HomeMy WebLinkAboutCAG2024-005 - Original - State of WA Dept of Ecology - Mill Creek Canyon Invasive Vegitation Removal - 10/01/2023 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr:
GL
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
WASHINGTON Sheet forms. Dlr/Dep Dil
Originator: Department:
Shayla Ott Parks, Recreation & Community Services
Date Sent: Date Required:
> 12/28/2023 01/02/2024
0
CL Authorized to Sign: Date of Council Approval:
QDirector or Designee N/A
Budget Account Number: Grant? Yes No
10006600.64190.5303
Budget?w]Yes No Type: N/A
Vendor Name: Category:
State of Washington Department of Enterprise Services Contract
Vendor Number: Sub-Category:
= 421846 Original
0 provide Vendor to rovide invasive ve itation removal at Mill Creek Can
Project Name: g y
1.1. Project Details:Vendor to provide invasive vegitation removal and disposal at Mill Creek
0
= Canyon as outlined in Exhibit A.
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Agreement Amount: $8 070.00 Basis for Selection of Contractor: Other
`Memo to Mayor must be attached
Start Date: 01/02/2024 Termination Date: 01/31/2024
Im
Q Local Business? Yes1ZNo* 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:
YesONo CAG2024-005
Comments:
Im
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Date Routed to the City Clerk's Office: 1/4/24
,c«w»373__,0 Visit Documents.KentWA.gov to obtain copies of all agreements
rev.20210513
DEPARTMENT OF
ECO LOGY
State of Washington
AGREEMENT NO WCC-2389
AGREEMENT BETWEEN
The State of Washington, Department of ECOLOGY
AND
City of Kent (SPONSOR)
THIS AGREEMENT is made and entered into by and between the Department of Ecology, hereinafter referred to as
"ECOLOGY", and City of Kent hereinafter referred to as the "SPONSOR."
IT IS THE PURPOSE OF THIS AGREEMENT to provide Washington Conservation Corps (WCC) members to complete
environmental or disaster services projects, pursuant to Chapter 43.220 of the Revised Code of Washington.
THEREFORE, IT IS MUTUALLY AGREED THAT:
STATEMENT OF WORK
Both parties agree to do all things necessary for or incidental to the performance of the work set forth in Appendix "A"
attached hereto and incorporated herein.
PERIOD OF PERFORMANCE
Subject to its other provisions, the period of performance of this Agreement shall commence on 10/1/2023 and be
completed on 9/30/2024 unless terminated sooner as provided herein.The WCC Crew and/or WCC Individual Placement
corps member specified in this agreement will be available to SPONSOR on the dates set forth on the calendar in
Appendix "B" attached hereto and incorporated herein.
COMPENSATION
The parties have determined that the cost of accomplishing the work herein will not exceed $8,070. Payment for
satisfactory performance of the work shall not exceed this amount unless the parties mutually agree to a higher amount.
Compensation for service(s) shall be based on the following established rates:
Provided by ECOLOGY Reimbursed to ECOLOGY by Sponsor
WCC Services
6 days of WCC Crew time @ $1,345/day $8,070
Total SPONSOR Cost $8,070
Above cost not to be exceeded
The costs reimbursed to ECOLOGY by SPONSOR are a cost-share rate. Estimated value of a WCC crew is $294,107
annually per WCC Crew consisting of five WCC/AmeriCorps Members and one WCC Supervisor and/or$40,896 annually
per WCC Individual Placement. Indirect costs are included in SPONSOR share at a standard rate of 5%of direct costs.
Page 1 of 4 WCC-2389
BILLING PROCEDURE
ECOLOGY shall submit invoices monthly to the SPONSOR's designated contact person listed under"Agreement
Management" section. Payment to ECOLOGY for approved and completed work will be made by warrant or account
transfer by SPONSOR within 30 days of receipt of the invoice. Upon expiration of the Agreement, any claim for payment
not already made shall be submitted within 30 days after the expiration date or the end of the fiscal year,whichever is
earlier.
AGREEMENT ALTERATIONS AND AMENDMENTS
This Agreement may be amended by mutual agreement of the parties. Such amendments shall not be binding unless
they are in writing and signed by personnel authorized to bind each of the parties.
