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PSA Hunziker
PROFESSIONAL SERVICES AGREEMENT This Agreement is made by and between Kittitas County on behalf of Kittitas County Superior Court, Juvenile Court Services, (hereinafter "the County") and Kristi Hunziker (hereinafter "Contractor"). The County and Contractor agree as follows: General Conditions; Exhibit A (Scope of Work); Exhibit B (Compensation); Exhibit C (Proof of Insurance). copies of which are attached hereto and incorporated herein by this reference as fully as if set forth herein. The term of this Agreement shall commence on the September 1, 2019, and continue until August 31, 2020. Any party may terminate this Agreement by giving thirty (30) days' notice in writing either personally delivered or mailed postage-prepaid by certified mail, return receipt requested, to the party's last known address for the purposes of giving notice under this paragraph. Contractor acknowledges and by signing this Agreement agrees that the Indemnification provisions set forth in Paragraphs 7 (Independent Contractor), 9 (Taxes), 15 (Defense and Indemnity Agreement), 21 (PatenUCopyright Infringement) and 24 (Confidentiality), are totally and fully part of this Agreement and have been mutually negotiated by the parties. Professional Services Agreement (rev. 09/24/2018) Page 1 of 19 11,1 WITNESS WHEREOF, the parties have executed this Agreement this ~ day of 3.tpt;-2019 . -- ~ ~ / APPROVED :$~~ BOARD OF COUNTY COMMISSIONERS KITTITAS COUNTY, WASHINGTON ,~--f-"-~-+-"-------~-~--~a------ Kristi Hunziker Print Name of Signatory Contractor Address : Kristi Hunziker l!J-st.amaa., Commissioner -- , \,,, 11 11,1/1,- 1111 , '' t ,1)M 11s s. 'Y14.ttest: ' :<$. J, ••••••••••••• 10,.,, •;;,;, ~',; .• · ·-. ·v,.,. ~ 0 / ·. '~ .-,. '.J / ... tJ\ ~ • • ' , ". ( s_;~ ~QXl.lse~k~the ~~d . ·. .. F,. ~ ,,.~·. .. ~.;:;:,- ~-~ '··~ .,··~~ , ..... ',:,, '9 r-..:_:-....... :~1p.._.,,' 1~t11,""VLJNT'{ --i, ;:..'''' 11 -,,111,p ,11 1•''' ~p~r~~LaS-t.:?or_m_: _ By : _______ -----1f----- Douglas R. Mitchell, WS A #22877 Deputy Prosecuting Atta ney County's Address : 3204 Summitview Avenue Yakima, WA 98902 Kittitas County Professional Services Agreement (rev. 09/24/2018) Page 2 of 19 205 West 5th Avenue, Suite 108 Ellensburg, WA 98926 Project Contact: Kristi Hunziker 509-304-9025 hynzykris@yahoo.com Professional Services Agreement (rev. 09/24/2018) Page 3 of 19 Project Contact: Katrina Mankus, Juvenile Court Administrator or designee, Suite 211 katrina. mankus@co. kittitas. wa. us GENERAL CONDITIONS 1. Scope of Contractor's Services : Contractor agrees to provide to the County services and any materials set forth in the project narrative identified in Exhibit "A" during the Agreement period. No material, labor, or facilities will be furnished by the County, unless otherwise provided for in the Agreement. 2 . Performance of Work: Contractor shall perform work in accordance with, and shall comply with, all of the provisions of this Agreement. All work shall comply with applicable codes and ordinances . 3. Schedule of Performance: Unless directed otherwise by the County, Contractor shall perform the work in accordance with any schedules made a part of this Agreement. 4. Definitions : 4 .1 "Additional Insureds" means the County, its successors and assigns , and the respective directors, officers , employees, agents and representatives of the County and its successors and assigns. 4.2 "Support" means the following : Contractor's directors, officers, employees, agents and representatives; and sub-Contractors of any tier; the respective directors, officers, employees, agents and representatives of these sub- Contractors of any tier; and any other person or entity acting under the direction or control of, or on behalf of, Contractor or any Contractor's sub- Contractors of any tier in connection with or incident to the performance of the Work or this Agreement. 4.3 The "Work" means all of the duties listed in Exhibit A and the performance of all other obligations, under this Agreement by Contractor or its Support. 5. Accou ntin g an d Payment for Contract or Service s: Payment to the Contractor for services rendered under this Agreement shall be as set forth in Exhibit "B". Where Exhibit "B" requires payments by the County, payment shall be based upon billings , supported unless otherwise provided in Exhibit "B", by documentation of units of work actually performed and amounts earned, including where appropriate, the actual number of days worked each month , total number of hours for the month, and the total dollar payment requested . Unless specifically stated in Exhibit "B" or approved in writing in advance by the Kittitas County Board of Commissioners, the County will not reimburse the Contractor for any costs or expenses incurred by the Contractor in performance of this Agreement. Where required , the County shall, upon receipt of appropriate documentation, compensate the Contractor, no more often than monthly, through the County voucher system , for the Contractor 's service pursuant to the fee schedule set forth in Exhibit "B". Professional Services Agreement (rev. 09/24/2018) Page 4 of 19 6. Assignment an d Subcontracting : No portion of this Agreement may be assigned or subcontracted to any other individual , firm or entity without the express and prior written approval of the County . 7. Independent Contractor : The Contractor's services shall be furnished by the Contractor as an independent Contractor and nothing herein contained shall be construed to create a relationship of employer-employee or master-servant, but all payments made hereunder and all services performed shall be made and performed pursuant to this Agreement by the Contractor as an independent Contractor. The Contractor acknowledges that the entire compensation for this Agreement is specified in Exhibit "B" and the Contractor is not entitled to any County benefits including, but not limited to: vacation pay, holiday pay , sick leave pay , medical, dental, or other insurance benefits, or any other rights or privileges afforded to Kittitas County employees . Contractor will defend , indemnify and hold harmless the County , its Additional Insureds , officers, agents or employees from any loss or expense, including but not limited to settlements, judgments, setoffs, attorneys' fees or costs incurred by reason of claims or demands because of breach of the provisions of this paragraph. 8. No Guarantee of Employme nt: The performance of all or part of this Agreement by the Contractor shall not operate to vest any employment rights whatsoever and shall not be deemed to guarantee any employment of the Contractor or any employee of the Contractor or any sub-Contractor or any employee of any sub-Contractor by the County at the present time or in the future. 