HomeMy WebLinkAboutPK07-095 - Original - King County Umpires Association -Adult Slowpitch Softball Umpiring - 04/15/2007 Records Man-aagerne� i 1
KENT '` ��`'�'
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WA9HING20N
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact City Clerks Office.
Vendor Name: A-��;�/Vendor Number: v
JD Edwards Number
Contract Number:
This is assigned by Clerk's Office
Description: &hL�57
Detail:
Project Name: '2111L!; Z42�
Contract Effective Date: Termination Date. � 7
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manage j:;� / &dL Department:
Abstract:
SPublic\RecordsManagement\Forms\ContractCover\ADCL7832 07/02
i r
KENT
WAS� �ro
GOODS & SERVICES AGREEMENT
between the City of Kent and
King County Umpires Association
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and King County Umpires Association organized under the laws of the State of
Washington, located and doing business at 605 Cedar DR SE, Auburn, WA 98002 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and matenals and/or perform the following services for the
City:
Description. Adult Slowpitch Softball Umpinng
Start Time/Duration/Stop Time- April 15, 2007 to September 30, 2007
Event Location: City of Kent and Kent School Distnct Athletic Fields
The Contactor agrees to credit the City$20.00 and One (1) dozen approved softballs for failure to
provide umpire services for a scheduled game.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified nght to obtain these goods, matenals, and
services through other sources
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services by completion of the Adult Softball Season. September
30, 2007
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed 1 person/multiple
games-S28 00 per game, 2 person/multiple games-$50 00 per game, including applicable Washington State
Sales Tax, for the goods, matenals, and services contemplated in this Agreement. The City shall pay the
Vendor the following amounts according to the following schedule.
GOODS &SERVICES AGREEMENT- 1
(Over$10,000 00, including WSST)
King County Umpires Association will submit an itemized invoice of games worked, umpires
Per game and fee incurred Invoice may be divided into portions of the season, either on a
monthly or bi-monthly schedule or one invoice for the entire program/season
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to
only pay that portion of the invoice not in dispute In that event, the parties will immediately make every effort
to settle the disputed portion
A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor
for any defective or unauthorized goods, materials or services If Vendor is unable, for any
reason, to complete any part of this Agreement, the City may obtain the goods, materials or
services from other sources, and Vendor shall be liable to the City for any additional costs
incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs
and attorney fees, incurred by the City beyond the maximum Agreement price specified above.
The City further reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the Vendor.
B. Final Payment: Waiver of Claims. THE MAKING OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY
MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR
FINAL PAYMENT IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement and that the Vendor has the ability to control and
direct the performance and details of its work, the City being interested only in the results obtained under this
Agreement.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of this
Agreement.
VI. CHANGES. The City may issue a written change order for any change in the goods, materials or
services to be provided during the performance of this Agreement If the Vendor determines, for any reason,
that a change order is necessary, Vendor must submit a written change order request to the person listed in the
notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date
Vendor knew or should have known of the facts and events giving rise to the requested change. If the City
determines that the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment The City will attempt, in good faith, to reach agreement with the Vendor on all
equitable adjustments However, if the parties are unable to agree, the City will determine the equitable
adjustment as it deems appropriate The Vendor shall proceed with the change order work upon receiving either
a written change order from the City or an oral order from the City before actually receiving the written change
order If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make
any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor
disagrees with the equitable adjustment, the Vendor must complete the change order work; however, the
GOODS &SERVICES AGREEMENT -2
(Over$10,000 00, including WSST)
l i
Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims,
below '
The Vendor accepts all requirements of a change order by (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Vendor as
provided in this section shall constitute full payment and final settlement of all claims for contract time and for
direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected
by the change
VIL CLAIMS. If the Vendor disagrees with anything required by a change order, another written
order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the
City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City
of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or
within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events
giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or
extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been
waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions
of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1
through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING
THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim Provide a signed written notice of claim that provides the following
information.
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate was
determined, and
5. An analysis of the progress schedule showing the schedule change or disruption if
the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of
the asserted events giving rise to the claim. The City shall have access to any of the Vendor's
records needed for evaluating the protest
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this Agreement.
