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AGENDA BILL SCHEDULE AGENDA BILL TITLE Addepd m A1o.1-08 Yo Ci46-07-D65, avo Ans�u 'la 11-6xk-r"cnl-P��ram PREPARED BY: rjer—SI?'"A_ Extension: 7.z4 DEADLINE/DATE ACTION 41S/o 8 GREGG'S SIGNATURE 4/7/08 TRANSMIT TO CLERK(Done by I_jnda�41 ) JAY'S AGENDA BILL MEETING: 10 a.m. - 7th Floor Council Con£ Rm d/o 8 COUNCIL MEETING DATE Referred to Committee COMMITTEE MEETING DATE(e-mail Committee Report to Teresa who will final it and send it up to Julia) COMMITTEE Time: Place: COUNCIL MEETING REPORTED OUT USA\17\Misc Forms\AB-Schedule\tp CITY OF RENTON COUNCIL AGENDA BILL AI #: Submitting Data: Public Works For Agenda of. Dept/Div/Board.. Utility Systems Division/Surface April 14, 2008 Water Utility Staff Contact...... Ron Straka(ext. 7248) Agenda Status Allen Quynn (ext. 7247) Consent.............. X Subject: Public Hearing.. Addendum No. 1-08 to CAG-07-065, 2008 Mosquito Correspondence.. Abatement Program Ordinance............. Resolution............ Old Business........ Exhibits: New Business....... Issue Paper Study Sessions...... Addendum Information......... Recommended Action: Approvals: Council Concur Legal Dept......... Finance Dept...... X Other. Fiscal Impact: Expenditure Required... $43,752.60 Transfer/Amendment....... Amount Budgeted....... $50,000 Revenue Generated......... Total Project Budget $50,000 City Share Total Project.. SUMMARY OF ACTION The Surface Water Utility requests the Council authorize the Mayor and City Clerk to execute Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program contract, in the amount of $43,752.60. The addendum would authorize Whitworth Pest Solutions, Inc. (Whitworth), sole- source provider of the 2007-2008 Mosquito Abatement Program, to apply adulticide in uplands areas east of Panther Creek Wetlands in the Talbot Hill area(Task 1). In addition, Whitworth will apply larvicide to City stormwater facilities, irrigation facilities and catch basins for the control of mosquitoes (Task 2). Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program will be funded through the approved Surface Water Utility 2008 capital improvement project budget account. The approved budget for the 2008 Mosquito Abatement Program is $50,000. STAFF RECOMMENDATION: Authorize the Mayor and City Clerk to sign Addendum No. 1-08 to the 2007-2008 Mosquito Abatement contract with Whitworth Pest Solutions, Inc., in the ajMunt of$43,752.60. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CiP)\27-2000 Mosquito Abatement Program\2008 Program\2008 AgendaBill.doc\AQtp PUBLIC WORKS DEPARTMENT M E M O R A N D U M DATE: April 3, 2008 TO: Marcie Palmer, Council President Members of the Renton City Council VIA: Denis Law, Mayor FROM: Gregg Zimmerman('`Administrator STAFF CONTACT: Ron Straka, Surface Water Utility Supervisor(ext. 7248) Allen Quynn, Surface Water Utility Engineer (ext. 7247) SUBJECT: Addendum No. 1-08 to CAG-07-065, 2008 Mosquito Abatement Program with Whitworth Pest Solutions, Inc. ISSUE: Should the Council authorize the Mayor and City Clerk to execute Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program contract (CAG-07-065), in the amount of $43,752.60. The addendum would authorize Whitworth Pest Solutions, Inc. (Whitworth), sole-source provider of the 2008 Mosquito Abatement Program, to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes? RECOMMENDATION: Approve and execute Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program contract, in the amount of$43,752.60, with Whitworth as a sole-source provider of pest control consultant services for the 2008 Mosquito Abatement Program. BACKGROUND: Whitworth Pest Solutions has been the sole-source provider of the pest control consultant services for the City of Renton Mosquito Abatement Program since 1990. This addendum is proposed for the continued use of adulticide to treat adult mosquitoes in the areas upland and east of the Panther Creek Wetlands. In addition, the contract will include the application of larvicide to City stormwater ponds and vaults, irrigation ponds, and catch basins. This is the third year the City has been using larvicide to treat City-owned irrigation and stormwater ponds and vaults. In 2006, the City initiated the Mosquito Larvicide Program Council/Whitworth Add 1-08 CAG-07-065 April 3,2008 Page 2 of 3 under the advice of the Washington State Department of Health in response to the anticipated arrival of the West Nile virus in our state. West Nile virus is a mosquito- borne virus that is spread to humans by the bite of an infected mosquito and not by person-to-person contact. No human cases of West Nile virus were reported in Washington State in 2007. In an effort to reduce the risk of human infection, the City has developed a response plan that includes'larviciding City stormwater facilities, irrigation facilities, and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Department of Health. The total expenditure required for the 2008 Mosquito Abatement Program contract is $43,752.60, and includes the following tasks: Task 1 (Treatment of Panther Creek Wetlands) Whitworth will apply an Environmental Protection Agency (EPA) registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack- mounted, portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of April through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. The cost for adulticiding the areas upland and east of Panther Creek is $19,227.60 and will be funded through the approved 2008 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$50,000. Task 2 (Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins Larvicide treatment is scheduled to begin June 2008 and will continue for the duration of the mosquito season, which typically extends through the end of September 2008. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities, and catch basins. These facilities and catch basins are owned and maintained by the Maintenance Division, Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile virus in King County. The total cost to treat City stormwater and irrigation facilities and catch basins is $24,525.00 and will be funded as follows: H:\File Sys\SWP- Surface Water Projects\SWP-27 - Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Addendum Issue paper.doc\AQtp Council/Whitworth Add 1-08 CAG-07-065 April 3,2008 Page 3 of 3 PW Maintenance Services Division: Larvicide treatment to be funded through the approved Surface Water Utility 2008 Capital Improvement Program budget for the 2008 Mosquito Abatement Program. The approved 2008 adjusted budget for the Mosquito Abatement Program is $50,000. The estimated cost to treat Maintenance Division stormwater facilities and catch basins with larvicide is $10,627.50. The remaining balance in the project account of$39,372.50 will be used to complete Task 1 ($19,227.60) leaving a balance of$20,144.90 for City staff time to administer both tasks as well as additional treatments if required. Maplewood Golf Course: Larvicide treatment to be funded through the Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, and catch basins with larvicide is $4,768.75. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $4,768.75. Parks Division: Larvicide treatment to be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $8,311.25. This project was funded in the 2008 Parks Maintenance Operating Budget. Facilities Division: Larvicide treatment to be funded through the 2008 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $817.50. CONCLUSION: The Public Works Department requests Council authorize the Mayor and City Cleric to execute Addendum No. 1 to the 2007-2008 Mosquito Abatement contract, in the amount of$43,752.60, authorizing Whitworth Pest Solutions, Inc., sole-source provider of the 2008 Mosquito Abatement Program, to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes. Attachment cc: Lys Hornsby, Utility Systems Director Greg Stroh, Facilities Maintenance Manager Terry Flatley,Parks Maintenance Manager Kelly Beymer, Golf Course Manager File H:\File Sys\SWP- Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Addendum Issue papendoc\AQtp EXIIIETT7A Neighborhood Detail Map/Site Plan SWL.6td S 1 t HWE MI � v NA ESt S 1 167 S 19th Ln n Sw 21st St t] S 21st Q F o P CT L ITS SW 23rd t , St > a � v Q W Vl SW 27th St SW th S a SW Oth St Q J 16 a SW 4th St --- 3 -- v a � � a SW 39th St 8th i I SW 41st S O Note:TREATMENT WILL NOT BE APPLIED WITHIN 100' OF WATER, TREATMENTS WILL NOT BE PERFORMED NEAR HOMES. TREATMENT WILL ONLY BE DONE ON THE UPLAND AREA 1000 2000 BETWEEN THE WETLAND EASTERN EDGE AND THE RESIDENTIAL AREAS.PROPERTY OWNER APPROVAL REQUIRED PRIOR TO TREATMENT ON PRIVATE PROPERTY. Mosquito Abatement Program (2005-2009) 1 : 12000 ADDENDUM NO. 1-08 CONSULTANT CONTRACT CAG 07-065 FOR ENTOMOLOGIST/PEST CONTROL AGENT SERVICES 2008 MOSQUITO ABATEMENT PROGRAM This Addendum is made and entered into this day of 2008, by and between the City of Renton, hereinafter called the "City", and Whitworth Pest Solutions, Inc., whose address is 2533 Inter Ave., Puyallup, WA 98372-3428, hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS, the City engaged the services of the Consultant under Consultant Agreement CAG-07-065 dated April 25, 2007, to provide entomologist/pest control agent services for the 2007- 2008 Mosquito Abatement Program; and WHEREAS, the 2007 Mosquito Abatement Program has been completed in accordance with the original agreement; and WHEREAS, the City desires that the Consultant provide the services identified in the attached Exhibit A for the 2008 Mosquito Abatement Program. NOW, THEREFORE, in accordance with Section VIII- Extra Work of the original Agreement CAG-07-065, dated April 25, 2007, it is mutually agreed upon that Consultant Agreement CAG-07-065 is amended as follows: 1. The scope of work for the 2008 Mosquito Abatement Program shall be as set forth in Exhibit A of this addendum. 2. Payment for the work defined in Exhibit A shall be at the rates set forth in Exhibit B of this addendum. Payment for services rendered in 2008 shall not exceed $43,752.60 without a written amendment to the contract, agreed to and signed by both parties. All other provisions of Consultant Agreement CAG-07-065 dated April 25, 2007, apply to this addendum. EXECUTION IN WITNESS WHEREOF, the parties have executed this Addendum No. 1-08 to CONSULTANT AGREEMENT CAG-07-065 as of the day and year first above written. WHITWORTH PEST SOLUTIONS CITY OF RENTON Signature Denis Law,Mayor Date Type or Print Name Title H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Addenduml.doc\AQtp EXHIBIT A SCOPE OF WORK 2008 MOSQUITO ABATEMENT PROGRAM TASK NO. I: TREATMENT OF PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume (ULV), Environmental Protection Agency registered, insecticide will be applied to brush and other upland vegetation using a gasoline-powered, backpack-mounted, portable fogger. Treatment will be conducted in upland areas away from water or wetland areas as weather conditions allow and in accordance with the product label and other federal and state regulations. Treatment must also be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated (Application Number LUA05- 022, ECF) for the program made by the City of Renton Environmental Review Committee on April 1, 2005 and included as Exhibit D of this contract. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit E, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to I-405 on the north, within the City of Renton, Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment, the City will provide a highlighted copy of the map included in Exhibit D of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment, the consultant shall provide to the City a brief summary of the area treated and the type of chemical used, weather conditions during the treatment application, the time during which treatment was conducted, an estimate of the relative abundance and distribution of mosquitoes, and a recommendation on the scope and timing of subsequent treatment. TASK NO. 2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES) Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus (BS) and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: Owner Facility Name/Type Facility Location PBPW Maint. Svcs. Division Stonegate/WQ Pond NE 26"' and Lyons Ave PBPW Maint. Svcs. Division NE 10`l' St Pond/Detention NE 10"' St and Anacortes Ave PBPW Maint. Svcs. Division Talbot Ridge 2/WQ Pond S 47"' St and 102"d Ave SE PBPW Maint. Svcs. Division Catch Basins Various Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course(west-central) Golf Course Hole#7 Pond/Irrigation Maplewood Golf Course (east-central) Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course (east) Golf Course Catch Basins Various Parks Maintenance Division Catch Basins Various Facilities Division City Hall/WQ Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. HAFile Sys\SWP-Surface Water Projects\SWP-27 -Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Scope of work and budget.doc\AQtp Reporting: Following each treatment, the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date, time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count(larve per dip). 7. Number of manhours per facility visited (includes testing and larviciding). Notification: Maplewood Golf Course — Whitworth Pest Solutions, Inc. shall contact the Golf Course Manager 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property(this is a mandatory safety requirement). H:\File Sys\SWP -Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Prograin\2008 Scope of work and budget.doc\AQtp EXHIBIT B TIME OF COMPLETION 2008 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City,testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Scope of work and budget.doc\AQtp EXHIBIT C COST ESTIMATE 2008 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The estimated total cost of Task 1 including Washington States sales tax is $19,227.60, The cost shall include all necessary work for 21 treatments including clearing of the trails. Work conducted in performance of Task I will be billed at the following rates: For 12 or more total treatments: $840/treatment For 6 to 11 total treatments: $890/treatment For I to 5 total treatments: $990/treatment The billing rates include state sales tax. Subtotal Contract Cost: $17,640.00 � 4 State Sales Tax(9.0%) $1,587.60 Total Cost Task 1: $19,227.60 TASK NO. 2: The estimated total cost of Task 2 including Washington States sales tax is $24,525.00. The cost shall be based on a rate of$125.00 per manhour, which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups, protective gloves, and respirators, etc. At the City's discretion, facilities listed under"Areas of Treatment"above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. HAFile Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(C[P)\27-2000 Mosquito Abatement Program\2008 Program\2008 Scope of work and budget.doc\AQtp A minimum scheduled trip charge from the consultant's office to the stormwater/irrigation facilities of $375.00 shall apply. Below is the estimated contract cost for the three City divisions, based on the billing rate of$125.00 per manhour for a total of 180 manhours: PBPW Maintenance Services Division Costs Stormwater facilities: 3 11 /q 7 tips Total number of treatments per stormwater facility: 8 4 Total manhours per stormwater facility.