HomeMy WebLinkAbout5964 TOURISM PROMOTION SERVICES AGREEMENT
Dominion Historical Workboat Association
The City of Bremerton ("City") and Dominion Historical Workboat
Association("Organization"), referred to collectively as the "Parties," enter into the following
Agreement for Tourism Promotion services:
L Scope: The Organization shall provide tourism promotion services for the City. Tourism
promotion shall mean activities and expenditures designed to increase tourism to the City.
Tourism promotion activities may include, but are not limited to, advertising, publicizing, or
otherwise distributing information for the purpose of attracting and welcoming tourists to the City.
The Organization shall provide to the City a work plan attached hereto as Exhibit A setting forth
its goals and objectives for successful tourism promotion. The event(s)promoted by Organization
must occur within the agreement Term, unless otherwise agreed to in writing by the City.
II. Term: This agreement shall commence on January 1, 2019 and shall continue in full force
and effect until December 31, 2019 unless terminated earlier pursuant to Section IX of this
Agreement.
III. Compensation: In consideration of the services provided pursuant to this Agreement City
shall pay the Organization an amount not to exceed Four Thousand Dollars ($4,000.00) for
Tourism Promotion services. However, funding for this Agreement is subject to the actual
Hotel/Motel Tax funds received by the City. If Hotel/Motel Tax receipts are lower than budgeted
funding may be decreased.
Payment will be released when the following has been fulfilled:
a. The Organization shall submit monthly billing invoices, by the 15th of the month,
following the month in which services were performed, detailing how activities and
services performed by the Organization during the preceding month have specifically
promoted tourism in the City of Bremerton including measurable results.
b. The Organization will provide proof of insurance, agree to the use of Automated
Clearing Housing (ACH) Direct Deposit, a signed W-9, and current City Business
license.
Upon receipt of a conforming billing invoice,the City shall promptly process payment. If a billing
invoice does not conform to this Agreement, the City may withhold payment until the invoice is
brought into compliance. Sample of a conforming invoices and support is provided in Exhibit B.
a. Such withholding does not relieve the Organization of its obligations under this
Agreement. Failure by the Organization to submit all conforming billing
invoices by January 10th,2020 after the expiration of this Agreement may result
in the forfeiture of remaining unbilled compensation.
The Organization shall not perform work beyond the Scope of Work,nor shall be compensated for
such work, unless the Scope of Work or amount of compensation is modified pursuant to this
Agreement.
Bremerton/DHWA
Page 1 of 4
IV. Relationship of Parties: The Organization represents that it is skilled in the matters
addressed in the Scope of Work and is performing independent functions and responsibilities
within its field of expertise. The Organization and its personnel are independent contractors and
not employees of the City. The Organization and its personnel have no authority to bind the City
or to control the City's employees and other contractors. None of the benefits provided by the
City to its employees, including, but not limited to, compensation, insurance, and unemployment
insurance are available from the City to the employees, agents,representatives, or sub-consultants
of the Organization. Organization will be solely and entirely responsible for its acts and for the
acts of the Organization's agents, employees, representatives and sub-consultants during the
performance of this Agreement. The City may, during the term of this Agreement, engage other
independent contractors to perform the same or similar work.
As an independent contractor, the Organization is responsible for its own management.
The City's administration and enforcement of this Agreement shall not be deemed an exercise of
managerial control over Organization or its personnel.
As an independent contractor, Organization is responsible for payment of all taxes and
licensing fees necessary to perform its obligations under this Agreement. These taxes and fees
include but are not limited to State industrial insurance,Business&Occupation, State professional
licensing, and City business licensing. If any taxes or fees due the City have been declared
delinquent,the City may withhold the delinquent amount,plus any additional charges arising from
the delinquency, from any payments due Organization.
V. Indemnification: Organization shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages,
losses or suits, including all legal costs and attorney fees, arising out of or in connection with the
performance of this Agreement, except for that portion of the injuries and damages caused by the
City's sole negligence.
The City's review or acceptance of any of the work when completed shall not be grounds
to avoid any of these covenants of indemnification.
The provisions of this section shall survive the expiration or termination of this Agreement.
