HomeMy WebLinkAbout6079 TOURISM PROMOTION SERVICES AGREEMENT
BOOMTOWN PRODUCTIONS
The City of Bremerton ("City") and Boomtown Productions ("Organization"), referred to
collectively as the "Parties," enter into the following Agreement for Tourism Promotion services:
I. 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, 2020 and shall continue in full force
and effect until December 31, 2020 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 _Five Thousand Dollars ($5,000.00) 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.
A. Payment will be released when the following has been fulfilled:
I. The Organization shall submit monthly billing invoices, by the 15th of the month
following the end of the quarter 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.
II. The Organization will provide proof of insurance, agree to the use of Automated
Clearing House (ACH) Direct Deposit, a signed W-9, and current City Business
license.
B. 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.
I. 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,2021 after the expiration of this Agreement may result
in the forfeiture of remaining unbilled compensation.
C. 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/Boomtown Productions
Page 1 of 5
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 comprehensive general 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/Boomtown Productions
Page 2 of 5
The Organization's insurance shall be primary and non-contributory insurance as respects
the City and shall contain a waiver of subrogation against the City for claims arising out of any
operations, liabilities and obligations to which coverage applies.
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.
Contracts Administrator Organization Address
City of Bremerton _Boomtown Productions
345 6`h Street, Suite 100 _15156 NW Hite Center Rd
Bremerton,WA 98337 Bremerton,W 98380_
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/Boomtown Productions
Page 3 of 5
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 BREMERTO
By: Gr eeler By: Johnathan Miller oo,p,,,,,,, .. . ..
its: Mayor its:
Date: Z/t a '2 o 2 o Date:
Approved as to form: Attest:
Bremerton City Attorney City Clerk
Bremerton/Boomtown Productions
Page 4 of 5
EXHIBIT A
Scope of Services
Print Marketing including Rack Cards,reader boards, Kitsap Sun and Sound Publishing
Advertisements, Posters
Event: the only Bridge Fireworks show on the west-coast, including Fireworks, Airshow, live
bands,beer garden, food vendors.
Bremerton/Boomtown Productions
Page 5 of 5
i
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 2019. Please complete this form and return to the City
no later than March 1, 2020. If you have any questions or concerns please contact Melinda Monroe,
Contracts Administrator at(360)473-5306 or by email at Melinda.monroe@ci.bremerton.wa.us.
Organization: Date:
Completed By: Email: Telephone:
ACTIVITY
Activity Name Type Date
❑ Event/Festival Start
❑ Facility
Total Cost of Activity ❑ Marketing End
ATTENDEE ESTIMATES
Projected Actual Methodology Notes/Explanation
Overall Attendance Select Drop-Down ItE
Attendees who traveled 50 miles or more to attend:
Total Select Drop-Down ItE
Of Total, attendees who
traveled from another state Select Drop down 'ter
or country
Attendees who stayed overnight:
Paid accommodations Select Drop-Down ItE
Unpaid accommodations Select Drop-Down ItE
Paid Lodging nights Select Drop-Down ItE
PLEASE RETURN COMPLETED WORKSHEET BY MARCH 1, 2020
Please return to Melinda Monroe at melinda.monroe@ci.bremerton.wa.us or fax(360)473-5306.
EXHIBIT B
�s
CITY OF BREMERTON
LODGING TAX WORKSHEET
CITY OF
BREMERTOi'
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 2019. Please complete this form and return to the City
no later than March 1, 2020. If you have any questions or concerns please contact Melinda Monroe,
Contracts Administrator at(360)473-5306 or by email at Melinda.monroe@ci.bremerton.wa.us.
Organization: Date:
Completed By: Email: Telephone:
ACTIVITY
Activity Name Type Date
❑ Event/Festival Start
❑ Facility
Total Cost of Activity El Marketing End
ATTENDEE ESTIMATES
Projected Actual Methodology Notes/Explanation
Overall Attendance Select Drop-Down Ite
Attendees who traveled 50 miles or more to attend:
Total Select Drop-Down Ite
Of Total, attendees who
traveled from another state Select Drop down Iter
or country
Attendees who stayed overnight:
Paid accommodations Select Drop-Down Ite
Unpaid accommodations Select Drop-Down Ite
Paid Lodging nights Select Drop-Down Ite
PLEASE RETURN COMPLETED WORKSHEET BY MARCH 1, 2020
Please return to Melinda Monroe at melinda.monroe@ci.bremerton.wa.us or fax(360)473-5306.
