HomeMy WebLinkAboutPK08-390 - Original - The Way Back Inn Foundation - 9815 SE 252nd St Rental Agreement - 09/01/2008 l \
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Lease Agreement
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: The Way Back Inn Foundation Number:
JD Edwards Number
Contract Number:
This is assigned by Deputy City Clerk
Description: Lease Agreement for The Way Back Inn Foundation
Detail:
Project Name: The Way Back Inn Foundation Lease Agreement
Contract Effective Date: November 4 2008 Termination Date: Aug 3, 2013
Contract Renewal Notice (Days): 30 Days
Number of days required notice for termination or renewal or amendment
Contract Manager: Charlie Lindsey Department: Parks/Facilities
Abstract:
S:Public\RecordsManagement\Forms\ContractCover\ADCL7832 07/02
CITY CLERK
CITY OF KENT
220 4Kente nue South
KENT WA 98032
WA5HINGTGN
Fax 253-856-6725
PHONE: 253-856-5725
Lease Agreement Cover Sheet
Instructions
This document is to be used in lieu of the Contract Cover Sheet
SECTION 1 — CONTRACT PROCESSING AND TENANT SET-UP:
All lease agreements must be signed by the Mayor or his/her designee and approved
by the City Council. Lease amendments, extensions, renewals, and assignments may
or may not require Council approval (contact the Law Department), but they must be
signed by the Mayor.
The City Clerk's Office will perform the following tasks associated with all lease
agreements and amendments:
• Assign a sequential lease agreement number based on starting with 001 and
preceded with "U', e.g. L001.
• Scan the Lease Agreement Cover Sheet, Lease Agreement (or Amendment) and,
if any, related supporting documentation into the document imaging system.
• Provide notification via e-mail to the Contact Person (Question 2), Law and
Customer Services.
The Lease Agreement Cover Sheet is to be completed for each existing and active and
all subsequent lease agreements, lease amendments and assignments of lease. There
is recognition that certain existing and active agreements and amendments may not
incorporate new policies, e.g. commencement of the lease on the 1'Y of the month or
year. Those agreements and amendments will be addressed through subsequent
agreements and/or amendments, if any.
Contract Number: L016-09
1. Responsible Department/Division: Parks/Facilities
2. Contact Person and Title: Charlie Lindsey
Telephone Extension: 5081
3. Tenant (Customer) Name: Way Back Inn Foundation
4. Tenant (Customer) Number: 228001
Lease Agreement Cover Sheet—Page 1 of 4
5. General Ledger Account Number: 54006900.32500.0303 (Leasehold Excise
Tax Only Invoiced)
6. King County Tax Parcel Number: 192205-9075
7. Address of Parcel: 9815 Southeast 252"d Street, Kent
8. Type of Lease: Rental Agreement - Residential Building Rental
9. Council Authorization Date: November 4, 2008
10. Mayor Signature Date: November 7, 2008
SECTION 2 - LEASE DURATION AND IMPORTANT DATES:
All lease agreements and amendments must reflect the lease start date, lease
termination date and the duration of the lease. The lease agreement may also
authorize the tenant to request an extension of the lease term, i.e. either "month to
month" or for a defined period of time. The tenant must provide advanced written
notice of the intent to exercise this lease option.
A date certain lease start date must be established in the lease agreement and must
be the first of the month. Commencement of certain leases may be predicated on
certain actions by the tenant, e.g. installation of cellular tower equipment. In such
instances, a reasonable fixed future date must be established in the lease agreement.
11. Lease Start Date: September 1, 2008
12. Tenant Lease Option Renewal Notification Due Date: N/A
13. Lease Termination Date: August 3, 2013
14. Lease Duration: September 1, 2008 through August 3, 2013. No option to
extend lease term.