GOODS&SERVICES AGREEMENT-3
(Over$10,000 00, includmg WSST)
D. Failure to Protest Constitutes Waiver By not protesting as this section provides, the Vendor also
waives any additional entitlement and accepts from the City any written or oral order (including
directions, instructions, interpretations, and determination)
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the City
any written or oral order (including directions, instructions, interpretations, and determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD
IX. WARRANTY. This Agreement is subject to all warranty provisions established under the
Uniform Commercial Code, Title 62A, Revised Code of Washington Vendor warrants goods are
merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance
with their specifications and Vendor's representations to City. The Vendor shall correct all defects in
workmanship and materials within one (1) year from the date of the City's acceptance of the Contract work In
the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts
will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for =
one (1) year from the date such correction is completed and accepted by the City The Vendor shall begin to
correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect If the
Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may
complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the
correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or
sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the
presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and
available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XI. INDEMNIFICATION. Vendor 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, ansmg out of or in connection with the Vendor's performance of this
Agreement, except for that portion of the injuries and damages caused by the City's negligence
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
GOODS&SERVICES AGREEMENT-4
(Over$10,000 00, including WSST)
The provisions of this section shall survive the expiration or termination of this Agreement.
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit A attached and incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions
and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the
contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's
own risk, and Vendor 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.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3 80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price preference
may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement
in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements
or options, and the same shall be and remain in full force and effect.
C Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington If the parties are unable to settle any dispute,
difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving
that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction
of the King County Superior Court, King County, Washington, unless the parties agree in writing to an
alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties'
performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending
or bringing such claim or lawsuit, in addition to any other recovery or award provided by law; provided,
however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section
XI of this Agreement
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the
addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice
hereunder shall become effective three (3)business days after the date of mailing by registered or certified mail,
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
E Assignment. Any assignment of this Agreement by either party without the written consent of
the non-assigning party shall be void If the non-assigning party gives its consent to any assignment, the terms
of this Agreement shall continue in full force and effect and no further assignment shall be made without
additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the
City, and such statements shall not be effective or be construed as entering into or forming a part of or altering
in any manner this Agreement. All of the above documents are hereby made a part of this Agreement.
GOODS&SERVICES AGREEMENT-5
(Over$10,000 00, including WSST)
However, should any language in any of the Exhibits to this Agreement conflict with any language contained in
this Agreement, the terms of this Agreement shall prevail
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business,
equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance
of those operations.
IN WITNESS, the parties below execute this Agreement,which shall become effective on the last
date entered below.
VENDOR: CITY OF KEN>T:
Bykam7e:.jJ)
6 By:
(signat � � �� /� (signature)
Prin nL(7 F'LY Print N e: uzette Cooke
ItsPC.1'z Its Ma o
(Title) _
DATE: 5�7 DATE.
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Jim Oswald David E. Heldt
King County Umpires Association City of Kent
605 Cedar Dr SE 220 Fourth Avenue South
Auburn, WA 98002 Kent, WA 98032
253-931-8185 (telephone) (253) 856-5000 (telephone)
253-395-7935 (facsimile) (253) 856-6000 (facsimile)
APP OVED AS TO FORM:
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[In this field,you may enter the electronic filepath where the contract has been saved]
GOODS &SERVICES AGREEMENT-6
(Over$10,000 00, Including WSST)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all
contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with
the regulations of the City's equal employment opportunity policies.
The following questions specifically identify the requirements the City deems necessary for any contractor,
subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of
the following questions for this Agreement to be valid and binding If any contractor, subcontractor or supplier
willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of
contract and it will be at the City's sole determination regarding suspension or termination for all or part of the
Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color,
national origin, age, or the presence of all sensory, mental or physical disability.
3. During the time of this Agreement the prime contractor will provide a written statement to all new
employees and subcontractors indicating commitment as an equal opportunity employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of
women and minorities
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime
Contractor, that the Prime Contractor complied with the requirements as set forth above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of A P?ui �- , 200_7
By: (!:�?,41jw
For:
Title: 1V2£c--M�-
Date: `"! k(7
EEO COMPLIANCE DOCUMENTS- 1 of 3
r
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White,Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All
contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity
within their organization and, if holding Agreements with the City amounting to $10,000 or more within any
given year, must take the following affirmative steps.
1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal
opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
'I
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and
equal opportunity requirements shall be considered in breach of contract and subject to suspension or
termination for all or part of the Agreement
I
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works
Departments to assume the following duties for their respective departments
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are
familiar with the regulations and the City's equal employment opportunity policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS-2 of 3
> s r
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement
I, the undersigned, a duly represented agent of Company, hereby
acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement
known as that was entered into on the (date,
between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent
Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part
of the before-mentioned Agreement.
Dated this day of , 200
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS-3 of 3
+ r
EXHIBIT A
INSURANCE REQUIREMENTS FOR SOFTBALL
AGREEMENT
Insurance
The Contractor shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may arise from or in
connection with the performance of this Agreement by the Contractor, their agents,
representatives, employees or subcontractors
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from premises,
operations, independent contractors, personal injury and advertising
injury, and liability assumed under an insured contract The Commercial
General Liability insurance shall be endorsed to provide the Aggregate Per
Project Endorsement ISO form CG 25 03 1195. The CGL coverage shall
cover participant liability.