9. Taxes: The Contractor understands and acknowledges that the County will not withhold Federal or State income taxes . Where required by State or Federal law, the Contractor authorizes the County to make withholding for any taxes other than income taxes (i .e. Medicare). All compensation received by the Contractor will be reported to the Internal Revenue Service at the end of the calendar year in accordance with the applicable IRS regulations. It is the responsibility of the Contractor to make the necessary estimated tax payments throughout the year , if any , and the Contractor is solely liable for any tax obligation arising from the Contractor 's performance of this Agreement. The Contractor hereby agrees to indemnify the County against any demand to pay taxes arising from the Contractor's failure to pay taxes on compensation earned pursuant to this Agreement. The County will pay sales and use taxes imposed on goods or services acquired hereunder as required by law. The Contractor must pay all other taxes including, but not limited to : Business and Occupation Tax , taxes based on the Contractor's gross or net Professional Services Agreement (rev. 09/24/2018) Page 5 of 19 income, or personal property to which the County does not hold title . The County is exempt from Federal Excise Tax. 10. Regulations and Requirement: This Agreement shall be subject to all laws, rules and regulations of the United States of America, and State of Washington, and political subdivisions of the State of Washington, and to any other provisions set forth herein or in the attached exhibits. 11 .. Right to Review: This contract is subject to review by any Federal or State auditor. The County or its designee shall have the right to review and monitor the financial and service components of this program by whatever means are deemed expedient by the County. Such review may occur with or without notice, and may include, but is not limited to, on-site inspection by County agents or employees, inspection of all records or other materials which the County deems pertinent to the Agreement and its performance , and any and all communications with or evaluation by service recipients under this Agreement. The Contractor shall preserve and maintain all financial records and records relating to the performance of work under this Agreement for 6 years after contract termination , and shall make them available for such review, within Kittitas County, State of Washington, upon request. 12 . Modifications : 12.1 Either party may request changes in the Agreement. Any and all agreed modifications shall be in writing, signed by each of the parties . 12 .2 The County may, at any time, by written notice thereof to Contractor ("Change Notice") makes changes in the Work within the general scope of this Agreement, including, but not limited to: (a) changes in, revisions to , substitutions for, additions to or deletions of any Work; (b) changes in schedule; and (c) acceleration , deceleration or suspension of performance of any Work. · 12.3 If any change in the Work causes an increase or decrease on Contractor's cost of, or the time required for , performance of the Work, an equitable adjustment in the compensation to Contractor and in the schedule for the performance of the Work shall be made to reflect such an increase or decrease. 12.4 Notwithstanding any dispute or delay in arriving at a mutually acceptable equitable adjustment, Contractor shall proceed in accordance with all Change Notices. Contractor must , within thirty (30) days after receipt of any Change Notice that does not set forth any acceptable adjustment, submit to the County a written statement setting forth any adjustment claimed . Professional Services Agreement (rev. 09/24/2018) Page 6 of 19 12.5 If any change results in a decrease in the Work performed, Contractor shall be entitled to compensation associated with changing the Work, such as revising design already completed, revising calculations already performed, and revising documents. 13. Termination for Default: If the Contractor defaults by failing to perform any of the obligations of the Agreement or becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency or makes an assignment for the benefit of creditors, the County may, by depositing written notice to the Contractor in the U.S. mail, postage prepaid, terminate the Agreement, and at the County's option, obtain performance of the work elsewhere. If the Agreement is terminated for default, the Contractor shall not be entitled to receive any further payments under the Agreement until all work called for has been fully performed. Any extra cost or damage to the County resulting from such default(s) shall be deducted from any money due or coming due to the Contractor. The Contractor shall bear any extra expenses incurred by the County in completing the work, and all damage sustained, or which may be sustained by the County by reason of such default. If a notice of termination for default has been issued and it is later determined for any reason that the Contractor was not in default, the rights and obligations of the parties shall be the same as if the notice of termination had been issued pursuant to the Termination for Public Convenience paragraph hereof. 14 . Termination for Public Convenience: The County may terminate the Agreement in whole or in part whenever the County determines, in its sole discretion that such termination is in the best interests of the County. Whenever the Agreement is terminated in accordance with this paragraph, the Contractor shall be entitled to payment for actual work performed at unit contract prices for completed items of work. In the event of such termination, an equitable adjustment shall be made in the compensation payable to Contractor. An equitable adjustment in the contract price for partially completed items of work will be made, but such adjustment shall not include provision for loss of anticipated profit on deleted or uncompleted work. Termination of this Agreement by the County at any time during the term, whether for default or convenience, shall not constitute a breach of contract by the County. 15. Defense & Indemnity Agreement: The Contractor agrees to and shall defend, indemnify and hold harmless the County, its Additional Insureds, appointed and elective officers, agents and employees, from and against all loss or expense, including but not limited to judgments, settlements, attorney's fees and costs by reason of any and all claims and demands upon the County, its Additional Insureds, its elected or appointed officials, agents, or employees for damages because of personal or bodily injury, including death at any time resulting therefrom, Professional Services Agreement (rev. 09/24/2018) Page 7 of 19 sustained by any person or persons and on account of damage to property including loss of use thereof, whether such injury to persons or damage to property is due to the negligence of the Contractor, its sub-Contractors, its elected officers, employees or their agents, except only such injury or damage as shall have been occasioned by the sole negligence of the County, its Additional Insureds, appointed or elected officials, agents, or employees. It is further provided that no liability shall attach to the County by reason of entering into this contract, except as expressly provided herein . 16 . Industrial Insurance Waiver: With respect to the performance of this Agreement and as to claims against the County, its Additional Insureds, officers, agents and employees, the Contractor expressly waives its immunity under Title 51 of the Revised Code of Washington, the Industrial Insurance Act, for injuries to its employees and agrees that the obligations to indemnify, defend and hold harmless provided in this agreement extend to any claim brought by or on behalf of any employee of the Contractor. This waiver is mutually negotiated by the parties to this Agreement. 17 . Venue and Choice of Law : In the event that any litigation should arise concerning the construction or interpretation of any of the terms of this Agreement, the venue of such action of litigation shall be in the Superior Court of the State of Washington in and for the County of Kittitas. This Agreement shall be governed by the law of the State of Washington. 