09-233.05WesternDanceAssociationLeaseAgreement CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF
SPOKANE VALLEY AND WESTERN DANCE ASSOCIATION OF SPOKANE
Spokane Valley Contract#09-233.05
For good and valuable consideration,the legal sufficiency of which is hereby acknowledged,City and the
Lessee mutually agree as follows:
1.Purpose:This Amendment is for the Lease Agreement with the Western Dance Association of the Dance
Hall at Sullivan Park by and between the Parties, executed by the Parties on July 14, 2009, with a
termination date of June 1, 2019, ten years. Lease could be renewed for up to two additional five-year
terms. Said contract is referred to as the "Original Contract" and its terms are hereby incorporated by
reference. Total compensation under the Original Contract is a lease fee of$500 per month. The Original
Contract was amended June 25,2019,to extend the lease until June 1,2020. It was further amended May
11,2020,to extend the lease until December 31,2022. It was also amended November 30,2020,to suspend
future monthly payments while unable to open due to COVID-19 restrictions,until it could re-open,and to
credit the payments that were already made while unable to open. It re-opened in July 2021. It was further
amended December 14,2022,to extend the lease to December 31,2023.
2.Original Contract Provisions:The Parties agree to continue to abide by those terms and conditions of the
Original Contract and any amendments thereto which are not specifically modified by this Amendment.
3.Amendment Provisions: The Original Contract is subject to the following amended provision,which is
as follows. All such amended provisions are hereby incorporated by reference herein and shall control over
any conflicting provisions of the Original Contract,including any previous amendments thereto.
Lease Agreement is extended until December 31.2024. All terms and conditions remain the same.
4. Compensation Amendment History: This is Amendment#5 of the Original Contract. The history of
amendments to the compensation on the Original Contract and all amendments is as follows:
Date Compensation
Original Contract Amount 07/14/2009 $500.00/month lease fee
Amendment#1 06/25/2019 $ 0.00
Amendment#2 05/11/2020 $ 0.00
Amendment#3 11/30/2020 $ 0.00
Amendment#4 12/06/2022 $ 0.00
Amendment#5 to be executed $ 0.00
Total Amended Compensation $500.00/month lease fee
The parties have executed this Amendment to the Original Contract this v�'y dayof December 2023.
C 0 S KANE VALLEY: WESTERN DANCE
ASSOC.OF SPOKANE:
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City M ager Its: 1"r e s N�1
APP VED 0 FORM:
Office the Ci Attorney
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,d►c---- CERTIFICATE OF LIABILITY INSURANCE DATE 23
�f 8/15/2023
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 1 MGT
McDonald-Zaring Insurance,a Marsh&McLennan Agency LLC company PHONE FAX
22 E Main St (NC,No,Ext):(509)525-5730 I pvc,No):(509)525-5705
Walla Walla,WA 99362 (is;Inffoemcdonaldzaring.com
INSURER(S)AFFORDING COVERAGE NAIC•
INSURER A:The Cincinnati Casualty Company 28665
INSURED INSURER B:
Square&Folk Dance Federation of Washington,Inc. INSURER C;
5612 S Napa St INSURER D:
Spokane,WA 99223
INSURER E; _
•
• INSURER F:
-
COVERAGES _ RTIFICAIF. aER: REVISION NUMBER:
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.
g TYPE OF INSURANCE _SUM POLICY NUMBER POUY EFF POLICY EXP UNITS
_MVODtYYY MMND/YSTa.