VI. Insurance: Prior to and during the performance of the work covered by this Agreement,
Organization shall provide the Risk Manager for the City with evidence that it has obtained and
maintains in full force and effect during the term of this Agreement liability
insurance coverage of at least $500,000.00 per occurrence. In the event Organization organizes,
promotes or sponsors an event involving the sale or consumption of food or alcoholic beverages,
Organization shall also provide evidence that it has obtained products liability and liquor liability
insurance of at least $500,000.00 per occurrence, for each event. The City shall be named as
additional insured and it shall be an affirmative obligation upon Organization to advise the City's
Risk Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of
Bremerton, Attn: Risk Management, 345 6th Street, Suite 100, Bremerton, WA 98337 within two
days of the cancellation, suspension or substantive change of any insurance policy set out herein,
and failure to do so shall be construed to be a breach of this Agreement.
Bremerton/DHWA
Page 2 of 4
•
- e • -- - •. ary ann - y- surance-as-respects
_the-City.-and-shall_contain a waiver of subrogation against-the City for claims arising out of any,--
-operation, bilines a dons-t o age-appli.es,, /6L-
VII. General Conditions:
A. Reports and Information: When requested by the City, Organization shall furnish periodic
reports and documents on matters covered by this Agreement. The reports and documents shall
be furnished in the time and form requested per Exhibit B. Organization shall maintain accounting
records in accordance with Generally Accepted Accounting Principles (GAAP) to substantiate all
billed amounts.
B. Work Performed at Organization's Risk: Organization shall take all precautions necessary and
shall be responsible for the safety of its employees, agents, and sub-consultants in the performance
of the work hereunder and shall utilize all protection necessary for that purpose. All work shall be
done at Organization's own risk, and Organization shall be responsible for any loss of or damage
to materials, tools, or other articles used or held for use in connection with the work.
C. Place of Work: The Organization shall perform the work authorized under this Agreement at
its offices in Bremerton, Washington. Any necessary meetings with the City staff shall take place
at the City's offices, or at locations mutually agreed upon by the parties.
D. Entire Agreement: This Agreement and its Exhibits constitutes the entire agreement between
the Parties, and the Parties acknowledge that there are no other agreements, written or oral, that
have not been set forth in the text of this Agreement.
E. Severability: Should any part of this Agreement be found void, the balance of the Agreement
shall remain in full force and effect.
F. Modification: This Agreement may only be modified by written instrument signed by both
Parties.
G. Written Notices: All communications regarding this Agreement shall be sent to the parties at
the addresses listed below by registered or 1st class mail, or by personal service, and shall be
deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such
other address as may be hereafter specified in writing.
City Address Organization Address
City Clerk Executive Director
345 6a' Street, Suite 100 400 Washington Ave, #311
Bremerton, WA 98337 Bremerton WA 98337
H. Waiver: Failure to enforce any provision of this Agreement shall not be deemed a waiver of
that provision. Waiver of any right or power arising out of this Agreement shall not be deemed
waiver of any other right or power.
Bremerton/DHWA
Page 3 of 4
I. Non-Waiver of Breach: The failure of the City to insist upon strict performance of any of the
covenants and agreements contained herein, or to exercise any option herein conferred in one or
more instances shall not be construed to be a waiver or relinquishment of said covenants,
agreements or options, and the same shall be and remain in full force and effect.
J. Compliance with Laws: Organization shall comply with all applicable Federal, State, and local
laws in performing its obligations under this Agreement.
K. Choice of Law and Venue: This Agreement shall be interpreted according to the laws of the
State of Washington. Any judicial action to resolve disputes arising out of this Agreement shall
be brought in Kitsap County Superior Court.
L. Attorneys' Fees: In the event of litigation to enforce any of the terms or provisions herein, each
party shall pay all its own costs and attorney's fees.
M. Assignment: Any assignment of this agreement by the Organization without the written
consent of the City shall be void.
VIII. Nondiscrimination: Organization shall not discriminate in employment or services to the
public on the basis of race, color, national origin, sex, religion, age, marital status, sexual
orientation or disability, except for employment actions based on bona fide occupational
qualification.
