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HomeMy WebLinkAboutFIR2024-00016 Fireworks - FIR Permit / Conditions - 6/5/2024 BIG DOG FIREWORKS Phone: (360) 863-2756 Cell: (801) 598-6370 FIREWORKS LEASE AGREEMENT This Agreement is made between Heather Groat as Lessor, and BDF Corporation as Lessee,for the sale of 1.4g consumer fireworks at the following location. NAME: Heather Groat ADDRESS: 290 NE State Route 300 CITY: Belfair STATE: Washington ZIP: 98528 The parking lot or commonly occupied premises as listed above is owned and/or controlled by the Lessor, and the Lessor grants to Lessee, and the group selected by the Lessee, the exclusive right to operate a temporary Fireworks Structure on these premises for the period from: June 27 -July 5, 2023 (The tent company may deliver and set up the tent prior to June 271h and remove the tent after July 51n ) The exclusive right to operate a fireworks structure during the period stated above, with the same terms stated herein shall be automatically rene%ved for the years 2024& 2025, if both parties agree. AGREED AND DATED THIS 27th DAY OF June 2023. THIS AGREEMENT IS CONTINGENT UPON LESSEE SECURING LOCAL AND STATE LICENSES. Lessor: Heather Groat Lessee: BDF Corporation Signature: Signature: P•,r e Print Name: Heather Groat Print Name: Holly Sitabile Title: Title: Vice President/CFO Address (where to 290 NE State Route 300 Address: 4725 1131h Ave SE. mail rent check): City/St/Zip: Belfair. WA 98528 City/St/Zip: Snohomish, WA 98290 Phone: 360.551.7560 Phone: 801.597.9363 ACORL761' fl/1Z Z11�16 ll`.� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEZR?THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is all ADDITIONAL INSURED, the policy(ies) must be endorsed, ION IS WAIVED, subject to the terms and cond If SUBRO itions of the policy, certain policies may require an endorsement. A statement or1 this certificate does not confer rights to the certificate holder in lieu Of such endorsement(s). PRODUCER Acrlsure. LLC dba Britton Gallagher&AssociatesTINSURER CT 3737 Park East Dr. STE 204 _ Beachwood OH 44122 o,Exq:216-658-7100 _ _jarc.Not;216_�59-710— NAC1 SS INSUR E R(S)AFFO R DING COVERAGE - _ _ _ _ ti INSURED R A:Arch Speciality Ins COJaKe's Fireworks Inc. 21199 R B:Lexington Ins Co1500 E 27th Terr. 19437Pittsburg KS 66762 R C:R DR E:COVERAGES R F CERTIFICATE NUMBER: 539409092 =INSR TIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 6EEN ISSUED TO THE INSURED ENAMED ABOVISION VE FOR OR THE POLICY PERIOD TWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS Y BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, D CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ADDL�SUBR E OF INSURANCE POLICY EFF - POLICY EXP R WVD POLICY NUMBER MMIDO'YYYY POL'C YYYY 6 GENERAL LIABILITY LIMITS 0521151)5 2r 5/2024 21 i j/2025 EACH OCCURRENCE $1 000.000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) S 5oo 000 ME EXP(Any one person) S PERSONAL 3 ADV INJURY S 1,000,0p0 `---- GENERAL AGGREGATE S 000,000 POLICY PRO- X GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGC 52,000000 LOC AUTOMOBILE LIABILITY — $ I BILITY COMBINED SINGLE LIMIT (Ea acodent) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) S — _ AUTOS AUTOS BODILY INJURY(Per acudent) S HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS ' (Der accident) S UMBRELLA LIAB X OCCUR UXP1037038&-0s 2/15/2024 2115/2025 EACH OCCURRENCE $1.000,000 _ X EXCESS LIAB CLAIMS-MADE AGGREGATE S 1.000,000 DED R=TENTION S $ WORKERS COMPENSATION VUC TATU• TH•. AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER - 'NYPROPRIETOR,PARTNER/EXECUTIVE EL EACH ACCIDENT i S OFFICER,MEMBEREACLUDEU� NIA (Mandatory in if cescnbe und uncer EL DISEASE-EA EMPLOYES $ yes -- -- rt-- ----- - DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Sales Location.290 NE State Route 300,Belfair.WA 98528 Land Owner:Intrepid Holdings LLC;290 NE State Route 300. Belfair,WA 98528 Heather B's Cottage Boutique and its employees Mason County,its officers,elected officials,agents,and employees. Term. February 15,2024 through February 14,2025: The Certificate Holder and above listed are Additional Insureds with respects to General Liability Policy as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN Big Dog Fireworks ACCORDANCE WITH THE POLICY PROVISIONS. Joseph and Holly Stabile 4725 113th Ave. SE AUTHORIZED REPRESENTATIVE Snohomish VVA 98290 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 4,5*%1AGTOM 1T+lam Washington State Patrol Fire Protection Bureau Office of the State Fire Marshal G24133 CONSUMER FIREWORKS RETAIL SALES (CFRS) FACILITY LICENSE Stand Number: SN-15879 Licensee Data J - Operational Data Joseph Stabile WASHIpp NG 1 k..*i Wholesaler: [MULTIPLE SUPPLIERS] 4725 113th Avenue Southeast Co my of Operation: Mason Snohomish, WA 98290 Operated For. Licensee License Number: WSPFL-01902 Stand Operated By: Ian Gardner Phone Number: (360) 863-2756 Date of Issue:April 3, 2024 Date of Expiration:January 31, 2025 Consumer Fireworks Retailer Licenses issued after May are ONLY valid for New Years Sales This license is NOT valid without a permit from a local fire code official/authority having jurisdiction This license allows for operation of a single location/stand for retail sales to the public of state legal consumer fireworks purchased only from a licensed fireworks wholesaler 3000420-041(torts) THIS PORTION OF THE LICENSE MUST BE POSTED AT THE STAND AT ALL TIMES el Fl2 uZU�vao/'�' 10<4 litJo�ePl s� G,� �" •�c � �pj_Sqd ��7v S� BDF Belfair , Legend 290 NE State Route 300 0 BDF Behir BeBair,WA 98528 �r n�n4� ,� L, BDF TENT 20'x40' © FLAGGED PERIMETER-20' Contact Joseph Stabiles Mobile 901 598.6370 �O ' ' ` • FUEL PUMP-200' ,. ' i PARKING - _ t • !� ! h �. -kill ��� w •SY - <t' • -':.^fit�i\��"� ... i �V "'Slow ; - e. am—pp'O.�P'Alkv �°� • PUMP ►,, _ w- ► •�., Y