A Ion CERTIFICATE OF LIABILITY INSURANCE DATE
a2/18 020/YYYY)
_
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
AX
David Connoliy(7913315) No,EMtI; 360-692-6439 i ,Nol:
shore Dr NW E-MAIL
9393 Bayshore ADDRESS; dconnoliyefatmersagent.wm.
INSURER(S)AFFORDING COVERAGE NA►C N
Silverdale WA 98383-9113 INSURERA: Truck Insurance Exchange 21709
INSURED OVAL.) "1. let , INSURER B_ Farmers Insurance Exchange 21652
MILLER,JOHN INSURER C: Mid Century Insurance Company 21687
BOOMTOWN SERVICES,LLC. N D INSURER D:
15156 HITE CENTER INSURER E:
SEABECK WA 98380 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR — _ — ADDL SUER '- --- —
1M OLICY EFF POIJ pY EXP _----.-------- - TS
LTR TYPE OF INSURANCE __INSR WVD POLICY NUMBER M/DIr ICLIN WD /YYYYL
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X I COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED :✓
.—� PREMISES(Ea occurrence) $ 100,000
CLAIMS-MADE (X OCCUR t," MED EXP(Any one person) $ 5,000
C r x x 605508299 01/03/2020 01/03/2021 PERSONAL&ADVINJURY S 1,000,000
_ GENERAL AGGREGATE $ 2,000,000
GEM.AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
7 POLICY 1 FA [ LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
ANY AUTO BODILY INJURY(Per person) $
C ALL OWNED P/ SCHEDULED X 605508299 01/03/2020 01/03/2021 BODILYINJURY(Peraccident S
AUTOS !� AUTOS )
X HIRED AUTOS X N-0WNED PROPERTY DAMAGE _
AUTOS 1Per accident)
_ _ i
X 1 UMBRELLA LIAR OCCUR EACH OCCURRENCE S 2,000,000
C 1 EXCESS LIAR. -.-- CLAIMS-MADE 606282277 1 01/03/2020 01/03/2021 AGGREGATE ...._ $
I DED r I RETENTIONS
_ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABIUTY YIN ,_-....._TORY LIMITS X FR _ stop gap
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L,EACH ACCIDENT $ 1,000,000
C OFFICERIMEMBER EXCLUDED? f I N/A 605508299 01/03/2020 01/03/2021 ------- --- -
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
B yes,descdbe under - ---
DESCRIPTION OF OPERATIONS below El.DISEASE-POLICY LIMIT i 1,000,000
I I _ i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(9ttach ACORD 101,Additional Remarks Schedule,R more space Is required)
Certificate Holder is Listed as Additional Insured
•
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
•
City Of Bremerton THE EXPIRATION DATE THE TICE WILL BE DELIVERED IN
345 8th Street 1ACCORDANCE WITH THE P PR IONS.Suite 100 AUTHORIZED RE E TATIVE 4d)7
Bremerton WA 98337
ACORD 25(2010/05) 988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo regis ered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY,NUMBER:60550-82-99
FARMERS J6840
FARM znd Edltlen
INSURANCE
ADDITIONAL INSURED-SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
BUStNESSOWNERS LIABILITY COVERAGE FORM
BUSINESSOWNERS COMMON POLICY CONDITIONS
With respect to coverage provided by this endorsement.the provisions of the Coverage Form apply unless modified by the
endorsement.
SCHEDULE
Name Of Additional Mstrredferson(s) 'v/
Or Orrattbellon(s): CITY OF BREMERTON
Lecelbn Of Covered OPeraden(s): 1
Effective Date Of Endersenvent
lino entry appears above.information required to complete this en nc 01/03/2020
dorsement wIN be shown In the Declarations.
The BUS INESSOWNERS LIABILITY COVERAGE FORM is amended as follows.
A. With respect to the additional Insured described In Paragraph B.of thisendorsement the following exclusions are added
to Paragraph 1.Applicable Te Business LIeA1YtyCoverage under Section S.E clusiorts:
This Insurance does not apply to:
1. "Bodily Injury"or'property damage"for which the additional Insureds)is obligated to pay damages by reason of
the assumption of liability In acontract or agreement. This exclusion does not apply to Liability for damages that the
additional insured(s)would have in the absence of the contract or agreement
2. "Bodily injury'or"property damage"occurring alter:
a. Your ongoing operations at the location of covered operations other than service maintenance or repairs
performed by you or on your behalf have been completed or
►. The portion of your ongoing operation out of which the'bodily Injury"or'property damage"arises has been
put to Its intended use by any person or organization.
