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18-048.00 SuperTots Sports Academy: Recreational Svcs i 10t1 AGREEMENT AGREEMENT FOR RECREATIONAL SERVICES SuperTots Sports Academy THIS AGREEMENT is made by and between the City of Spokane Valley,a code City of the State of Washington,hereinafter"City"and SuperTots Sports Academy,hereinafter"Contractor,"jointly referred to as "Parties." IN CONSIDERATION of the terms and conditions contained herein,the Parties agree as follows: 1.Work to Be Performed. Contractor shall provide all labor,services,and material to satisfactorily complete the attached Scope of Services. A. Administration. The City Manager or designee shall administer and be the primary contact for Contractor. Prior to commencement of work,Contractor shall contact the City Manager or designee to review the Scope of Services,schedule,and date of completion. Upon notice from the City Manager or designee,Contractor shall commence work,perform the requested tasks in the Scope of Services, stop work, and promptly cure any failure in performance under this Agreement. B. Representations. The City has relied upon the qualifications of Contractor in entering into this Agreement. By execution of this Agreement,Contractor represents it possesses the ability,skill,and resources necessary to perform the work and is familiar with all current laws,rules,and regulations which reasonably relate to the Scope of Services. No substitutions of agreed-upon personnel shall be made without the prior written consent of the City. Contractor represents that the compensation as stated in paragraph 3 is adequate and sufficient compensation for its timely provision of all services required to complete the Scope of Services under this Agreement. • Contractor shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Contractor shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City-furnished information. C. Standard of Care. Contractor shall exercise the degree of skill and diligence normally employed a person or entity performing the same or similar services at the time such services are performed. D. Modifications. The City may modify this Agreement and order changes in the work whenever necessary or advisable. Contractor will accept modifications when ordered in writing by the City Manager or designee. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Contractor shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by the City without additional compensation. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by the City. Contractor shall complete its work within by December 31,2018,unless the time for performance is extended in writing by the Parties. Agreement for Recreational Services Page 1 of 6 Either party may terminate this Agreement for material breach after providing the other party with at least 10 days'prior notice and an opportunity to cure the breach. The City may,in addition,terminate this Agreement for any reason by at least 10 days'written notice to Contractor. In the event of termination without breach,the City shall pay Contractor for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation. SuperTot Sports Academy shall pay the City the following amounts for the initial term: A. SuperTot Sports Academy shall pay the City an annual amount of$2,100,with payment due no later than 4:00 p.m. on September 30, 2018 for the following programs: SoccerTots, Baseball Tots,SuperTots,VolleyKats,SoccerTouch,HoopsterTots,and 1stDownTots. The annual fee may be reviewed by the City at the beginning of any renewal terms. B. Interest on late payments shall be charged a late fee of one percent per month. 4.Payment. Contractor shall be paid monthly upon presentation of an invoice to the City. Applications for payment shall be sent to the City Finance Department at the address stated in paragraph 5. The City reserves the right to withhold payment under this Agreement which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Services,City standards,City Code, and federal or state standards. 5. Notice. Notice shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge, City Clerk Name: SuperTots Sports Academy Phone Number: (509)720-5000 Phone Number: (509)466-6590 Address: 10210 East Sprague Avenue Address: 9425 North Nevada Street, Ste. 210 Spokane Valley,WA 99206 Spokane, WA 99218 6.