SECTION 3 - RENT DETERMINATION AND DUE DATE:
Lease agreement must include provisions establishing the stated rent and, if over one
year in length, modification of stated rent. Typically, rental increases are based on
changes in the Consumer Price Index. Example of possible contract language:
Effective as of each anniversary of the Commencement date (the
"Adjustment Date") by an amount equal to the greater of four (4) percent
or the percentage increase in the CPI two (2) months prior to the
Adjustment Date and the CPI for the month 12 months pnor to the
Adjustment Date. "CPI" means the Consumer Price Index - All Urban
Consumers, (Seattle-Tacoma-Bremerton, WA)_, All Items, base Pero
1982-84=100, Not Seasonally Adjusted, issued by the U.S. Bureau of Labor
Statistics. If the CPI Is converted to a different standard reference base, or
otherwise revised, the adjustment set forth in this paragraph shall be made
with the use of the conversion formula published by the U.S. Bureau of
Labor Statistics.
Lease Agreement Cover Sheet-Page 2 of 4
15. Rent: No monetary rent. In lieu of monetary rent tenant to make all stated
improvements at its sole expense (outlined in Exhibit B to the Rental
Agreement), and pay all costs associated with or arising ourt of the maintenance
and operation of the leased premises. In an e-mail dated May 28, 2009 Llewellyn
Real Estate established an estimated fair market value rental at $750.00/month.
16. Rent Due Date: 15T of the Month (Leasehold Excise Tax Only)
17. Calculation of Rental Increase(s): N/A - No increases within the term of the
Rental Agreement except with respect impact of potential changes in fair market
value of rental on leasehold excise tax.
SECTION 4 — LEASEHOLD EXCISE TAX:
Leasehold excise tax applies to the possession and use of publicly owned real property
by a private sector individual, business or other organization. This tax is calculated
based on 12.84 percent of the contract rent amount. See also Department of
Revenue Leasehold Excise Tax Frequently Asked Questions and Answers
(http://dor.wagov/docs/Pubs/IndustSpecific/Leasehold.i)df). Contact the Customer
Services Financial Analyst (LIDS/Receivables) or the Audit Manager regarding
questions in this area.
18. Is this lease subject to leasehold excise taxes?
® YES (go to Question 19)
❑ NO, reason: Reason
19. Are leasehold excise taxes for this tenant centrally assessed, i.e. directly
collected from the tenant by the Washington State Department of
Revenue?
❑ YES (attach written verification received directly from DOR or indirectly
through the tenant, e.g. DOR notification letter)
® NO (go to Question 20)
20. Does Lease Rent include Leasehold Excise Tax?
(Leasehold taxes must be broken out on the invoice and coded: Business
unit.32500.0303)
® YES Calculate the leasehold excise tax (Stated Rent divided by 1.1284)
❑ NO Calculate the leasehold excise tax (Stated Rent times .1284)
SECTION 5 — APPLICABLITY OF UTLITIES:
The Lease agreement must include provisions establishing responsibility for payment
of utilities, including but not limited to electricity, natural gas, water, sewer, storm
drainage, and garbage collection and disposal services.
In certain instances, the utility service may not be applicable, e.g. septic system, or
may not be provided by the City, e.g. Highline Water District service area. In all
instances, City utilities will be billed through the Customer Services utility billing
Lease Agreement Cover Sheet—Page 3 of 4
system. Other utilities paid by the City on behalf of the tenant, e.g. electricity or
natural gas, will be invoiced to the tenant through the central accounts receivable
system (JD Edwards).
Electricity or natural gas charges may be established based on actual consumption,
e.g. usage of a meter or by a reasonable amount established through appropriate
financial analysis. Separate meters for measurement should not be established on
City-owned or leased properties. The dollar amount of electric and natural gas
charges must be included in the lease agreement (amendment) and should be subject
to future modification based on appropriate methodologies, e.g. change in rate, etc.
Contact Finance Customer Services for questions in this area, as well as ensuring that
City accounts are transferred into the name of the tenant.
21. Applicability of Utilities — Check all that utilities that are affected and
indicate provider (e.g. City of Kent), Account Number or basis of
exclusion.
