HomeMy WebLinkAboutCAG2018-0399 - Supplement - Regional Motorcade, LLLP - Authorized Emergency Vehicles - 04/02/2021 Agreement Routing Form
• For Approvals,Signatures and Records Management
KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
WASHINGTON (Print on pink or cherry colored paper)
Originator: Department:
Jalene King Police
Date Sent: Date Required:
> 4/6/2021
0
Authorized to Sign: Date of Council Approval:
Q
0 Director or Designee ❑ Mayor rl/a
Budget Account Number: Grant? ❑Yes O No
Budget? ❑Yes 0 No Type:
Vendor Name: Category:
Regional Motorcade, LLLP Application
Vendor Number: Sub-Category:
Original
0
Project Name:
E
i
= Project Details:authorized emergency vehicles
c
a
E Agreement Amount: Basis for Selection of Contractor:
I- Start Date: 04/02/2021 Termination Date:
CA
Q
Local Business? ❑Yes ❑ No*
*If meets requirements per KCC 3.70.700,please complete"Vendor Purchase-Local Exceptions"form on Cityspace.
Notice required prior to disclosure? Contract Number:
❑Yes ❑ No CAG2021-181
Date Received by City Attorney: Comments:
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30
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� 40
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p� Date Routed to the Mayor's Office:
V1
Date Routed to the City Clerk's Office:
adccW22313_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements
AUTHORIZED EMERGENCY VEHICLE PERMIT w �
APPLICATION � ?
DATE APPROVED:
VALID UNTIL:
CAPTAIN:
WASHINGTON STATE PATROL
EQUIPMENT & STANDARDS REVIEW UNIT
GENERAL ADMINISTRATION BLDG
PO BOX 42600 For Department Use Only)
OLYMPIA WA 98504-2600
This application must be submitted by the Chief Executive of the firm or corporation making application.
Please type or print in ink.
Person, Company, Department, or Agency
(if a person, must list agency/department representing) Regional Motorcade,LLLP
Address 3211 West McGraw St, Suite#99022
City Seattle State WA Zip 98139
Phone (888)988-1723 ext 700 E-mail mitchell@regionalmotorcade.com
1. Purpose of Application/Authority: Describe below the specific purpose for which the vehicle(s)will be
used as authorized emergency vehicle(s) and what necessitates permitting as an authorized emergency
vehicle. The purpose should include the nature and scope of the duties, responsibilities, and intended uses
of emergency equipment, as well as the statutes that give authority for the listed equipment and uses.
The purpose and intended use of these vehicles are for funeral escorts using lights and sirens to
alert the public of our approach, presence and intent to escort the funeral procession to the place of
internment by the route which is both legal and practicable in accordance with WAC 308-330-466;
and having equipment which has met the requirements of RCW 46.37.190 (Warning devices on
vehicles) facilitates requesting other vehicles to yield the right-of-way and immediately drive to a
position parallel to, and as close as possible to, the right-hand edge or curb of the roadway clear of
any intersection and stop and remain in such position until the authorized emergency vehicle has
passed in accordance with RCW 46.61.210. The purpose of this application is for the safety of
pedestrians, other vehicles, procession participants and escort vehicle operators. The nature of the
duties and responsibilities of each operator extend only to the safety of the procession in
compliance with law and jurisdictional restrictions and does not relieve the operator of an
authorized emergency vehicle from the duty to drive with due regard for the safety of all persons
using the roadways.
3000-323-006(R 8/15) Page 1 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT IyI!!& s,��L
APPLICATION ", 117
2. Vehicle Information: List all vehicles intended to be used as authorized emergency vehicles. For each
vehicle, provide all vehicle and emergency equipment information as outlined below. Prior approval must be
given before utilizing a new vehicle or a vehicle with equipment installed other than what is authorized under
the current permit for that vehicle. Proof of insurance for each vehicle must be attached pursuant to VVAC
204-36-030. If providing funeral escorts, proof of commercial insurance in Washington State or business
use exemption must be provided pursuant to WAC 204-36-040.
