HomeMy WebLinkAbout6682 DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
TOURISM PROMOTION SERVICES AGREEMENT
The City of Bremerton("City")and Downtown Bremerton 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.
IL Term: This agreement shall commence on January 1, 2024 and shall continue in full force
and effect until December 31, 2024 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 Twenty Thousand Two-Hundred dollars and
zero cents. ($22,000.00) 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 month or 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 the attached
reporting form for the reimbursement period with measurable results as required by
RCW 67.28.1816 (2).
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.
L 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, 2025 after the expiration of this Agreement may result
in the forfeiture of remaining unbilled compensation.
Bremerton/Year (2024) Lodging Tax Awardee DBA
Page 1 of 6
DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
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.
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. Indenmification: 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$1,000,000.00 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 $1,000,000.00 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
Bremerton/Year (2024) Lodging Tax Awardee DBA
Page 2 of 6
DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
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.
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 Downtown Bremerton Association
345 6th Street, Suite 100 155 Washington Avenue
Bremerton, WA 98337 Bremerton, WA 98337
Bremerton/Year (2024) Lodging Tax Awardee DBA
Page 3 of 6
DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
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.
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. Equal Employment Opportunity Statement: In the hiring of employees for the
performance of work under this Agreement, the Consultant, its subcontractors, or any person
acting on behalf of Consultant shall not discriminate in any employment practice on the basis of
age (40+), sex, race, creed, color, national origin, sexual orientation/gender identity,marital status,
military status, or the presence of any physical, mental or sensory disability.
IX. ADA Statement: The City of Bremerton does not discriminate on the basis of disability
in programs and activities, which it operates pursuant to the requirements of the Americans with
Disabilities Act of 1990, and ADA Amendments Act. This policy extends to both employment
and admission to participation in the programs, services and activities of the City of
Bremerton. Reasonable accommodation for employees or applicants for employment will be
provided.
X. 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.
XI. Termination of Other Contracts. This Agreement shall supersede all prior Agreements
between the parties relating to the use of Hotel/Motel Tax.
Bremerton/Year (2024) Lodging Tax Awardee DBA
Page 4 of 6
DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
CITY OF BREMERTON DOWNTOWN BREMERTON
ASSOCIATION
�DocuSigned by: DocuSigned by:
uCu ' P(Jtt
By? 7 Vlllie i1ey By: Dg ti ie4s@e]ka
its: Finance Director its: DBA Board/Treasurer
Date: 4/18/2024 Date: 4/11/2024
Approy, Sg form: Attest:
c e y: DocuSigned by:
AA-166a &Ur, iyix Rtmx
52ACDC33131 D04G2...
Kylie Finnell, Bremerton City Attorney City Cl4E� E� 'CF
erk, Angela Hoover
Bremerton/Year(2024) Lodging Tax Awardee DBA
Page 5 of 6
DocuSign Envelope ID: B92D020A-48AF-43F0-A0A1-746CF0004FEE
EXHIBIT A
Scope of Services
DBA will provide marketing for Bremerton and DBA events and attract tourism to the City of
Bremerton in the following ways:
Support the operational budget for the Downtown Bremerton Association programmatic updates
including a new website design and marketing and events throughout 2024.
Bremerton/Year (2024) Lodging Tax Awardee DBA
Page 6 of 6
DocuSign Envelope ID:B92D020A 48AF-43F0-A0A1-746CF0004FEE
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 2024. Please complete this form and return to the City
no later than March 1, 2025. 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:
Click here to enter
a date.
Completed By: Email: Telephone:
ACTIVITY
Activity Name Type , Dat
E Event/Festival Start Click here to enter
❑ Facility a date.
Total Cost of Activity ❑ Marketing End Click here to enter
a date.
ATTENDEE ESTIMATES
Projected Actual Methodology Notes/Explanation
Overall Attendance Choose an
item.
Attendees who traveled 50 miles or more to attend:
Total Choose an
item.
Of Total,attendees who Choose an
traveled from another state item.
or country
Attendees who stayed overnight:
Paid accommodations Choose an
item.
Unpaid accommodations Choose an
item.
Paid Lodging nights Choose an
item.
I certify that the above reporting numbers is in compliance with RCW 67.28.1816(2) and agree that
discrepancies discovered may prevent reimbursement or disbursement of awarded lodging tax funds or
the recapture of disbursement of funds.
Name,Title Date
PLEASE RETURN COMPLETED WORKSHEET WITH EACH REIMBURSEMENT REQUEST AND YOUR FINAL REPORT NO LATER
THAN MARCH 1,20xx
Please return to Melinda Monroe at melinda.monroe@ci.bremerton.wa.us or fax(360)473-5200.
