HomeMy WebLinkAboutCrime Stoppers Application & Ins.'ld-AI(IlVt A C(fLINT"!r
January 23,2023
Kittitas County Commissioners
205 W. 5th Suite 108
Ellensburg, WA 98926
l\
RE: Yakima County Crime Stoppers "Your Canyon for a Day" May 21,2029
I.i.
T
ro rn€m it may concern:
ln preparation for our annual Bike Tour on May 2L,2A23 we have sent the following for your review and
approval.
r Event Application
r An attachment to the Event Applicationo Certificate of lnsurance from State Farm naming Kittitas County, Yakima County, Washington
state Patrol, BLM, WSDOT and Federal Government as additional insured or certificate holders.. Application for exemption from permitr $200.00 Adminisration fee. f t,;i tl mArl
We are again requesting a waiver of the $5,000.00 cash or bond provisions 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 mitigate any
risks.
Thank you once again for your time and consideration of our application.
Sincerely yoursf
Mark Peterson
President, Yakima County Crime Stoppers
(s09) 728-4329
RECEIVED
JAN 27 2023
'on'fHS"?131,T".r,
Kittitas County, Washington
BOARD oe COTINTY COMMISSIONERS
EVENT APPLICATION PROCESS
1. Subrnit a completed Event Application and materials to the Kittitas County
Commissioners Office at least 6o days prior to the event. There are seyeral
departments who review the Event Applications 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 Seryices, and the Public Works Depaftment. A gzoo.oo permitiee is to be
submitted at thetime of application for each event. Applications will n-ot 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 Departnrent) up to five days in
a{v-an-ce priortoopening to tf9 general public. This is to ensure that you are complfng
withthe stated plans upon which the approval was made. If you fail io comply with thlse
requirements, your permit may be r.evoked 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.). Sbme
events may require approval from other agencies or jurisdictions.
4. Permittee covenants and agrees to indemnifii, defend and hold harmless the County, its
offi-cers, agents a-nd-employees from any and all claims actions, damages,liability, cost
andexpense, including reasonable attorney fees in connection with orloccasioned, 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, regaidiess of
whether it is alleged or proven that the acts or omissions bf ttre County, its officers,
agents or employees caused or contributed hereto.
5. Insurance Requirement: A Certificate of Insurance and endorsements specifically
naming "Kittitas County" as an additional insured in the minimum amount of
$r,9o-o,9og._oo per occurrence and agz,ooo,ooo.oo aggregate coverage must be
included with the Event Application. This insurance mi*t apply first ancl on a primary
non-contributing basis in relation to any other insurance oiseltinsurance arrailable tb
Kittitas County. The County Prosecutor's office may rcquire a greater arnount if it is
determined to be necessary for the proposed event.
6. Written statements signed by the applicant ancl property owner allowing pelmission to
enter the event site for inspections and stating responsibility for the evenf and
compliance with the codes is required as part of the written documentation to be
submitted at the time of application.
7. Before appllng for an event it is encoulaged that you schedule a time to meet with
County d,epaftments so they may assist with questions you may have prior to subrnitting
your application.
KITTITAS COUNTY COURTI.IOUSI . 205 WIST 5'h, SUIT[, I08 DLLINSI}URC. WA !}8926
(-509) 962-7508 r;AX (509) 962-767e
ryrvrv.co.kittitas.rva,us
n
tvww.co.ki ttitas.wa.us
Board of County Commissioners - (Sog) 96z-75o8
Community Development Services - (Sog) 96z-T5o6
Environmental Health - (So91 96z-7oog
Fire Marshal - (Sog) 96z-7ooo
Prosecutor - (Sog) 96z-7gzo
Public Health - (Sog) g6z-7gt5
Public Works Department - (Sog) g6z-7gz3Sheriffs
Office - (Sog) 96z-7525
Solid Waste Department - (Sog) 96z-7g42
KITTITAS COUNTY COURTI{OUSE . 205 WEST 5'h , SUITI IO8 ELLENSBURC, VrA 98926
(509) 962-7508 FAX (509) 962-7679
rvrvrv.co.kitt i tas. rva. us
Admissions Tax
Kittitas County Ordinance 2Arc-0A3
Ordinance amending Ch.3.22 Kittitas County Code to impose an Admissions Tax
"Adtnissions clurge," in addition to its usual and ordinary meaning includes but shall not be
limited to a charge for participation in an event or activity; a charge made tbr. season tickets or
subscriptionsr or a charge made for use of seats and tables, r'eserved or otherwise, and other
similar accommodations; and a charge made for rerital or use of equipment or facilities fbr
pttrpose of recreation or amusement" and where the rental of the ecluipment or lacilities is
necessary to the enioyment of the privilege for which a general admission is charged, the
cornbined charges shall be considered as an admission charge. A donation for admittance
shall also be deemed an aclrnissiott charge. Admission charge includes any money paid
rvithin or lvithout of Kittitas County fbr any of the kinds ol adrnission charges detined heiein solong as the tacilities, entertainment, recreation or amusement privilegJ clerived fionr such
admission charge occurs in Kittitas County.