2. Workers' Compensation coverage as required by the Industrial Insurance
laws of the State of Washington
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with limits no
less than $2,000,000 each occurrence, $2,000,000 general aggregate.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions
for Automobile Liability and Commercial General Liability insurance
1. The Contractor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance. or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it
2. The Contractor's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior written
notice by certified mail, return receipt requested,has been given to the
City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the contractor and a copy of the endorsement naming the City as
additional insureds shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not less than
ANIL
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the amendatory
endorsements, including but not necessarily limited to the additional insured
endorsement, evidencing the insurance requirements of the Contractor before
commencement of the Agreement.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall furnish
separate certificates and endorsements for each subcontractor All coverages for
subcontractors shall be subject to all of the same insurance requirements as stated herein
for the Contractor.
r �
Issue Data (41m=" INT
CERTIFICATE OF INSURANCE 4/1112007 3:04 51 PM
PRODUCER
SADLER$COMPANY,INC. THIS CERTIFICATE IS i5SUEO AS A MATTER OF
INFORMATION ONLY AND CONFERS NO RIGHTS UPON
PA.BOX 586E THE CERTIFICATE HOLDER THIS CERTIFICATE DOES
COLUMBIA,SOUTH CAROLINA 29250�S866 NOT AMEND,EXTEND OR ALTER THE COVFM43E
(800)622-7370 AFFORDED BY THE POLICIES BELOW,
EMAIL:ameteur@sadlereports.com
INSURED
COMPANIES AFFQROING COVERAGE
SPORTS LEISURE 6 ENTERTAINMENT RPG d1bl9
COMPANY Nationwide Mutual Insurance
King County Umpires Association LETTER company
Jim Oswald
505 Cedar Drive SE COMPANY
Auburn, WA 98002 LETTER
8
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE
POLICY PERIOD INDICATED,NOTNMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT
WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 09 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
POLICY POLICY
CO TYPE OF POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
LTR INSURANCE DATE DATE {
IAM/DD(YY M OD(Y
General Liability clCnarn'Aggrcgsce $z,000,000
Produne-CompalOps SR1000 000
n re rite
r' Commercial Genorat pCr umt`$ 92,oCQ0a❑
t,mlty RPG25453 12 01 AM 12.01 AM AdvcrdeinatRlnlY
A r,, Gaims Made Ezh Occmmnce $2 OD0,000
� S3oC OOa/ Occurrence 05/14/2007 05/14/20D$ Fire Dmnnµc(Anync Tire
Mcdtcnl E.rcnsc. $S,COC
I-" Owners&Contractors (Ary one paean)
Protection PnnlclpAnt I'quil S7,000,OCO I'
Lmbllll
Participant RPG25453 12:01 AM 12:01 AM Ex=enaMam°nl a,Eo,000
S Accident 05114/2007 05/14/2008
AD&D NA
(8100 deductible per Balm)
Wackly hldemnity X
DP_SCRIFT1ON Or OPERA'1"IONSJLOCATIONSNF.111CT.RSIRSSTRiC 11ONSISPI31:1I Al,ITEMS
COVERED SPORTS: UMPIRE/REFEREE ASSOCIATIONS 13-15, UMPIRE/REFEREE
ASSOCIATIONS Over 19
with Respect to the GWeml Llablllty,the CertlWta Holder is added as an Addltlonel Insurod BOI*in Its=P#ttY All,a proporty owner or^;Ponsor,but -
bnty with raspea to liability ari!ing out of the Insurod'a operation, This Insurance does,not apply to the ante nogllgenee of tno Addlwmt Imiimd
CERTIFICATE tIOT.DER CANCET,r,ATION
Property Owner SHOUI U ANY OF TF1[ABOVr•DFSCRIPED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE-Wr.REOF,THE ISSUING COMPANY WILL
City of Kent Parks and Recreation ENDEAVOR TO MAIL 30 DAYCWRITTEN NOTICr_TO 9 I[[('°RTrrICATE
220 4th Avenue South IIOLDLR NAMED TO THE LErT B[)T rA1LURETO MAIL SUCH NOTICE
Kent, WA 98032 SHALL IMPOSE NO OBLIOA MONS OR LIARIL17Y OF ANY KIND UPON T1113
AUTHOrf A)
R5PRE8 NTATIVL
(Cmnpmly A)
Amateur
Inwa Date (MMrO]!YY) INT
CERTIFICATE OF INSURANCE
4J111Z007
PRODUCER
SADLER&COMPANY,INC. THIS CERTIFICATE 13 ISSUED AS A MATTER OF
INFORMATION ONLY AND CONFERS NO RIGHTS UPON
P.O,BOX 5866 THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
COLUMBIA,SOUTH CAROLINA 29250.5B66 NOT AMEND,EXTEND OR ALTER THE COVERAGE
(800)622.7370 AFFORDED BY THE POLICIES BELOW.