18. Wi thholding Pay ment: In the event the Contractor has failed to perform any obligation to be performed by the Contractor under this Agreement within the time set forth in this Agreement, then the County may, upon written notice, withhold all monies due and payable to Contractor, without penalty, until such failure to perform is cured or otherwise adjudicated . 19. Future Non-Allocation of Funds: If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the County will not be obligated to make payments for services or amounts incurred after the end of the current fiscal period. No penalty or expense shall accrue to the County in the event this provision applies . 20 . Co ntractor Commitments , W arranties an d Represe ntati ons: The Contractor represents and warrants to the County as follows : 20.1 The Contractor is duly incorporated, validly existing and in good standing under the laws of the State of Washington, and has all requisite corporate power and authority to enter into and to perform its obligations under this Agreement. 20.2 The Contractor has the authority to execute this Agreement, to make the representations and warranties set forth in it and to perform the Professional Services Agreement (rev. 09/24/2018) Page 8 of 19 obligations of the Contractor under this Agreement in accordance with its terms. 20.3 This Agreement has been validly executed by an authorized representative of the Contractor and constitutes a valid and legally binding and enforceable obligation of Contractor. 20.4 The Contractor has or will obtain prior to the commencement date such licenses, permits and other authorizations from federal, state and other governmental authorities, as are necessary for the performance of its obligations under this Agreement. 20.5 The Contractor is not in violation of any applicable law, ordinance or regulation the consequence of which will or may materially affect Contractor's ability to perform its obligations under this Agreement. The Contractor is not subject to any order or judgment of any court, tribunal or governmental agency which materially and adversely affects its operations or assets in the State of Washington, or its ability to perform its obligations under this Agreement. 20.6 None of the representations or warranties in this Agreement, and none of the documents, statements, certificates or schedules furnished or to be furnished by Contractor pursuant hereto or in connection with the performance of the obligations contemplated under this Agreement, contains or will contain any untrue statement of a material fact or omits or will omit to state a material fact necessary to make the statements of fact contained therein not misleading. 21. Patent/Oopyr1ght Infringement Contractor will defend and indemnify the County from any claimed action, cause or demand brought against the County; to the extent such action is based on the claim that information supplied by the Contractor infringes any patent or copyright. The Contractor will pay those costs and damages attributable to any such claims that are finally awarded against the County in any action. Such defense and payments are conditioned upon the following: 21.1 21.2 · 22. Disputes : Contractor shall be notified promptly in writing by County of any notice of such claim. Contractor shall have the right, hereunder, at its option and expense, to obtain for the County the right to continue using the information, in the event such claim of infringement is made, provided no reduction in performance or loss results to the County. 22 .1 General Differences between the Contractor and the County, arising under and by virtue of the Agreement Documents shall be brought to the attention of the County at the earliest possible time in order that such matters may be settled or other appropriate action promptly taken. Except for such objections as are Professional Services Agreement (rev. 09/24/2018) Page 9 of 19 made of record in the manner hereinafter specified and within the time limits stated, the records, orders, instructions, and decisions of the Kittitas County Commissioners shall be final and conclusive. 22.2 Notice of Potential Claims The Contractor shall not be entitled to additional compensation which otherwise may be payable, or to extension of time for (1) any act or failure to act by the County, or (2) the happening of any event or occurrence, unless the Contractor has given the County a written Notice of Potential Claim within ten (10) days of the commencement of the act, failure, or event giving rise to the claim, and before final payment by the County. The written Notice of Potential Claim shall set forth the reasons for which the Contractor believes additional compensation or extension of time is due, the nature of the cost involved, and insofar as possible, the amount of the potential claim. Contractor shall keep full and complete daily records of the work performed, labor and material used, and all costs and additional time claimed to be additional. 22.3. Detailed Claim The Contractor shall not be entitled to claim any such additional compensation, or extension of time, unless within thirty (30) days of the completion of the portion of the work from which the claim arose, and before final payment by the County, the Contractor has given the County a detailed written statement of each element of cost or other compensation requested and of all elements of additional time required, and copies of any supporting documents evidencing the amount or extension of time claimed to be due. 23. Ownership of Items Produced: All writings, programs, data, public records or other materials prepared by the Contractor and/or its consultants or sub-Contractors, in connection with performance of this Agreement shall be the sole and absolute property of the County. 24. Confidentiality : The Contractor, its employees, sub-Contractors, and their employees shall maintain the confidentiality of all information provided by the County or acquired by the Contractor in performance of this Agreement, except upon the prior written consent of the Kittitas County Prosecuting Attorney or an order entered by a court after having acquired jurisdiction over the County. Contractor shall immediately give to the County notice of any judicial proceedings seeking disclosure of such information. Contractor shall indemnify and hold harmless the County, its Additional Insureds, officials, agents or employees from all loss or expense, including, but not limited to settlements, judgments, setoffs, attorneys' fees and costs resulting from Contractor's breach of this provision. Professional Services Agreement (rev. 09/24/2018) Page 10 of 19 To the extent that any information obtained by the Contractor is required to be shared with or provided to others by the terms of the Statement of the Work, this provision is not breached by such acts. 25 . Notice: Except as set forth elsewhere in the Agreement , for all purposes under this Agreement , except service of process, notice shall be given by the Contractor to the department head of the department for whom services are rendered , and to the Kittitas County Commissioners , 205 W 5th Ave, Suite 108, Ell ensburg, WA 98926 . Notice to the Contractor for all purposes under this Agreement shall be given to the address reflected on the signature page . Notice may be given by delivery or by depositing in the U.S. Mail, first class, postage prepaid. 