❑ Does Not Apply
® Water: 803-09625.02
® Sewer: 803-09625.02 (hooked up to City sewer April 13, 2009)
❑ Drainage: Property below the 2,500 square foot minimum established
for billing purposes
® Garbage: Allied Waste
® Electricity/Natural Gas: Puget Sound Energy
Ensure that Finance Customer Services is properly notified to ensure City utility
account, if any, is recorded into the name of the tenant if so established in the
Agreement. Ensure all other applicable charges are properly invoiced to the tenant.
SECTION 6 — MONETARY PENALTIES AND LATE INTEREST CHARGES:
Lease agreement should contain provisions establishing penalties and must contain
provisions establishing late interest charges. Late interest (also referred to as
"finance charges") should be consistent with Chapter 3.10 of the Kent City Code, i.e.
currently 1% of the amount of the unpaid balance or $2.00, whichever is greater, if
not paid within 30 days from the due date.
22. Monetary Penalties: None
23. Late Interest: None
SECTION 7 — OTHER LEASE CONSIDERATIONS:
This is a non-monetary lease rental. Leasehold excise tax is calculated based on the
estimated fair market value of the property and is billed to the tenant.
Lease Agreement Cover Sheet—Page 4 of 4
RENTAL AGREEMENT BETWEEN THE CITY OF KENT AND
THE WAY BACK INN FOUNDATION
The CITY OF KENT, a Washington municipal corporation (`Lessor"), whose
mailing address is 220 Fourth Avenue South, Kent, Washington 98032 enters
into this Rental Agreement with The Way Back Inn Foundation, (a
Washington non-profit corporation, under the following terms:
UPON THE FOLLOWING TERMS AND CONDITIONS:
1. PREMISES. Lessor leases to Lessee the Residence and all
appurtenances situated on the real property (the "Premises") legally
described in Exhibit A, attached hereto and incorporated herein by this
reference and commonly referred to Campus Park House at 9815 South 252
Street.
2. TERM. This Rental Agreement shall commence on the 1st day of
September, 2008 and shall terminate on the 3rd day of August, 2013 unless
sooner terminated under the terms of this Rental Agreement.
3. USE. Lessee shall use the leased premises to provide temporary
single-family dwellings for homeless families with children under fourteen
years of age (tenants), and all current uses incidental thereto, and for no
other purpose without first obtaining Lessor's prior written consent.
4. RENT. During the Term hereof, Lessee may occupy the leased
premises rent free; provided, however, Lessee shall make all necessary
improvements at its sole expense, as outlined in Exhibit B; provided such
improvements shall be subject to a final inspection and the approval of the
Facilities Superintendent of the Kent Parks, Recreation and Community
Services Department, prior to the occupancy of the leased premises, and pay
all costs associated with or arising out of the maintenance and operation of
the leased premises as set forth herein.
5. RENTAL AGREEMENT POSSESSION. Lessee is currently in possession
of the Premises under a prior Rental Agreement. Lessee shall be deemed to
have accepted possession of the leased premises in as-is condition. Lessor
has made no representations to Lessee respecting the condition of the leased
premises. Upon taking possession of the premises by the Lessor, either upon
Rental Agreement - Page 1 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
termination of this Agreement or upon abandonment of said premises by the
Lessee, the Lessor or his Agent may remove from the premises all personal
property of tenants located therein and place the same in storage at a public
warehouse at the expense and risk of the owners thereof. Personal property
so stored shall be subject to the rules and regulations as set down by such
public warehouse. Disposition of any personal property shall be subject to the
Residential Landlord-Tenant Act, Chapter 59.18 RCW.
6. LESSEE MAINTENANCE AND REPAIR RESPONSIBILITY. Lessee shall,
when and if needed, at Lessee's sole expense, make repairs to the leased
premises and every part thereof; and Lessee shall maintain the leased
premises, including the yard, in a neat, clean, safe and sanitary condition at
all times. At the end of the lease, Lessee shall surrender the leased premises
and dwelling to Lessor in a clean, good, and a sanitary condition with the
exception of reasonable wear and tear.
7. UTILITIES. Lessee shall pay, prior to delinquency, all charges for heat,
electricity, water, sewer, garbage, telephone, and other utility services
supplied to the leased premises. All leasehold assessments and charges not
specifically assumed by the Lessor are the obligation of, and payable by, the
Lessee.