IX. Termination: This Agreement may be terminated by either party for convenience upon
thirty (30) days written notice to the other party, or for cause if either party fails substantially to
perform through no fault of the other and does not commence correction within five (5) days of
written notice and diligently completes the correction thereafter. Upon such termination, City will
be entitled to reports showing the status of all services Organization is providing to the City as of
the effective date of termination.
X. Termination of Other Contracts. This Agreement shall supersede all prior Agreements
between the parties relating to the use of Hotel/Motel Tax.
CITY OF BREMERTON DOMINION HISTORICAL
WORKBOAT ASSOCIATION
�. ._.�- l __ - , /
By: )114ZWheeler By: David Clark '``
its: Mayor its:l „Ap, '4_,
Date: Marr, 2°t v Zo (°I Date: 12 `3b—/ t
Approved as to form: Attest:
l ' .'- i .1 r,'l I Jai t
BrC.emerton Attorne ity Cl:
Bremerton/DHWA
Page 4 of 4
EXHIBIT A
Scope of Services
The funding will be used to: develop marketing material showcasing the organization's mission and
promotes the Bremerton community.
A. Dominion Tug will do this by marketing Dominion Tug as City of Bremerton Destination.
B. Dominion Tug will also be listed as"Seattle's Haunted Ships and Lighthouses"becomes avail w/
Dominion Tug profiled and Bremerton mentioned as her location to visit
C. Implement dockside marine science program
D. Publish children's book and also a galley cookbook. Bremerton highlighted as homeport
E. Off-site presentations and events
•
Page 1 of 1
Dominion Workboats Historical Association
EXHIBIT B
Payment Terms
Payment will be released when the following has been fulfilled:
1) Direct Deposit (ACH Agreement) form, current W-9, and City Business License have been
received.
2) Monthly Fund Reimbursement Request form with support has been received,by the 15th of the
month following services performed.
a) Follow the services outlined in your scope of work, include the funding reimbursement
form (Form B.3.2019) incorporated into this contract via Exhibit B.
3) Please note that payment can be held up for the following:
a) If a prior year award reporting is not submitted by March 1,2019 via the attached reporting
form.
b) If required support documents are not received including: Automated Clearing House
(ACH) Direct Deposit form, W-9, Copies of Receipts and Invoices for Reimbursement,
and City Business license.
Page 1 of 6
Dominion Historical Workboats Association
EXHIBIT B
Exhibit B
G r n e i
+.11.:I`.. ..
X11
Ara ttiMd s
asenameollmarrasti 353-473-53/3
ke.361-473-52112
3-0e.iSt'.6'✓Elute 507
67+_rteeter%IVA5 137
AUTHORIZATION AGREEMENT FOR ACH
I hetiy authorize the City of Bremerton to remit my fee via direct deposit to my checking o
savings a co unt in the financial institution named below.
This auttho'iza an shall continue in effect tunt a written nom of cancellation is received by
Fenandal Services. I understated that it is nay responsibikty to notify the City of Bremerton if I
change banks or change account numbers.
Business Name
Bank Name Account Number
Bank Routing Number ❑Cheri ing ❑Savings
Signature Date
E-mail Address for Notificaticm
City of Bremerton Vendor Number
Please return the completed form to:
City of Bremerton
Accounts Payable
345 fid Street
Suite 100
Bremerton,WA 98337-1873
Page 2 of 6
Dominion Historical Workboats Association
EXHIBIT B
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Page 3 of 6
Dominion Historical Workboats Association
EXHIBIT B
CITY OF BREMERTON
LODGING TAX WORKSHEET
The City of Bremerton is required by RCW 67.28.1816 to report the use of lodging tax funds each year.
Your organization received lodging tax funds for 2018_Please complete this form and return to the Cty
no later than March 4 2019. if you have any questions or concerns please contact Melinda Momroe,
Contracts AdminEstrator at(360)473-5306 or by email at t,Belinda.monroe@ci.bremerton.wa_us.
Organization: bate:
Ci.:1 here to ante'
a date_
Completed Bir: Email: Telephone:
ACTIVITY
Activity Name Type Data
Event/Festival Stan C i-l;here to erter
Facility a date.