26. Severabi lity: If any term or condition of this Agreement or the application thereof to any person(s) or circumstances is held invalid , such invalidity shall not affect other terms, conditions or applications which can be given effect without the invalid term , condition or application. To this end, the terms and conditions of this Agreement are declared severable. 27. Miscellaneous : 27.1 The County's failure or delay to insist upon strict performance of any of the provisions of this Agreement or to exercise any rights or remedies under this Agreement shall not be construed as a waiver or relinquishment to any extent of its right to assert or rely upon any such provisions, rights or remedies in that or any other instance ; rather the same shall be and remain in full force and effect. 27.2 This Agreement embodies the entire Agreement between the County and Contractor, and supersedes any and all prior agreements , regarding the Work. No change, amendment or modification of any provisions of this Agreement shall be valid unless set forth in a written instrument signed by the party to be bound thereby . 27.3 The rights and remedies of the County set forth in any provision of this Agreement are in addition to and do not in any way limit any other rights of remedies afforded to the County by any other provisions of this Agreement, by any of Contractor's Support or by law. 27.4 The headings of sections and paragraphs of this Agreement are for convenience of reference only and are not intended to restrict, affect or be of any weight in the interpretation or construction of the provisions of such sections or paragraphs. 28. Waiver: Waiver of any breach or condition of this Agreement shall not be deemed a waiver of any prior or subsequent breach. No terms or conditions of this Agreement shall be held to be Professional Services Agreement (rev . 09/24/2018) Page 11 of 19 waived, modified or deleted except by an instrument, in writing , signed by the parties hereto. 29. Survival: The provisions of paragraphs 7, 9, 11, 13, 14 , 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 28, 30, 31, and 32 shall survive, notwithstanding the termination or invalidity of this Agreement for any reason . 30 . Nondiscrimination : 30.1 The County is an equal opportunity employer . 30.2 Nondiscrimination in Employment In the performance of this Agreement, the Contractor will not discriminate against any employee or applicant for employment on the grounds of race, creed, color, national origin, sex , sexual orientation, marital status , age or the presence of any sensory , mental or physical handicap ; provided that the prohibition against discrimination in employment because of handicap shall not apply if the particular disability prevents the proper performance of the particular worker involved. The Contractor shall ensure that applicants are employed, and that employees are treated during employment without discrimination because of their race, creed, color, national origin, sex, sexual orientation, marital status , age or the presence of any sensory, mental or physical handicap . Such action shall include, but not be limited to : employment, upgrading, demotion or transfers, recruitment or recruitment advertising , layoff or termination, rates of pay or other forms of compensation, and programs for training including apprenticeships. The Contractor shall take such action with respect to this Agreement as may be required to ensure full compliance with local, state and federal laws prohibiting discrimination in employment. 30.3 Nondiscrimi nati on in Services The Contractor will not discriminate against any recipient of any services or benefits provided for in this Agreement on the grounds of race, creed, color, national origin , sex, sexual orientation, marital status, age or the presence of any sensory, mental or physical handicap . 30.4 If any assignment and/or subcontracting has been authorized by the County, said assignment or subcontract shall include appropriate safeguards against discrimination . The Contractor shall take such action as may be required to ensure full compliance with the provisions in the immediately preceding paragraphs herein. Professional Services Agreement (rev. 09/24/2018) Page 12 of 19 31. Prevai ling Wage: Contractor shall pay the prevailing rate of wages -to all workers, laborers, or mechanics employed in the performance of any part of the Work in accordance with RCW 39.12 and the rules and regulations of the Department of Labor and Industries. The schedule of prevailing wages rates for the locality or localities of the Work is determined by the Industrial Statistician of the Department of Labor and Industries . It is the Contractor's responsibility to verify the applicable prevailing wage rate . It is understood that the Contractor is responsible for obtaining and completing all required government forms and submitting same to the proper authorities . Disputes regarding prevailing wage rates shall be referred for arbitration to the Director of the Department of Labor and Industries . The arbitration decision shall be final and conclusive and binding on all parties involved in the dispute as provided for by RCW 39.12 .060 . 32. Debarment Certification : The Contractor certifies that it: 32.1 Is not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal department or agency. 32.2 Has not within a three-year period preceding the execution of this contract with Kittitas County, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain , or performing a public or private agreement or transaction , violation of Federal or State antitrust statutes or commission of embezzlement , theft, forgery, bribery , falsification or destruction of records, making false statements , tax evasion, receiving stolen property, making false claims, or obstruction of justice. 32.3 Is not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph 32 .2 of this section . 32.4 Has not within a three-year period preceding the preceding the execution of this contract with Kittitas County had one or more publ ic transactions (Federal , State , or local) terminated for cause of default. Professional Services Agreement (rev. 09/24/2018) Page 13 of 19 EXHIBIT "A" SCOPE OF WORK In addition to providing all material and labor, the Contractor shall perform the following: a. Services Provided. Special Sex Offender Disposition Alternative evaluation and treatment for youth determined to be eligible by the Court pursuant to applicable standards will consist of a combination of services identified in the SSODA assessment completed and submitted by Contractor to Juvenile Court Services, Kittitas County Superior Court. Special Sex Offender Disposition Alternative evaluation and treatments are to be completed in accordance with guidelines as set forth in the Juvenile Disposition Manual under the authority of the Caseload Forecast Council; the State of Washington as mandated by RCW 13.40.160; the statutory authority of the Department of Health as implemented in the provisions of the Washington Administrative Code; and any other controlling legal authority, including requirements for any form of background check or investigation required for unsupervised access to juveniles. As the provider of services to youth determined to be eligible and designated by Juvenile Court Services, in Contractor's role as Certified Sexual Offender Treatment Provider Contractor agrees to provide the SSODA evaluation and subsequent treatment services for up to the 24 months as mandated in the SSODA Disposition Order. Professional Services Agreement (rev. 09/24/2018) Page 14 of 19 EXHIBIT "B" COMPENSATION As full