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16-120.01 SuperTots Sports Academy: Youth Recreational Services CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND SuperTot Sports Academy Spokane Valley Contract#16-120.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged, City and the SuperTot Sports Academy mutually agree as follows: 1. Purpose: This Amendment is for the Contract for providing recreational services for the Parks and Recreation Department by and between the Parties, executed by the Parties on July 22, 2016 and which terminates on December 31,2017. Said contract shall be referred to as the"Original Contract"and its terms are hereby incorporated by reference. Total compensation under the Original Contract is $2,000.00 annually paid to the City of Spokane Valley. 2. Original Contract Provisions:The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are either as follows,or attached hereto as Appendix"A". All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. Decrease the Amount of Annual Compensation to$1,700.00 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount July 22, 2016 $2,000.00 Amendment#1 December 31,2016 $1,700.00 Total Amended Compensation $1,700.00 The parties have executed this Amendment to the Original Contract this 5" day of February,2017. CITY OF SPO E LLEY: CONSULTANT/CONTRACTOR: Mark Calhoun By: upe Tot Spoqs.AcademDJ' • City Manager Its:Title \/ iia v v �� r 2G�G� A 1 . AAP AS TO FORM: .r4sla hristine Bainbridge, City Clerk Offi of the ( Attorney 1 � .41 SKYHSPO-02 BHATCH AC-OE," DATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/6/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT L di NAME: Ya Scales,ACSR FAX Alliant Insurance Services Inc. PHONE 509 343-9271 (NC 509 325-1803 Moloney O'Neill MA No.Ext):( ) (ac,No):( ) 818 W Riverside Ave,Ste 800 ADDRESS:Iscales@mo-ins.com Spokane,WA 99201 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: Skyhawks Sports Academy Inc INSURER C: 9425 N Nevada St. Suite 210 INSURER D: Spokane,WA 99218 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: WA REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRINSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 )( PHPK1610179 02/08/2017 02/08/2018 DAMAGE ERaENTED $ 300,000 CLAIMS-MADE OCCUR X PREMISES(Ea occurrence) MED EXP(Any one person) $ Excluded PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO-T LOC PRODUCTS-COMP/OP AGG $ 3,000,000 JEC OTHER: Abuse/Molest $ 1,000,000 AUTOMOBILE LIABILITY COMBINED O BI DSINGLE NLIMIT $ 1,000,000 A X ANY AUTO PHPK1610179 02/08/2017 02/08/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED — BODILY INJURY(Per accident) $ AUTOS OS NON--OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Peracddent) — $ X UMBRELLA LIAB X OCCUREACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE PHUB572546 02/08/2017 02/08/2018 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PEATUTE ETH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) City of Spokane Valley is additional insured under the general liability for ongoning operations of the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation 2426 N.Discovery Place Spokane,WA 99216 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 2/6/2017 SKYHAWKS SPORTS ACADEMY INC :101‘,e lal.,.iwl r•n-Lsct isearch L&I ? i I 1-i.; tar' 'el., :,<trstu &Health C lei its&110.mica Workplacevtt�'its, i odes& iceiv,mp 0Washington State Department of Labor & Industries SKYHAWKS SPORTS ACADEMY INC Owner or tradesperson 9425 N NEVADA ST STE 210 SPOKANE,WA 99218-1294 CHRIS STILES Doing business as SKYHAWKS SPORTS ACADEMY INC WA UBI No. Governing persons 601 332 118 CHRIS STILES DAVE MICHAEL BERTO; • JEFFREY J HEIMBIGNER; Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 805,153-00 Doing business as SKYHAWKS SPORTS ACADEMY INC Estimated workers reported Quarter 4 of Year 2016"11 to 20 Workers" L&I account representative T2/LESLIE QUNELL(360)902-5631 -Email:BAKY235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. m Washington State Dept.of Labor&Industries.Use of this sate is subject to the taws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601332118&LIC=&SAW=False 1/1