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal,state,and local laws and regulations. Contractor warrants that its designs,construction documents, and services shall confirm to all federal,state,and local statutes and regulations. 7.Relationship of the Parties. It is understood and agreed that Contractor shall be an independent contractor, and not the agent or employee of the City,that the City is interested in only the results to be achieved,and that the right to control the particular manner, method and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to the City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 8. Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement shall be the property of the City,and may be subject to disclosure pursuant to chapter 42.56 RCW or other applicable public record laws. The City shall be permitted to retain these documents,including reproducible camera-ready originals of reports,reproduction-quality mylars of maps,and copies in the form of computer files,for the City's use. The City shall have unrestricted authority to publish, disclose, distribute, and otherwise use, in whole or in part, any reports, data, drawings, images, or other Agreement for Recreational Services Page 2 of 6 material prepared under this Agreement,provided that the Contractor shall have no liability for the use of the Contractor's work product outside of the scope of its intended purpose. 9.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine,make excerpts or transcripts from such records,and to make audits of all contracts,invoices,materials,payrolls,and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 10. Insurance. Contractor shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents,representatives,employees, or subcontractors. A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. If use of vehicles pursuant to the Agreement is only incidental,and Contractor will not transport any persons not directly related or affiliated with Contractor,then Contractor is only required to have automobile liability insurance to meet at least minimum Washington state requirements. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,stop-gap independent contractors and personal injury, and advertising injury. The City shall be named as an insured under Contractor's commercial general liability insurance policy with respect to the work performed for the City. 3.Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of$1,000,000 per accident. If Contractor will not use its vehicles in the performance of this Agreement, automobile liability insurance is only required to meet Washington statutory minimum requirements. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate. C. Other Insurance Provisions. The insurance policies are to contain,or be endorsed to contain,the following provisions for automobile liability,professional liability and commercial general liability insurance: 1.Contractor's insurance coverage shall be primary insurance with respect to the City. Any insurance,self-insurance,or insurance pool coverage maintained by the City shall be excess Agreement for Recreational Services Page 3 of 6 of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in.pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VB. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to the City at the time Contractor returns the signed Agreement. The certificate shall specify all of the Parties who are additional insureds, and shall include applicable policy endorsements, and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to the City. Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self-insurance. 11.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify,and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors,or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify,and hold City harmless shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify,and hold City harmless against liability for damages arising out of such services caused by the concurrent negligence of(a)City or City's agents or employees, and(b) Contractor, Contractor's agents, subcontractors, subconsultants, and employees, shall apply only to the extent of the negligence of Contractor, Contractor's agents, subcontractors, subconsultants, and employees. Contractor's duty to defend,indemnify,and hold City harmless shall include,as to all claims,demands,losses, and liability to which it