But In no event shall this insurance apply to"bodily injury"or"property damage"arising out of your operations that
were completed prior to the effective data of this endorsement.
_. 'Bodily Injury"or"property damage"arising out of any act or omission of the additional insured(s)or any of Its
"employees",agents or contractors other than you,except for general supervision by the additional insureds)of
your ongoing operations performed for that additional Instead.
4. "Property damage'to:
a. Property owned,used or occupied by or rented to the additional Insured(s):
b. Property In the care custody or control of the additional Insureds)or over which the additional insured(s)
exercise physical control;or
c. Any work Including materials,parts or equipment furnished In connection with such work which la performed
for the additional Insured by you.
6j B 10-E02 09-18 Indida copyrighted meted of!Norma ferries 011fos,Inc,wit its prmldon. Page I eI of2
B. Section C.Who la An Insured Is amended to include as an insured the person(s)or organizations)shown in the
Schedule,but only to the extent that the additional insured(s)is held liable for "bodily injury"or "property damage"
caused in whole or In part by:
1. Your ongoing operations performed for such person or organization at the location designated above;
2. The acts or omissions of your subcontractors acting on"your"behalf on the scheduled protect in the performance of
your ongoing operations for the additional insureds)which start and are completed within the effective period of
this endorsement;or
3. The acts or omissions of such additional insured(s)In connection with its general supervision of such operations.
C. With respect to this endorsement, `wrap up policy" means an Owner or Contractor Controlled Insurance Program
providing one or a series of policies designed to cover a specific construction protect that Insures all of the persons and
entities working on such project.
The BUSINESSOWNERS COMMON POLICY CONDITIONS are amended as follows:
A. With respect to the additional Insured described In Paragraph B.of this endorsement,Section H.Other Insurance Is
replaced by the following:
H. Other insurance
1. Pri(rlary and Nonaentytbutory Insurance
The coverage provided to an additional Insured under this endorsement shall be primary and noncontributory
ONLY to any Insurance issued directly to the additional insured if:
a. The Named insured agreed in a written contract or written agreement to provide the additional Insured
coverage on a primary and noncontributory basis;
b. Such written contract or written agreement referenced in a.above was executed prior to the Issuance of
this endorsement;
c. The additional insured designated herein has a policy with an Other Insurance provision making that policy
excess;and
d. There is no"wrap up policy'In effect for the work performed at the location designated in the Schedule of
this endorsement.
2. exams{neuritic*
tf there Is other valid and collectable Insurance available to the additional insured(s)as an additional insured
under other policies covering the work performed at the location designated and described In the schedule of
this endorsement,this insurance will be excess over those polfcies.
This endorsement Is part of your policy. It supersedes and controls anything to the contrary. it is otherwise subject to all the
terms of the policy.
J93
6840--E0209.113 rvtr
inclinescnpyrlphtedmaterlalofInsuranceSee+Olrka,inc.,withItsyermhs/nn, Page 2of2
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY /^ E3306
FA R M E R WAIVER OF TRANSFER OF RIGHTS OF RECOVERY ; 1st Edition
INSURANCE AGAINST OTHERS TO US
01/03/2020 605508299___
Effective Date— Policy Number
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COMMON POLICY CONDITIONS-BP 00 09
SCHEDULE
Name of Person or Organization:
(If no entry appears above, Information required to complete this Endorsement must be shown in the Declarations as applicable to
this endorsement.)
The provisions of the Businessowners Common Policy Conditions are modified by this endorsement as follows
Condition K. Transfer Of Rights Of Recovery Against Others To
Us in the Businessowners Common Policy Conditions Is amended
by the addition of the following:
3. We waive any right of recovery we may have against the
person or organization shown in the Schedule above because
of payments we make for Injury or damage arising out of your
ongoing operations or 'your work" done under a contract with
that person or organization and included in the
'products-completed operations hazard.' This waiver applies
only to the person or organization shown in the Schedule
above.
This endorsement is part of your policy. It supersedes and controls anything to the contrary. It Is otherwise subject to all the leans of the
policy,
91.1311 1ST FOITION Far tre ads.Coprnpht Mreriel trauma-a 5.r ,,Ore.,la.,17V2 t17111101 PAGF 1 OF 1
ACGRIJ
+ i....--- CERTIFICATE OF LIABILITY INSURANCE DATE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER.