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2019 9339LEM ®SIREN BMW K52SF
MAKE MODEL ®LAMP(s) (location/Colors)
BMW R1250RT-P Front,Sides,Rear/Red Code 3 LEDX
VIN Front,Sides/White Code 3 TSX3
WBlOJ6309KZG34059
REGISTERED OWNER ®OTHER EQUIPMENT
Paul W. Fison Rear Pole Light/Red 911 Signal Phantom C12-2
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2013 9344LEM ®SIREN Code 3 R120ORTP
MAKE MODEL ®LAMP(s) (location/Colors)
BMW R120ORT-P Front,Sides,Rear/Red Code 3 TSX3
2' VIN Front/White Code 3 LTD-901
WB1044003DZW22005 v Sides/White Code 3 XT3
REGISTERED OWNER ®OTHER EQUIPMENT
Paul W. Fison Rear Pole Light/Red Redtronic EM403
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2009 9371LEM ®SIREN Code 3 R120ORTP
MAKE MODEL ®LAMP(s) (location/Colors)
BMW R120ORT-P Front,Sides,Rear/Red Code 3 TSX3
3' VIN Front/White Code 3 LTD-901
WB10388029ZT15446 V/ Sides/White Code 3 XT3
REGISTERED OWNER ®OTHER EQUIPMENT
Thomas Chiswell Rear Pole Light/Red Redtronic EM403
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2003 8E8144 ®SIREN Code 3 R1150RTP
MAKE MODEL ®LAMP(s) (location/Colors)
BMW R1150RT-P Front,Sides, Rear/Red Code 3 LEDX
4' VIN Sides/Red Redtronic BX31
WB10499A63ZE89539
REGISTERED OWNER ®OTHER EQUIPMENT
Regional Motorcade, LLLP Rear Pole Light/Red Redtronic EM403
3000-323-006(R 8/15) Page 2 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT
APPLICATION -
m
2. Vehicle Information (continued):
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2013 LEM9718 ®SIREN Whelen WS321
MAKE MODEL ®LAMP(s) (location/Colors)
H/D FLHTP Front/Red/White Whelen PAR-36
5. VIN Front Forks/Red/White Star Signal DLXT
1HDlFMM15DB651436 ✓ Radio Box/Red/White Whelen 500
REGISTERED OWNER Radio Box/Red Redtronic BX62
Albert Mitchell ®OTHER EQUIPMENT
Array/Red/White Whelen M04Z
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2013 LEM9525 ®SIREN Whelen WS321
MAKE MODEL LAMP(s) (location/Colors)
WD FLHTP Front/Red Whelen PAR-36
6, VIN Bags,Fender/Red/White Whelen LINZ6/TIR3
1HDlFMM14DB645837 ,/ Radio Box/Red/White Whelen TIR6/500
REGISTERED OWNER Radio Box/Red Redtronic BX62
Douglas Morgan ®OTHER EQUIPMENT
Array/Red/White Whelen MO1LD
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2014 7C6153 ESIREN Whelen WPAl12
MAKE MODEL ®LAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen PAR-36
7. VIN Radio Whelen Dual LED
1 HD I FMM 13EB616413 Box/Red/White
REGISTERED OWNER
Patric Kelly ❑OTHER EQUIPMENT
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2014 LEM9696 ®SIREN Whelen WPA112
MAKE MODEL LAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen PAR-36
$. VIN Crashbar/Red Whelen LIN6
1HDIFMMIXEB619695 ✓ Radio Box/Red/White Whelen 400 Dual LED
REGISTERED OWNER Radio Box/Red Redtronic TIR6
Thomas Chiswell ®OTHER EQUIPMENT
Array/Red/White Whelen MO 1 LD
3000-323-006(R 8/15) Page 3 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT roY ITRR fM-
APPLICATION ?r
2. Vehicle Information (Continued)
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2011 5173133 NSIREN Whelen WS320
MAKE MODEL NLAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen PAR-36
9. VIN Radio Box/Red 911 Signal E3
1HDIFMM11BB617068 ✓
REGISTERED OWNER
Black Sheep, LLLP MOTHER EQUIPMENT
