The URL can be used to link to this page

Home My WebLink AboutCAG2010-1000 - Original - Olympic Motor Escort - Authorized Emergency Vehicle Pemit (AEVP) - 11/10/2010CIIRISTINE O. GRECOIRE Covernor ,OhIN R. EATISTE Chief I wAsHr'iTrEtr'#??iur*ol- Cenerat Administration Building . PO Box 42600 ' Olynnpia, wA 9s504-2699 ' (360) 596'4000 ' www'wsp'wa"Sov November 10,2010 Mr. Dave Eady Olympic Motor Escort 1606 SW 104th Street #97 Seattle WA 98146 Dear Mr. Eady: Your renewal application for your Authorized Emergency Vehicle Perrhit (AEVP) for the vehicles used by'Olympic Motor Escort has been processed, Enclosed is an amended version of your ienew"t applicatidrl,outlining the vehicles, operators and geographic areas that you have been approved to operate in. The amendments to your application are as follows: 1. Authority - Revised Code of Washington (RCW) 46.61.035 states "The driver of an authorizdd emergency vehicle, When igsponding to an emerggncy qa.l.t or when in pursuit of an actrialsuspected violator olthe law... ma)l exeicise privileges set forth in tnis section..." Funeral'escorts are not considered an emergency,_!!"t_9r9!o1e authorization is not provided for your company to operate under RCW 46.61,035 to provide funeral escort servi -ces. Therefore, your permit was amended to remqv-e-this statute, as funeral escorts are not authorizedto operate under RCW 46.61.035' 2. Removal of operators - Kelty Patric and Kenneth Nishiyori.are not apPrwed operators undir your permit Wq have not receiveg.fing.erprint cards for. Mr. Nishiyori, ahO tne fingerprint caids for Mr. Patrick have are still being processed.. ln order for Mr. Nishiyo]r tb Oe approved under your permit, pleas_e submit fingerprint cards for each operator along with the processing fee of $45.25. 3. Geographic areas not authorized - Please note that the cunent application form whicfl wbs provided to you was not used which provides jurisdictions with a line to indicate redtrictions for emergency vehicle use under the applicatiol, !fg.restrictions as outlined on the previous applic-ation will stitl apply within each jurisdiction, unless you receive written authorization from each.jurisdiction.which removes these iestrictions. lf the renewal application provided to you is not used in the future, this office may refuse to review thb applicaiion and reqirire that you start over in obtaining authorizations from each jurisdiction. ln addition, a number of geographic areas listed were removed from your permit as there was no authorizatidn piovided for these areas. ln order to operate within these, ge.ographic areas you will be required: a. For city streets - to gain authorization from the Chief of police for the_ following cities that iou had originally listed: Mount Vernon, Seattle,_Tac.om?, Kent, R6nton, Aubuin, Wenatchee, Bellev_ue, Puyallup; Kennew[cb Richland, Sumner, Easi Wenatchee, FederalWay, Sea-Tac, Bonney Lake, Buckley, EEes Page2 Mr. Eady November 10,2010 LaConner, Tanasket, Bremerton, Port Townsend, Shoreline, and Burien. ln addition, you have also listed Swinomish which would require the authorization from the Swinomish Police Chief. For county roads - to gain authorization from the Sheriff for the following cities that-you had orig-inally listed: Pierce, King, Snohomish, Lewis, ' Thurston, Benton, Chelan, Douglas, Jefferson and Spokane. For State Routes and lnterstates - to gain authorization from the Washington State Patrol District Commander in charge of each area. Since you have listed all State Routes and lnterstate 5 in your application, this would require the signature of every WSP District Commander. Their contact information is listed below for your convenience.. District t lRierce and Thurston Counties) - Captain Jeff DeVere (253) 536-6210. District 2 (King County) - Captain Steve Burns (425) 401-7701 o District 3 (Yakima, Benton, Franklin, Walla Walla, Columbia, Asotin and Garfield Counties) Captain Shawn Berry (509) 249-6708 r Diglrfc! _4_(Spokane, Lincoln, and Adams Counlies) Captain Jeff Otis (509) 227-6566. bistrict 5 (Clark, Lewis, and Cowlitz Counties) Captain Robert Johnson (360) 260-6333. District 6 (Kittitas, and Grant Counties) Captain Karen DeWitt (509) 663-9721. District 7 (Snohomish, Whatcom, and Skagit Counti6s) Captain Ken Ginnard (360) 654-1108 o District 8 (Clallam, Jefferson, Grays Harbor, Mason, Pacific, Wahkiakum, and Kitsap Counties) Captain Steve Sutton (360) 405-6608 lf additional authorizations are received, your permit will be amended at that time to include the geographic areas that have been authorized. As of the date of this letter, you are only aulhoiized to operate on the city streets of Everett, Edmonds, Port Orchard and Enumclaw, and the County Roads in Benton, Franklin and Skagit Counties. Please ensure a copy of this permit is carried in each vehicle at all times. Approximately one month prior to the expiration date, a renewal form will be sent to you. lf you have any questions please call Ms. Melissa Van Gorkom at (360) 596-4017. Sin n Jason ment a Media Relations JGB:mvgEnclosure .cc: Chief James Arsanto, Buckley Police Department Chief Ken Bergsma, Mount Vernon Police Department Captain Shawn Berry, District 3 - Yakima Chiet Robert Burks, Tonasket Police Department Captain Steve Burns, District 2 - Bellevue , Chief Jim Collyer, Puyallup Police Department ' Chief A.D. Compaan, Edmonds Police Department b c. Page 3 Mr. Eady November 10,2010 Chief Tony Corsi, Richland Police Department Chief Conner Daily, Port Townsend Police Department Captain Jeff DeVere, District 1 - Tacoma Captain Karen DeWitt, Digtrict 6 -Wenatchee Chief John Diaz, Segttle Polige Department ' ' , , Chief John Galle, Sumrier Police Department . , . ' Captain Ken Ginnard, District 7 - Marysville Sheriff Harvey Gjesdal, Douglas County Sheriffs Office Chief James Graddon, SeaTac Police Department Sheriff Rick Grimstead, Skagit County Sheriffs Office Chief J.R. Harrison, East Wenatchee Police Department Sheriff Mike Harum, Chelan County Sheriffs Office Sheriff Tony Hernandez, Jefferson County Sheriffs Office Chief Ken Hohenberg, Kennewick Police Department Chief Andy Hwang, FederalWay Police Department Captain Robert Johnson, District 5 - Vancouver Chief K. Scott Kimerer, Burien Police Department Sheriff Ozie Knezovich, Spokane County Sheriffs Office Sheriff Richard Lathim, Franklin County Sheriffs Office Chief Robert Lee, Auburn Police Department Sheriff John Lovick, Snohomish County Sheriffs Office Sheriff Steve Mansfield, Lewis County Sheriffs Office Chief Kevin Milosevich, Renton Police Department Chief Mike Mitchell, Bonney Lake Police Department Captain Jeff Otis; District 4'- Spokane Sheriff Paul Pastor, Pierce Gounty. Sheriffs Office Chief Linda Pillo, Bellevue Police Department Chief Dan Pingrey, Shoreline Police Department Sheriff Sue Rahr, King County Sheriffs Office Chief Don Ramsdell, Tacoma Police Department Chief Tom Robbins, Wenatchee Police Department Chief Craig Rogers, Bremerton Police Department Chief Jim Scharf, Everett Police Department Chief Tom Schlicker, Swinomish Police Department Sheriff John Snaza, Thurston County Sheriffs Office Chief Steven Strachan, Kent Police Department Captain Steve Sutton, District 8 - Brernerton Sheriff Larry Taylor, Benton County Sheriffs Office Chief Alan Townsend, Port Orchard Police Department Ms. Melissa Van Gorkom, Equipment and Standards Chief Larry Yonally, La Conner Police Depadment Chief Jim Zoll, Enumclaw Police Department AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEMZ_mst{utcloll 6I^tE P TROLWDtr WASH I NGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BLDG PO BOX 42600 oLYMPTA WA 98504-2600 DATE AppROVED: Novernber 10, 2OL0 VALID UNTIL:"Novemb 2 20Lt CAPTAIN Only) 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, orAgency (if a person, must list agency/department representing)Olympic Motor Escort LLC Address 1606 SW 1O4th Street#97 City Seattle State WA Zip 98146 Phone (206) 850-5474 E-mail daveeady@msn.com 1. Vehicle lnformation: List all vehicles being used as authorized emergency vehicles. For each vehicle, provide both the vehicle and emergency equipment information as outlined below. Any new vehicles--or vehicles with equiprnent installed other than what is authorized on the current permit for that vehicle-must receive prior approval before being utilized under this permit. : ,-,.;,., :YE {!.c l e'i ru r=onMA1oNtiu,, i,,,,., YEAR 2007 LICENSE NO. 909850 MAKE Harley MODEL Davidson FLHTP VIN 1HD1FMM137Y663697 REGISTERED OWNER Patric Kelly SIREN Whelen wPz 112 SA350 LAMP COLOR(S) PAR 36LR LEDWhelen OTHER EQUIPMENT: 4 Rear Lights Whelen LED 400 1EH.!l .;Lts INF()ITMAIIC)N. .....1.i .i YEAR 2007 LICENSE NO 909854 MAKE Harlev MODEL Davidson FLHP VIN 1HD1FHM177Y657618 REGISTERED OWNER James lrwin X srneru Whelen ES 320 X r-ervrP coLoR(S) LAMP MAKE/MODEL Whelen WHRSRO 3ZCR/ 2ER00ZCR Red OTHER EQUIPMENT: 3000-323-006 (R 12109)Page 1 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,F-"HffiWT YEAR 2008 CENSE NO gs9eo4 1[Q1fHM1x8Y654oo4 REGISTERED OWNER . James lrwin Davidson FLHP MAKE VIo. WS LAMP COLOR(S)Red Whelen YEAR 2oo7 LICENSE NO. 194 MAKE Harley LM Davidson FLHTP VIN 1HDl FMM167Y649762 REGISTERED OWNER Dave Eady [] srneru Whelen WPA 112I r-nrvre coloR(s) LAMP MAKE/MODEL Sound Off INC EPRO55DBD OTHER EQUIPMENT: YEAR 2006 843422 NSE NO- MAKE Harley MODEL : Davison FLHTP VIN 1HD1FMW126Y601610 REGISTERED OWNER Terry Ketcham SIREN UTL Red Whelen LAMP COLOR(S) MAKE/M OTHER EQUIPMENT: YEAR 2003 LICENSE 819556 MAKE BMW MODEL R-1500 VIN w810499A632E89539 REGISTERED OWNER Robert Nash Red EL r-AMP COLOR(S) LAMP N.9te1 T.his page may be copied if additional vehicles need to be added to the permit. Any additionalsheetsattached must provide the vehicle and equipment information in the same format as above. 3000-323-006 (R 12109)Page 2 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL mnEt- E-rei-nci6I-EiIEEiF6iWtr YEAR 2004 0 LICENSE NO. Davidson. F MAKE ,.t i j VIN I HDl FMW1 24Y623gg1 REGISTE John Tyo ED OWNER Ha LEM9525 ENO 2007 MAKE MODEL Davidson FLHTP VIN 1HD1FMM187Y701120 REGISTERED OWNER Douglas Morgan YEAR 1 990 81 3586 LICEN MODEL l<2.1000 MA VIN JKA!<ZCP2318507999 REGISTERED OWNER Melvin Centers YEAR 2008 LICENSE NO. LEMg196 MAKE Harlev MODEL Davidson FLHTP VIN 1HD1FMM1984607796 D OWNEREGISTERE Dave SIREN Whelen' ' .LAMP CgLOR(S) . WhelenMAKE/MODEL PAlO()SIREN 4416R Red General Electric LAMP COLOR(S) LAMP fl ornrn EeUTPMENT: LAMP COLOR(S) LAMP MAKE/MODEL Red OTHER EQUIPMENT: PAlOt)SIREN WhelenD X r-nrrrrp coloR(s)Red - Whelen I PAR.36LAMP MAKE/MODEL Note: inis page may be copied if additional vehicles need to be added to the permit. Any additionalsheets attached 3000-323-006 (05/09)Page 1 of 5 AUTHOR IZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H"F-"HffiWtr YEAR 2007 LICENSE NO LEM9488 MAKE Harley MODEL Davidson 1HD1 17276 WrightJames VIN M1 REGISTERED OWN RMATION. MODEL PMENT INFORGENCYEQUI LAMP COLOR(S) PAR 36 Red WhelenMAKE/MODEL LICENSE NO 965952 YEAR 2008 MODEL Davidson FLHTP MAKE Harley VIN 1HDlFMM178Y657466 REGISTERED OWNER Douglas Clark LICENSE NO.,. 99031 1 YEAR 2008 MODET Davidson FLHTP MAKE Harley VIN 1HD1FMM138Y700488 REGISTERED OWNER Roger Shenrvood WhelenSIREN LAMP COLOR(S) LAMP MAKE/MODEL HD Linear LED OTHER EQUIPMENT: ENCY E SIREN Whelen LAMP COLOR(S) P MAKSMODEL 09161 HD Red Whelen OTHER EQUIPMENT: YEAR 2009 LICENSE NO. 245515 MAKE Harley MODEL : Davidson FLHTP VIN 1HD1FMM189Y624073 '.:i:REGISTERED OWNER Bob Holmgren SIREN sD210R LAMP COLOR(S) Red EL Par36& TR3 Note: This page may if additional vehicles need to be ad ded to the permit. Any additionalsheets attached must provide the 3000-323.006 (05/09) vehicle and equipment information in same format as above. Page 2 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT F^,H,HffiWTAPPLICATIONRENEWAL YEAR 1 999 LICENSE NO. LEM7400 , MAKE Ford MODEL Crown Victoria VIN 2F4F971W5XX105832 REGISTERED OWNER Dave Eady WPA112 LAMP MAKE/MODEI-PAR36 coLoR(s) OTHER E YEAR 1996 A',15177X ENSE NO. MAKE Ford MODEL Crown Victoria VIN 2FALP71W7TX141552 REGISTERED OWNER Douglas Morgan SIREN Whelen 112 L Code 3 LAMP COLOR(S) LAMP OTHER EQUIPMENT: ff:it s YEAR 2009 LIcENSE NO, 340931 MAKE Harley MODEL Davidson FLHTP VIN 1HD1FMM149Y633921 REGISTERED OWNER Thomas Chiswell LAMP COLOR(S) EL Wheten YEAR 2009 LICENSE LEM9654 MODEL Davidson FLHTPrleyHa MAKE VIN 1HD1FMM1X9Y692617 REGISTERFD OWNER Melody Young t", X stnel.t Whelen PAlOO Red TR5 LAMP COLOR(S) MAKE/MODEL Note: This page may be copied if additional vehicles need to be added to the permit. Any additionatsheets attached must provide lhe vehicle and equipment information in the same form'a1as above. : - r' r:-;- 3000-323-006 (05/0e)Page 3 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEM_W YEAR 2008 4l_EM91 LICENSE NO. MODEL : Davidson FLHTP ', MAKE Harley 1HD1FHM128Y639 769 VIN Delon Sandmire REGI ED OW SIREN Whelen LAMP COLOF(S)White LAMP Whelen TierWindshield Array OTHER EQUIPMENT: YEAR 2007 LlCENSENO. 917298 Davidson FLHTP E ODEL VIN lHDFMMlX 1 389 REGI Kevin STE RED OWNER X srneru Federal FS-l00 ffi r-nrvrn COLOR(S)Red Whelen PAR.36LAMP YEAR 2010 MODEL Davidson FLHTP 1HD1 3A8648577 H MAKE ISTERED OWNER Albert Mitchell REG D( stnrt't Whelen ffi r-nnn coLoR(s) LAMP EL wheten I soo st,ou. Red Kil 12Rt OTHER EQUIPMENT: Pursuit Red M Clear 1HD1FHW116Y68 7015 REGISTER ED OWNER YEAR LICENSE NO 2006 9A0874 MAKE MO Ha Davidson FLHPT VIN Melvin Centers. 1 LAMP COLOR(S) Code 3 PAR OTHER EQUIPMENT: Red lights Tir Note: This page may be copied if additional vehicles need to be added to the permit. Any additional sheetsattached must provide the vehicle and equipment information in the same format as above. 3000-323406 (05/0e) Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEIIIZ_wasxrHclLg! tE PrrRoLWDtr 2 3. Purpose of Application:. Describe the speqific purpose for which the vehicie(s) shall be used asauthorized emergency vehicle(s) and whafnecessitates the vehicles' registration.r .r"i'"n.i u.ni"er.Explain the nature and scope of the duties, responsibility, and intended ise of "m"rgency-"quipment. , Authority: Explain authority outlined under statute (Revised Code of Washington) that allows the vehicles'operators to use emergency equipment for the purpose outlined under part z 6t tnis application. Geographic Area: Chqck which types of roads you will be operating on and state the speciflc geographic ?Iea(.:) in whi-ch the vehicles shall be used as authoriled emeqgencfvehictes 1city, couffic.1. :, (Certifieation from each primary juiisdiction is required under pirt z 6f tnis "ppf i""li'on.l : ' RCW 46.37.194 Chapter 204-36 WAC wAc 308-330-466 4t i- ,i Fu neral Assisting ored tradition;d evoted to those that have place of nternm ent,wh ile kee plng the safett of County Roads (list all counties)Benton, Franklin and Ska sit n State Routes/l nterstates 5.Operators: Please list all drivers that you intend to have operating the vehicle(s) listed in this applicationand indicate whether or not the operatoridriver is nerrv since your ljst application.' (Use addjtlonat she.e! i[necgssq Bodgan, Jeffery n tr tr u tr u tr Eady, Dave McCarte, Jason H lrwin James Chiswell Thomas Mitcheil Jr Albert Jr., Robert D tr tr tr tr tr ullorgan, Douglas I r Ketchum. Terrv Hernan Kevin Ca Brice Clark. Douqlas Frederick ' tr tr D D tr tr u Centers, Melvin Clavton Jr , Evan Nash Robert William Mever. Paula Matthew Hvett. Rov 3000-323-006 (R 12l0e)Page 3 of5 AUTHORIZED EMERGENCY VEHIC LE APPLICATION RENEWAL 6. Permit Validation: I certify that: a. b. been convicted ol nor served convicted of a drug or alcohol as a sex offender, nor Only the and that vehicle(s)and equipment listed in this application will be as outlined in this application,only the operators listed under this permit wiil drive the As the primary horder or. e.xecutive officer in charge of overseeing this permit,issued, it is my responsibility to ensuie.-' ' - i that if ihe permit is No driver risted in this permit uses the vehicre for private purposesremoved or covered. ' '-all emergency equipment is fo a vehicle(s) listed untess att under this or vehicle to thispernit, I The driver must e.xercise dye care and caution and must obey a[laws. liability as wellas result in crinrinal or civil ln addition, a. b. c. understand drivers are $ignature Name 7 Please type oi Name {Ptease list of approved if requested, (CHIEF EXECUTIVE ffYPE OR Title Date Date /a -Lf-tcsTitle Jurisdiction' by the chief of a law the political sub-dlvision. The sig Phone {#2J-) c*1-?-i. CcrzrtG+, AS 3oo&323-rlcE {05/09} 'E-Mail @e Page 4 of 5 $ AUTHORIZED EMERGENCY VEFIICLE APPLIGATION RENEWAL 6. Permit Validation: I certify that: a- and, {if the are to be b.been convicted ol norserved Only the and that vehicte(s) and equiprnent lisied in this application will be as outlined in this application,onlythe operators listed under this permit will drive the As the pifary holder or executive.o. fficer in charge of overseeing this pernit,issued, it is my responsibility to ensure:that if the permit is No driver listed in this permit uses the vehicle for private purposesremoved or oovered.all emergency equipment is a. b. c. {cHrEF Name Please type or Sign Narne (Pteese Pfintl Phcrne tfuZ ) a result in crimlnal or civil ' : and Title Date o will not be accepted is to be used for used as authorized by the chief of a law the political sub-division. The Date /-/a Jurisdiclion t<u- ttS lu this The driver must exercise due care and caution and must obey all laws. that liability as weltas the inappropriate cancellation of th ln addition, drivers'are Signature responsibility alltimes and nderstand I understand present in oRPR|NT) 7 3000-323€96 {0510s} 73r-G E-Mail kBry Title @, ca Page 4 of 5 6. PermitValidation: I certify that: AUTHORIZED EMERGENCY VEH ICLE APPLICATION RENEWAL uired law e Title {cHrEF EXECUTIVE Date oR PRtMr) provided in is lo be usedale to be used as year,been convicted ol norserved as outlined in this application, The a- b Signature Name Please type or Signature Name {Ptease Pfint, Phone Only the and that As the primary horder ore.xecutive officer in charge of oversebing this permit,tssued, it is my responsibility to ensuie:-' 'nderstand that if the permit is No driver listed in this pe*nit uses the vehicre for private purposesremoved or covered.all emergency equipmeni is No driver other than those listed under this approved permit ) listed unless allemergency equiprnent is removedmust receive prior approval before orcoyered. lf I wish fo a or to this permil, tthey are authorized under this The driver must exercfse due care and caution and must obey ari laws. ' I uncierstand that the inappropriate'cancellation of thliability as weil as result in criminal orciyil ln.addition, oflvers are to ensure that a coov must be pre.sentedtb list of approved, if requested, a, b. 7 tYLt'+e{Jurisdiction E-Mail a[,co ct ,e+{n^..Jt, ddd,taf o 3ooc-3zg{C6 {O5r0gt ,CIba Page 4 of 5 l ii i: :i AUTHORIZED EMERGENCY VEHICLE APPLICATION RENEWAL 6. PermitValidation: I certifu that: a- b. None of the drivers, to the best of my any sentences or violation or illegal periods of probation {if the ln are,to be used as !e usea tast yeal been convicted of, nor serued nor knowledge in the tor any felonies, use or possession of drugs, nor been required been adjudicated incompetent or insane.-have any ofthem c-Only the and that vehicle(s)and equipment lisied in this apptication will be as outlined in this application,onlythe operators listed under this permit witl drive the As the pJi|nary holder or executive officer in charge of overseeing this permit, issued, it is my responsibility to ensiire: ' : 'that if the permit is No driver listed in this pennit uses the vehicle for private purposes removed or covered. all emergency equipment is No driver other than those listed under this listed unless all a. b. C. ernergency equipment is rernoved must receive prior approval before drivers are present in each.veh QT IfT to a Date or to this permit, I result in criminal:or civil ' ,, ,: and list of approved if requested, o will they are authorized underthis The driver must exercise due care and caution and must obey all laws. I understand that the inappropriate liability as weil as cancellation of th ln addition, I understand that it is my responsibiiig icle at all.times and Signature Name Please type or Signature Name (Frease PfiFt, Phone ffYPE OR PRrMr) Title {cHrEF 7 not be accepted be used foris to Date Title JuriSdiction { so1) srlr ,35b { ' ,ol:y'tr used as authorized by the chief of a law the politieal sub-division. The 3 of this application lo denied." til'o,.U S 11, I it i ,( 3ooo-3e3{i?6 {ot?gt E-Mail ,r-lq^VL:l^ p Page4 of 5 6. PermitValidation: I certify that Only the and that I undersbnd that liability as well as Name Please type orprint: Signature Name {Ftease Prhg Phone AUTHORIZED EMERGENCY VEHICLE APPLICATION RENEWAL iro a and provided'in (if the vehide isbbe used to be used as been mnvic-ted ol norserved as outlined in this application, that if thepermit is all emergency equipment is listed unless all or to this pennit, I result in criminal or civil and o will not be accepted isto be used for used as authorized. by the ctief of a law the political sub-dlyision. The denied.' 0,0 a. b. As the primary holder or execrrtive officer in ehargre of overseeing this permitissued, it is rny responsibility to ensuie:-. ' a. No driver r':Fi.itrir permit uses the vehicre for pdvate pumosesremoved orcovered. b. o. underthis The driver must exercise due care and eution and must obey alr larrrc. in addition, I understand frat it is mv drivers are present in each vehicle it Signature responsibility to ensure ffrat a copy alltilnes and mustbe presentedtb list o[approyed if requested,law o(Ect TrvE oRPRNT) Title Date entire ftatl am as for the listed vehicles be reason 7 Date Jurisdiction n ltlO- rige 3o8O€23-{lC6 {05/O8t Lla E-Mail ICr,(Wta Page4 of 5 AUTHORIZED EMERGENCY VEHICLE APPLICATION RENEWAL lll ll niri-\wrsfrcTfrTiFffiiWtr 6. PermitValidation; I certify that a- b. None of the drivers, to ihe best of my any sentences sr periods of probation emergency equipment is removed must receive prior approval before liability as well as ln addition, drivers are $ignature {CHIEFEXECUIIVE Name Please type or print: Signature Name (Prease Pri4ti Fhone violation or illegal use or possession of drugs. nor been required been adjudicated incompetent or insane.'have any of them Only the and that or lff fo a they are authorized underthis The driver must exercise due care and caution and must obey all that 'to last year,been convicted ol norserved nor as outlined in this application, of and listbf approved law if requested. Tiile Date will not be accepted icle is to be used for used as authorized by the chief of a law ihe politicat sub-division. The knowledge in the for any felonies, i: l!: plfary holder cr.e.xecutive 9ffcer in charge of overseeing this permit,rssued, tt is my responsibility to ensure:that if the permit is No driver listed in this permit uses the vehicie f,or private purposes removed or covered.all emergency equipment is No driver other than those listed under this a. b. understand OR 7 Date, 1r-01-10 Title of Pol.ice Jurisdiction E-Mail 3os&323{c€ {0;/09J Jin Zo11 Page4 of5 AUTHORIZED EMERGENCY VEHICLE RENEYYAL o 7. Certification: This renewal appli,cation forAuthorized reviewed this my vehicles and that the the operate such reason Signature willnot be accepted is to be used for be used as authorized by the chief of a law irie porNiai iuo-oivision. rne etu'ff ta05b1 Name (Pleass Frinl) Phcne Signature. Name Date t l-?S Jurisdiction E-Mail Date Jurisdiction E-Mail Date Jurisdiction E-Mail Date Jurisdiction E-Mail Date (Ploa6a Print) Phone () Signature Name (Please Pr'ml) Phone Signature Name (Pleaeg Printl Phone' ( l SignatureName : {Ptease Prtrtl Phone Signature Jurisdiction E-Mail Date - Jurisdiction E-Mail Date Jurisdiction E-Mail : Date Jurisdiction E-Mail () Name (Please Pddl Phone Name {Please Prinl) Phone Signature' Name (Pleas€ Prlnt, Phone S!gnature 3000-38-{'06 {05()9} lf additional certificatigns are , add an additionalsheet.) {}l{-Vfuif 'lg; \i1U I {,i"J Oct.24,2O1O To Whom lt May Concern, Olympic Motor Escort is requesting permission to assist funeral processions in your jurisdiction. The purpose for which these vehicles will be operated is to aid funeral directors and their "families" in a time honored tradition, devoted to those that have passed, in a procession of their loved ones to their place of internment, while reasonably asking the public not to interfere and keeping the safety of the procession and general public at the forefront. Olympic Motor Escort is a business, and as such is licensed and carries a Two Million Dollar insurance policy. All of our riders are Emergency Vehicle certified through the Washington State Patrol and consist of active and retired, off-duty police, fire fighters, military, and properly trained civilians. All personnel must meet strict background checks by the FBI and WSP before they are allowed to begin training. Safety is our highest priority and therefore we have active, off-duty, police motor officers that preserve the high levels of proficiency of our riders with continuous training. Every effort is made to facilitate the needs of the bereaved, while maintaining a structured movement to the place of internment. You can rest assured that we do not take our duty to everyone's safety lightly and that every precaution is demanded of our riders. Respectfully submitted,kryOwner \ Olympic Motor Escort, LLC (206) 8s0-s474 OLYMPIC MOTOR ESCORT L.L.C. 1606 SW 1O4TH ST #97 SEATTLE WA 98146 (206) 850-5474 "Your Safety is Our Concern" AUTHORIZED EMERGENCY VEH ICLE APPLICATION RENEWAL WASH INGTON STATE PATROL EOUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BLDG PO BOX 426A0 OLYMPIA WA 98504-2600 DATEA ROVED VALID CAPTAI (For Department Use Only) making application. Or-yrq?t e R Esrcr*)L.L-C zip qavl (" @ rnsn. Corn icles. For each vehicle, Any new vehicles--or permitfor thai vehicle-must c} $A.r/ 3so *-oCu.r- l5 ,IfiAKE IT L This application must be submitted by the Chief Execuiive of the firm or Please type or print in ink. Person, Company, Department, orAgency (if a person, must list agency/department representing) Address lbD 3\,v lo4:x!-tJ- State Phone ( Zf,,lo)85() *517q E-mail dove City 1 YEAR 3c'c;r 9o 8sc NO. pFLMAKE \+ IF\D STERED MAKE MODEL vrrQh l)35k\-P \,-g-\'' ) bLAMP COLOR(S) OTHEREAUIPMENT: CL"fy1{c siREN ' MODELMAKE Ft-rLPTI \'t/ \lrrDitr 60tlo€23-Oo6 {05i0-a} Page 1 ofS SIREN LAMP COLOR(S) LAMP SIRENSE NOEAR LAMP MODELMAKE OWNERREG SIREN LAMP COLOR(S) LAMPMODELMAKE SIREN LAMP COL9R(S) AUTHORIZED EMERGENCY VEHICLE A PPUCAilON RENEWAL Note: This page may be copied if additional vehicles need to be added to attacneO must-providl the vehicle and equipment information in the same IT permit. AnY additional sheets LICENSE NOYEAR MODELMAKE REGISTERED OWNER LICENSE NO.YEAR MODELMAKE VIN s000329O06 (R 12109) as above. Page 2 of 5 AUTHOR IZED EMERGENCY VEHICLE PERMIT APPLI CATTON RENEWAL 2. Purpose ofAPP|ication authorized emergen cy veh the natuie and sco hich these vehicles will be operated is to assist local funeral directors andThe purpose for wl ition, devoted to those that have passed, in a prqcessiontheir "familiqs" in a time honored tradition, devoted ?,tn' of their loved ones to their place of internmen! while reasonably asking the public not to i"a"*-* and keeping the safety of the procession and general public at the forefront' 3 V City Streets (list all cities)Y 'l tr CountY Roads (list atl counties) 4. . Geographi" Ar"", ctrecr wrricrr tvnes of roads you will be operating o1 3$ sj{e the spggilig geographic: - -' . . .area(s) in which the vehicles shall be u.Lo rt auihorjzed emergetcy:]19licles (ci$- county, etc'), ' - -. !- -^-..;--l ,,-.tar nart 7 ^i tlare annllneflnn l (Certification rrom,Jrln piirurfrJUrirOiriion is required under part 7 of this application') . n StateRoutes/lnterstates -.5 operators: prease risi ail drivers that you intend to rrayg o_n.e.1ating the vehicre(s) risted in this application and indiaate wnelrer or not the operator/driver is new since your last application' l necessary) tr n n n n tr n n n u tr D tr tr tr E tr tr tr tr n 3oo0-323-O03 (R 12/091 (Use onal sheet if Page 3 of 5 a 6. PermitValidation: I certify that: a- h I understand that liability as wellas $ignature Name Please type or t: Signature Narne (Please Pfi,ntl Phone AUTHORIZED HMERGENCY VEHICLE ,APPLICATION RENEWAL of law Tiile (cHrEF EXECUTIVE Date ffYPE oR PRTNT) provided in is fo be used are to be used as been convicted of, norserved d sl as outlined in this application Etsm/-W Only the and that this itIftfo a are authorized under this The driver must exercise due care and caution and must obey ail ). As the primary holder or. e.xecutive officer in charge of overseeing this permi!rssued, it is my responsibility to ensuie:-' "that if the permit is No driver risted in this permit uses the vehicre for private purposesremoved or covered.all emergency equipment is a. b. c. In.addition, I understand that if is mvsnvers are present in each vehicle it responsibility to ensure that a copyalltimes and must be presented'tb list of approved if requested, 6 ) listed unless all or cle to this permit, f laws result in criminalor ciyil and o, its willnot be accepted icie is to be used for used as authorized by the chief of a law the political sub-division. The the applicant intends to that 7 Date I loS /o rite OF Jurisdiction{j.t3 ) gst"_sgg{u . Ke h^,gJA ,U9 3o0G3234CE {05/09J E-Mail $$TKac* ml Page 4 of5 aI AUTHORIZED EMERGENCY VEH ICLE RENEWAL Date Jurisdiction E-Mail Date Jurisdiction E-Mail, Date Jurisdiction E-Mail Date Jurisdiction E-Mail Date Jurisdiction E-Mail Date its will not be accePted is to be used for be used as authorized 3 of this aPPlication to be denied." bv the chief of a law the political sub-division. The th in at the applicbnt intends to part Z df tnis application: that authorized emergency Signature Name (Pleass Print) Phcne ( Signature : Name (Pleass Prinl) Phone ( Signature Name {PlEase Print} Phone () Signature Name (Pleass Print) Phone ) Signature Name (Please Ptiot) Phone Signature Name (Ploasa Prinll Phone ) i () Jurisdiction E-Mail Date Jurisdiction E-Mail Date Signature Name (Pleaso Print) Phone () Signature Name {Plaase Print) Phone Jurisdiction E-Mail add an additional sheet-) ( 3flXl-3F-006 ((Er09) ) lf additional certifications are Page 5 of 5 Attachment "A" ,Page l of7 , VEHICLE INFORMATION EI\G,RGENCY EQTIIPMENT INFORMATION INSTALLED MAKE MODEL I YEAR 2007 LICENSENO. 909854 SIREN:Whelen si.as0+ltr{ w3 -320 MAKE Harley Davidson MODEL FLI{P LAI'{P COLORS: MAKE/MODEL:,H6^_ *wl\c.3,3 J 49 ^d'-a ^^4F1, Whelen REGISTEREDOWNER James Irwin OTIIEREQUIPMENT: VEHICLE INFORMATTON EMERGENCY EQUIPMENT INF ORMATION INSTALLED MAKE MODEL YEAR 2008 LICENSENO. 959&04 SIREN:Whelen sA-350-MH MAKE HarleyOavidson MODEL FLI{P 'LAMP COLORS: MAKEMODEL::ffi6' Itf;[1.@,3p r IMhelen VIN 1HDlFHMlX8Y654OO4 REGISTERED OWNER James Irwin OTIIEREQUIPMENT: VEHICLE EMERGENCY INSTALLED '+lA€ffif WFQ \r2 Y.EAR 2007 NO. LEM9194 SIREN Whelen MAKE HarleyDavidson MODEL FLHTP LAMP COLORS: MAKE/IVIODEL: rillheten - 3*"t='6{-o$s VIN liID I FI\trvI 1 67 Y 6497 62 REGISTERED OWNER Dave Eady OTTIEREQLIIPMENT: \f\e I 6/€5e+EI <-flckatoY , vflretelr. c€I-e 3819556 NO. Whelen eooLe 3 LAMP COLORS: MAKEI]VIODEL: MODEL R-l500 RobertNash VIN w810499A632E89s39 Sat'35ei'fff- 3ea lllbelet t/L-t-L LICENSE 843422 LAMP COLORS: N{AKEnnooel,: MAKE Harley Davidson OWNER Terry Ketcham LAMP COLORS: MAKE/]VIODEL: MAKE Flarley Davidson John Tyo OWNER ii f \t:-'.'':: \.\ -- At&achment "A" Page 3 of7 VEHICLE INFORMA-TION EMERGENCY EQUIPMENT DnOnnAeTION INSTALLED. , MAKE MODEL' YEAR 2007 LICENSENO. : LEM9525 : SIREN:Whelen SiF35HtffI-- ?h roo MAKE HarleyDavidson MODEL FLHT-P LAMP . , COLORS: MAKE/IVIODEL::Par36-4r-llu a Whrl€a 6erte.'te l-]) VIN rHDIFMMI87Y70fL2A REGISTERED OWNER Douglas Morgan OT}IEREQLIIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL YEAR 1990, LICENSENO. 813585 SIREN:. -{trftrct'en Federor-\ *nr+S$*f,I- :ltsioo MAKE: Kawasaki MODEL KZ-1000 LAMP COLORS: MAKE/]VIODEL: Red Ptr36 S -ttotcolea ,-Wbclcrt- U-\i -Poup'a( PCGISTEREDOWNER Melvin:Centers OTHEREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQI.IIPMENT INFORMATION INSTALLED :MAKE MODEL 9 YEAR 2008 LICENSENO. LEIU9196 SIREN:Whelen SrCc+504'*I !)f;1@o MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKE/TVTODEL: , Red Par 36 Wneten VIN 1HDiFMIv{l9846A7796 REGTSTERED OWNER Dave Eady OTIIEREQUIPMENT: EMERGENCY INSTALI,ED MAKE 990311 NO- LAMP COLORS: MAKEII\'oDEL: Roger Sherwood OWNER lHD1FMMl3 8Y700488 ONCLEVEHI S*r+Se+'fft PR LOG NO. LEM9488 .YEAR 2007 LAMP COLORS: MAKE/]VIODEL: MODEL FIHP James Wright OWNER llflFHtvttXz.Tl]276 VIN SA-350-MII Soato(z LICENSE LEM96O9 NO. lAo L\ {wrcrdilLAMP ..COLORS: MAKEIIvIODEL: MODEL FLHTPHarleyDavidson MAKE Douglas Clark OIVNER 1HDlFMM1 78Y6s7466 "/ ,Attachment'4." Vage S o,f Z EMERGENCY EQINPMENT INFORMATION INSTALLED MAKE MODEL VEHICLE INFORMATION SIREN;Whelen sb5jcR €*=*Sga,*I YEAR 2009 LICENSENO. 2A55t5 Whelen MODET FLHTP MAKEiIVIODEI,: LAMP COTORS:Red Par 36zadz3 MAKE HarleyDavidson REGISTERED OWNER Bob Holrigren OTIIER EQUIPMENT: YIN . IID1FMM189V624073 VEHICLE INFORMATION EIVIERGEN CY EQUIPMENT FIF ORMATION INSTALLED ] 1AKE : MODEL l4 YE4R 1999 LICENSENO. LEMT4OO SIREN:Whelen SffiJi0iltftI 'v...tPh - \\z MAKE FORD MODEL Crown Vic LAMP COLORS: IMAKE/IVTODEL: Red Par36 Whelen VnI i 2FAF971Ws)O(i05S32 REGISTERED OWNER Daveiiady ' ' . OTTIEREQUIPMENT: VEHICLE INFORMATION srcr{50;IvEl'Ph t oo LICENSENO. 909836 YEAR 2007 'Whelen MODEL FLIITP MAKE 'HarleyDavidson REGISTERED OWNER Steven Sundstrom VIN lHDlFMMls7Y647380 EMERGENCY EQUIPMENT IhIFORMATION INSTALLED MAKE Red ar 36 helen VEHICLE TION EMERGENC Y EQUTPMENT N{FOBMATION INSTALLED IVTAKE MODEL SA.35O-MH YEAR 1996, LICENSENO. AtsrTTx Whelen MAKE Ford MODEL , Crown Victoria LAMPiorons:' MAKE/IyIODEL: j$eeten+ n? -( Cc-o\e3 VIN zFALP7lW7TXt4lssz REGISTERED OWNER Douglas Morgan OTTIEREQUIPMENT: VEHICLE EMERGENCY EQUIPMENT INFORMATION INSTALLED. MAKE MODEL YEAR 2009 NO. 3A0931 SIREN:Whelen sA-350-MH MAKE Harley Davidson MODEL FLHTP I_AfufP ., COLORS: MAKEIVTODEL: Red "d:16Lq.A Whelen VIN trmtrm'vlt 49y633921, REGISTERED OWNER Thomas Chiswell OT}IEREQUIPMENT: VEHICL€ INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL YEAR 2d09 LICENSENO. L,EMII654' ' Whelen Sk8d0Elefif ?n los' MAKE HarleyDavidson MODEL FLHT-P LAMP Corons: MAKE/]VIODEL: Red Par 36 Whelen VIN 1HDrFMM1X9Y6926l7 REGISTERED OW]\rER MelodyYoung OTHEREQUIPMENT: Attiachment'?" PageT of7 'IPl\trVEHICLE INFORMA'TION EMERGENCY INSTALLED'I\4AKE YEAR . 2008 T,ICENS€NO. LEIo/dg174 SIREN:Whelen .sA.3s&ffr- l-lD MAKE i Harley Davidson MODEL FLHTP tAMP COLORS: MAKEAVIODEL: \"rn r*e q- Red I ' Par36 Whelen .\rN lHD1FHM128Y639769 REGISTERED O-qnIER Delon Sandmire \^{ht,\€.tl TTEV I?, : \IEIIICT.;E INFORMATION EMERGENCY EQUIPMENT INFORMA'TIONINSTALLED MAKE MODEL YEAR LICENSENO. SIREN Whelen SA.35O:MH 1VIAKE MODEL LAMP COLORS: MAKEA,IODEL: Red Par 36 'Whelen VIN REGISTERED PWNER OTTIEREQUIPMENT: ATTACHMENT'B' Page 1 of 1 Operators: Bodgan, JefFery T. Carl, Brice E. Centers, Melvin J. Chiswell, Thomas J. Clark, Douglas R.' Clayton Jr., Evan J. Eady, Dave E. Hernandez, Kevin J. Hoff, William W. Holmgren Jr., Robert G Huiatt, Forrest Donald Hyett, Roy E. lrwin, James M. Kelly, Patric Ketchum, Terry W. Laigo, Matthew A. McCarte, Jason Mclntyre, Fredrick J. Meyet Paula E. MitchellJr., Albert Morgan, Douglas E. t Nash, RobertA. Nelson, Gregg M. Nishiyori, Kenneth Sandmire, Delon Sherwood, RogerA. Steinauer, Matthew R. Tyo, Johrr E. " t VanHalteren, Scott D. Walker, Kevin D. Willrns, Andy Wright, James K. Young, MelodyA. AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,F,,MaW (For Department Use Only) This application must be submitted by the Chief Executive of the firm or corporation making application. WASHINGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BLDG PO BpX 42600 oLYrvtPtA WA 98504-2600 Please type or print in ink. Person, Cornpany, Department, orAgency (if a person, must list agency/department representing) -ril DATE APPROVED: VALID UNTIL: CAPTAIN Or-yr.,t?t c Mo-roR. EEcovet, L.L .C Address lbDte S\,'d lo'{<OT h7 7 City Sf"errle State WA Zip %l'llo Phone ( Za\o) 85O * 5171 E-mail dove ec\d @ rnsn.corn 1. Vehicle lnformation: List all vehicles being used as authorized emergency vehicles. For each vehicle, provide both the vehicle and emergency equipment information as outlined below. Any new vehicles-or vehicles with equipment installed other than what is authorized on the current permit for that vehicl+-must receive prior approval before being utilized under this permit. Seg, FntRCttED r\6r/ . .. VEHIGLE INFORMATION YEAR LICENSE NO MAKE MODEL VIN REGISTERED OWNER OTHER EQUIPMENT EMERGENCY EQIJIPMENT INFORMATION INSTALLED MAKE MODEL SIREN I rnun coLoR(s) LAMP MAKE/MODEL VEHICLE INFORMATION .,i '.] YEAR LICENSE NO MAKE MODEL VIN REGISTERED OWNER EMERGENCY EQUIPMENT INFORMATION TNSTALLED MAKE MODEL L SIREN f] r-nr'rn coloR(s) LAMP MAKE/MODEL OTHER EQUIPMENT: 300G.323-O06 (0s/09)Page 1 of5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL RF.HMWtr 2.Purpose of Application: Describe the specific purpose for which the vehicle(s) shall be used as authorized emergency vehicle(s) and what necessitates the vehicles' registration as emergency vehicles. Explain the nature and scope of the duties, responsibility, and intended use of emergency equipment. 3. Authority: Explain authority o under statute (Revised Code of Washington) that allows vehicles' operatcrs to use emergency equipment for the purpose outlined under part 2 of this application. 4 Geographic Area: Check which types of roads you will be operating on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles (city, county, etc.). (Certification fronr each primary jurisdiction is required under part 7 of this application.) C City Streets (list all cities)&,e AnAc*Ep *6t/ Wnc 3Db-330-4rrU /tcW 1b.s+.lq'l / qcW 4b bl' o3s -To ?eoVrOe *i-rap*rrrc- CoNr(OL lZp" fuNeR*L Pfao*t"6toN:, fr County Roads (list allcounties) 5 d State Routes/lnterstates Operators: Please list all drivers that you intend to have operating the vehicle(s) listed in this application and indicate whether or not the operator/driver is new since your last application. 3€E ATTACI+ED t,C " additional sheet if necessary) OPERATORIDRIVER NEWOPERATOR/DRIVER NEWOPERATOR/DRIVER. NEW tr n n n tr tr n I n n tr tr D tr tr tr tr n ! tr tr 300G323-006 (05i09)Page 3 of 5 AIJTHORIZED EMERGFNCY VEI{ICLE PFRMIT AFFLISAT;ON REfrIEWAL F"F*ffiW 6. Fermii Validaiion: I certiiy that: a- All of the information given !n this app_lication is correci to-lhe best of my knowledge and provided inits full form.ai to ihe undeisigned chief law enforcement officer or fire chief (if the riehicre ii io ne rsea iot firefrghiing purposes) of each primary jurisdiction in which the vehicles ire to i:e used as authorized eme!-gency vehicle(s). b. None sf the drivers, to the besi of rny i(nowledge in the iast year, have been convictecj oi nor served any s.tt.t.es or periods of probaiion for any felonies, nor arrested and convicted of a drug or aleohol violaiion or illegai use or possession of drugs, nor been required to register as a sex cffender, nor have any of ihenr been adjuciicated incornpetent or insane, e. Only the vehicle(s). and equipnreni listed in this anplication will be used as ouilinecj in this application, ancl that only the operatois listed under this permit will drive the vehicle{s). As the qfmary holder or executive officer in charge of overseeing ilris pernrit, I understand thai if ihe permii is issued, it is my responsibility to ensure: a. I'lo driver listed in this permii uses the vehicie for private purposes unless all emergency equipnreni is removed or covered. b- No driver other than those listed under this approved pernrit operates the vehiole{s) listed unless all emergency ecuipmeni is removed or covered. lf t wish to add a new drfver or vehicle to this pernrit, I musi receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traific laws. I uncierstand that the inappr-opriate cr misuse of authorized emergency vehicles may result in crinrinal or cirril liabiiity as well as cancellation of this permit as outlined under chapter 204-36 WAC. ln addition, I understand that it is my responsibilify to ensure that a copy of this permit and drivers are present in each vehicle at alltimes and must be presented to law enforcement, Signature riile oan/ep (CHIEF EXECUTIVE Date /o/ro/o7 list of approved if requested. Name CI-YPE OR PRINT) Certification: This renewal application forAuihorized Emergency'fehicle Pernrits will not be accepteC unless CERTIF|ED by the chief lavr enforcement officer or fire chief {if ihe vehicie is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicles (see part 4 of this applicaiion). tf the application is made by the chief of a law enforcement agency orfire departmeni, it must be CERTIFIED by the head of ihe politicalsub-ditision. The certiflcation must csniain the following language: "l hereby ceriiiv ihat I have reviewed this entire application; that I am awaie that the applicant intends to use tlre vehicte{s) and emergency equipment listed as specifically described in part 2 of ihis application; that a need continues to exist in my jurisdiction for the listed vehicles to be used as auihorized emergency vehicles and ihai the applicant has the appropriate authoriiy as describecj in pari 3 of this application to operate such equipnrent and I know of no reason why this application should be denied." Please type Signature Narne (Please Ffintl Phone or tf-l ) g5G 561o Date lDKq Jurisdiction E-Mail so00-32346 {05i09) riilethtlffi Page 4 of 5 lnMEL_!fisiliirdiifi'ffiffidiWtr Geffification: This renewal application for Authorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the chiellaw 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 emeigency'vehicles (see part 4 of this application). lf 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 contain the following language: "t hereby certifv that I have reviewed this entire application;. that.l am aware that the_ap,plicant intends to.. use the veffi1s; and emergency equipment listed as specifically described in part 2 of this application; that a need coniinues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the applicant has the appropriate authority as described in part 3 of this application to operate such equipmeni; anO I know of no reason why this application should be denied." AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL 7 Signature Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail Date Title Jurisdiction E-Mail lf additional certifications are needed, add an additional sheet.) Name (Please Print) Phone (Please Print) Name (Pleass Print) Phone Name (Pleass Pr'nt) Phone Name (Please Print) Phone Name (Please Print) Phone Name (Please Print) Phone Name (Please Print) Phone () Signature Name Phone ( ) Signature () Signature () Signature () Signature () Signature ( Signature () sooo-323-O6 (0s/09)Page 5 of 5 Attachment "A'o Page 1 of7 VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 1 YEAR 2007 LICENSENO. 909854 SIREN Whelen SA-350-MH MAKE Harley Davidson MODEL FLIIP LAMP COLORS: MAKE/]VIODEL: Red Par 36 Whelen VIN 1HDlFHMl77Y65761.8 REGISTERED OWNER James Irwin OTHEREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 2 YEAR 2008 LICENSE NO. 959804 SIREN Whelen SA-350-MH MAKE Harley Davidson MODEL FL}IP LAMP COLORS: MAKEiIVIODEL: Red Par 36 Whelen VIN iHD1FHM1X8Y654OO4 REGISTERED OWNER James Irwin,OTHEREQUIPMENT: VEHTCLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL J YEAR 2047 LICENSENO. LEM9194 SIREN Whelen PA-l00 MAKE Harley Davidson MODEL FLHTP. LAMP COLORS: MAKEAVIODEL: Red Par 36 Whelen VIN 1HD1FMM167Y649762 REGISTERED OWNER Dave Eady OTTIEREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 4 YEAR 2006 LICENSENO 843422 SIREN Whelen SA-35O-MH MAKE Harley Davidson MODEL FLHT-P LAMP COLORS: MAKE/TVIODEL: Red Par 36 Whelen VIN lHDlFMS/126Y6016t0 R.EGISTERED OWNER Terry Ketcham OTHER EQTIIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 5 YEAR 2004 LICENSE NO. 777100 SIREN:Whelen SA-35O.MH MAKE $arley Davidson MODEL FLHTP LAMP COLORS: MAKE/]VIODEL: Red Par 36 Whelen VIN 1HDlFMW124Y623331 REGISTERED OWNER John Tyo OTHER EQLIIPMENT; VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 6 YEAR 20a3 LICENSENO. 819ss6 SIREN Whelen SA-350-MH MAKE BIvt\4/ MODEL R-1500 LAMP COLORS: MAKE/IVIODEL: Red Par 36 Whelen VIN w810499A632E89539 REGISTERED OWNER Robert Nash OTI{ER EQLIIPMENT: Attachment "A" Page 3 of7 VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 7 YEAR 2007 LICENSENO LF'M9525 SIREN Whelen SA-35O-MH MAKE Harley Davidson MODEL FLHT.P LAMP.. COLORS: MAKE/]VIODEL: Red Par 36 Whelen VIN lHD1FMM187Y70ll20 REGISTERED OWNER Douglas Morgan OTTIER EQTIIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 8 YEAR ,1990 LICENSENO 8 13586 SIREN Whelen SA-350-MH MAKE Kawasaki MODEL KZ-10b0 LAMP COT,ORS: MAKE/]V[ODEL Red Par 36 Whelen VIN ' IRAKZCP23LB5O7999 REGISTERED OWNER Melvin Centers OTIMREQIIIPMENT: INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 9 YEAR 2008 LICENSENO. LEM9196 SIREN Whelen SA-35O-MH MAKE Harley Davidson MODEL FLHTP i: LAMP COLORS: MAKEAyIODEL: Red Par 36 Whelen VIN 1HD1FMM1984607796 REGISTERED OWNER Dave Eady OTIIEREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 10 YEAR 2007 LICENSENO. LEM9488 SIREN Whelen SA-35O-MH MAKE Harley Davidson MODEL FLIIP LAMP COLORS: MAKEAyIODEL: Red Par 36 Whelen VIN 1HDIFHM1X7Y7T7276 REGISTERED OWNER James Wright OTHEREQIJIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 11 YEAR 2008 LICENSENO. Lp\agoos SIREN:Whelen SA.35O-MH MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKE/]VIODEL: Red Pm 36 Whelen VIN 1HDlFMMl78Y657466 REGISTERED OWNER Douglas Clmk OTT{EREQTIIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 12 YEAR 2008 LICENSENO. 9903 1 I SIREN:Whelen SA-350-MH MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKEAyIODEL: Red Par 36 Whelen VIN 1HD1FMM138Y700488 REGISTERED OWNER Roger Sherwood OTIIEREQLIIPMENT: Attachment "A" Page 5 of 7 VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL l3 YEAR 2009 LICENSENO. 2A5515 SIREN:Whelen SA-35O.MH MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKEAyIODEL: Red Par 36 Whelen VIN lHD1FMM189Y624073 REGISTERED OWNER Bob Hofuagren OTIIER EQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 14 YEAR r999 LICENSENO LEMT4OO SIREN Whelen'SA-350-MH MAKE FORD MODEL Crown Vic LAMP COLORS: MAKEAVIODEL: Red Par 36 Whelen \ruN zrarsztws)o(l05832 REGISTERED OWNER Dave Eady !OTI{EREQIIIPMENT:' VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 15 YEAR 2007 'LICENSENO. 909836 SIREN Whelen SA-350-MH MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKEAVIODEL: Red Par 36 Whelen VIN lHDlFMMl57Y647380 REGISTERED OWNER Steven Srurdstrom OTIIER EQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL r6 YEAR 1996 LICENSENO. A]5t77l{ SIREN:Whelen SA-35O-MH MAKE Ford MODEL Crown Victoria LAMP COLORS: MAKEAvIODEL: Red Ter 6 Whelen VIN 2FX-P7tW7TXt4t552 REGISTERED OWNER Douglas Morgan OTTMREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQI-IIPMENT INFORMATIONINSTALLED MAKE MODEL t7 YEAR 2009 LICENSENO. 340931 SIREN Whelen SA-350-MH MAKE Harley Davidson MODEI, FLHTP LAMP COLORS: MAKE/IVIODEL: Red Par 36 Whelen ViN 1HD1FMMI49Y63392T REGISTERED OWNER Thomas Chiswell OTIIER EQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATIONINSTALLED MAKE MODEL 18 YEAR 2009 LICENSENO. LEMg654 SIREN Whelen SA-350-MH MAKE Harley Davidson MODEL FLHT-P LAMP COLORS: MAKE/N{ODEL: Red Par 36 Whelen VIN 1HD1FMMlXgY692617 REGISTERED OWNER Melody Young OTFIEREQUIPMENT: (, Attachment'oA" PageT of7 VEHICLE INFORMATION EMERGENCY EQUIPMENT INF ORMATION INSTATLED MAKE MODEL t9 YEAR 2008 LICENSBNO. LEi|d9174 SIREN:Whelen SA-35O-MH MAKE Harley Davidson MODEL FLHTP LAMP COLORS: MAKE/}IODEL: Red Par 36 Whelen VIN lHDtFHMl28Y639769 REGISTERED OWNER Delon Sandmire OTHEREQUIPMENT: VEHICLE INFORMATION EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL 20 YEAR LICENSENO. SIREN:Whelen SA-350-MH MAKE MODEL LAMP COLORS: MAKEMODEL: Red Par 36 Whelen VIN REGISTERED OWNER OTIIEREQUIPMENTI Attachment "B" Page 1 of1 4. Geographic Area: City Streets (list all cities): Mount Vemon, Seattle, Tacoma, Kent, Renton, Auburn, Wenatchee, Bellevue, Puyallup, Kennewick, Richland, Sumner, Enumclaw, East Wenatchee, Federal Way, Sea-Tac, Bonney Lake, Buckley, Edmonds, Everett, LaConner, Tanasket, Bremerton, Port Townsend, Port Orchard, Shoreline, and Burien' County Roads (list all counties): Skagit, Swinomish, Pierce, King, Snohomish, Lewis, Thurston, Benton, Chelan, Douglas, Franklin, Jefferson, and Spokane. State Routes/Interstates : A11 State Routes and I-5 Page 1 WSP Appl-Olympic Motor Escorl, LLC Confidential r01812009 5. Operators: Bogdan, Jeffery T. Carl, Brice E. Centers, Melvin J. Glark, Douglas R. Clayton Jr., Evan J. Eady, Dave E. Hernandez, Kevin J. Hoff, William W. Holmgren Jr., Robert G Huiatt, Forrest Donald Hyett, Roy E. lnryin, James M. Ketchum, Terry W. Laigo, Matthew A. McCarte, Jason Mclntyre, Frederick J. Meyer, Paula E. MitchellJr., Albert Morgan, Douglas E. Nash, Robert A. Nelson, Gregg M. Sherwood, Roger A. Steinauer, Matthew R. VanHalteren, Scott D. Wright, James K. Young, Melody A. Attachment "C" Page I of1 Page i WSP Appl_Oiympic Motor Escofi, LLC Confidential rc18t2a09 iiiiii't{} x,iillil I iirl] LOlOtl09 To Whom It May Concerno Olympic Motor Escort is eagerly interested in providing funeral escort services in your city or may use routes that go through your jurisdiction. As requested by Washington State Patrol, we are requesting approval from your department to perform funeral escorts in your jurisdiction. This would be limited to funeral escorts only and no other fype of duties. Olympic Motor Escort is a well established company and has been in business for over seven years. All of our riders are certified through the Washington State Patrol as emergency vehicle operators and their escort motorcycles are inspected and permitted for ,tse a. authorized emergency vehicles. Our riders consist of off-duty/retired police officers, off-duty fire fighters and we also utilize properly trained civilians. All of our personnel go through strict background checks and are approved by the X'BI as well as WSP before they are even allowed to begin their traininglFTO. Safety is our priority so our riders are all motor school trained. We have current active Police motorcycle officers on our team which conduct all of our motorcycle training. All of our riders go through continuous training and have to meet or exceed high levels of proficiency in several areas. Again, with your approval we would like to obtain a permit to workwithin your jurisdiction. ff you have an; questionqr plpase dqprf hositate to give me a cpll. Thanlr You iu aflvqnce,r&i^'/l4{Me( ouvio Eady ?'" 7 Qwner / Olympic Mofqr Espofh LLC (206) 8sq-s474 OLYMPIC MOTOR ESCORT L.L.C. 1606 SW 104TH ST #97 SEAfiLE WA 98146 (206) 850'5474 "Your Safety is Our Concern"