ASSIGNMENT
The work to be provided under this Agreement, and any claim arising thereunder, is not assignable or delegable by
either party in whole or in part, without the express prior written consent of the other party,which consent shall not be
unreasonably withheld.
ASSURANCES
Parties to this Agreement agree that all activity pursuant to this contract will be in accordance with all the applicable
current federal, state and local laws, rules, and regulations.
CONFORMANCE
If any provision of this Agreement violates any statute or rule of law of the state of Washington, it is considered
modified to conform to that statute or rule of law.
DISPUTES
If a dispute arises under this Agreement, it shall be determined by a Dispute Board in the following manner: Each party
to this Agreement shall appoint one member to the Dispute Board.The members so appointed shall jointly appoint an
additional member to the Dispute Board.The Dispute Board shall review the facts, agreement terms and applicable
statutes and rules and make a determination of the dispute.The determination of the Dispute Board shall be final and
binding on the parties hereto.As an alternative to this process, if SPONSOR is a state agency, either of the parties may
request intervention by the Governor, as provided by RCW 43.17.330, in which event the Governor's process will
control.
FUNDING AVAILABILITY
The obligation of the SPONSOR to provide reimbursements is contingent upon appropriation of funds by the SPONSOR's
governing body for the specific purpose of funding the project, which is the subject of this Agreement. Upon the failure
of such appropriation, the SPONSOR may terminate this Agreement.
ECOLOGY's ability to provide cost-share is contingent on availability of funding. In the event funding from state, federal,
or other sources is withdrawn, reduced, or limited in any way after the effective date and prior to completion or
expiration date of this Agreement, ECOLOGY, at its sole discretion, may elect to terminate the agreement, in whole or
part, for convenience or to renegotiate the agreement subject to new funding limitations and conditions. ECOLOGY may
also elect to suspend performance of the agreement until ECOLOGY determines the funding insufficiency is resolved.
ECOLOGY may exercise any of these options with no notification restrictions.
GOVERNING LAW AND VENUE
This Agreement is entered into pursuant to and under the authority granted by the laws of the state of Washington and
any applicable federal laws.The provisions of this Agreement shall be construed to conform to those laws.This
Agreement shall be construed and interpreted in accordance with the laws of the state of Washington, and the venue of
any action brought hereunder shall be in the Superior Court for Thurston County.
Page 2 of 4 WCC-2389
INDEPENDENT CAPACITY
The employees or agents of each party who are engaged in the performance of this Agreement shall continue to be
employees or agents of that party and shall not be considered for any purpose to be employees or agents of the other
party.
INDEMNIFICATION
To the fullest extent permitted by law, each party shall defend, indemnify, and hold harmless the other party, including
officials, agents, and employees from and against all claims of third parties, and all associated losses arising out of or
resulting from the performance of the contract. "Claim," as used in this contract, means any financial loss, claim, suit,
action, damage, or expense, including but not limited to attorney's fees, attributable for bodily injury, sickness, disease,
or death, or injury to or destruction of tangible property including loss of use resulting therefrom. Parties waive their
immunities under Title 51 RCW to the extent it is required to indemnify, defend and hold harmless the other party and
their agencies, officials, agents or employees.
ORDER OF PRECEDENCE
In the event of an inconsistency in the terms of this Agreement, or between its terms and any applicable statute or rule,
the inconsistency shall be resolved by giving precedence in the following order:
1. Applicable federal and state of Washington statutes, regulations, and rules.
2. Mutually agreed written amendments to this Agreement
3. This Agreement
4. Statement of Work and Budget.
5. Any other provisions of this Agreement, including materials incorporated by reference.
RECORDS MAINTENANCE
The parties to this Agreement shall each maintain books, records, documents and other evidence that sufficiently and
properly reflect all direct and indirect costs expended by either party in the performance of the service(s) described
herein.These records shall be subject to inspection, review or audit by personnel of both parties, other personnel duly
authorized by either party,the Office of the State Auditor, and federal officials so authorized by law. All books, records,
documents, and other material relevant to this Agreement will be retained for six years after expiration of this
Agreement and the Office of the State Auditor, federal auditors, and any persons duly authorized by the parties shall
have full access and the right to examine any of these materials during this period.