(including travel time): 0.75 hrs 0-60 Total stormwater facility manhours: 18 hrs ItI•uo Subtotal cost for stormwater facilities: $2,250.00 111 Sales Tax (9.1"o): $202.50 g16q Total cost for)stormwater facilities: $2,452.50 I i)l0 Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $7,500.00 Sales Tax(9.0%): $675.00 -712-' Total cost for catch basin treatment: $8,175.00 4 2►Z-S Total manhours (stormwater facilities +catch basins): 78 hrs Subtotal cost(stormwater facilities +catch basins): $9,750.00 Sales Tax (9.0%): $877.50 Total cost(stormwater facilities +catch basins): $10,627.50 O i W'S Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility(including travel time): 1 hr Total irrigation facility manhours: 32 hrs Subtotal cost for irrigation facilities: $4,000.00 Sales Tax(9.0%): $360.00 Total cost for irrigation facilities: $4,360.00 Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $375.00 Sales Tax(9.0%): $33.75 Total cost for catch basin treatment: $408.75 Total manhours(irrigation facilities +catch basins): 35 hrs Subtotal cost(stormwater facilities+catch basins): $4,375.00 Sales Tax(9.0%): $393.75 Total cost(stormwater facilities +catch basins): $4,768.75 HAFile Sys\SWP-Surface Water Projects\SWP-27 -Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Scope of work and budget.doc\AQtp Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Subtotal cost for catch basin treatment: $7,625.00 Sales Tax(9.0%): $686.25 Total cost for catch basin treatment: $8,31 1.25 Total manhours (irrigation facilities+catch basins): 61 hrs Subtotal cost(stormwater facilities+catch basins): $7,625.00 Sales Tax(9.0%): $686.25 Total cost(stormwater facilities+catch basins): $8,31 1.25 Facilities Division Costs Stormwater facilities: I Total number of treatments per facility: 8 Total manhours per stormwater facility(including travel time): 0.75 lirs Total stormwater facility manhours: 6 hrs Subtotal cost for stormwater facilities: $750.00 Sales Tax(9.0%): $67.50 Total cost stormwater facilities: $817.50 Catch Basin: 0 Total manhours (stormwater facilities+catch basins): 6 hrs Subtotal cost(stormwater facilities+catch basins): $750.00 Sales Tax(9.0%): $67.50 Total cost: $817.50 Total Contract Cost for all Divisions: $22,500.00 State Sales Tax(9.0%): $2,025.00 Total Cost Task 2: $24,525.00 Total Contract Cost(Task 1 +Task 2): $43,752.60 Invoicing Whitworth Pest Solutions, Inc. shall submit a separate invoice to the City of Renton Surface Water Utility Section, Parks Maintenance Division, Maplewood Golf Course, and Facilities Division for any services it provides under this project. Payment cannot be authorized or payment may be delayed until separate invoices are received. HAFile Sys\SWP -Surface Water Projects\SWP-27 -Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Scope of work and budget.doc\AQtp CITY OF RENTON t + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator December 15,2008 Jo Marie Brauner Washington State Department of Health Zoonotic Disease Program P.O. Box 47825 Olympia, WA 98504-7825 SUBJECT: 2008 Mosquito Larvicide Use Report Dear Ms. Brauner: Enclosed for your records,please find the City of Renton's 2008 Mosquito Larvicide Use Report as required under the NPDES Aquatic Mosquito Control Permit. If you have any questions,please call me at 425-430-7247 or email me at aquynn@rentonwa.go_v. Sincerely, Allen Qu , P ., Surface W ter tility Engineer Enclosure HAFile Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement r�\2008 `Program\Reporting\2008 larvicide report.doc\AQaw 1055 South Grady Way-Renton,Washington 98057 E L V T 0 t�T A H ki A U 13 T ti F. id'c'T; This papzr:;erRains 50%•ecycled material,30%post consumer Mosquito General Permit - Annual Report Page 1 of 1 Treatment Annual Report AQUATIC MOSQUITO CONTROL GENERAL PERMIT "Vwi� WASFINGT0N STATE 0 E F A R T m E N T o F To comply with the terms of the statewide general permit for discharges of aquatic pesticides to control mosquito E C O L O G Y larvae to surface waters of the state. Name of Entity: City of Renton Entity Name Larvicide Used Amount & Units County City of Renton Bacillus sphaericus 262 oz King I certify under penalty of law that this document and all attachments were prepared under my direction or supervision. The information submitted is, to the best of my knowledge and belief, true, accurat and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing vi ations. Signature: Vic.' Date: Printed name of permittee: ' https://secureaccess.wa.gov/ecy/wgmosquito/PrintReport.aspx 12/12/2008 Mosquito larvacide use records are due February 1, 2009 Below are six steps for successful reporting. 1. Go to the SecureAccess Washington login page at https://secureaccess.wa,gov/mvAccess/saw/select.do. Enter your User ID and Password to login. • You can retrieve your Password by clicking on the "Forgot your password?" link on the SecureAccess Washington login page. Once you login, it may prompt you to create a new password if you haven't accessed your account for 120 days. (Be sure to write down your User ID and Password for next year's reporting.) 2. Select the "Aquatic Mosquito Control Permit Application" link located on the My Services tab. 3. Scroll to the bottom of the page and select the "Submit Annual Report" button. 4. Instructions for entering Mosquito Treatment Annual report information are provided at the top of the annual report page in addition to the general steps outlined starting on number 5. 5. You must select the correct Entity Name (first drop down menu) if you have reports for more than one permit to submit. Fill out the reporting form by totaling up the amount of each larvacide used for the season and hitting the Add Data button to add the record to the Report List Summary on the bottom of the page. • If you have no larvicide use information to report, select None Used in the larvacide and unit drop down boxes, enter 0 for the amount, and then click the Add Data button. • If your application area covers more than one county, you will need to total up each larvacide product for each county. • If you are a commercial pest control business, you'll need to select each contracted site's name and total up the amount of larvacide used at each contracted site. 6. Once all records are completely entered and showing up under the Report List Summary on the bottom, select Save and Submit Report to print out a hard copy. 7. Mail the signed hard copy to: Washington State Department of Health Zoonotic Disease Program Attn: Jo Marie Brauner PO Box 47825 Olympia, WA 98504-7825 Please contact me at jomarie.brauner@doh.wa.gov or 360.236.3064 if you have questions. 12/11/2003 14 : 09 FAX 2538451133 WHITWORTH PEST SOLUTIONS [a001/003 WHITWORTH PEST SOLUTIONS INC. 2533 INTER AVE. PUYALLUP, WASHINGTON 98372 Pierce Co. (253) 845-1818 • King Co. (206) 248-2222 • Toll Free 1-888-959-1818 Fax: (253) 845-1133 • www.whitworthpestsolutions.ccm FAX TRANSMITTAL SHEET DATE FAX: Q 2 FROM; PAGES: „( Including Cover If you do not receive all the pages indicated, please contact us. 05i'20/2008 10 :42 Fait 25',0451153 NIT ORTH PEST SOLUTIONS 0001/002 l WHITWORTH PEST SOLUTIONS INC. 2533 INTER AVE. PUYALI-UP, WASHINGTON 98372 Pierce Co. (253) 845-1818 • King Co. (206) 248-2222 • Toll Free 1-886-959-181 B Fax: (253) 845-1133 • www.whitworthpestsolutions.com FAX TRANSMITTAL SHEET DATE: z FAX: T Z- -(� FROM: 115111C'c.1 (c(��cr � PAGES: ( Including Cover ) RE: IZ ►���* � �L;YL' `�/ (1�C ' i 12i c�� t:..Lr�,j If you do not receive all the pages indicated, please contact us. 05/20/2008 10 : 48 FAX 2538451133 WHITWORTH PEST SOLUTIONS Z 002/002 Mosquito Management Day Sheet Year )Oy Month n Day Person Making application/samplings\bN ACC License # Terry Whitworth Applicator #374 Whitworth Pest Solutions 2533 liter Avenue Puyallup, WA 98372 Product: vcctolex CG EPA# 73049-20 Time-Depart Shop (g'-I� AM/AM Time Return to Shop L Q 1 �GAM/ M A 2j2 I J V, C 1 y�,p� Total time for billing 7 l 2-CD Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name Ibs 1000 s l't Golf Course 40,000sgf[ -4 Hole#6 Sew 5 oz <O�►t� t �y rni�uL,� Golrcoursc ;IL Aboli Golf Course About I acre $:1Q1, Hole#7 % 5 oz - Golfcourse ;up ncj2• GolrC0urse 40,000sgft -vq Hole 49 5 oz l) �` Golf course , ,) Sod• S�> 5 (;ul f Course 30,000syfl _r7 Hole#1 B 5 oz Golf course �oz � R•lainteri ance Pond NE 10' & 5 oz AnacOrtes Maintenance Pond NE 26' & 5 oz Lyons Nlainrcnance 2 Tanks S 471 & 5 oz 36 sq ft each 102"d Ave Facilirie; 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way i5crCr-IUna I):inu`.Mosyurto ILems\Mnsgtitly Managcnienl Edited pay Sheet-doc 12/11/2002 14 : 10 FAX 2532451133 WHITWORTH PEST SOLUTIONS la o03/009 Mosquito Management Day Sheet Year 200� Month _�J N c Day Z Person Making application/sampling VkO tEc-N i License# (p Z 71,,t) Terry Whitworth Applicator#374 Whitworth Pest Solutions 2 533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 _ Time-Depart Shop ' PM Time Return to Shop 5 AM/PM '—I 25 Total time for billing _ H RS Billing Size Time Location Larval Product Total Rate/ Comments _ in/out count Name lbs 1000 ScIft _ 17101f Course 40,000sgft 26 Hole 96 I e 5 oz Golf course -'�D P+t6'o4E �Q�' Golf Course About 1 acre 5S Hole #7 5 oz c i i it U)es k p Golf course ;tS 52- Gol f Course 40,000sq ft }`i Hole #9 5 oz Golf course 20 1 Soz, Ciol f Course 30,000sgft A 3 Hole#1 S 5 oz ++ + Golf course q'.oa Maintenance Pond NE 16"& 5 oz Anacortes Maintenance Pond NE 26"' & 5 oz Lyons Maintenance 2 Tanks S 47t' & 5 oz 36 sq ft each 102nd Ave i'acilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way OJ �Scrvcr-1\datW\Dana\R4osqutto Item.,Nosquito Management Edited pay 5hcct.doc 12/11/2008 14 : 10 FAY' 2538451133 WHITWORTH PEST SOLUTIONS 0004/009 Mosquito Management Day Sheet Year BOO g Month �Z Day Person Making application/sampling Li Novi License #_ Q0. 11W115 Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 q Time-Depart Shop tom,' A PM Time Return to Shop ti I' t� AM/PM �v ��` ota time for billing Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name Ibs 1000 s ft Golf Course 40,0009gft i- Hole#6 6 5 oz Golf course :%p �'�°�, T R�P`��ED I�To2'Tt4 S►t3�, 601f Course About 1 acre • 50 Hole#i7 5 oz Golf course 35 Gol f Course 40,000sgft `11.15 Hole #9 _ 5 oz ,, it o _ Golf course -7�50 Oz N 5i Golf Course 30,000sg-ft SM4 Hole Pr IS 5 oz Golf course Js �Z 1 ' " t tJoRTN S tOf Maintenance Pond NE IOr' & 5 oz Anacortes Maintenance Pond NE 26` & 5 oz Lvons Maintenance 2 Tanks S 47" & 5 07 36 sq ft each 102"' Ave Facilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way l ' \\Server-I\data\D;ina\Mosquito IternsNosquiro Manugoment Educd Day Shect.doc 12;-"111'2008 14 ' 10 FAX 2538451133 WHITWORTH PEST SOLUTIONS �005;'009 Mosquito Management Day Sheet Year Zo°� Month �X_ Day Person Making application/sampling i�\)0�'g License # to Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue LEAVC r-nPR soon q ��q F` Puyallup, WA 99372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop AM/PM Time Return to Shop AM/PM Total time for billing Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft -7 2S Hole#6 5ise 5 oz V66EY Ho-T C"_' ' E-le—, Golf course I Ne 1 Golf Course About 1 acre -7 q Hole 97 5 oz Golf course 0 1 ez Golf Course; 40,000sgft 05 Hole#9 R 5 oz \ ' ' I r►1 t Golf course " 30 ��� �o��o �►� Golf Course 30,000sgft 3 Hole#18 5 oz ' Golf course oo �✓ SoZ, Maintenance fond NE 10` & ✓ 5 oz Anacortes Maimenance Pond NE 26` & 5 oz Lyons Maintenance 2 Tanks S 47` & 5 oz 36 s ft each 102"d Ave Facilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way � 35 ':`Server-I\data\Dana\Mosquito Items\Mosquito Management Edited nay Sheet.doc 12/11/2008 14 : 10 FA," 2532451133 WHITWORTH PEST SOLUTIONS la o06/009 Mosquito Management Day Sheet Year Month Day Person Making application sampling 40N 31L=-C"-ticense # im to,5 Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop AM/PM Time Retum to Shop ,Z� A M') Total time for billing S; 12jz-5 Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft rj'A5 Hole#6 I S6= 5 oz WOQ 009-:431 Clb Golf course �f'50 PaC).lE Golf Course About 1 acre 7: T-iole#7 5 oz Golf course Z t —So Ti-1 ON I Gol I'Course 40,000sgft j F 53 Hole#9 5 oz Golf course RE•►a ,� Golf Course 30,000sgft $"- 15 Hole#18 C 5 oz Golf course � Maintenance Pond NE 10` & 5 oz .t �F, Tli� Anacortes O2' Maintenance Pond 7 ,OD NE 26 & 5 oz lg' Lyons C� Mctinwn-ance 2 Tanks Ac0 40 S 47` & lJQ 5 oz 36 sq ft each t, 'CO 102nd Ave y2-oZ Facilities 9 Tanks 0c City Hall . 5 oz 36 sq ft each 02 1055 S. Yv� Grady Way \,Scivcr-)\data\Dana\Mosquito hems\Mosquito Managemem Edited Day 5hcet.doc 121'11,'2008 14 : 10 Fri;, 2538451139 WHITWORTH PEST SOLUTIONS d007/009 Mosquito Management Day Sheet Year 2-COF- Month I q Day 2y Person Making application/sampling ( .\.OnJ GW,(1 ieense #_fQ 77CQp '2 Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 lnrer Avenue; Puyallup, WA 98372 Product: Vectoleh CG EPA# 73049-20 mgV7(2s,� Time-Depart Shop ' Ic, A /PM Time Return to Shop ) 1 , AM/PM �9-9-ieL _ `7--3 Total time for billing i.R.l� t► �� ,� ; 9 ;�� Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft _ Golf Course 40,000sgft �;2a Hole#6 C 5 oz EASE S►fl C I S Golf course i'�j A3D�1� )� C. <_1OVt=e_ (Z-jJ;�OuJvJ CAIJ Golf Course About I acrey39 Hole#7 }O o2 5 oz c tt Golf course Golf Course 40,000sgft Hole#9 2 5 oz Golf course :I Golf Course 30,000sgft 2p Hole#18 1� 5 oz Golf course 4 Maintenance Pond 'CY-05 NE I 0" && 5 oz C1 Anacortes Maintenance Pond j� NE 26 '& Z 5 oz Lyons Maintenance 2 Tanks ='TO S 47"' & 5 oz 36 s ft each 102nd Ave Z�Z Facilities 9 Tanks )b;2_0 City Hall 5 oz 36 sq ft each 1055 S_ Grady Way \.Server-1\dat3�Dana\Mosquito lcemsNosquito Manpment)ditcd Day Sheet.doc 12/11/2008 14 : 10 FAY, 2538451133 MITWORTH PEST SOLUTIONS Z008/009 Mosquito Management Day Sheet Year Month Day 1 � Person Making applicatioil/SamplinglI-�V0t1 1 =mot' T License# Terry Whitworth Applicator #374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 00 Product: Vectolex CG EPA# 73049-20 Time-Depart Shopte'.3 AM/PM Time Return to Shop � ��m A MV wo 0 D Total time for billing o I f►R 5 3� Billing Size Time Location Larval Product Total )Efate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft 2°\ Hole#6 5CE 5 oz (,t/(ATti=('-- tS t t_jk�- ri Golf course 1 A 1�O\jC D o z Golf Course About 1 acre 1:50 Hole#7 5 oz i ooND 1- e m :I� I�oz, r LAavRE oni soSOOT?./ Erast Golf course Golf Course 40,000sgft L5• iq Hole#9 �01 5 oz Golf course Golf Course 30,000sgft Hole#18 r�z. 5 oz TR � � } tnla Golf Course cl. , J Maintenance Pond 0,,-5D NE lot' & �,( 5 oz I I =00 Anacortes Maintenance Pond W 20 NE 26` & oZ 5 oz -r Pry 1: Lyons Maintenance 2 Tanks Z'2 a S 47' & A b Z 5 oz _ 36 sq ft each 2. 3W 102 d Ave 1=acilities 9 Tank.s City Hall 5 oz 36 sq ft each � 1055 S. — -5oL Grady Way 2 �3 ,\Strvei•I\daca\Liana\Mosquito hems\Mosquito Mangemenl Edited Day Shee[.doc 12/11/2002 14 : 10 FAX 2538451133 WHITWORTH PEST SOLUTIOWa z Oo9i'009 Mosquito Management Day Sheet Year _ Month D Day 2 s Person Making application/sampling �\100 60CI TZicense # - Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 OZ_D Product: Vectolex CG EPA# 73049-20 �j1 rt Time-Depart Shop AM/PM Time Retum to Shop 'QED _AM6i) 'W5 Total time for billing (n_ , -7 _ rlP- Billing Size Time Location Larval product Total Rate/ Comments in/out count Name lbs 1000 s Ift Golf Course 40,000sgft 7--qp Hole#6 5 oz ` �� A$� Golf course 1 ,5 ti "7— Golf Course About 1 acre io�!O l Hole#7 1(�oz 5oa T2 Tip Sov-XN S1mt Golf course :9LO Gol f Coursc 40,000sgft L Z3 Hole#9 5 oz Golf course 141 Golf Course 301,000sgft -W H Hole#18 5 oz Golf course 9 `oo °Z' St OE5 Maintenance Pond NE 10 & 5 oz Anacortes Maintenance Pond I//',O�`u NE 261 &. 5 oz qo Lyons Maintenance 2 Tanks 12-;0�7 S 47%h& 5 oz _ 36sq ft each 2'. 0 102"d Ave Facilities 9 Tanks O City Hall �A Z 5 oz 36 sq ft each 1055 S. 1�� Grady Way ,�Serrver-I\data\Dana\Mosquito hems\Mosquito Management Edited pay Sheet.doc 09/09/2008 10 : 12 FA.' 2538451133 I'MIT1ORTH PEST SOLUTIONS Z 002/002 Mosquito Management Day Sheet Year Month Day F Person Making application/sampling L�voN EG1aT License # (a7](Q Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 � Product: Vectolex CG EPA# 73049-20 �� Ti Depart Shop q,bD AM/PM. Time Return to Shop ' IT' AM/PM Total time for billing 3. S 14112-5 Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft _ Golf Course 40,000sgft Hole 46 5 oz Golf course Golf Coursc About 1 acre Hole#7 5 oz Golf course Golf Coursc 40,000sgft \ J Hole#9 5 oz Golf course x Golfcourse 30,000sgft Hole #18 50z Golf course Maintenance Pond 10''- Ili NE 10` & � � 5 oz ijo rwosgoi-Toes -rp 01 3 Anacortes Maintenance Pond 10!44 NE 26` & � 5 oz ' 1 Lyons Maintenance 2 Tanks "J S 47` & 5 oz 36 sq ft each f()t 00 102nd Ave N A �Z Q. Facilities 9 Tanks N+: 30 City Hall 5 oz 36 sq ft each t t'u5 1055 S_ Grady Way ,,SCrver-I\dUL-L1\1Ja11a\M0squu0 Items\Mosquito Managemenc Ldiced Day Shccr.doC t 09I2i/2008 14 : 14 FAX 2539451135 WHITWORTH PEST SOLUTIONS Z 002/002 Mosquito Management Day Sheet Year Month Day 2. Person Ma ing application/samplingLEyoly ;MCiJlT License # `7 (p5 Terry Whitworth Applicator##374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 �STIr�PrT Product- Vectolex CG EPA# 73049-20 Tune-Depart Shop /PM Time Retum to Shop , u•q AM/PM Total time for billing 2 H a-S Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name Ibs 1000 s ft Golf Course 40,000sgft Hole#6 5 oz Golf course: S LSE Golf Course About 1 acre Hole 47 5 oz Golf course Golf Course 40,000sgFt , Hole#9 5 oz Golf course x G01f Course 30,000sgft Hole 918 5oz Golf course Maintenance Pond q' NE 10` & ( 5 oz IpoO)A 9 ,40 Anacortes bi=D 7.j7) cdvp-6 Maintenance Pond !A NE 26` & 5 oz 10 '05 Lyons Maintenance 2 Tanks 04 S 47" & �� 5oz 36 s ft each e► t l p 102nd Ave 2� 1=aciliiies 9 Tanks 10 1123 City Hall 5oz 36 sq ft each 1° 2� 1055 S- NA Mdl Z �o Grady Way '\Scrvtr•1`,da1❑\Duna\Mo5quiro 11ems\Mosquito Nianagaueni Ediicd Day Sheet-doc 09/'5/2008 14 : 14 FA;t 2538451133 „'HITWORTH PEST SOLUTIONS 001; 002 Date of Application: Year 2008 Month 09 Day 22 Firm-Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 96372 Person(s) who applied the pesticide: Levon License No(s) §7Z65 Apparatus License No. - � Pesticide Information: See Chemical Sheet Dated: Appointment 01-0138930 Louis Dreyfus Corporation - 955 Alaskan Way W -98119 Weed Control Follow-up Product&Amount Used Application Site Time In/Out Temp Wind DirNel_ 2'D- /n2 �-�, A L-►�le I I :twos Sty 5 Comments 01-0128999 Maintenance/Utility Sytems - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Comments 01-0129159 Facilities - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Comments 5 x g 5coq-H 1A IZA ->4 X C, Post-it"'Fax Note 7671 Date of � pa#gc� To From Co./Dept. Co. Phone# Phone u Fax A cd2-5• H 30. 7z t✓I 1 pax 11 Mosquito Management Day Sheet Year Ou'a Month Day 19 Person Making application/sampling License # Terry Vklitworth Applicator #374 Whitworth Pest Solutions 2533 Inter .Avenue Puyallup. WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop IS AM/PM Time Return to ShopILL cOAM/ M 7 p er, Total time for billing Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name Ibs 1000 s ft Golf Course 40,OOOsgft -:3tj_ Hole#6 4t� 15 5 oz FOvto� t v_j na�l Golf course 1Z A S °�' u �2J� Golf Course About 1 acre Ins- Hole#7 Z 5 oz A Si S�tX Golf course U� - ��E ���U� Golf Course 40,OOOsgft $,ciq Hole#9 5 oz �Q NcR Golf course q .ol GolfCourse 30,OOOsgft Hole#18 t2 5 oz Golf course V > Maintenance 5Pond NE 10` & 5 oz Anacortes `1aintenance Pond NE 26` & 5 oz Lyons Maintenance 2 Tanks S 47` & 5 oz 36 scl ft each 102nd Ave Facilities 9 Tanks City Hall 5 oz 36 sg ft each 1055 S. Grady Way arr.er-i d;na Dana Mosquito Items`,Mosquito Management Edited Day Sheet.doc Mosquito Management Day Sheet Year Month —�V 0£ Day Z Person Making application/sampling LiE,o ?6c-q T License # 7te`-) Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup. WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop ' 2-0- A4PM Time Return to Shop 5 AM/PM Ada a� �P 125 Total time for billing 5 ;� H RS Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft 7'3s Hole#6 1 5;--e 5 oz Golf course T. P%1bJJ€ SO2 Golf Course About 1 acre 55- Hole #7 5 oz t, I i r t W ls5 E�vv Golf course Golf Course 40,000sgft "tti Hole#9 5 oz + + + +t PJr,9-:TO E NC Golf course . yN i �C'z. Golf Course 30,000sgft 43 Hole#18 5 oz �����Golf course .©a 5�z' Maintenance Pond NE 10 & 5 oz Anacortes Maintenance Pond NE 26" & 5 oz L ons Maintenance 2 Tanks S 47' & 5 oz 36 scl ft each 102nd Ave Facilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way Server-I data Danallosquito Items\Mosquito Management Edited Day Sheet.doc Mosquito Management Day Sheet Year Z�©� Month °� Day t Person Making application/sampling bitr_O N License # Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup. WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop t` A M Time Return to Shop eN., AM/PM t 1 u�A om w .-Total time for billing 3 ?''A© Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name Ibs 1000 s ft _ Golf Course 40,000sgft t5 Hole#6 60EIS 5 oz Golf course .t© Golf Course About I acre ..50 Hole#7 _ 5 oz Golf course 35 Golf Course 40,000sgft -1 Hole#9 _ 5 oz t t t t Stolz Golf course 7,.3o J °z N��� Golf Course 30,000sgft Hole#18 5 oz Golf course 'vlaintenance Pond NE 10` & 5 oz Anacortes Maintenance Pond NE 261 & 5 oz L ons Maintenance 2 Tanks S 47` & 5 oz 36 sq ft each 102"d Ave Facilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way Sen er•I data Dana\Mosquito I tems\Mosqui to Management Edited Day Sheet.doc Mosquito Management Day Sheet Year Zv aX Month Day _�;O Person Making application/sampling License # (Q -7-7�oS Terry Whitworth Applicator#374 Whitworth Pest Solutions ���"tom � {rPv�oC�P ' �.t�oAa 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop AM/PM Time Return to Shop AM/PM Total time for billing Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft �' 2� Hole#6 <) 5 oz a HOT t' Golf course Ove �' Golf Course About 1 acre 741 Hole#7 � 5 oz Golf course g. c 02. Golf Course 40,000sgft OS Hole#9 5 oz ' ' IT►1 ' Golf course 30 SoZ. �o�t�o �►� t��sipt Golf Course 30,000sgft 3 q Hole#18 5 oz t Golf course 00 5oz Maintenance Pond NE 10 & 5 oz Anacortes Maintenance Pond NE 26 & 5 oz Lyons Maintenance 2 Tanks S 47 & 5 oz 36 sq ft each 102nd Ave Facilities 9 Tanks City Hall 5 oz 36 sq ft each 1055 S. Grady Way Server-1',data,Dana\Mosquito Items\Mosquito Management Edited Day Sheet.doc Mosquito Management Day Sheet Year Month Day 4 Person Making application/sampling `'�c�a �iLC as License # Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 t� ,� Time-Depart Shop L Q; - AM/PM Time Return to Shop s AI &� ) , rl,M Total time for billing ( Qa.S ij 4-5 Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,OOOsgft 'J' n Hole#6 I 5 oz - t}w N(?izrti ! C.rXD Golf course ",`�(_) Golf Course About 1 acre "]` Hole#7 3 5 oz ©l°tv Sc Golf course 0 ME Sc Golf Course 40,OOOsgft �s 5,j Hole#9 5 oz JY6—vs t� > Golf course l a Golf Course 30,000sgft $ 15 Hole#18 5 oz Golf course �z Maintenance Pond NE 10 th& 5 oz Anacortes Maintenance Pond 1 -OO NE 26 & �/ 5 oz :lg' Lyons C� Maintenance 2 Tanks AO, 0 S 47` & � 5 oz 36 s ft each VOO 102"d Ave y2_oZ Facilities 9 Tanks City Hall f— 5 oz 36 sq ft each 1 1055 S. OA Grady Way Mosquito Management Day Sheet Year 2--co Month Day 21F Person Making application/sampling ( t,-\k-tJ �%tj icense # (�7 Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop 1 /PM Time Return to Shop } : V , AM/PM Total time for billing QL � Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft — -- - _ Golf Course 40,000sgft '7;2-0 Hole#6 5 oz ��5� S t D L= (S Golf course i3� �2�0�3 )I o% �0ve—;-� caj t30ujw C.q t_ Golf Course About 1 acre ,39 Hole#7 5 oz C t� "fits -ro Golf course :'5`s I 10 e z i rem s��r.�- f�------ Golf Course 40,000sgft ''��S�} Hole#9 C Z 5 oz Golf course l� Golf Course 30,000sgft '-2C Hole#18 t� 5 oz Golf course '7,:4 Maintenance Pond 'c)S NE 10 & 5 oz CA Anacortes Maintenance Pond q NE 26` & 5 oz T� Lyons Maintenance 2 Tanks S 47 1h& Y2— 5 oz 36 s ft each 102ndAve 0-2 Facilities 9 Tanks 2_�_> City Hall v _ 5 oz 36 sq ft each 1055 S. ' G z Z. C Grady Way Server-I data Danallosquito ItemsNosquito Management Edited Day Sheet.doc Mosquito Management Day Sheet Year Z-o Month Day Person Making application/samplingl_,:e_\/ON L License # U`1��5 Terry Whitworth Applicator #374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 ,DO Product: Vectolex CG EPA# 73049-20 Time-Depart Shop AM/PM Time Return to Shop A�� r CCU ��11+�, oo00 , �c5 Total time for billing_ co.5 IqP L�F� ro ' ' LcL000D' � Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft _ Golf Course 40,000sgft 1' 2°` Hole#6 Sce 5 oz Golf course t-1�p\j(E 10 DL Golf Course About 1 acre /�50 Hole#7 5 oz dour jp A1,P m,'cVl Golf course :i� � i�v2, r ry 2v Rt✓ 2 foNri ri1 Er��7 Golf Course 40,000sgft g Iq Hole#9 � 502 5 oz �+ o r2 ; r� ��; Golf course Golf Course 30,000sgft ,',g Hole#18 r 5 oz D k:,o )T Golf course C( )'G ✓nz Maintenance Pond 0,.3D NE 101 & , ( 5 oz I ( e7O Anacortes `�' Maintenance Pond 11, 2-0 NE 261 & g 501. 5 oz -` ��t FJ Z 5�� LC6Z Lyons Maintenance 2 Tanks 1 Z'Z.I S 47a & A �2 b 5 oz 36 s ft each Z'• 102 Ave Facilities 9 Tanks a,.--bV City Hall N A 5 oz 36 sq ft each l�SO� 1055 S. Grady Way Mosquito Management Day Sheet Year Month Y Day 2 Person Making application/sampling I,'IFU�rJ �CCI-�TLicense # (°-1-7(Q 5 Terry Whitworth Applicator#374 Whitworth Pest Solutions 2533 Inter Avenue Puyallup, WA 98372 Product: Vectolex CG EPA# 73049-20 Time-Depart Shop j AM/PM Time Return to Shop t :a0 AMS' 7'15 Total time for billing P 0. , •7� rt+z 5 Billing Size Time Location Larval Product Total Rate/ Comments in/out count Name lbs 1000 s ft Golf Course 40,000sgft � qi) Hole#6 ` J � 5 oz r� `� ass N.' 1► Golf course - _=� � P ?n Golf Course About I acre Fa�t I Hole#7 l�nG 5 oz TQEA--Qp Golf course ',qe Golf Course 40,000sgft $tZ5 Hole#9 5 oz Golf course LA I �'L N� _ Golf Course 30,000sgft `I q Hole#18 5 oz Golf course 9 oo �OZ �i DCs Maintenance Pond t Z3 NE l0` & 5 oz 00 Anacortes Maintenance Pond j/-OT NE 26` & 5 oz yp Lyons Maintenance 2 Tanks 12.;01,4 S 47 & 5 oz 36 sq ft each Z'.-50 102"d Ave Facilities 9 Tanks C) City Hall t 5 oz �►' IJA Z 36 sq ft each 1055 S. I�•� Grady Way Server-I,data Dana\Mosquito ItemsWosquito Management Edited Day Sheet.doc April 4, 2008 SUBJECT: 2008 MOSQUITO ABATEMENT PROGRAM AUTHORIZATION AND RELEASE REQUEST Dear Resident/Property Owner: The City of Renton is preparing to conduct its annual Mosquito Abatement Program to control mosquito populations near the Panther Creek Wetlands complex(Exhibit A). The target area is approximately 60 acres adjacent to and upland of the eastern edge of the Panther Creek Wetlands, located between SR-167 on the west, and Lake Avenue South/Talbot Road South on the east, and extending from SW 39th Street on the south to I-405 on the north, within the City of Renton. Mosquito control will consist of land treatment applications of an Environmental Protection Agency registered, ultra-low volume insecticide spray(Exhibit C). A portable fogger(gasoline- powered backpack-mounted)will be used to apply the spray to upland vegetation. During April through September, when mosquito populations are higher, a licensed applicator/entomologist will apply the treatments in upland areas away from water and wetlands no more than twice per week. The application will be in accordance with the product label, and local, state and federal requirements. We are requesting you sign the enclosed Authorization and Release (Exhibit 13)form,to allow the applicator access through your property, if needed,to apply treatment. Please return the completed Authorization and Release form, using the business reply envelope provided, by April 18, 2008. If you do not return the form, we will not be able to treat your property. Thank you for your cooperation. If you have any questions, or would like more information about the Mosquito Abatement Program, please contact me at 425-430-7247. If you would like information on precautions you may take to help repel mosquitoes, see Exhibit C. Sincerely, Allen Quynn, P.E. Surface Water Utility Engineer Enclosures H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\1003 City Correspondence\2008 Release Request.DOC\AQtp Y O� PUBLIC WORKS DEPARTMENT + 919 + M E M O R A N D U M DATE: April 3, 2008 TO: Marcie Palmer, Council President Members of the Renton City Council VIA: Denis Law, Mayor FROM: Gregg Zimmerman,Administrator STAFF CONTACT: Ron Straka, Surface Water Utility Supervisor(ext. 7248) Allen Quynn, Surface Water Utility Engineer(ext. 7247) SUBJECT: Addendum No. 1-08 to CAG-07-065, 2008 Mosquito Abatement Program with Whitworth Pest Solutions, Inc. ISSUE: Should the Council authorize the Mayor and City Clerk to execute Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program contract(CAG-07-065), in the amount of $43,752.60. The addendum would authorize Whitworth Pest Solutions, Inc. (Whitworth), sole-source provider of the 2008 Mosquito Abatement Program, to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill area) and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes? RECOMMENDATION: Approve and execute Addendum No. 1-08 to the 2007-2008 Mosquito Abatement Program contract, in the amount of$43,752.60,with Whitworth as a sole-source provider of pest control consultant services for the 2008 Mosquito Abatement Program. BACKGROUND: Whitworth Pest Solutions has been the sole-source provider of the pest control consultant services for the City of Renton Mosquito Abatement Program since 1990. This addendum is proposed for the continued use of adulticide to treat adult mosquitoes in the areas upland and east of the Panther Creek Wetlands. In addition,the contract will include the application of larvicide to City stormwater ponds and vaults, irrigation ponds, and catch basins. This is the third year the City has been using larvicide to treat City-owned irrigation and stormwater ponds and vaults. In 2006, the City initiated the Mosquito Larvicide Program Council/Whitworth Add 1-08 CAG-07-065 April 3,2008 Page 3 of 3 PW Maintenance Services Division: Larvicide treatment to be funded through the approved Surface Water Utility 2008 Capital Improvement Program budget for the 2008 Mosquito Abatement Program. The approved 2008 adjusted budget for the Mosquito Abatement Program is $50,000. The estimated cost to treat Maintenance Division stormwater facilities and catch basins with larvicide is $10,627.50. The remaining balance in the project account of$39,372.50 will be used to complete Task 1 ($19,227.60) leaving a balance of$20,144.90 for City staff time to administer both tasks as well as additional treatments if required. Maplewood Golf Course: Larvicide treatment to be funded through the Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, and catch basins with larvicide is $4,768.75. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $4,768.75. Parks Division: Larvicide treatment to be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed$8,311.25. This project was funded in the 2008 Parks Maintenance Operating Budget. Facilities Division: Larvicide treatment to be funded through the 2008 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $817.50. CONCLUSION: The Public Works Department requests Council authorize the Mayor and City Clerk to execute Addendum No. 1 to the 2007-2008 Mosquito Abatement contract, in the amount of$43,752.60, authorizing Whitworth Pest Solutions, Inc., sole-source provider of the 2008 Mosquito Abatement Program,to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill area)and apply larvicide to City stormwater facilities, irrigation facilities, and catch basins for the control of mosquitoes. Attachment cc: Lys Hornsby,Utility Systems Director Greg Stroh,Facilities Maintenance Manager Terry Flatley,Parks Maintenance Manager Kelly Beymer,Golf Course Manager File H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Addendum Issue paper.doc\AQtp Council/Whitworth Add 1-08 CAG-07-065 April 3,2008 Page 2 of 3 under the advice of the Washington State Department of Health in response to the anticipated arrival of the West Nile virus in our state. West Nile virus is a mosquito- borne virus that is spread to humans by the bite of an infected mosquito and not by person-to-person contact. No human cases of West Nile virus were reported in Washington State in 2007. In an effort to reduce the risk of human infection,the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities, and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile virus. Larvicide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Department of Health. The total expenditure required for the 2008 Mosquito Abatement Program contract is $43,752.60, and includes the following tasks: Task 1 (Treatment of Panther Creek Wetlands) Whitworth will apply an Environmental Protection Agency(EPA)registered insecticide spray to brush and other upland vegetation,using a gasoline-powered, backpack- mounted, portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of April through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. The cost for adulticiding the areas upland and east of Panther Creek is $19,227.60 and will be funded through the approved 2008 Surface Water Utility's Mosquito Abatement Program Capital Improvement Program budget of$50,000. Task 2 (Larvicide Treatment of City Stormwater and Irrigation Facilities and Catch Basins Larvicide treatment is scheduled to begin June 2008 and will continue for the duration of the mosquito season, which typically extends through the end of September 2008. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities, and catch basins. These facilities and catch basins are owned and maintained by the Maintenance Division, Parks Division, Facilities Division, and the Maplewood Golf Course. However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile virus in King County. The total cost to treat City stormwater and irrigation facilities and catch basins is $24,525.00 and will be funded as follows: H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2008 Program\2008 Addendum Issue paper.doc\AQtp CITY OF RENTON PLANNINGBUILDING/PUBLIC WORKS MEMORANDUM DATE: March 28, 2007 TO: Kathy Keolker, Mayor FROM: Gregg Zimmerman, Administrator STAFF CONTACT: Ron Straka, Supervisor, Surface Water Utility, (ext. 7248) Allen Quynn, Project Manager, Surface Water Utility, (ext. 7247) SUBJECT: 2007-2008 Mosquito Abatement Program—Whitworth Pest Solutions, Inc., as Sole-Source Provider of Entomologist/Pest Control Consultant Services ISSUE: Should the Mayor execute a contract authorizing Whitworth Pest Solutions, Inc., (Whitworth) as a sole-source provider of the 2007-2008 Mosquito Abatement Program to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill Area) and apply larvicide to City stormwater facilities, irrigation facilities and catch basins for the control of mosquitoes. RECOMMENDATION: Approve and execute a contract with Whitworth as a sole-source provider of pest control consultant services for the 2007-2008 Mosquito Abatement Program. BACKGROUND: The Surface Water Utility has administered the Mosquito Abatement Program since 1990. A sole-source contract with Whitworth is proposed for the continued use of adulticide to treat adult mosquitoes in the area upland of Panther Creek Wetlands. In addition, the contract will include the application of larvicide to City stormwater ponds and vaults, irrigation ponds and catch basins. City Policy 250-02, Section 5.14.3, requires the Mayor to approve the use of a sole- source contractor. In accordance with City policy,the Surface Water Utility requests the Mayor's approval to use Whitworth as a sole-source provider for the pest control consultant services contract. The expenditure required for the Mosquito Abatement Program pest control consultant services contract for 2007 is $43,712.46.- Mayor/Sole-Source Provider March 30,2005 Page 2 of 3 Task 1 Treatment of Panther Creek Wetlands) Whitworth has been the sole-source provider of pest control consultant services for the City's mosquito abatement efforts since 1990. Whitworth is the only known, qualified provider of this type of service and is extremely familiar with the overall project area, including the areas where mosquitoes tend to congregate; e.g., access trails, wetlands, springs, and adjacent residences. Whitworth also has an experienced entomologist on staff to provide assistance in responding to public inquiries. Whitworth will apply an Environmental Protection Agency(EPA)registered insecticide spray to brush and other upland vegetation, using a gasoline-powered, backpack-mounted,portable fogger. The applications will be conducted at a maximum frequency of twice per week during the months of April through August. Treatment will be conducted in upland areas, away from water or wetland areas, as weather conditions allow, and in accordance with the product label and other local, state, and federal requirements. The cost for adulticiding the upland areas of Panther Creek(Task 1), is $19,209,96 and will be funding through the approved 2007 Surface Water Utility's Mosquito Abatement Program capital improvement account budget of$50,000. �Task 2 (Treatment of City Stormwater and Irrigation Facilities and Catch Basins)A40 �� h� � ✓a v roc 'J A,-,- Washington State had tw4 confirmed human cases of West Nile Virus last year.and the State Department of Health anticipates potentially many human cases this year. West Nile is a mosquito-borne virus that is spread to humans by the bite of an infected mosquito and not by person-to-person contact. In an effort to reduce the risk of human infection, the City has developed a response plan that includes larviciding City stormwater facilities, irrigation facilities, and catch basins, if needed, with Bacillus sphaericus. The response plan will augment the Department of Health program, which emphasizes prevention as the best protection from West Nile Virus. Larvicide treatment will be conducted in accordance with the City's Aquatic Mosquito Control Permit or as directed by the Health Department. Larvicide treatment is scheduled to begin June 2007 and will continue for the duration of the mosquito season, which typically extends through the end of September 2007. The contract scope of work and budget covers larviciding stormwater facilities, irrigation facilities, and catch basins. These facilities and catch basins are owned and maintained by the Maintenance Division, Parks Division, Facilities Division, and the Maplewood Golf Course. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2007 Program\2007 contract issue paper.doc\AQ\tb • Mayor/Sole-Source Provider March 30,2005 Page 3 of 3 However, the City must authorize targeted catch basin treatment and the decision to treat will depend on whether there is confirmation of the West Nile Virus in King County. The total cost to treat City stormwater and irrigation facilities and catch basins is $24,502.50 and will funded as follows: PBPW Maintenance Svcs. Division—Larvicide treatment to be funded through the approved Surface Water Utility 2007 Capital Improvement Program budget for the 2007 Mosquito Abatement Program. The approved 2007 adjusted budget for the 2007 Mosquito Abatement Program is $50,000. The estimated cost to treat Maintenance Division stormwater facilities and catch basins with larvicide is $10,617.75. The remaining balance in the project account of$39,382.25 will be used to complete the 2007 Mosquito Abatement Program as well as City staff time to administer both Task 1 and Task 2 of the contract. Maplewood Golf Course - Larvicide treatment to be funded through the Golf Course Operating Fund. The estimated cost to treat the Maplewood Golf Course irrigation pond, stormwater ponds, and catch basins with larvicide is $4,764.38. Should all ponds and catch basins need to be treated with larvicide, the estimated project cost shall not exceed $4,76.0 . g Parks Division—Larvicide treatment to be funded through the Repairs and Maintenance Operating Fund. The estimated cost to treat Parks Maintenance Division catch basins with larvicide is estimated not to exceed $8,303.63. This unanticipated project was not funded in the 2007 Parks Maintenance Operating Budget. It can be anticipated this amount will be a mandated annual expense in future years. Facilities Division—Larvicide treatment to be funded through the 2007 Repairs and Maintenance Operating Fund. The estimated cost to treat Facilities Division stormwater facilities with larvicide is $816.75. CONCLUSION: The Planning/Building/Public Works Department requests the Mayor sign a contract in the amount of$43,712.46 authorizing Whitworth Pest Solutions, Inc., (Whitworth) as a sole-source provider of the 2007-2008 Mosquito Abatement Program to apply adulticide in the areas upland and east of the Panther Creek Wetlands (i.e., Talbot Hill Area) and apply larvicide to City stormwater facilities, irrigation facilities and catch basins for the control of mosquitoes. Attachments cc: Lys Hornsby,Utility Systems Division Director Greg Stroh,Facilities Maintenance Manager Terry Flatley,Parks Maintenance Manager Kelly Beymer,Golf Course Manager H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2007 Program\2007 contract issue paper.doc\AQ\tb �Y p� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator DECEIVE{) EXHIBIT B 8860500110 MAI JOANNE APR, 2.4 2008 2011 DAVIS AVE S RENTON WA 98055 CITY Or RENTON PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. ;," 1, �ff ( ,, DATE SIGNATF Llep� ne Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr48-Pregw City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer y o� CITY OF RENTON A ru Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 3023059075 TURNER DAVID E& JODIE D 3107 TALBOT RD S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 4�- o-9- vR ' DATE SI TURE ;J_S7 d35 - �12-��1 (1a(� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Prog� City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RE 1055 South Grady Way-Renton,Washington 98057 NTON ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer y Yo CITY OF RENTON !� Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 5070000010 AGOO SILVER D+GRACE T 3621 SHATTUCK AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE VG ATURE �� a -43)� _ C7 R" Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(C[P)\27-2000 Mosquito Abatement Progra D. - 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N ®This paper contains 50%recycled material,30% AHEAD O F THE CURVE p pe y post consumer v4s7f�, CITY OF RENTON � Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8557000260 TONSGARD PATRICIA L 2515 TALBOT CREST DR RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington,and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton,and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. .l 8' AT SIGNAT P", Telephone Number rint Name COMMENTS: l ' ScJ G a )o /e A e o td- or Ae- bae"k, . /Va PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON 1055 South Grady Way-Renton,Washington 98057 AHEAD OF THE CURVE 9 This paper contains 50%recycled material,30%post consumer Y ��� o� CITY OF RENTON + is Public Works Department 1110 Denis Law,Mayor Gregg Zimmerman P.E.,Administrator NT� EXHIBIT B 3023059050 HAWKINS JACK M+JANE I 2825 TALBOT RD S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. -_ 7- '0, DATE SIG TURE fas=�Ss=8ra JnIrE ,I f Flcu �/i.�s Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Prcjects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Corcespondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RE N T O N ®This paper contains 50%recycled material,30%post consumer AHEAD OF THE CURVE Y o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �N�o RECEIVED 3023059068 APR 1 4 2008 EXHIBIT B PHAM VANG VAN+NGOC-LOAN THI CITY OF RENTON 408 S 33RD PL UTILITY SYSTEMS RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration,I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in 'ts efforts to effect mosquito control on my property. ,4h /a DATE , SIGNATURE . 1�i - �/ — Telephone Num er Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grad Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y p� CITY OF RENTON ru � Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator SIN EXHIBIT B 3023059081 SCHNEIDER KATHLEEN E 3037 TALBOT RD S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE IGNATURE Telephone N er Print ame COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Prog am"4B-Prue NTON City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp E 1055 South Grady Way-Renton,Washington 98057 R ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer U��Y o� CITY OF RENTON ! Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �UNTO EXHIBIT B 3023059107 KREBS FREDERICK D 2703 TALBOT RD S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE 4aS_-,2Q?- 4-03 /::�IericK 0, Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ®This paper contains 50%recycled material,30%post consumer AHEAD OF THE CURVE v��Y o� CITY OF RENTON �9 a•} Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator ��NTO EXHIBIT B 3023059116 FULLER NATHAN C RECEIVED 3113 TALBOT RD S RENTON WA 98055 APR 1 Z008 C �,' ENTON PUBLIC WORKSIDEPAR rY,TUOs Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration,I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE L125 —�_72iS IY4 aY� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr �_ _O� City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y o CITY OF RENTON �� '} . „u Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator 3023059130 RECEIVE EXHIBIT B HERNANDEZ JORGO&MARTHA APR 402 S 33RD PL c�9 ZQQB RENTON WA 98055 CITY UTiLITY's -NTOs PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. D TE Cq Telephone Number Print Na COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2fl11}ira� 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator 3340401115 �/ RECEIVED EXHIBIT B PANGILINAN JOB+ROSEMARIE APR j 5 2008 17238 163RD PL SE CITY OF RENTON RENTON WA 98058 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. .7 DATES N lephone Number Pri>It ame COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON This paper contains 50%r AHEAD OF THE CURVE recycled material,30%post consumer **YrN�>e-s CITY OF RENTON AM Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator RECEIVED EXHIBIT B 3340401120 APR 14 2008 LARSEN KELLY F+JESSICA E 1803 LAKE AVE S CITY OF RENTON RENTON WA 98055 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. ,,1 - to -C9 DATE SIG TURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 ARENTON ®This paper contains 50%recycled material,30% AHEAD O F. T H E CURVE p p cY post consumer o� CITY OF RENTON is )4. !� Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 3340401125 ALLEN JUST P RECEIVED 1801 LAKE AVE S RENTON WA 98055 APR Y 5 2008 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. V-IZ- 06 DATE SICYATURE 206- 33S -oZ2-? vL) �'� ll�>°r� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ®This paper contains 50%recycled material,30%post consumer AHEAD OF THE CURVE Y o� CITY OF RENTON „u + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 3340401131 LEWIS OLGA M RECEIVED 1717 LAKE AVE S RENTON WA 98055 APR 15 2008 CITY PUBLIC WORKS DEPARTMENT rlt UIL a'zRENTON rry SYSTEMS Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mOsot!ito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNAT RE _'_') ), 7-- �e 6 XF 6-Z ai,�z Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE this paper contains 50%recycled material,30%post consumer o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator INTO EXHIBIT B 3340401140 — —�___._-------_-_-.__--�— VILLA CHARLES A+CONSTANCE M RECEIVED 1717 LAKE AVE S RENTON WA 98055 APR 1 0 2008. CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. Z,/Z ,/, / DATE ar NATURE 4s__2 0 rJ'l�e' Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program12II48- Sw 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON 1055 South Grad Way-Renton,Washington 98057 AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer n�ti�y o� CITY OF RENTON -� !� � Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �NT� EXHIBIT B 3340401150 DELLA ROSSA EDWIN 1625 LAKE AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. D lP16) 0�aj Lt d ctJ DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RE N T O N ®This paper contains 50%recycled material,30% AHEAD OF THE CURVE p pe y post consumer Y o� CITY OF RENTON !4 a� !� ra + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator SIN EXHIBIT B 3340401151 TOBACCO JANA A 1701 LAKE AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMFNT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito"control on my property. y DAT NATURE S 6-7724 jq�ne�7 1,4 /0 q Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer o� CITY OF RENTON ♦ AM ra Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 3340401165 POZZOBON TERESA& EDA RECEIVED 1615 LAKE AVE S RECEIVED G RENTON WA 98055 APR 1 0 2008 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze,and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATA SIGNATURE .EOq ,06ZZ6Q0N Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grad Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator INTO RECEIVED EXHIBIT B 3340401172 APR 14 2008 C1 AVEZ KATHRYN G 1607 LAKE AVE S CITY OF RENTON RENTON WA 98055 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito ahaternent. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration,I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned m thods a d chemi als in its efforts to effect mosquito control on my property. lell5liv DA E IGNA RE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N AHEAD OF THE CURVE ®This paper contains 50%recycled material.30%post consumer y o� CITY OF RENTON t� >} !�;a Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �NT4 RECEIVED EXHIBIT B 5070000020 APR 14 2008 GILLILAN ANNE LIVING TRUST CITY of RENTON SHATTUCK AVE S UTILITY SYSTEMS RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGN& URE Telephone Number Print ame COMMENTS: 00 PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y p� CITY OF RENTON !�ru + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator INTO EXHIBIT B 5070000030 RECEIVE® HOANG BAY T 3609 SHATTUCK AVE S APR 15 2008 RENTON WA 98055 C"OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SyS7EMS Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT SIG U V /^ � =� '- Telephone Number Prtnt Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 105$ South Grady Way-Renton,Washington 98057 R E N T O N ®This paper contains 50%recycled material,30% AHEAD O F THE CURVE p p ecy post consumer Y p� CITY OF RENTON + + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator RECEIVED 5070000040 APR 14 2008 EXHIBIT B KUMARAN RUDRA+SAVITRI CITY OF RENTON 3603 SHATTUCK AVE S UTILITY SYSTEMS RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Penton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. � 1 (0 ob y DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\2 003 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ®This paper contains 50%recycled material,30%post consumer AHEAD OF THE CURVE Y o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator 5070000070 RECEIVED EXHIBIT B MOSS KATHERINE E APR 1 4 2008 3509 SHATTUCK AVE S RENTON WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton,and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE NATURE �25-�iyl- 21 �f1bnawc mosS Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra F+e 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grad Way-Renton,Washington 98057 RE N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer o� CITY OF RENTON ig �- + ra + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator INTO EXHIBIT B 5070000080 CAMERINI DONALD A+CARMEL D 3503 SHATTUCK AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington,and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE GNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 03 City Correspondence\2008 Signature Authorization Exh B.DOCWQtp RENTON 1055 South Grady Way-Renton,Washington 98057 AHEAD OF THE CURVE ®This paper contains 50%recycled material,30%post consumer y o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator ' EIVED EXHIBIT B 7222000410 APR FORD GLEN 1 12008 1925 SHATTUCK AVE CITY OF RENTON RENTON WA 98055 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control n m roperty. Z// DATf SIGNATURE `C Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Prograrn�� 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 - RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer o CITY OF RENTON ♦ e's '.' Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �F�VO EXHIBIT B 7222000511 GREGORIS NINFA 223 S 19TH ST RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington,and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SiGNATUkE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:Tile Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\ 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RE N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer ns�o CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator SIN 8557000180 - RECEIVED EXHIBIT B MAGNO LILY O APR 1 1 2�68 2331 TALBOT CREST DR S RENTON WA 98055 CITY OF RENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE" form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. op�—, �5-- Czl< DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer O� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8557000200 NGUYEN XIN 2401 TALBOT CREST DR S RECEIVED RENTON WA 98055 ^dclr'es.s tcl� � APR 0 9 2008 Gt,n a hl-c, Fo F�✓ PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON 1055 South Grady Way-Renton,Washington 98057 AHEAD OF THE CURVF. This paper contains 50%recycled material,30%post consumer y o CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �NTD EXHIBIT B 8557000230 ESPEY DIANE RECEIVED 2419 TALBOT CREST DR S RENTON WA 98055 APR 1 0 2008 CITY OF RENTON PUBLIC WORKS DEPARTMENT UTILITY SYSTEMS Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 8b8 /A4A_& 5 DAT SIGNATURE elephone Number Print ame COMMENTS: PLEASE RE URN THIS FORM BY APRIL 18,200 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra AFegrA City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y o� CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8557000270 NESS ROSEMARY 2521 TALBOT CREST DR S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze,and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. - Z- Dk DATE SIGNATURE `/al.tr 7 7 7 �s�v► lie Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:Tile Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program nu n. 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON , 1055 South Grad Way-Renton,Washington 98057 AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer Y o� CITY OF RENTON + + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator RECEIVED EXHIBIT B 8557000280 APR 14 2008 HOLZBOOG DAVID S+AMY L 2527 TALBOT CREST DR S CITY OF RENTON UTILITY SYSTEMS RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration,I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. -� DATE SIGNATURE Z " - 2 'D d� Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program nQ� 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE ISThis paper contains 50%recycled material,30%post consumer CITY OF RENTON Y Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator IN EXHIBIT B 8557000290 TRAUTMANN JOHN F 2601 TALBOT CREST DR S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. If-/0 "F-7 DATE SI ATURE 7;Z Telephcrc Numbcr Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer y o� CITY OF RENTON A M !�„u Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8860500130 LUONG HINH rid i ai-set 2023 DAVIS AVE S ble �rJA��� RECEIVED RENTON WA 98055 APR X 4 2008 PUBLIC WORKS DEPARTMENT CITY OF RENTON ,F-!l -.',,(STEMS Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer �ti`sY o CITY OF RENTON !� WL Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �NTD ECEwED EXHIBIT B 8860500140 KIAZIMOV ALI+JOULIA BOGACHOV APR 4 ZOO' 2101 DAVIS AVE S RENTON WA 98055 CIN Or-FEW ON SYSTEMS PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DA E SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program\ 003 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 R E N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer v�Y o� CITY OF RENTON ♦ is '} Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator �NT4 EXHIBIT B 8860500160 i2' e.h,rn ed DAVIS GEORGE E+DAVIS DALIA P 671 HARRINGTON AVE NE Onahle, 7� HECEIVED RENTON WA 98056 APR 0 8 PUBLIC WORKS DEPARTMENT CITY OF REENTON UTILITY SYSTEMS Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON ®This paper contains 50%recycled material,30%post consumer AHEAD OF THE CURVE Gti`s o CITY OF RENTON !� RAN Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8860500170 DURDUEVA SVETLANA RECEIVED 307 S 21 ST ST RENTON WA 98055 APR 1 0 2008 PUBLIC WORKS DEPARTMENT CITY OF RENTON UTILITY SYSTEMS Below is an"AUTHORIZATION AND RELEASE"form that, when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington,and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton,or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNATURE _d4i2 VC, Ck V\Ct DLL( Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra nun 03 City Correspondence\2008 Signature Authorization Exh B.DOCWQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer o� CITY OF RENTON a� + + Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8860500190 KING ALBERT WONG+LYNN WING 2115 DAVIS AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE" form that, when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abaterneia. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers j and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. IZ17 �Yzv v t DXTI1 URE — q17 _P111_13 0- Ay�_ kf4 Telephone Number Print Name 14-11-771 COMMENTS: 4 PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS RE Y ENVELOP H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Wat c 00 Mos ui Ab tement Program �03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 - RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer �ti`sY o� CITY OF RENTON ba Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator RECEIVED EXHIBIT B 8860500220 APR 14 2008 BROADDUS SUSAN G 2133 DAVIS AVE S UTIL O�RENTON SYS TTEMM S RENTON WA 98055 TILI PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities,for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 206 DA E SIGNATURE itiephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progrlm\2ILrD-:::: 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RENTON AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer CITY OF RENTON Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 8860500350 VALLEY VUE ESTATES HOMEOWNER ASSOC 332 S 20TH PL RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you,will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health, the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For,the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. Z/ DATE SIGN RE Telephone Number Print flTame COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Prog;�4E�N City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp1055 South Grady Way-Renton,Washington 9805 7TON ®This paper 50%recycled material,30% AHEAD q F THE CURVE p pe recy post consumer Y o� CITY OF RENTON A Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator EXHIBIT B 9899200010 FAST JOHN L 3431 SHATTUCK AVE S RENTON WA 98055 PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of ,_ masgiiiiu aliate:uerit. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others,I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DAT9 GNATURE r' Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement.D Progra^���n,,,,,�.b City Correspondence\2008 Signature Authorization Exh BOC\AQtp R �T T �T 1055 South Grady Way-Renton,Washington 98057 1 ` jr 1 lr ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer �ti`sY o� CITY OF RENTON . Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator IN EXHIBIT B 3023059018 RECEIVED OLSON SHAWN &JAIME 3101 TALBOT RD S APR 16 2C;38 RENTON WA 98055 CITY OF RENTON' PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County,Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. DATE SIGNA&IURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progra 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RE N T O N AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer CITY OF RENTON !� Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator `,�� 8860500090 RECEIVED EXHIBIT B THOENNES NICHOLAS A 200 S 20TH PL APR 2 1 Z ` RENTON WA 98055 CITY Or-RENTON UTILITY SYSTEMS P U BIT NORKS DEPAR T irlENT Below is an "AUTHORIZATION AND RELEASE"form that,when signed by you,will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives, to enter my land for the purpose of mosquito abatement through the use of the following methods: I. Inspection; 2. Testing and Analysis; and/or 3 Treatment of Areas with Chemicals For the same consideration,I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 07 DATE SIGNATURE Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON 1055 South Grady Way-Renton,Washington 98057 ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer y o� CITY OF RENTON is �- !� Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator 3340401145 RECEIVE® EXHIBIT B BROWN WAYNE ARTHUR JR APR 2 j 2008 1711 LAKE AVE S RENTON WA 98055 CITY of 13ENTON UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an "AUTHORIZATION AND RELEASE"form that, when signed by you, will authorize the City of Renton or its representative to inspect,analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE, In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree old har the City of Renton, and its officers and representatives, in their official or individual ca i ' , for an pe nal injury or property damage that may arise from the use of the above-mentio d thods a s in its efforts to effect mosquito control on my property. DA E IGN URE Ielephone Number t;It Na ne COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Program 03 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp 1055 South Grady Way-Renton,Washington 98057 RE N T O N ® AHEAD OF THE CURVE This paper contains 50%recycled material,30%post consumer `s o� CITY OF RENTON „u � Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator RECEIVED EXHIBIT B 8557000190 APR 2 1 ZOl: >j VU HAI V 16020 SE 156TH ST CITY OF RENTON RENTON WA 98058 UTILITY SYSTEMS PUBLIC WORKS DEPARTMENT Below is an"AUTHORIZATION AND RELEASE"form that,when signed by you, will authorize the City of Renton or its representative to inspect, analyze, and treat your property for the purpose of mosquito abatement. AUTHORIZATION AND RELEASE In consideration of my interest as a resident and property owner in King County, Washington, and realizing that mosquito control is essential for my family's health,the same as for that of others, I hereby authorize the City of Renton, or its representatives,to enter my land for the purpose of mosquito abatement through the use of the following methods: 1. Inspection; 2. Testing and Analysis; and/or 3. Treatment of Areas with Chemicals For the same consideration, I also release and agree to hold harmless the City of Renton, and its officers and representatives, in their official or individual capacities, for any personal injury or property damage that may arise from the use of the above-mentioned methods and chemicals in its efforts to effect mosquito control on my property. 0,8 DATE SIGNATURE 2-0 G 0--G"V_ ,,'0' 7 --4 A- :; A V LJ Telephone Number Print Name COMMENTS: PLEASE RETURN THIS FORM BY APRIL 18,2008 USING THE ENCLOSED BUSINESS REPLY ENVELOPE H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatement Progr 3 City Correspondence\2008 Signature Authorization Exh B.DOC\AQtp RENTON 1055 South Grady Way-Renton,Washington 98057 ® AHEAD OF THE CURVE This paper contains50%recycled material,30%post consumer EXHIBIT A Y SCOPE OF WORK 01 2009 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: TREATMENT OF PANTHER CREEK WETLANDS Treatment Methods and Materials: Land treatment applications of an ultra low volume(ULV), Environmental Protection Agency registered, insecticide will be applied to brush and other upland vegetation using a gasoline-powered,backpack-mounted,portable fogger. Treatment will be conducted in upland areas away from water or wetland areas as weather conditions allow and in accordance with the product label and other federal and state regulations. Treatment must also be conducted in accordance with the conditions of the Determination of Non-Significance-Mitigated(Application Number LUA05- 022,ECF)for the program made by the City of Renton Environmental Review Committee on April 1,2005 and included as Exhibit D of this contract. All necessary licenses and permits shall be the responsibility of the consultant to ensure their issuance prior to treatment. The synthetic pyrethroid insecticide product to be used is Permanone or other products containing similar formulations. Area of Treatment: The treatment area, shown in Exhibit E, is adjacent to and upland of the eastern edge of the Panther Creek Wetland generally located between SR-167 on the west and Lake Avenue South/Talbot Road South on the east and extending from SW 39th Street on the south to I-405 on the north,within the City of Renton,Washington. The project area covers approximately 60 acres to the east of the approximately 65-acre Panther Creek Wetland complex. Prior to treatment,the City will provide a highlighted copy of the map included in Exhibit D of this contract to indicate the properties within the project area for which authorization and release for access and treatment has been granted by the property owner or the owner's legal representative. The treatment application will be performed from foot trails through the project area used in the previous Mosquito Abatement Program treatment applications. The cost per treatment shall include all necessary work for clearing of the trails to allow the treatment to be applied. Frequency of Treatment: Fogging will be conducted in coordination with and at the request of the City at a maiximum frequency of once per week during the months of April through August. The City may request treatments as frequent as twice per week if larger than normal mosquito populations justify more frequent treatment. The contract budget assumes a maximum number of 21 treatment applications. Coordination: Following each treatment,the consultant shall provide to the City a brief summary of the area treated and the type of chemical used,weather conditions during the treatment application,the time during which treatment was conducted,an estimate of the relative abundance and distribution of mosquitoes,and a recommendation on the scope and timing of subsequent treatment. a TASK NO.2: TREATMENT OF CITY STORMWATER AND IRRIGATION FACILITIES AND CATCH BASINS Treatment Methods and Materials: Water treatment applications of an Environmental Protection Agency registered larvicide will be applied to City owned stormwater/irrigation impoundment facilities using hand applied briquettes or granules. Treatment will be applied in accordance with the product label and other federal and state regulations. Larvicide treatment must also be conducted in accordance with City obtained Aquatic Mosquito Control National Pollutant Discharge Elimination System (NPDES)Waste Discharge General Permit. All necessary licenses shall be the responsibility of the consultant to ensure their issuance prior to treatment. The larvicide product to be used is Bacillus Sphaericus(BS)and is sold under the trade name VectoLex. Area of Treatment: The treatment areas consist of the following facilities: Owner Facility Name/Type Facility Location PBPW Maint. Svcs. Division Stonegate/WQ Pond NE 26th and Lyons Ave PBPW Maint. Svcs.Division NE 10`'St Pond/Detention NE l Oth St and Anacortes Ave PBPW Maint. Svcs. Division Talbot Ridge 2/WQ Pond S 47th St and 102°d Ave SE PBPW Maint. Svcs.Division Talbot Estates/Pond Talbot Rd S PBPW Maint. Svcs. Division Benson Woods/Pond l l 1th PL SE PBPW Maint. Svcs. Division Olympic Peak Estates/Pond S. 196th PL PBPW Maint. Svcs. Division Larson Parke/Pond 112th Ave SE PBPW Maint. Svcs. Division Watershed Terrace/Pond SE 200`h St PBPW Maint. Svcs.Division Wilkens Wood/Pond 113t"Ave SE PBPW Maint. Svcs. Division Serenity Ridge Tract A/Pond 110th PL SE PBPW Maint. Svcs.Division Serenity Ridge Tract B/Pond 110th PL SE PBPW Maint. Svcs. Division Auria Woods Tract C/Pond SE 186th St PBPW Maint. Svcs.Division SR-169/Pond 140th Way SE PBPW Maint. Svcs. Division Fredericks Place/Pond SE 186th St PBPW Maint. Svcs. Division Aster Park/Pond NE 13`h PL PBPW Maint. Svcs. Division Hamilton Place/Pond 160'h Ave SE H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp PBPW Maint. Svcs.Division Evendell/Pond 160"'Ave SE PBPW Maint. Svcs.Division Nichols Place/Pond 160t'Ave SE/SE 5`h St PBPW Maint. Svcs.Division Catch Basins Various Golf Course Hole#18 Pond/Irrigation Maplewood Golf Course(west) Golf Course Hole#9 Pond/Irrigation Maplewood Golf Course(west-central) Golf Course Hole 47 Pond/Irrigation Maplewood Golf Course(east-central) Golf Course Hole#6 Pond/Irrigation Maplewood Golf Course(east) Golf Course Catch Basins Various Parks Maintenance Division Catch Basins Various Facilities Division City Hall/WQ Grady Way Parking Lot Frequency of Treatment: Each water impoundment facility and catch basin as described above shall be tested for the presence of mosquito larve every two weeks. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. Reporting: Following each treatment,the consultant shall provide to the City a brief summary of all stormwater/irrigation impoundment facilities tested and treated. Information to be provided for each shall include the following: 1. Date,time, and street location of facility or catch basin tested. 2. Type of Larvicide and EPA registration number. 3. Amount of larvicide in gallons or pounds that was applied. 4. The number of acres treated. 5. Name and address of person applying larvicide. 6. Larval count(larve per dip). 7. Number of manhours per facility visited(includes testing and larviciding). H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp Notification: Maplewood Golf Course—Whitworth Pest Solutions, Inc. shall contact the Golf Course Manager 24 hours in advance of entering the Golf Course. Whitworth Pest Solutions, Inc. shall arrange with the Golf Course Manager to be escorted onto the golf course and in no circumstances shall Whitworth Pest Solutions, Inc., enter upon the golf course without one golf course employee in attendance at all times while on golf course property(this is a mandatory safety requirement). H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp EXHIBIT B TIME OF COMPLETION 2009 MOSQUITO ABATEMENT PROGRAM Upon contract execution and issuance of Notice to Proceed, adulticiding of the upland areas east of the Panther Creek Wetlands will be conducted in coordination with and at the request of the City at a frequency of once per week during the months of April through September. The City may request a treatment frequency of twice per week if larger than normal mosquito populations justify more frequent application. The project budget assumes a maximum number of 21 treatment applications. Larve concentrations for City stormwater facilities, irrigation facilities, and catch basin will be conducted at a frequency of once every two weeks from July through September. If the larve count exceeds 0.3 larva per dip then larvicide shall be applied in accordance with the requirements of the City obtained Aquatic Mosquito Control NPDES Permit. By direction from the City,testing and larviciding may begin prior to July and extend past September if recommended by King County Department of Health. H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp EXHIBIT C COST ESTIMATE 2009 MOSQUITO ABATEMENT PROGRAM TASK NO. 1: The estimated total cost of Task 1 including Washington States sales tax is$19,315.80. The cost shall include all necessary work for 21 treatments including clearing of the trails. Work conducted in performance of Task 1 will be billed at the following rates: For 12 or more total treatments: $840/treatment For 6 to 11 total treatments: $890/treatment For 1 to 5 total treatments: $990/treatment The billing rates include state sales tax. Subtotal Contract Cost: $17,640.00 State Sales Tax(9.5%) $1,675.80 Total Cost Task 1: $19,315.80 TASK NO.2: The estimated total cost of Task 2 including Washington States sales tax is$33,342.75. The cost shall be based on a rate of$125.00 per manhour,which includes labor, materials, and equipment required to apply larvicide as specified in the scope of work and shall include but not be limited to the following: 1. Transportation costs associated with transit from the consultant's office to the stormwater/irrigation facilities, and transit between facilities including catch basins. 2. Material costs for larvicide. 3. Equipment necessary to test and apply larvicide including sampling cups,protective gloves,and respirators, etc. At the City's discretion,facilities listed under"Areas of Treatment"above may be eliminated or treatment frequency reduced and other facilities added depending on mosquito levels and recommendations from the Public Health Department. Catch basins will only be treated when requested in writing by the City. H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp A minimum scheduled trip charge from the consultant's office to the stormwater/irrigation facilities of $375.00 shall apply. Below is the estimated contract cost for the three City divisions,based on the billing rate of$125.00 per manhour for a total of 180 manhours: PBPW Maintenance Services Division Costs Stormwater facilities: 18 Total number of treatments per stormwater facility: 8 Total manhours per stormwater facility(including travel time): 0.6 hrs Total stormwater facility manhours: 86.4 hrs Subtotal cost for stormwater facilities: $10,800.00 Sales Tax(9.5%): $1,026.00 Total cost for stormwater facilities: $11,826.00 Total manhours available for catch basin treatment: 60 hrs Total cost for catch basin treatment: $7,500.00 Sales Tax(9.5%): $712.50 Total cost for catch basin treatment: $8,212.50 Total manhours(stormwater facilities+catch basins): 146.4 hrs Subtotal cost(stormwater facilities+catch basins): $18,300.00 Sales Tax(9.5%): $1,738.50 Total cost(stormwater facilities+catch basins): $20,038.50 Golf Course Costs Irrigation facilities: 4 Total number of treatments per facility: 8 Total manhours per irrigation facility(including travel time): 1 hr Total irrigation facility manhours: 32 hrs Subtotal cost for irrigation facilities: $4,000.00 Sales Tax(9.5%): $380.00 Total cost for irrigation facilities: $4,380.00 Total manhours available for catch basin treatment: 3 hrs Subtotal cost for catch basin treatment: $375.00 Sales Tax(9.5%): $35.63 Total cost for catch basin treatment: $410.63 Total manhours(irrigation facilities+catch basins): 35 hrs Subtotal cost(stormwater facilities+catch basins): $4,375.00 Sales Tax(9.5%): $415.63 Total cost(stormwater facilities+catch basins): $4,790.63 H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp Parks Division Costs Irrigation facilities: 0 Total manhours available for catch basin treatment: 61 hrs. Subtotal cost for catch basin treatment: $7,625.00 Sales Tax(9.5%): $724.38 Total cost for catch basin treatment: $8,349.38 Total manhours(irrigation facilities+catch basins): 61 hrs Subtotal cost(stormwater facilities+catch basins): $7,625.00 Sales Tax(9.5%): $724.38 Total cost(stormwater facilities+catch basins): $8,349.38 Facilities Division Costs Stormwater facilities: 1 Total number of treatments per facility: 8 Total manhours per stormwater facility(including travel time): 0.75 hrs Total stormwater facility manhours: 6 hrs Subtotal cost for stormwater facilities: $750.00 Sales Tax(9.5%): $71.25 Total cost stormwater facilities: $821.25 Catch Basin: 0 Total manhours(stormwater facilities+catch basins): 6 hrs Subtotal cost(stormwater facilities+catch basins): $750.00 Sales Tax(9.5%): $71.25 Total cost: $821.25 Total Contract Cost for all Divisions: $31,050.00 State Sales Tax(9.5%): $2,949.75 Total Cost Task 2: $33,999.75 Total Contract Cost(Task 1 +Task 2): $53,315.55 Invoicing Whitworth Pest Solutions,Inc. shall submit a separate invoice to the City of Renton Surface Water Utility Section,Parks Maintenance Division,Maplewood Golf Course,and Facilities Division for any services it provides under this project. Payment cannot be authorized or payment may be delayed until separate invoices are received. H:\File Sys\SWP - Surface Water Projects\SWP-27 - Surface Water Projects (CIP)\27-2000 Mosquito Abatement Program\2009 Program\Contracts\2009 Scope of work and budget.doc\AQtp 05/02/2008 08 : 51 FAX 2538451133 WHITWORTH PEST SOLUTIONS Z 001/001 Date of Application: Year 2008 Month 05 Day 01 Firm Name: Whitworth Post Solutions Phone No_ 253-845-1818 R��;'OVE Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 MAY 0 2 2008 Person(s) who applied the pesticide: Levon,Nic 13 P^E5 CITY OF RENTON License No(s)jg777b5- t3 _7b Apparatus License No. LT'-!-YSYsk=r,;s Pesticide Information: See Chemical Sheet Dated: Z AppointmentAddress 01-0123148 City of Renton --Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In ,, y�m v /Out Temp Wind DirNel. -- !.a) � W 2_ 2'. Comments j o `t vj c s -VI V-A IEZ- O A FcW '°� 1"�G -ro v 7-4 C:_��P 6T4"/fi b G�U--v-(}C-L- j!9p_0F(, ` uto II of � post-it"Fax Note 7671 D P°JQ9 7o From CDJDop l . .\ 0 y- C?�:Hrriri Phone Phone It Fux a Fax 11 1 — 05/09i2008 09 : 01 FAX 25384511113 WHITWORTH PEST SOLUTIONS 002i'002 Date of Application: Year 2008 Month 05 Day 08 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Levon,Nic License No(s) (p 7(pS. A00-7 Apparatus License No. Pesticide Information: See Chemical Sheet Dated: Z/2 ► 10 -7 �ppointrnent 01-0123149 City of Renton --Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Tamp Wind Dirtyel. PC) 00 Comments 01-0123852 Puget Sound Energy—Wickersham Basin - -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Comments D()A)T- A- 0-4 F—oUA)O 7t� e MAJ O12IsTY o (-- TtM� -A-T- T�46- 05/23/2008 10 : 15 FAX 2538451133 WHIT4'OFTH PEST SOLUTIONS 001;'001 Date Of A lication: Year 2008 Month 05 Day 22 Firm Name: Whitworth Pest Solutions Phone No- 253-845-1818 Commercial A licator: Terry Whitworth License No- 374 RtCEIVED Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Levon,Nie MAY 2 3 2008 License No(s) Apparatus License No. CITY OF RENTON Pesticide Information: S e Chemical Sheet Dated: UTILITY SYS1:-anS 01-0123151 City of Renton — Panther Creek Wetland - -98055 Mosquito Control Weekly Product 8 Amount Used Application Site Time In/Out Temp Wind Dir/Vel. Comments 01-0123854 Puget Sound Energy--Wickersham Basin - - 98321 Mosquito Control Weekly Product$Amount Used plication Site Time In/Out Temej Wind DlrNel. Comments 6 tj "T�-� Vj(::+LQ 5 Tit L 5 I t (Y`E b j-�' Hm-a-ok'/ ANY �W-�;Qo rr06-5 e- T12�iww ,AS vsum-L, _ -- pagol- 767t _----- pate -- ------- Post IV Fax Note From so / c Co o ALL Phone Phone lf` I (ax 11 1 ax u L '25 - 05/30/2008 08 :52 FAY 2538451133 WHITWORTH PEST SOLUTIONS a 0011/001 Date of Application: Year 2008 Month 05 Day 29 CEIVED Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 RE Commercial Applicator: Terry Whitworth License No: 374 MAY 3 0 2008 Address: 2533 Inter Ave, Puyallup, WA 98372 CITY OF RENTON, Person(s) who applied e pesticide. Levon,Nic +sc License No(s) l'n77WJ ' 10 Apparatus License No. Pesticide Information: See Chemical Sheet Dated: 'fit D Address Information Service(s) 01-0123152 City of Renton--Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Tlme yr, qJOut Temp Wind DirNet_ ( Comments 01-0123855 Puget Sound Energy--Wickersham Basin - -98321 Mosquito Control Weekly Product&Amount Used A plication Site Time In/ ut Temp Wind it el. u� Comments 4cvS P O-©P P ED /Atti.p -r-� 7rg-,A I L f 5 be�ir��yn1 N `7� �2y y Tim .� ��s o N ��� �C�rfl V I-F _7j�t_ 4T 0S hy1f-,V rev PL . — L-4ol"j Post-it"Fax Note 7671 Date pugo�� To From 00. Phono II` Phono II Z Fax 11 L .S —LI:�t,-- -ZL/I Fax 07/16;'2008 08 : 15 FA:N( 2538451133 "'HITWORTH PEST SOLUTIONS Z0011001 Date of Application: Year 2008 Month 07 Day 10 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who ap liedAhe pesticide: Levon,Nic License No(s) ( Apparatus License No. Pesticide Information: See Chemical Sheet Dated: Appointment Customer Name I Address information service(s) 01-0123158 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control weekly Product&Amount Used Application Site Time In/Out Temp Wind DirfVel. 1 2C---j ro fe a 0 _ A CMS ct ,?,fl Comments 01-0123861 Puget Sound Energy--Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wi d Dir/Vel. 1 ri'?asT 10, 15 ° '32A(Y_ 1, ; r5 Comments r /-L crr o f r>7 a 5() (TO AC77 v1 F)e" Togo�� r� w� 0 8/ 7�/,5 Post-ir`Fax Note 7671 Dale pages 10. ToJ_Le From in Phone# Phone# Fux a L S _L 30 -7ZL/j 0 i/22;'200^0 10 : 27 FA { 2531245113 1 "HIT NORTH PEST SOLUTIONS 001;'001 Date of Application- Year 2008 Month 07 Day 24 Firm Name: Whitworth Pest Solutions Phone No= 253-845-1818 Commercial Applicator Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Nic, JamesLicense No(s) ' .-k;1 1 L Apparatus License No. Pesticide Information: See Chemical Sheet Dated: ! 01-0123160 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time InlOut Temp Wind DirlVet- 65 comments 01-0123863 Puget Sound Energy--Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind Dlr/Vel. Comments --- v Off`'S �,)E F n /7 �i\E �L.. Post-it",Fax Note 7671 Dal0 l nl � Fu9�'u 'fA ; �en From Ga./Depl. Rhonn 11 '' 11 hhono '4b- I I �(� 02/01;%2008 0 9 : S 5 FA.>' 2538451101 i4HITi4ORTH PEST SOLIJTIOtJS i 001i'001 Date of Application: Year 2008 Month 07 Day 31 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who ap lie e pesticide. Levon,Nic License No(s) Apparatus ,License No. Pesticide Information: See Chemical Sheet Dated: -7 1 Appointment Customer Name I Address Information I Service(s) 01-0123161 City of Renton — Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time InlOut Temp Wind DirNel. 240 Comments 01-0123864 Puget sound Energy --Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. _7t _ A.0"E;?3n— — 5:� "Tait— I Comments , -c'-4 E:),+- Y Post-it Fax Note 7671 Da�c p psges� 1 To From\_ Co. c W N1 Phone# J Phone# Fox114�J� �T� PLtxll�. ��11— 07/30/2007 03 : 54 FAX 2538451133 WHITWORTH PEST SOLUTIONS 001/001 Date of Application: Year 2007 Month 07 Day 26 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 r fi 4 .,{ L, 4� Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Levon,Nic nA License No(s) 4#00 --1'- Apparatus License No. Pesticide Information: ee Chemical Sheet Dated: Appointment Customer Name/Address Information Service(s) 01-0078434 Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Tampa Wind Dir/Vel. Comments 01-0078463 Wickersham Basin - -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp O Wind Dir/Vel. 1 �1 ^ljT 1, 1 Comments r Of Lam► 7-rur'2 Post-It"Fax Note 7671 Date pa°gas► 7o From Cofnpti �'F ? T °PJri4r&�V � e &57 �tY i Phone it Phone Fax# 08/08/2008 11 : 39 FF,:>; 2538451103 YHIT MRTH PEST SOLUTIMP S I 001/001 Date of Application: Year 2008 Month 08 Day 07 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Levon,Nic License No(s)t; Z20 Apparatus License No. '1v14 Pesticide Information: See Chemical Sheet Dated- 2/Z 1 /n-1 01-0123162 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind Dir/Vel. 5 - Comments • u r , 01-0123865 Puget Sound Energy --Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. r� I - 1(:jb L Ak� 0 -7a 3 Com ments 01-0132891 River Mobile Home Estates - 3611 1 St NE -98002 Tree& Shrub Bid Product&Amount Used Application Site Time In/Out Temp Wind DirNel. o' f Comments 01-0132892 River Mobile Home Estates - 3611 1 St NE 98002 Weed Did Product& Amount Used Application Site Time In/Out Temp Wind DirNel. Comments 01-0132890 River Mobile Horne Estates - 3611 1 St NE -98( Product&Amount Used Application Site Time In/O Post-it" Fax Note 7671 °�1e Q Pages► To From Co./Dept. L Co. Phone# t I Irk —_zf� �n Phone 11 _1 I Comments Fnx n `i � 11�`�.J_ pf-(—'[ r,x n - _ 3 02/15/2002 10 : 45 FAX 25024511JJ WHIT;40RTH PEST SOLUTIONS 001/001 Date of Application: Year 2008 Month 08 Day 14 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide_ Levon,Nic License No(s) 007 Apparatus License No. Ai Pesticide Information- ee Chemical Sheet Dated: - 01-0123163 City of Renton — Panther creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind Dir/Vel. Com ments 01-0123866 Puget Sound Energy —Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used plication Site Time In/Out Temp Wind Dir/Vel. Ieilz Comments LA-) OV-6 � Y k)fi 0 TO 9" -/ o�c ALso BA-o L�Evo� Post-it"'Fax Note 7G71 Data 1A II or 15 pugoa Co./Dept Co. ` - Phono H Phono P 1 Fax 0 � 1 Fax If 11 08;122/2008 10 : 24 FAX 25,3845113"' WHITWORTH PEST SOLUTIONS 001;'001 Date of Application: Year 2008 Month 08 Day 21 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who ap li d the�Qpesticide: Levon,Nic License No(s) Apparatus License No. Pesticide Information: See Chemical Sheet Dated: Z.1 4v! • ... Address 01-0123164 City of Renton --Panther Creek Wetland - -98055 Mosquito Control Weekly Pr duct&Amount Used Application Site Time In/Out Temp Wind DirNel, ,'p 4aC-R� IU 3y Comments 01-0123867 Puget Sound Energy--Wickersham Basin - Wickersham Basin -96321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Voges-r 1,2,115m E Cal Comments 01 0122044 Water Gardens - 21810 SE 276th St -98038 Mosquito Control for August Product&Amount Used Application Site Time In/Out Temp Wind DirNel- a3 Comments `9 OTkT�C_ nPAy t�_501E ET ALL.';'Ed - W6 �—W-rT:`7D Tct--Al P->_e:_Ck0'S E_ 0 f T�+,e ' \("� vjt- ONl f�W A- �0 t_-Tt l lj_ vU Post-it*Fax Note 7671 oaie'N pag s► ( LE VO'Iv OlAilnrl From Co./Dept.I Co, Phone# , F:ix 8 _ --r�� Fax 41 —I 3 03/05I2008 10 :57 FAX 25384511"" "'HIT'd'ORTH PEST SOLUTIOtIS � 002;'002 Date of Application: Year 2008 Month 09 Day 04 Firm Name: Whitworth Pest Solutions Phone No- 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) whoa lie the pesticide: Levon, James License No(s) (� , 117 '23 Apparatus License No. p' Pesticide Information: See Chemical Sheet Dated: Z1 'Appointment Customer Name/Address Information Service(s) 01-0123166 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind Vir/Val, Duj i LY" 2- Comments 01-0123869 Puget Sound Energy -- Wickersham Basin - Wickersham Basin - 98321 Mosquito Control Weekly Product 8,Amount Used Application Site Time In/Out Temp Wi d DirNol. Q=35 � 1 - 10 Comments 01-0123091 River Mobile Home Estates - 3611 1 St NE: 98002 Mosquito Control for September Pr duct& Amount Used A plication Site Time In/Out Temp Wind DIrlVel. rD In- 1O Comments INV- Tt-\ �Ay N-P-Tpl) R- - L-b)00 09/12/2003 13 : 39 F 2501845110110 "'HITNORTH PEST SOLUTIONS 001/001 Date of Application: Year 2008 Month 09 Day 11 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator., Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who aonlied,,thepesticide: Levon, Jaynes License No(s) 1 Apparatus License No. Pesticide Information: ee Chemical Sheet Dated: — 2k 01-0123167 City of Renton — Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Comments 01-0123870 Puget Sound Energy--Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used A placation Site Time In/Out Tempt/ Wind DirNel. Comments 'ku��r �� �4 A, -D L_� Toop�/ ' / 4 �F_C- L�) N v 6—(2— —F4C C ce-C !