8. ALTERATIONS AND ADDITIONS BY LESSEE. The Lessee shall not
remove any fixtures, alter, or make major improvements to the premises
without prior written approval of the Lessor. After obtaining the prior written
consent of Lessor, Lessee may make, at its sole expense, such additional
improvements or alterations to the leased premises that it may deem
necessary or desirable. Any repairs or new construction by Lessee shall be
done in conformity with the Uniform Building Code and City of Kent
regulations. All work performed shall be done in a workmanlike manner and
shall become the property of the Lessor.
9. LIENS. Lessee shall keep the leased premises. free from any liens
arising out of any work performed, materials furnished, or obligations
incurred by Lessee.
10. INSURANCE. Prior to the commencement date, at no expense to the
City of Kent, the Lessee shall obtain and furnish to the City of Kent Risk
Manager, a CERTIFICATE OF INSURANCE showing general liability
insurance coverage including blanket contractual coverage, which certificate
(1) shall be subject to approval of the City Attorney as to the company, form
Rental Agreement - Page 2 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
and coverage, and shall be primary over all other insurance the City may secure;
(2) must fully protect the City from any and all claims and risks in connection with
any activity performed by The Way Back Inn Foundation and tenant by virtue of this
Lease; and (3) must specifically name the City of Kent as an additional insured as
respects work performed by or on behalf of Lessee and a COPY OF THE
ENDORSEMENT NAMING THE CITY OF KENT AS AN ADDITIONAL INSURED
SHALL BE ATTACHED TO THE CERTIFICATE OF INSURANCE AND SIGNED
LEASE. Such policy must provide the following minimum coverage:
Commercial General Liability insurance written on an occurrence basis with limits no
less than $1,000,000.00 combined single limit per occurrence and $2,000,000.00
aggregate for personal injury, bodily injury and property damage. Coverage shall
include but not be limited to blanket contractual; products/completed operations;
broad form property damage; explosion, collapse and underground (XCU) if
applicable; and employer's liability.
Any payment of deductible or self-insured retention shall be the sole responsibility
of the Lessee.
The Lessee's insurance shall be primary insurance as respects the City and the City
shall be given thirty (30) days prior written notice of any cancellation, suspension
or material change in coverage.
11. DESTRUCTION OR DAMAGE. Should said dwelling be totally destroyed by
fire, lightning, earthquake or any other casualty, this Agreement shall be deemed
terminated, forthwith. Should fire, lightning, earthquake or any other causality
partially damage said dwelling, whether or not the premises are affected thereby;
Lessor may elect to terminate this Agreement or to repair such damage.
12. HOLD HARMLESS AGREEMENTS. Lessee covenants to hold Lessor harmless
from all claims, demands, causes of action, judgments, attorney's fees, costs and
expenses arising from or connected with Lessee's use or occupancy of said
premises or the area adjacent thereto, and from all claims, demands, causes of
action, judgments, attorney's fees, costs and expenses for property damage, bodily
injuries or death suffered or caused in or about said premises or the area adjacent
thereto, resulting directly or indirectly from the acts or omissions of Lessee, tenant
or any agent or guests of Lessee or tenant.
13. ASSIGNMENT AND SUBLETTING. Lessee shall not assign this Lease or sublet
any part of these premises without Lessor's prior written consent.
14. DEFAULT. Failure by Lessee to make the improvements as set forth in
Exhibit B, or failure by Lessee to observe or perform any of the covenants,
conditions, or provisions of this Lease, where such failure shall continue for a period
Rental Agreement - Page 3 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
of ten (10) days after written notice from Lessor to cure the default, shall constitute
a default and breach of the Lease by the Lessee. Lessee shall notify Lessor
promptly of any default that by its nature would not necessarily be known to
Lessor.
15. ACCESS. Lessor reserves the right to make periodic inspections of the leased
premises at reasonable times for the purpose of ascertaining compliance with the
provisions hereof by Lessee, but nothing herein shall be construed as imposing any
obligation on Lessor to perform any work or duties.