Total Cost of Activity ❑Marketing End C.i 1.here to enter
a date_
ATTENDEE ESTIMATES
Projected Actual Atethockdogy NatesfExplanatiota
Overall Attendance Cl?c4'e`"
iter,.
Attendees who traveled 50 miles or more to attend:
Taal Cl;cn
item.
Of Tota`.,attendees who Choose an
traveled from another state item.
or country
Attendees who stayed overnight:
Paid accommodations Choose an
item
Choose an
Unpaid accommodations item_
Paid Lodging nights Choose an
item.
PLEASE RETURN COMPLETED WORKSHEET BY MARCH 1,2019
,pease swum to Melinda Monroe at me1inda .wo_us or fax(360)473-5200.
Page 4 of 6
Dominion Historical Workboats Association
EXHIBIT B
CITY OF BREMERTON
LODING TAX FUND REIMBURSEMENT REQUEST FORM
Date
•
rug, asn 161E
Contract Nal
Total Award Amount!
Organization Name
Mailing address
Contact Name: Phone:
email:
Date of Service
Event/Program Title
Please isr,you eiaensts bcio* at cap.. of mat&rp mortals.if mare saws is netrt a ah3Y ase page 2
Total;Request:
Touiis+m:FursdPng Recipient Name(printed).
Tourism Funding Recipient Signature:
Date:
certfirwde•p -u Ty d peri:Jrr,the IYfo•rrJbar caitatred it the reauest far re•nbursemen:is tor and
correct:I a-n ajt'sorsod to cetlty all subrnt t-ie'ei jc t,.and art'rnauc:rne reMrbarsemcrt of mIIney
a:tublyspeed fa,ttcprolectorebel:asdescht In the rap!itatana-6coy:raftritetICCtyofeenrctar
Kan!reec^i/cern alora with moles of support 'ieolcns.ar..receipts to:
City of Brernerton
Contracts Mrnlnistrato•
366 6th Street,STI,100
6-enrerto7.WA 48337-1873 Fern t.3 2019
Ptra1
Page 5 of 6
Dominion Historical Workboats Association
EXHIBIT B
______-II CITY OF BREMERTON
Bi CODING TAX FUND REIMBURSEMENT REQUEST FORM
Date-'
C i T T [t
E•i:EME;:Tc=std
G itract No.
Organization Name
Reese i st your expenses below-attach copies of matching receipts.
Font,63 2819
Paou 2
Page 6 of 6
Dominion Historical Workboats Association
111111
MARKEL
1/17/2019
DAVE CLARK
PO BOX 1247
Bremerton,WA 98337
Hi DAVE:
Please find your Declarations page updating your policy.
It is important that you review the enclosed policy documents to make sure everything is correct. If you
believe any changes are required, or if you need additional help, please call your agent reflected on the
Declarations Page.
If you'd like to make a payment by phone,please call your agent. To make a payment online,please visit
markelamerican.com/pay.
Thank you for choosing Markel.
Sincerely,
Markel
Specialty Insurance by Real Specialists
(or GO PAPERLESS
markelamerican.com/paperless
MTD00000328404
MTDPC-0117
Page 1 of 2
PRIVACY POLICY AND OFAC NOTICE
We would like to thank you for your business and let you know we respect your privacy. We are
committed to protecting your personal information. Please read this notice,which outlines our
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We collect nonpublic information about you from the following sources:
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We do not disclose any nonpublic information about our customers or former customers to
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U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN
ASSETS CONTROL ("OFAC")
ADVISORY NOTICE TO POLICYHOLDERS
No coverage is provided by this Policyholder Notice nor can it be construed to replace any
provisions of your policy. You should read your policy and review your Declarations page for
complete information on the coverages you are provided.
This Notice provides information concerning possible impact on your insurance coverage due to
directives issued by OFAC. Please read this Notice carefully.
The Office of Foreign Assets Control (OFAC) administers and enforces sanctions policy,based on
Presidential declarations of"national emergency". OFAC has identified and listed numerous:
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In accordance with OFAC regulations, if it is determined that you or any other insured, or any
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MTDPC-0117 Includes copyrighted material of Insurance Services Office,Inc.