applies,City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection,and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages, compensation,or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, Contractor's waiver of immunity under this provision extends only to claims against Contractor by City,and does not include,or extend to, any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 12.Waiver. No officer, employee,agent, or other individual acting on behalf of either party has the power, right,or authority to waive any of the provisions of this Agreement. No waiver in one instance shall be held to be a waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by Agreement for Recreational Services Page 4 of 6 law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions,nor shall it affect the validity of this Agreement or any part thereof. 13. Assignment and Delegation. Neither party may assign, transfer, or delegate any nor all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other Party. 14.Subcontracts. Except as otherwise provided herein,Contractor shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written consent of the City. 15. Confidentiality. Contractor may,from time-to-time,receive information which is deemed by the City to be confidential. Contractor shall not disclose such information without the prior express written consent of the City or upon order of a Court of competent jurisdiction. 16. Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between the City and Contractor shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing, Contractor agrees that it may, at the City's request, be joined as a party in any arbitration proceeding between the City and any third party that includes a claim or claims that arise out of,or that are related to Contractor's services under this Agreement. Contractor further agrees that the Arbitrator(s)' decision therein shall be final and binding on Contractor and that judgment may be entered upon it in any court having jurisdiction thereof. 17. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation(including expert witness fees). 18. Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed,modified,or altered except in writing signed by the Parties hereto. 19.Anti-kickback. No officer or employee of the City,having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this Agreement or have solicited, accepted, or granted a present or future gift, favor, service, or other thing of value from any person with an interest in this Agreement. 20. Business Registration. Prior to commencement of work under this Agreement,Contractor shall register with the City as a business if it has not already done so. 21.Severability. If any section,sentence,clause,or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence, clause, or phrase of this Agreement. 22. Exhibits. Exhibits attached and incorporated into this Agreement are: 1. Scope of Services 2. Insurance Certificates Agreement for Recreational Services Page 5 of 6 lAvi 4.L._ riky The Parties have executed this Agreement this /° day of lbfartI,2018. CITY OF SPOKANE VALLEY Contractor:SUPERTOTS SPORTS ACADEMY r #a____ �J 1)1 00 4 5. Mark Calho /4—u , City Manager By: Its: Authorized Representative ATTEST:/ hr Ch tr Stine Bainbridge, City Clerk APPROVED AS TO FORM: ' II 410...1f.U. A, l Office ic e Ci Atto ' -31 Agreement for Recreational Services Page 6 of 6 Exhibit A: SCOPE OF SERVICES SuperTots Sports Academy partners with the City of Spokane Valley Parks and Recreation Department to provide a variety of sports programs for 2018. • SuperTots Sports Academy will utilize the open areas of Terrace View Park,Valley Mission and Edgecliff Park for their summer programs. This agreement does not include the use of the picnic shelters or ballfields at these locations. The scheduling is done through Spokane Valley Parks and Recreation Department. I. SuperTots shall provide an annual report to the Director of Parks and Recreation by November 1 of each year including complete rosters for each program offered, with participants' names, addresses and fees paid for participation. II. SuperTots shall process all participant registrations and collect all fees. III. SuperTots shall provide all equipment and qualified instructors for each program. IV. All classes added to roster in addition to "confirmation of services" provided after March 16, 2018 will be subject to a$250 additional fee per class/camp. Below are lists of classes that are permitted to be offered through this Agreement. SoccerTots®is a franchised child physical development program that uses a variety of fun games to delight and engage kids in physical activity.The curriculum is professionally designed to develop motor skills,promote physical fitness,and create self confidence in kids and younger children. BaseballTots® BaseballTots®classes develop important baseball skills such as throwing,catching,hitting and base running. Developmentally appropriate equipment and games are used to teach kids the game. lstDownTots® 1 stDownTots®is a development program for kids ages 3 to 5 years old that uses a variety of games to engage kids while teaching the sport of Football and developing fundamental skills. SuperTots® SuperTots Multi-Sports is a development program for kids 3-6 years old that uses a variety of games to engage kids while exposing them to a variety of different sports. VolleyKats@ A variety of games are used to teach basic volleyball techniques including passing, setting,hitting, serving and blocking. HoopsterTots Basketball program focusing on dribbling, shot technique,passing and teamwork. SoccerTouch The goals are to accelerate soccer development,prepare kids for league play,and create general fitness. SuperTots Sports Academy partners with Spokane Valley Parks and Recreation to provide sport-based development programs where children discover and develop athletic, motor, and social skills. SuperTots' curriculum is specifically designed to promote development alongside a healthy active lifestyle. Til [ i. All SuperTots Sports program registrations are processed through Super- Tots. Please call 509.534.5437 or go online to www.SuperTotSports.com SoccerTots Our flagship program! Playable on almost any surface,these soccer-themed motor skill classes are very easy for youngsters to get into. Younger age groups focus on developing motor skills and self-confidence;older classes focus more on developing core soccer skills and personal focus,and introduce an element of light competition. Teddies/Teddies II Ages Day Dates Time Fee Location 18—30 months Tuesday 6/19—8/07 5:30pm—6:15pm $120 Edgecliff Park Teddies II/Koalas Ages Day Dates Time Fee Location 26-36 months Wednesday 6/20-8/15 5:30pm-6:15pm $120 Terrace View Park Cubs/Pandas Ages Day Dates Time Fee Location 3-4 yrs Tuesday 6/19-8/07 6:30pm—7:20pm $120 Edgecliff Park 3-4 yrs Wednesday 6/20-8/15 4:30pm—5:20pm $120 Terrace View Park Bears/SoccerTouch Ages Day Dates Time Fee Location 4-5'/2 yrs Tuesday 6/19-8/07 4:30pm—5:20pm $120 Edgecliff Park 4-5'/a yrs Wednesday 6/20-8/15 6:30pm—7:20pm $120 Terrace View Park CheerTots TM CheerTots is a great way to promote exercise,improve gross motor skills, and build confidence. Children in these high-energy classes learn far more than just core cheer concepts and technique. They also explore their personal expression,agility rhythm and teamwork. There are no stunts in this program and minimal basic tumbling skills designed with each age group in mind. Bluebirds Ages Day Dates Time Fee Location 3-4 yrs Tuesday 6/19-7/31 4:30pm—5:20pm $90 Edgecliff Park Robins Ages Day Dates Time Fee Location 4—5'/z yrs Tuesday 6/19-7/31 5:30pm—6:20pm $90 Edgecliff Park (SO SuperTots OfORTS ACADEMY" 10 2018 Spring/Summer Recreation Guide BaseballTots TM Learning basketball has never been more fun!These classes for kids ages 3 through 5 years old use a variety of fun games to engage kids while teaching the sport of baseball and developing fundamental skills. The goal is to build fitness,muscle coordination, baseball fundamentals and create a love of the game. Batters I/Batters II Ages Day Dates Time Fee Location 3-4 yrs Tuesday 6/19-8/7 4:30pm-5:15pm $120 Edgecliff Park 3-4 yrs Saturday 6/23-8/18 10:30am-11:15am $120 Terrace View Park Batters II Ages Day Dates Time Fee Location 3''A-4'/z yrs Tuesday 6/19-8/7 6:30pm-7:15pm $120 Edgecliff Park Hitters/Homers Ages Day Dates Time Fee Location 4—5%z yrs Tuesday 6/19-8/7 5:30 pm-6:I5pm $120 Edgecliff Park Hitters/Grand Slammers Ages Day Dates Time Fee Location 4-5'A yrs Saturday 6/23-8/18 11:30am-12:15pm $120 Terrace View Park Multi-Sport These multi-sport programs give children a positive first step into athletics. The essen- tials of each sport are taught in a safe,structured environment with lots of encourage- ment and a focus on fun. All games and activities are designed to allow kids to explore balance,movement,hand/eye coordination and skill development