IMPORTANT;If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDmONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and
conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
David Connolly(7913315) PHONE FAX
9393 Bayshore Dr NW (A/c,NO, :360-692-6439 (A/C,NO):360-692-1847
E-MAIL
SILVERDALE WA 98383-9113 ADDRESS: dconnolly@farmersagent.com
INSURER(S)AFFORDING COVERAGE NAIC N
INSURED INSURER A: Truck Insurance Exchange 21709
INSURER B: Farmers insurance Exchange 21652
BOOMTOWN SERVICES LLC INSURER c: Mid Century Insurance Company 21687
15156 NW HITE CENTER RD
INSURER D:
SEABECK WA 98380 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY
REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE
POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSLTRR TYPE OF INSURANCE AIDN3T VIL SSUER POLICY NUMBER POLICY EFF POLICY DIP LIMITS
(MM/DD/YYYY) (MM/DD/YYr0
x COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED
PREMISES(EaOccurrence) $ 100,000
MED EXP(Any one person) $ 5,000
C Y Y 605508299 01/03/2020 01/03/2021 PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
Xr POLICY PROJECT LOC PRODUCTS-COMP/OPAGG S 2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
X ANY AUTO BODILY INJURY(Per person) $
C OWNED AUTOS X SCHEDULED BODILY INJURY(Per accident)$
ONLY ^ AUTOS X 605508299 01/03/2020 01/03/2021
X
HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
ONLY AUTOS ONLY (Per accident) $
$
X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 2,000,000
c EXCESS LIAB CLAIMS-MADE 606282277 01/03/2020 01/03/2021 AGGREGATE $ 2,000,000
DED RETENTION$ $
WORKERS COMPENSATION PER X OTHER $ STOP GAP
AND EMPLOYERS'LIABIUTY STATUTE
ANY PROPRIETOR/PARTNER/ Y/N N/A E.L.EACH ACCIDENT $ 1,000,000
EXECUTIVE OFFICER/MEMBER 605508299 01/03/2020 01/03/2021 c EXC E.L.DISEASE $
LUDED?(Mandatory in NH) 1,000,000
If yes,describe under DESCRIPTION OF
OPERATIONS below E.L DISEASE-POLICY LIMIT S 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Halo Fireworks LLC and the City of Bremerton are Listed as Additional Insured
CERTIFICATE HOLDER ( CANCELLATION
Halo-�- a til..� y-r G/,(i/K.(J-�BRIOULD ANY 0 THE AB CRIBE r •OLICIES BE LED EFORE THE EXPI
15156-NW-Me CenferRd' 34 u4-Pi 3 i- DATE THERE ,NO LLBEDE RED RDANCE H THE POLI °VISIONS.
Swatimr•.k 4 ir.,,,A.vki n
AUTHORIZ ESENTA
ACORD 25(2016/03) O 1988-2015 AC ORPORATION.All Rights Reserved
31-1769 11-15 The ACORD name and logo are regist• . marks of ACORD
Notice of Cancellation
this notice
is issued by: MID—CENTURY INSURANCE COMPANY
Date: 11 / 16/22
Property
location:
U of er than shown be owl
Po icy Or Let icate Num er(s) Agent Num er Conce anon Date
60550-82-99 79-13-315 01/07/23
Named Insured And Mailing Address:
BOOMTOWN SERVICES
13507 79TH AVENUE CT NW
GIG HARBOR WA 98329-9201
Notice of Cancellation Of
Mortgagee Or Other Interest
® You are hereby notified, that all coverage extended to you under the above listed policy is cancelled effective
on the cancellation date shown above at the time specified in the Declarations of this policy, unless you
have been notified of a more recent cancellation under other provisions of the policy.
❑ You are hereby notified that all coverage extended to you under the above poliry(ies) or certificates) on:
is cancelled effective on the cancellation date shown above at the time specified in the Declarations of this
policy, unless you have been notified of a more recent cancellation under other provisions of the policy.
Note to Mortgagee: Your loan with this policyholder may have expired, however, this notice complies with
the provision of our policy.
Loan Number:
Mortgagee or Other Interest:
CITY OF BREMERTON
345 6TH ST STE 600
BREMERTON
WA 98337
25-so96 5-02 MORTGAGEE, BUREAU, COMMISSIONS A5o96131
OR OTHER INTEREST COPY