DBA Regional Motorcade Array/Red/White Whelen MO 1 LD
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2019 7F2690 NSIREN Whelen WS321
MAKE MODEL NLAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen PAR-36
10. VIN Side/Red/White Feniex Wide Lux 7x3E3
1HDlFMP14KB638427 ✓ Front/Rear/Red Whelen Linz 3
REGISTERED OWNER Rear/Red Whelen M7
Dave Wyatt ❑OTHER EQUIPMENT
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2012 9455LEM NSIREN Whelen SA315P
MAKE MODEL NLAMP(s) (location/Colors)
HONDA ST1300P Front/Red Whelen M6
11. VIN Front,Rear,Sides/Red Whelen Linz 6
JH2SC5158CK000139 Front,Rear,Sides/White Whelen Linz 6
REGISTERED OWNER Front/Red Whelen VTX609R
Richard Fisher ❑OTHER EQUIPMENT
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2013 9601LEM NSIREN Code 3 R1200RTP
MAKE MODEL NLAMP(s) (location/Colors)
BMW R1200RT-P Front,Sides,Rear/Red Code 3 TSX3
12. VIN Front/White Code 3 LTD-901
WB1044000DZW22043 ✓ Sides/White Code 3 XT3
REGISTERED OWNER ❑OTHER EQUIPMENT
Paul Fison Rear Pole Light/Red 911 Signal Phantom C 12-2
3000-323-006(R 6/15) Page 4 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT ®mG.�.�
APPLICATION
d
2. Vehicle Information (Continued)
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2012 3F8191 ®SIREN Whelen SD210R
MAKE MODEL ®LAMP(s) (location/Colors)
WD FLHTP Front/Red Whelen Par36
13. VIN Front/Red& White E.T.D. Enforcer 8
1HDIFMMIOCB607827 ✓ Sides/Red& White Tricolour Tricolour 4
REGISTERED OWNER Rear/Red & White Whelen 50CR2ZCR
Leroy D Barker ❑OTHER EQUIPMENT
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2009 6G0138 ®SIREN Code 3 R1200RTP
MAKE MODEL NLAMP(s) (location/Colors)
BMW R1200RT-P Front,Sides,Rear/Red Code 3 TSX3
14. VIN Front/White Code 3 LTD-901
WBI0388069ZT15272 ✓ Sides/White Code 3 XT3
REGISTERED OWNER ❑OTHER EQUIPMENT 1
John Paredes Rear Pole Light/Red 911 Signal Phantom C12-2
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2017 9016LEM ®SIREN Whelen WSSPA30
MAKE MODEL ®LAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen Par36
15. VIN Front/Red&White Whelen LINZ6
1HDlFMC13HB643830 ✓ Sides/Red&White Whelen LINZ6
REGISTERED OWNER Rear/Red& White Whelen LINZ6
Earl S Radford ❑OTHER EQUIPMENT
VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION
YEAR LICENSE NO. INSTALLED MAKE MODEL
2011 9511LEM ®SIREN Whelen WS320H
MAKE MODEL ®LAMP(s) (location/Colors)
H/D FLHTP Front/Red Whelen Par36
16. VIN Sides/Red& White Whelen LINZ6
IHDlFMM14BB638710 ✓ Rear/Red& White Whelen TIR3 & LIN3
REGISTERED OWNER ❑OTHER EQUIPMENT
John Devlin Array/Red/White Whelen MO 1 LD
3000-323-006(R 6/15) Page 5 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT kb
APPLICATION a fn
3. Operators:Please list all drivers that will be authorized to operate the vehicle(s) listed in this application and
indicate whether or not the operator/driver is new since your last application by placing an X in the"New?"
column; otherwise, leave this column blank. No drivers should be listed unless they have been approved. Per
WAC 204-36-040, all operators involved in traffic control must be a Washington State certified flagger, and carry
their certified flagger card at all times.
Name Driver's License Number J Flagger Certification Number New?
