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HomeMy WebLinkAboutPK12-063 - Original - Rocco Salsa Dogs - Consessionaire Contract - 3/26/12 400,7*.. Records Maur time r' E KENT Document WASHINGTON 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 Clerk's Office. Vendor Name: Rocco Salsa Dogs Vendor Number: JD Edwards Number Contract Number: Pt: ('•Z- ®�� This is assigned by City Clerk's Office Project Name: Conessionaire Contract Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract a ❑ Other: Contract Effective Date: 3/26/2012 Termination Date: 11/20/2012 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Lori Hogan Department: Parks Recreation Detail: (i.e. address, location, parcel number, tax id, etc.): Concessions for athletic events _ S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 I CITY OF KENT CONCESSION AGREEMENT-Mobile Unit THIS AGREEMENT is made and entered into by and between the City of Kent, a Washington municipal corporation, (the "City"), and Rocco Salsa Dogs, (Rocco Cacciatore, owner) 10030 SE 225th Place, Kent, WA 98031, (253) 334-8873 / (253) 852-8737, ("Concessionaire"). AGREEMENT 1. Grant of Concession. The City grants to Concessionaire the right and privilege to sale food, beverage, merchandise, and other goods, products and services within the limits of Wilson Playfields, City of Kent, County of King, State of Washington. This right applies to all events, with the exception, at City's sole discretion, of certain events where organizers may be allowed to bring in additional vendors during large national tournaments and/or special events, in order to meet the needs of their event (see Exhibit A, Schedule of Events). 2. Term of Agreement. The term of this agreement shall commence March 26, 2012 and end November 20, 2012, with an option to renew for additional one (1) year terms at the end of each term, by mutual agreement of the parties in writing. 3. Termination of Agreement. The failure on the part of Concessionaire to comply with any of the provisions of this agreement, or the failure to obey, perform or to comply with local, state or federal laws, rules, regulations or requirements now existing or hereinafter enacted, shall be grounds for the City to terminate this agreement and revoke its grant of all rights of Concessionaire under this agreement The City expressly reserves the right and power to terminate this agreement upon giving Concessionaire ten (10) days advance written notice for cause as set forth herein, and Concessionaire expressly waives the right to claim or recover any damages on account of such termination against the City, its officers, officials, employees, agents and volunteers. The City may order Concessionaire to cease operations hereunder immediately at any time should the City, in its sole discretion, determine that Concessionaire's operation is detrimental to public safety, health or welfare. Upon expiration of this agreement, or upon prior termination thereof Concessionaire agrees to promptly cease to operate the point of sale concession at the location specified herein, without any right or claim to reimbursement, compensation, or remuneration of any kind. Notwithstanding the foregoing, either party may terminate this agreement with ninety (90) days' notice to the other party in writing. 4. Payment for Concession. Concessionaire shall pay to City 10 % of its monthly gross receipts from the concession privileges granted by this agreement as described in Section 1. Concessionaire shall make payment to the City for each calendar month of operation, said payment being due and payable no later than the tenth (loth) of the following, accompanied by a signed and certified written report for the prior calendar month period of all Gross Receipts for such period in a form reasonably approved by the City. All payments shall be paid or delivered to: City of Kent Finance Department Customer Services Division 220 Fourth Avenue South Kent, WA 98032-5895 In addition, a copy of the written report shall be delivered to the City of Kent Parks Department at the above noted address by the tenth (10th) of each month. If any payment due under this Agreement is not paid to the City within ten (10) days after the date specified, a one-time late charge of five percent (5%) of the payment due shall be added to the payment as a penalty, and the total sum shall become immediately due and payable. Any amount remaining unpaid by the first day of the month following the due date for payment (i.e. approximately 20 days late) shall bear interest at the rate of one percent (1%) per month. The Concessionaire shall maintain records respecting that activity which truly, completely, and accurately disclose all information necessary to determine the Concessionaire's rent liability hereunder during each reporting period. Such records shall be kept and maintained for a period of not less than three (3) years. All books, records, and other items required to be kept and maintained under this section shall be subject to, and immediately made available for inspection and audit at any time, with or without notice, at the place where such records are kept upon the demand of the finance director or his or her designee. Any amount due and unpaid under this Agreement and all penalties, service charges, or fees shall constitute a debt to the city. The city may, pursuant to Chapter 19.16 RCW, use a collection agency to collect outstanding debts, or it may seek collection by court proceedings, which remedies shall be in addition to all other existing remedies. 