing Attachment and a regulatory agency later invalidates the ICB Terms after they became effective, Customer will pay Centurylink QC any difference in the amounts listed in the applicable Tariff for the Service and the amounts Customer was charged for the Service When approved by the regulatory agencies, Customer may add additional quantities of Services under the same terms and conditions with no further filing required In the event a regulatory agency does not approve the ICB Terms, the parties will enter into good faith negotiations to mutually resolve the failure to receive the necessary approval The subject Service Exhibit, Pricing Attachment, and subsequent addenda containing the ICB Terms will remain in effect in all other jurisdictions Each Service Exhibit or subsequent addenda will explain which Rates or terms are ICB The parties agree that any notation to the "CenturyLink Total Advantage Agreement" on the Service Exhibits will be disregarded and such exhibits will be governed by the Agreement The Service Exhibits attached to the Agreement as of the Effective Date and incorporated by this reference are shown below CenturyLmk QCC Services • Domestic Voice Service Exhibit • International Voice Service Exhibit CenturyLmk QC Services (Centurylink QC Services are available only in CenturyLink's local service areas in the following states Arizona, Colorado, Idaho, Iowa, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming ) • ISDN PRS /DSS /UAS 2 Term Customer selects the following "Initial Term" of the Agreement two years ( "Initial Term "), 600052 code (QLAGESZ) The Initial Term begins on the Effective Date At the end of the Initial Term, the Agreement will automatically renew for consecutive renewal periods equal to the Initial Tenn (a "Renewal Term ") if not terminated earlier in accordance with the Agreement The Initial Term and each Renewal Term are referred to as the "Term " 3 Rates Unless specified otherwise in a Service Exhibit, CenturyLink QCC Services will receive the applicable rates specified in a Service Exhibit, valid Order Form, or CenturyLmk- approved quote form, for the duration of the Term Notwithstanding the preceding sentence, CenturyLink reserves the right to modify rates and charges due to Regulatory Activity and will provide as much prior written notice as practicable but not less than 14 calendar days' notice If Regulatory Activity causes an increase in the rates for Customer's ordered CenturyLink QCC Services that materially and adversely affects Customer, then Customer may terminate the affected CenturyLink QCC Service upon 30 days' prior written notice to CenturyLink QCC without liability for Cancellation Charges for the affected Service, provided, however that Customer (e) provides such notice within 30 days after the increase occurs, and (f) provides CenturyLink QCC 30 days to cure such increase If Customer does not provide CenturyLmk QCC such notice during the time permitted in this Section, Customer will have waived its right to terminate the affected Service under this Section The parties agree that the rates set forth in the Service Exhibit are in lieu of all other rates, discounts, or promotions The rates for any CenturyLink QC Service provided will be those in effect at the time the Service is installed and CenturyLink QC Services will renew at the rate and for the term specified in the applicable Tariff, RSS, or Service Exhibit 4. Payment CenturyLink may begin invoicing for specific Services as specified in the applicable Service Exhibit Customer must pay CenturyLink all charges within 30 days after the invoice date or by the due date on the invoice if specified Any amount not paid when OMR #N55756 (QLAGESZ) Page 1 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT due is subject to late interest at the lesser of 1 5% per month or the maximum rate allowed by law In addition to payment of charges for Services, Customer must also pay CenturyLink any applicable Taxes assessed in connection with Services Taxes may vary and are subject to change CenturyLink reserves the right to charge administrative fees if Customer selects paper delivery of an invoice or when Customer's payment preferences deviate from CenturyLink's standard practices 5 Confidentiality Except to the extent required by an open records act or similar law, neither CenturyLink nor Customer will, without the prior written consent of the other party (a) disclose any of the terms of the Agreement, or (b) disclose or use (except as expressly permitted by, or required to achieve the purposes of, the Agreement) the Confidential Information of the other party Each party will use reasonable efforts to protect the other's Confidential Information, and will use at least the same efforts to protect such Confidential Information as the party would use to protect its own CenturyLrnk's consent may only be given by its Legal Department A parry may disclose Confidential Information if required to do so by a governmental agency, by operation of law, or if necessary in any proceeding to establish rights or obligations under the Agreement 6 CPNI CenturyLink is required by law to treat CPNI confidentially Customer agrees that CenturyLink may share CPNI within its business operations (e g , wireless, local, long distance, and broadband services divisions), and with businesses acting on CenturyLrnk's behalf, to determine if Customer could benefit from the wide variety of CenturyLink products and services, and in its marketing and sales activities Customer may withdraw its authorization at any time by informing CenturyLink in writing Customer's decision regarding CenturyLrnk's use of CPNI will not affect the quality of service CenturyLink provides Customer 7 Use of Name and Marks Neither party will use the name or marks of the other party or any of its Affiliates for any purpose without the other party's prior written consent CenturyLrnk's consent may only be given by its Legal Department 8 Disclaimer of Warranties EXCEPT AS EXPRESSLY PROVIDED IN THE AGREEMENT, ALL SERVICES AND PRODUCTS ARE PROVIDED "AS IS" CENTURYLINK DISCLAIMS ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING BUT NOT LIMITED TO ALL WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON - INFRINGEMENT 9 Limitations of Liability The remedies and limitations of liability for any claims ansrng between the parties are set forth below 9.1 Consequential Damages NO PARTY OR THEIR AFFILIATES, AGENTS, OR CONTRACTORS IS LIABLE FOR ANY CONSEQUENTIAL, INCIDENTAL, INDIRECT, SPECIAL, OR PUNITIVE DAMAGES OR FOR ANY LOST PROFITS, LOST REVENUES, LOST DATA, LOST BUSINESS OPPORTUNITY, OR COSTS OF COVER THESE LIMITATIONS APPLY REGARDLESS OF THE LEGAL THEORY UNDER WHICH SUCH LIABILITY IS ASSERTED AND REGARDLESS OF FORESEEABILITY 9 2 Claims Related to Services For Customer's claims related to Service deficiencies or interruptions, Customer's exclusive remedies are (a) those remedies set forth in the SLA or applicable Tariff for that Service or (b) the total MRCs or usage charges paid by Customer for any affected Service in the one month immediately preceding the event giving rise to the claim if an SLA or applicable Tariff does not exist for the affected Service 9 3 Personal Injury, Death, Property Damages For claims ansrng out of personal injury or death to a party's employee, or damage to a party's real or personal property, that are caused by the other party's negligence or willful misconduct in the performance of the Agreement, each party's liability, to the extent permitted by law, is limited to proven direct actual, physical damages 9 4 Other Direct Damages For all other claims ansrng out of the Agreement, the maximum liability for Customer and CenturyLrnk will not exceed in the aggregate the total MRCs and usage charges paid by Customer to CenturyLink under the Agreement in the three months immediately preceding the event giving rise to the claim ( "Damage Cap ") The Damage Cap will not apply to a party's obligations under the Responsibilities Section below or Customer's payment obligations under the Agreement 10 Responsibilities To the extent permitted under law, each party agrees to be responsible to the other, their Affiliates, agents, and contractors against all third party claims for damages, liabilities, or expenses, including reasonable attorneys' fees, ansrng directly from performance of the Agreement and related to personal injury or death, or damage to personal tangible property that is alleged to have been caused by the negligence or willful misconduct of the responsible party unless otherwise stated in a CenturyLink QC Service Exhibit or Tariff To the extent permitted under law, Customer also agrees to be responsible for all third party claims for damages, liabilities, or expenses, including reasonable attorneys' fees against CenturyLink, its Affiliates, and contractors, related to the modification or resale of the Services by Customer or End Users, or any AUP violation 11 Termination 11 1 Service Either party may terminate an individual Service or a Service Exhibit (a) in accordance with the individual Service Exhibit's term requirements with 60 days' prior written notice to the other party, or (b) for Cause If Service or a Service Exhibit is terminated by Customer for Convenience or by CenturyLink for Cause, then Customer will pay Cancellation Charges 112 Agreement. Either party may terminate the Agreement and all Services by (a) providing written notice to the other party of its intention not to renew the Agreement at least 60 days prior to the expiration of the then current Term or (b) for Cause Cause to terminate an individual Service Exhibit will not constitute Cause to terminate the Agreement, rather, Cause to terminate the entire Agreement for Service- related claims will exist only if Customer has Cause to terminate all or substantially all of the Services under the applicable SLA, Service Exhibit, RSS or Tariff If the Agreement is terminated by Customer for Convenience or by CenturyLink for Cause prior to the conclusion of the Term, then Customer will pay (c) for CenturyLink QCC Services the higher of the Early Termination Charge or the sum of all CenturyLink QCC Cancellation Charges that apply for terminating all CenturyLink QCC Services at the time the Agreement is terminated, and (d) for CenturyLink QC Services, the CenturyLink QC termination charges as set forth in the Tanff or the applicable Service Exhibit(s) 113 Unpaid Charges Customer will remain liable for charges accrued but unpaid as of the termination date 12 Non - Appropriations Customer intends to continue this Agreement for its entire Term and to satisfy its obligations hereunder OMR #N55756 (QLAGES2) Page 2 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT For each fiscal period for Customer (a) Customer agrees to include in its budget request appropriations sufficient to cover Customer's obligations under this Agreement, (b) Customer agrees to use all reasonable and lawful means to secure these appropriations, including but not limited to applying for Universal Service Fund Discounts as described in the Federal Communications Commission Docket No 96-45, (c) Customer agrees it will not use non - appropriations as a means of terminating this Agreement in order to acquire functionally equivalent products or services from a third party Customer reasonably believes that sufficient funds to discharge its obligations can and will lawfully be appropriated and made available for this purpose In the event that Customer is appropriated insufficient funds, by appropriation, appropriation limitation or grant, to continue payments under this Agreement and has no other funding source lawfully available to it for such purpose (as evidenced by notarized documents provided by Customer and agreed to by CenturyLrnk), Customer may terminate this Agreement without incurring an Early Termination Charge or CenturyLink QCC Cancellation Charges by giving CenturyLrnk not less than 30 days' prior written notice Upon termination and to the extent of lawfully available funds, Customer will remit all amounts due and all costs reasonably incurred by CenturyLink through the date of termination 13 Miscellaneous 131 General The Agreements benefits do not extend to any third parry (e g , an End User) If any term of the Agreement is held unenforceable, the remaining terms will remain in effect Except for time requirements as specifically stated in a Service Exhibit or SLA, neither party's failure to exercise any right or to insist upon strict performance of any provision of the Agreement is a waiver of any right under the Agreement The terms and conditions of the Agreement regarding confidentiality, indemnification, limitation of liability, warranties, payment, dispute resolution, and all other terms of the Agreement that should by their nature survive the termination of the Agreement will survive Each party is not responsible for any delay or other failure to perform due to a Force Majeure Event 13 2 Conflicts Provision If a conflict exists among provisions within the Agreement, the following order of precedence will apply in descending order of control Service Exhibit, the Agreement, Order Form, Centurylrnk QC records, and if applicable, CenturyLink QC Tech Pubs If Services are provided pursuant to a Tariff, RSS, or ISS as described in the applicable Service Exhibits, the order of precedence will apply in the following descending order of control Tariff, Service Exhibit, the Agreement, RSS, ISS, Order Form Centurylrnk QC records, and if applicable, CenturyLrnk QC Tech Pubs 13 3 Independent Contractor CenturyLrnk provides the Services as an independent contractor The Agreement will not create an employer - employee relationship, association, point venture, partnership, or other form of legal entity or business enterprise between the parties, their agents, employees or affiliates 13 4 ARRA Customer will not pay for the Services with funds obtained through the American Recovery and Reinvestment Act or other similar stimulus grants or loans that would obligate CenturyLrnk to provide certain information or perform certain functions unless each of those obligations are explicitly identified and agreed to by the parties in the Agreement or in an amendment to the Agreement 13 5 HIPAA CenturyLrnk does not require or intend to access Customer data in its performance hereunder, including but not limited to any confidential health related information of Customer's clients, which may include group health plans, that constitutes Protected Health Information ( "PHI "), as defined in 45 C F R §164 501 under the Health Insurance Portability and Accountability Act of 1996 ( "HIPAA Rules ") Any exposure to PHI will be random, infrequent and incidental to Centuryl-ink's provision of Service and is not meant for the purpose of accessing, managing the PHI or creating or manipulating the PHI Such exposure is allowable under 45 CFR 164 502(a)(1)(ili) As such, if Customer is a Covered Entity or Health Care Provider under the HIPAA Rules or supports the healthcare industry, CenturyLrnk and Customer agree that CenturyLrnk is not a "Business Associate" or "Covered Entity" under the HIPAA Rules for the purposes of the Agreement 13 6 Credit Approval Provision of Services is subject to Centuryl-ink's credit approval of Customer As part of the credit approval process, CenturyLink may require Customer to provide a deposit or other security Additionally during the Term, if Customer's financial circumstance or payment history becomes reasonably unacceptable to CenturyLink, CenturyLrnk may require adequate assurance of future payment as a condition of continuing Centuryl-ink's provision of Services Customer's failure to provide adequate assurances required by CenturyLink is a material breach of the Agreement CenturyLink may provide Customer's payment history or other billing /charge information to credit reporting agencies or industry clearinghouses 13 7 Installation, Maintenance and Repair (a) Provision of Services is subject to availability of adequate capacity and Centuryl-ink's acceptance of a complete Order Form (b) Customer will reasonably cooperate with CenturyLrnk or its agents to install, maintain, and repair Services Customer will provide or secure at Customer's expense appropriate space and power, and rights or licenses if CenturyLrnk must access the building of Customer's premises to install, operate, or maintain Service or associated CenturyLink equipment CenturyLink may refuse to install, maintain, or repair Services if any condition on Customer's premises is unsafe or likely to cause injury (c) Customer is responsible for any facility or equipment repairs on Customer's side of the demarcation point Customer may request a technician dispatch for Service problems Before dispatching a technician, CenturyLrnk will notify Customer of the dispatch fee CenturyLrnk will assess a dispatch fee if it determines the problem is on Customer's side of the demarcation point or was not caused by Centuryl-ink's facilities or equipment on Centuryl-ink's side of the demarcation point 13 8 Governing Law, Dispute Resolution (a) Billing Disputes If Customer disputes a charge in good faith, Customer may withhold payment of that charge if Customer makes timely payment of all undisputed charges when due and provides CenturyLrnk with a written explanation of the reasons for Customer's dispute of the charge within 90 days after the invoice date of such amount If CenturyLink determines, in its good faith, that the disputed charge is valid, CenturyLink will notify Customer and within five business days after Centuryl-ink's notification, Customer must pay the charge and accrued interest (b) Governing Law, Forum The Agreement will be governed by the laws of the State in which the Customer's principal office is OMR #N55756 (QLAGESZ) Page 3 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGC AGREEMENT located without regard to its choice of law principles Any legal proceeding relating to the Agreement will be brought in a U S District Court, or absent federal jurisdiction, in a state court of competent jurisdiction, in Thurston County, Washington This provision is not intended to deprive a small claims court or state agency of lawful jurisdiction that would otherwise exist over a claim or controversy between the parties (c) Waiver of Jury Trial and Class Action. Each party, to the extent permitted by law, knowingly, voluntarily, and intentionally waives its right to a jury trial and any right to pursue any claim or action relating to the Agreement on a class or consolidated basis or in a representative capacity If for any reason the jury trial waiver is held to be unenforceable, the parties agree to binding arbitration for any dispute relating to the Agreement under the Federal Arbitration Act, 9 U S C § 1, et seq The arbitration will be conducted in accordance with the JAMS Comprehensive Arbitration Rules Judgment upon the arbitration award may be entered in any court having jurisdiction (d) Limitations Period Any claim relating to the Agreement must be brought within two years after the claim arises other than Customer disputing an amount in an invoice, which must be done by Customer within 90 days after the invoice date of the disputed amount 13 9 No Resale, Compliance Customer must not resell the Services and its use of Services must comply with all applicable laws 13 10 Assignment Either party may assign the Agreement without the other party's prior written consent (a) in connection with the sale of all or substantially all of its assets, (b) to the surviving entity in any merger or consolidation, or (c) to an Affiliate provided such party gives the other party 30 days' prior written notice Any assignee of the Customer must have a financial standing and creditworthiness equal to or better than Customer's, as reasonably determined by CenturyLink, through a generally accepted, third party credit rating index (i a D &B, S &P, etc) Any other assignment will require the prior written consent of the other party But Customer may not assign this Agreement or any Service to a reseller or a telecommunications tamer under any circumstances 1311 Amendments, Changes The Agreement may be amended only in a writing signed by both parties' authorized representatives However, any change in rates, charges, or regulations mandated by the legally constituted authorities will act as a modification of any contract to that extent without further notice Each party may, at any time, reject any handwritten change or other alteration to the Agreement CenturyLink may change features or functions of its Services, for material changes that are adverse to Customer, CenturyLink will provide 30 days' prior written notice, but may provide a shorter notice period if the change is based on Regulatory Activity or Tariff provisions CenturyLink may amend, change, or withdraw the Tariffs, RSS, ISS or AUP, with such updated Tariffs, RSS, ISS or AUP effective upon posting or upon fulfillment of any necessary regulatory requirements 1312 Websites References to websites in the Agreement include any successor websites designated by CenturyLink 13 13 Required Notices Unless provided otherwise in the Agreement, all required notices to CenturyLink must be in writing, sent to 1801 California St, #900, Denver, CO 80202, Fax 888 - 778 -0054, Attn Legal Dept, and to Customer as provided above All notices are effective (a) when delivered via overnight courier mail or in person to the recipient named above, (b) three business days after mailed via regular U S Mail, or (c) when delivered by fax if duplicate notice is also sent by regular U S Mail 13 14 Service Termination Notices Customer's notice of termination for CenturyLink QCC Services must be sent via mail, facsimile or e-mail to CenturyLink, Attn Dublin Service Center, GBM Disconnects, 4650 Lakehurst, 2 nd Floor Disconnect Center, Dublin, OH 43017, Fax 866 887 6633, e-mail GBMdisconnectsCuD-4west com Such termination is effective 30 days after CenturyLink's receipt of the notice, unless a longer period is otherwise required For Services under the Select Advantage Service Exhibit or for CenturyLink QC Services, Customer must call the customer care number specified on Customer's invoice to provide notice of termination 13 15 Entire Agreement The Agreement (including any applicable Service Exhibit, CenturyLink accepted Order Forms, and all referenced documents) constitutes the entire agreement between the parties and supersedes all prior oral or written agreements or understandings relating to the same service, ports, or circuits at the same locations as covered under the Agreement 14 Clauses for CenturyLink QC RSS No 1 Services The clauses in this section apply only to the CenturyLink QC Service Exhibits stating that service is offered out of CenturyLink QC RSS No 1 141 Jurisdiction Customer understands that Service is an interstate telecommunications service, as defined by Federal Communications Commission regulations and represents that during the Term, more than 10% of its usage will be interstate usage 14 2 Construction and Funding Approval CenturyLink QC may assess separate Construction charges if facilities are not available to meet an order for Service and CenturyLink QC constructs facilities under one or more of the following circumstances (a) if the amount of Customer's expected payments over the term of the Agreement does not exceed CenturyLink QC's calculated cost of providing the Service plus its expected rate of return, (b) Customer requests that Service be furnished using a type of facility, or via a route that CenturyLink QC would not normally utilize in providing the requested Service, (c) more facilities are requested than would normally be required to satisfy an order, and (d) Customer requests that Construction be expedited, resulting in added cost to CenturyLink QC Service provided under this Agreement is subject to Funding approval and that approval will be evidenced in the Funding Concurrence block on the Pricing Attachment That approval will be granted at the sole discretion of CenturyLink QC In the event contract documents are signed, under which Customer is ordering Service for which Funding is not approved, CenturyLink QC will cooperate with Customer in good faith to develop an alternative service solution if Funding cannot be achieved on the contracted solution and CenturyLink QC may immediately terminate, without penalty, the Pricing Attachment under which Customer ordered the Service, when Funding of the contracted and alternate Service solutions is determined to not be possible 14.3 Expedite Any Customer requests for CenturyLink QC to Expedite the delivery of Service before the standard or negotiated Service Due Date will be deemed an expedited order and Expedite charges will apply Upon CenturyLink QC's receipt of an Expedite request from Customer, Customer and CenturyLink QC will mutually agree to a new Service Due Date OMR #N55756 (QLAGES2) Page 4 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGC AGREEMENT 14 4 Service Changes Customer may add, move, or upgrade each Service in a Pricing Attachment via an Amendment to this Agreement New Service and any addition, move, or upgrade to existing Service is subject to the terms of the RSS in effect when the Amendment to add, move, or upgrade existing Service is executed or for new Service when the new Service is installed Existing terms and conditions will continue to apply to existing Service But if an RSS change results in a conflict with the terms and conditions applicable to the Service, then Customer must agree to an amendment modifying the terms and conditions before CenturyLink QC will provision the new Service or the additions, moves, or upgrades to existing Service 14 5 Service Interruptions Service interruption means a total disruption of the Service subject to restrictions and exclusions outlined in an SLA or in the RSS Services with a Service - specific SLA are subject to the credit for service interruptions contained in the applicable SLA and described in the RSS posted at qwest centurylink com /legal Services without a Service- specific SLA are subject to the credit for service interruptions contained in the RSS The credits outlined in the SLAB or RSS are Customer's sole and exclusive remedy for interruptions of any kind to the Service CenturyLink QC may, from time to time, suspend Service for routine maintenance or rearrangement of facilities or equipment CenturyLink QC will give advance notification of any such suspension of Service Such suspension of Service is not considered an out -of -service condition unless Service is not restored by the end of the period specified in the notification 14 6 Additional Payment Language (a) Rates, including Rates for optional features or functions, are set forth in each Pricing Attachment applicable to the Service The Rates shown on each Pricing Attachment are for informational purposes Customer will receive the Rates in effect in the RSS on the Service Acceptance Date CenturyLink QC will keep an archive of the RSS Web pages listing Rates, including dates of Rate changes Customer agrees that CenturyLink QC's archive is conclusive evidence in the event of a dispute (b) If Customer requests items from the RSS for which charges do not appear in a Pricing Attachment, CenturyLink QC will inform Customer of the charges at the time of the request, giving Customer the opportunity to cancel the request, rather than incurring the charges Those items may include, but are not limited to (a) Expedites, including third -party charges incurred by CenturyLink QC in connection with the Expedite, (b) CPE, (c) Construction, (d) Termination Charges, (e) charges for labor, testing, or design changes (f) inside winng, and (g) additional administrative charges that may be applied for services not described on Pricing Attachments or for requests to provision Services in a manner inconsistent with CenturyLink QC's then - current practices Customer will pay such charges regardless of whether Customer cancels Service or CenturyLink QC fails to deliver on the requested Expedite date, unless such failure was caused by CenturyLink QC (c) CenturyLink QC will require Customer to accept Service by the end of the Grace Period, in which case CenturyLink QC will commence with regular monthly billing for the Service and Customer agrees to pay for the billed Service If Customer has not accepted the Service by the end of the Grace Period, then CenturyLink QC may terminate the Service subject to the Termination section of this Agreement 14 7 Customer Responsibilibes Customer is responsible for the following (a) Access Customer will provide prompt access to its premises to CenturyLink QC authorized personnel and other authorized parties, responding to Service restoration, equipment failure, maintenance, or other relevant situations (b) On-Site Operations All Customer operations concerning Service at Customer's premises will be performed at Customer's expense, and Customer will be required to conform to all applicable specifications that CenturyLink QC may adopt as necessary to maintain Service Any special structural work required for supporting telecommunications facilities needed to provide Service on Customer's premises will be provided only at Customer's expense (c) Customer will properly use the Service Customer will not itself or permit others to use the Service in ways it is not intended or alter, tamper with, adjust, or repair the Service 14 8 QC RSS No 1 Service Termination (a) Service; Service Exhibit