compensation for satisfactory performance of the work, the County shall pay Contractor compensation not to exceed: SSODA Evaluation and Written Report $1,080.00 Individual Counseling Sessions $85.00 @ 1 hour weekly Group Counseling Session $45 .00@ 90 minutes weekly Quarterly Detailed Progress Reports $45.00@ 1 report quarterly Kittitas County will provide reimbursement through the Kittitas County Auditor as outlined above . Monthly invoices for services provided which document the dates and details of services provided during that billing period as described above are required. Billing shall be submitted in a timely manner to allow the County to process your reimbursement in a like manner. The Contractor shall ensure that work to be performed does not duplicate work to be charged to Kittitas County under any other contract or agreement with the Contractor. If the Contractor bills and is paid fees for services that Kittitas County later finds were (a) not delivered or (b) not delivered in accordance with applicable standards, Kittitas County shall recover the fees for those services and the Contractor shall fully cooperate during the recovery. Billing and Payment a. The Contractor shall submit an Invoice Voucher to the Kittitas County Juvenile Court at the end of each month, except that any work provided in September 2018 may be billed with that work provided in October 2018. The Quarterly Report referenced above, mandated by RCW 13.40.162(7) shall be provided to the Court through Juvenile Court Services and to the parties through counsel. The invoice for the month in which this report is provided as required shall include the above charge for the report. Provision of each of those reports as required is a mandatory condition precedent to payment for any invoice subsequent to that period. b. Kittitas County shall pay the Contractor upon acceptance of a properly completed Invoice Voucher. The invoice shall describe and document the following: Professional Services Agreement (rev. 09/24/2018) Page 15 of 19 (1) Date and time period of service(s) performed; (2) Case#; and (3) Description of work performed. c. Payment shall be considered timely if made by Kittitas County within 30 days after the receipt of the properly completed invoice. d. The Contractor accepts Kittitas County payment as the sole and complete payment for the services provided under this contract. e. Kittitas County shall not reimburse the Contractor for authorized services not provided to clients, or for services provided which are not authorized or provided in accordance with the "Statement of Work". If the Kittitas County Juvenile Court pays the Contractor for services authorized but not provided by the Contractor in accordance with this Contract's "Statement of Work", the amount paid shall be considered to be an overpayment. f. If this Contract is terminated for any reason, the Kittitas County Juvenile Court shall pay for only those services authorized and provided through the date of termination. Professional Services Agreement (rev. 09/24/2018) Page 16 of 19 EXHIBIT "C" PROOF OF INSURANCE The Contractor shall secure and maintain in effect at all times during performance of the Work such insurance as will protect Contractor, its Support and the Additional Insureds from all claims, losses, harm, costs, liabilities, damages and expenses arising out of personal injury (including death) or property damage that may result from performance of the work or this Agreement, whether such performance is by Contractor or any of its Support. All insurance shall be issued by companies admitted to do business in the State of Washington and have a rating of A-, Class VII or better in the most recently published edition of Best's Reports unless otherwise approved by the County. If an insurer is not admitted, all insurance policies and procedures for issuing the insurance policies must comply with Chapter 48.15 RCW and 284-15 WAC. The Contractor shall provide proof of insurance for: ~ Commercial General Liability Insurance Coverage limits not less than: • $5,000,000 per occurrence • $1,000,000 per occurrence liquor liability • $1,000,000 products & completed operations aggregate • $1,000,000 personal and advertising injury, each offense • Certificate Holder -Kittitas County • The Certificate must name the County as additional insured • Sixty (60) days written notice to the County of cancellation of the insurance policy ~ Commercial Automobi le Liability Insurance (if ANY use of vehicle in performance) Automobile Liability for owned, non-owned, hired, and leased vehicles (MCS 90 endorsement and a CA 9946 endorsement must be attached if 'pollutants' are to be transported) • Coverage limits not less than: • $1,000,000 combined single limit • Thirty (30) days written notice to the County of cancellation of the insurance policy. ' Additional Coverage May Be Required: ~ Workers ' Compensation Professional Services Agreement (rev. 09/24/2018) Page 17 of 19 Workers' Compensation in amounts required by law D Stop Gap/Employers Liability Coverage limits not less than: • $1,000,000 each accident • $1,000,000 disease -policy limit • $1,000,000 disease -each employee • Thirty (30) days written notice to the County of cancellation of the insurance policy. ~ Professional Liability The Contractor and/or its Subcontractor and/or its consultant providing professional services shall provide evidence of Professional Liability Insurance covering professional errors and omissions. Such policy must provide the following minimum limits: • $1,000,000 per claim • $2,000,000 annual aggregate • If insurance is on a claims-made form, its retroactive date, and that of all subsequent renewals, shall be no later than the effective date of this Agreement. D Pollution Liability The Contractor shall provide a Pollution Liability policy, providing coverage for claims involving bodily injury, property damage (including loss of use of tangible property that has not been physically injured), cleanup costs, remediation, disposal or other handling of pollutants, including costs and expenses incurred in the investigation, defense, or settlement of claims arising out of: • Contractor's operations related to this project; and/or • Remediation, abatement, repair, maintenance or other work with lead-based paint or materials containing asbestos; and/or • Transportation of hazardous materials away from any site related to this project Such Pollution Liability policy shall provide the following minimum coverage: • $ per claim • $ annual aggregate D Pro.party Damage The Contractor shall provide a policy that covers damage to Kittitas County facilities, including buildings, equipment, grounds, etc. Such policy shall provide the following minimum coverage: • $ per occurrence D Umbrella Coverage Professional Services Agreement (rev. 09/24/2018) Page 18 of 19 Umbrella policies shall provide coverage at least as broad as specified for underlying coverages (CGL, Auto, Employer's Liability) and cover those insured in the underlying policies, including additional insured. • Amount required for this Agreement: $ Contractor shall furnish the County a Certificate of Insurance to include the Policy Endorsements/Exclusions as evidence that policies providing insurance required by this Agreement are in full force and effect. Contractor hereby waives all rights of recourse, including any right to which another may be subrogated, against Kittitas County for personal injury, including death, and property damage. Contractor's insurance policies required above shall be primary