5. Rules Governing Concession Operation. Concessionaire agrees to comply with the following provisions. Violation of any of these provisions in City's sole discretion shall constitute cause to terminate the agreement with ten (10) days' notice pursuant to Section 3 Termination of Agreement: a. The location of Concessionaire's point(s) of sale, methods of sale, and prices charged for commodities sold under this agreement are subject to the supervision, direction and approval of the City. The City expressly reserves the right to make rules, regulations and requirements relating to the management of any and all of the locations operated by the Concessionaire under this agreement, including the regulation and prices at which commodities handled or dispensed by the Concessionaire shall be sold to the public. b. Concessionaire shall pay a $200.00 cleaning deposit fee to the City. The cleaning deposit fee will be returned to Concessionaire within 14 days of termination of this agreement, provided Concessionaire cleans the concession area to the satisfaction of the City. Any cleaning or waste disposal deemed necessary to be performed by the City will be at Concessionaire's sole expense. Concessionaire will be required to timely reimburse the City for any cleaning or disposal expense it incurs, and the City may retain Concessionaire's cleaning deposit to offset any such expense. c. Concessionaire shall not establish any point of sale that interferes with on-field events or spectator viewing of events. d. Concessionaire shall furnish all necessary equipment to store, prepare, cook and hold all items of a perishable nature in accordance with King County Health Department rules and regulations. Page 2 e. Concessionaire shall not permit any lewd or immoral conduct in or about the concession area. All persons working in the concession area shall present a neat and clean appearance. f. Concessionaire shall keep the general area around the designated point of sale clean; i.e., keep all bottles, cans, papers and refuse picked up from the area. Upon any failure to do so, after written notice by the City, the City reserves the right to clean the area and charge labor costs to the Concessionaire. g. Concessionaire shall permit any authorized officer or employee of the City to have free access to the concession area at any and all times to ensure compliance with the agreement. h. Concessionaire shall not serve, handle or otherwise possess or store alcoholic beverages or tobacco products of any kind in the concession area. i. A radio or musical device for entertainment may be used by the Concessionaire in the point of sale area; provided, however, that any radio or musical device shall be operated at reduced volume so it cannot be heard at a distance of more than 100 feet from the concession area. j. All deliveries of merchandise shall be made at a time so as not to disrupt scheduled activities. k. Concessionaire shall devote as much time to this concession as may be necessary to provide first-class service to the patrons. Concessionaire shall be open for business seven days per week, while scheduled activities are in progress. All closures, regardless of the circumstances, must be approved by the City; provided, however, that approval shall not be required when any scheduled event has been canceled due to any local, state, or national disaster or force of nature. I. Calling out of wares shall be done in such a manner so as to not interfere with the scheduled event in progress, and no unnecessary loud noises will be permitted. No advertisement, sign, notice, poster or other advertising of any kind or character whatsoever shall be placed, affixed, distributed and/or used in the concession area without prior approval of the City. 6. Independent Contractor. The parties intend that an Independent Contractor- Employer Relationship will be created by this agreement. By their execution of this agreement, and in accordance with Chapter 51.08 RCW, the parties make the following representations: a. Concessionaire 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. b. Concessionaire has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Concessionaire's services and is a service other than that furnished by the City, or Concessionaire is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this agreement. c. Concessionaire is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. Page 3 d. Concessionaire has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Concessionaire's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. e. Concessionaire has a valid contractor registration pursuant to Chapter 18.27 RCW or an electrical contractor license pursuant to Chapter 19.28 RCW. f. Concessionaire maintains a set of books dedicated to the expenses and earnings of its business. 7. Indemnification. Concessionaire agrees to indemnify, defend 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 Concessionaire's performance of this agreement, except for that portion of injuries and damages caused by the City's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'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. In the event Contractor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor's part, then Contractor shall pay all the City's costs for defense, including all reasonable expert witness fess and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Contractor's part. The provisions of this section shall survive the expiration or termination of this Agreement. 8. Discrimination. In the hiring of employees for the performance of work under this agreement or any sub-contract, Concessionaire, its sub-contractors, or any person acting on behalf of Concessionaire or its 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. Concessionaire shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of this agreement, file the attached Compliance Statement. 9. Permits and Insurance. It shall be the responsibility of the Concessionaire to obtain all food handling permits as required by the King County Health Department. Concessionaire shall obtain a comprehensive liability insurance policy with limits of not less than $1,000,000 for bodily injury, and $1,000,000 property damage and shall have a certificate of insurance issued to the CITY OF KENT naming the City as an additional insured. Such certificate shall cover all activities of the Concessionaire with respect to this agreement. The CITY OF KENT shall be provided with thirty (30) days notice prior to termination of such coverage by the insurer. Page 4 10. Taxes, Fees and Permits. The Concessionaire shall obtain and at all times maintain a current City of Kent business license. The Concessionaire shall promptly pay all taxes and fees for its operations to the appropriate collecting agencies. These taxes and fees include, but are not limited to, sales tax and any other taxes imposed by governmental agencies pertaining to the Concessionaire's operations under this Agreement. 11. 