Before Service Due Date If Customer cancels an order for Service before the Service Due Date or does not accept the Service by the conclusion of the Grace Period, and CenturyLink QC terminates the Service at the end of the Grace Period, Termination Charges will apply, including the full NRCs that would have otherwise applied and any non - reusable and non - recoverable portions of expenditures or liabilities, such as Construction charges incurred exclusively on behalf of the Customer by CenturyLink QC and not fully reimbursed by NRCs (b) Service, Service Exhibit After Service Acceptance Date Either party may terminate an individual Service ordered under a Service Exhibit after the Service Acceptance Date under the terms of the applicable Service Exhibit CenturyLink QC will waive the Termination Charge in excess of the Minimum Service Period if Customer terminates due to a move or upgrade of all or a portion of Service and all of the following conditions are met ("Waiver Policy") (i) Customer must have satisfied the Minimum Service Period for the existing Service or be subject to the Termination Charge applicable to the unexpired portion of the Minimum Service Period, OMR #N55756 (QLAGESZ) Page 5 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT (u) Customer must agree to a new service term and Minimum Service Period for the new service, (iii) The total value of the new Service must be equal to or greater than 115% of the remaining value of the Service being terminated NRCs and Construction charges will not contribute toward the 115% calculation, (iv) The request to disconnect the existing Service and the request for the new service are received by CenturyLink QC at the same time and both requests must reference this Waiver Policy, (v) For ATM, FR, and Metro Ethernet, the new Service installation due date must be within 30 days of the due date of the disconnection of the existing Service, unless the installation is delayed by Centuryl-ink QC, for SHNS, SST, GeoMax, and HDTV -NET the new Service installation due date must be on or before the due date of the disconnection of the existing Service, unless the installation is delayed by Centuryl-ink QC, (vi) Customer agrees to pay all outstanding MRCs and NRCs for existing Service, (vu) The NRCs in effect at the time the Service is moved or upgraded will apply to the move or upgrade, and (viii) This Waiver Policy only applies to moves or upgrades to other CenturyLink QC services that are subject to a CenturyLink QC Tariff or the QC RSS 14 9 CenturyLink QC RSS No 1 Service Definitions "Construction" means when Service may not be available due to facilities limitations and it is necessary for Centuryl-ink QC to construct facilities "Demarcation Point" means the CenturyLink QC designated (a) physical interface between the CenturyLink QC Domestic Network and Customer's telecommunications equipment, or (b) physical interface between a third -party camer connecting the CenturyLink QC Domestic Network to Customer's telecommunications equipment "CenturyLink QC Domestic Network" means the CenturyLink QC operated facilities located within Centuryl-ink QC's 14 -state local service area (those states are listed in the opening paragraph of this Agreement) and which consists of transport POPs, physical media, switches, circuits and /or ports that are operated solely by CenturyLink QC "Expedite" means Customer's request to CenturyLink QC to provision a Service more quickly than the CenturyLink QC standard or negotiated interval for which an additional Expedite charge will apply "Funding" means Customer charges over the term of a Service contract that covers Centuryl-ink QC's calculated costs for providing Service and it's expected rate of return when network infrastructure is not available to provide Service to Customer "Grace Period" means a period of 30 business days from the later of the Service Due Date or the date when Service is made available to the Customer, and during which the applicable Service will be held available for Customer upon Customer's request "Minimum Service Period" means 12 months following the Service Acceptance Date, as evidenced by Centuryl-ink QC records In the case of Frame Relay, this means 6 months following the Service Acceptance Date "Pricing Attachment' means each document containing Service Rates, Term, and location- specific information, all of which are incorporated by this reference and made a part of each Service Exhibit "Rates" means the MRCs and NRCs for the Service "Service Acceptance Date" means the date Customer accepts the Service and billing commences, as evidenced by CenturyLink QC records "Service Due Date" means the date CenturyLink QC makes the Service available to Customer for testing "SONET" means Synchronous Optical Network "Termination Charge" means the termination charges detailed in the Service Exhibits 15 Definitions "Affiliate" means any entity controlled by, controlling, or under common control with a party "AUP" means the Acceptable Use Policy incorporated by this reference and posted at gwest centurylink com/le-ga Charge" means cancellation or termination charges that apply when Customer cancels Service without Cause (a) as described in a Service Exhibit (or in the Tariff for applicable CenturyLink QC Services), and (b) when charges are incurred by CenturyLink QCC from a third party provider as a result of an early termination "Cause" means the failure of a party to perform a material obligation under the Agreement, which failure is not remedied (a) for payment defaults by Customer, within five days of separate written notice from CenturyLink of such default, or (b) for any other material breach, within 30 days after written notice "Confidential Information" means any information that is not generally available to the public, whether of a technical, business, or other nature, (including CPNI), and that (a) the receiving party knows or has reason to know is confidential, proprietary, or trade secret information of the disclosing party, or (b) is of such a nature that the receiving party should reasonably understand that the disclosing OMR #N55756 (QLAGESZ) Page 6 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT party desires to protect the information from disclosure Confidential Information will not include information that is in the public domain through no breach of the Agreement by the receiving party or is already known or is independently developed by the receiving party "Convenience" means any reason other than for Cause "CPE" means any customer equipment, software, and /or other materials of Customer used in connection with the Service "CPNI" means Customer Proprietary Network Information, which includes confidential account, usage, and billing- related information about the quantity, technical configuration, type, destination, location, and amount of use of a customer's telecommunications services CPNI reflects the telecommunications products, services, and features that a customer subscribes to and the usage of such services, including call detail information appearing in a bill CPNI does not include a customer's name, address, or telephone number "Early Termination Charge" means an amount equal to 35% of the average monthly charges billed under this Agreement through the date of termination multiplied by the number of months remaining in the Term "End User" means Customer's members, end users, customers, or any other third parties who use or access the Services or the CenturyLink network via the Services "Force Majeure Event" means an unforeseeable event beyond the reasonable control of that party, including without limitation act of God, fire, explosion, lightning, hurricane, labor dispute, cable cuts by third parties, acts of terror, material shortages or unavailability, government laws or regulations, war or civil disorder, or failures of suppliers of goods and services "ISS" means CenturyLink's Information Services Schedule incorporated by this reference and posted at http //tariffs gwest corn 8000fidc /groups /public/documents /service agreements /qcc info services ridf "MRC" means monthly recurring charge "NRC" means nonrecurring charge "Order Form" includes both order request forms and quotes issued by CenturyLink If a CenturyLink service requires a quote to validate the Order Form pricing, the quote will take precedence over the order request form, but not over the Service Exhibit "Regulatory Activity" is a regulation or ruling by any regulatory agency, legislative body or court of competent jurisdiction "RSS" means as applicable CenturyLink QCC's Rates and Services Schedules incorporated by this reference and posted at http / /tanffs gwest corn 8000frdc /groups /public/documents /rss/htmltoc qcc rss2 htm for CenturyLink QCC's International RSS and at http //tanffs gwest corn 8000fidc/ groups /public/documents /rss /htmltoc gcc rss no 3 htm for CenturyLink QCC's Interstate RSS "SLA" means the service level agreement applicable to a Service as described in a Service Exhibit "State" means one of the 50 states of the United States or the District of Columbia "Tariff" includes as applicable CenturyLink QCC or CenturyLink QC state tariffs, price lists, price schedules, administrative guidelines, catalogs, and rate and term schedules incorporated by this reference and posted at http //tariffs awest com 8000 /Q Tariffs /QT Tariff State Page/index htm "Taxes" means foreign, federal, state, and local excise, gross receipts, sales, use, privilege, or other tax (other than net income) now or in the future imposed by any governmental entity (whether such Taxes are assessed by a governmental authority directly upon CenturyLink or the Customer) attributable or measured by the sale price or transaction amount, or surcharges, fees, and other similar charges that are required or permitted to be assessed on the Customer These charges may include state and federal Carrier Universal Service Charges, as well as charges related to E911, and Telephone Relay Service "Tech Pub" means the technical publication specific to each CenturyLink QC service, all of which are located at http //www gwest com/techpub/ Each CenturyLink QC Service Exhibit stipulates the Tech Pub that applies to that service, if any OMR #N55756 (QLAGESZ) Page 7 of 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081511 CENTURYLINK LOYAL ADVANTAGE" AGREEMENT DOMESTIC VOICE SERVICE EXHIBIT 1 General, Definitions Capitalized terms not defined herein are defined in the Agreement CenturyLink QCC will provide domestic Voice Services ( "Service ") under the terms of the Agreement, Tariff, RSS, ISS, and this Service Exhibit "Net Effective Rate" means the rates less the Custom Discount Net Effective Rates are subject to change if there is a change in the underlying rates and /or applicable discount(s), with any such changes to be done in accordance with the terms of the Agreement or this Service Exhibit "Net Rate" is in lieu of all other rates, discounts, and promotions, including the CTA Discount "Pricing Attachment" means a document containing rates specific to the Service and is incorporated by reference and made a part of this Service Exhibit "SLA" means the service level agreement specific to the Service, located at http //www gwest centurylink comAegal /, which is subject to change 2 Service 2 1 Description Voice Service consists of domestic Long Distance, domestic Toll Free (including features), domestic Virtual Network Service ( "VNS "), domestic worldcard and domestic Directory Assistance service Domestic Long Distance service is available both interstate and intrastate, through switched and dedicated facilities Toll Free service is also available through switched or dedicated facilities CenturyLink is required by the FCC to state in this Service Exhibit that Customer is prohibited from using any Toll Free telephone number, or other telephone number advertised or widely understood to be Toll Free, in a manner that would violate FCC rule 47 CFR 64 1504 Directory Assistance offers one rate to Voice Service customers domestically With respect to Outbound Long Distance (a) Per the Federal Trade Commission ( "FTC "), telemarketers are required to transmit their telephone number to Caller ID services As such, all telemarketers using CenturyLink commercial services are required to provide CPN /pseudo -CPN according to the rules below IF A TELEMARKETER DOES NOT PROVIDE CENTURYLINK WITH A NUMBER FOR THIS PURPOSE, THEIR BILLING TELEPHONE NUMBER WILL BE USED AS THE TRUNK GROUP'S CPN, and (b) Federal Do Not Calls rules require that companies that telemarket or engage in telephone solicitations adhere to the requirements set forth in 47 C F R section 64 1200 (FCC) and 16 C F R Part 310 (FTC) Please consult with your company's legal advisor for more information The SLA provides Customer's sole and exclusive remedy for service interruptions or service deficiencies of any kind whatsoever for the Service worldcard offers domestic calling card services available either interstate or intrastate and is available through switched access only worldcard is offered with three options 1) the standard option includes CenturyLink's trademarks and telephone number, 2) the " cologo" option includes Centuryl-ink's and Customer's names and trademarks and /or logos and will include either Centuryl-ink's or Customer's telephone number, and 3) the "private label" option only includes Customer's names trademarks and/or logos and will include either CenturyLink's or Customer's telephone number If Customer selects the cologo or private label worldcard options, then Customer grants CenturyLink permission to create a card using Customer's name, trademarks and /or logos as provided to CenturyLink by Customer Customer further agrees that even though Customer's name, trademarks, logo and/or phone number may appear on the cards, except for Customer's rights in its name, trademarks, and /or logo, CenturyLink will be sole owner of all right and title in and to all intellectual property associated with the cards and the worldcard service Furthermore, if Customer selects either the cologo or private label cards, then Customer agrees to indemnify and hold CenturyLink harmless for any costs, fees, damages, or expenses of any sort incurred by CenturyLink as a result of claims arising from CenturyLink's use of Customer's name, trademarks or logo in accordance with this Agreement In addition to the other worldcard charges listed herein, Customer will pay to CenturyLink any set -up charges associated with the design and production of the cologo and private label cards CenturyLink will notify Customer of the total amount of set -up charges prior to production of the cards If Customer objects to the set -up charges, then the parties will work together to create a less