insurance and shall be non-contributing with any other insurance maintained by Kittitas County. The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Contractor's employee-owned tools, machinery, equipment, or motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. The Contractor shall have sole responsibility for ensuring the insurance coverage and limits required are obtained by subcontractors. NOTE: No contract shall form until and unless a copy of the Certificate of Insurance with Endorsements/Exclusions, properly completed and in the amount required, is attached hereto. Failure of the Contractor to fully comply with the above insurance requirements during the term of the Agreement shall be considered a material breach of contract and cause for immediate termination of the Agreement at the County's discretion. Alternatively, the County may procure and maintain, at the Contractor's sole expense, insurance to the extent deemed proper up to the amount of the required coverage(s). The County may offset the cost of such insurance against payment due to the Contractor under this Agreement. Professional Services Agreement (rev. 09/24/2018) Page 19 of 19 ASW lnsurance Company, RRG Customer ID: 3TDIS920X Policy Number-: G-45T45HGS4.J-OO Effective Date: 07/16/2019 Expiration Date: 07/16/2020 Aggregate I OCCUR8ENCf GENERAL lJABlur:t POLICY DEC!.AAATIONS Named Insured: Krim l Hunziker Address: 903 S 341h Ave Yakima, WA 98902 $1.008,000.00 $3,000,000.00 TOTAL PREMIUM FOR THIS COVERAGE PART: $254.00 THIS IS AN OCCURRENCE POLICY, COVERAGE IS EFFECTIVE UPON RECEIPT Of YOUR FIRST PREMIUM PAYMENT FORTHlS OCCURRENCE GENBW..UABIUIY POUC'I. COVERAGE ONLY i\PPUES TO PROPERTY DAMA.GE, 800HY INJURY, PERSONAL lrt.lURY, ADVERT NG INJURY, AND FIRE LEGAL UABIUTY STl\TE.'O IN IBE MORESTrltEO POLICY l100M rnAT ACl'IJALO' OCCUR ANO AfU:-~lll 00 Oft .\Frat rnE 0At£m OClll l"T Of YOUR ARST Pfl8Ull!JM ~YMtlillr roll 11WS WfflfK POllCV COVEM6£, ANO Pll10R lO THE TERMl NAtlOO OA'fE Of ll"HIS ~OC POU(.'!' COV61Wi£. Authorized Repra-entnive: The NASWRRG Inc. ~ 1his policy with its 1\.1 l;illh, credit and ~ '5NASW Tony Benedetto Insurance Company. RRG Jlo\SIJll"l•Mlllillifnla 12Ql)E.Ela Pw.w td1"1i.UISJ6.Si L~CA110176076,AJ!W11l.I This policy is rell'ISllllld by Swl6S Re America . s . ISS e ~ 01',[t(Ml<A;/[lQl'l'ffi'T ACORD• \a. _,,,,,., CERIIEICA!E..OE.LlABI.Ul¥..lblSURAJJCE 07/1712019 'MS~l5155tJB!)RiA"""11610Fttll~Sl!lll.VRIUJi(lOlllRRS!'ID!ILGlf!l&1!!Pt!llllfl'litEltEllllllR!lilllH fl!IOJJElt-lellSC61[JEJQ!JElilllleiiN/Jllr ·di ll.LLVNLJL-3 AmllMA'lMI.YOll~JMIYMIENl\EXIOOOl!Vli'rmliliE~WnlEPOWOESE!El!.OVt'.71litS<SfTiflCAlE=CFNSUfWIC£00511!ar o:it4SllMEACOHTRACT~ n£ts9JNG~~IIS'ReiENTA1M: OIi Pm!JfBl Nil>~ c:arnnctrcttoUlSl ~Atre.1'11'1e~lsat~.LIN5UIB).1k~IIUl5l AOOC"II ll!EUR8> pr !Mlli:nS crbe fflllar55f. 15l.lE:llCJGllm»i 15\'W.WED, ~tDthel!mlsillld~at1hepol(y, cfflitln PQG~ma,-~ana,cbst11ia1t.~•till!;antllta(edol'snotarm ,W.SmtfleQ!l'l&:ale holder!n llaJ d5Udl ~ PRODUCER ooimcr !WE- NASW RRG Plan Adminrstrator !!lbE l~ ..... ) ,200 !Ea9t ~ A'iv!u~ IA:c.Na,!&0- Pe.on., IHIBiffe!s,, IL 61516-5348 -,_. 1NSLIRERl'S'l~CDVEIWiE .NAlC# INSURED ttilR:llk. N~9W/ IR,;~~, 1~en'1'.ton 1itPO\ltll) i~SJ·fofi Kt ts ti H mi ' r IHSUlBIB: 9U3 534 . A"e INSURBI C ~~3. \\~9m2 l'is1ullau!t_ INSUll.fR ~ ftf5UAERl't OJSTOMER ID: 3TIJIS'9i?CJX CERTIRCAlE NUMBER: G-451 4-SH G54}CO REVlSION NUMBER: O(ll1 nu, 1, TG f.FJTTlf'fll-1).\l WE U'GUCES DF INSU!i1.I\IT<N£ liJ'iTED f:ELDW lf~'Vf:. llUN Mt;fJ[)"lfHHlt. fN'iltJRFJ} Ml,lli>/UJ 1/eifJllf:. ff.lll'.THIE ~J.Jr..Vll'l[JRlliJI[; IINlt!IG .. TW. ~,OTW!Trl51ANlll,'>0.Al-i'f ~QCTU MENl. lEIOd Ott llJ ' lltJN Of' Am COl\lfv\CT D!l OTHrn U•Jl"UMHIT W\'Ti-1 flbl-'ECT lO WHIO-,IHl:i tlJmr.ici.. n M'.Y llE IS:,tJH) IJf{ MI.V PEllT /\IN, THE l'-l5llRl,Ntt Ar-HJlllJEl) !lY THE POLlllfi UE5t1Uc!El: HEREIN(';, '*lli(ffT 10 All lHE TEP,M;. EX(LIJo~. IS AND COKJtrr.1,vs OF ','lJCH i"OUllE;i; li'AllS ~K'.f#l'J.Wii!t'JM':'.~'>&oi0Clilll!il/1i 'P/ollDU,\,IM':i.. INS.I ~OF~ Rm!_ SIJilR POOO"t,ltlWi!iil POUCYHIF POUIO'EI' UIMIIS LTil -'11111P ~Wl'lj IIDffl'O -GIHJIAi. UA8!lJ1Y """"' !i!LIJ'<:al!.f :J; 'S•.;1;111,,-,:)» ,- LX ~}~ ~"t ~'i£1"f:W it<ft.iTV '[;i~'N4.:.\f.riE 7:r.J)!~Bt+ITS[j s R~lSf'"_5i((f.a0r.f>1.i.1Nff'lllCJ (t.Qf,M-"'l< (i]u:cl'II tJE[) :e.::fll ,An~· .:111~ ~:011.l $ -A ffill -<MIII S I\U>liE V N (: "K~·•· (l]/1 (,1}(11!) OT/1 q\)il ~~t.-JNI.J. & 1/CJV.INfU!rY :$ -f..t1'llillMAfJ0<ll:CN<J1if i i3w(01w:l%".fi'11\I -E~Qi-\'(t\ll'i Plf.\JJID\ JCT'.i-OlJMF't(l"Jlf'' /.'iliC-1. t M'~licMflfllMr Al~'lll5 1°':lt j; X.'C, D QIICJIED o,.nc I o:ier ~OM081LELW!!UTY CS"JI. l!;!.<;11,,;JJ;I.Jll'il $ l'Ll.Jg,~r1Jl 1N-.V '. 0 l:10l."ia.''l''IJ.Ut11\'t'(k"lyir Ult.'Y'-.;uti) 1 -C'Wl!I Bt1 85:\~i' ~ A:~lt-V -:.irn~ !UJJLlJL.ii'!JhUl!IRlt' (fer c1c,~1de1n:) '~ ,--~ :i,• w.s£ s 1-tf&V-:.5 ,br. L< .~~.,JJI., 1--\'lll •'l>' ~ []Of.t..J'-t . ·-~ :s ,--Tf t Ell:B.'SUAB t ,1,1~1"°8 !i; .--,,m n REfi:N Jl(.>:>J '.$ ~ CDMPENS,\1\0N ltWS'iAllflE JornE,: J'l!D~W'aH!JiE't' mt ~ILE.«CCltt' AC.l:lIDfN.TI \ .v.,·~.:-"Rllt" D WI!., 11 E,H\. ,':Cll .~1,d,ia, llcL r~!,:c\W"c-r:KJ~EMWIS;'i!!E ·l = ll~d,!-:;ci rku·ldiir E"lL[.'Ql:iE~-f10LJl'C'1itlW ~ ll>N iib,.,uij,rrimdC1perol!lll!Plli \II.~ 1.){5:1:J«fJJ\"lTilON ~~ (»' lo';C,'i 1 L'..:>CA-UJJINS J ~If.CLP, t'llX".-. :1m" .i'!.!ii~~inn;Jl.ilA1!11ank,SiibPddle,, ,m;,y'he ;mailled ,n 1mc,re 51fA( e i, ''"~llir adj csmACAlE HOLDER CANCEUATION SHOlltD M«OFlHE 1,ftOV£lJ5CRIBED POUOS BE <:ANCE.l.ED BER>RflHE ~ Ol.lElHEREOF, NOTICE WILL BE 08.M;RfD ON ACCORDANCE WllH POLICY PROVISIONS. 1/11.I fH(:~-o ~pf!--P )';&i!E:SE -~ © tl88--10l5 AC.ORD C01tPORAT10N. All rights reseved. ACORD 25 (2016/03) The ACORD name and logo are reeJstered marlcs of ACORD 2. A description of the n eeds of the incapacitated perso n for care and treatment, the probable residential requirements of the alleged incapacitated person, and the basis upon which these findings were made; 3. An evaluation of the appropriateness of the guardian or limited guardian whose appointment is sought and a description of the steps the proposed guardian has taken or intends to take to identify and meet current and emerging needs of the incapacitated person; 4. A description of any alternative arrangements previously made by the alleged incapacitated person or which could be made, and whether and to what extent such alternatives should be used in lieu of a guardianship, and, if the GAL is recommending discontinuation of any such arrangements, specific findings as to why such arrangements are contrary to the best interest of the alleged incapacfl at ed person; 5. A description of the abilities of the alleged incapacitated person and a recommendation as to whether a guardian or limited guardian should be appointed. If appointment of a limited guardian is recommended, the GAL shall recommend the specific areas of authority the limited guardian should have and the limitations and disabilities to be placed on the incapacitated person; 6. An evaluation of the person's mental ability to rationally exercise the right to vote and the basis upon which the evaluation is made; 7. Any expression of approval or disapproval made by the alleged incapacitated person concerning the proposed guardian or limited guardian or guardianship or limited guardianship; 8. Identification of persons with significant interest in the welfare of the alleged incapacitated person who sho u ld be a dvised of their right to req uest special notice of proceedings pursuant to RCW 11.92.150; and 9. Unless independent counsel