EMAIL:anmWur@sadiersport5,com
INSURED COMPANIES AFFORDING COVERAGE
SPORTS LEISURE &ENTERTAINMENT RIPS d/b/a
COMPANY Nationwide Mutual Insurance
King County Umpires Association LETTER
Jim Oswald A Company
605 Cedar Drive SE COMPANY
Auburn, WA 98002 LETTER
B
covERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTYD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE
POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTI•IF-R OCCUMENT
WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PrRTAIN THE INSURANCE AFFORDED BY TIhIC POLICIES
DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OP SUCH POLIOIFS,LIMITS SHOWN MAY HAVE
BEEN REDUCED BY PAID CLAIMS
POLICY POLICY M
CO TYPE OF POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
LTR INSURANCE IDATE DATE
mlon/ YI MMIDDNY
General LiabilityCowen)]Aggrcgatc $2,000,000
Prodimts•Compx/Op, S2 000,000
A rc fife
� Commercial Goreral Pereonal -
LIablity RPG26453 12:01 AM 12,01 AM A6emsme,InPlry $2 000 000
A r" claims Mnao rACII Ocoarcnco 52,000,000
Fire DamngdAny 'F300,000
N occurrence 05/14/2007 05/14/2008 we fire
Mcd�anl EKpee<de $5,000
r OwnOM 8 Contractura (Any one person)
Protection P,rncipnnf Legal 52,000,000
enNfi
Participant RPG25453 12 01 AM 12.01 AM fxcec^Medical $100,000
=ludivia dental
6 Accident 05/14/2007 05/14/2008 ADRD NA
(5100 deductible per claim)
weekly Indclnmly X
OPSCRIPTION OF OPERAli0NSl1,OC'ATTONStVERICLES/RESTRICTIONS19PGCIAL ITEMS
COVERED SPORTS: UMPIRE/REFEREE ASSOCIATIONS 13-15, UMPIRE/REFEREE
ASSOCIATIONS Over 19
CERTIFICATE HOLDER CANCELLArION
SHOULD ANY OF TME ABOVE DESCRIRFn POI,K'IES BE CANCELLED
EVIDENCE OF COVERAGE BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL
ENDEAVORTOMA❑ lO DAYS WRITTEN NOTTCP TOTAECLRTIFICATE
IIOLDERNAMEDTOTTILLbM BUT FAII,Ultr TO MAIL SUCH NOTICE
ST/ALL TM POSE NO OBLIGATI ONS OR UART1,ITY OF ANY KIND UPON THE ,
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AUTHORIZED
RPPRESCNTAIIVEy�,�
(Compnny A) �-"�
AlnatelIr
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Medical Expense/General Liability
Enrollment for
Amateur Sports Insurance Plan
Page 1 of 5 Application Receipt Oats: 4/11/2007 Tracking Number 5,458
1. GENERAL INFORMATION
Sports Organization: King County Umpires Association
Contact Person: Jim Oswald
Mailing Address: 605 Cedar Drive SE
City, St Zip Code: Auburn, WA 98002
Home Phone: 253-931-8186 Business Phone: 263-395-7911
Fax. 253-396-7935 Found Sadler: Already buy from sadler
Email- joswaldotshsc.com
Temporary Email:
Type of Business. Corporation #of Years in Business, 9
Compensation: No #of Teams in LeaguelAssociabom 0
Location of Sports: 'none listed
I
Agreement Accepted: Yes
II. MEDICAL EXPENSE/GENERAL LIABILITY INSURANCE
Effective Date: 05114/2007
Expiration Date: 05/14/2008
Nation Wide Mutual lnsurancc Company Policy N: RPG25453
Limits:
General Liability Limit $2,000,000,00
Medical Expense Limit: $100,000.00
Medical Expense Deductible, $100 00
Medical Expense Plan Full Excess
COVERAGE EFFECTIVE DATE: Coverage begins the exact time nod dptc that this elecirotnc application
and inte^net check is received at Sadler&Company or a future cffecrivc date it requested,whiehcvcr is later
and continues for one full year from the effective date
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0 1997-2007 Sadicr R Company,htc All Rtghls Rcacrved
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