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with its permission.
MARKEL AMERICAN INSURANCE COMPANY
lig I
GLEN ALLEN,VIRGINIA
MARKEL WATERCRAFT DECLARATIONS PAGE
Page# 3
Policy Number: Agency Number: Effective Date/Transaction:
MTD00000328404 10656-000001 2019-01-17 Endorse
Policy Period: From 05/15/2018 To 05/15/2019 12:01 A.M.Standard Time at Your Mailing Address
Insured Name and Mailing Address Your Agent 608-249-2111
DAVE CLARK AMERICAN FAMILY BROKERAGE
6000 AMERICAN PARKWAY
PO BOX 1247
MADISON,WI 53783
Bremerton,WA 98337
DECLARED USAGE
R
Primary Usage and ID Owner/Operator 1 � 3 ;)-U ! \CI
Usage Type Corporately Owned,Client Entertainment or Employee Use �✓' •,.�
Additional Usage Description J
Hull Type Commercial Boat #of Vessels 1
Mooring Location 120 WASHINGTON BEACH Bremerton Kitsap WA 98337
Navigation Limits PORT RISK AFLOAT--3 MILE RADIUS OF PORT ALLOWED FOR MAINTENANCE REASONS
Lay-Up None From To
COVERAGE LIMIT* DEDUCTIBLE* PREMIUM
Hull,Agreed Value $50,000 per occurrence 10%min$2500 per vessel $1,861
Watercraft Liability $1,000 b0®per occurrence $2,360
Oil Pollution Liability $939,800 per occurrence $12
*If Hull Coverage is shown above,the Hull Limit is the total value for all insured vessels. See Vessel Schedule for the individual vessel
limits and deductible amounts.
Endorsement
Premium Total$24.00 Usage Premium $4,257.00
Non-Seasonal Rating:If you cancel the policy or if the policy is cancelled for nonpayment of premium,any return premium will be computed on a 90%
pro-rata basis subject to our minimum earned premium.If we cancel the policy,any return premium will be computed on a pro-rata basis.
Minimum Earned Premium $500.00 Policy Taxes/Fees $0.00 TOTAL ANNUAL PREMIUM $4,257.00
Add Additional Insured
Additional Insured
CITY OF BREMERTON
ATTN:RISK MANAGEMENT
345 6TH ST SUITE 100
Bremerton WA 98337
Producer AMERICAN FAMILY BROKERAGE Customer Ref#
Forms and Endorsements Please see the back of this form.
Signed on 1/17/2019 at MADISON,WI _ • ' '
n
MTD5000-0218 Insured 7i2014
MARKEL AMERICAN INSURANCE COMPANY
MARICE` WATERCRAFT DECLARATIONS PAGE
Policy Number: Primary Usage and ID Agency Number: Page Number
MTD00000328404 Owner/Operator 1 10656-000001 4
MTD5001-0215-The Markel Tradesman Policy
MTD5017-0215-Owner/Operator Usage Endorsement
MTD5052-0215-Agreed Value Endorsement
MTD5110-0215-Additional Insured Endorsement
MTD5121-0215-Named Perils Machinery Endorsement
MTD5124-0215-Policy Change Endorsement
MTD5125-0215-Port Risk-Afloat Endorsement
MTD5133-0215-Survey Ashore Required
MTD5200-0317-General Amendatory Endorsement
MIL1214-0917-Trade or Economic Sanctions Endorsement
MTD5000-0218 17`01
MARKEL AMERICAN INSURANCE COMPANY
ii I
GLEN ALLEN,VIRGINIA
MARKEL WATERCRAFT SCHEDULE PAGE
Page# 5
Policy Number: Agency Number: Effective Date/Transaction:
MTD00000328404 10656-000001 2019-01-17 Endorse
Policy Period: From 05/15/2018 To 05/15/2019 12:01 A.M.Standard Time at Your Mailing Address
Primary Usage and ID Owner/Operator 1
Usage Type Corporately Owned,Client Entertainment or Employee Use
Additional Usage Description
Hull Type Commercial Boat #of Vessels 1
Mooring Location 120 WASHINGTON BEACH Bremerton Kitsap WA 98337
Navigation Limits PORT RISK AFLOAT--3 MILE RADIUS OF PORT ALLOWED FOR MAINTENANCE REASONS
Lay-Up None From To
MTD5000-0218 Page# 5 Owner/Operator 1
INDIVIDUAL VESSEL INFORMATION
Year Length Manufacturer HIN# Limit Deductible
1944 128 ARMY TUG 276557 $50,000 $5,000
MARKEL AMERICAN INSURANCE COMPANY
MARKEL
ADDITIONAL INSURED ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows:
WATERCRAFT LIABILITY is amended by adding the following:
Additional Definition
An insured, as used in the WATERCRAFT LIABILITY section, includes any `Additional Insured'
shown on the Declarations Page,but only with respect to liability arising from your negligence.