has appeared for the alleged incapacitated person, an explanation of how the alleged incapacitated person responded to the advice of the right to jury trial, to independent counsel, and to be present at the hearing on the petition; H. Within forty-five days after notice of commencement of the guardianship proceeding has been served upon the GAL, and at least fifteen days before the hearing on the petition, unless an extension or reduction of time has been granted by the court for good cause, the GAL shall file his or her report and send a copy to the alleged incapacitated person and his or her counsel, spouse or domestic partner, all children not residing with a notified person, those persons described in (f)(viii) of this subsection, and persons who have fi led a req uest for s pecial not ice pursuant to RCW 11.92.150. If the GAL needs additional time to finalize his or her report, then the GAL shall petition the court for a postponement of the hearing or, with the consent of all other parties, an extension or reduction of time for filing the report. If the hearing does not occur within sixty days of filing the petition, then upon the two- month anniversary of filing the petition and on or before the same day of each following month u ntil the hearing , the GAL shall file interim reports summarizing his or her activities on the proceeding during that time period as well as fees and costs incurred; I. The GAL's report shall be filed as two separate documents, one public and one sealed. The sealed report must be filed under a Sealed Confidential Reports cover sheet. The sealed GAL report may not be pf aced in the court file or used as an Order Appointing GAL (ORAPGL) -Page 4 of 6 GDN 01.0400 (07/2017) RCW 11 .88.090 ____., lcl A B'f il',!l<ii'L'l«lrnffl') ACORD• '----" CERTIFICATE OF UABIUlY INSURANCE 07/17/2019 lflSCfR11ffCA1EIS~ASA~lllTIIIIIRllW,\~~~·llr,,NQ(ll)!l4imSN0f!lafl&l!l)f'lll!llTil~Hl!mlITTOllicl:f~-m1:.-akl.lE\IOOlfOOESllll!lV Aff!liMKIMLYOR ~ MENll, ecrolJ Oi:IAC:fflnl·IECIMW.GE AFRJIUDEl!'TI£!10ti!CIS~ 11TIScsmRCAlE <FNSlJRl'HCEOOESNOT COHSlTl\llrA CONTRACTl!ElV&HTHEmJlt'l6 ~QERC5lAllllilH0RI RS'leENLIDlEOR ll~l)tEcamAOOi::tlOltllER IMPORTNff:W~CBGllc*~lsm~lt'SlJISJ,tllepolJ~mu,t~L.INS!:l9EDpu,t;bls«be~l'Sl&IOOlrnOlllS',IIAIVO), ~todleCl!rm5ncmdllansd1he~wtmpllfdesffllJ'req,Jfre·an~.i\~m1ill!!:m:t6:atechsootc:cnll,r,W-todleaniltn holderlrlllelJalsuchMdorsements.. PRODUCER cnmc:r --NA.SW RRG Plan Administrator !i\¥.:111£ t~ U2:1lll &tslt l@lem Y!!Tll,lf WC.tm&C' p.c!N:,-,. P~ia Heiglllt'S., IL ·6i6 n 5-534s ~ INSUllfRt5l/lFFOlllllNGcovmAGE NAIC# INSURED WSl.11:RA: ~w Ri~k 11.'et-eil'tron !Ginouµ, ~-Bbn Kristi L H uruii.:er INSLHRB: 903 S 34th Ave IHSl.llERC: ~.WA,9~2 rll!mlalik ~e lNSIMltR OJSTOMER ID: 3TDIS92C_JX CBmRCATE NUMBER: 645 45 654}00 RE'JlSION NUMBER: om ml, 1., TO f"_fITTFf lf~l THI:. A'l'JUCll:.5 Of W,t.Jll<A~I ltl.5:J:IL'J: BfJ,i}\\\l'tfAVF.. llffN l','ilJUJ TGlHIE.IN,!JnEDlftMFJJ·IJ'A"}:f:. F0/1\THE. rGUC¥~fJl'\if)ll), lli<UUll"~·\Jff.}. NOTMTHSli<NlllNG ANl"WEQ\.Ml1EMENl. TEl!M OH tlJNOOIOM O!'ntl COMAACf 00 OTHrn lllJOJMEN: W\'!1-1 H£5f'ECT lOWHltl!'i WI$ t1:l<flr-l(',>;1f P<!Al"lli ~"1.IHl OR MAY PERTAIN. THE IN9Jl,ANC'E AffiJ!li)Ell BY THE POUr.1ESDE':lc1m1n: HBIEIN ISSlllljECT TOAH THE TE ~. t5' EXC\J_ IJ, !UIC'.1. .t:.lftt"'!N:i:Of'SlX:H ?<Ji.K1E'i UMfTS •:;H:,l\l\1N IWIM of;;-/>/£ 'fit[trn :i/£QiciUJCo fliilf' 'PlillC!J t;Li,\Thif'i, ' INSR lWEOFffil.M!ANCE Alllll. 9Jll!I POUcYHLIIJIBER P[li(jQ'81f !Wll!ICY6P UMl15 llR I _, ~ --CDMLlmaALGataW. IJABl.llY :6~(H =UNijEf~f.j' $ ~ 1:DfJ!l.naaD• ~ lX l."t14' \ 'l' •• -!W l m;tliif\/ ;a;~'[\JUK:lE ru ~Bl\J TBll $ PFCM~1f5i1tf..i Orn1rri'!f"«j Cl.1.1~-lllA('IE [i]uctuFit 'MED B::f'I (Any OI~ j~'il.m.} $ -A ,!J'U -CLAIMS MADE y N G..<;51"-451 G'.,,.!j-flO (1711 !,f}t,· 1 o,, -f,i"}{i:,0 Pr.J{:..t"l-.!A.l. f..1-nYlt~Wty .$ r.A::~l!llAtl ALf.1Ht:~.ffif '1 '.5:'?.:L,l',l'UCJrlfL!i.lYI -Ef'lll-oct".I~ Pff.:tl)f01Jl'!'J''i-(JIJJ\4P"NJ~ KID, 'I. jj,l'\'l =<llf(;,trf ~l\dJlf Al'Plltc, l't7~ Sc 4"ntn D PI'-! .1m 0 1s,c Or.ial ~OM081l.ELIABIUTY ~-J:JIM1'3iNIEfJ• ':.1,l,1.1'5.l..k fJ.\t1.1 $ ~EJ • .n.'lf.:h!nll M v • !10 60C&::f l'{ll/1~ (~r~"ff'.>Jr; \ -r~6L1 Bw-.ro . ..m ~r,,,L" Aurn; IHUtl1JuY11Nll!IR"r]f'!er a,~,:;io!Jemt) ·.t -\ !O . I\ is:, ~~5.1.Al.Ft.'S >'il:GIU:'tu;.w.a: g, -r.f.tLf Ml'ilS.<Jf-i( ,I)• \cteclJ ~ cfr)C; ~ !c'AC~C<C:).!l'l!WQ $ -3'!:,8Rff.,;Uf t 1-- SIXE!li'Ule Wl).l !.-kvLIE ,t DE,,1 n ki:1.,111l)N j ~ ~OH J t'l:l'IS1J<:'c,TE JontE~ ~ BIR.OVSS-lfffllUiliY 'll/!11 ~·•=l'Jl;:I '\ IN ,~~ ' 1~,1,··~ D Ii<:/;\, 1m ~ -nt ff!Crill /,!!'';le;!< rt:L i':Jllir::1~".ii=-rcr1li<"JH: r::l\rJfj'li..fJ~IEf~ -;. D/lJ.,'fo.E" lr ;&e-,. .tr.do:> E[ lllt!'E=-PrJLr:nin,ll!T t , ~·0 1~'1.'>l.l'\ll!(U l .:toi,,.-r..-:u ;:r ll<,b,. I I " 'i.lOi~ J)f 01'iE.1¼1ION'i I ux:,-111ows; 1/E.HlGLU :'1 lm. ·Mro!:i;-;,;,;il '1fl!'T1"'1k.,~clnecidle, ,.,,,,,\he m:ac\h~d :n mrn e:,jra:" ·;,, .,,,q,lir l'd) CERTIACA TE HOLOl:R C/INCBJ.ATION DCYF SH00U>ANYOFTHE"80\'E'OESClll8ED POUOE5 8E 1661 Fowler St CNICEU.ED BEFORE THE e<PtAA.llOff DATElHBlEOF, NOTICE Richard WA 99352 WILL BE 00..MRfD ON ACCORl:WICl:WITH POU~ PltO\llslONS. 4-1.ITHOHilfD JJvPf!--P f/~-ATl'Vf:: @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and loco are ~stered marts of ACORD _____, ACORD• LlP I'€ tMM/11l\[l/'(/'!i<) L.---' CERTIFICATE OF LIABILllY INSURANCE 07/17/2019 llilSCERt'iRO((E!ilSISI.Ql6A~OF\tflR!lWililirn!I ~.I.Olli:UllltillfE~INOiiUam:l!l~lil!t!E~'IJElf~ lltt5ffi11111HO!lFlll1!ll!S.llll!l'IT ~Y al~lMLYM!all>,EXrBEOlltlll.llRl!llECIMll'AGENRlf,Wl-"lllUWCSISEI.DW:llttl5caumcATE<F~Nalr COKSJ'ITVT'E ACONllWTIEYtHMlHE~llll!il!lllERISAlJJJtOAIZEO~CRP!WfllllJfflVil>lHECl:Rl'lflCAlctiOUlEil l~Nff;lflhe~hakler-lsanM)()fOOW,l.~lhe~nu:st'-~fl'E!G9!)~ar~~lf~l5WAIVB>, 5Uljet:tto1heterm;aro ccndllJons cfltepolrq, ~emltJ.p:lloes:~an ~ASllte1lellt m11$m'llllcllte iflleslllltO)rJfB',WUtoOle;anlfGQ holderJn lleu ~sud, l!f daf:sl!I IW!I& PRODUCER CllNrACf !WE NASW RRG. Plari Aclmirri.strator ~ ~-UBO!Ea!.t G'lern Affi~.ie wi:ruii~ ~@ Heigflts, ll £i :&! 66348 I~ ltB.RM>~COVBWiE INSURED IHSUf/B!A: N'/li S-W lil!i£k li!.'etenliion 1Gino:1w Kristl L H..m:th '1'&lllB.l8; 903 S 34th ,\.','f! lla.R:R C \'a.!.Jrn-~. %'/, 9-)~'i , __ lllt \t!:5llFIER fl ™-'!UiB!Ft QJSTOMER ID: 3TD !S92CJX cmTIRCATE NUMBER: G--451' 45HGS4}-00 REVISION NUMBER: l[):m WIS 15-TCJ f..ERT~ Uli\1 THE n'tJIJr_ES OF 1...:s-u1<Ar«-:E mnr.:-FlfJJi).1\\1 H.1<\IF.. lt!ffl'. t,,UF.:f..> TiHHlt. IN,URFJJ W.Mlf.J[) Aik)\/1: fcft.THic ll'Glr.Y ~IEJRl\iJfLI IJNlilli:':.~Trn. NOTi"IITH"ilANIJING ANf HEQUf!EMENT. lEl!M OIH1JNOOlrn-. Of-Nl'i tlJNlAA.:_, 00 lTrtcEIWUOJ,WW wm-1 fl£5l'ECT 10 W.'1-iktl 1Hl5 nmlf-lCHE !JA:r"l:li tsSI.IEO Oft MAY PEIHA IN, THE IN.SlJ!U\Nlt AFH.1Rl.lEll BVTHE l'<JUOE5 OE50lf8flt !-IEP.IJ!Hi 51.J!llECT TO All lHE lEf!M"; 1:JKU~..llJNS I\N.l.!· OITPl'6 0/C '.it.K.li f':JlK.1E5' LIMIT<;; WlC!M11'1llJ c, ftl/\\>£ -,N Il[i)f0.Cfll)!l>1f ,·.,1[:o :Cl.,Thfl'i. A ,.......;_ LX, rcJMl~'l"illU ra'' L U, I - _ El'U -CJJ<IMS IIAAOE _ E~ilJ-O<Cl.lJI. [i]r.>r.~c'k ~:::~co ;.'1~:~11 D IS;C 7 or.-e IJif -o•,111H1BC1 _ ill!.ITOS(.M: I f®h/P;!:i -~lt.!.( 1£:, ~ro I' SP, r !~tra,1! lff'Kt'l/1,f:~>!!£' ~L:l;f..._ -lliyt!l.~ilu.,r.dln ~11 ~-~1'1Ftl m wfQil..