HomeMy WebLinkAboutCrime Stoppers Special Event AppY.A,KIMA C()T'NTY
January 21,2022
Kittitas County Commissioners
205 W. sth sulte 108
Ellensburg, WA 98926
Mark Peterson
Presideng Yakima County Crlme Stoppers
$aer728432e
RECEIVED
JAN 2 8 2n2
KITTfTAS GOUI{TY
BOARD OF COtUtSSlOllERl
RE: Yakima County Crime Stoppers "Your Canyon for a Day" May 22,2O22
Dear Sirs:
ln preparation for our annual Blke Tour on May 22,2022 we have sent the following for your review and
approval.
r Event Application
r An attachment to the Event Appllcationr Certificate of lnsurance from State Farm naming Kittitas County, Yakima County, Washlngton
state Patrol, BLM, WSDOT and Federal Government as additional insured or certificate holders.. Application for exemption from permit.
o $200.00 Administration fee.+* UJ il I ma.{ ,
We are agaln requesting a waiver of the $5,000.00 cash or bond provlsions of KCC 5.2.100. This is the
16th annual ride in the Yakima River Canyon. We are confident that we have sufficient safe guards and
precautions in place, including many members of various law enforcement agencies to mitlgate any
risks.
Thank you once again for your time and consideration of our application.
srncerery*qh
Kittitas County, Washinglon
BOARD oF COLINTY COMMISSIONERS
E\IENT APPLICATION PROCESS
1. Submit a completed EventApplication and materials to the Kittitas County
Commissioners Office at least 6o days prior to the event. There are several
departments who reviewthe EventApplications and make their determination based
upon the application, written plans and documentation that has been provided. Please
note that additional permits may be required in addition from individual departments
including: the Fire Marshal, Public Health, Environmental Health, Community
Development Services, and the Public Works Department. A $zoo,oo permit fee is to be
submitted at the time of application for each event. Applications will not be processed
until the permit fee has been received.
2. Once a special event has been approved by the County Commissioners, the site and
facilities may need to be inspected by County officials (including but not be limited to the
Fire Marshal, Sheriffs Department, and Public Health Deparlment) up to five days in
advance pnol to opening to the general public. This is to ensure that you are complying
with the stated plans upon which the approval was made. If you fail to comply with those
requirernents, your permit maybe revoked and the event closed.
3. Depending upon the nature and scope of the proposed event, other permits may be
required as determined through the application process (liquor license, etc.). Some
events may require approval from other agencies or jurisdictions.
4. Permittee covenants and agrees to indemnify, defend and hold harmless the County, its
officers, agents and employees from any and all claims actions, damages, liability, cost
and expense, including reasonable attorney fees in connection with or occasioned, in
whole or in part by any act or omission of Permittee, its officers, agents, employees,
customers or licenses, or arising from or out of Permittee's failure to comply with any
provision of the Event Permit granted as a result of this application, regardless of
whether it is alleged or proven that the acts or omissions of the County, its officers,
agents or ernployees caused or contributed hereto.
5. Insurance Requirement: A Certificate of Insurance antl endorsements specifically
naming "Kittitas County' as an additional insured in the minimum amount of
$1,ooo,ooo.oo per occurrence and a$z,ooo,ooo.oo aggregate coverage must be
included with the Event Application. This insurance must apply first and on a primary
non-contributiag basis in relation to any other insurance or self-insurance available to
Kittitas County. The County Prosecutor's office may require a greater amount if it is
determined to be necessary for the proposed event.
6. Written statements signed by the applicant and properry owner allowing permission to
enter the event site for inspections and stating responsibihf for the event and
compliance with the codes is required as part of the written documentation to be
submitted at the time of application.
7. Before applfng for an event it is encouraged that you schedule a time to meet with
County departments so they may assist with questions you may have prior to submitting
your application.
KtrrrrAs couNTy couRTHousE' 2{r5 wEsr J,r', sutrE t08 ELLENSBURc, wA 9f926
(i09) 962-7508 FAX t509) 962-76?9
www.co,kittiisa.wa.us
Kittitas Countv Contact Information
www. co.kittitas.wa.us
Board of County Commissioners - (Sog) g6z-75o8
Community Development Senices - (Sog) 96e-79a6
Environmental Health - (Sog) g6z-7oas
Fire Marshal - (Sog) 962-7oao
Prosecutor - (Sog) 962-7gzo
Public Health - (Sog) g6z-Zlrs
Public Works Departrnent - (So9) 96z-7gz9 Sheriffs
Office - (Sog) g6z-Z1zs
SolidWaste Department - (Sop) 96z-Z54z
KtrrrrAscouNTVcouRTHousE. 20iwEsr5e, surE tog ELLENSBURG,wA98926
(509) 962-?508 FAX {50e) e6z-?67e
www,co,kitdtas.wr.ur
Admissions Tax
Kittitas County Ordinance 201 6-003
Ordinance amending Ch322 Kittitas County Code to impose an Admissions Tax
"Admissions chargc," in addition to its usual and r:rdinary rneaning includss but shall not bc
limited to a charge for parlicipation in an evcnt or activity; a charge made t'or $cason tickets or
subscriptions, or a charge made for use of seats and tables, reserved or otherwise, and olher
similar accotnmodations; and a charge rnade for reltal or use of equipmei:t or facilities for
purpose of recreation or amusement, and where the rental of the equipment or facilities is
.necessaly lo the enjoyment of the privilege for which a general admission is ehargcd, the
combined charges shall be considered as an admission charge. A donation for admittance
shall also be deemed au admission charge. Admission charge includes any money paid
wifhin or without of Kittitas County fbr any of the kinds of admission charges defined hcrein so
long as the fhcilitics, entertainment, reoreation or alnusernent privilege derived fi'on such
admission charge occurs in Kittitas County.
