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HomeMy WebLinkAboutL12-028 - Amendment - #2 - Vortex Agility & Dog Training - Limited Use of City Real Property - 12/22/2015 KEN 7" WASH NGTON ' Document I ��rt�i r i tla� 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: Sandra Katzen dba Vortex Agility and Dog Training Vendor Number: Customer #434050 ]D Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: Limited Use Licence - Renewal Amendment Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 3/13/2012 Termination Date: 3/13/2018 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Lynn Osborn Department: Parks Planning & Dev. Detail: (i.e. address, location, parcel number, tax id, etc.): Amendment #2 to original agreement; operation on premises began under agreement with former owner Huse prior to our acquisition of property; Division contract #PPD14-20 S:Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 B®C�T W naitnciox AMENDMENT TWO TO LICENSE FOR LIMITED USE OF CITY REAL PROPERTY (between the City of Kent and Sandra Katzen d/b/a Vortex Agility and Dog Training) NAME OF LICENSEE: Sandra Katzen, d/b/a Vortex Agility and Dog Training ORIGINAL EXPIRATION DATE: 03/13/2014 REVISED EXPIRATION DATE UNDER PRIOR AMENDMENT(S): 03/13/2016 REVISED EXPIRATION DATE UNDER THIS AMENDMENT TWO: 03/13/21018 This Amendment Two to License for Limited Use of City Real Property ("Amendment Two") is made between the city of Kent, a Washington municipal corporation ("City"), and Sandra Katzen, d/b/a Vortex Agility & Dog Training ("Licensee"), and amends the parties' License Agreement, dated March 13, 2012, as that License Agreement was amended through Amendment One, dated August 5, 2014. For valuable consideration and through the mutual intent, desire, and promises of the parties, the City and Licensee agree to further extend the term of the license through March 13, 2018, upon the same terms and conditions provided for in the original License Agreement, as previously amended through Amendment One. Licensee accepts all requirements of this Amendment Two by signing below, and by her signature, waives any protest or claim she may have regarding the License Agreement or any Amendment. This Amendment Two, unless otherwise provided, does not relieve Licensee from strict compliance with the indemnification and insurance provisions of the original License Agreement. All acts consistent with the authority of the License Agreement, Amendment One, and this Amendment Two, prior to the effective date of this Amendment Two, are hereby ratified and affirmed, and the terms of the Agreement, Amendment One, and this Amendment Two shall be deemed to have applied. Except as expressly modified by this Amendment Two, all other terms and conditions of the License Agreement and its prior Amendments shall remain in full force and effect, and the failure of the City to strictly enforce any provision of the License Agreement, as amended, shall not be construed as a waiver of such provision, or any other provision of said License Agreement. The parties whose names appear below affirm that they are authorized to enter into this Amendment Two and bind their respective party. IN WITNESS, the parties below have executed this Amendment Two, which will become effective on the last date written below. LICENSEE: CITY: Sandra Katzen City of Kent d/b/a Vortex Agility and Dog Training 220 Fourth Avenue South 3016 22"d Ave S Kent, WA-986 Seattle, WA 98144 r" By: _'i, i ce i Sig ture) ! ; n By. (signature) Print Name _'4� lk Print Name 5, ksTu Its III A")LZ Its / (,WkJ.,--9._ / (title) DATE: ! ~f " DATE: AMENDMENT TWO TO LICENSE FOR LIMITED USE OF CITY REAL PROPERTY - 1 OF 2 APPR �E AS TO FORM: IP 1 Kent L apartment s ' t x P:\PlaonLiO\Muselpo4 A9111Ly Gmup\ofax�llity Yce�Se�AMHJ�MCNT A2doa \ �.�� } AMENDMENT TWO TO LICENSE FOR LIMITED USE OF CITY REAL PROPERTY - 2 OF 2 A�o CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 5/18/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS !i 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 to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: 1 Nanc Lovatt (36p)734-1173 Rice Insurance LLC a olio (360)734-1161 Eplc No; 1400 Broadway pone ,Etn (cy@ riceinsurance.com P.O. Box 639 INSURER(S)AFFORDING COVERAGE_ NAIC a Bellingham WA 98227 g INSURER A:Libert Northwest 41939 INSURED INSURER B: Sandra Katzen INSURERC: DBA: Vortex Agility and Dog Training INSURER D: 3016 22nd Avenue S INSURER E: _ Seattle WA 98144 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1551829325 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.ADDL�SUBR _ ILTRrr TYPE OF INSURANCE UNS. WVD POLICY NUMBER MMIDD/YVYY MM�DNYYV LIMITS L R X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A _ CLAIMS MADE �X OCCUR PREMISES Ea occurrence $ 1,000,000 X B1056522774 6/4/2015 6/4/2016 MED EXP(Any one person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 GEML AGGREGATE UMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 1 PRO- ❑ �' - 2,000,000 X POLICY�J JEOT LOG PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Be accident). ANY AUTO BODILY INJURY(Per person) $ ALL OPMED F I SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON--OWNED PROPERTY DAMAGE $ HIREDAUTOS H AUTOS Per accident i $ UMBRELLA LIAB OCCUR - LEACH OCCURRENCE $ EXCESS LIAB CLAIMS-JADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE YI INI NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUOED4 —J (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $. . _ If yes,describe under E.L.DISEASE-POLICY LIMiIT $ DESCRIPTION OF OPERA I IONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may us attached If more space Is required) Certificate Holder is Additional Insured in respects to the property leased by the named insured per form CG8810 0413 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN attn: Brian Levenhagen ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave S Kent, WA 98032 AUTHORIZED REPRESENTATIVE Tim Dickerson/PRO � — ©1989-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD AC�® DATE(MMIDDNYYY) �� CERTIFICATE OF LIABILITY INSURANCE 3/7/2018 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 to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nancy LOvatt Rice Insurance LLC PHONE Ext)c (360)734-1161 FAX No): (360)734-1173 1400 Broadway aDORless:nancy@riceinsurance.com P.O. BOX 639 INSURERS)AFFORDING COVERAGE NAIC 0 Bellingham WA 98227 INSURERA:Ohio Casualty Insurance Co. 24074 INSURED INSURER B: Sandra Katzen INSURERC: Vortex Agi 1 i ty INSURER D: 3016 22nd Ave S INSURERE: Seattle WA 98144 INSURERF: COVERAGES CERTIFICATE NUMBER:CL175242315 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 ADCL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ 1,000,000 X BLOS6522774 6/4/2017 6/4/2018 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 11000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: Addl for policy minimum $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUTOSWNED (F OPERT (DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE .ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? 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 (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION losborn@kentwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Lynn Osborn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M Dickerson/PRO 01988-2014 ACORD CORPORATION. All rights reserved. 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