•.itu-:s "'-oln Manne. lane! Medk'aU Ofli e, llC Ste 101 Kennewick WA 99336 y N w.' t.;,~M».f..tf TJj ~6l'llT8C..1 ~1utl.YJ'll""«J t .. I~~EfJ·illl ~_':-1J-\lH 0:J .IL1..iJ1trTf) SHOUlO NNOFTiiE NXlVED&RfBED POLIOES BE CANCEU.ED SEFOAE lHE Bll'!AATION Do\.lE lHEREOF, NOTICE WILL BE DE1.NERED ON ACCORDANcr ~ POllCY PnOVISIONS. iAl.ffHCRtlfD ~f?e-P ~\ ,,-ATNE \ @ 1S88-2015 ACORD CORPORM'ION. All rights reserved. ACORD 25 (2016/03} The ACORD name and la,o an! n1 glstered manes of ACORD NAie# 1-Bf,1_, ____, C'I' l1f (MWITTl!l'Nl'n! ACORU ~ CERTIFICATE OF LlABILllY INSURANCE 07/1711019 1lf:5 CERnflCAlE IS~ 15.AIMmll'OIFIO~W~dV Al\llil, ~NO llll i9!t13i\llllOIIIWIIEmmffllDIYiF.c.,~ 1ttlS cemsr02 lll01!5 NltlV ~YOR/'IEGAJMl.YAMeC>lEXJ6'DOSlM.1Blllm~AfFOl\tlS)ln(lltfEllUIOl:5.BROW.lllit5CBllilflCKl£CF~OOESNm CON5TTJUJEA CONTIW:f lEl'i\,ftJ,I THE ~NSnl~ RB'Rf59111'fiIL'IEOR~~ltlECElffiffCAlEHOitllE!l IMPORT"AHT:lflhraltlllciklldder"t!;an~l~1!Jie~ffU!l,_~,JN5Ue>-~crllle~ r!itlHl6A'IIOtllSWAMD, Slj)jetttDthetfflnsiflllc;ondillonsdfte~CA!!ltlffllp:Cdes:mey~an~~Gn1Ns~doesJld:an'!!r~IDtheartMIQie holder ... lieu ~such~ PRODUCER a:NDa HME; NASW RRG Plari Adminisrrator ,!!\-I~ " 2IDCl !Eas.t :Sfarn "et~ll'e ...-i:;~r:oit P.f;l)llia 1H1etw,ts, tl 61£! f>-Sl-18 l'IMIL -~MrolmlNG~ NAICI! INSURED INSUIBtA: N1+SiW '~i~k lillel"1>~ic,rr G1101JI] ·,ts,.,11 Kristi L Humike:r INSURfRB: 903 S 34th Ave INSUlBIC Y.ri\'im.a. ¥>i'. S'c3/J.? ~Ilk IHllJraE: ~P. CUSTOMER ID: 3TOI S92CJ)( CERTIRCATE NUMBER: G4514SHGS4j--OD REVISION NUMBER:: om Wl'i,IS TO ffJTTIFfl~T H,F.. WJIJfJE.5 OF l'<S!JRJ.W£ IJMF.fJ Bf_}J')Wif,1\,1/c. flffN MtJEfJ H;:1iH£.IN'511JfJ:fJJ '-li,\r.llW •1A'i'.fc fOfJ:Thil:. l"OlcJr.Vl!'fJR1i'Jl[J' INJrrlCATl'J}. NOHllTH5T/\NUIN.IJ ANYIIEQUIIIEMENl. lEHM rn; CONOOIUl-i Oe-1(.',i\' tlJNlAACI OR OTHER llOOJMHff wm-11-tESl'EfT lOWHll~ liHIS tl:ICT ~lE l',Hn,E t>;,IEIJ OR MAV PERTAIN. 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ACORD 25 {2016/D.3) The ACORD name and lofo ill'e re,fstered marks at ACORD .......----, ' ACORD• Oi': ff r .1-•,1 t1!l'Kf'r>1 ~ CERTIFICATE OF UABIUlY INSURANCE 07/17/1019 1HISCEEl1lflCA]l£1S IS9.IID JIEAIWill'TiR<lf'l l!l ~X1DllJ!IIIIDJ!l11J'JIMillOO$URB!ls.lNOl!IIQiJHJll51iUIP@lll!MmmETIDil!E'H!~Wffl!iaJ!i1!lfl!!XJ:i:'!DmSlll!IN ~lMLY OR NEG\lMLY Melt>, fXlENb OlltAl!.TERTtiE CIM'RAEEN'RRJID ll'fllltEPOUOl!!S'ISEUl'i't fflSCER!iflCA'JcCF~OOfS INlilf CON5TTIUJEA CDNIRACTBEJViH~ J.Ul'H(A2ED~AThE<RPIIOOll(alHll>"Jl'iecatlRCi'O"Et10Un IMPORIAHT:ltthe mtlllalte hdder"i!ian ~~lhe~nllil'-AOOl110W.INISl!IRED~ar-be ~lt~l5WM'9>, s.t,Jetttolhetfflnsnfanlllonsoflhepo/llq/,a.rlllr.,piicl5~~~an ~A~onWs;ar1l&a!e doesflflt ~111dltstodleanllbte holder11111euotsumei~ PRODUCER. a:,ma NAME: I ASW RRG Plan Administrator -c~ U:00 fast <Glen A\'e'lUl.e l«,1Hi,,&:$c P:eoria ~ll'igms, ll 61 :&U 6-S34 8 E6MIL ,.,_,,,,., NSURERISI An'OIIDl4G Ol'fflVoGE NAIC# jN'SiURED ffilJil:RA'. N~sw 11!:isk ~uenm:r01, !iil'o'Jl] 1-6M, Kristi L H umiker tHSUIBI B: 903 S 34th A\le INSUAERC: V.r.\fm"'I, WA 9JS!J2 INgire,IJlt ltl!5UIERE: ~F, OJSfOMER ID: 3TDIS91CJX CERTIRCATE NUMBER:: G-4-ST 45HIGS4}00 REVISION NUMBER: 1!11lll WI'> ts Tl'.l f_f_R'ftfV lHll,l WE. P\'"JU,Ji:S OF l'iS!J!t'-1-1<£. )J<,J,i'_JJ BFJ.1'111 Hl!,VE. ~.IN l,~LJIDTfJ: 1rllE IN51'JR!S'.'.' ~.MU> Mi/f)V[ rnR.rnE. 1mu:::>' ~itOOlf;('L/) 111-!KJ~':ATD. NDTWfiH'..tllNlllNG ANYHl:QUl!lfMENl. TflW Oil llJNOOIOII'< Uf-A;-t,· CUNTfW.."T OH CTi-lE!l llCC,.l!.tUtT Wfl'-H!E5PEl"T lOWHIOH U-lti(U!Il'KA1E !,IA'/ HE ta!Ell Oft lh\YPEflTAIN. THE IN',lJllANCE ~Hi.'llll)ELH\YTHE !'GUOESTE srn HH',£1t. IS'itll!{ffT TO All lHf lEwt-t_;; EX.G. " • AK, ~1Jf ::;f'YJ!\5l'f-:,,JO, i-'rXKlES: UMITS -StiiC!l\10\i 1'JV.\-R ,rv:\:JE tfi:::Ja ;kfiefl jCtJr.iJ ;f;lf :P1'vD c.L~1wr::. 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ACORD 25 (2016/43) The ACORD name and lop are ~lll!red marks of ACORD _____, IJ"1E11 ·aurif¥'1", ACORD ~ CERTIFICATE OF LIABILl1Y INSURANCE 07B0/201 9 lliSlfJ<OOtAtEISIISSlJEDl&AWJlfR~11ka:l!il'.MliHllM£1NllWlll!ilill<rollRJ511tD!l1!lll\HSUPCllll~Bl!ll!lilEl!l711111S CERTflOffE 00e5ii'IOI' ~ OIUEG\'llMI.Y ~eGEN[) OIAUERn£aMJV.6ENroK)ED BYlliE POUCIE5Bl:W#.11tfl5 CBltlROJEOF~IXSNCfO!lN51JTUTEll.~~llEIS!iUIM61HSUR!311Sl.MllltORUB)~OR - IIIPORTN«: IJh~~ll!.an~ ~ lhtpclk:j(l,e!i) m&lStbe~ t~ ISWAMD. d(m:l'Alill! tfflnsandcmclllcr51lfthepolcy, cetlh~mr/rtllllfrl~~Astitementon!JllsC!!llllcUdoesllOCCIJlffl'~tDtli,t, PRODUCER coma tw.e NASW RRG Plan Administrator !'l!l 'ICMt li:.-I 1.200 IE~ Gllem A\l'.ll'nli!te Wt:111,,,Ellt: p . Herghts., IL 61616-53148 E<WUl ~ UiSlJREll!S)~ CD'IERAGE WIIC# INS'U!!ED ~ 'l..'U..\P/ll(e,1(\Rt 11t•,l/11w 1(;,i(>tlIO 14?,!;,6 l<nsu l 1-luniJker lNSUIERB; 3204 5ummiruew Ave IIN'CI-C Va'r,I11.;, \ 9S002 1115Wl1191:llll ' lliSltlllfRE: \JISUl£R F! 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The ACORD name and logo are regisl:ered ma:r1<s of A.CORO THIS ENDORSEME T CHA GES THE POLICY. PLEASE READ IT CAREFULLY_ GENERAL PURPOSE ENDORSEMENT This endorsement modifies insurance provided under the following: This information is c ompleted ent , wnen this endorsemen is · ed preparation of the policy: POLICY CHANGES ARE INDICATED BY AN T: [X] Endorsecnent(s) is/ar e amended as s h own betow. seq el to The Additional Insured is hereby added solely for Damages arising out of a Professional Incident covered under this policy. The Professional Incident must arise out of services provided by the Insured, under contract with the Additional Insured. DCYF 1661 F01Ao4er St Richard , V*. 99352 All other terms and conditions of this Policy remain undlanged. This endorsement is part of your Policy and takes effect on the effective date of your polrcy , unless another effective. date is shown below. PL Policy: P-IND3TDIS9KVQX-02 Effective on and after: 0711612019 Issued to: Kristi L Hunziker Expiration: 03/08/2020 NASWRRG UE-00 1 7 /30/201 9 (~ptriQht) 2015 NASW Risk Retontion Group. Inc.; Al righlS reserved. By: Customer ID: 3TDIS92CJX GLPolicy:G--45T45HGS4J-OO Total Amount Paid: $16.10 Tony Benedetto, Authorized Representative 'INASW Insurance Company, RRG 7/30/2019 Kristi L Hunziker 3204 Summitview Ave Yakima WA 98902 NASWIUlti l'taddrnillirtnfDJ 1200 E. 61en Avmue Peoriil Hel(}bts, L61616-™8 RE: Professional Liability Insurance Policy Term: 07-16-2019 to ~08-2020 Customer ID:3TDIS92CJX QUOTEACCEPTANCEFORM This quote is for the endorsement request; Endorsement Type Premium PmfesstonaJ Liabi · Jnsarance: $16.10 Add Additional Insured . .. r lnsued Signature: ~-. L- Total Premium: $16.10 ----~------ Dale: I I T!tle: llcsvl Insured: Kristi L Hunziker Customer ID: 3TDIS92CJX Endorsement Date: 07-1&-2019 THIS IS YOUR INVOICE AND THE ONLY NOTICE YOU WILL RECEIVE PLEASE PAY THE TOTAL AMOUNT DUE FOR THE TOTAL PREMIUM INDICATED ABOVE Secretary Secretary Washington State Department of Health By the authority of RCWI 8 .155this person Kristi Lee Hunziker is granted a · ; Sex Offender Tr~atment Provider Certification Status ACTIVE Effective Date 07/18/2019 Initial Issuance 08/20/2018 Credential Number FC 60877516 Expiration Date 09/17/2020 Washington State Department of Health By the authority of Chapter 18.225 RCW this person Kristi Lee Hunziker is ,.granted_.a Social Worker Independent Clinical License Status ACTIVE Effective Date 07/18/2019 Initial Issuance 07/13/2013 Credential Number LW 60354465 Expiration Date 09/17/2020 .stareFa(m W ASlilNGTON INSURANC.E CARD STAIR.PARM State Farm Mutual Automobile Insurance Company INSURED HUNZIKER, KRISTI MUTL VOL PO't.lCY NUMBER 404 0049-F15-47 EFFECTIVE JUN152019 Til DEC152019 VIN JfDKARFUOH3042537 YR 2017 MAKE TOYOTA MODEL PRIUS AGENT ERIC SILVERS PHONE (509)453-8286 NAIC 25178 2632-BA1 A BC:lOILY IN. JURY/PfOPERTY DAMAGE LIABIUTY P1 PERSONAL INJU"Y PROTECTION D 500 OEDl,!CT COMPREHENSIVE G 500 DEDUCT COLLISION U, U1 SEE REVERSE SIDE FDR ADDITIDNALCll\'EIIAGE INFORMATION ~ ''\