The tax inrposed shall bs collccted at tirc tinre adnrission charge is paid by thc person seeking
admission to any place and shall be repofted and remitted by the person teceiving the tax to
the Treasurer in quarterly installments on or before the last day of the month next succeeding
the end of the quarterly period in which Lhe llx is collected or received.
Any person conducting or operating any activity fbr which an adr:rission charge is made
shall register with the Auditor.
ln order to complete the registration process, you will need to register online.
Any questions, please contact the Treasurer's office at 509-962-7535; Auditor's office at 509-
962-7 502 or enrail at admissionstax@co.kittitas.wa.us.
Kittitas County, Washington
BOARD or COIINTY COMMISSIONERS
EVEIVT APPLICATION
Thank you for your interest in holding a special event in Kittitas County. Please
complete and return this application along with any other materials to the Kittitas
County Board of Commissioners at leaet 50 daye prior to the day upon the event is
scheduled. Any misrepresentation in the application materials or deviation from the
final agreed upon route and/or method of operation described may result in the
immediate revocation of an issued permit. Specifics outlining Event Permits can be
viewed at http:/ /www.co.kittitas.wa.us/boc/countycode/ title0S.asp
Event Information
Name of event: Your Canvon for a Day Bike Tour
Date(s)of event: Mav 22. 2A22
Hours of
Description of ihe ev ent: Familv bicvcle ride th Yakima River
Canvon
Has this event taken place before? t(t No Dates: 2005-2019
Estimated 650 incl volunteers
How is your event being publicized?Bike shops, email. our website
Please altach any flyers, poste?s, etc, zuith your application srbuissiott
Contact Information
Name of the organlzetfcontact person: Yakima County Crime Stopners - Me
Address: PO Box 1 1056 Yakima. WA 98909
Phone number(s) : $0917 284329
Email address:hhfumiture4tOaol-com
Date of birth of applican* 5/3/1960
KTTITAS coUNTY coURTHoUSE ' 205 wEsT $ , SUITE IO8 ELLENSBURC, wA 98926
(509) e62-?508 FAX (509) 962-?619
*rvw.co.kilriras,wa,us
If the application is made on behalf of a partnership, please submit full names with their
residence and post office address for a period of six months prior to the date of
application together with the location of principal office or place of business o{ such
corporation"
Emergency contact name(s) and phone number(s) that can be contacted during the
event:
Mark Peterson (509)7284327
Name
Alinia Sfrnm Tobin
Name Phone Number
WRITTEN PERMISSION TO ENTER EVENT SITE
l/We hereby permit law en{orcement and/or Counfy officials to enter the site for which
the Event Application has been granted at the time of the event and up to five days
prior to the event for the purposes of inspecting and enforcement of County Code and
other applicable laws, and pursuant to my agreement and representations made in
connection with this Event Application.
SWORN STATEMENT OF COMPLIANCE
l/We hereby acknowledge that llWe have read Kittitas County Code, have
familiarized myself with County requirements, I/We agree that either my designated
agent or Irlwe shall be on site at all times and shall be responsible for the operation of
the event and for compliance with all legal requirements in connection with this event
l/We understand that failure to comply with the rules, regulations and conditions set
Phone Number
f509)969-8683
forth in Code may be deemed a gro6s
violations are crimes under RCW.
//"-* &rson
ApplicantName (Print)
Applicant Name (Print)
and or narcotics
Signature
KrrnrAs couN"y couRTHousE . 20s wEsr S, surrt tog EurNsBURc. wA 98926
(509) 962-7508 FAX (509) 962-767e
www.oo,kiltiras,wa.us
Kittitas Counfy, Washington
BOARD or COUNTY COMMISSIONERS
Fire Safetv and Protection
If more than 50 people are expected at your event, you must complete a separate
applicafion process which can be obtained through the Kittitas County Fire Marshal's
office. You may contact the Fire Marshal's office at 509-952-7000.
Will there be a temporary structure erected for the event? Yes v6
If yes, you must attach a drawing including the dimen-qions. The structure may
require an inspection by County staff prior to the event.
Public Health/Invironmental Health
Will there be food served at the event? Yes LId
If no food will be served at the event then, no permit or application is required,
If yes, is the food and beverage that you intend on preparing and serving at the event
exempt from permit requirements ht4:r:/,/www.co.kittitas.wa.us/health/food.asp?
- If yes, please submit an applicatilanlglexglqptian from permit and proof of food
handlers training to the Kittitas County Public Health Department (KCPHD).