WATERCRAFT LIABILITY,Exclusions is amended by adding the following:
This policy excludes coverage to any `Additional Insured' shown on the Declarations Page for bodily
injury or property damage caused directly or indirectly by any maintenance, repair or servicing to
the insured vessel by that `Additional Insured'.
All other terms,conditions, and limitations of the policy remain unchanged.
MTD5110-0215 Page 1 of 1
MARKEL AMERICAN INSURANCE COMPANY
MARKEL
POLICY CHANGE ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows
Usage ID Owner/Operator- 1
Policy Change IT IS AGREED AND UNDERSTOOD THAT THE HAULED C&V SURVEY WITH
Description ULTRASOUND WILL BE COMPLETED NO LATER THAN THE EXTENDED DATE
OF 03/01/2019.
THE NAMED PERIL MACHINERY WARRANTY HAS ALSO BEEN ADDED TO THE
2018 RENEWAL
All other terms,conditions,and limitations of the policy remain unchanged.
MTD5124-0215 Page 1 of 1
illMARKEL AMERICAN INSURANCE COMPANY
MARKEL
PORT RISK - AFLOAT ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows:
Usage ID Owner/Operator- 1
Insured Vessel 1944 128'ARMY TUG
#276557
Miles of Radius 3
Location 120 WASHINGTON BEACH,Bremerton/Kitsap,WA,98337
The 'Navigation Limits' shown on the Declarations Page or Schedule Page are deleted and replaced with
the'Miles of Radius' limit shown in the above schedule.
WARRANTIES & CONDITIONS, 2. Conditions, is amended by adding the following items for each
insured vessel scheduled above:
▪ The insured vessel will be at the location shown in the above schedule as the `Location' of the
insured vessel.
• The insured vessel may only be operated or moved from the `Location' of the insured vessel,
whether ashore or afloat,within the'Miles of Radius' shown in the above schedule, and only if the
sole purpose of the operation or movement is for maintenance, servicing, repair, refurbishment,
safety or demonstration for sale.
All other terms,conditions, and limitations of the policy remain unchanged.
MTD5125-0215 Page 1 of 1
idMARKEL AMERICAN INSURANCE COMPANY
MARKEL
SURVEY ASHORE REQUIRED
Usage ID Owner/Operator- 1
Date Survey Required 2019-03-01
Insured Vessels 1944 ARMY TUG#276557
This is an important notice that each insured vessel above is due for a professional survey.
We are providing ample time to secure the survey,which is due by the date listed above. Once the survey
is secured,send a copy directly to 'Your Agent' shown on the Declarations Page.
The surveyor must inspect each insured vessel while hauled from the water to properly assess the
condition of the hull and running gear.
For wood hulls,random fasteners must be pulled so the surveyor can assess wastage.
For aluminum/steel/metal hulls over 15 years of age, an audiogauge to validate hull integrity must be
performed.
It is important to choose a well-qualified surveyor to ensure that each insured vessel is fit and safe on the
water.
You may locate a surveyor at Society of Accredited Marine Surveyors (SAMS) at:
www.marinesurvey.org or National Association of Marine Surveyors(NAMS)at www.nams-cms.org.
As always,please contact'Your Agent' at the number shown on the Declarations Page with any questions
or concerns.