Records and other documents, in any medium, furnished by one party to this Agreement to the other party, will remain
the property of the furnishing party, unless otherwise agreed.The receiving party will not disclose or make available this
material to any third parties without first giving notice to the furnishing party and giving it a reasonable opportunity to
respond. Each party will utilize reasonable security procedures and protections to assure that records and documents
provided by the other party are not erroneously disclosed to third parties subject to state public disclosure laws.
RESPONSIBILITIES OF THE PARTIES
Each party of this Agreement hereby assumes responsibility for claims and/or damages to persons and/or property
resulting from any act or omissions on the part of itself, its employees, its officers, and its agents. Neither party will be
considered the agent of the other party to this Agreement.
RIGHTS IN DATA
Unless otherwise provided, data, which originates from this Agreement shall be "works for hire" as defined by the U.S.
Copyright Act of 1976 and shall be jointly owned by ECOLOGY and SPONSOR. Data shall include, but not be limited to,
reports, documents, pamphlets, advertisements, books magazines, surveys, studies, computer programs,films,tapes,
and/or sound reproductions. Ownership includes the right to copyright, patent, register, and the ability to transfer these
rights.
Page 3 of 4 WCC-2389
SEVERABILITY
If any provision of this Agreement or any provision of any document incorporated by reference shall be held invalid,
such invalidity shall not affect the other provisions of this Agreement which can be given effect without the invalid
provision, if such remainder conforms to the requirements of applicable law and the fundamental purpose of this
agreement, and to this end the provisions of this Agreement are declared to be severable.
TERMINATION FOR CAUSE
If for any cause, either party does not fulfill in a timely and proper manner its obligations under this Agreement, or if
either party violates any of these terms and conditions, the aggrieved party will give the other party written notice of
such failure or violation.The responsible party will be given the opportunity to correct the violation or failure within 15
working days. If failure or violation is not corrected,this Agreement may be terminated immediately by written notice of
the aggrieved party to the other.
TERMINATION FOR CONVENIENCE
Either party may terminate this Agreement upon 30 days prior written notification to the other party. If this Agreement
is so terminated,the parties shall be liable only for performance rendered or costs incurred in accordance with the
terms of this Agreement prior to the effective date of termination.
WAIVER
A failure by either party to exercise its rights under this Agreement shall not preclude that party from subsequent
exercise of such rights and shall not constitute a waiver of any other rights under this Agreement unless stated to be
such in a writing signed by an authorized representative of the party and attached to the original Agreement.
ALL WRITINGS CONTAINED HEREIN
This Agreement contains all the terms and conditions agreed upon by the parties. No other understandings, oral or
otherwise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties hereto.
AGREEMENT MANAGEMENT
The program manager for each of the parties shall be responsible for and shall be the contact person for all
communications and billings regarding the performance of this Agreement.
The Contract Manager for ECOLOGY is: The Contract Manager for SPONSOR is:
Josiah Downey Margaret Wagner
PO Box 47600 400 W Gowe St.
Olympia, WA 98504 Kent, WA 98032
(360)480-2603 206-798-7894
Josiah.downey@ecy.wa.gov mwagmer@kentwa.gov
IN WITNESS WHEREOF,the parties have executed this Agreement.
State of Washington SPONSOR
Department of ECOLOGY
$�i�lp2tTa6ebr" Jan 3 2024 Dec 28,2023
6 dkP[Talei�Ja�32124)5'.40 PSTi 1 ��
Signature Date Signature Date
Bridget Talebi WCC Director Garin Lee Park Operations Superintendent
Printed Name,Title Printed Name,Title
Page 4 of 4 WCC-2389
STATEMENT OF WORK
Appendix A
Work summary:
Under direction of SPONSOR, crew(s)will perform restoration activities. Specific tasks could include invasive control,
native species installation, plant nursery care, scientific monitoring, and fence installation or repair.
Special terms and conditions:
1. WCC resources (members, supervisors,tools and trucks) will not be utilized to clean public restrooms, monitor,
survey, or clear active or abandoned encampments, and/or to clean up hazardous materials including hypodermic
needles. If a significant amount of hazardous or unidentifiable material is discovered on a project site, activity will cease
until SPONSOR mitigates potential hazards or finds an alternate project site. If active or abandoned encampments
prevent WCC activities from taking place at a project site, WCC supervisors and members may contact their partner
organization and work with their coordinator on alternative activities. While WCC can share encampment information
with project partners,when relevant to service activities, WCC personnel will not monitor, survey, or report on
encampments directly to regulatory agencies or anyone other than a partner organization.