16. COMPLIANCE WITH LAWS. RULES AND REGULATIONS. Lessee shall, at its
sole cost and expense, promptly comply with all laws, statutes, ordinances, and
governmental rules, regulations or requirements now in force or which may
hereafter be in force relating to or affecting the conditions, use, or occupancy of the
leased premises. Lessee shall faithfully observe and comply with the rules and
regulations that Lessor shall from time to time promulgate, including, without
limitation, those regulations affecting signage on the Premises.
17. PERMITS. Lessee shall, at its sole cost and expense, be responsible for
obtaining any permits or licenses that are necessary to perform the covenants of
this Rental Agreement.
18. NOTICES. All notices under this Lease shall be in writing and shall be
effective when mailed by certified mail or delivered to Lessor at the address below
stated, or to Lessee at the address below stated, or to such other address as either
party may designate from time to time:
LESSOR: CITY OF KENT DEPARTMENT OF PARKS, RECREATION & COMMUNITY
SERVICES
ATTN: SUPERINTENDENT OF FACILITIES
220 4th AVENUE SOUTH
KENT, WASHINGTON 98032-5895
LESSEE: THE WAY BACK INN FOUNDATION
C/O Dorothy Francis
PO BOX 621
RENTON, WASHINGTON 98057-0621
19. TERMINATION. Either party has the right to terminate this Agreement if the
other party is in default of any material obligation or representation of this Lease
which substantially harms the non-defaulting party and which default is incapable of
cure, or which being capable of cure, is not cured within ten (10) days after receipt
of written notice of such default.
Rental Agreement - Page 4 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
20. GENERAL PROVISIONS.
a. TIME IS OF THE ESSENCE OF THIS LEASE.
b. The Lessee hereby agrees to be responsible for and reimburse in full,
the Lessor, for any costs or attorney's fees that may arise from any
legal action the Lessor may bring under this Agreement.
C. This Lease shall be construed and governed by the laws of the State of
Washington.
d. Lessee agrees that the existing locks for the premises are reasonably
adequate and that, upon termination of the tenancy, Lessee shall
return all keys in its possession to the Lessor.
e. Lessee shall maintain the smoke detection device in accordance with
the manufacturer's recommendations, including the replacement of
batteries as required for the proper operation of the smoke detection
device.
f. Lessee shall maintain the carbon monoxide detector in accordance
with the manufacturer's recommendations, including the replacement
of batteries as required for the proper operation of the carbon
monoxide detector.
g. Lessee shall properly dispose of all rubbish, garbage and other organic
or flammable waste, in a clean and sanitary manner at reasonable and
regular intervals, and Lessee shall assume all costs of extermination
and fumigation for infestation caused by Lessee.
h. Lessee shall properly use and operate all electrical, gas, heating,
plumbing and other fixtures and appliances supplied by the City of
Kent that are in reasonably good working order.
21. AUTHORITY OF LESSEE. Lessee and each individual executing this Lease on
behalf of Lessee represent and warrant that he or she is duly authorized to execute
and deliver this Lease, and that this Lease is binding upon Lessee in accordance
with its terms.
22. WAIVER AND FORBEARANCE. No waiver by Lessor of any breach or default
by Lessee of any of its obligations or agreement or covenants herein, shall be
deemed to be a waiver of any subsequent breach or default of the same or any
other covenant, agreement or obligation, nor shall forbearance by Lessor to seek
remedy for any breach or default of Lessee be deemed a waiver by Lessor of its
rights and remedies with respect of such breach or default.
23. ENJOYMENT. Provided Lessee is not in default hereunder, Lessor covenants
that Lessee shall have peaceful and quiet enjoyment of the leased premises without
hindrance on the part of the Lessor.
Rental Agreement - Page 5 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
IN WITNESS WHEREOF, the parties hereto have executed this Lease the date and
year written.