The tax iniposed shall be collected at the time adnrission charge is paicl by the person seeking
admission to any place and shall be reported and remitted by the person receiving the rax to
the Trcasurer in quarterly instalhnents on or before the last clay of ihe month nexisucceeding
the end of the quarterly period in which the tax is collected or received.
Any person conducting or operatirtg any activity for which an admission charge is nrade
shall register r,vith the Auditor.
ln order to complete the rcgislration process, you will neecl to register online.
Any questions, please cotrtact the Treasurer's office at 509-962-7535; Auditor's oflice at 509-
L) 6?-7 5 02 or emai I at admissionstax(}co.kittitas,wa.us.
Kittitas County, Washington
BOARD or COIJNTY COMMISSIONER
EVENT APPLICATIOI{
Event Information
Narne of event: Your Canvon for a Dav Bike Tour
Date(s)of event: Mav 21, 2A23
Hotus of opera tion: 8:00 - 4:00 om
Description of the event: Bicvcle ride throuoh the Ya kima River Canvon
S
Has this event taken place before? gt No
Estimated attendance: 750 includinq volunteers
Dates: Past 16 yrs in May
How is your event being pr"rblicized?Bike sho ps, email, website
Plesse attach any flyers, posters, etc. zuith yow' applicntiar submissiott.
Contact Informati on
Name of the organizer/contact pc'rson:Yakima County Crime Stoppers - Mark Peterson
Adclress PO Box 1 1056 Yakima wA 98909
Phone number(s): (509\728-4329
Email address: hhfurnitu re4@aol.com
Date of birth of app licant: 5/3/1960
KITTITAS COLTNIY COURTHOLISL, , 205 WIST Jh, SUITE I08 ELLENSBUI{G, IVA 9892(I
(509) 962-7508 FAX (509) t)62:7679
rvrvrv.co.kitilns.rva. 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 of such
corporatinn.
Emergency contact narne(s) and phone nurnber(s) that can be contacted during the
event:
Mark Pete (509)
Name
Alicia tromme Tobin
Name Phone Number
WRITTEN PERMISSION TO ENTER EVENT SITE
I/We hereby permit law enforcement and/or County officials to enter the site for which
the Evcnt Application has been granted at the time of thc 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 l/we have read Kittitas County Code, have
familiarized myself with County requirements. llWe agree that either my designatcd
agent ar If we 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 rvith this event.
IlWe understand that failure to comply with the rules, regulations ancl conditions set
forth in Code may be deemed a gross misdemeanor and that drug or narcotics
violations are crimes under RCW.
Mark Peterson
Applicant Name (Print)App
Alicia Stromme T obin
Applicant Name (Print)Applicant Signature
KrrrlrAs couNTy couttrt{ousll . 20i WEST ih, sut]'E loti ELLENSBURC. \\:A 9.q92(r
(5{}9) 962-7508 FAX (509) 962-7679
rlryrv.co,kiilitas.rva.us
Phone Number
{509)969-8683
Kittitas County, Washington
BOARD oe COLTNTY COMMISSIONERS
Fire Safetv and Protection
If more than 50 people ar_e expected at your event, you must complete a separate
application process which can be obtained througli the Kittitas Cbunf Fiie Marshal'soffice. You may contact the Fire Marshal's office at s0g-962-700a,
will there be a temporary structure erected for the event? yes V"
If yes, you must attach a dran'ing including the dimensions. The structure may
require an inspection by County staff prior to the eveni.
Public Health/Environmen tal Health
Will there be food served at the event? Yes bld
If no food will be served at the evcnt then, no permit or application is required
If ycs, is the food and bevera ge that you intend on preparing and
.co.kittitas.wa.usl
serving at the event
exempt from permit requirements htto www hca /food.aso?
-rcyes,pleasesubmit?n@frompernitandproofoffooc1
handlers training to the Kittitas County Public Health Dbpartrnent (I<CfHO;.
if yes, and the food or beverage is not considered exempt from permit, then cloes the
person or organization preparing and serving the {ood have a food service permit,
temporary food service permit, or catering pirmit from KCPHD?
- If yes, plcase-provide a list of foods and beverages that you intencl on having
prepared and served at the event along with the name and phone number(slof
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
3- lg3p:rary food.service permit or catering permit will neecl to be acquirecl
from I(CPHD prior to the event.
Please allow at least 2 weeks to complete the food service permitting process.
KITTITAS COLINTY COURTHOTTSE ' 205 WESI .5'h, SUITE 108 }-,I-1,I.]NSI]URO, \\'A 98926
(509) 962-7s08 FAX (509) 962-761t)
rylrv. co.kil tilas.rva, us
Are there-permanent or fixed bathroom facilities already available at the location ofthe event?