If yes, and the food or beverage is not considered exempt from permit, then does the
person or organization preparing and serving the food have a food service permit,
temporary food service permit, or catering permit from KCPHD?
- If yes, please provide a list of foods and beverages that you intend on having
prepared and served at the event along with the name and phone number(s) of
the permitted person or organization.
If yes, and the person or organization preparing and serving the food does not already
have a food service permit.
- Then a temporary food service permit or catering permit will need to be acquired
from KCPHD prior to the event.
Please allow at least 2 weeks to complete the food seffice pennifting process.
KITTI?AS coUNTY coURTHoUsg . 205 wEsT 9', SUITE IOS ELT^ENSBURC, wA 98926
(509) 962-7508 FAX (509) 962-761e
www,co,kitrius,rrra.ur
Are there perman€nt or fixed bathroom facilitiee already available at the location of
the event?
Yes )td
ff yes, please provide an estimated attendance for the event, a detailed map that
identifies the name and address of the physical facility that will provide lavatory
facilifes for the event, quantity of toilette facilities available for each gender, and the
distance from the event that patrons must walk.
If no, please provide an estimated attendance for the event, specific information
related to the number of portable restrooms that will be provided, the distance from
the event that patrons must walk, and a service plan to ensure that sani-cans remain in
a sanitary condition. You must include the location of the portable restrooms on a
map/diagram of the event.
KtfrITAs couNTy couRTHousE . :0s wEsr f' . sulrn l0g ELtsNsBURo, wA 98926
(509) 962-?s08 FAX (509) e62-76?9
www'co.kitdtas.wa.us
Kittitas County, Washington
BOARD on COUNTY COMMISSIONERS
Law Enf orc emenVS ecurity/'Emergency M e dic al Seruic es
Will there be security on site during the event? Yes J6
If yes, please provide a complete list of names and contact information for who will be
providing the security.
Will Emergency Medical Services (EMS) be on site during the event? t/s No
If yes, please provide written verification from the providers.
WilI there be music, sound amplification or any other noise impacte? Yes yd
If yes, Kittitas County has a noise ordinance in effect (see County Code for details). If
you.r event is scheduled for outside oJ the allowed time, you must submit a written
letter to the Board of County Commissioners requesting a waiver and it must be
included with your application materials,
Will you have traffic conhol? gt No
If yes, please provide documentation on how the traffic control will be addressed.
Will there be off-site parking? V, No
If yes, please provide the location and a parking plan.
Will there be ehuttle buses provided for attendeeg? Yes fid
lf yes, provide a map of their route,
Will there be alcohol served at the event? Yes V
If yes, a State permit is required from the WA State Liquor Control Board and must
submitted with your application materials,
KITTITASCOUNTY coURTHoUsE, 2O5wEsT9, SUITE IO8 ELLENSBURG,wA98925
(50e) 962-7508 FAX (50e) 962-'1619
wrpw,co, kitqius,wa,us
Kittitas Ccunty, Washington
BOARD or COUNTY COMMISSIONERS
Public Roads
Will the event obstruct, interfere or require the cloeure and fiee uee of any public
road, street or right-of-way? (s No
lf yes, please provide a detailed adequate traffic and detour plans at the time of
submission of the application.
Will there need to be road closure or detour signs poeted? V, No
KTTTITAS couNTY coURTHoUsg . 205 wEsT S, sUrTE IO8 ELI,ENSBURG, wA 9E926
(50e) e62-?s08 FAx {soe) e62-76?9
www.co, kiltitss.wa"ur
Kittitas County, Washington
BOARD or CO{JNTY COMMISSIONERS
Garbage/Recycling
Do you have a plan for garbage and recycling? #" No
A written plan for garbage and recycling must be attached to your application
materials. For questions or assistance contact the Kittitas County Solid Waste
Department at 509-96 2-7 542.
Insurance
Have you obtained a Certificate of lnsurance and endorsements, specifically
naming "Kittitas Count5r" as an inaured? V No
A copy of the Certificate of Insurance amd endorsements must be included with your
application materials. Kittitas County rnust be named as an additional insuyed in the
amount of $1,000,000.00 per occturence and $?000,000.00 aggregate coverage. This
insurance must apply fir-st and on a primary non-contributih"g bEsis in relation to any
other insurance or self-insurance available to Kittitas County.
Penal Bond - Bond of Indemnity
A $5,000.00 Penal Bond - Bond of Indemnity is required to be deposited with the
County Treasurer to save and protect the etreets, pavements, bridgee, etc. from
damage. The deposit or its balance will be rehrrned once the event has been held and
the Board of County Commission€rs has certified no damage has been done and that
the County has not incuned additional expences
Are you submitting a $5,000.00 Penal Bond - Bond of Indemnity with your EventApplication? Yes lt6
If no, you must request a letter in writing to the Board of County Commiseioners
requesting a waiver to the Penal Bond - Bond of Indemnify and outline the specific
reasons why it should not be required of your event.
CountJr Filings and Registration
Is there a cost to attend the event? V No
Hort much are you charging to attend your event? $60 Single ride
KITTITAS couNTy couRTttousE . 205 wEsr 9, sutrc 108 ELLB.isBuRc, wA 98926
(s0e) 962-7s08 FAX {50e) e62-?6?9
www.co.kitriras.wa-uf
Supplement to Questions:
This is the 15e year we have held the event (typically the 3d Sunday in May annualty).