expensive design than originally requested by Customer (this sentence and the previous sentence combined constitute the "Set -up Process ") If Customer revokes the use of its mark for the cologo or private label cards or requests new cards due to its mark changing, then Customer must cease using those cards and CenturyLink will issue replacement cards that either do not include Customer's mark or contain the new mark, as appropriate The Set -up Process will apply to the replacement cards and Customer will pay CenturyLink the set -up charges for the replacement cards The person(s) named on the calling card and those identified on Centuryl-ink's records for the associated account are jointly and severally responsible for the charges made using the calling card The calling card is not transferable, but the cardholder may authorize others to use it The cardholder is responsible for all charges incurred by authorized users, and giving the calling card to someone else or telling someone else the security code is such authorization The calling card will be cancelled at the cardholder's request CenturyLink may cancel the calling card if the cardholder cancels or fails to pay, if CenturyLink suspects fraud, improper, or unauthorized use or observes unusual use, or if it changes its policies for issuing worldcard calling cards CenturyLink may cancel the calling card without notice CenturyLink is not liable for any damages for any reason due to the cancellation of, or failure to accept the calling card If a calling card is canceled for any reason, the cardholder must notify all authorized users and destroy all calling cards The cardholder should notrfy CenturyLink immediately if the cardholder changes address or telephone number or if a calling card is lost, stolen, or misplaced or if a cardholder suspects unauthorized use or misuse of a calling card To report a loss, theft, or suspected misuse, please call 1 800 -860 -1020 Some uses of the worldcard calling card may be subject to rules, regulations, and tariffs of state public utility commissions and the Federal Communications Commission 2 2 Domestic IP Voice Domestic IP Voice Service consists of IP intrastate and interstate dedicated Long Distance and IP dedicated Toll Free Domestic IP Voice accepts intrastate and interstate dedicated Long Distance traffic in IP format and converts such traffic for transmission across the telecommunications network Domestic IP Voice also accepts domestic Toll Free traffic and converts it into VoIP format for transmission to Customer The pricing for Domestic IP Voice services is the same as for non -IP intrastate and interstate dedicated Long Distance and non -IP dedicated Toll Free Domestic IP Voice does not support local services, 911, E911, V911, operator services, local number portability, or directory listings All use of Domestic IP Voice will comply with and be subject to the service guide, AUP, and applicable sections of the SLA which are posted at http //www gwest centurylink com/legal/ CenturyLink OMR #N55756 (QLAGESZ) Page 8 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT DOMESTIC VOICE SERVICE EXHIBIT reserves the right to refuse to accept, suspend, or limit any or all of Customer's IP traffic not complying with the service guide technical specifications or that CenturyLink believes is adversely affecting other customers on the CenturyLink network The service guide and AUP are incorporated into the Agreement by this reference CenturyLink may reasonably modify the service guide, AUP, and SLA to ensure compliance with applicable laws and regulations and to protect CenturyLink's network and customers, and such change will be effective upon posting to the Web site 2 3 CenturyLink 8XX Outbound Service CenturyLink 8XX Outbound Service ( "8XX Outbound ") allows Customer to place Toll Free TDM or IP calls to CenturyLink owned or non - CenturyLink owned Toll Free numbers on Customers CenturyLink dedicated access lines ( "DALS ") 8XX Outbound is only available on DALs provisioned on CenturyLink DMS250, NGS, and IPLD switched 8XX Outbound is not subject to an SLA 8XX Outbound is governed by the CenturyLink RSS and /or Tariffs CenturyLink reserves the right, upon 30 calendar days prior written notice to Customer, to cancel or modify 8XX Outbound If Customer does not agree to the 8XX Outbound modifications, then Customer must notify CenturyLink prior to the expiration of the 30 day time frame that Customer wishes to cancel 8XX Outbound Customers continued use of 8XX Outbound after the 30 -day time frame will indicate that Customer agrees to the modifications Limitations CenturyLink provides 8XX Outbound by routing and terminating the toll -free call to a CenturyLink dedicated facility that is connected to a LEC facility to allow re- origination to the dialed Toll Free number CenturyLink is only responsible for getting the call to the LEC for re- origination CenturyLink cannot provide any kind of support or help troubleshoot problems with toll free origination or termination once the call is delivered to the LEC for re- ongination Because all outbound Toll Free calls will re- onginate from a LEC central office, the outbound toll -free call will route as if the call originates from the LEC central office, and not from the geographic location of Customers DAL If there is regional (i e, calls only allowed to originate from specific states or disallowed from specific states) or point of call (geographic) routing on the dialed Toll Free number, the call may not be completed From time to time CenturyLink may add, change, and /or remove the central offices from which calls are re- onginated, without notice to Customer Customer requests for 8XX Outbound changes or additions, including additional 8XX Outbound traffic volumes, are subject to availability and CenturyLink's acceptance of the order 2 4 Non - Completed Calls "Non- completed Call Percentage Threshold" means 30% of all attempted calls, both completed and non - completed If the percentage of Customer's calls that do not complete (out of all attempted calls) meets or exceeds the Non - completed Call Percentage Threshold for any given monthly billing cycle, CenturyLink may, upon 30 calendar days notice to Customer, disconnect any and all circuit(s) providing Service on which the Non - completed Call Percentage Threshold was exceeded 3 Term This Service Exhibit will expire or terminate coterminous with the Agreement, unless terminated earlier by either party by providing 60 days advance written notice 4 Charges As applicable, Customer will pay the rates, Net Rates, Net Effective Rates, and all other charges set forth in the Pricing Attachment, RSS, ISS, Tariff, or Order Form Customer is responsible for all metered usage charges and per call charges that occur from the point Service is available for Customer use, regardless of whether CenturyLink notifies Customer of Service availability Domestic Long Distance calls crossing state boundaries, within the same LATA, will be billed at the interstate rate The rates, Net Rates, and Net Effective Rates do not include costs associated with local access or CPE, which rates are described in the Service Exhibits specific to those services or in a separate agreement for such service Customers 8XX Outbound will bill the same rates as Customers dedicated outbound Long Distance (1 +) Customer understands and agrees that all 8XX Outbound calls will be billed to the trunk group owner, even if the dialed toll -free numbers belong to CenturyLink CenturyLink reserves the right, upon 30 calendar days prior written notice to Customer, to charge an MRC for 8XX Outbound If Customer does not agree to the MRC, then Customer must notify CenturyLink prior to the expiration of the 30 day time frame that Customer wishes to cancel 8XX Outbound Customer's continued use of 8XX Outbound after the 30 -day time frame will indicate that Customer agrees to pay the MRC Unless a Net Rate or Net Effective Rate is specified in the Pricing Attachment, domestic Outbound Long Distance and 8XX Outbound, domestic Toll Free (including any features), domestic VNS, and domestic worldcard voice services will be charged at the Agreement rates in the Tariff, ISS, and RSS Rates and Net Rates will be used for calculating Contributory Charges Customer represents that it has received from a CenturyLink competitor an offer comparable to the offer in this Service Exhibit for the Services OMR #N55756 (QLAGESZ) Page 9 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT DOMESTIC VOICE SERVICE EXHIBIT PRICING ATTACHMENT 1 Interstate For all Interstate Long Distance usage, Centuryl-ink will bill Customer an 18 second minimum per call and 6 second increments Domestic Interstate Per Minute Outbound Long Distance Net Rate On ►nation — Termination Dedicated — Switched $00100 Switched — Switched $00230 Dedicated — Dedicated NS $00100 Domestic Interstate Per Minute Toll Free Net Rate On ►nation - Termination Switched — Dedicated $00189 Switched — Switched $00250 Domestic Interstate Net Rate worldcard —Op tion 1 On inahon — Termination Per Minute Switched — Switched $00250 Per Call Surcharge from Non- Payphone $0 3500 per call $0 3500 plus Per Call Surcharges from Payphone $0 5500 surcharge per p ayphone call Domestic Interstate Net Rate Directory Assistance all states Directory Assistance — per call (up to two numbers may be provided per call ) $19900 2 Intrastate Domestic Intrastate (including interl-ATA and intral-ATA) Outbound Long Distance Per Minute By State Net Rate State Ongination — Temmmation Washington Dedicated — Switched $00187 Washington Switched - Switched $00370 Domestic Intrastate (including mterLATA and intral-ATA) Per Minute Toll Free Rates By State State Onginabon — Termination Washington Switched — Dedicated $00189 Washington Switched — Switched $00 Intrastate (including interLATA and intraLATA)worldcard - Option 1 Net By State Effective Rates State Per Minute Switched - Switched $00370 Washington Per Call Surcharge from Non-Payphone 1 0 3500 Per Call Surcharges from Payphone $03500 $0 3000 OMR #N55756 (QLAGES2) Page 10 © Centuryl-ink, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT DOMESTIC VOICE SERVICE EXHIBIT Domestic Intrastate Net Directory Assistance per call Effective Rates States Alabama, Arizona, Colorado, Iowa, Idaho, Minnesota, Montana, $19900 Nebraska, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming Michigan, Nevada, New Jersey, Virginia, Wisconsin $14000 Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, $09500 Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Mississippi, Missouri, New Hampshire, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont West Virginia Maryland first 2 calls are free each call thereafter $09500 Massachusetts (first 10 calls are free, each call thereafter) $09500 3 LOCATIONS THRESHOLD The Switched Inbound and Outbound Interstate rates and Dedicated Inbound and Outbound Interstate rates described under the Agreement will be provided to no more than 25 total locations (the "Locations Threshold ") Each location in excess of the Location Threshold requiring Switched Inbound and Outbound Interstate Service or Dedicated Inbound and Outbound Interstate Service will receive standard month -to -month RSS rates in lieu of the rates, discounts and /or credits specified herein 4 INBOUND 8XX FEATURE(S) Customer will pay the following NRCs, MRCS, Change Charges and Surcharges, if applicable, for the Enhanced 8XX Features listed below ( "Feature(s) ") Pricing for Features listed below is subject to change without notice and is sub ect to applicable federal state and local taxes fees and surcharges Feature NRC MRC Change Surcharge Alternate Call Routing $50 00 per 8XX $50 00 Der 8XX $50 00 per 8XX N/A Busy Ring No Answer (BRNA) $150 00 per 8XX $50 00 Der 8XX $50 00 per 8XX $0 01 Der call Day of Week Routing DO $50 00 per 8XX $50 00 per 8XX $50 00 per 8XX N/A Day of Year (Holiday) Routing DO $50 00 per 8XX $000 $50 00 per 8XX N/A Dialed Number Identification Service DNIS $15 00 per 8XX $000 $15 00 per 8XX N/A Direct Termination Overflow (DTO) $50 00 Der 8XX $50 00 per 8XX $50 00 per 8XX N/A EZ E R ute- Enhanced Reporting Manager $500 00 per 8XX $0 $0 $0 EZ Route -Menu and Database * $150 00 per 8XX $50 00 per 8XX $000 $0 04 per call EZ Route - Speech Recognition Menu & $150 00 per 8XX $50 00 per 8XX $000 $0 08 per call Database Routing * EZ Route - Percent Allocation, Time of Day, Included with EZ Included with EZ Included with EZ Included with EZ Day of Week, Area Code & Customer - Route Route Route Route Entered Digit Routing * EZ Route-Bridging $000 $0 05 Der MOU $000 $000 EZ Route Enhanced Reporting Manager ERM $50000 $000 $000 $000 Extended Call Coverage (ECC) $000 __ $000 $000 N/A Geographic Routing GeoRoutm $50 00 per 8XX $50 00 per 8XX $50 00 per 8XX N/A $35 00 per 8XX $35 00 per 8XX Industry Toll Free Directory Assistance (standard) (standard $100 00 per 8XX $3 00 per 8XX $100 00 per 8XX $2 00 per query ( expedite) ex edite Menu Routing $250 00 per 8XX $25 00 per 8XX $10000 er 8XX $0 05 per call Percent Allocation Routing $50 00 per 8XX $50 00 per 8XX $50 00 per 8XX N/A Project Account Codes PAC $15 00 per 8XX $15 00 per 8XX $15 00 ner 8XX N/A This advanced routing option is only offered through an alliance with AdGeo Please CenturyLink GeoPlus contact AdGeo directly at 888 -947 -3100 or visit www QwestGeoPlus com Log -in west PIN qwestl Real Time ANI $000 $000 $000 N/A Tailored Call Coverage CC $50 00 per 8XX $000 $50 00 per 8XX N/A Time of Day Routing OD $50 00 per 8XX $50 00 per 8XX $50 00 per 8XX N/A Transfer and Release nR) $1 00 per 8XX $100 00 per 8XX $100 00 per 8XX $0 05 per transfer Control Center for Toll Free $000 $000 1 $000 1 N/A Super Trunk Overflow $50 00 per 8XX 1 $50 00 per 8XX 1 $50 00 per 8XX N/A In Switch Overflow Trunk $50 00 per 8XX $50 00 per 8XX 1 $50 00 Der 8XX I N/A * Limited to 500 nodes per application OMR #N55756 (QLAGESZ) Page 11 © CenturyLmk, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT 1 General, Definitions Capitalized terms not defined in this Service Exhibit are defined in the Agreement CenturyLink will provide International Voice Service ( "Service ") under the terms of the Agreement, RSS, ISS, and this Service Exhibit "Pricing Attachment" means a document containing rates specific to the Service and is incorporated by reference and made a part of this Service Exhibit 2 Service 21 Description International Voice Service consists of International Outbound Long Distance, International Toll Free and International worldcard® Except where specified otherwise, for international outbound voice service, the rates specified herein will only apply to international outbound voice service originating in the U S (subject to availability) and terminating internationally