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. 12. 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. 13. 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 alternate 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, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limited the City's right to indemnification under Section 7 of this agreement. 14. 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 be 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. 15. 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. 16. 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 Concessionaire. 17. 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. 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. Page 5 18. comply agrees Compliance with Laws. Concessionaire a to IY with all federal, state and P 9 P municipal laws, rules and regulations that are now effective or in the future become applicable to Concessionaire's business, equipment and personnel engaged in operations covered by this agreement or accruing out of the performance of those operations. 19. Counterparts. This agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this Agreement. This agreement shall become effective on the last date entered below. CONCESSIONAIRE CITY OF �/i7� g y: Su Cooke Its: Its: M r Date: /� �� a e: 3 8 /.2 Notices to be sent to Concessionaire: Notices to be sent to the City: Address: . Address: 1490-50 56 Z250 City of Kent Parks, Recreation & Community Services Attn: Lori Hogan, Parks Superintendent r 220 4`h Avenue South Kent, WA 98032 Page 6 Exhibit A Schedule of Events for Wilson Playfields Agreement The concessionaire agrees to be open for business for the following events: March 26 - May 3, 2012 Kent Parks Youth Track Weeknight Meets April 28, 2012 T-Ball and Toss Ball Games May 5, 12, 19, 2012 June 2, 9, 16 2012 May 7 - July 12, 2012 Kent Parks Youth Baseball/Softball weeknight Games September 8, 2012 Kent Parks Youth Soccer Jamboree Sept. 10 - Nov. 20, 2012 Kent Parks League Games (Soccer & Flag Football) Page 7 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 outlined, 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 ///�� / , 20 By: For: Title: Date: Page 8 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. 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. 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. Page 9 r �Y 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 compiled 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 20 By: For: Title: Date: Page 10 ROCCO-1 OP ID:JW CERTIFICATE OF LIABILITY INSURANCE DATE 03123/12 Y) 3/23 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights t0 the certificate holder in lieu of such endorsements. PRODUCER 865-670-0911 CONTACT NAME The Insurance Group,LLC 865-6700877 PHONE FAX - PO Box 32545 AIC No Ext (A/C,No Knoxville,TN 37930-2545 E-MAIL Josh Witt ADDRESS INSURER(S)AFFORDING COVERAGE NAIC IF INSURER A Mount Vernon Fire Ins Co INSURED Rocco's Salsa Dogs,LLC INSURER B 10030 SE 225th Place Kent,WA 98031 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MM DDPOLICY LTR NYYY MMIDDfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CL2598542 06/02/11 06102/12 PREMISES Ea occurrence S 100,00 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL B ADV INJURY S 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ Included POLICY PRO- LOD $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident k $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR El CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T M T ANY PROPR IETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ NIA (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER IS ADDITIONAL INSURED Art Wright Ball Fields, Service Park Ballfields and Wilson Fields Playfields CERTIFICATE HOLDER CANCELLATION CITY OF KENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 FOURTH AVE SOUTH ACCORDANCE WITH THE POLICY PROVISIONS KENT,WA 98032 AUTHORIZED REPRESENTATIVE Cyx =i 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ROCCO-1 OP ID:JW CERTIFICATE OF LIABILITY INSURANCE D ATE (MMID12YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s) PRODUCERNAME 865-670-0911 CONTACT The Insurance Group,LLC 865-670-0877 PHONE FAX PO BOX 32545 A/C No Exl AIC No Knoxville,TN 37930-2545 E-MAIL Josh Witt aooREs$ INSURERS AFFORDING COVERAGE NAIC p INSURERA Mount Vernon Fire Ins Co INSURED Rocco's Salsa Dogs,LLC INSURERS 10030 SE 225th Place INSURER Kent,WA 98031 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE INSR MD ADDL SUER POLICY NUMBER MM DDIYYYY I MM D DYVYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CL2598542 06/02111 06/02/12 PREMISES Ea occumencei $ 100,000 CLAIMS-MADE [X1 OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ Included POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) 5 ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peracadent 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION$ S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T RV L M T R ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E L DISEASE-EA EMPLOYEE S If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER IS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION KENT CORNUCOPOIA DAYS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DRAGON BOAT RACES ACCORDANCE WITH THE POLICY PROVISIONS %KDBA 12932 SE KENT RD AUTHORIZED REPRESENTATIVE KENT,WA 980307940 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD REQUEST FOR MAYOR'S SIGNATURE KENT Please Fill in All Applicable Boxes Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Reviewed by Parks Director Originator: Lori Hogan Phone Ori inator : x5067 Date Sent: 3/26/2012 Date Required: 3/30/2012 Return Signed Document to: Lori H/Teri P CONTRACT TERMINATION DATE: 11/20/2012 VENDOR NAME: Rocco Salsa Dos DATE OF COUNCIL APPROVAL: n/a Brief Explanation of Document: This is an annual concession agreement for mobile food cart to be available at athletic events. All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: �� Approval of Law Dept,: MAR 2 7 2012 Law Dept. Comments: �Q F _ Date Forwarded to Mayor: Shaded Areas To Be Completed By Administration Staff Received: �j Recommendations and Comments . i Disposition:-������ � /�/��,,,, � �i Cl't'Or K;NT Date Returned: