HomeMy WebLinkAboutCAG2023-629 - Original - Green River College Foundation - 2024 Community Arts Support Program: Interurban Center for the Arts Docent Program - 01/01/2024 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr:
Agreement Routing Form Dir. Assist:
• For Approvals,Signatures and Records Management
KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover
WASHINcroN Sheet forms. Dir/Dep Dir:
Originator: Department:
Ronda Billerbeck Parks, Recreation & Community Services
Date Sent: Date Required:
> 12/13/2023 ASAP
0
CL Authorized to Sign: Date of Council Approval:
QDirector or Designee N/A
Budget Account Number: Grant? Yes WINo
10006222.64190.4311
Budget?W]Yes:No Type: N/A
Vendor Name: Category:
Green River College Foundation Contract
Vendor Number: Sub-Category:
= 1418758 Original
R0 2024 Community Arts Support Program: Interurban Center for the Arts Docent Program
Project Name:
1.1. Project Details:Contractor will provide membership discounts for 8 Kent schools to
0
= participate in ICA's Art Docent program.
c
40
40 Agreement Amount: $2 000 Basis for Selection of Contractor: Other
`Memo to Mayor must be attached
Start Date: 1/1/2024 Termination Date: 12/31/2024
Im
Q Local Business?F--]YeslzNo* If meets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions'form on Cityspace.
Business License Verification:Yes In-Process Exempt(KCC 5.01.045)
Notice required prior to disclosure? Contract Number:
FTesONo CAG2023-629
Comments:
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Date Routed to the City Clerks Office: 1 2/1 5/23
,c«w»373__,0 Visit Documents.KentWA.gov to obtain copies of all agreements
rev.20210513
•
KENT
W A 5 H I N G T O N
CONTRACTOR SERVICES AGREEMENT
between the City of Kent (Community Arts Support Grant Program) and
Green River College Foundation's Interurban Center for the Arts
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and
Green River College Foundation's Interurban Center for The Arts organized under the laws of the State of Washington,
located and doing business at 12401 SE 320th Street, Auburn, WA. 98092. (hereinafter the "Contractor").
I. DESCRIPTION OF WORK.
Contractor shall perform the following services for the City:
Description: Contractor will provide membership discounts for 8 Kent schools to participate in
ICA's Art Docent program.
Day, Date, Year: January 1 — December 31, 2024
Event Location: Various Kent schools and online access
Contractor further represents that the services furnished under this Agreement will be performed in accordance
with generally accepted professional practices in effect at the time those services are performed.
II. COMPENSATION. The City shall pay Contractor the total sum of$2,000 (as part of the Community Arts
Support Grant Program) for the work to be performed under this Agreement, upon satisfactory completion of all services
and requirements specified in this Agreement.
III. PRESS MATERIALS. Contractor agrees to provide where appropriate, at his or her own costs, complete
press materials, including but not limited to black and white glossy photographs, biographic descriptions, and program
materials, not less than eight (8) weeks prior to the initial event date. All publicity and promotional materials released to
the media by the Contractor shall credit the City of Kent Arts Commission for its support of the event or project.
Promotional credit must be clear and prominent.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer
Relationship will be created by this Agreement and that the Contractor 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.
V. EVALUATION. The Contractor shall have the authority to control and direct the performance and details
of the contract work, the work must also meet the approval of the City and shall be subject to the City's general right of
inspection and supervision to secure the satisfactory completion thereof. Contractor agrees to cooperate in this
evaluation process and to make available to the City all information required by such evaluation process. Contractor
agrees to comply with all federal, state and municipal laws, rules, and regulations that are or may in the future become
applicable to Contractor or Contractor's business, equipment and personnel engaged in operations covered by this
Agreement or accruing out of the performance of such operations.
VI. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor shall take all necessary precautions and
shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work
and shall utilize all protection necessary for that purpose. All work shall be done at Contractor's own risk, and Contractor
shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with
the work.
VII. INDEMNIFICATION. Contractor shall defend, indemnify 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 the Contractor's performance of this Agreement, except for
that portion of the injuries and damages caused by the City's negligence, including assertions that the use or transfer of
any software, book, document, report, film, tape or sound reproduction delivered in accordance with this Agreement
constitutes an infringement of any copyright, patent trademark, trade name, or otherwise results in unfair trade practices.
The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of
these covenants of indemnification.
The provisions of this section shall survive the expiration or termination of this Agreement.
CONTRACTOR SERVICES AGREEMENT- I
(Community Arts Funding Projects)
VIII. INSURANCE. The Contractor shall procure and maintain for the duration of the Agreement, insurance of
the types and in the amounts described in Exhibit A attached and incorporated by this reference.