Yes yd
If.yes,please provide an estimated attendance for the event, a detailed map that
icientifies the name and address of the physical facility that will provicle iavatory
facilities for the event, quantity o{ toileite-facilities ar,iilabl* for each gender, ur,& tf,"
distance fron the event that patrons must waik.
If 1o, 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 inch-rde the location of the portable restrooms on amap/diagram of the event.
KITTITAS COIINTY C;OURTIIOUSiI . 205 WEST 5'h. SUITIi IOS EI-I-IJNSBUITG. WA 9S926
(509) 962-7508 rAX (509) 96?:7619
rvrvrv.co. kil tilas. rva.us
Kittitas County, Washington
BOARD or. COUNTY COMMISSIONERS
Law Enforcemenysecuri cv Medical Services
Will there be security on site during the event? yes U6
If yes, please provide a complete list of names and contact inJormation for who will be
providing the security.
will Emergency Medical services (EMs) be on site during the event? fd No
If yes, please provide written verification from the proviclers.
Will there be music, sound amplification or any other noise impacts? Yes ryd
If yes, Kittitas 9"ryty \u-t " noise ordinance in effect (see County Code for details). If
your event is scheduled for outside of the allowed time, you must submit a written
letter to the Board of County Cornrnissioners requesting a waiver ancl it must be
included with your application materials.
Witl you have traffic control? V" No
if yes, please provide documentation on how the trafJic control will be acidressecl.
Will there be off-site parking? V No
If yes, please provide the location ancl a parking plzu"r.
Will there be shuttle buses provided for attendees? yes Vd
If 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 ancl mtrst
submitted with your application materials.
KITTITAS COUNTY COURTHOUSE . 10s WEST 5'h , SUITp l0B ELLENSIIUI{G. \\rA 9ti926
(509) t)62-7508 IAX (509) 9(t?-7679
rvrvrv.co. k i t litas. rva. us
Kittitas County, Washington
BOARD or COLINTY COMMISSIONERS
Will the event obstruct, interfere orrequire the closure and free use of any public
road, sheet or right-of-way? V" - No
If 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 posted? Vt No
Public Roads
KITTITAS couNTy couRTHousE , 20i WEST ih , suire 108 F.I.LENSIIURG. \v.4, 9$926
(509) 962-7508 F'AX (509) 962:76'19
rvl'w.co.kittitas.rva.us
Kittitas County, Washington
BOARD or COUNTY COMMISSIO NERS
Garbaee/R ecyc
Do you have a plan for garbage and recycling? V, No
A written plan for garbage and. recyciing must be attachecl to your applicationmaterials. For questions or assistance contact the Kittitas Cotinty Soiih WasteDepartment at 509-9 62-7 542.
Insurance
Have you obtained a Certificate of Insurance and endorsernents, specificanynaming "Kittitas CountSr" as an insured? V* No
A copy of the Certificate of Insurance amcl endorsements must be ilcluclect with yourapplication materials. Kittitas County must be namecl as an aclditional insured in'theamount of $1,000,00.0 0p per occurrence and $2,000,000,00 aggresate coveraee. Thislnsurance mlrst apply tirst and on a primary non-contributi"n$ bXsis in relatibn to a'y
other insurance or self-insurance available to Kittitas County.
Penal Bond - Bo nd of Indemnitv
County Filinss and Resistration
Is there a cost to attend the event? Vt No
How much are you charging to attend your event? $6s indiv/$110 fam
KITTITAS coUNTy (_:olrttTI.tousFt . 205 whtsT 5,h, sUITu l0S nLI_DNSLURC;. wA 98926
(509) 962-7508 trAX (509) 962-76]9
qryrv. co.ki I t itas. rva. us
A $5,000.00 Penal Bond - Bond of Indemnity is required to be deposited with theCounty Tre-asurer to.save and protect !!e streets, pivements, brid^ges, etc. fromdamage. -Th-e deposit or its balance wilt be returied once tlre eveit has been held andthe Board of County Commissigners has certified no damage has been done and thatthe County has not incurred additional expenses
Are you submitting-a $5,000.00 Penal Bond - Bond of Indemnity with yotrr EventApplication? Yes )a6
If no, you must request a letter in writing to the Board of County Commissioners
requesting a waiver to the Penal Bond - Bond of Indemnity auci outlile the specific
reasons why it should not be required of your event.
Attachment
To
Special Use Event Application
For Event on May 21,2023
R-E: Your Canyon for a Day Bike Tour
Yakima County Crime Stoppers, Iuc
DESCRIPTION OF ACTIVT|Y AND EVENT AT THE YAKTMA CANYON MAY 21, 2023 BY THE
YAKIMA COUNTY CRIME STOPPERS' ''YOUR CANYON FOR A DAY BIKE TOIIR''
The Yakima County Crime Stoppers' "Your Canyon for a Day Bike Tour" is a fun ride designed for the
whole family to enjoy the Yakima Canyon without any through traffic. This is Yakima County Crime
Stoppers' only fund raiser with the funds to be used for rewards paid out to tipsters who are instrumental
in the apprehension of felons. This lvill be the tenth year we have sponsored the bicycle tour in the
Yakirna Canyon. We had approximately 1,000 riders last year with over 50% of them starting the ride at
the Yakima River RV Park in Ellensburg. The majority of our riders corne fronT the Westside of
Washington.
We will be using the Roza Recreation site and the Yakima River RV Park as our staging areas lor the
bicycle ride. The riders will leave from the Roza site or the RV Park and travel north or south on SR 821
then turn around at Thlall Road or the Roza site and retum the their stagitrg site. The RV Park and the
Roza site will mainly be used for participants to park and unloadlload their bicycles. In the NE comer of
the Roza parking lot we will also be selling concessions as we have done in years past. Coca-Cola may
be providing a srnall trailer which will be at the concession site to dispense soft drinks with alt profits
going to the Yakima County Crime Stoppers. Even though we have worked with the Department of
Transportation to close SR821 to tluough vehicle traffic, we understand there will be others using the
canyon and we will be sharing the facilities at the Roza Site rvith thern.
We rvill be provicling the following:
1. Portable toilets (8 total)
Two at the Itoza site (both with hand sanitization equipment and one for handicapped access).
One at Big Rock rest site.
One at Umtanum/Big pines rest site.
Tr.vo at TluallRoad site (both with hand sanitization equiprnent and one for handicapped access)
Two at Yakima RV Park,
t
2. Tnffic Control - r.ve will have 8 officers
ricle.
2 Yakima Police Officers and 2 Yakima County Sheriff Deputies patrolling the canyon cluring the
2 Yakima Couttty Sheriff Deputies on duty at each barricacle on both ends of tlie canyon. 2 at
Thrall road on the Ellensburg side and two at the Firing Center entrance of the canyon.
As in previ0us years, persons doing traffic control will allor,v 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.
the ride.
All residents will be notified five days befbre the ride ancl given a pass they can show the day of
All campers will be notifred the day before the ricle of the 25 mile an hour speed limit in the
canyon during the ride (Red's Fly Shop rvill also be notified).
25 mile an hour speed signs will be posted in the canyon durir"rg the ride.
4. Emergency medical personal from ALS Ambulauce will be posted during the ri{e in the canyon.
5. Garbage and Recycling
At each rest stop we wiil have garbage and recycling cans. At the end of the ride we will carry all
garbage and recycling out of the canyon to Fi&H Furniture, olvned by Mark peterson, yakima County
Crime Stoppers Boarct President/Member. Recyclecl items will be transported to Michaelson's nackaging
next to H&H Furniture. We will have 5 rest sites with the garbage ancl recycling cans.
6. All food given out at the rest sites will be prepackaged granola bars, sport drinks, and rvater. At the
Roza site Coca-Cola may be providing a small trailer to clispense soft drinks with all profits going to the
Yakirna County Crime Stoppers.
Should you have any questions or need further infomration, please feel free to contact me.
Thank you,
-fr*r./ &A^ru
Mark Peterson
President, Yakima County Crime Stoppers
Cell: (509)728-4329
2
Supplement to Questions:
This is the 16tl'year we have helcl the event (typically the 3d Sunday in May annually).
We rent portable toilets frorn the same vendor every year: Valley Septic. They provide
drop off and pick up services of their equiprnent. Washington State Patrol, yat<ima
Police Department, The Blue Knights, YC Rangers, and the Yakima Sheriff s Office all
provide voluntary patrol seruices and traffic control. We also provide emergency
services through EMS, as well as HAMM Radio operators due to lirnited cell coverage in
the canyon. We have Valley Cycle on site for bicycle repairs, as well as Recycle Bicycle
frorn Ellensburg. All road closurc signs and barricades are provicled by Yakima County
Crirne Stoppers. We used to rent these services but purchased our own three years ago.
CERTIFICATE OF LIABILITY INSURANGE DATE (MM/DD/YYYY}
o1t24t2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG TNSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
StateFarm Bruce Sears
105 South 1st Street&,
Selah wA 989420669
CONTACT
NAME:Bruce Sears
509-697-4900
bruce.sears.com
INSURER(S} AFFORDING COVERAGE NAIC #
rNsuRER A : State Farm Fire and Casualty Company (Auto or Fire)25143
INSURED
CRIME STOPPERS OF YAKIMA COUNTY INC
PO BOX 1 1056
YAKIMA wA 989092056
INSURER B
INSURER C :
INSURER D
INSURER E ;
INSURER F
COVERAGES NUMBER:REVISION NI,JMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHO\^N MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSK
tfR TYPE OF INSURANCE
ADD
INSD
-ub
WVD POLICY NUMBER
tsULIUY EFF
TMM/ND/YYvvI
tsULIUY EIts
IMM'DNryYYYI LIMITS
EACH OCCURRENCE s 2,000,000
DAMAGE TO RENTED
PRFMISFS /Fa nen' 'rrFn.al s 300,000
MED EXP (Any one person)E 5,000
PERSONAL & ADV INJURY $
GENERAL AGGREGATE s 4,000,000
PRODUCTS - COIV]P/OP AGG E 4,000,000
A
COMMERCIAL GENERAL LIABILITY
X
GEN'L AGGREGATE LIMIT APPLIES PER:
CLAIMS-MADE OCCUR
LOCPOLICY
OTHER:
PRO-
JECT
Y N 98-BJ-G478-3 07t01t2022 07101t2023
$
s
BODILY INJURY (Per person)$
BODILY INJURY (Per accident)$
TKUTEK I Y UAIVIAbE
lPer accidenl)$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON-O\^JNED
AUTOS ONLY
s
EACH OCCURRENCE $UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-MADE AGGREGATE $
DED RETENTION $$
PER OTH-
$
E,L, EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRI ETOR/PARTNER/EXECUTIVE
OFFICERYMEMBER EXCLUDED?
(Mandatory in NH)
lf yes, describe under
DFSCRIPTION OF OPFRATIONS helow
Y/N
N/A
E,L. DISEASE - POLICY LIMIT $
DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (ACORDl0l,Additional RemarksSchedule,m.ybeattachedifmorespaceisrequired)
LOCATION: 128 N 2ND ST, YAKIMA, WA 98901
YOUR CANNYON FOR A DAY RIDE
ADDITIONAL INSURED - CERTIFICATE HOLDER: KITTITAS COUNTY, WASHINGTON STATE PATROL, DEPT OF TRANSPORTATION, BUREAU OF
LAND MANAGEMENT, US GOVERNMENT AND "The United States Department of the lnterior-BLM, WSDOT 2809 Rudkin Rd, Union Gap, WA 98903 is
additionally insured."
CANCELLA
@ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
1001486 2005 155279 205 01-'t9-2023
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ELLENSBURG wA 98926
KITTITAS COUNTY
205 W 5TH STE .I08
AUTHORIZED REPRESENTATIVE
R. 4/J*_,
This form was system-generated on 0112412023
ACORD 25 (2016/03)
STATE FARM FIRE AND CASUALTY COMPANY
A STOCK COMPANY WITH HOME OFFICES TN BLOOMINGTON, ILLINOIS RENEWAL DECLARATIONS
ffi
F?"ffi fa€ai! l* z so I s - 3 s 2 s
Named lnsured
Ar2 M-15-2689-FBA1 F N
003865 3125
CRIME STOPPERS OF
YAKTMA COI]NTY ]NC
PO BOX 11056
YAKIMA WA 98909.2056
lllllrlrlrrhllLlll'lrlllrrrL;hlllrl;rLlllllllllrllulllllll
Businessowners Policy
Policy Number 98-BJ-G478-3
Policy Period Ellective Date Expiralion Date
12 Mbnths JUL12022 JUL12023
The policv oeriod beoins and ends at 12:01 am standard
fime at thC premises Tocation.
Agent and Mailing Address
BRUCE SEARS CLU
PO BOX 669
SELAH WA 98942-0669
PHONE: (509) 597-4900
+
Aulomatic_fionowal - lf ttre policy period is shown as 12 months , this policy will be renewed automatically subjectto tre pre
forms in effect for each succeeding policy period. lf this policy is terminated, we will give you and dre Mortgagde/Lienholder
compliance witr the policv provisions or as reouired bv law.
miums, rules and
written notice in
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
Prepa red
MAY 09 2022
cMP-4000
024085294 INL4
O Copyright,State Fann Mutual Automobile lnsurance Colnpany,2008
lncludes copyrighted material of ll)surance Services 0ffice, llc., with its psnnission.
Continued on Reverse Side of Page Page 1 of 7
530'606 a.2 05-31.2011 {ol13231c)
M 24085
RENEWAL DECLARATTONS (CONTTNUED)
Businessowners Policv for CRIME STOPPERS OF
Policy Number -98-BJ-c478-3
SECTION I . PROPERTY SCHEDULE
Location
Number Location of
Described
Premises
Limit of lnsurance*
Coveraoe A -
Buildings
Limit of lnsurance*
Coveraoe B -
Business Fersonal
Property
Seasonal
lncrease-
Business
Personal
Property
001 128 N 2ND ST
YAKTMAWA 98901-2639
No Coverage $ 13,700 25Y"
* As of the effective date
SECTION I - INFLATION COVERAGE INDEX{ESI
as includes any increase in the limit due
tCov A - lnflation Coverage lndex:
Cov B - Consumer Price lndex:
sFcTtr-tN I - nFnl tnTt]ll Fq
N/A
287,5
Basic Deductible
Special Deductibles:
Money and Securities
$5oo
$2so Equipment Breakdown $5oo
Other deductibles may apply - refer to policy.
Prepared
MAY 092022
cMP-4000
024085
O Copyright,State Farm Mutual Automobile lnsurance Cornpany,2008
lncludes copyrighted material of hsurance Services 0fftce, lnc., with its pennission.
Continued on Next Page Page 2ol 7
M 24085
RENEWAL DECLARATTONS (CONTTNUED)
Businessowners Policy for CRIME STOPPERS OF
Policy Number -98-BJ-c478-3
ffi
CF|ITI.lN I - FYTFNCI'INC'IE COVFRAGF - I IMIT rlF INSIIPANNF - trAl:I.I NFIINPIRtrN
5
! The-coverages and corresponding limits shown below apply separately to each described premises shown in theseQ Declarations, unless indicated by "See Schedule." lf a coverage does hot have a correspohding limit shown below,e but has "lncluded" indicated, please refer to that po licy provisaon 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 Property)
Newly Acquired Or Constructed Buildings (applies only if this policy provides
Coverage A - Buildings)
LIMIT OF
INSURANCE
$1o,ooo
$5;ooo
$5,ooo
lncluded
Coverage B Limit
257o of covered loss
lncluded
$2,soo
$s,ooo
$1 o,ooo
lncluded
10%
Pre pa red
MAY 092022
cMP-4000
o240a6 294
N
O Copyright,State Fann Mutual Alttomobile lnsurance Compa|y,2008
lncludes copyrighted rnaterial of lnsurance Services office, lnc., with its pormission.
Continued on Reverse Side of Page
$2,ooo
$5,ooo
$1 ,ooo
$1oo,ooo
$25o,ooo
Page 3 of 7
RENEWAL DECLARATTONS (CONTTNUED)
M 24085
lncluded
$s,ooo
$2,500
$15,ooo
$1o,ooo
30 Days
$2,soo
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 $2,soo
Valuable Papers And Records
On Premises
Off Premises
$1
Water Damage, Other Liquids, Powder Or Molten Material Damage lncluded
qFNTINN I - FYTtrNCI'INC 6E covFRAGF - t tMtT oF tNsllpaNeF - pFp prlt rl:v
The coverages and corresponding limits shown below are the most we will pay regardless of the number of
described premises shovyn in these Declarations.
COVERAGE
Loss Of lncome And Extra Expense
LIMIT OF
INSURANCE
Actual Loss Sustained - 12 Months
SF(:TI.IN II - I IAFIII ITY
,000
,000
0
$5
t
COVERAGE
Coverage L- Business Liability
LIMIT OF
INSURANCE
$2,ooo,ooo
Pre pared
MAY 09 2022
cMP-4000
024086
O Copyright, State Fann Mutual Autotnobile lns{rance Colnpaily.2008
lncludes copyrighted mdterial of lnsuranc6 Services office, lnc., with its pennission,
Continued on Next Page Page 4 of 7
RENEWAL DECLARATTONS (CONTTNUED)
M 24085
$5,ooo
$30o,ooo
LIMIT OF
INSURANCE
$4,ooo,ooo
$4,ooo,ooo
Ehiliffi
Businessowners Policy for CRIME STOPPERS OF
Policy Number -98-BJ-c478-3
Coverage M - Medical Expenses (Any One Person)
Damage To Premises Rented To You
AGGREGATE LIMITS
Products/Completed Operations Aggregate
General Aggregate
I
Each paid claim for Liability Coverage reduces the amount of insurance we provide dudng the applicable
annual period. Please refer to Section ll - Liability in the Coverage Form and any attached endoidements,
Your policy consists 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.
F'IPMS ANN FN
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-4s61.1
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 09 2022
cMP-4000
o240a7 294
N
O Copyrigh! State Fann Mutual Autotnobile lnsurarrce CornpanV,2008
lncludes copyrighted rnaterial of hsurance Services Office, lnc., with its permlssion,
Continued on Reverse Side of Page Page 5 of 7
M 24085
RENEWAL DECLARATTONS (CONTTNUED)
Businessowners
Policy Number
Policy for CRIME STOPPERS
98-BJ-G478-3
OF
SCHEDULE OF ADDITIONAL INTERESTS
lnterest Type: Addl lnsured-Section ll
Endorsement#: CMP4791
Loan Number: N/A
KITTITAS COUNTY
205 W 5TH AVE STE 108
ELLENSBURG WA 989262887
lnterest Type: Addl lnsured-Section ll
Endorsement#: CMP4860
Loan Number: N/A
YAKIMA COUNTY
COUNTY COMMISSIONERS
PO BOX 12570YAKIMAWA 989092570
lnterest Type: Addl lnsured-Section ll
Endorsement #: CMP4788
Loan Number: N/A
WASH INGTON 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 distributiorr of the eanrings of the company as determined by our Board of Directors in
accordance with the Company's Articles of lncorporation, as amended.
ln Witness Whereof, the State Farm Fire and Casualty Company has caused this policy to be signed by its President and
Secretary at Bloomington, lllinois.
ff ,",-ny*,n //4./*Mq-^)
Secretaiy President
Prepared
MAY 09 2022
cMP-4000
024087
O Copyright, State Farm Mutual Autornobile lnsurf,nce Company.2008
lncludes copyrighted material of lnsuralce Services ()ffice, lnc., with its pennission.
Continued on Next Page Page 6 of 7
M 24085
RENEWAL DECLARATTONS (CONTTNUED)
Businessowners Policy for GRIME STOPPERS OF
Policy Number -98-BJ-G478-3
ffi
J
NOTICE TO POLICYHOLDER:
For a comprehensive description of coverages and forms, piease refer to your policy.
Policy changes requesled before the "Date Prepared", which appear on this notice, are effective on lhe Renewal Date
of this policy unless otherwise indicated by a separate endorsernent, binder, or amended declarations. Any coverage
forms attached to lhis notice are also effective on the Renewal Date of this policy.
Policy changes requested after the "Date Prepared'' will be senl to you as an amended declarations or as an
endorsement to your policy. Billing lor any additional premium for such changes will be mailed al a laler date.
lf, during the past year. youVe acquired any valuable property items, made any improvements to insured property,
or have any questions about your insurance coverage, contact your State Farm agent.
Please keep this with your policy.
Your coverage amount....
It is up to you to choose the coverage and limits that meet your lleeds. We recommend that you purchase a coverage limit
equal to. the estimated replacement cost of your structure. Replacement cost estimates are avqjlable from building contiactors
and replacement cost appraisers, or, your agent can provide an estimate from Xactware, lnc.Eusing information-you provide
about your structure.We can accept the type of estimate you choose as long as it provides a reasonable level of detail about
your structure. State Farm"does notguaraniee that any estimate will be the actual iuture 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
underwriting requirements. We encourage you to periodically review your coverages and limits with your agent and to notify us
of any changes or additions to your structure.
Prepared
MAY 09 2022
cMP-4000
o240aa 294
N
O Copyright,State Fdnn Mutual Autornobile lnsurance Company,2008
lncludes copyrighted material of lnsurance Services 0ffice. lnc., with its pennission.
Page 7 of 7
98-BJ-G478-3 tvt 24085
024088
STATE FARM FIRE AND CASUALTY COMPANY
A STOCK COMPANY WTH HOME OFFICES IN BLOOMINGION, /ILINO/S INLAND MARINE ATTACHING DECLARATIONS
Er"H ra8"8i! l* z s o I i - 3s 2 o
Named lnsured
CRIME STOPPERS OF
YAI(TMA COUNTY INC
PO BOX 1r.0s6
YAKTMA WA 98909-20s5
ATTACHING INLAND MARINE
M-15.2689-FBA1 F N
Policy Numher 98-BJ-c478-3
Policv Period Ellectiye Date Exoiration Dats
12 Mbnths Jt)L 1 2022 JUL 1 2023
The policv oeriod beoins and ends at 12:01 am standardtme'at thC premtses Tocatron.
ffi
/
Aulomalic Ronewal - lf fre
forms in effectfor each suc
compliance widr fre oolicv
s 12 months . this policy will be renewed automatically sublect to tfre premiums, rules and
this policy is terminated, we will give you and tre Mortgageellienholder wriften notice in
by law
Annual Policy Premium lncluded
The above Premium Amount is included in the Policy Premium shown on the Declarations
Your policy consists of these Declarations, dre INLAND MARINE C0NDITI0NS shown below,
apply, including those shown below as well as ftose issued subsequentto fre issuance oldr
and any ofter forms and endorsements that
is policy.