2. WCC vehicle is not to be used for heavy hauling; the primary use is for transportation of crew,tools, and safety
equipment. In the event that WCC vehicles are requested to tow SPONSOR-provided equipment(including rentals), it
will only be on a limited basis and SPONSOR is solely responsible for accidental damages, unless damages are caused by
WCC negligence.
3. WCC is not responsible for normal wear and tear when project requires the use of SPONSOR-provided tools,
equipment, or safety gear.
4. The assignment of members shall not result in the displacement of currently employed workers, including partial
displacement such as reduction in hours of non-overtime work, wages, or other employment benefits.Agencies that
participate in the program may not terminate, lay-off, or reduce working hours of any employee for the purpose of using
a member with available funds. In circumstances where substantial efficiencies or a public purpose may result,
participating agencies may use members to carry out essential agency work or contractual functions without displacing
current employees.
5. All state holidays and shutdown weeks are non-working days for members. Shutdown weeks are to be used by WCC
staff/supervisors for planning purposes.The WCC standard 40-hour schedule is Monday through Thursday from 7:OOam
to 5:30pm.An alternate schedule may be arranged with prior approval from the WCC.
6. WCC's cost-share rate is calculated using the full costs of supporting WCC crews and IPs, including time spent
training, required community service events, shutdowns, etc. Indirect costs are included in SPONSOR share at a standard
rate of 5%of direct costs.
7. If inclement weather makes a project site inaccessible, then the sponsor should reassign the WCC crew or IP to
alternative projects in an accessible location. In inclement weather, WCC crews follow the weather-related guidance
(e.g. shut-down, delayed start, early end, etc.)from the regional Ecology office closest to the crew lock-up or IP service
location. If the member's assigned location is more than one hour from an Ecology regional office,then WCC follows
weather-related guidance of federal, state and local governments. Only WCC can instruct a crew or IP to shut-down due
to weather. Sponsors are not charged for WCC-initiated,weather related shut-downs or delays.
If a shut-down is requested by the SPONSOR for any reason,then the sponsor is responsible for crew costs.
Appendix A, Page 1 of 3 WCC-2389
ECOLOGY shall:
1. Provide WCC members for the number of weeks specified in this agreement. Full-term crews and Individual
Placements are available to SPONSOR for a maximum of 164 days (approximately 41 weeks) during the Federal
AmeriCorps program service year(October-September). WCC members receive living stipends pursuant to 42 U.S.C.
126551 which governs AmeriCorps programs being enrolled in AmeriCorps exempts members from prevailing
wage at the federal level. WAState RCW75A35.130 similarly states that programs operating under AmeriCorps
are exempted as well.
2. Enroll members to begin service no sooner than October 2, 2023 and no later than October 16, 2023 to attain a full
AmeriCorps scholarship. Member vacancies may be filled with a 1200 hour, three-quarter-term AmeriCorps Education
Award beginning January 16, 2024.Any further member enrollment for the remainder of the program year is at the
discretion of ECOLOGY and based on availability.
3. In the event of a disaster response deployment, ECOLOGY will make every effort to fulfill SPONSOR needs, including
sending additional members, whenever possible. Unless disaster response activities are requested by the sponsor,
sponsors are not charged for WCC's emergency and disaster responses.
4. Provide training and development specified in Appendix B: eight days of formal WCC training, a two to four day
Orientation Training, one day dedicated to MLK Community Service, one day of training in noxious weed control, and
one day for a debrief meeting near the conclusion of the term. Beyond dates included in Appendix B, Ecology will
schedule up to six additional days of Supervisor training or meetings during the term. WCC members and supervisors are
logging hours on the dates identified for WCC-sanctioned events, but are unavailable to SPONSOR. ECOLOGY will provide
a four day Assistant Supervisor training to the designated Assistant Supervisor.
5. Each full-term crew or IP may spend up to two weeks (eight days)with an alternative sponsor during the crew year.
These dates will be determined in coordination with their full-term Sponsor.