DocuSign Envelope ID:75A3D8E3-6522-4681-A55384963929032A
CITY OF BREMERTON
LODGING TAX FUND REIMBURSEMENT REQUEST FORM
Date
CITY pc
BREMERTON
Contract No.
Total Award Amount
Organization Name
Mailing address
Contact Name: Phone:)
email:
Date of Service
Event/Program Title
J
Please list your expenses below, attach copies of matching receipts.
If more space is needed please use page 2 of this form.
Total Request: 0.00
Tourism Funding Recipient Name(printed):
Tourism Funding Recipient Signature:
Date:
•Icertify under penalty of perjury,the information contained in this request for reimbursement istrueand
correct:I am authorizedtocertify andsubmit this request;and lam requesting reimbursement of money I
actually spend for the project or erentasdescribed in the applicationandoontract withtheCity of Bremerton.
Please return form along with copies of supporting invoices and receipts to:
City of Bremerton
Contracts Administrator
346 6th Street,Ste 100
Bremerton,WA98337-1873 Form B.3 2019
Page 1
DocuSign Envelope ID:75A3D8E3-6522-4681-ASS3-843133929332A
CiTY
LODNFTAXFUNDN
IADIN6TAX FUND REIMBURSEMENT REQUEST FORM
Date
CITY Of
EREMERTON
Contract No.
Organization Name
Please list your expenses bet o:v, attach copies of matching receipts.
•
Para'8.'2019
P3?e 2
CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYV)
AC0120" 2M2/2024
THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT
AFFIRMATIVELY OR NEGATIvELY Au1END,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT
CONSTITUTEA CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRO DUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAJVED,subject to the terms
and conditions of the policy,certain policies may require m endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu
of such endorsement(s).
PRODUCER CONTACT NAME
TAPCO-ILL(5576) PHONE(NC No.EA): FAX(NC No):
PO Box 286 EMAIL ADDRESS:
Burlington,NC 27216
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A Mount Vernon Fire Insurance Company 26522
DOWNTOWN BREMERTON ASSOCIATION INSURE B:
PO BOX 245 INSURER C:
BREMERTON,WA 98337 INSURER D:
INSURE R E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIRBo1ENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THEPOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES.LMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS R A Ott SUER POLICY EfF POLICY C)CP
LTR TYPE OF INSURA ICE INSR ` JO POLICY NUMB ER (1JMAIOAYVY) (1JMAIOAYVY) LIMITS
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A t4BP2556854 06/30/2023 06/30/2024 EPL Ea.ctb $IpmmO
DPAltPLSIaredAggieg a $Ipmp70
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tliTIF!LATE HOLDEN CANCELLATION
City of Bremerton SID ULD ANY OF THE ABOVE DESCRIBED POLCIES BE CANCELLED BEFORE THE
345 6th St EXPIRATON DATE THEREOF,NOTCEINILL B E DELIVERED IN ACCORDANCE WITH THE
Bremerton,WA 98337 POLICY PROV SONS.
AUTHORIZED REPRESENTATIVE n
ACORD 25(2010/05) Copyright 1988-2010 ACORD ^TI Dn-COORPPOORRA/TIONN e.I rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 5576
LOC#: All
A`oRD' ADDITIONAL REMARKS SCHEDULE Pagel oft
AGENCY INSURED
TAPCO-XL(5576) DOWNTOWN BREMERTON ASSOCIATION
POLICY NUMBER PO BOX 245
NBP2556854 BREMERTON,WA 98337
CARRIER NAIL CODE
Mount Vernon Fire Insurance Company 26522 EFFECTIVE DATE: 6/30/2023
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
COVERAGE PART LIMITS
Businessowners Liability
Liability and Medical E menses $1,000,000
Medical E dense(per person) $5,000
Dam ages To P remises Rented To You(My One Premises) $1 00,000
General Aggregate $2,000,000
Management Liability
Employment P radices Liability E ach Claim Limit $1,000,000
Employment P radices Liability In The Aggregate Limit $1,000,000
Directors and Officers Liability E ach Claim Limit $1,000,000
Directors and Officers Liability In The Aggregate Limit $1,000,000
Directors and Officers Liability Retention $0
Employment P radices Liability Retention $0
Directors and Officers Retroadive Date Full Prior Ads
Employment P radices Liability Retroactive Date Full Prior Ads
Directors and Officers Prior or Pending Litigation Date 06/30/2023
Employment P radices LiabilityPrior or Pending Litigation Date 06/30/2023
This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington,Title
48 RCW. It is not protected by any Washington state guaranty association law.
ACORD 101 (2008/01) Copyright 2008 ACORD CORPORATION.All rights reserved.
The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE DATE (MM,DDIYYYV)
AC0120" 7/2/2024
THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT
AFFIRMATIVELY OR NEGATIvELY Au1END,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT
CONSTITUTEA CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRO DUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAJVED,subject to the teens
and conditions of the policy,certain policies may require m endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu
of such endorsement(s).
PRODUCER CONTACT NAME Holly Crossley
TAPCO-ILL(5576) PHONE(NC No.EA): 360200.3005 FAX(NC No):
PO Box 286 EMAIL ADDRESS: hcrossleyNXhambersbayinscom
Burlington,NC 27216
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A Mount Vernon Fire Insurance Company 26522
DOWNTOWN BREMERTON ASSOCIATION INSURE B:
PO BOX 245 INSURER C:
BREMERTON,WA 98337 INSURER D:
INSURE R E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIRBe1ENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THEPOLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THETERMS.EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES.LMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS R A Ott SUER POLICY EfF POLICY CO
LTR TYPE OFINSURA ICE It/SR 'MO POLICY NUMB ER (1JMmomYV) (1JMmomYV) LIMITS
GENERAL LIABILITY
EACHOCCURENCE $1pwm0
X COMMERCIAL GENERAL LIABILITY X X NBP2556854A 06/30/202406/30/2025 Ritgff5 (e%o¢irrcece) $t00pm
CLAMS-MADE El OCCUR MED EXP(Ary01e re Bol) $Bain
A P ERSONAL a ADV INJURY
GENERAL AGG NEGATE spin MO
G EN'L AGO REGRTE LIMITAPPLIES PER: P RD DUCTSCOLLPAP AGO
POLICY I JEL`T I LOc
UTOMOBILIE LIABILITY C(QOtlaexIREDDSINGLE LIMIT $
_ ANY AUTO BODILY IIINJURY(Perpelsot) $
RLL OUIINED 8ULED BODILY INJURY(Per acctleLD$
HIRED RUMS R jLNNEO PA7PElDAILOE
UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $
EXCESS LAB CLAMS-MADE AGGREGATE
DED RETENTIONS S
'AORKERS COMPEISASON 487 oar
AND EMPLOYERS'LIABILITY YIN
ANY PROP RIE ORIPARTNERIZXBCUTME❑ NIA E.L.EACH ACCIDENT S
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Non Profit Directors&Officers DLO Ea.Ctam $lamina
A NBP2556854A 06.1012024 06)30r2025 EPL ca.Cbm Stamina
D&OIEPLSL3N0Aggreg3N $1p1X1p70
D ESCRIPTON OF O PERATIONS/LIDCATD S IVEHCLES(See attacked AAOrd iDi tram Lb13I InD]Ir r Irri its
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partofa B Fe ity.
ERTII-!CATE HOLDER CANCELLATION
City of Bremerton SIO ULD ANY OF THE ABOVE DESCRIBED POLCIES BE CANCELLED BEFORE THE
345 6th St EXPIPRTON DATE THEREOF,NOTCEI ILL B E DELIVERED IN ACCORDANCE WITH THE
Bremerton,WA 98337 POLICY PROV SONS.
AUTHORIZED REPRESENTATIVE A 446
e.ACORD 25(2010/05) Copyright 1988-2010LACCO�R/pDn-COORPPOORRA/TIONN I rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 5576
LOC#: All
A`oRD' ADDITIONAL REMARKS SCHEDULE Pagel oft
AGENCY INSURED
TAPCO-XL(5576) DOWNTOWN BREMERTON ASSOCIATION
POLICY NUMBER PO BOX 245
NBP2556854A BREMERTON,WA 98337
CARRIER NAIL CODE
Mount Vernon Fire Insurance Company 26522 EFFECTIVE DATE: 6/30/2024
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
COVERAGE PART LIMITS
Businessowners Liability
Liability and Medical E menses $1,000,000
Medical E dense(per person) $5,000
Dam ages To P remises Rented To You(My One Premises) $1 00,000
General Aggregate $2,000,000
Management Liability
Employment P radices Liability E ach Claim Limit $1,000,000
Employment P radices Liability In The Aggregate Limit $1,000,000
Directors and Officers Liability E ach Claim Limit $1,000,000
Directors and Officers Liability In The Aggregate Limit $1,000,000
Directors and Officers Liability Retention $0
Employment P radices Liability Retention $0
Directors and Officers Retroadive Date Full Prior Ads
Employment P radices Liability Retroactive Date Full Prior Ads
Directors and Officers Prior or Pending Litigation Date 06/30/2023
Employment P radices LiabilityPrior or Pending Litigation Date 06/30/2023
This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington,Title
48 RCW. It is not protected by any Washington state guaranty association law.
ACORD 101 (2008/01) Copyright 2008 ACORD CORPORATION.All rights reserved.
The ACORD name and logo are registered marks of ACORD