LESSEE: LESSOR:
THE WAY BACK INN FOUNDATION CITY OF KENT
B BY:
4 V
Its: Presid t Its• r
Dated: c gX -2-eo D6 d: ZZ7 100,
APPROVED AS TO FORM:
Kent Law Department
(Notary Acknowledgements Appear on Next Page)
Rental Agreement - Page 6 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
STATE OF WASHINGTON )
) ss:
COUNTY OF KING )
I hereby certify that on the 1 "k day of 2008, I
know or have satisfactory evidence that SUZETTE COOKE is the person who
appeared before me, and said person acknowledged that he signed this instrument,
on oath stated that he is authorized to execute the instrument on behalf of the CITY
OF KENT as its Mayor, and such execution to be the free and voluntary act of such
party for the uses and purposes mentioned in the foregoing instrument.
-Notary Seal Must Appear Within This Box-
IAW � REOF, I have hereunto set my hand and official seal the day and
year fits i '
otAR) l ,
s l�_ ft OFF
lit Or WAB� NOTARY PUBLIC, in and for the State of Washington
i
residing at f5L- i` VQrc
My appointment expires (7--Z9-Oq
STATE OF WASHINGTON )
) ss:
COUNTY OF KING )
I hereby certify that on the day of Se., v 2008, I
know or have satisfactory evidence that Kr&,, '1 is the person
who appeared before me, and said person ac nowledged that he signed this
instrument, on oath stated that he is authorized to execute the instrument on behalf
of the WAY BACK INN FOUNDATION as its President, and such execution to be
the free and voluntary act of such party for the uses and purposes mentioned in the
foregoing instrument.
-Notary Seal Must Appear Within This Box-
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day
and year first.above written.
n
rr; s NOTARY PUBLIC, in and for the State of Washington
residing at �tr-�d,J��,JA -
�, My appointment expires S- - 'ZoD9
P:\CIvll\Files\OpenFlles\0733-2008\W ayBackInn Fou ndatlon-RentalAg reement2008.doc
Rental Agreement - Page 7 of 7
(Between City of Kent and Way Back Inn Foundation) (September 17, 2008)
King County Property Description for parcel number 1922059075 Page 1 of 3
IL
HOME NEWS SERVICES DIRECTORY CONTACTSear
KCGIS Center
www.KingCounty.gov/GIS
KCGIS Parcel Reports Assessor information for parcel number 1922059075
Property Report Taxpayer name KENT CITY OF Parcel number 1922059075
Districts and Development Tax Account 192205907509
Conditions Report Mailing address 220 4TH AVE S
KENT WA number
Find Your Council District 98032 Levy code _ J525
Find Your Watershed Jurisdiction KENT
KCGIS Center Present use Single Family(Res
Use/Zone
Appraised value $420,000
Address(es)at this 9815 SE 252ND ST 98030
parcel
King County GIS Center Legal description
King Street Center
201 S. Jackson St N 1/2 OF NE 1/4 OF SE 114 OF SE 114 LESS W 100 FT OF E 450 FT LESS ST
Suite 706
Seattle, WA 98104 Sales/Quit Claims/Transfers
giscenter@kingcounty.gov
Sale date Sale Buyer Seller Excise tax Recording Instrument
+47.59909 N price number number type
- 12-2.33136 W 12-29-1982 $0 KENT KENT 701468 198301040032 Warranty
CITY OF CITY OF Deed
+470 35' 56 72"
- 122° 19' 52.90" Parcel description
Property Plat Water WATER
name name system DISTRICT
Property type R-RESIDENTIAL Plat Sewer PUBLIC
Present use Single Family(Res block system
Use/Zone) _ Plat lot _ Access PUBLIC
Lot area 174,125 sq.ft.(4.00 acres) Q-S-T-R SE-19-22- Street ~ GRAVEL
5 surface
Residential building description
Building 1 of 1 Total living sq.ft. 830 Bedrooms 2
Year built 1959 Baths 1
Year renovated 0 1st floor sq.ft. 830 1/2 baths 0
Stories 1 ------- --- 3/4 baths 0
Half floor sq.ft. 0 ----
Building grade 7-Average Single story 1
2nd floor sq.ft. 0 fireplace
Condition_ Average - Upper floor sq.ft. 0