We rent portable toilets from the same vendor every year: Valley Septic. They provide
drop offand pick up services of their equipment. Washington State Patrol, Yakima
Police Department, The Blue Knights, YC Rangers, and the Yakima Sheriffs Office all
provide voluntary pafol services and traffic confol. We also provide emergency
services through EMS, as well as HAMM Radio operators due to limited cell coverage in
the canyon. We have Valley Cycle on site for bicycle repairs, as well as Recycle Bicycle
from Ellensbwg. All road closure signs and barricades are provided by Yakima County
Crime Stoppers. We used to rent these services but purchased our own three years ago.
Attachment
To
Special Use Evont Application
For Event on May 22,2422
RE: Your Canyou for a Day Bike Tour
Yakima County Crime Stoppers, Inc,
DESCRIPTION OF ACTIVITY AND EVENT AT THE YAKIMA CANYON MAY 22,20228Y THE
YAKIMA COT'NTY CRIME STOPPERS' UYOUR CANYON FOR A DAY BIKE TOUR"
The Yakirna County Crime Stoppers' "Your Canyon for a Day Bike Tour" is a trn ride designed for the
whole family to enjoy the Yakima Canyon without any through traffic. This is Yakima County Crime
Stoppers' only firnd raiser with the ftnds to be used for rewards paid out to tipsters who are ins8umental
in the apprehension of fclons. This will be the tenth year we have sponsored the bicycle tour in the
Yakima Canyon. We had approximately 1,000 riders last year with over 50o/o of thern starting the ride at
the Yakima River RV Park in Ellensburg. The majority of our riders come from the Westside of
Washington.
We will be using the Roza Recreation site and the Yakima River RV Park as our st4ging areas for the
bicycle ride. The riders will leave from the Roza site or the RV Park and tavel norfh or south on SR 821
then turn around at Thrall Road or the Roza site and rerum the their staging site. The RV Park and the
Roza site will mainly be ussd for participants to park and unload/load their bicyoles. In the NE corner of
the Roza parking lot we will also be selling concessions as we have done in years past. Coca-Cola may
be providing a small tailer which will be at the concession site to dispense soft drinks with all profits
going to the Yakinra County Crime Stoppers. Even though we have worked with the Department of
Transportation to close SR821 to through vehicle traffic, we understand there will be others using the
crmyon and we will be sharing the facilities at the Roza Site with them.
We will be providing the following:
l. Portable toilets (8 total)
Two at the Roza site (bottr with hand sanitization equipment and one for handicapped access).
One at Big Rock rest site.
One at Umtanum./Big pines rest site.
Two at Thrall Road site (both with hand sanitization equipment and one for handicapped access).
Two at Yakima RV Park.
t
2. Traffc Confol - we will have 8 officers
2 Yakirna Police Officers and 2 Yakima County Sheriff Deputies pafolling the canyon during the
ride.
2 Yakima County SheriffDeputies on duty at each banicade on boflr ends of the canyon. 2 at
Thrall road on the Ellensburg side and tveo at the Firing Center €nbanco of the canyon.
As in previous years, persons doing raffic contol will allow access to residences, people fishing, hikers,
campers and other recreationalists attempting to access the area.
3. Road closure signs will be posted 48 hours before the ride at each end of the canyon and during the
ride.
All residents will be notified five days before the ride and given a pass they can show the day of
the ride.
All campers will be notified the day before the ride ofthe 25 mile an hour speed limit in the
canyon during the ride (Red's Fly Shop will also be notified),
25 mile an hour speed signs will be posted in &e canyon during the ride.
4. Emergency medical pasonal tom ALS Ambulance will be posted during the ride in the canyon.
5. Garbage and Recycling
At each rsst stop we will have garbage and recycling cans. At the end of &e ride we will carry all
garbage and recycling out of the canyon to H&H Furniture, owned by Mark Peterson, Yakima County
Crime Stoppers Board President/lr4ember. Recycled items will be transport€d to Michaelson's Packaging
next to H&H Furniture. We will have 5 rest sites with the garbage and recycling cans.
6. AU food given out at the rest sites will be prepackaged granola bars, sport &inks, and water. At the
Roza site Coca-Cola may be providing a small trailer to disponse soft drinks with all profits going to the
Yakima Coung Crime Stoppers.
Should you have any questions further information, please feel free to contact me.
Thank you,
Mark Peterson
President, Yakima County Crime Stoppers
Cell: (509)7284329
2
CERTIFICATE OF LIABILITY INSURANCE oArE {ut/DD/YYYn
01t27t2022
THIS CERTIFICATE IS ISSUED AS A fUATTER OF II{FORII'ATION ONLY AND CONFERS TIO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERNFrcATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AIIEND, EXTEND OR ALTER THE COVERAGE AFFORDFO BY THE POLICIES
BELOW. tHls CERTIFICATE OF INSURANCE DOES tlOT CoNSTITUTE A CoNtRAcT BEnVEEII THE lSsUlNc INSURER{S), AUTHoRTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLOER.
IiIPORTANT: ll thc csrtlliccte holder ia an ADDITIONAL lltlSURED, the policy{iesl murt have ADDflONAL INSURED piovisioru or be endorse{
lf SUFROCATION tS WAIVED, subJect lo the terms rnd conditlons of lhe pollcy, certaln pollclss may roqulro an gndortement, A rtNtamont onthb cerliflcate doos noi confer dnhts to the m;tiffsla hnldor in lieu of such endorsamonl(s).
FRODUCER
StateFarm BRUCE H SEARS
105 S 1ST STREET
SELAH, WA 98942&,
ISAEEL MUNGUIA
lss.*f,' =,u,
509.is7,4900 50s.697.93S4
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IISURERI8) AFFORD'HG COVERAOE NAIC J
Ifi3uRER A : Slate Farm Flre and Cesualty Company 25143
lilst.tnED
CRIME STOPFERS OF YAKIMA COUNry NC
PO BOX 1{056
YAKIMA. WA 9890S
tNsuRER E: Slate Fsrm Mutual Automobile lnsurance Company 25178
lx8uR€R C :
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INSUREN F :
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TYPE OF I'ISURAIICE
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GENI AGGREGA|E LIMIT APPLIES
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BOOILY INJURY (P€rperoon)$
SODILY lNJLlRY (Ptr s6idcnt)t
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AUTOTIOSILE LI,ABLTY
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OFOPERAI|ON8ttOcATloNS,VEHELEt {Acofr,o10t,ArtdldonslRin.tto8ehcdul.,rhrybidtlititdltmorcipN6lrr.qutr.dl
LOCATION: 128 N zND ST, YAKIMA, WA 99901
YOUR CANNYON FOR A DAY RIDE
ADDIT,ONAL INSURED - CERTIFICATE HOLOER: KITTITAS COUNTY, WASHINGTON STATE PATROL, DEPT OF TRANSPoRTATIoN, BUREAU oFLAND MANAGEMENT, US GOVERNM€NT AND "The Unlted Slales Dopartmenl of th€ lnterior-BlM is additionatly insured."
OESCRIPTION
SHOULO AIgY OF T}IE ABOVE OESCRIBED POLICIES BE CAilCELLED BEFORETHE EXPIRATIOI{ DATE TI{EREOF, ]IIO'ICE WLL BE DELNERED IN
ACCORDANCE WITH THE POUCY PROVISION8.KITTITAS COUNry
205 W sTH, STE 't08
ELLENSBURG, WA 98926
I
AUTHO$zGD REPNESEI{TATIVE
o 1088-2015 ACORD
The ACORD namo and logo are roglst€red marke of ACORD
All righfs raserved.ACORD 25 (20t6103)
t001r€6 1328d9..t2 0&16.2016
STATE FARM FIRE AND CASUALTY COMPANY
A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGIOM /LIINOIS RENEWAL DECLARATIONS
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R?"8 3 ia€*i! ?* rco 8 s-3 s 2 s
Named lnsured
AT2 M-15-2689-FBA1 F N002200 312s
CRIME STOPPERS OF
YAKTMA COUNTY TNC
PO BOX 11056
YAKIMA WA 98909_2056
"';l',;rrlrlrrlll;lll'lltlll'lllil'ltl'l'il'll'tlllllllllll"'ll
Businessowners Policy
Policy l{umber 98-BJ-G478-3
Policv Petiod Elfsctive Dale Exoiration Date
12 Mbnths JIJL1 2021 JLJLl 2022
The polipy period begins and ends at 1 2:01 am standard[me alme premtses tocallon.
Agent and Mailing Address
BRUCE SEARS CLU
PO BOX 569
SELAH WA 98942_0669
PHONE: (509) 697-49009+
Automalic-Renewal - lf dre policy period is shown as 12 months , fiis policy will be renewed automatically subiectto tre premiums, rules and
forms in effect for each succeeding policy period. lf tris policy is terminated, we will give you and tre Mortgagee/Lienholder written notice in
comoliance witr tre policv orovisions or as reouired bv law.
Entity: Corporation
NOTICE: lnformation concerning changes in your policy language is included. Please call your agent
if you have any questions.
POLICY PREMIUM
Minimum Premium
Discounts Applied:
Renewal Year
Years in Business
Sprinkler
Claim Record
$ 440.00
Prepared
MAY 07 2021
cMP-4000
013008 294 I
N
@ Copyright State Farm Mutual Automobile lnsurance Company,2008
lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
Continued on Reverse Side of Page Page 1 of 7
530-686 s.2 05'31'20t1 {olf3231c)
M 13008
RENEWAL DECLARATTONS (CONTTNUED)
Businessowners Pol
Policy Number
icv for CRIME STOPPERS OF
38-BJ-c47s-3
SECTION I - PROPERry SCHEDULE
Location
Number Location of
Described
Premises
Limit of lnsurance*
Coveraoe A -
Buildinss
Limit of lnsurance*
Coveraoe B -
Business Fersonal
Property
Seasonal
lncrease-
Business
PersonalPropefi
001 128 N 2ND ST
YAKTMAWA 98901-2639
No Coverage $ 12,600 25y"
*As this the Limit of lnsurance as
SECTION I .INFLATION COVERAGE INDEX{ESI
any to
Cov A - lnflation Coverage lndex:
Cov B - Consumer Price lndex:
SECTION I. DFD1IETIRI FS
N/A
264.9 n
Basic Deductible
Special Deductibles:
Money and Securities
$5oo
$250 Equipment Breakdown $5oo
Other deductibles may apply - refer to policy.
Prepared
MAY 07 2021
cMP-4000
013008
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lncludes copyrighted material of lnsurance Services 0ffice, lnc., with its permission.
Continued on Next Page Page 2of 7
M 13008
RENEWAL DECLARATTONS (CONT|N UED)
Businessowners
Policy Number
Policv for CRIME STOPPERS
98-BJ-G478.3
OF
ffi
SECTION I - EXTENSIONS OF COVERAGE - I IMIT OF E - EACH DESCRIBED PREMISES
5
i The coverages and corresponding limits shown below apply separately to each described premises shown in these
I Declarations, unless indicated by "See Schedule." lf a coveragC does hot have a corrosponding limit shown below,F but has "lncluded" indicated, please refer to that po licy provision for an explanation of that coverage.
COVERAGE
Accounts Receivable
On Premises
Off Premises
Arson Reward
Collapse
Damage To Non-Owned Buildings From Theft, Burglary Or Robbery
Debris Removal
Equipment Breakdown
Fire Department Service Charge
Fire Extinguisher Systems Recharge Expense
Forgery OrAlteration
Glass Expenses
lncreased Cost Of Construction And Demolition Costs (applies only when buildings are
insured on a replacement cost basis)
Money And Securities (Off Premises)
MoneyAnd Securities (On Premises)
Money Orders And Counterfeit Money
Newly Acquired Business Personal Property (applies only if this policy provides
Coverage B - Business Personal Propefi)
Newly Acquired Or Constructed Buildings (applies only if this policy provides
Coverage A - Buildings)
LIMIT OF
!NSURANCE
$1o,ooo
$5,ooo
$5,ooo
lncluded
Coverage B Limit
257o of covered loss
lncluded
$2,soo
$s,ooo
$ 1 o,ooo
lncluded
1Oya
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MAY 07 2021
cMP-4000
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Continued on Reverse Side of Page
$2,000
$5,000
$1 ,ooo
$ t oo,ooo
$2so,ooo
Page 3 of 7
RENEWAL DECLARATTONS (CONTTN UED)
t\'' 13008
lncluded
$s,ooo
$2,soo
$15,ooo
$1 o,ooo
30 Days
$2,soo
$2,500
$1o,ooo
$5,ooo
lncluded
Businessowners
Policy Number
Policv for CRIME STOP
98-BJ-G478-3
PERS OF
Ordinance Or Law - Equipment Coverage
Outdoor Property
Personal Effects (applies only to those premises provided Coverage B - Business
Personal Property)
Personal Property Off Premises
Pollutant Clean Up And Removal
Preservation Of Property
Property Of Others (applies only to those premises provided Coverage B - Business
Personal Property)
Signs
Valuable Papers And Records
On Premises
Off Premises
Water Damage, Other Liquids, Powder Or Molten Material Damage
q
\
SFI:TIr|N I - FYTFNSINNq .lF COVERAGF .I IMIT OF INSIIRANCF. PFR PrlI I|1Y
The coverages and corresponding limits shown below are the most we will pay regardless of the number of
described premises shown in these Declarations.
COVERAGE
Loss Of lncome And Extra Expense
LIMIT OF
INSURANCE
Actual Loss Sustained - 12 Months
COVERAGE
Coverage L - Business Liability
LIMIT OF
INSURANCE
$2,ooo,ooo
Prepared
MAY 07 2021
cMP-4000
013009
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lncludescopyrightedmaterialoflnsuranceServices Office,lnc.,withitspermission.
Continued on Next Page Page 4ot 7
H+$iH_i::
Businessowners Policv for CRIME STOPPERS OF
Policy Number 38-8J.c478-3
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
Each paid claim for Liability Coverage
annual period. Please refer to Section
RENEWAL DECLARATTONS (CONTTNUED)
reduces the amount of insurance
ll - Liability in the Coverage Form
we provide during the applicable
and any attached endorsements.
M 13008
$5,ooo
$3oo,ooo
LIMIT OF
INSURANCE
$4,ooo,ooo
$4,ooo,ooo
a
?F
Your policy consisls of these Declarations, the BUSINESSOWNERS COVERAGE FORM shown below, and any other
forms and endorsements that apply, including those shown below as well as those issued subsequent to the
issuance of this policy.
FORMS AND ENDORSEMENTS
cMP-4102
FE-6999.3
cMP-4804
cMP-4247.1
cMP-4705.2
cMP-4709
cMP-4788
cMP-4791
cMP-4779
cMP-4860
FE-3650
cMP-4572
cMP-4561.1
FD-6007
Businessowners Coverage Form*Terrorism lnsurance Cov Notice
Addl lnsd Club Members
Amendatory Endorsement
Loss of lncome & Extra Expnse
Money and Securities
Addl lnsd Mgrs Lessor of Prem
Addl lnsd State Political Perm
Employers Liability
Al Design Person Org
Actual Cash Value Endorsement
Amendment of Premium Cond
Policy Endorsement
lnland Marine Attach Dec
* New Form Attached
Prepared
MAY 07 2021
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013010 294
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Continued on Reverse Side of Page Page 5 of 7
M 13008
RENEWAL DECLARATIONS (CONTINUED)
Businessowners Policy for CRIME STOPPERS OF
Policy Number 98-BJ-c478-3
S|iHFDIII F rlF ANNITI'1NAI NTFRFSTS
lnterest Type: Addl lnsured-Section ll
Endorsement#: CMP4791
Loan Number: N/A
KITTITAS COUNTY
205 W sTH AVE STE 108
ELLENSBURGWA 989262887
lnterest Type: Addl lnsured-Section ll
Endorsement #: CMP4860
Loan Number: N/A
YAKIMA COUNTY
COUNry COMMISSIONERS
PO BOX 12570YAKIMAWA 989092570
lnterest Type: Addl lnsured-Section ll
Endorsement #: CMP478B
Loan Number: N/A
WASH I NGTON STATE PATROL
DEPT OF TRANSPORTATION
BUREAU OF LAND MANAGEMENT
US GOVERNMENT
205 W sTH AVE STE 108
ELLENSBURG WA 989262887
\t
This policy is issued by the State Farm Fire and Casualty Company.
Participating Policy
You are entitled to participate in a distribution of the earnings of the company as determined by our Board of Directors in
accordance with lhe Company's Articles of lncorporation, as amended.
ln Witness W!ereo!, the State Farm Fire and Casualty Company has caused this policy lo be signed by its President and
Secretary at Bloomington, lllinois.W"Y"Y ,{,f
Prepared
MAY 07 2021
cMP-4000
01 301 0
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lncludes copyrighted material of lnsurance Seruices office, lnc., with its permission.
Continued on Next Page Page 6 of 7
M 13008
RENEWAL DECLARATTONS (CONTINUED)
Businessowners Policy for GRIME STOPPERS OFPolicy Number 98.8J-c478-3
HE
I
F
9
NOTICE TO POLICYHOLDER:
For a comprehensive description of coverages and forms, please reler lo your policy.
Policy changes requested before the "Date Prepared", which appear on lhis notice, are effeclive on the Renewal Date
of this policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage
forms attached to this notice are also elfective on the Benewal Date of this policy.
Policy changes requested after the "Date Prepared" will be sent to you as an amended declarations or as an
endorsement io your policy. Billing for any additional premium for such changes will be mailed at a later date.
lf, during the past year, you've acquired any valuable property items, made any improvements to insured property,
or have any questions about your insurance coverage, contabt your State Farm ajent.
Please keep this with your policy.
Your coverage amount....
It is up to_ you to choose the coverage and limits that meet your needs. We recommend lhat you purchase a coverage limit
equal to. the estimated replacement co$t of your structure. Replacement cost estimates are av{labl6 from building coniiactors
and replacement cost-appraisers, or, your agent can provide an estimate from Xactware, lnc.@using information-you provide
about your structure.We can accept the type of estimate you choose as long as it provides a reasonable level of betail about
your structure. State Farm-does notguarantee that any estimate will be the actual luture cost to rebuild your structure. Higher
limits are. available at higher premiums. Lower limits are also available, as long as the amount of
-coverage meets-our
underuriting requirements. We encourage you to periodically review your coveragei and limits with your agent and to notify us
of any changes or additions to your structure.
Prepared
MAY 07 2021
cMP-4000
013011 294
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Page 7 ot 7
98-BJ-c478-3 M 13008
013011
STATE FARM FIRE AND CASUALW COMPANY
A STOCK COMPANY W'TH HOME OFFICES IN BLOOMINGION, /LLINO'S INLAND MARINE ATTACHING DECLARATIONS
R?"8 3 ia"|;i! l*, uo 8 s - r s 2 s
Named lnsured
CRIME STOPPERS OF
YAKIMA COUNTY INC
PO BOX 11056
YAKIMA WA 98909-2056
M-15-2689-FBAI F N
Policy Number 98-BJ-c478-3
Policv Period Ellective Dale Exoiration Date
12 Mbnths JUL1 2021 JJL| 2022
The polipy period begins and ends at 12:01 am standard
ume alme premlses locauon.
ffi
IFq
I
Auiomalie-Renowal - lf fie policy period is shown as 12 monlhs , tris policy will be renewed automatically subjectto tre premiums, rules and
forms in effect for each succeeding policy period. lf .*ris.policy is terminated, we will give you and fre Mortgagee/Lienholder written notice in
compliance witr dre policy provisions or as required bv law.
ATTACHING INLAND MARINE
Annual Policy Premium lncluded
The above Premium Amountis included in fie Policy Premium shown on fre Declarations.
Your polic.y consists of fiese Declarations, tre INIAND MARINE C0NDITI0NS shown below and any otrer forms and endorsements that
apply, including trose shown below as well as fiose issued subsequentto fie issuance of tris polic'i.