using land - line facilities and will not apply to international outbound voice service terminating internationally using cellular facilities or, for international inbound voice service, the rates specified herein will only apply to international inbound voice service originating internationally using land -line and cellular facilities However, airtime is charged for mobile calls With respect to International Outbound Long Distance (a) Per the Federal Trade Commission ( "FTC "), telemarketers are required to transmit their telephone number to Caller ID services As such, all telemarketers using CenturyLink commercial services are required to provide CPN /pseudo- CPN according to the rules below IF A TELEMARKETER DOES NOT PROVIDE CENTURYLINK WITH A NUMBER FOR THIS PURPOSE, THEIR BILLING TELEPHONE NUMBER WILL BE USED AS THE TRUNK GROUP'S CPN, and (b) Federal Do Not Calls rules require that companies that telemarket or engage in telephone solicitations adhere to the requirements set forth in 47 C F R section 64 1200 (FCC) and 16 C F R Part 310 (FTC) Please consult with your company's legal advisor for more information 2 2 International IP Voice International IP Voice Service consists of IP international Long Distance and IP dedicated international Toll Free International IP Voice accepts international dedicated Long Distance traffic in IP format and converts such traffic for transmission across the telecommunications network International IP Voice also accepts dedicated international Toll Free traffic and converts it into VoIP format for transmission to Customer The pricing for International IP Voice services is the same as for non -IP dedicated international Long Distance and Toll Free International IP Voice does not support local services, 911, E911, V911, operator services, local number portability, or directory listings All use of International IP Voice will comply with and be subject to the Service Guide and AUP which are posted at http //www gwest centurylink com/legal/ CenturyLink reserves the right to refuse to accept, suspend, or limit any or all of Customer's IP traffic not complying with the Service Guide technical specifications or that CenturyLink believes is adversely affecting other customers on the CenturyLink network The Service Guide and AUP are incorporated into the Agreement by this reference CenturyLink may reasonably modify the Service Guide and AUP to ensure compliance with applicable laws and regulations and to protect CenturyLink's network and customers, and such change will be effective upon posting to the Web site 3 Charges Customer will pay all applicable rates and charges as set forth in the Pricing Attachment, in the RSS, ISS, or Order Form The per minute rates, country/mobile codes and charges contained in the Pricing Attachment are provided for informational purposes only, but should reflect the applicable rates as of the Effective Date of the underlying Agreement The rates for International Voice Service are controlled by the RSS and are subject to change The rates set forth in the Pricing Attachment do not include costs associated with local access If a Term of less than one year is in effect, then Customer will not receive any discounts No other discounts or promotions will apply OMR #N55756 (QLAGESZ) Page 12 © CenturyLink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TI AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT PRICING ATTACHMENT All rates are quoted in minutes and will be billed in the following initial and incremental time penods based on traffic type International Voice Service Initial Billing Incremental Period Billing Period Outbound U S to International 30 seconds 6 seconds Outbound U S to Canada 30 seconds 6 seconds Outbound U S to Mexico 60 seconds 60 seconds worldcard Initial Billing Incremental Period Billing Period Outbound US to International (excluding Mexico 30 seconds 6 seconds Inbound International (excluding Mexico to US 60 seconds 60 seconds Outbound International to International 60 seconds 60 seconds Inbound Mexico to US 60 seconds 60 seconds Outbound Mexico to Mexico 60 seconds 60 seconds Outbound Mexico to international 60 seconds 60 seconds Outbound International to Mexico 60 seconds 60 seconds Outbound US to Mexico 60 seconds 60 seconds Inbound Canada to US 30 seconds 6 seconds Outbound US to Canada 30 seconds 6 seconds Outbound Canada to International (excluding Mexico 30 seconds 6 seconds Outbound International (excluding Mexico to Canada 60 seconds 60 seconds Outbound Canada to Mexico 60 seconds 60 seconds Outbound Mexico to Canada 1 60 seconds 1 60 seconds International Toll Free Service "ITFS" /Universal International Freephone Number "UIFN" billing increments ITFS /UIFN Initial Billing Period Incremental Billing Period Inbound International (excluding Mexico to US 30 seconds 6 seconds Inbound Canada to US 30 seconds 6 seconds Inbound US to Canada 30 seconds 6 seconds Inbound Mexico to US 60 seconds 60 seconds International Outbound Long Distance Switched Dedicated Origination - Origination - Country of Termination Switched Switched Termination Termmabon Rate Per Rate Per Minute Minute Afghanistan $08535 $08355 Albania $04104 $03924 Albania - Mobile /Special Services $03243 $03063 Algeria $03528 $03348 Algeria - Mobile /Special Services $03888 $03708 Andorra $01680 $01500 Andorra - Mobile/Special Services $03494 $03314 Angola $05256 $05076 Angola - Mobile /Special Services $05 16 $05436 Anguilla $03024 $02844 Anguilla - Mobile /Special Services $03321 $03141 Antarctica $05850 $05670 Antigua $02671 $02491 Antigua — Mobile /Special Services $04230 $04050 Argentina $01125 $00945 Argentina - Mobile /Special Services $03454 $03274 OMR #N55756 (QLAGES2) Page 13 © CenturyLmk, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Armenia $04464 $0 4284 Armenia - Mobile /Special Services $04824 $0 4644 Aruba $02304 $02 124 Aruba - Mobile /Special Services $02664 $02484 Ascension Island $1 1224 $1 1044 Australia $00614 $00434 Australia - Mobile /Special Services $02538 $02358 Austria $01066 $00886 Austria - Mobile /Special Services $03248 $03068 Azerbaijan $04976 $04796 Azerbaijan - Mobile /Special Services $04976 $04796 Bahamas $01440 $01260 Bahamas — Mobile /Special Services $01980 $01800 Bahrain $03816 $03636 Bahrain - Mobile /Special Services $04176 $03996 Bangladesh $04241 $04061 Bangladesh - Mobile /Special Services $06247 $06067 Barbados $03024 $02844 Barbados - Mobile /Special Services $03370 $03190 Belarus $04230 $04050 Belarus - Mobile /Special Services $04500 $04320 Belgium $00540 $00360 Belgium - Mobile /Special Services $02970 $02790 Belize $03816 $03636 Belize - Mobile /Special Services $05542 $05362 Benin $03384 $03204 Benin — Mobile /Special Services $04680 $04500 Bermuda $01872 $01692 Bermuda - Mobile /Special Services $02232 $02052 Bhutan $07584 $07404 Bhutan — Mobile /Special Services $08280 $08100 Bolivia $02873 $02693 Bolivia - Mobile /Special Services $03869 $03689 Bosnia & Herzegovina $03010 $02830 Bosnia & Herzegovina - Mobile /Special $04032 $03852 Services Botswana $03240 $03060 Botswana — Mobile /Special Services $03960 $03780 Brazil $01440 $01260 Brazil - Mobile /Special Services $03022 $02842 British Virgin Islands $02376 $02196 British Virgin Islands - Mobile /Special $01917 $01737 Services Brunei $03816 $03636 Brunei - Mobile /Special Services $04176 $03996 Bulgaria $02520 $02340 Bulgaria - Mobile /Special Services $03348 $03168 Burkina Faso $04176 $03996 Burkina Faso — Mobile /Special $04680 $04500 Services Burundi $08208 $08028 Burundi - Mobile /Special Services $03448 $03268 Cambodia $09216 $09036 OMR #N55756 (QLAGESZ) Page 14 © CenturyLmk, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Cambodia - Mobile /Special Services $09576 $09396 Cameroon $03967 $03787 Cameroon - Mobile/Special Services $05929 $05749 Canada $00449 $00269 Cape Verde Islands $04770 $04590 Cape Verde Islands — Mobile /Special $06030 $05850 Services Cayman Islands $02160 $01980 Cayman Islands — Mobile /Special $02430 $02250 Services Central African Republic $07942 $07762 Central African Republic — Mobile/Special Services $0 8280 $0 8100 Chad $12494 $12314 Chad - Mobile /Special Services $08972 $08792 Chile $01632 $01452 Chile - Mobile /Special Services $03402 $03222 China $01642 $01462 China - Mobile /Special Services $02664 $02484 Christmas & Cocos Islands $01366 $01186 Colombia $01778 $01598 Colombia - Mobile /Special Services $03096 $02916 Comoros $06696 $06516 Comoros - Mobile /Special Services $06480 $06300 Congo, Republic of $05292 $05112 Cook Islands $54000 $53820 Cook Islands - Special Services $46980 $46800 Costa Rica $02268 $02088 Costa Rica - Mobile /Special Services $02628 $02448 Croatia $02873 $02693 Croatia - Mobile /Special Services $03606 $03426 Cuba $09180 $09000 Cuba - Guantanamo Bay $10080 $09900 Cyprus $03024 $02844 Cyprus - Mobile /Special Services $04102 $03922 Czech Republic $02376 $02196 Czech Republic - Mobile $0 3246 $0 3066 Special/Services Denmark $01080 $00900 Denmark - Mobile /Special Services $02880 $02700 Diego Garcia $27180 $27000 Djibouti $05263 $05083 Djibouti - Mobile /Special Services $07063 $06883 Dominica $03134 $02954 Dominica — Mobile /Special Services $04230 $04050 Dominican Republic $01778 $01598 Dominican Republic - Mobile/Special $02160 $01980 Services East Timor $13500 $13500 Ecuador $02668 $02488 Ecuador - Mobile /Special Services $03672 $03492 Egypt $03283 $03103 Egypt - Mobile Special /Services $04608 $04428 El Salvador $02189 $02009 OMR #N55756 (QLAGES2) Page 15 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TI AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT El Salvador - Mobile /Special Services $02518 $02338 Equatorial Guinea $09648 $09468 Equatorial Guinea — Mobile /Special $10080 $09900 Services Entree $06703 $06523 Estonia $03096 $02916 Estonia - Mobile /Special Services $04918 $04738 Ethiopia $06120 $05940 Ethiopia - Mobile /Special Services $06480 $06300 Faeroe Islands $02760 $02580 Falkland Islands (Islas Malvinas) $1 1250 $1 1070 Fiji Islands $05220 $05040 Fiji Islands - Mobile /Special Services $06539 $06359 Finland $01080 $00900 Finland - Mobile Special /Services $02340 $02160 France $00540 $00360 France - Mobile /Special Services $02662 $02482 French Antilles (incl Martinique) $02736 $02556 French Guiana $03564 $03384 French Guiana — Mobile /Special $04680 $04500 Services French Polynesia $04976 $04796 Gabon Republic $04248 $04068 Gabon Republic - Mobile /Special $04608 $04428 Services Gambia $03672 $03492 Gambia - Mobile /Special Services $05189 $05009 Georgia $05294 $05114 Georgia - Mobile /Special Services $05506 $05326 Germany $00540 $00360 Germany - Mobile /Special Services $02970 $02790 Ghana $03312 $03132 Ghana - Mobile /Special Services $03672 $03492 Gibraltar $03812 $03632 Gibraltar- Mobile /Special Services $04342 $04162 Greece $01300 $01120 Greece - Mobile Special /Services $02662 $02482 Greenland $07650 $07470 Greenland - Mobile /Special Services $07650 $07470 Grenada $03254 $03074 Grenada - Mobile/Special Services $03614 $03434 Guadeloupe $02808 $02628 Guadeloupe - Mobile /Special Services $04630 $04450 Guatemala $02189 $02009 Guatemala - Mobile /Special Services $03276 $03096 Guinea $04320 $04140 Guinea - Mobile /Special Services $05758 $05578 Guinea - Bissau $14189 $13976 Guinea- Bissau - Mobile /Special $22500 $22320 Services Guyana $05280 $05100 Guyana - Mobile /Special Services $0 6075 $05895 OMR #N55756 (QLAGES2) Page 16 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TO AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Haiti $03706 $03526 Haiti - Mobile $04342 $04162 Haiti - Special Services $05400 $05220 Honduras $04500 $04320 Honduras - Mobile /Special Services $05220 $05040 Hong Kong $01150 $00970 Hong Kong - Mobile /Special Services $01656 $01476 Hungary $00836 $00656 Hungary - Mobile /Special Services $03502 $03322 Iceland $02520 $02340 Iceland - Mobile /Special Services $03745 $03565 India $02610 $02430 India - Mobile /Special Services $04176 $03996 Indonesia $01215 $01035 Indonesia - Mobile /Special Services $03238 $03058 INMARSAT — 870 $63000 $62820 INMARSAT - Atlantic East $63000 $62820 INMARSAT - Atlantic West $63000 $62820 INMARSAT - Indian $63000 $62820 INMARSAT - Pacific $63000 $62820 International Networks $42353 $42142 Iran $04651 $04471 Iran - Mobile /Special Services $06264 $06084 Iraq $07835 $07709 Ireland $01080 $00900 Ireland - Mobile /Special Services $03150 $02970 Indium $36529 $36318 Israel $00630 $00450 Israel - Mobile /Special Services $01726 $01546 Italy $00529 $00349 Italy - Mobile /Special Services $02835 $02655 Ivory Coast $05335 $05155 Ivory Coast - Mobile /Special Services $06408 $06228 Jamaica $03215 $03035 Jamaica - Mobile /Special Services $04553 $04246 Japan $00656 $00476 Japan - Mobile /Special Services $03023 $02753 Jordan $04651 $04471 Jordan - Mobile /Special Services $05352 $05172 Kazakhstan $01984 $01804 Kazakhstan - Mobile /Special Services $02650 $02470 Kenya $04320 $04140 Kenya - Mobile /Special Services $04680 $04500 Kiribati $09212 $09032 Kinbat - Mobile /Special Services $1 1250 $1 1070 Korea, North $08208 $08028 Korea, South $01222 $01042 Korea, South - Mobile /Special Services $01510 $01330 Kuwait $03830 $03650 Kuwait - Mobile /Special Services $05328 $05148 Kyrgyzstan $02531 $02351 Kyrgyzstan - Mobile /Special Services $04658 $04478 OMR #N55756 (QLAGESZ) Page 17 © CenturyLink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Laos $08304 $08124 Laos - Mobile /Special Services $10397 $10217 Latvia $03010 $0 2830 Latvia - Mobile /Special Services $04492 $04312 Lebanon $04378 $04198 Lebanon - Mobile /Special Services $05198 $05018 Lesotho $04392 $04212 Lesotho - Mobile /Special Services $04752 $04572 Liberia $03312 $03132 Liberia - Mobile /Special Services $06982 $06802 Libya $04464 $04284 Libya — Mobile /Special Services $05580 $05400 Liechtenstein $01300 $01120 Liechtenstein - Mobile /Special Services $01958 $01778 Lithuania $03010 $02830 Lithuania - Mobile /Special Services $04953 $04773 Luxembourg $01080 $00900 Luxembourg - Mobile/Special Services $03150 $02970 Macau $04024 $03844 Macau - Mobile/Special Services $04464 $04284 Macedonia $03096 $02916 Macedonia - Mobile /Special Services $04230 $04050 Madagascar $12672 $12492 Madagascar - Mobile /Special Services $13032 $12852 Malawi $03456 $03276 Malawi - Mobile /Special Services $03816 $03636 Malaysia $00667 $00487 Malaysia - Mobile /Special Services $01726 $01546 Maldives $06864 $06684 Maldives - Mobile /Special Services $22500 $22320 Mali Republic $05616 $054 Mali Republic - Mobde /Special $04782 $04602 Services Malta $02952 $02772 Malta - Mobile /Special Services $03312 $03132 Marshall Islands $06750 $06570 Mauritania $05184 $05004 Mauritius $05824 $05644 Mauritius — Mobile/Special Services $06930 $06750 Mayotte Island $06696 $06516 Mayotte Island - Mobile /Special $08518 $08338 Services Mexico Step 1 -3 $01150 $00970 Mexico Step 4 - 7 $01154 $00974 Mexico Step 8 $01260 $01080 Micronesia $05130 $04950 Moldova $03967 $03787 Moldova - Mobile /Special Services $07729 $07549 Monaco $01080 $00900 Monaco - Mobile /Special Services $03494 $03314 Mongolia $08640 $08460 Montserrat $03420 $03240 Montserrat - Mobile /Special Services $05130 $04950 OMR #N55756 (QLAGESZ) Page 18 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE W AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Morocco $04129 $03949 Morocco - Mobile /Special Services $04673 $04493 Mozambique $04549 $04369 Mozambique - Mobile /Special Services $05760 $05580 Myanmar (Formerly Burma) $10906 $10726 Namibia $04950 $04770 Namibia - Mobile /Special Services $04032 $03852 Nauru $14400 $14220 Nauru - Mobile /Special Services $22235 $21706 Nepal $05544 $05364 Nepal — Mobile /Special Services $06930 $06750 Netherlands $00540 $00360 Netherlands - Mobile /Special Services $03420 $03240 Netherlands Antilles $02435 $02255 Netherlands Antilles - Mobile /Special $03282 $03082 Services New Caledonia $06048 $05868 New Zealand $01300 $01120 New Zealand - Mobile/Special Services $03033 $02853 Nicaragua $03060 $02880 Nicaragua - Mobile /Special Services $03420 $03240 Niger Republic $05136 $04956 Niger Republic - Mobile /Special $03613 $03433 Services Nigeria $04230 $04050 Nigeria - Mobile /Special Services $05026 $04846 Niue $22680 $22500 Niue - Mobile /Special Services $22680 $22500 Norfolk Island $17894 $17714 Norway $01080 $00900 Norway - Mobile /Special Services $02223 $02043 Oman $04860 $04680 Oman - Mobile /Special Services $05220 $05040 Pakistan $05400 $05220 Pakistan - Mobile /Special Services $05328 $05148 Palau, Republic of $05400 $05220 Palestine $01510 $01330 Palestine Mobile $02025 $01845 Panama $03010 $02830 Panama - Mobile/Special Services $03456 $03276 Papua New Guinea $03600 $03420 Papua New Guinea - Mobile /Special $18000 $17820 Services Paraguay $03312 $03132 Paraguay - Mobile /Special Services $03851 $03671 Peru $02285 $02105 Peru - Mobile /Special Services $03382 $03202 Philippines $02070 $01890 Philippines - Mobile /Special Services $03330 $03150 Poland $00784 $00604 Poland - Mobile Special /Services $03650 $03470 Portugal $00688 $00508 Portugal - Mobile /Special Services $02970 $02790 OMR #N55756 (QLAGESZ) Page 19 © CenturyLink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TI AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Qatar $05670 $05490 Qatar - Mobile /Special Services $06300 $06120 Reunion Island $06671 $06491 Reunion Island - Mobile /Special $07222 $07042 Services Romania $01980 $01800 Romania - Mobile /Special Services $04234 $04054 Russia $01915 $01735 Russia - Mobile /Special Services $02520 $02340 Rwanda $06216 $06036 San Marino $01424 $01244 San Marino - Mobile /Special Services $20250 $20070 Sao Tome $20250 $20070 Saudi Arabia $03967 $03787 Saudi Arabia - Mobile /Special Services $05544 $05364 Senegal Republic $05335 $05155 Senegal Republic - Mobile /Special $06565 $06385 Services Seychelles Islands $07404 $07224 Seychelles Islands - Mobile /Special $04998 $04818 Services Sierra Leone $05850 $05670 Sierra Leone - Mobile /Special Services $05436 $05256 Singapore $01573 $01393 Singapore - Mobile /Special Services $02160 $01980 Slovak Republic $02326 $02146 Slovak Republic - Mobile /Special $03606 $03426 Services Slovenia $02520 $02340 Slovenia - Mobile /Special Services $04024 $03844 Solomon Islands $13500 $13320 Solomon Islands - Mobile /Special $18000 $17820 Services Somalia $13235 $13055 South Africa $00900 $00720 South Africa - Mobile /Special Services $03382 $03202 Spain $00540 $00360 Spain - Mobile /Special Services $03389 $03187 Sri Lanka $05184 $05004 Sri Lanka - Mobile /Special Services $05544 $05364 St Helena $09106 $08926 St Kitts /Nevis $02729 $02549 St Kitts /Nevis - Mobile /Special $04242 $04062 Services St Lucia $02808 $02628 St Lucia - Mobile /Special Services $04712 $04532 St Pierre /Miquelon $02688 $02508 St Vincent/Grenadines $03336 $03156 St Vincent/Grenadines - $04417 $04237 Mobile/Special Services Sudan $06336 $06156 Sudan - Mobile /Special Services $04995 $04815 Suriname $06468 $06288 Suriname - Mobile /Special Services $06008 $05828 Swaziland $02952 $02772 OMR #N55756 (QLAGESZ) Page 20 © CenturyLmk, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE T " AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Swaziland - Mobile $03312 $03132 Sweden $00900 $00720 Sweden - Mobile /Special Services $03282 $03102 Switzerland $00540 $00360 Switzerland - Mobile /Special Services $03918 $03738 Syrian Arab Republic $05328 $05148 Syrian Arab Republic - Mobile /Special $05688 $05508 Services Taiwan $01150 $00970 Taiwan - Mobile /Special Services $01510 $01330 Tapkistan $03812 $03578 Tapkistan - Mobile /Special Services $03812 $03578 Tanzania $04860 $04680 Tanzania - Mobile /Special Services $05832 $05652 Thailand $01292 $01112 Thailand - Mobile /Special Services $02952 $02772 Togo $05436 $05256 Togo — Mobile /Special Services $06930 $06750 Tokelau $18090 $17910 Tokelau - Mobile /Special Services $18360 $18180 Tonga Islands $05537 $05357 Tonga Islands - Mobile /Special $05027 $04847 Services Trinidad & Tobago $03010 $02830 Trinidad & Tobago - Mobile /Special $02986 $02806 Services Tunisia $03918 $03738 Tunisia - Mobile /Special Services $03918 $03738 Turkey $02736 $02556 Turkey - Mobile /Special Services $03398 $03218 Turkmenistan $06035 $05855 Turkmenistan - Mobile /Special $06035 $05855 Services Turks & Caicos $04024 $03844 Turks & Caicos - Mobile /Special $04455 $04275 Services Tuvalu $20118 $19938 Tuvalu - Mobile /Special Services $49680 $49500 Uganda $03967 $03787 Uganda - Mobile /Special Services $04464 $04284 Ukraine $02462 $02282 Ukraine - Mobile /Special Services $03600 $03420 United Arab Emirates $04342 $04098 United Arab Emirates - Mobile /Special $05850 $05670 Services United Kingdom $00518 $00338 United Kingdom - Mobile /Special $03600 $03420 Services Uruguay $03240 $03060 Uruguay - Mobile /Special Services $03600 $03420 Uzbekistan $02531 $02351 Vanatu - Mobile /Special Services $21389 $21209 Vanatu, Republic of $13702 $13522 Venezuela $01984 $01804 Venezuela - Mobile /Special Services $03454 $03274 OMR #N55756 (QLAGESZ) Page 21 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Vietnam $04500 $04320 Vietnam - Mobile /Special Services $05400 $05220 Wallis & Futuna Islands $22680 $22500 Western Samoa $05718 $05538 Yemen Arab Republic $05054 $04874 Yemen Arab Republic - Mobile /Special $05882 $05702 Services Yugoslavia - Mobile /Special Services $03960 $03780 Yugoslavia (incl Serbia) $03488 $03308 Zaire, Republic of $05718 $05538 Zaire, Republic of - Mobile /Special $06882 $06702 Services Zambia $03967 $03787 Zambia - Mobile /Special Services $04464 $04284 Zimbabwe $03240 $03060 Zimbabwe- Mobile /Special Services $04565 $04385 worldcard Switched Origination to Switched Termination Rate Schedule worldcard Usage Switched Origination — Switched Per Call Termination Rate Per Minute Surcharge US to Canada Per above table $02500 US to International (including Mexico Per above table $05000 ITFS /UIFN In certain countries, the following applications are not permitted for ITFS /UIFN calling card, VRU (Voice Response Unit), operator services, third- country termination, dial tone, dial up access, dead air or any other response the individual carrier deems inappropriate to ITFS Originating carriers treat all carriers equally regarding these restrictions Restrictions on usage are imposed on all other camers, including CenturyLink, by the originating carriers ITFS service orders violating the restrictive guidelines of the originating carrier will not be processed by CenturyLink's ITFS /UIFN implementation group Toll -free originating carvers finding usage in violation of their guidelines can, and will, block toll -free numbers on the originating side of the call without notice or appeal Carriers may change their restrictions to be more restrictive without notice to CenturyLink Information regarding which country has this type of limitation is located in the "ITFS /UIFN Availability Matrix " CenturyLink is able to supply a copy of the ITFS /UIFN Availability Matrix upon request ITFS /UIFN MRC Per Number NRC Per Number ITFS $1000 N/A UIFN $1000 $16000 UIFN is a service which allocates 1 toll free number to be used in multiple foreign countries to call the United States and bill to the number in the United States Countries which are currently available for UIFN are indicated in the table below There is an NRC and an MRC, which are applicable per number, regardless of the number of countries in which the number is active The per minute rates using the UIFN number are the same as the ITFS rates listed in the table below The UIFN nonrecurring charge and monthly rate applies to any CenturyLink product where the customer subscribes to UIFN(s) UIFN Switched Origination - Switched Origination - Country of Origination Switched Termination Dedicated Termination Availability Rate Per Minute Rate Per Minute Anguilla $10260 $10080 Anti qua $05292 $05112 Argentina YES $08730 $08550 Australia YES $01530 $01350 Bahamas $02430 $02250 Bahrain $05148 $04968 Barbados $03330 $03150 Belgium YES $01080 $00900 Bermuda $04212 $04032 Brazil YES $04644 $04464 British Virgin Islands $10260 $10080 Canada $00630 $00450 OMR #N55756 (QLAGESZ) Page 22 © CenturyLink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Cayman Islands $02192 $02012 Chile $03708 $03528 China YES $07740 $07560 Colombia $04212 $04032 Costa Rica $09828 $09648 Cyprus $01662 $01482 Denmark YES $01260 $01080 Dominica $06703 $06523 Dominican Republic $01350 $01170 Fiji $08190 $08010 Finland YES $02430 $02250 France YES $00810 $00630 German YES $00810 $00630 Greece $02107 $01927 Grenada $05710 $05530 Guatemala $08820 $08640 Hong Kong YES $03150 $02970 Hungary YES $05292 $05112 India $09630 $09450 Indonesia $07164 $06984 Ireland YES $00900 $00720 Israel YES $01530 $01350 Italy YES $00810 $00630 Jamaica $02298 $02118 Japan YES $03150 $02970 Korea South YES $09180 $09000 Luxembourg YES $02844 $02664 Macau YES $03780 $03600 Malaysia YES $04860 $04680 Mexico (Zone 1) $01530 $01350 Mexico (Zone 2) $01530 $01350 Mexico (Zone 3) $01530 $01350 Mexico (Zone 4) $01530 $01350 Montserrat $10260 $10080 Netherlands YES $00900 $00720 Netherlands Antilles $06750 $06570 New Zealand YES $01530 $01350 Norwa YES $02430 $02250 Panama $04284 $04104 Peru $12330 $12150 Philippines YES $03150 $02970 Poland $05292 $05112 Portugal YES $02430 $02250 Singapore YES $03150 $02970 South Africa YES $06084 $05904 Spain YES $02430 $02250 St Kitts $05882 $05702 St Lucia $13860 $1 3680 St Vincent/Grenadine $07380 $07200 Sweden YES $02430 $02250 Switzerland YES $02430 $02250 Taiwan YES $05220 $05040 Thailand YES $05652 $05472 Trinidad & Tobago $05292 $05112 OMR #N55756 (QLAGESZ) Page 23 © CenturyLmk, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE W AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT United Kingdom YES $00810 $00630 Venezuela $06084 $05904 Canada Services — To and From Toll Free Services to and from Canada From Canada to United States Switched Origination - $0063 Switched Termination Switched Origination - $0045 Dedicated Termination Toll Free Service Switched termination service Terminating in Canada available onl United States Switched Origination - Canada $0063 Switched Termination worldcard Usage Switched Origination — Switched Per Call Termination Rate Per Minute Surcharge Canada to US $00720 $02500 Canada to International Per US to International rates in $05000 Section 5 1 worldcard International Origination to U S Termination Switched Origination — Per Call Surcharge Country of Origination Switched Termination Rate per Minute Antigua Barbuda $14040 $1 0000 Argentina $14040 $10000 Australia (Tasmania, Chismas Islands, Cocos $05544 $10000 Islands Austria $07200 $10000 Bahamas $1 1448 $10000 Bahrain $20250 $10000 Barbados $08352 $10000 Belarus (Vitebsk, Grodno, Brest, Minsk, Moghilev, $1 1520 $1 0000 Gomel Belgium $07200 $10000 Bermuda $1 1250 $10000 Bolivia $18360 $10000 Brazil $07488 $10000 Brunei $22536 $10000 Bulgaria $1 1520 $10000 Chile $10440 $10000 China $1 2384 $10000 Colombia San Andres Isl $09720 $10000 Cook Island $71400 $10000 Costa Rica $08136 $10000 Croatia $1 1520 $10000 Cyprus $11520 $10000 Czech Republic $10440 $10000 Denmark $07200 $10000 Dominica $13500 $10000 Dominican Republic $08280 $10000 Egypt $14040 $10000 El Salvador $14040 $10000 Fm Islands $22536 $10000 Finland $07200 $10000 OMR #N55756 (QLAGESZ) Page 24 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT France Corsica Island $04608 $10000 French Guiana $1 1255 $10000 German $04536 $10000 Greece $09936 $1000 Guadeloupe (St Barthelemy, St Martin French $11255 $10000 Part Mane Galante Hong Kong $05904 $10000 Hungary $07200 $10000 Iceland $08568 $10000 India $27000 $10000 Indonesia Do not cover East Timor $13104 $10000 Ireland $06840 $10000 Israel -Beze Not cover Palestinian Territories $09648 $1 0000 Italy Elba Island San Marino Vatican City) $06480 $10000 Japan $05616 $10000 Jordan $17400 $10000 Kenya $21600 $10000 Korea South $10368 $10000 Lativa $14040 $10000 Lithuania $10440 $10000 Luxembour $07200 $10000 Macedonia $16200 $10000 Mala sia Peninsular Malaysia and East Malaysia) $12312 $1 0000 Malta $09000 $10000 Martinique $14040 $10000 Mauritius $22536 $10000 Mexico $09288 $10000 Monaco $07200 $10000 Netherlands $04392 $10000 New Zealand Chatham Islands $1 1520 $10000 Nicaragua $14328 $10000 Norway Jan Mayen, Svalbard Islands $07200 $10000 Pakistan $12600 $10000 Panama $14040 $10000 Peru $08568 $10000 Philippines $11376 $10000 Poland $10584 $10000 Portu al Azores Madeira $1 1016 $10000 Reunion Island France $0 9000 $10000 Romania $13500 $10000 Russia $1 1520 $10000 Senegal $22536 $10000 Singapore $1 1520 $10000 Slovak Republic $1 1520 $10000 Slovenia $03396 $10000 South Africa $09504 $10000 Spain (Balearic Island, Canary Islands, Ceuta, $08784 $10000 Melilla Islands Sri Lanka $18000 $10000 St Kitts & Levis $14040 $10000 St Pierre $14040 $10000 Sweden $07200 $10000 Switzerland Do not cover Liechtenstein $07200 $10000 Syrian Arab Republic $17550 $10000 Taiwan $05976 $10000 Thailand $13608 $10000 Trinidad & Taba o $13500 $10000 Ukraine $11520 $10000 OMR #N55756 (QLAGESZ) Page 25 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE' AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT United Arab Emirates $08400 $10000 United Kingdom (England, Scotland, Wales, Nothem Ireland, Isle of Man, Guernsey, Channel $03168 $10000 Island Venezuela (Margarita Island $08100 $10000 Vietnam $17604 $10000 worldcard International Origination to International Termination Switched