Foms, 0plions, and Endorsemonts
FE-8724
FE-8744.1
lnland Marine Conditions
lnland Marine Computer Prop
See Reverse for Schedule Paqe with Limits
Pre pared
MAY 09 2022
FD-6007
024089
O C0pyright, State Fdnn lvlutual Autotnobile lnsurance Cornpany,2008
lncludes copyrighted rnaterial of lnsuraIce Services office, luc., with its pennlsslon,
530'686 a., 05.31'701 1 {o113232c1
98-BJ-c478-3
ATTACHIt{G lt{tAND MARIt'lE
ATTACHING INTAND MARINE SCHEDUIE PAGE
M 24085
ENDORSEMENT
NUMBER
FE-8744.1
COVERAGE
lnland Marine Computer Prop
Loss of lncome and Extra Expense
LIMIT OF
INSURANCE
DEDUCTIBLE
AMOUNT
$ soo
ANNUAL
PREMIUM
4
$
25,000
25,000
Included
Included
n
Prepared
MAY 09 2022
FD-6007
024089
OTHER LIMITS AND EXCLUSIONS MAY APPLY- REFER TO YOUR POLICY
O Copyrighl State Fann Mutual Automobile lnsurance Company,2008
lncludescopyrightedmaterialoilnsuranceSeruicss Of{ics,htc.,withitspennission.
530-6t6 a.2 05-31-2011 {oll3233c)
98-BJ-G478-3 024090
FE-0999.3
Page 1 of 1
ln accordance with the Terrorism Risk I nsurance Act of 2002 as amended and extended by the Tenorism Risk lnsurance Program
Reauthorization Act of 2019, this disclosure is part of your policy.
POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGEffi
+
Covaage for acts of tenorism is not excluded fiom your policy.
Horrueva your policy does contain other exclusions uhich may be
applicable, such as an exclusion for nuclear hazard. You are
hereby notified that the Tenorism Risk lnsurance Act as
amended in20'19, definesan actoftenorism in Section 102(1) of
the Act: The term "act of tenorism" means any act that is certified
by the Secretary of the Treasury-in consulbtion with the Secre-
tary of Homeland Security, and the Attomey General of the
United States-to be an act of terrorism, to be a Molent act or an
act that is dangerous to human life, property, or infrastucture; to
have resulted in damage within the United States, or outside the
United States in he case of certain air caniers or vessels or the
premises of a United States mission; and to have been commit-
ted byan individual or individuals as part of an effort to coerce the
ciMlian pryulation of the United Shtes or to influence the policy
or afiect tre conduct of the United States Government by coer-
cion, Under this policy, any covered losses resulting from certified
acts of tenorism may be partially reimbursed by the United States
Government under a formula established by the Tenorism Risk
lnsurance Act, as amended. Under the formula. the United States
Government generally reimburses 80% beginning on January 1.
FE-6999.3
2020 ofcovered tenorism losses exceeding the statutorily estab-
lished deductble paid by the insurance company providing the
coverage. The Tenorism Risk lnsurance Act, as amended. con-
tains a $100 billion cap that limits U.S. Government reimburse-
ment as vrlell as insurers' liability for losses resulting ftom certified
acts of tenorism when the amount of such losses exceeds $'l 00
billion in any one calendar year lf the aggregate insured losses
for all insurers exceed $100 billion, your coverage may be re
duced.
There is no separate premium charged to cover insured
losses caused by terrorism. Your insurance policy establishes
the coverage that exists for insured losses, This notice does
not expand coverage beyond that described in your policy.
THIS IS YOUR NOTIFICATION THAT UNDER THE TERROR.
ISM RISK INSURANCE 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-
@. Copyright, State Farm li[rtual Autornobile lnsurance Company 2020
98-BJ-G478-3 024090 M 24085
98-BJ-G478-3 024091
Request certificates of
liability insurarlce for most
business policies.
Choose an existing
additional irlsured frorn
your policy or entet a new
certiflcate holder
No login |equired. You just
need your policy number
and buslness locatiorl
Lets get started.-.
Use your snlart phone to
scan this code or visit
statef arm.cotn/cert if icate.
553-;351
t_t
Lo -q-l
I
ffi
+
Good news! We're making it easier for you to get
a Certificate of Liability lnsurance online.
_-l
L ffi())
553 ,lLll
ojj:
98-BJ-G478-3 024051 t\4 24085
Kittitas County Office Of The Treasurer
Amy Cziske, Treasuttr
205 lIIsth tr*rru*, iirdir lU.?
Eleruburg,\:Ve 98926
Pftnnr (509) 962-7535 Fax (509) 933-S212
Cash Receipts
Receipt Number: 2023-802
ReceivedFrom: MANDYBUCHHOLZOFFICEADMINISTRATOR
Check Amounr $200.00
Cash Amount: $0.00
Other Amount, $O.OO
Total Amount: $200.00
Deputy: KRISTENW Receipt Type CHK
Template:
Comments:
csR 2023-658
YAKIMA COUNTY CRIME STOPPERS- SPECIAL EVENT APPLICATION
Date 0210812023
FundCode
001
Total Amount:
GlCode
1632171
Description
SPECIAL EVENTS FEE
Kittitas County Treasurer's Office
Submitted By: KRISTEN WASHINGTON
Amount
$200.00
$200.00
(c) 2002 Cashtax AII Rights Reserved 0210812023 1 4:53:50 KRI STENW