A X COMMERCIAL GENERAL UADILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR X EPP 034 62 68 9/1/2023 9/1/2024 ff&°(ERaE nee) $ 500,000
MED EXP(Any one pemon) $ 5,000
PERSONAL 8 ADV INJURY $ 1,000,000
GEM AGGREGATE pL�IMaITAPPLHES PER: GENERAL AGGREGATE $ 2,000,000
JECT
POLICY n n LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER; $
AUTOMOBLE LIABILITY (COMBINEDa INGLE LIMIT $
ANY AUTO BODILY INJURY(Per Person) $
_
AAyUTOSDONLY —AUTOS SCHEDULED B• ODILY IINNyJUpM
INJURY
accident)Per S
AUTOS ONLY _ ens (Per�aodtlantl GE $
$
A i X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000
EXCESS LIAO CLAIMS-MADE X EPP 034 62 68 9/1/2023 911/2024 AGGREGATE $
DIED X RETENTIONS 0 $ 1,000,000
WORKERS COMPENSATION PER 0T
AND EMPLOYERS'LIABILITY Y!N
ANY
NHNNYPROPR �FXCLNER EC�� ) N!A EL.EACH ACCIDENT $
( ) E.L.DISEASE-EA EMPLOYEE $
If yyssss decries under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES(ACORO 101,Additional Remarks Schedule,may be attached I more space le required)
Square and Round Dancing for the dance season of 2022-2023 at Western Dance Center,1901 N Sullivan,Spokane Valley,WA 99216.
Certificate holder is named as additional Insured In regard to operations of the named insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE PIRATION DATE THEREOF,
City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIO CE WILL BE DELIVERED IN.
Parks and Recreation Centerpiece
2426 N Discovery Place
Spokane,WA 99216 AUTHORIZED REPRESENTATIVE
-ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Br)l14R.FP7_f11 TI OrATI
T
CERTIFICATE OF LIABILITY INSURANCE
DATE f MMf o24YY)
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(ies) 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
McDonald-Zaring Insurance, a Marsh & McLennan Agency LLC company
Marsh McLennan Agency LLC
22 E. Main
Walla Walla, WA 99362
CONTACT
AME;
_
PHONE FAX
(AIc, No, Exti: (509) 525-5730 ! JArC, No):
Eop IEs : mmanwmziinfo@marshmma.com
INSURER(SLAFFORDING COVERAGE
NAIC k
INSURER A: Cincinnati Casual{ Com -any
28665
INSURED
INSURER 8 : ..v_
�.
INSURERC:
Square & Folk Dance Federation of Washington, Inc,
_
INSURER D :
5612 S Napa St
Spokane, WA 99223
_
INSURERE;
INSURER F :
DCIJICIn KI AIIIAAP9zP-
vTHIS IS TOCERTIFYTHAT 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.
INSR
LTRTYPE
OF INSURANCE
ADDL
p
SUBR
p
POLICY NUMBER
POLICY EFF
IDD
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
M Ea c r enq
$ 600,000
CLAIMS -MAD£ 7X OCCUR
X
EPP 0346268
9/1/2024
91112025
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY❑PRO- LOC
JECT
GENERAL AGGREGATE
2,000,000
PRODUCTS-COMPIOPAGG
2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
BODILY INJURY(Per person)
S
ANYAUTO
e0DILY INJURY Per accident
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON OV�MED
AUTOS ONLY AUTOS NLY
PROPERTY AMAGE
Per accident
A
X
UMBRELLA LIAR
X
OCCUR
i
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
EXCESS LIAB
CLAIMS-MADEI
X
EPP0346268
911/2024
911f2025
DED X I RETENTIONS 0
$ 1,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERiFXECUTIVE
PSTATUTE ER A_ Ef3
—
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYEE
S
OFFICER/MEMgE� EXCLUDED? LJ
(Mandatory (n NH)
N f A
E.L. DISEASE - POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required)
K"Q:4112lyG'I1NW;LOI DJRV
City of Spokane Valley
Parks and Recreation Centerplace
2426 N Discovery Place
Spokane, WA 99216
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) U 196t3-2U1b AGUKU GUKI`UKA I IVIV. All nyn lb FVb VI V Vu.
The ACORD name and logo are registered marks of ACORD
NOTICE TO POLICYHOLDERS
ADDITIONAL INSURED ENDORSEMENTS
This is a summary of the major changes found in new editions of additional insured endorsements. NO
COVERAGE IS PROVIDED BY THIS SUMMARY. Nor can it be construed to replace any provision of your
policy. YOU SHOULD READ YOUR POLICY AND REVIEW YOUR DECLARATIONS PAGE CAREFULLY for
complete information on the coverages that you are provided. If there is any conflict, between the policy and
this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL.