MTD5133-0215 Page 1 of 1
id!! MARKEL AMERICAN INSURANCE COMPANY
GLEN ALLEN, VIRGINIA
MARKET WATERCRAFT DECLARATIONS PAGE
Page# 3
Policy Number: Agency Number: Effective Date/Transaction:
MTD00000328404 10656-000001 2019-01-17 Endorse
Policy Period: From 05/15/2018 To 05/15/2019 12:01 A.M.Standard Time at Your Mailing Address
Insured Name and Mailing Address Your Agent 608-249-2111
DAVE CLARK AMERICAN FAMILY BROKERAGE
6000 AMERICAN PARKWAY
PO BOX 1247
MADISON,WI 53783
Bremerton,WA 98337
DECLARED USAGE
Primary Usage and ID Owner/Operator 1
Usage Type Corporately Owned,Client Entertainment or Employee Use
Additional Usage Description
Hull Type Commercial Boat #of Vessels 1
Mooring Location 120 WASHINGTON BEACH Bremerton Kitsap WA 98337
Navigation Limits PORT RISK AFLOAT--3 MILE RADIUS OF PORT ALLOWED FOR MAINTENANCE REASONS
Lay-Up None From To
COVERAGE LIMIT* DEDUCTIBLE* PREMIUM
Hull,Agreed Value $50,000 per occurrence 10%min$2500 per vessel $1,861
Watercraft Liability $1,000,000 per occurrence $2,360
Oil Pollution Liability $939,800 per occurrence $12
*If Hull Coverage is shown above,the Hull Limit is the total value for all insured vessels. See Vessel Schedule for the individual vessel
limits and deductible amounts.
Endorsement
Premium Total$24.00 Usage Premium $4,257.00
Non-Seasonal Rating:If you cancel the policy or if the policy is cancelled for nonpayment of premium,any return premium will be computed on a 90%
pro-rata basis subject to our minimum earned premium.If we cancel the policy,any return premium will be computed on a pro-rata basis.
Minimum Earned Premium $500.00 Policy Taxes/Fees $0.00 TOTAL ANNUAL PREMIUM $4,257.00
Add Additional Insured
Additional Insured
CITY OF BREMERTON
ATTN:RISK MANAGEMENT
345 6TH ST SUITE 100
Bremerton WA 98337
Producer AMERICAN FAMILY BROKERAGE Customer Ref#
Forms and Endorsements Please see the back of this form.
Signed on 1/17/2019 at MADISON,WI B__ _ 4_
MTD5000-0218 Insured 1/17/2019
illMARKEL AMERICAN INSURANCE COMPANY
MARKEL WATERCRAFT DECLARATIONS PAGE
Policy Number: Primary Usage and ID Agency Number: Page Number
MTD00000328404 Owner/Operator 1 10656-000001 4
MTD5001-0215-The Markel Tradesman Policy
MTD5017-0215-Owner/Operator Usage Endorsement
P g
MTD5052-0215-Agreed Value Endorsement
MTD5110-0215-Additional Insured Endorsement
MTD5121-0215-Named Perils Machinery Endorsement
MTD5124-0215-Policy Change Endorsement
MTD5125-0215-Port Risk-Afloat Endorsement
MTD5133-0215-Survey Ashore Required
MTD5200-0317-General Amendatory Endorsement
MIL1214-0917-Trade or Economic Sanctions Endorsement
1/17/2019
MTD5000-0218
MARKEL AMERICAN INSURANCE COMPANY
gll II
GLEN ALLEN,VIRGINIA
MARKEL WATERCRAFT SCHEDULE PAGE
Page# 5
Policy Number: Agency Number: Effective Date/Transaction:
MTD00000328404 10656-000001 2019-01-17 Endorse
Policy Period: From 05/15/2018 To 05/15/2019 12:01 A.M.Standard Time at Your Mailing Address
Primary Usage and ID Owner/Operator 1
Usage Type Corporately Owned,Client Entertainment or Employee Use
Additional Usage Description
Hull Type Commercial Boat #of Vessels 1
Mooring Location 120 WASHINGTON BEACH Bremerton Kitsap WA 98337
Navigation Limits PORT RISK AFLOAT--3 MILE RADIUS OF PORT ALLOWED FOR MAINTENANCE REASONS
Lay-Up None From To
MTD5000-0218 Page# 5 Owner/Operator 1
INDIVIDUAL VESSEL INFORMATION
Year Length Manufacturer HIN# Limit Deductible
,
1944 128 ARMY TUG 276557 $50,000 $5,000
IIIMARKEL AMERICAN INSURANCE COMPANY
MARKEL
ADDITIONAL INSURED ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows:
WATERCRAFT LIABILITY is amended by adding the following:
Additional Definition
An insured, as used in the WATERCRAFT LIABILITY section, includes any `Additional Insured'
shown on the Declarations Page,but only with respect to liability arising from your negligence.