6. For crews, ECOLOGY agrees to provide a crew of 5 members, a crew supervisor,vehicle, and basic hand tools. Rates
are not based on actual attendance, however, invoices will be reduced for member or supervisor vacancies lasting 20
days or more.
SPONSOR shall:
1. Guide completion of appropriate projects for number of weeks specified in this agreement by providing logistical,
technical and safety-related support necessary for project completion. Provide site orientation for WCC members, site-
specific training, and materials beyond basic hand tools to complete tasks. Obtain and ensure adherence to applicable
permits as set by local, state, tribal or federal laws and regulations.
2. Help promote the AmeriCorps and WCC brands, logo, slogans and phrases. WCC will provide camera-ready logo.
AmeriCorps is a registered service mark of the Corporation for National and Community Service.
3. For a SPONSOR hosting Individual Placement positions, SPONSOR agrees to provide computer access, email,
transportation to and from WCC events (or private mileage reimbursement), and day-to-day direction of activities.
4. For a SPONSOR hosting full-term WCC Crew(s),SPONSOR shall provide a secure site to store tools and park crew
vehicles that allows access to potable water and restrooms as well as desk and internet access for the crew supervisor.
In the event of theft,vandalism, or loss,the SPONSOR shall provide reimbursement (75 percent sponsor share) of
expenditures and deductibles.
5. For a SPONSOR that assigns WCC crew(s) or WCC Individual Placement members to serve with other organizations,
SPONSOR shall inform the other organizations of WCC policies, procedures and contract terms.
Appendix A, Page 2 of 3 WCC-2389
AmeriCorps Prohibited Activities:
While charging time to the AmeriCorps program, accumulating service or training hours, or otherwise performing
activities supported by the AmeriCorps program, staff and members may not engage in the following activities (see 45
CFR § 2520.65):
A. Attempting to influence legislation;
B. Organizing or engaging in protests, petitions, boycotts, or strikes;
C. Assisting, promoting, or deterring union organizing;
D. Impairing existing contracts for services or collective bargaining agreements;
E. Engaging in partisan political activities, or other activities designed to influence the outcome of an election to
any public office;
F. Participating in, or endorsing, events or activities that are likely to include advocacy for or against political
parties, political platforms, political candidates, proposed legislation, or elected officials;
G. Engaging in religious instruction, conducting worship services, providing instruction as part of a program that
includes mandatory religious instruction or worship, constructing or operating facilities devoted to religious
instruction or worship, maintaining facilities primarily or inherently devoted to religious instruction or worship,
or engaging in any form of religious proselytization;
H. Providing a direct benefit to—
I. A business organized for profit;
II. A labor union;
III. A partisan political organization;
IV. A nonprofit organization that fails to comply with the restrictions contained in section 501(c)(3) of the
Internal Revenue Code of 1986 related to engaging in political activities or substantial amount of lobbying
except that nothing in these provisions shall be construed to prevent participants from engaging in
advocacy activities undertaken at their own initiative; and
V. An organization engaged in the religious activities described in paragraph 3.g. above, unless AmeriCorps
assistance is not used to support those religious activities;
I. Conducting a voter registration drive or using AmeriCorps funds to conduct a voter registration drive;
J. Providing abortion services or referrals for receipt of such services; and
K. Census Activities.AmeriCorps members and volunteers associated with AmeriCorps grants may not engage in
census activities during service hours. Being a census taker during service hours is categorically prohibited.
Census-related activities (e.g., promotion of the Census, education about the importance of the Census) do not
align with AmeriCorps State and National objectives.
L. Election and Polling Activities. AmeriCorps members may not provide services for election or polling locations or
in support of such activities
M. Such other activities as AmeriCorps may prohibit.
AmeriCorps members may not engage in the above activities directly or indirectly by recruiting,training, or managing
others for the primary purpose of engaging in one of the activities listed above. Individuals may exercise their rights as
private citizens and may participate in the activities listed above on their initiative, on non-AmeriCorps time, and using
non-AmeriCorps funds. Individuals should not wear the AmeriCorps logo while doing so
Appendix A, Page 3 of 3 WCC-2389
Appendix B WCC CALENDAR
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Appendix B, Page 1 of 1 WCC-2389
Exhibit A
Scope of work—Washington Conservation Corps days with Kent Parks 2023-24
The work area for Dec 26-28 and Jan 2-4 with Kent Parks will be at Mill Creek Canyon.
Parking: 100 Reiten Rd, Kent, WA 98030 - https://maps.app.goo.gl/hiY7TzFKuF5o84cB6
Work Summary: Mechanical invasives removal through a WRIA 9 CWM grant-funded riparian
forest restoration site
The project area extends upstream along a hiking trail. The primary focus for this crew
will be the relatively flat areas on either side of the trail to the N/NW of the creek. There
is dense ground ivy in this area that has not yet been treated. This is an area where we
will be planting next year, potentially with volunteers. We'd like to maintain existing
native vegetation and increase efficacy of follow up ivy spot sprays with a first round of
mechanical removal that prioritizes clearing around native shrubs and sword ferns.
Work Tasks:
• Cut climbing ivy—survival rings
• Hand-pull ground ivy— prioritizing clearing around existing native shrubs to facilitate
follow up spray by Parks staff
• Cut small invasive trees (holly, laurel, hawthorn) and mark stumps for Parks staff to
follow up with herbicide
• All organic material to be left on site —either dispersed or in piles at least 15 feet from
the trail.
Rough map and site photos below. I'll be the day-of point of contact and my cell is 206-798-
7894
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CERTIFICATE OF LIABILITY INSURANCE Issue Date 12/6/2023
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
Department of Ecology MANAGEMENT FOR PROCESSING IN ACCORD WITH STATUTORY
ATTN: Josiah Downey REQUIREMENTS.
300 Desmond Drive
Lacey, WA 98503
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: MARGARET WAGNER STATE OF WASHINGTON WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN
220 4TH AVE SOUTH 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 2024-00385
Jason Siems, State Risk Manager
Signature: Signature: 4�% ��
Melissa McCormick(Jan 4,202408:31 PST)
Email: kkomoto@kentwa.gov Email: cityclerk@kentwa.gov
O PS-122823-WCC-1 nvasiveVeg itation Removal
Final Audit Report 2024-01-04
Created: 2023-12-29
By: Shayla Ott(sott@kentwa.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAhMGoSWgPDgpLCITFMfxvjmbm_H7fTxUp
"OPS-1 22823-WCC-1 nvasiveVegitation Removal" History
Document created by Shayla Ott (sott@kentwa.gov)
2023-12-29-0:07:34 AM GMT
Document emailed to glee@kentwa.gov for signature
2023-12-29-0:11:16 AM GMT
Email viewed by glee@kentwa.gov
2023-12-29-0:11:35 AM GMT
d4 Signer glee@kentwa.gov entered name at signing as Garin Lee
2023-12-29-0:13:59 AM GMT
�a Document e-signed by Garin Lee (glee@kentwa.gov)
Signature Date:2023-12-29-0:14:01 AM GMT-Time Source:server
Document emailed to brim461 @ecy.wa.gov for signature
2023-12-29-0:14:02 AM GMT
Email viewed by brim461@ecy.wa.gov
2024-01-02-4:35:24 PM GMT
d4 Signer brim461 @ecy.wa.gov entered name at signing as Bridget Talebi
2024-01-03-4:40:02 PM GMT
�p Document e-signed by Bridget Talebi (brim461 @ecy.wa.gov)
Signature Date:2024-01-03-4:40:04 PM GMT-Time Source:server
Document emailed to Kim Komoto (kkomoto@kentwa.gov)for signature
2024-01-03-4:40:05 PM GMT
Email viewed by Kim Komoto (kkomoto@kentwa.gov)
2024-01-03-7:02:54 PM GMT
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�p Document e-signed by Kim Komoto (kkomoto@kentwa.gov)
Signature Date:2024-01-03-7:03:03 PM GMT-Time Source:server
Document emailed to cityclerk@kentwa.gov for signature
2024-01-03-7:03:05 PM GMT
Email viewed by cityclerk@kentwa.gov
2024-01-04-4:25:32 PM GMT
Signer cityclerk@kentwa.gov entered name at signing as Melissa McCormick
2024-01-04-4:31:17 PM GMT
dp Document e-signed by Melissa McCormick (cityclerk@kentwa.gov)
Signature Date:2024-01-04-4:31:19 PM GMT-Time Source:server
Q Agreement completed.
2024-01-04-4:31:19 PM GMT
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