IX. USE OF CITY MATERIALS. Contractor shall not, without prior written approval and permission of the
City, use participant roster or related program materials for any purpose outside this Agreement including, but not limited
to, solicitation of participants for Contractor's use in competition with City programs.
X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any
subcontract, the Contractor, its subcontractors, or any person acting on behalf of the Contractor or subcontractor 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. Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy
Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XI. TERMINATION AND BREACH. In the event of loss of funding or the Contractor's failure to comply with
the terms and conditions of this Agreement, the City may terminate this Agreement upon providing only thirty (30) days
written notice to Contractor. All costs incurred by the City due to Contractor's failure to comply with the terms and
conditions of this Agreement shall be the responsibility of the Contractor. The City may deduct its costs from any
payments due to the Contractor or pro-rate the Agreement amount based upon the actual time of Contractor's
performance compared to the contracted performance schedule.
XII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its Contractors to
use recycled and recyclable products whenever practicable. A price preference may be available for any designated
recycled product.
B. 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.
C. 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 alternative 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, in addition to any other recovery or award provided
by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under
Section VIII of this Agreement.
D. 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 become 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.
E. 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.
F. 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 Contractor.
G. 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.
CONTRACTOR SERVICES AGREEMENT-2
(Community Arts Funding Projects)
H. Compliance with Laws. The Contractor agrees to comply with all federal, state, and municipal laws, rules,
and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and
personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations.
I. Counterparts and Signatures by Fax or Email. 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 one Agreement.
Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that
signature shall have the same force and effect as if the Agreement bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date
entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified
and affirmed, and the terms of the Agreement shall be deemed to have applied.
CONTRACTOR: CITY OF KENT:
ge rrao,e-r `-01-1 1foav
By:
George Fra ier(Dec 15,2023 08:40 PST) By: Lori Hogan(Dec ,2023 16:36 PST)
Print Name: George Frasier Print Name: Lori Hogan
Its: Executive Director Its: Recreation and Cultural Services Supt
DATE:
12-15-23 DATE: 12/13/2023
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
Monica Tolas, Program Coordinator Ronda Billerbeck, Cultural Programs Manager
GRC Foundation Interurban Center for the Arts City of Kent
12401 SE 320th Street 220 Fourth Avenue South
Auburn, WA 98092 Kent, WA 98032
253-833-9111 ext. 2735 (telephone) (253) 856-5055 (telephone)
MTolas@greenriver.edu (email) rbillerbeck@kentwa.g_ov (email)
ATTEST:
6wk
Kent City Clerk
CONTRACTOR SERVICES AGREEMENT-3
(Community Arts Funding Projects)
DECLARATION
CITY OF KENT NON-DISCRIMINATION POLICY
The City of Kent (City) is committed to conform to Federal and State laws regarding equal
opportunity. As such all contractors, subcontractors, consultants, vendors, and suppliers who
perform work with relation to this Agreement shall comply with the regulations of the City's
equal employment opportunity policies.
The City of Kent and its contractors are subject to and will comply with the following:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat.
252), (prohibits discrimination on the basis of race, color, national origin);
0 49 C.F.R. Part 21 (entitled Non-discrimination In Federally-Assisted Programs
Of The Department Of Transportation-Effectuation Of Title VI Of The Civil
Rights Act Of 1964);
28 C.F.R. section 50.3 (U.S. Department of Justice Guidelines for
Enforcement of Title VI of the Civil Rights Act of 1964).
• Ch. 49.60 RCW (Washington Law Against Discrimination)
The preceding statutory and regulatory cites hereinafter are referred to as "the Acts and
Regulations".
The following statements specifically identify the requirements the City deems necessary for any
contractor, subcontractor, or supplier on this specific Agreement to adhere to. An affirmation of
all of the following is required for this Agreement to be valid and binding. If any contractor,
subcontractor, or supplier willfully misrepresents themselves with regard to the directives
outlined below, 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 statements 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 I, 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. During the performance of this contract, the contractor, for itself, its assignees, and
successors in interest (hereinafter referred to as the "contractor") agrees as follows:
EEO COMPLIANCE DOCUMENTS - 1 of 5
A. Compliance with Regulations: The contractor, subcontractor, consultant,
vendor, and supplier (hereinafter "Contractor") will comply with all Acts and the
Regulations relative to non-discrimination, including those applicable to Federally-
assisted programs of the U.S. Department of Transportation, State-assisted
programs through the Washington State Department of Transportation, and
generally under Washington's Law Against Discrimination, Ch. 49.60 RCW, as they
may be amended from time to time, which are herein incorporated by reference
and made a part of this contract.