(if applicable—see WAC 204-36-044)
Albert Mitchell WDL6SNSFC63B 312561
Thomas Chiswell CHISWTJ456NM 312562
Douglas E Morgan WDL4RZSB78SB 312563
Paul Fison FISONPW429NA 420422
Patric Kelly KELLYPB471MB 312565
David Wyatt WDL2SNB3113B 373347
Darren Thackeray WDL51Z34F3SB 406874
Richard Fisher WDL1T76776SB 386006
Leroy D Barker BARKELD462NA 334239
John Devlin WDL61ZP9113B 431336
TomaHawk S Pearson PEARSTS314LF 431337
Earl S Radford RADFOES465RT 429575
John Paredes WDLB7971843B 452729 YES
3000-323-006(R 8115) Page.6 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT 1A�n.,vl
APPLICATION
n
4. Geographic Area: Indicate which types of roads and which specific geographic area(s) the authorized
emergency vehicles will be used. Certification from each jurisdiction is required under WAC 204-36-030.
Certification is covered in section 6 of this application.
❑X City Streets (list all cities) - Kent
❑ County Roads (list all counties) -
❑ State Routes/Interstates (list all state routes, interstates, and counties) -
5. Permit Validation:
I certify(or declare) under penalty of perjury under the laws of the state of Washington that the foregoing is
true and correct to the best of my knowledge, information, and belief, and that:
a. All of the information given in this application is correct to the best of my knowledge and provided in its
full format to the undersigned chief law enforcement officer or fire chief(if the vehicle is to be used for
firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized
emergency vehicle(s).
b. None of the drivers, to the best of my knowledge, in the last year, have been convicted of, nor served
any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol
violation or illegal use or possession of drugs, nor been required to register as a sex offender.
c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application,
and that only the operators listed under this permit will drive the vehicle(s).
As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit
is issued, it is my responsibility to ensure:
a. No driver listed in this permit uses the vehicle for any purpose not authorized under this permit unless
all emergency equipment is removed or covered-
b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all
emergency equipment is removed or covered. If I wish to add a new driver or vehicle to this permit, I
must receive prior approval before they are authorized under this permit.
c. The driver must exercise due care and caution and must obey all traffic laws.
I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminal or civil
liability as well as cancellation of this permit as outlined under chapter 204-36 WAC.
In addition, I understand that it is my responsibility to ensure that a copy of this permit listing all approved
drivers and geographic areas authorized, as well as a copy of the vehicle permit authorizing emergency
equipment is present in each vehicle at all times and must be presented to law enforcement, if requested.
. .T
Signature ! 4� `! _ Title President
(CHIEF EXECUTIVE OFFICER)
Name Albert Mitchell Date 03/05/2021
(TYPE OR PRINT)
3000-323-006(R 8115) Page 7 of 8
AUTHORIZED EMERGENCY VEHICLE PERMIT on-01
WAZ�,I4GTOM-N MW,
APPLICATION r
6. Certification: This application for an Authorized Emergency Vehicle Permit will not be accepted unless
CERTIFIED by the chief law enforcement officer or fire chief(if the vehicle is to be used for firefighting
purposes) of each primary jurisdiction in which the vehicle(s) are to be used as authorized emergency
vehicles (see part 4 of this application). If the application is made by the chief of a law enforcement agency
or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must
include the following language:
"I hereby certify that I have reviewed this entire application; that I am aware that the applicant intends to use
the vehicle(s)and emergency equipment listed in part 2 of this application, for the specific purposes listed in
part 1 of this application; that a need exists in my jurisdiction for the listed vehicle(s)to be used as
authorized emergency vehicles and that the applicant has the appropriate authority as described in part 1 of
this application to operate such equipment; and I know of no reason why this application should be denied."
Please type or print:
Signature ��' �' Date Oq-oa,}Title C re-le
Name ,,��}} •
(Please Print) RS ,I JO&J� do, Jurisdiction Kent, City of
Phone $S'b - .S'!R 8S� E-Mail <p WW Wa , y c,
Restrictions
Note: This page may be copied if additional certifications need to be added to the permit. Any additional
sheets attached must provide the certification information in the same format as above.
3000-323-006(R 6/15) Page 8 of 8