Origmabon — Per Call Country of Origination Switched Termmabon Surcharge Rate per Minute Argentina $14774 $10 Australia (Tasmania, Christmas Islands, Cocos Islands $07135 $100 Austria $08864 $100 Azores (Portugal) $17609 $100 Belgium $07270 $100 Bolivia $24001 $100 Chile $16124 $100 China $17226 $100 Colombia San Andres Isl $16832 $100 Croatia Republic of $14999 $1 00 Czech Republic $1 1768 $100 Denmark $05807 $100 Dominican Republic $10645 $100 El Salvador $12861 $100 Finland $06370 $100 France Corsica Island $05245 $100 French Guyana $14346 $1 00 German $06721 $100 Greece $09092 $100 Guadeloupe (St Barthelemy, St Martin French Part, $14346 $100 Marie Galante Hong Kong $05605 $100 Hungary $09824 $100 Iceland $12524 $100 Ireland $09809 $100 Israel -Beze Not cover Palestinian Territories $09998 $1 00 Italy Elba Island, San Manno, Vatican City) $07614 $100 Japan $09745 $100 Korea South $07101 $100 Latvia $09850 $100 Luxembourg $08586 $100 Macedonia $23663 $100 Madeira Islands $17609 $100 Martinique $16463 $100 Mexico $10836 $100 Monaco $09938 $100 Netherlands $0 5234 $100 New Zealand Chatham Islands $06820 $100 Norway Jan Mayen Svalbard islands $06280 $100 Panama $07758 $100 Philippines $10274 $100 Poland $09722 $100 OMR #N55756 (QLAGESZ) Page 26 © Centuryl-ink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE W AGREEMENT INTERNATIONAL VOICE SERVICE EXHIBIT Portugal Azores Madeira $17609 $1 00 Reunion Island $14346 $100 Russia $16124 $100 San Manno $07614 $100 Sm a ore $05189 $100 Slovak Republic $16911 $100 South Africa $13446 $1 00 Spain (Balearic Island, Canary Islands, Ceuta, Melilla Islands) $0 7742 $1 00 St Pierre & Miquelon $14346 $100 Sweden $05796 $1 00 Switzerland Do not cover Liechtenstein $04289 $1 00 Ukraine $20061 $100 United Kingdom (England, Scotland, Wales, Northern Ireland, Isle of Man, Guernsey, Channel $06314 $100 Island Vatican City $07614 $100 OMR #N55756 (QLAGES2) Page 27 © CenturyLink, Inc All Rights Reserved FOR INFORMATIONAL PURPOSES ONLY v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT ISDN PRS, DSS ADVANCED OR UAS SERVICE EXHIBIT INDIVIDUAL CASE BASIS 1 General; Definitions In order to qualify for the pricing in the Pricing Attachment under this individual case basis service exhibit ( "Service Exhibit"), Customer must order the total circuits indicated on the Pricing Attachment for each state, for CenturyLmk QC Integrated Services Digital Network Primary Rate Service ("ISDN PRS "), or Digital Switched Service ( "DSS ") with "Advanced" or "Basic" trunks, or Uniform Access Solution Service ( "UAS ") (individually and collectively referred to as the "Service") The Minimum Circuits must be installed within 30 days of the Effective Date ( "Ramp Period "), unless an installation delay is caused by CenturyLmk, and must remain installed during the Term of this Agreement The circuits may be aggregated across Centuryl-ink's local serving areas in Arizona, Colorado, Idaho, Iowa, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming CenturyLmk will provide Service under the terms of the Agreement, Tariff, and this Service Exhibit CenturyLmk may be required to submit this Service Exhibit and any subsequent addenda for the Service to certain regulatory agencies for approval because the rates and some terms in this Service Exhibit are being offered on an individual case basis ( "ICB ") The service specific rates, and the terms and conditions in the Termination Section of this Service Exhibit ( "ICB Terms ") require filing with or approval by regulatory agencies Although the general terms and conditions of this Service Exhibit are effective on the Effective Date, the ICB Terms will not become effective for a given jurisdiction until the filing and approval requirements for that jurisdiction are fulfilled The Service will be offered in accordance with the applicable Tariff until the ICB Terms become effective If Customer receives reduced pricing under this Service Exhibit and a regulatory agency later invalidates the ICB Terms after they had become effective, Customer will pay to CenturyLmk any difference in the amounts listed in the applicable Tariff for the Service and the amounts Customer was charged for the Service When approved by the regulatory agencies, Customer may add additional quantities of Services pursuant to the Service Changes Section under the same terms and conditions with no further filing required In the event a regulatory agency does not approve this Service Exhibit, the parties will enter into good faith negotiations to mutually resolve the failure to receive the necessary approval This Service Exhibit will remain in full force and effect for the Service in all other jurisdictions Other than the ICB Terms in this Service Exhibit, the Service will be governed by (i) the Tariff applicable to the Service, and (u) to the extent a comparable Tariff term or condition does not apply to the Service, the terms and conditions set forth in this Service Agreement Capitalized terms not defined herein are defined in the Agreement "Minimum Circuits" means the total circuits initially ordered for all states, as shown on each state's Pricing Attachment "Minimum Service Period" means 12 months from the Start of Service date "Pricing Attachment" means the document containing Rates, Service Term and other location- specific information, which is incorporated by reference and made a part of this Service Exhibit "Rates" means the MRCs and NRCs for the Service "Service Term" means the term length for Service on the Pricing Attachment(s), which will commence on the Start of Service date for the first Service added on the Pricing Attachment "Start of Service" means the effective bill date of the service order to add Service to Customer's account, as evidenced by CenturyLmk records 2 Service Service is subject to Tech Pub 77400 2 1 Service Description (a) ISDN PRS If Customer purchases ISDN PRS, CenturyLmk will provide digital intraLATA, intrastate, switched local exchange telecommunications service utilizing ISDN PRS technology that transports and distributes voice, data, image, and facsimile communications separately or simultaneously over the public, switched, local exchange network An ISDN PRS circuit includes a DS1 facility, an ISDN PRS service configuration, and trunks ISDN PRS operates at 1 544 megabits per second (Mbps) ISDN PRS may be configured as 23 B channels and one D channel, 24 B channels only (24B), or 23 B channels and one back -up D channel (23B +BUD) Each B channel transmits voice or data at 64 kilobits per second (Kbps) The D channel carries signaling information at 64 Kbps (b) ISDN PRS -UAS If Customer purchases ISDN PRS, Customer may also select Uniform Access Solution service as an optional feature as that service is defined in the Tariff under Primary Rate Service An ISDN PRS -UAS circuit provides digital service with single- number route indexing, which includes a DS1 facility with common equipment, and a network connection which provides for local exchange, toll network access Each DS1 facility utilizes channels configured as (i) in -only trunking, or (u) two -way trunking (c) DSS if Customer purchases DSS, CenturyLmk will provide Customer with a circuit that includes a digital DS1 facility, common equipment to interconnect with Centuryl-ink's local exchange switching office and Advanced or Basic flat -usage trunks and DID trunk termination for access to the local exchange and toll networks DSS Advanced and Basic operates at a maximum speed of 1 544 Mbps (d) UAS If Customer purchases UAS, CenturyLmk will provide Customer with a digital circuit with single- number route indexing, which includes a DS1 facility with common equipment, and a network connection which provides for local exchange, toll network access Each DS1 facility utilizes channels configured as (i) in -only trunking, or (u) two -way trunking 22 Information Service Providers Customer represents and warrants that it (check one box) ® IS NOT a provider of "information service," as that term is defined in 47 U S C §153 (20) OMR #N55756 (QLAGES2) Page 28 © CenturyLmk, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE" AGREEMENT ISDN PRS, DSS ADVANCED OR UAS SERVICE EXHIBIT INDIVIDUAL CASE BASIS ❑ IS a provider of "information service," as that term is defined in 47 U S C §153 (20), and that ISDN PRS under this Service Exhibit WILL NOT be used to provide information service to its Subscribers, including termination or origination of Voice over Internet Protocol ( "VoIP ") "Subscribers" means any entity to which Customer provides information service If at any time during the Exhibit Term of this Service Exhibit this representation and warranty is no longer accurate, Customer agrees to notify CenturyLink and execute an amendment to add the ISP Certification Addendum ❑ IS a provider of "information service", as that term is defined in 47 U S C §153 (20), and that ISDN PRS under this Agreement WILL be used to provide information service to its Subscribers, including but not limited to termination or origination of Voice over Internet Protocol ( "VoIP ") and therefore agrees to the additional terms and conditions set forth in the ISP Certification Addendum attached hereto and incorporated herein by reference "Subscribers" means any entity to which Customer provides information service 23 Service Provided (a) CenturyLink will provide and maintain the Service at the locations specified in the Pricing Attachment(s), and as requested on any subsequent order for Seance or amendment to this Agreement (b) CenturyLink will notify Customer of the date Service is available for use In the event Customer informs CenturyLink that it is unable or unwilling to accept Service at such time, the subject Service will be held available for Customer for a period not to exceed 30 business days from such date ( "Grace Penodl If after the Grace Period, Customer still has not accepted Service, CenturyLink may either (i) commence with regular monthly billing for the subject Service, or (ii) cancel the subject Service If Customer cancels an order for Service prior to the date Service is available for use, or is unable to accept Service during the Grace Period and CenturyLink cancels the Service at the end of the Grace Period, the Tariff cancellation charges may apply 24 Customer Responsibilibes for 911 Call Routing (a) Customer understands and acknowledges that the PBX's main number Automatic Number Identification (ANI) may be forwarded to a Public Safety Answering Point ( "PSAPI during a 911 call DID digits assigned to a PBX station may not be used for 911 calls unless an Automatic Location Identification (ALI) record has been created for the DID number (b) Customer's PBX must be capable of recognizing "911" or "9911" digits as a complete dialing sequence, and routing those calls as an outbound local call (c) Customer hereby agrees to release CenturyLink from any liability if an incorrect telephone number is forwarded to a PSAP as a result of PBX or ISDN PRS signaling parameters set by Customer 25 Service Changes (a) Moves Customer may move the physical location of all or part of a Service to another location within a CenturyLink serving area, provided the following conditions are met (i) Service moved to the new location is provided to Customer by CenturyLink, (ii) Customer advises CenturyLink that Service at the new location replaces the existing Service, (iii) Customer's request for disconnection of the existing Service and installation of the Service at the new location are received by CenturyLink on the same date, (iv) Customer requests that CenturyLink install the Service at the new location on or prior to the disconnection date of the existing Service, and (v) Customer agrees to pay all applicable rate and charges for the requested move and Service at the new location (b) Additions to Service Service may be added under a pricing Attachment up to 12 months prior to the expiration date its Service Term, at the MRCs specified therein CenturyLink will supply such additions to Customer, subject to the following conditions (i) the necessary facilities are available as determined by CenturyLink to provide the Service, and (ii) a new Minimum Service Period is established for each new addition to Service If the Service being added is not itemized in the Pricing Attachment, Customer agrees to execute a written amendment evidencing such addition to Service (c) Additions During Last 12 Months of Term Service ordered during the last 12 months of the Term must be added (a) pursuant to a new agreement that may include the existing Service, or (b) on a month -to -month basis at the rates in effect in the Tariff 26 Out-of-Service Credit If CenturyLink causes a Service interruption, an out-of-service credit will be calculated under the state local exchange Tanff If there is no applicable Tariff and the interruption lasts for more than 24 consecutive hours after CenturyLink receives notice of it, CenturyLink will give Customer a credit calculated by dividing the MRC for the affected Service by 30 days and multiplying that daily rate by the number of days that Service was interrupted 27 Use of Service Customer represents and warrants that it will use ISDN PRS and its optional features for communication purposes only If CenturyLink determines that ISDN PRS or any optional feature is being used inappropriately, CenturyLink may disconnect the ISDN PRS service or feature without notice in accordance with any applicable termination provision of the Tanff, and the Termination Charges specified in the Termination section below may apply 3 Exhibit/Service Term, Termination 31 Exhibit/Service Term This Service Exhibit will begin on the Effective Date of the Agreement (or an amendment to the Agreement if Customer adds this Service Exhibit after the Effective Date of the Agreement) and will continue until the expiration or cancellation of the last to expire (or cancel) Service ( "Exhibit Term ") The Service Term for each Service will be indicated on a Pricing OMR #N55756 (QLAGESZ) Page 29 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE AGREEMENT ISDN PRS, DSS ADVANCED OR UAS SERVICE EXHIBIT INDIVIDUAL CASE BASIS Attachment Each Service ordered will have its own Minimum Service Period Any Service installed for 12 consecutive months prior to being added under a Pricing Attachment will be deemed to have met the Minimum Service Period At the conclusion of the Service Term, the MRC will revert to the month -to -month rate in the Tanff, unless Service is renewed for a new Service Term on a Pricing Attachment or new agreement 32 Terminabon (a) Either party may terminate this Service Exhibit in accordance with the applicable Tariff or for Cause Customer may disconnect the number of "Permitted Disconnects" indicated on the Pricing