The major areas within the endorsements that broaden or reduce coverage, and other changes, are
highlighted below. This notice does not reference every editorial change made in the endorsements.
Clarification of Coverage:
The following additional insured endorsements are revised to indicate that when these endorsements are
attached to a policy, if coverage provided to the additional insured is required by contract or agreement,
coverage to the additional insured will be afforded to the extent permitted by law and to the extent the named
insured is required by the contract or agreement to provide insurance available under the applicable Limits of
Insurance shown in the Declarations, whichever is less:
• CG 20 03 04 13
ADDITIONAL INSURED - CONCESSIONAIRES TRADING UNDER YOUR NAME
• CG20050413
ADDITIONAL INSURED -CONTROLLING INTEREST
• CG 20 07 04 13
ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS
• CG 2010 0413
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION
• CG 2011 04 13
ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES
• CG 2012 04 13
ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR
SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS
• CG 2013 04 13
ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR
SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS
RELATING TO PREMISES
• CG 2015 04 13
ADDITIONAL INSURED -VENDORS
• CG 2018 04 13
ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE OR RECEIVER
• CG 20 23 04 13
ADDITIONAL INSURED - EXECUTORS, ADMINISTRATORS, TRUSTEES OR
BENEFICIARIES
• CG 20 24 04 13
ADDITIONAL INSURED - OWNERS OR OTHER INTERESTS FROM WHOM LAND
HAS BEEN LEASED
• CG 20 26 04 13
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
• CG 20 27 04 13
ADDITIONAL INSURED - CO-OWNER OF INSURED PREMISES
• CG 20 28 04 13
ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT
• CG 20 29 04 13
ADDITIONAL INSURED -GRANTOR OF FRANCHISE
• CG 20 30 04 13
OIL OR GAS OPERATIONS - NONOPERATING, V\ORKING INTERESTS
• CG 20 3104 13
ADDITIONAL INSURED- ENGINEERS, ARCHITECTS OR SURVEYORS
• CG 20 32 04 13
ADDITIONAL INSURED - ENGINEERS, ARCHITECTS OR SURVEYORS NOT
ENGAGED BY THE NAMED INSURED
• CG 20 34 04 13
ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC
STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU
• CG 20 35 04 13
ADDITIONAL INSURED - GRANTOR OF LICENSES - AUTOMATIC STATUS
WHEN REQUIRED BY LICENSOR
GA 4496 0918
Page 1 of 2
• CG 20 36 04 13 ADDITIONAL INSURED- GRANTOR OF LICENSES
• CG 20 37 04 13 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
COMPLETED OPERATIONS
• CG 29 35 04 13 ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR
SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS
• GA 4248 0917 ADDITIONAL INSURED - PICK UP OR DELIVERY - SCHEDULED PERSON OR
ORGANIZATION
• GA 4397 0917 ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
(VICARIOUS LIABILITY)
GA 472 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC
WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR
AUTHORIZATION
GA 4255 09 18 CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC
WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT
The above forms have the following changes:
Broadening of Coverage:
• Coverage is no longer restricted to entities for whom work is performed by you.
Reduction of Coverage:
• Coverage has been removed for oral contracts.
Clarification of Coverage. -
Expressly address, in part, claims alleging negligence or other wrongdoing in the hiring, employment,
training, supervision or monitoring of others by any insured.
• Expressly states the exclusion applies only in your capacity as an engineer, architect or surveyor and not
within construction means, methods, techniques, sequences and procedures employed by you in
connection with your operations in your capacity as a construction contractor.
CG 20 08 0413 ADDITIONAL INSURED - USERS OF GOLFMOBILES
The above form has the following change:
Reduction of Coverage:
• Golfmobile was added as a defined term.
GA 4496 0918
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