B. Non-discrimination: The contractor, with regard to the work performed by it
during the contract, will not discriminate on the grounds of race, color, or national
origin in the selection and retention of subcontractors, including procurements of
materials and leases of equipment. The contractor will not participate directly or
indirectly in the discrimination prohibited by the Acts and the Regulations, including
employment practices when the contract covers any activity, project, or program
set forth in Appendix B of 49 CFR Part 21.
C. Solicitations for Subcontracts, Including Procurements of Materials and
Equipment: In all solicitations, either by competitive bidding, or negotiation made
by the contractor for work to be performed under a subcontract, including
procurements of materials, or leases of equipment, each potential subcontractor or
supplier will be notified by the contractor of the contractor's obligations under this
contract and the Acts and the Regulations relative to non-discrimination on the
grounds of race, color, or national origin.
D. Information and Reports: The contractor will provide all information and reports
required by the Acts and Regulations and directives issued pursuant thereto and will
permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined applicable to contractor's contract by the City or the
Washington State Department of Transportation to be pertinent to ascertain
compliance with such Acts and Regulations and instructions. Where any information
required of a contractor is in the exclusive possession of another who fails or
refuses to furnish the information, the contractor will so certify to the City or the
Washington State Department of Transportation, as appropriate, and will set forth
what efforts it has made to obtain the information.
E. Sanctions for Noncompliance: In the event of a contractor's noncompliance with
the non-discrimination provisions of this contract, the City will impose such contract
sanctions as it or the Washington State Department of Transportation may
determine to be appropriate, including, but not limited to:
a. withholding payments to the contractor under the contract until the
contractor complies; and/or
b. cancelling, terminating, or suspending a contract, in whole or in part.
F. Incorporation of Provisions: The contractor will include the provisions of
paragraphs (A) through (F) above in every subcontract, including procurements of
materials and leases of equipment, unless exempt by the Acts and Regulations and
directives issued pursuant thereto. The contractor will take action with respect to
any subcontract or procurement as the City or the Washington State Department of
Transportation may direct as a means of enforcing such provisions including
sanctions for noncompliance. Provided, that if the contractor becomes involved in,
or is threatened with litigation by a subcontractor, or supplier because of such
EEO COMPLIANCE DOCUMENTS - 2 of 5
direction, the contractor may request the City to enter into any litigation to protect
the interests of the City. In addition, the contractor may request the United States
to enter into the litigation to protect the interests of the United States.
6. During the performance of this contract, the contractor, for itself, its assignees, and
successors in interest agrees to comply with the following non-discrimination statutes and
authorities; including but not limited to:
Pertinent Non-Discrimination Authorities:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252),
(prohibits discrimination on the basis of race, color, national origin); and 49 CFR
Part 21.
ii. The Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or
whose property has been acquired because of Federal or Federal-aid programs and
projects);
iii. Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits
discrimination on the basis of sex);
iv. Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as
amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27;
V. The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.),
(prohibits discrimination on the basis of age);
vi. Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as
amended, (prohibits discrimination based on race, creed, color, national origin, or
sex);
vii. The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope,
coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age
Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by
expanding the definition of the terms "programs or activities" to include all of the
programs or activities of the Federal-aid recipients, sub-recipients and contractors,
whether such programs or activities are Federally funded or not);
viii. Titles II and III of the Americans with Disabilities Act, which prohibit discrimination
on the basis of disability in the operation of public entities, public and private
transportation systems, places of public accommodation, and certain testing
entities (42 U.S.C. §§ 12131-12189) as implemented by Department of
Transportation regulations at 49 C.F.R. parts 37 and 38;
ix. The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. §
47123) (prohibits discrimination on the basis of race, color, national origin, and
sex);
X. Executive Order 12898, Federal Actions to Address Environmental Justice in
Minority Populations and Low-Income Populations, which ensures Non-
discrimination against minority populations by discouraging programs, policies, and
activities with disproportionately high and adverse human health or environmental
effects on minority and low-income populations;
xi. Executive Order 13166, Improving Access to Services for Persons with Limited
English Proficiency, and resulting agency guidance, national origin discrimination
EEO COMPLIANCE DOCUMENTS - 3 of 5
includes discrimination because of Limited English proficiency (LEP). To ensure
compliance with Title VI, you must take reasonable steps to ensure that LEP
persons have meaningful access to your programs (70 Fed. Reg. at 74087 to
74100);
xii. Title IX of the Education Amendments of 1972, as amended, which prohibits you
from discriminating because of sex in education programs or activities (20 U.S.C.