Attachment, if any, without incurring a Termination Charge, provided that such Service has satisfied the requirements of the Minimum Service Period before any termination may be effective If, prior to the conclusion of the Service Term, Service is terminated in excess of the Permitted Disconnects, either by CenturyLmk for Cause or by Customer for any reason other than Cause, then Customer will also be liable for 100% of the MRC for terminated Service in excess of the Permitted Disconnects times the number of months (or fraction thereof) remaining (if any) in the Minimum Service Period, and 50% of the MRC times the number of months (or fraction thereof) remaining in the Service Term after the Minimum Service Period ( "Termination Charge ") If no Permitted Disconnects are indicated on the Pricing Attachment, Customer will pay the Termination Charge for each circuit terminated, either by CenturyLmk for Cause or by Customer for any reason other than Cause, prior to the Service Term (b) A Termination Charge will be waived when all of the following conditions are met (i) Customer discontinues Service and signs a new service agreement(s) for any other CenturyLmk provided service(s), (n) the new service agreement(s) have a total value equal to or greater than 115% of the remaining prorated value of the existing agreement(s) (excluding any special construction charges, applicable nonrecurring charges, or previously billed but unpaid recurring and nonrecurring charges), (m) Customer places the orders to discontinue the Service and establish new service at the same time (within 30 calendar days of each other if service is in New Mexico), (iv) the new service(s) installation must be completed within 30 calendar days of disconnection of the Service, unless such installation delay is caused by CenturyLmk, and (v) a new minimum service period, if applicable, goes into effect when the new service agreement term begins The waiver does not apply to changes between regulated and unregulated or enhanced products and services 3 Charges 41 Charges for the Service are as set forth in the Pricing Attachment Customer will pay the total MRC and NRC for the Service specified in the Pricing Attachment For Service requested on any subsequent orders or amendments to this Agreement, Customer will also pay the total MRC and NRC specified on the subsequent orders or amendments The MRC for the Service is based on the then current Service Term set forth in the Pricing Attachment and will not change during the Service Term provided that the Minimum Circuits are installed by the end of the Ramp Period and the total circuits do not drop below the Minimum Circuits threshold If due to Customer's request, actions or failure to act, the Minimum Circuits are not installed by the end of the Ramp Period or drop below the Minimum Circuits threshold, CenturyLmk may adjust the pricing and Permitted Disconnects defined herein based on the actual number of circuits installed Such adjusted pricing will be effective immediately following the rate adjustment The MRCS will be used to calculate Contributory Charges Customer will not be eligible for any discounts or promotions other than those specifically set forth herein Such promotions will not be effective unless the applicable promotion term sheet is appended to this Service Exhibit 42 If the MRCs herein are based upon Customer's intent to transition DS1 facilities to contracted DS3 or higher facilities ('Higher Facility) when available as indicated in a Prang Attachment, Customer will have ten business days from the date the contracted Higher Facility is installed to migrate the Service contained herein to the contracted Higher Facility In the event Customer's Service is not migrated, a pricing adjustment will be made to all DS1 facilities in service The adjustment will be retroactive to the original installation date, as evidenced by CenturyLmk records, and will be the difference between the rates provided herein based on the facilities riding a Higher Facility and the applicable rates for facilities not riding a Higher Facility 43 If Service is not available in Customer's wire center, standard interoffice private line mileage charges ( "Mileage MRC" and "Mileage NRC ") for transport between switches will apply in addition to the rates and charges for the Service ATTENTION FINAL EXECUTED AGREEMENT, THIS SERVICE EXHIBIT AND THE PRICING ATTACHMENT MUST BE FORWARDED TO THE APPROPRIATE STATE REGULATORY FILING MANAGER OMR #N55756 (QLAGES2) Page 30 © CenturyLmk, Inc All Rights Reserved CONFIDENTIAL v1 081111 CENTURYLINK LOYAL ADVANTAGE TM AGREEMENT ISDN PRS, DSS ADVANCED OR UAS SERVICE EXHIBIT INDIVIDUAL CASE BASIS FOR THE STATE OF WASHINGTON PRICING ATTACHMENT CITY OF BREMERTON Customer Service Term 24 Months AQCB Contract Number Type of Service USOC & MRC /line for NRC 24 month Tenn PRS Voice /Data DS1 $36500 $0 00 Higher Facility Service Location (Yes or Total MRC ( including City & State Circuit ID or BTN Type of Service No Qty per Location 1025 Burwell PRS Voice /Data DS1 Bremerton, WA (USOC ) No 1 $35000 345 6 Street, PRS Voice /Data DS1 Bremerton, WA 98337 (USOC ) No 1 $35000 7261 Belfair Valley Rd PRS Voice/Data DS1 WA (USOC ) No 1 $35000 Total Circuits 3 Permitted Disconnects 0 Total MRC $1,05000 OMR #N55756 (QLAGESZ) Page 31 © CenturyLink, Inc All Rights Reserved CONFIDENTIAL v1 080811 Lori Smith From Lori Smith on behalf of City Council Sent Wednesday, April 24, 2013 2 33 PM To City Council Subject FW (Response) - Item 4A Renewal of Service Agreement with Century Link for Long Distance Service Attn Council Members (FYI) From: Kevin Matthew Sent: Wednesday, April 24, 2013 2 09 PM To: City Council Cc: Becky Hasart Subject: Answers to questions raised during yesterday's finance committee meeting Lori, A few members of the Finance committee had some questions yesterday regarding the Telecommunications item coming up this evening Why a T1 Line? A T1 line is a means of transporting voice traffic at a rate of 1 544 Mbps, or 1,544,000 bits per second It was developed by Bell Labs in the 1960's and is still the preferred method of connecting customer PBX's to the Public Switched Telephone Network (PSTN) The reliability of a T1 line is much greater than standard telephone lines or DSL Therefore, telephone companies give T1 lines a much greater level of service Most T1's come with a Service Level Agreement (SLA) as part of the lease that will guarantee such things as speed and uptime This level of service is a critical element in our ability to provide reliable business service and emergency 911 communications for all our phone extensions Long Distance Increased competition has seen the cost of long distance phone calls drop in recent years Most private cell phone plans include free long distance as do certain VoIP internet phone services Some vendors will offer different plans that include a monthly fee in exchange for a certain number of "free" long distance minutes In all cases, the costs to provide long distances services is either bundled into the basic rates or charged separately As a consumer of commercial grade telecommunications services, the City of Bremerton's must contract for its long distance service Since our PBX is connected to Centuryl-ink, any long distance call placed will be automatically delivered to our contracted long distance provider for completion Our current long distance provider is actually Centuryl-ink This new agreement will bring our existing rates down to competitive levels Kevin Matthew Manager, Information Technology City of Bremerton (360) 473 -5473 Kevin Matthew @ci bremerton wa us Lori Smith From Lori Smith on behalf of City Council Sent Wednesday, April 24, 2013 2 33 PM To City Council Subject FW (Response) - Item 4A Renewal of Service Agreement with Century Link for Long Distance Service Attn Council Members (FYI) From: Kevin Matthew Sent: Wednesday, April 24, 2013 2 09 PM To: City Council Cc: Becky Hasart Subject: Answers to questions raised during yesterday's finance committee meeting Lori, A few members of the Finance committee had some questions yesterday regarding the Telecommunications item coming up this evening Why a T1 Line? A T1 line is a means of transporting voice traffic at a rate of 1 544 Mbps, or 1,544,000 bits per second It was developed by Bell Labs in the 1960's and is still the preferred method of connecting customer PBX's to the Public Switched Telephone Network (PSTN) The reliability of a T1 line is much greater than standard telephone lines or DSL Therefore, telephone companies give T1 lines a much greater level of service Most T1's come with a Service Level Agreement (SLA) as part of the lease that will guarantee such things as speed and uptime This level of service is a critical element in our ability to provide reliable business service and emergency 911 communications for all our phone extensions Long Distance Increased competition has seen the cost of long distance phone calls drop in recent years Most private cell phone plans include free long distance as do certain VolP internet phone services Some vendors will offer different plans that include a monthly fee in exchange for a certain number of "free" long distance minutes In all cases, the costs to provide long distances services is either bundled into the basic rates or charged separately Asa consumer of commercial grade telecommunications services, the City of Bremerton's must contract for its long distance service Since our PBX is connected to Centuryl-ink, any long distance call placed will be automatically delivered to our contracted long distance provider for completion Our current long distance provider is actually CenturyLink This new agreement will bring our existing rates down to competitive levels Kevin Matthew Manager, Information Technology City of Bremerton (360) 473 -5473 Kevin Matthew @a bremerton wa us i AGENDA BILL CITY OF BREMERTON CITY COUNCIL ......................................................... ............................... SUBJECT: Appointment of a Senior Study Session Date Planner in Community Development at a COUNCIL MEETING Date May 1, 2013 step higher than Rate 1 in Pay Band 11 of Department DCD Management, Professional, Confidential & Presenter Andrea L Spencer Fiduciary Salary Plan 2013 Phone 360 473 5283 SUMMARY: The Director of Community Development proposes to fill the vacant position of Senior Planner with Nicole Floyd, an individual who has worked for DCD since 2005 Nicole has a demonstrated track record with the city of successful project management, excellent permit review skills and an exceptional ability to work with our varied customers The Director has negotiated salary compensation with the Ms Floyd and proposes making this appointment at Rate 5 of Pay Band 11 Pursuant to the promotion provisions contained in BMC 2 50 032(c)(3) this advancement requires City Council Approval ATTACHMENTS: Ms Floyd's resume is on file with Human Resources FISCAL IMPACTS (Include Budgeted Amount) None The salary can be accommodated within the 2013 personnel budget for DCD STUDY SESSION AGENDA 0 No Presentation ❑ Full Presentation STUDY SESSION ACTION: 0 Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION Move to approve the promotion of Nicole Floyd as Senior Planner at Pay Band 11, Rate 5, of the 2013 City of Bremerton Management, Professional, Confidential & Fiduciary Salary Plan COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/25/13 AGENDA BILL 7A CITY OF BREMERTON CITY COUNCIL SUBJECT: Amendment to previous Council Study Session Date motion to Eastside Beach Main COUNCIL MEETING Date May 1, 2013 Replacement project Department PW & U Presenter Chal Martin Phone 473 -5758 SUMMARY: Bids were opened for this project on April 2, 2013 and Council previously approved the execution of a contract with Rognlin's Construction for this project pending the receipt of the necessary environmental permits At this point the permits have been delayed pending a 30 day comment period In order to ensure that the contractor can access the beach as early as possible during the mandated fish window the 3000 feet of 24" diameter high density polyethylene (HDPE) pipe needs to be purchased as soon as possible Staff is recommending execution of the construction contract with Rognlin's Construction with phased notice to proceed only being issued for the pipe purchase pending the issuance of the environmental permits ATTACHMENTS: �. ,pyL ( Cc ur / t4A-'vLA G n Apr►1 17, -Lo l3 .1 FISCAL IMPACTS (Include Budgeted Amount) This project is included in the 2013 Budget and is fully funded by wastewater rates The budget amount is $1,250,000 STUDY SESSION AGENDA ❑ No Discussion ❑ Full Presentation STUDY SESSION ACTION: ❑ Consent Agenda ® General Business ❑ Public Hearing RECOMMENDED MOTION: Move to authorize the Mayor to finalize, execute, and amend the agreement as necessary with substantially the same terms and conditions as presented to allow purchase of the pipe materials prior to the permits being issued COUNCIL ACTION: ❑ Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02/12 Kal acl on. AGENDA BILL ' CITY OF BREMERTON CITY COUNCIL C Fpm PrPr +( 17) SUBJECT: Bid Award to Rognlin's Inc Study Session Date April 10, 2013 for the Eastside Beach Sewer Main COUNCIL MEETING Date April 17, 2013 Replacement Project Department PW & U Presenter Chal Martin/Tom Knuckey Phone 473 -5758 SUMMARY: The work to be completed under this contract consists of installing approximately 3000 feet of 24" diameter high density polyethylene (HDPE) pipe to replace the existing 20" asbestos - cement pipe located on the beach in East Bremerton The existing 20" pipe was installed in 1947 and is scheduled for replacement The existing pipe is also exposed at one location and shallow buried at other locations Accomplishing the work requires coordination with permitting agencies The contract will not be awarded until all necessary environmental permits have been issued to the City There were eight (8) bids Roanlin's Inc was the lowest responsible, responsive bidder in the amount of $878,98125 (which includes sales tax) ATTACHMENTS: 1 Council Summary, 2 Site Plan, 3 Agreement, and 4 Bid Tabulation FISCAL IMPACTS (Include Budgeted Amount) This project is included in the 2013 Budget and is fully funded by wastewater rates The budget amount is $1,250,000 STUDY SESSION AGENDA ® No Discussion ❑ Full Presentation STUDY SESSION ACTION: ® Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve the bid for Eastside Beach Main Replacement from Ro4nlm's Inc in the amount of $878,98125 (which includes sales tax) and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented upon receiving all necessary environmental permits COUNCIL ACTION: [Approve El Deny ❑ Table ❑ Continue ❑ No Action Form Updated 11/02112