16-178.01 Le Catering Co: CenterPlace Food & Beverage Svcs OFFICE OF THE CITY ATTORNEY
Spokane CA.Y P. - DEELLPUTY
- CITY ATTORNEY
ERIK J. LAMB- DEPUTY CITY ATTORNEY
Valley x 10210 East Sprague Avenue • Spokane Valley, WA 99206
(509) 720.5105 ♦ Fax: (509)720-5095 ♦cityattorney@spokanevalley.org
December 12,2017
Adam Hegsted
Eat Good Group LLC, dba Le Catering, Co.
24001 E. Mission Ave., Ste. 190
Liberty Lake, WA 99019
Re: Implementation of 2018 option year, Agreement for CenterPlace Food and
Beverage Services, Contract#16-178, executed January 6, 2017.
Dear Mr. Hegsted:
The City executed an Agreement for provision of CenterPlace Food and Beverage
Services on January 6, 2017, by and between the City of Spokane Valley, hereinafter
"City", and Eat Good Group LLC, dba Le Catering Co., hereinafter "Contractor" and
jointly referred to as"Parties."
The original Agreement states that it was for one year, with five optional one-year terms
possible if the parties mutually agree to exercise the options each year. This is the first of
five possible option years that can be exercised and runs through December 31,2018.
The City would like to exercise the 2018 option year of the Agreement. The
Compensation Terms are outlined in Exhibit 3,2017 to the Agreement.
All of the other contract provisions contained in the original Agreement shall remain in
place and remain unchanged in exercising this option year.
If you are in agreement with exercising the 2018 option year, please sign below to
acknowledge the receipt and concurrence to perform the 2018 option year. Please return
two copies to the City for execution, along with current insurance information. A fully
executed original copy will be mailed to you for your files.
CITY OF SPOKANE VALLEY EAT GOOD GROUP LLC,
DBA LE CATERING CO.
'A/AL , / _ go
,"- -
Mark Calhoun,City Manager Name ,
owner
Title
ATTEST
/j
Christine Bainbridge,City Clerk
APPROVED A • FORM:
a ' 4 / ` /
Office o e City 7mey
(7-'', C" 164-g-coo
DATE(MMIDDIYYYY)
A R CERTIFICATE OF LIABILITY INSURANCE 4 05/1712017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL-INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME: Aaron Harris
PHONE 922-8950 (NC.No):(509)922-8960
E-MAILHoover Insurance No.Eat): (509)
E-MAIaaron@hooverinsurance.net
708 N Argonne Rd Suite 1 ADDRESS:
Spokane Valley,WA 9921 .�
—, INSURER(S)AFFORDING COVERAGE NAIC SI
R L.C,Ero IV 1.7.i) INSURER A: Mutual of Enumclaw
INSURED INISURERB: Progressive Insurance Company 11770
Le Catering Co MAY 17 'ft7 INSURERC:
DBA Eat GoodINSURER D
2572 E.Gunnison PI PARKS & RECRE^Tin!i ' INSURER E: •
Coeur D'alene,ID 83814
---- -,,- . _... INSURERF:
COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 1
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTRR URANCE ADDL SUER POUCY EFF POLICY EXP LIMBS
TYPE OF INSINSn WVn POLICY NUMBER (MWODIYYYYI (MMIDDM'YYI
A X COMMERCIAL GENERAL LIABILITY BOP0008892 03 05130/2017 05130/2018 EACH OCMAGECU RENTED a 2,000.000
CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 1,000,000
MED EXP(Anyone person)_S 10.000
— PERSONAL&ADV INJURY S
GENERAL AGGREGATE 5 4,000,000
GEM AGGREGATE LIMITAPPLIES PER: "
POLICY n Tei ri LOC _PRODUCTS-COMPIOPAGG S
$ ,
OTHER COMBtNEDSINOLELIMR $ 1,000,000
B AUTOMOBILE LIABILITY 02808199-1 12/15/2016 12/1512017 (Ea accident)
BODILY INJURY(Per person) S
ANY AUTO
OWNED SCHEDULED BODILY INJURY(Per accident) S
HIRED ONLY X AUT • PROPERTY DAMAGE 5
HIRED NON-OWNED (par accident)
AUTOS ONLY AUTOS ONLY S
EACH OCCURRENCE $
UMBRELLA LIAB OCCUR
EXCESS LIAR CLAIMS-MADE AGGREGATE S
DED I I RETENTIONS _ j S
WORKERS COMPENSATION PERRTUTE I H
ET
AND EMPLOYERS'LIABILITY YIN E. I EACH ACCIDENT $
ANY PROPRIETOWPARTNERIEXECUTNE N!A
OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMPLOYEE S
(Mandatory In NH)
If yes,describe under E.L.DISEASE-POLICY LIMIT S
DESRIPTION OF OPERATIONS below 1 ()�Q��d
A Liquor Liability BOP0008892 03 05/30/2017 05/30/2018 1,000,000
DESCRIPTION OF OPERATIONS i LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom space Is required)
City of Spokane Valley are listed as additional insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS.