1681 et seq).
xiii. Washington Law Against Discrimination (Ch. 49.60 RCW)
7. The submission of the final invoice for this contract will constitute a reaffirmation that the
preceding statements were complied with during the course of the contract's performance.
By signing below, I agree to fulfill the five requirements referenced above.
George Fra ier(Dec 15,2023 08:40 PSTI
By:
For: Green River College Foundation
Title: Executive Director
12-15-23
Date:
EEO COMPLIANCE DOCUMENTS - 4 of 5
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: October 20, 2022
SUBJECT: INCLUSIVE CONTRACTING SUPERSEDES: January 1, 1998
APPROVED BY Dana Ralph, Mayor
POLICY:
Equal employment opportunity and non-discrimination in contracting 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.
Further, all contractors, subcontractors, consultants, suppliers, grantees, or subgrantees of the
City, regardless of the value of the Agreement, are required to sign the City's Non-Discrimination
Policy Declaration, prior to commencing performance.
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 coordinate with the City's Title VI coordinator, and perform 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.
EEO COMPLIANCE DOCUMENTS - 5 of 5
EXHIBIT A
INSURANCE & INDEMNITY REQUIREMENTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which may
arise from or in connection with the performance of the work hereunder by the
Contractor, their agents, representatives, employees or subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General
Liability insurance shall be endorsed to provide the Aggregate Per
Project Endorsement ISO form CG 25 03 11 85. There shall be no
endorsement or modification of the Commercial General Liability
insurance for liability arising from explosion, collapse or
underground property damage. The City shall be named as an
insured under the Contractor's Commercial General Liability
insurance policy with respect to the work performed for the City
using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with limits
no less than $1,000,000 each occurrence, $1,000,000 general
aggregate and a $1,000,000 products-completed operations
aggregate limit.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Commercial General Liability insurance:
1. The Contractor's insurance coverage shall be primary insurance as respect the
City. Any Insurance, self-insurance, or insurance pool coverage
2. maintained by the City shall be excess of the Contractor's insurance and shall
not contribute with it.
3. The Contractor's insurance shall be endorsed to state that coverage shall not be
cancelled by either party, except after thirty (30) days prior written notice by
certified mail, return receipt requested, has been given to the City.
4. The City of Kent shall be named as an additional insured on all policies (except
Professional Liability) as respects work performed by or on behalf of the
contractor and a copy of the endorsement naming the City as additional insured
shall be attached to the Certificate of Insurance. The City reserves the right to
receive a certified copy of all required insurance policies. The Contractor's
Commercial General Liability insurance shall also contain a clause stating that
coverage shall apply separately to each insured against whom claim is made or
suit is brought, except with respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not less
than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the additional
insured endorsement, evidencing the insurance requirements of the Contractor
before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall
furnish separate certificates and endorsements for each subcontractor. All
coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
CERTIFICATE OF LIABILITY INSURANCE Issue Date 12/12/2023
ISSUED BY: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
State of Washington AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Department of Enterprise Services CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
Office of Risk Management AFFORDED BY THE STATE OF WASHINGTON SELF INSURANCE
g LIABILITY PROGRAM.
PO Box 41466
Olympia, WA 98504-1466
COVERAGE AFFORDED BY
State of Washington Self Insurance Liability Program
INSURED: THE STATE OF WASHINGTON, INCLUDING ALL ITS AGENCIES AND
DEPARTMENTS, IS SELF-INSURED FOR TORT LIABILITY CLAIMS. ALL
State of Washington CLAIMS MUST BE FILED WITH THE STATE OFFICE OF RISK
Green River College MANAGEMENT FOR PROCESSING IN ACCORD WITH STATUTORY
ATTN: Darcy Silvest REQUIREMENTS.
1204 SE 3201h SE
Auburn, WA 98092
COVERAGES
THIS IS TO CERTIFY COVERAGE DESCRIBED BELOW IS PROVIDED TO THE INSURED NAMED ABOVE FOR THE PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE COVERAGE AFFORDED BY THE SELF-INSURANCE LIABILITY PROGRAM IS SUBJECT
TO ALL THE TERMS,EXCLUSIONS,AND CONDITIONS OF SUCH PROGRAM.