WATERCRAFT LIABILITY,Exclusions is amended by adding the following:
This policy excludes coverage to any `Additional Insured' shown on the Declarations Page for bodily
injury or property damage caused directly or indirectly by any maintenance, repair or servicing to
the insured vessel by that `Additional Insured'.
All other terms, conditions, and limitations of the policy remain unchanged.
MTD5110-0215 Page 1 of 1
diMARKEL AMERICAN INSURANCE COMPANY
MARKEL
POLICY CHANGE ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows
Usage ID Owner/Operator- 1
Policy Change IT IS AGREED AND UNDERSTOOD THAT THE HAULED C&V SURVEY WITH
Description ULTRASOUND WILL BE COMPLETED NO LATER THAN THE EXTENDED DATE
OF 03/01/2019.
THE NAMED PERIL MACHINERY WARRANTY HAS ALSO BEEN ADDED TO THE
2018 RENEWAL
All other terms, conditions,and limitations of the policy remain unchanged.
MTD5124-0215 Page 1 of 1
illMARKEL AMERICAN INSURANCE COMPANY
MARKEL
PORT RISK - AFLOAT ENDORSEMENT
In consideration of the premium charge shown on the Declarations Page, it is hereby agreed and
understood that the Markel Tradesman policy is amended as follows:
Usage ID Owner/Operator- 1
Insured Vessel 1944 128'ARMY TUG
#276557
Miles of Radius 3
Location 120 WASHINGTON BEACH,Bremerton/Kitsap,WA,98337
P
The 'Navigation Limits' shown on the Declarations Page or Schedule Page are deleted and replaced with
the'Miles of Radius' limit shown in the above schedule.
WARRANTIES & CONDITIONS, 2. Conditions, is amended by adding the following items for each
insured vessel scheduled above:
✓ The insured vessel will be at the location shown in the above schedule as the `Location' of the
insured vessel.
■ The insured vessel may only be operated or moved from the `Location' of the insured vessel,
whether ashore or afloat,within the'Miles of Radius'shown in the above schedule,and only if the
sole purpose of the operation or movement is for maintenance, servicing, repair, refurbishment,
safety or demonstration for sale.
All other terms,conditions,and limitations of the policy remain unchanged.
MTD5125-0215 Page 1 of 1
•
MARKEL AMERICAN INSURANCE COMPANY
MARKEL
SURVEY ASHORE REQUIRED
Usage ID Owner/Operator- 1
Date Survey Required 2019-03-01
Insured Vessels 1944 ARMY TUG#276557
This is an important notice that each insured vessel above is due for a professional survey.
We are providing ample time to secure the survey, which is due by the date listed above. Once the survey
is secured,send a copy directly to 'Your Agent' shown on the Declarations Page.
The surveyor must inspect each insured vessel while hauled from the water to properly assess the
condition of the hull and running gear.
For wood hulls,random fasteners must be pulled so the surveyor can assess wastage.
For aluminum/steel/metal hulls over 15 years of age, an audiogauge to validate hull integrity must be
performed.
It is important to choose a well-qualified surveyor to ensure that each insured vessel is fit and safe on the
water.
You may locate a surveyor at Society of Accredited Marine Surveyors (SAMS) at:
www.marinesurvey.org or National Association of Marine Surveyors(NAMS) at www.nams-cros.org.
As always,please contact'Your Agent' at the number shown on the Declarations Page with any questions
or concerns.
MTD5133-0215 Page 1 of 1