2426 N Discovery Place
Spokane Valley,WA 99216 AUTHORIZED REPRESSE'NTTAATII�VE�J j�
C Lee- L/ `'`-' ': '" (ASH)
I
101988-2015 ACORD CORPORATION. Ali rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Printed by ASH on May 17,2017 at 01:58PM
Search L&l
0 Washington State Department of
Labor & Industries
EAT GOOD LLC
Owner or tradesperson 2100 N MOLTER RD
LIBERTY LAKE,WA 99019-9469
ADAM HEGSTED
Doing business as
EAT GOOD
WA UBI No.
603 295 429
Workers' comp
Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums.
L&I Account ID Account is current.
261,574-00
Doing business as
EAT GOOD
Estimated workers reported
Quarter 3 of Year 2017"11 to 20 Workers"
L&l account contact
T3/KEITH CURTISS(360)902-6641 -Email:CURQ235@Ini.wa.gov
Public Works Strikes and Debarments
Verify the contractor is eligible to perform work on public works projects.
Contractor Strikes
No strikes have been issued against this contractor.
Contractors not allowed to bid
No.debarments have been issued against this contractor.
Workplace safety and health
No inspections during the previous 6 year period.
<P,t'Pa 3t tutor Stote t3erit rtf Labe d Industries .Ise at this sde is s.bhect to the Tawe tf'he stat,.a-VF,ashinoi.,,t
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HOOVER INS LLC PR/IIR IJINL
708 N ARGONNE STE 1 COMMERCIAL
SPOKANE VALLEY,WA 99212
668523 499 2 M8 0 423 PPACA1OI 005 000499
Named insured Policy number: 02808199-2
Underwritten by:
United Financial Casualty Company
December 18,2017
EAT GOOD LLC Policy Penod:Dec 15,2017-Det 15.2018
2572E GUNNISON PL Page 1 of 2
COEUR IYALENE,ID 83814
progressiveagentcom
Itis��t�i••tItlhii,!„tithtltiliu�itNtllttit�trlHldtlrtlt
Online Service
Make payments,check billing activity,print
policy documents,or check the status of a
claim.
Commercial Auto
1-509-922-8950
Insurance Coverage Summary HOOVER INS LLC
Contact your agent for personalized ser'ice,
This is your Renewal 1-800-444-4487
Declarations Page For customer servrceifyour agentis
unavailable Dr to report a dam
Your coverage began on December 15,2017 at 12:01 a.m. this policy expires on December 15,2018 at 12:01 a.m.
This coverage summary replaces your prior one.Your insurance policy and any policy endorsements contain a full explanation of your
coverage.The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto,unless the
policy contract allows the stacking of limits.The policy contract is form 6912(06110).The contract is modified by forms 28521D
(08/08),4757(03/05),2313(05/07),485210 (01(12.),488110 (01/12)and Z228(01/11)
The named insured organization type is a corporation.
ra0uf iirt of, ai g , wQ
Description limas Deductible ?reclaim
Liability To Others 5839
Bodily Injury and Property Damage Liability $1.000,000 combined single limit
Uninsured Motorist $1,000,000 combined single limit 157
Underinsured Motorist $1,000,000 combined single limit .. ' 158
Medical Payments $5,000 each person .. "36
Comprehensive ... 71
See Auto Coverage Schedule limit of liability less deductible
Collision •
160
See Auto Coverage Schedule Limit of liability less deductible
RoadsideAssistance............................................ . . ....... .,�.,.....,..,....,,. ... . ._. . ...,.,_.....,.. . ... ., 4•6
See Auto Coverage Schedule
..,...
Total 12 month policy premium...... ..... .... ....... 2`,. ....., . 51.467
Discount if paid in full -173
Total 12 month policy premium if paid in full .,
$1,294
Rated driver
1. ADAM HEGSTED „
Form 6489 ID(01112)
rte.
3
1
Policy number. 02808199-2
EAT GOOD CIC
Page 2 of 2
Auto coverage schedule
1. 2002 Ford Econo/Club Wgn Actual Cash Value (plus$2,000.00 Permanently Attached Equip)
VIN: 1FBSS31 L42NB30532 Garaging Zip Code: 83814 Radius: 50
Liability liability UM BI UIM BI Med Pay
Premium $839 $157 $158 $36
Comp Comp Collision Collision
Physical Damage Deductible Premium Deductible Premium
Premium
.
3500 $71 $1,000 $160
Roadside Roadside
Other Coverages Limit Premium Auto Total
Premium Selected $46 $1,467
*A vehicle's stated amount should indicate its current retail value,including any special or permanently attached equipment. In the 5e±m
event of a total loss,the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value,less deductible. Be sur$,,,.,,,._
to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy.
ismeNEE
Premium discountsseine-
02808199-2 Business Experience and Package
Loss Payee information """"'"'
1 . Loss Payee Auto 1 WELLS FARGO FIN ACC V _"'''--
PO BOX 2075 CORAOPOLIS,PA 15108 a
a
2002 Ford Econo/Club Wgn{t FBSS31142tiB30532) _
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Agent countersignature a
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Form 6489 ID(p I/I 2)