Foms, 0ptions, and Endorssments
FE-8724
FE-8744.1
lnland Marine Conditions
lnland Marine Computer Prop
See Reverse for Schedule Page wi$ Limits
Prepared
MAY 07 2021
FD-6007
013012
O Copyright, State Farm Mutual Automobile lnsurance Company, 2008
lncludes copyrighted material of lnsurance Services 0ffice, lnc,, with its permission.
530.686 4.2 05-31'2011 (018232c)
98.8J-G478-3
ATTACHII'IG l1'lLAt{D MARINE
ATTACHING INTAND MARINE SCHEDUTE PAGE
M 13008
ENDORSEMENT
NUMBER
FE-8744.1
LIMIT OF
INSURANCE
DEDUCTIBLE
AMOUNT
ANNUAL
PREMIUMCOVERAGE
lnland Marine Computer Prop
Loss of lncome and Extra Expense
$
$
25
25
,000
,000
$ s00 Tncl-uded
Included
3
n
Prepared
MAY 07 2021
FD-6007
013012
0THERLlMlTsANDEXcLUsl0NsMAYAPPLY.REFERT0Y0URP0L|cY-
O CopyrighL State Farm Mutual Automobile lnsurance Company, 2008
lncludes copyrighted material of lnsurance Services office, lnc., with its permission.
530'686a.2 05-31-2011 lo18233c)
98-BJ-G478-3 013013
FE-6999.3
Page 1 of 1
ln accordance with the Tenorism Risk lnsuranceAct of 2002 as amended and extended by the Tenorism Risk lnsurance Program
Reaulhorization Act of 2019, this disclosure is part of your policy.
POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGEffi
Ilr
Coverage for acb of tqrorism is not excluded ftom your policy.
Houeva your policy does mnhin otrer exclusions wtrich may be
applicable, such as an exclusion for nuclmr hazard. You are
hereby notified that he Tenorism Risk lnsurance Act, as
amended in 20'l 9, defines an act of tenorism in Section 102(1) ol
he Acl The term "act of tenorism" means any act that is certified
byhe Secretary of the Treasury-in consultation witr ttre Secre
tary of Homeland Security, and tre Atkrney General of the
United Shtes-to be an act of terrorism; to be a violent act or an
act ftat is danguous to human life, propefi or inftasfucture, to
have resulted in damage within he United States, or outside tre
United Shtes in he case of cerbin air caniers or vessels or fte
premises of a United Shtes mission; and to have been commi!
ted byan indiMdual or individuals as part of an efiod to coerce the
civilian population of he United Shtes or to influence the policy
or afiect the conduct of he United Shts Govemment by coer-
cion. Undahis policy, any covaed losses resulting ftom certified
acts of tenorism maybepadiallyreimbursed bythe United Shtes
Government under a formula established by fre Tenorism Risk
I nsurance Act, as amended. Under the formula, the U nited States
Govanment genaally reimburses 80% beginning on January 1,
FE-6999.3
2020 of covered tenorism losses exceeding he shtutoilyestab-
lished deductible paid by the insurance company providing the
coverage. The Tenorism Risk lnsurance Act, as amended, con-
tains a $'100 billion cap trat limib U.S. Government reimburse
ment as uell as insurers' liability for losses resulting fom certified
acts of terorism when the amount of such losses exceeds $100
billion in any one calendar year. lf the aggregate insured losses
for all insurers exceed $100 billion, your coveftlge may be re
duced.
There is no separate premium charged to cover insured
losses caused by tenorism. Your insurance policy establishes
the coverage that exists for insured losses. This notice does
not expand covemge beyond that described in your policy.
THIS IS YOUR NOTIFICATION THAT UNDER THE TERROR.
ISM RISK INSUMNCE ACI AS AMENDED, ANY LOSSES
RESULTING FROM CERTIFIED ACTS OF TERRORISM UN-
DER YOUR POLICY MAY BE PARTIALLY REIMBURSED BY
THE UNITED STATES GOVERNMENT AND MAY BE SUB.
JECT TO A $1OO BILLION CAP THAT MAY REDUCE YOUR
COVERAGE
O, Copyright, State Farm lvlutual Automobile Insurance Company, 2020
98-BJ-G478.3 013013 M 13008
Kittitas CounQt Ofrce Of The Treasurer
Amy Cziske, TtEaiurer
2O5 lvslh$Il*rtll, tiulic lUtr
EnenshurE,T$e 98926
Phnru (509) 962-7533 Fax (509) 933-8212
Cash Receipts
Receipt Number:
Received From:
FundCode
001
2022-ss0
Commissioners-MANDY BUCHHOLZ ADMIN SUPERVISOR
Date:02/0t/2022
Check Amount: $200.00
Cash Amount: $0.00
Other Amount: $0.00
Total Amount: $200.00
Deputy: MINDYD Receipt Type: CHK
Template:
Comments:
csR-2022-440
YAKIMA COUNTY CRIME STOPPERS SPECIAL EVENT APPLICATION FEE
GlCode
163217 t
Description
SPECIAL EVENTS FEE
Anrount
$200.00
$200,00Total Amount:
Kittitas County Treasurer's Office
Submiued By: MINDY DELOZIER
(c) 2002 Cashtax All Rights Reserved 02101 12022 08:48:04 MINDYD