_ i�-l 'Tt � S d 0ri4 Post-itr Fax Note 7671 Dale pygcTO s From Co. Co,/DOp[. Phone 41 Ptiono II Fax 41 Faxii� 5. ��3b• 7�C.1� 00 /19/2008 12 : 37 FAX 2532451133 i4HITWORTH PEST SOLUTIONS 001/001 Date of Application_ Year 2008 Month 09 Day 18 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied he pesticide: Levon, James t J License No(s) L 73 Apparatus License No. `" Pesticide Information: See Chemical Sheet Dated: Z 0 Appointment Customer Name I Address 01-0123168 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In1Out Temp Wind DirNel. , _Lo C4�f5� Comments f2 -s 01-0123871 Puget Sound Energy —Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application Site Time Iniout Tern Wind DirNel. -� �3 Comments 01-0122046 Water Gardens - 21810 SE 276th St -98038 Aquatic Weed Control Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Mosquito Control for September Comments SIE A V V h I G �� �� r _'t' r— -1 T ryie_ (n�>LT-z -r4o 06H ry 19 Z-t.,� VY) A-00 �o post-it'Fax Note 7671 Dail) 7o H of Pages Co./Dopy, Fr m - Co. Phone# Ph no if Fax#� 72L� i Fax it 05/18/2008 09 :35 FAX 2538451133 WHITWORTH PEST SOLUTIONS 0011'002 i WHITWORTH PEST SOLUTIONS INC. 2533 INTER AVE. PUYALLUP, WASHINGTON 98372 Pierce Co. (253) 845-1818 • King Co. (206) 248-2222 • Toll Free 1-888-959-181 a Fax: (253) 845-1133 ww`^'.whitworthpestsolutions.com RECEIVED MAY 16 2008 CITY OF RENTON UTILITY SYSTEMS FAX TRANSMITTAL SHEET DATE: FAX: TO: ���e:► l L�'u�:���►1 FROM: �'11 �_ k PAGES: ( Including Cover ) RE: If you do not receive all the pages indicated, please contact us. 05/16%2006 09 : 35 FA;>; 2533451103 14HIT'NORTH PEST SOLUTIONS i 0021002 Date of Application: Year 2008 Month 05 Day 15 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied the pesticide: Levon,Nic License No(s) Apparatus License No. Pesticide Information: See Chemical Sheet Dated: Appointment Customer Narne Address Information 01-0122036 Water Gardens - 21810 SE 276th St -98038 Mosquito Control for May Product Amount Used Application site Time In/Out TemR Wind DirNel. i - I.65 0 (22 5 tc- A4 04TI C, \QJ"� ND} for 1-1prey SL4cE7 o7 5 Comments 01-,0123150 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Temp Wind DirNel. C0 is Comments 01-0123853 Puget Sound Energy--Wickersham Basin - -98321 Mosquito Control Weekly Product&Amount Used Application Site Time In/Out Ternp Wind DirNel. 2- Comments A/ AL O j p M0 SQ J( TC AC-'iI J r Fv 0 C� i -L�� 0 0 7/18/2008 10 3E FPkY: 2532451133 ,4HITJ0RTH PEST SOLUTIONS 00Ii'001 Date of Application'. Year 2008 Month 07 Day 17 Firm Name: Whitworth Pest Solutions Phpne No; 253-845-1818 Commercial Applicator, Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who ap liej the pes cid Levon,Nic License No(s) Apparatus License No. Pesticide Information: See Chemical Sheet Dated: 2 .. 01-0123159 City of Renton -- Panther Creek Wetland - -98055 Mosquito Control Weekly Product&Amount Used Application Site Time InlOut Temp Wind DirNel, �DQ-5ST "v ZO _(�oe )IJ ., Comments 01-0123862 Puget Sound Energy--Wickersham Bas' ' - Wickersham Basin -98321 Mosquito Control Weekly Product&Amount Used Application site ime In/Out Temp Wind DirNel. Comments ILI 01-0122042 Water Gardens - 21810 SE 276th St - 98038 Mosquito Control for July Product&Amount Used Application Site Time In/Out Temp Wind DirNel. Jtrl'�I o � ;P c Comments 3(7(r2� 1 I t"i 774E- N09-M� �0,51t1 7YDOE1 a Post-it'Fax Note 7671 Date ptooF33� To �eyl) From Co.IDopt Phone 11 Phonn!I Fax# L Fax# WHITWORTH PEST SOLUTIONS,INC, I 2533 Inter Ave. 3 �� -- ----t Puyallup,VIA 98372 T(r"�' 253.845.1818 -206i.248.2222 CuST�JMEFi# 01-0002347 � TECH Levor,Nic—lev,Nic 1 888 959 1818 41-0123161 APPO;�dTtdE€dT C}nTE& ME 7/31-12008 6.15 am TI � LlCE�1SE;� l Renton, WA 98Q55 ! E7 DO NOT EN?'ER TREATED AREA UNTIL DRY{ABOUT ONE HOUR) ,, E1 WEED CONI"ROL �7 S IRIJB BEDS Cl GRAVEL CI NOXIOUS'WEEDS 0 TREE_&SHRUB SPRAY FOR: O INSECT ❑ DISEASE City of Renton 5th Floor/Utility Systems I D SHRUB FERTILIZATION 0 DEEP ROOT FEEDING 1055 S, Grady Way � Cl INJECTION CI OAK 0 MAPLE O BIRCH 0 OTHER _ Renton, WA 98057 El GRAN.TRTMT: EI ROSES 0 LILACS n RHODYS ❑OTHER _ G LAWN F'ERTIUZ91-10N 0 NO WATERING NEEDED 0 PLEASE WATER IN - { _ — INCH, IF NO EQUIVALENT RAINFALL OCCURS WITHIN 24 HOURS. !_Mgsi9 o.Control vvq@ ly. 840.00 ; 0 CRANEFLYCONTROL O MOSS CONTROL Tax ( 75.60 0 LAWN WEED CONTROL-DO NOT WATER FOR AT LEAST 24 HRS CI WATERING IS NOT NEEDED ID AERATION 0 PRUNING DISCOU d s 5 0.00 L AQUATIC WEEDS "' a �� ,z 915.60u OTHER m, _.__,__ _ COMMENTS: . ..�1^vix; n 'a� �..ttub. y°yy_: ..�ii `k5 k �.. �a wdt i v $ + " • `( osqu(to on ro ee y 5.60 City of Renton—Panther Creek Wetla 1111111111l�l�llli����18� 111111111D ClsCC�N s 70 00 _ CUSToe�ER - n ! 01 i1121614�_ � _. !�104 CE N ZIP a•., R B CUST.NO, I SE 3/ICE DATE ITOTAL l Ali? 0 CASH 0 CK# wHi, WORTH PEST SOLUTIONS INC. ,. 2533 Inter Ave. Puyallup, VVA 98372 253,845.1818 - 206.248.2222 TECH Levon,Nic Nic l cusTOMER# 01-0002347 � 1,888.959,181$ aPPQINTIv�ENT 01-0123162 ��° ;� ' x OATS rIME 8/7/2008 6:00 am! +scENSE � a - 3 4 j} City of Renton—Panther Creek Wetland TAAGET PEST j j Renton, WA 98055 r i_I DO NOT ENTER TREATED AREA UNTIL DRY(ABOUT ONE IR)oF"�gz. y j 0 WEED CONTROL 0 SHRUB BEDS 0 GRAVEL D NOXIOU �U1'p/tI 0 TREE&SHRUB SPRAY FOR: 0 INSECT 0 DISEASE t �cz�r City of Renton 5th Floor/Utility Systems 0 SHRUB FERTILIZATION 0 DEEP ROOT FEEDING �L j 1055 S. Gravy Way I 0 INJECTION 0 OAK 0 MAPLE 0 BIRCH 0 OTH _ Renton, WA 98057 0 GRAN,TRTMT.: u ROSES 0 LILACS I0 RHODYS Q OTHER 0 LAWN FERTILIZATION 0 NO WATERING NEEDED ©PLEASE WATER IN • a � K I :� - 'NCH, iF NO EQUIVALENT RAINFALL OCCURS WITHIN 24 HOURS. Mosquito Control Weekly 540 00 E c A+ € c:ONT L MOSS CONTROL 0 v'r'.v wEeD CONTROL-Ci0 NOT WATER-FOR AT LEAST24 HRS_ Tax 75.60 I I I D WATERING IS NOT NEEDED CI AERATION O PRUNING I DIscaurrrs j 0.00 i 0 AQUATIC WEEDS 915.60 C7 OTHER COMMENTS: iiHH )) jj ## JJ !!�� ]]J ((ll jj ''Mosquito Contrt�i Weekly I 840.00 7 .. City of Renton —Panther Creek Wetia _ _ o,ScouN;s O:pU 01-0002347 _ 0 123162 M Y s � 91°540 B CUST.NO_ SERVICE OAT[ ITOTAL i AID 0 CASH 0 CK#i WHTTWORTH PEST SOLUTIONS,INC. a 2533 Inter Av@. TIME IN:Puyallup,WA 98372 TIME IN: 253.845.1818 205.248.2222 CUSTOMER a 01-0002347 TECH !.wort->>T8 1,888,959.1818 -- APPOINTMENT 01-0123167 LICENSE . 7 "'^-• PATE&.TIME <.,;9t1..'iX200$ 6.00 am' 1 . qw 0 TARGET PEST � � Renton,WA 9HO5$ ❑DO NOT ENTER TREATED AREA UNTIL DRY(ABOUT ONE HOUR) -O WEED CODtTROL ❑SHRUB SEDS O GRAVEL O NOXIOUS'WEED$ e OTREE-&SHRUB SPRAY FOR: O INSECT C DiSEAS£ i City Of Renton Sth Floor/Utility Sy$temS: O SHRUB FERTILIZATION O DEEP ROOT FEEDING -' 1055 S.Grady Way CJINJECTION ❑OAK EIMAPLE OBIRCH aOTHER_, Renton,WA 98057 OGRAN.TRTMT. ❑ROSES ❑LILACS MRHODYS C7 OTHER O LAWN FERTILIZATION ❑NO WATERING NEEDED O PLEASE WATER IN INCH,IF NO EQUIVALENT RAINFALL OCCURS WITHW24 HOURS. I Mosquito Control Weekly $40.00 11CRANEFLYCONTROL 0MoSSCONTROL TaxY 75.60 LAWN WEED CONTROL-DO NOT WATER TOR AT LEAST 24 HOURS ❑WATERING IS NOT.NEEIJ'cD G3 AERATION- C1^PRUNINb was$ '- ❑AQUATIC WEEDS.. 0.00 � _. x 1 915,50 OOTHER - COMMENTS: - - SEP 1a n . City of Renton—Panther Creek Wettedl1111111 lilt 11801��1��lON��l11�� Q - CUSTOMERi 1 2147--______._.., B GUST.NO. (( TECH bNO. TflTdt. _�L PAID ❑CASH a CkC _ a CITY OF RFNTO Public Works Department Denis Law,Mayor Gregg Zimmerman P.E.,Administrator April 22,2008 Terry Whitworth Whitworth Pest Solutions, Inc. 2533 Inter Avenue Puyallup,WA 98372-3428 SUBJECT: 2008 MOSQUITO ABATEMENT PROGRAM ADDENDUM NO. 1 NOTICE TO PROCEED,CAG-07-065 Dear Mr. Whitworth: For your records,please find enclosed one signed original contract addendum. You are authorized to begin mosquito treatment of the Panther Creek Wetlands beginning Thursday,May 1,2008. An authorization treatment map that identifies residents in the Talbot Hill area who have authorized treatment on their property is also included. Please call me at 425-430-7247, if you have any questions. Sincerely, Allen Q�ater n E. Surface Utility Engineer Enclosures HAFile Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-2000 Mosquito Abatementlrogr—\2008 �� Program\NTP.doc\AQgd A RE N T O N1055 South Grad Wa -Renton Washin on 57 980 y AHEAD OF THE CL:RVF This paper contains 50%recycled material,30%post consumer SY O HUMAN RESOURCES/ - , RISK MANAGEMENT DEPARTMENT M E M O R A N D U M DATE: November 29, 2007 RE TO: Al , Civil Engineer III, PBPW/Utility Systems CD QEC FROM: Mi bby, Administrator 0 3 2007 SUBJECT: Insurance Review/Whitworth Pest Solutions, Inc. UTIL,Try RE_rO Mosquito Abatement Program-2008 I have reviewed the Certificate of Insurance and supporting policy documents for the above-mentioned contract. The insurance coverage, provided for this contract, meets the City's risk management requirements. "Please remember to forward all originals to the City Clerk's office,if on file there" iArisk documents\certificates of insurance\contract okay.doc Client#:324924 WHITWPES ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) DATE PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI Northwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 700 NE Multnomah,Suite 1300 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Portland,OR 97232 503 224-8390 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Lexington Insurance Company 19437 Whitworth Pest Solutions,Inc. INSURER B: 2533 Inter Ave. INSURER C: Puyallup,WA 98372 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY PC293613807 12/01/07 M01/08 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RREMISES IE.ENTED $100 000 CLAIMS MADED OCCUR MED EXP(Any one person) $5 000 X PE Ded:2,500 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATUMIT- OTH- I ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISE4SE-EA EMPLOYFE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Renton, It's officers and employees are included as additional insureds for operations perfromed for them by the named insured regarding: 2005 Mosquito abatement program per CG 2010 11/85. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Renton DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN 1055 South Grady Way NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Renton,WA 98055 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S1810847/M1810839 LKHJT © ACORD CORPORATION 1988 CG2010 POLICY NUMBER: PC293613807 43/97 INSURED: Whitworth Pest Solutions,Inc. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ADDITIONAL INSURED—OWNERS,LESSEES OR CONTRACTORS- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization_ Any person or organization required to be named as an additional insured and evidenced by certificate of insurance on file with the company. (If no name appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) WHO IS INSURED(Section II) is amended to include as an insured the person or Organization shown in the Schedule,but only with respect to liability arising out of your Ongoing operations performed for that insured. Client#:324924 WHITWPES ACORU. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/21/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI Northwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 700 NE Multnomah,Suite 1300 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Portland,OR 97232 503 224-8390 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Lexington Insurance Company 19437 Whitworth Pest Solutions,Inc. INSURERB: 2533 Inter Ave. INSURER C: Puyallup,WA 98372 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR DATE MMIDDIYY DATE MM/DDIYY A GENERAL LIABILITY PC293613807 12/01/07 12/01/08 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAPREMGE TO RSES(E.ENTED $100 000 CLAIMS MADE OCCUR ME EXP(Any one person) $5 000 X PC Ded:2,500 PERSONAL&ADV INJURY $1 00D 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Renton and its officers,officials,agents,employees and volunteers are additional insureds per form CG 20 10 03/97 for operations performed for them by the named insured.This insurance is primary and non contributory with any other insurance coverages and/or self insurance (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Renton DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 1055 South Grady Way NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Renton,WA 98055 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 3 #S1810846/M1810839 LKHJT © ACORD CORPORATION 1988 DESCRIPTIONS (Con in ed fr©m Page 1) carried by City of Renton per page 9 of 13 CG 00 01 07/98.Severability of interest applies per page 10 of 13 of form CG 00 01 07/98. Waiver of Subrogation Clause applies per form CG 2404. AMS 25.3(2001/08) 3 of 3 #S1810846/M1810839 CG2010 POLICY NUMBER: PC293613807 03/97 INSURED: Whitworth Pest Solutions, Inc. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ADDITIONAL INSURED—OWNERS,LESSEES OR CONTRACTORS- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization required to be named as an additional insured and evidenced by certificate of insurance on file with the company. (If no name appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) WHO IS INSURED(Section II) is amended to include as an insured the person or Organization shown in the Schedule, but only with respect to liability arising out of your Ongoing operations performed for that insured. 02/29/2002 10: 02 FAX 2538451133 WHITWORTH PEST SOLUTIONS Z001/001 Date of Application: Year 2008 Month 08 Day 28 Firm Name: Whitworth Pest Solutions Phone No: 253-845-1818 Commercial Applicator: Terry Whitworth License No: 374 Address: 2533 Inter Ave, Puyallup, WA 98372 Person(s) who applied,t a pesticide: Levon,Tony PI License No(s) T� ` ) Apparatus License No. Pesticide Information: §ee Chemical Sheet Dated: - y 01-0123165 City of Renton ^ Panther Creek Wetland - -98055 Mosquito Control Weekly Product IL A ount Used A placation Site Time In/Out Temp Wind DirNel. ' rl,0 - Comments 01-0123868 Puget Sound Energy --Wickersham Basin - Wickersham Basin -98321 Mosquito Control Weekly Product S Amount Used Application Site Time InlOut Temg, Wi d DirNel. Comments v36 Post-it"Fax Note 7671 D°10 4S 2 p°9us� To From r+ Co./Dept.�1� 0 Co. Phone# 1,.'] 430— Phone - 53_ Fax V `TL 'C.�V rax n 3.rr _ I �22- 7,