Finished basement NONE OR Multi-story 0
grade UNKNOWN Total basement sq. 0 fireplace _
Free-standing 0
Finished basement 0 fireplace _
sq.ft. - Percent brick or 0
Basement garage 0 stone
sq.ft. - Daylight
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1922059075 9815 SE 252ND ST Wshow`;`
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Parcel Number 1922059075 *Identify
Address 9815 SE 252ND ST �N '
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Zipcode 98030 "7p Large
Taxpayer KENT CITY OF
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EXHIBIT B
TENANTIMPROVEMENTS
WAY BACK INN
9815 South 252nd Street
General/Routine Maintenance to be performed on an on-going basis
• Ensure that routine cleaning and custodial work is completed within
the interior of the building
• Paint interior walls and ceilings
• Maintain smoke detectors per Kent City Code
• Remove tree limbs
• Provide and spread bark mulch around all landscaping
• Clean gutters and downspouts
• Clean Roof
• General clean up of yard and out-building
• Quarterly review of plumbing, electrical, structural, fire extinguishers
• Professionally clean inside of House
Capital Improvements to be completed during the term of the lease
• Replace baseboard heater in Master bedroom
• Re-caulk bathroom
• Replace sub-floor and any rotted lumber under toilet
• Replace covering rear covered patio
• Replace gutters and downspouts
Rental Agreement Exhibit B 9/18/2008
Way Back Inn
BC® 7® DATE
. 07/24/2 008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
QRMS, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
Mercer Island WA 98040-
INSURED INSURER A:MARKEL INSURANCE COMPANY
The Way Back Inn Foundation INSURER B:
PO BOX 621 INSURER C:
INSURER D:
Renton WA 98055-0621 INSURERE:
COVERAGES
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.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE MMIDD DATE MMIDD/YY
A GENERAL LIABILITY / / / / EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE An one fire) $ 100,000
CLAIMS MADE �OCCUR 8502SS300430-1 07/24/2 008 07/24/2009 MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
X POLICY JERT M LOC
AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS / / / / BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS / / / / BODILY INJURY
NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO / / / / OTHER THAN EA ACC $„
AUTO ONLY: AGG $
EXCESS LIABILITY / / / / EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE / / / / $
RETENTION $ 7 $
WORKERS COMPENSATION AND / / / / TORY LIMITS ER
EMPLOYERS'LIABILITY
E.L.EACH ACCIDENT $
E.L.DISEASE-EA EMPLOYEE$
E.L.DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
THE CITY OF KENT IS NAMED AS AN ADDITIONAL INSURED WITH RESPECT TO THE LEASE OF PREMISE @ 9815 SE 252ND STREET, KENT,
WA 98031 BY THE INSURED DURING THE TERM OF THE POLICY.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED;INSURER LETTER:_ CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
CITY OF RENT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
220 4 th Avenue S. IN.IRER,ITS AGEL. ENTATI1-S.
AUTP^ "'^REPRESENT 7.
KENT WA 98032- c'
ACORD 25-S(7197) i c ACORD CORPORATION 1988
INS025S(9910).01 ELECTRONIC LASER i'ORMS,INC.-(800)327-0545 Page 1 of 2
POLICY NUMBER 8502SS300430-0 COMMERCIAL GENERAL LIABILITY
CG 20 10 03 97
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following-
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
CITY OF KENT-REGARDING LEASE OF PREMISE @ 9815 S.252nd,Kent,WA 98031
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement)
Who Is An Insured (Section II) is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured.