POLICY EFFECTIVE EXPIRATION
TYPE OF COVERAGE NUMBER DATE DATE LIMITS
GENERAL LIABILITY Self-Insured Continuous Continuous BODILY INJURY, PROPERTY $5,000,000
® GENERAL LIABILITY DAMAGE&PERSONAL INJURY
COMBINED EACH OCCURRENCE
® OCCURRENCE COVERAGE
AUTOMOBILE LIABILITY BODILY INJURY&PROPERTY $5,000,000
❑ANY AUTO DAMAGE COMBINED EACH
ACCIDENT
®ALL OWNED AUTOS
❑ SCHEDULED AUTOS
❑ HIRED AUTOS
❑ NON-OWNED AUTOS
WORKERS COMPENSATION AND L&I Continuous Continuous WC—STATUTORY
EMPLOYERS LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS: Coverage applies as respects tort liability claims against
the State of Washington as covered by the Tort Claims Act (RCW 4.92 et seq.) The Certificate Holder is named as
additional insured, but only as respects the negligence of the State of Washington.
CERTIFICATE HOLDER: CANCELLATION
CITY OF KENT SHOULD THE SELF INSURANCE LIABILITY PROGRAM BE CANCELLED, THE
ATTN: RONDA BILLERBECK STATE OF WASHINGTON WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN
525 FOURTH AVENUE NORTH NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE
TO MAIL SUCH NOTICE SHALL NOT IMPOSE ANY OBLIGATION OR LIABILITY
KENT, WA 98032 UPON THE STATE OF WASHINGTON, ITS OFFICIALS, EMPLOYEES, AGENTS
OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE:
CERTIFICATE NUMBER CRT 2024-00395 °n
Jason Siems, State Risk Manager
Signature• M0li55a MGCo�'�YIIGK
Melissa McCormick(Dec 15,202316:38 PST)
Email: cityclerk@kentwa.gov
REC-121323-GreenRiverCollegeFoundation-CA
SP
Final Audit Report 2023-12-16
Created: 2023-12-13
By: Ronda D Billerbeck(rbillerbeck@kentwa.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAuFUg_frjkubkl1goMDhb9sCISuBDgLdM
"REC-121323-GreenRiverCollegeFoundation-CASP" History
Document created by Ronda D Billerbeck (rbillerbeck@kentwa.gov)
2023-12-13-6:01:07 PM GMT-IP address: 146.129.252.126
Document emailed to Ihogan@kentwa.gov for signature
2023-12-13-6:04:17 PM GMT
Email viewed by Ihogan@kentwa.gov
2023-12-14-0:26:47 AM GMT-IP address: 104.47.64.254
Signer Ihogan@kentwa.gov entered name at signing as Lori Hogan
2023-12-14-0:36:26 AM GMT-IP address: 146.129.252.126
Document e-signed by Lori Hogan (Ihogan@kentwa.gov)
Signature Date:2023-12-14-0:36:28 AM GMT-Time Source:server-IP address: 146.129.252.126
Document emailed to Monica Tolas (mtolas@greenriver.edu) for signature
2023-12-14-0:36:30 AM GMT
Email viewed by Monica Tolas (mtolas@greenriver.edu)
2023-12-14-5:42:07 PM GMT-IP address: 104.47.59.254
Document signing delegated to George Frasier(gfrasier@greenriver.edu) by Monica Tolas
(mtolas@greenriver.edu)
2023-12-14-5:44:17 PM GMT-IP address: 134.39.100.6
Document emailed to George Frasier(gfrasier@greenriver.edu)for signature
2023-12-14-5:44:18 PM GMT
Email viewed by George Frasier(gfrasier@greenriver.edu)
2023-12-15-4:39:36 PM GMT-IP address: 104.47.66.126
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�p Document e-signed by George Frasier(gfrasier@greenriver.edu)
Signature Date:2023-12-15-4:40:45 PM GMT-Time Source:server-IP address:206.130.131.234
Document emailed to Kim Komoto (kkomoto@kentwa.gov) for signature
2023-12-15-4:40:46 PM GMT
Email viewed by Kim Komoto (kkomoto@kentwa.gov)
2023-12-15-10:54:12 PM GMT-IP address:67.183.101.179
Document e-signed by Kim Komoto (kkomoto@kentwa.gov)
Signature Date:2023-12-15-10:54:33 PM GMT-Time Source:server-IP address:67.183.101.179
Document emailed to cityclerk@kentwa.gov for signature
2023-12-15-10:54:34 PM GMT
Email viewed by cityclerk@kentwa.gov
2023-12-16-0:36:01 AM GMT-IP address: 104.47.65.254
�p Signer cityclerk@kentwa.gov entered name at signing as Melissa McCormick
2023-12-16-0:38:28 AM GMT-IP address: 146.129.252.126
�c Document e-signed by Melissa McCormick (cityclerk@kentwa.gov)
Signature Date:2023-12-16-0:38:30 AM GMT-Time Source:server-IP address: 146.129.252.126
Agreement completed.
2023-12-16-0:38:30 AM GMT
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