GG 2010 03 97 Copyright, Insurance Services Office, Inc.. 1996 Page I of 1
REQUEST FOR MAYOR'S SIGNATURE
�KKENT Please Fill in All Applicable Boxes
WASHINGTON
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) `
I
Originator: Charlie Lindsey Phone Ori inator .. 5081
Date Sent: 11/6/08 Date Required: 11/
Return Signed Document to: Rosalie CONTRACT TERMINATION DATE: 8/3/2013
VENDOR NAME: The Way Back Inn DATE OF COUNCIL APPROVAL: 11/4/2008
Foundation
Brief Explanation of Document: Rental Agreement for The Way Back Inn Foundation. This
agreement is for the Parks Property located at 9815 S. 252"d St. Kent. They do not pay the City
Rent, �beeause-it-is-Lined-€ef-tr=a4asisti o n-a l-h o u sing-fo r—fa m i_l ins-w ith-ch i Id r-en E., e-
��LCE.A..L_��✓ v-u jE&Q-, ► ��.r�'t �'� 1p �n
Ali Contracts Must Be Routed Through The Law Department
(This area to be completed by the Law Department)
RECEIVED
Received: [D Ei `fFmm
Approval of Law Dept. 2A4l / NOV 0 1 2OO8
Law Dept. Comments: City 1111i �, City of Kent
Office of the Mayor
EDateorwarded to Mayor: -71U Y S-s�o-L�,
Shaded Areas To Be Completed By Administration Staff
Received
Recommendations and Comments:
Z
Disposition
Date Returned,:, 11
Pay Back Inn
Post Office Box 621 Telephone(206)682-7382
Renton,WA 9 8 0 5 7-062 1 Website•www.way-back-inn.org
August 18, 2012
Ms. Rosalie Givens,
Parks Facilities
City of Kent
220 41h Avenue South
Kent,WA 98032
Reference: House Leased at
9815 South 252°d Street, Kent
Dear Ms. Givens,
Enclosed please find Certificate of Liability Insurance for the above property,July 2411%
2012 -July 24n', 2013.
Sincerely,
pDoroth Fran sent
1/1an,�youfo�lelp�toprnrxdeJo�fnrynrt✓rgclul�iz
ACORD� CERTIFICATE OF LIABILITY INSURANCE D0ATE8/16IDD/Y2
PRODUCER Phone.(206)230-0474 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ARMS, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
PO BOX 580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Mercer Island,WA 98040
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER MARKEL INSURANCE_COMPANY
THE WAYBACK INN FOUNDATION INSURER 8
PO BOX 621 INSURERC
Renton,WA 98055 INSURER D
INSURER E
COVERAGES
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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR AOD1 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A Y GENERAL LIABILITY 8502SS300430-5 07/24/2012 07124M13 EACH OCCURRENCE $ 11000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea t umnce $ 100 wo
CLAIMS MADE FX-1 OCCUR MED EXP(Any one erson) $ 5 000
PERSONAL 8 ADV INJURY $ 11000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 2000000
X POLICY F,PR06 LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO
(Ea ecudent)
ALL OWNED AUTOS BODILY INJURY
SCHEDULEDAUTOS (Per pemon) $
HIRED AUTOS BODILY INJURY
NON-OWNEDAUTOS (Per acadent) $
PROPERTY DAMAGE $
(Per acadent)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
E
DEDUCTIBLE $
RETENTION $ $
Y LIMITS
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS'LIABILITY
EL EACH ACCIDENT $
ANY PROPRI ETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? E L DISEASE-EA EMPLOYE $
It yes,descnbe under
SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
THE CITY OF KENT IS NAMED AS AN ADDITIONAL INSURED WITH RESPECT TO THE LEASE OF PREMISE C 9815 SE 252ND
STREET,KENT,WA 9=1 BY THE INSURED DURING THE TERM OF THE POLICY .
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN
CITY OF KENT NOTICE TO THE CERTIFICATE FOLDER NAMED TOTHE LEFT,BUT FAILURE TO DO SO SHALL
220 4th Avenue S. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Kent,WA 98032 REPRESENTATIVES
A REPRESENT
DJA
ACORD 25(2001108) )Pnnta0 ACORD CORPORATION 1988
JA on August 16,2012 at 02 50PM
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the pohcy(jes)must be endorsed A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)
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)
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s),authorized representative or producer,and the certificate holder, nor does it
affirmatively or negatively amend,extend or alter the coverage afforded by the policies listed thereon
ACORD 25(2001/W)
Pnnted by DJA an August 16,2012 at 02 50PM
a