at their own pace. SoccerTots/BaseballTots Ages Day Dates Time Fee Location 26-36 months Saturday 6/23-8/18 9:30am-10:15am $120 Terrace View Park BaseballTots/lstDownTots Ages Day Dates Time Fee Location 3-4 yrs Wednesday 6/20-8/15 5:30pm-6:20pm $120 Terrace View Park 4-5%z yrs Wednesday 6/20-8/15 6:30pm-7:20pm $120 Terrace View Park SoccerTots/HoopsterTots Ages Day Date Time Fee Location 5-6/z yrs Monday 6/25-7/30 9:30am-10:15am $90 Valley Mission Park 3-4 yrs Monday 6/25-7/30 10:30am—11:20am $90 Valley Mission Park 4-5 yrs Monday 6/25-7/30 10:30am—11:20am $90 Valley Mission Park City of Spokane Valley Parks and Recreation Dept. 11 DATE(MM/DD/YYYY) ACGRD® CERTIFICATE OF LIABILITY INSURANCE 04/02/2018 �.---- 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(ies)must have ADDITIONAL INSURED provisions or 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 NAME:CONTACT Jo Watson Roach, Howard, Smith and Barton PHONNo.Extt: (972) 231-1300 IIaC.N01:t972) 231-1368 8750 N. Central Expressway, Suite 500 E-MAIL watsoa®rhsb.com ADDRESS: j Dallas TX 75231 INSURER(S)AFFORDINGCOVERAGE NAICB RECEIVED INSURER A:Chubb Indemnity Co 12777 INSURED INSURER B:Philadelphia Indemnity 18058 Skyhawks Sports Academy LLC APR 1 1 2013 INSURERC: 9425 N. Nevada St., Suite 210 INSURERD: Spokane WA 99218 PARKS & RECREATION DEPT. INSURER E: ----- INSURER F COVERAGES CERTIFICATE NUMBER:Cert ID 41245 REVISION NUMBER: ITHIS IS TO THAT THE POLICIES OF ND CA ED.CERTIFY NOTWITHSTAND NG ANY REQUIREMENT,TERM OR CONDICE LISTED TION OF ANY CONTRACT OR OTHER DOCUMENT WITH ABOVE HAVE BEEN ISSUED TO THE INSURED NAMED RESP FOR THE CT TOL( CY 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. ADDL SUBR POLICY EFF POLICY EXP LIMITS tLTRR TYPEOF INSURANCE AMD AND POLICY NUMBER (MMIDOIYYYY) (MMIDDIYYYY) EACH OCCURRENCE 5 1,000,000 g X COMMERCIALGENERALLIABILITY DAMAGE TO REN TED 1 CLAIMS-MADE n OCCUR PHPK1731918 09/23/2017 09/23/2018 PREMISES(Ea occurrence) 5 100,000 MED EXP(Any ono person) S Excluded PERSONAL BADV INJURY S 1,000,000 GENERAL AGGREGATE S 3,000,000 GEN1.AGGREGATE LIMIT APPLIES PER — riPRODUCTS-COMPIOPAGG 5 3,000,000 POLICY JEC LOC S —'-11 OTHER NED OMBISINGLE LIMIT S AUTOMOBILE LIABILITY COMBNEDt) 1,000,000 B ANY AUTO PHPK1731918 09/23/2017 09/23/2018 BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY % NON-OWNEDAUTOS PROPERTY DAMAGI�—5 HIRED UTOS (Per accident) X AUTOS ONLY X AUTOS ONLY S B X UMBRELLALIAB X OCCUR PHUB605509 09/23/2017 09/23/2018 EACHOCCURRENCE $ 5,000,000 EXCESSUAB CLAIMS-MADE AGGREGATE -S 5,000,000 5 DED i RETENTION S WORKERS COMPENSATION 71754023 03/31/2018 03/31/2019 X PERTUTE ETH A AND EMPLOYERS'LIABILITY Y/N E.L.EACH ACCIDENT 5 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE NIA (Mandatory FREXCLUDED? E.L.DISEASE-EA EMPLOYEE S 1,000,000 (Mandatory In NH) 1,000,000 If yes.describe under E.L.DISEASE-POUCY LIMIT 5 1,000,000 DESCRIPTION OF OPERATIONS below S 5 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) General liability policy includes a blanket automatic additional insured endorsement or provision that provides additional insured status to the certificate holder when required by written contract or agreement. General liability policy contains a special endorsement or provision with "primary additional insured" wording. General liability and workers compensation policies include a blanket automatic waiver of subrogation endorsement or provision that provides this feature only when there is a written contract between named insured and certificate holder that requires it. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Spokane Valley Parks and Recreation AUTHORIZED REPRESENTATIVE • 2426 N. Discovery Place • Spokane WA 99216 4 X 1r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Page 1 of 1 Home YspuL,l 0,11:act Search L&I .ten A Z Ldex Help N13,L&I Safety&Health Claims&l is,,irar,ce Workplace Iliultts `rades&Lcerislog 0 Washington State Department of Labor & Industries SKYHAWKS SPORTS ACADEMY INC Owner or tradesperson 9425 N NEVADA ST STE 210 SPOKANE,WA 99218-1294 DAVE BERTO Doing business as SKYHAWKS SPORTS ACADEMY INC WA UBI No. Governing persons 601 332 118 DAVE MICHAEL BERTO JEFFREY J HEIMBIGNER; CHRIS STILES; JEFFREY J HEIMBIGNER; CHRIS STILES; 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 2017"11 to 20 Workers" L&I account contact T2/RAJ LUKE(360)902-5787-Email:LUKE235@Inl.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Help us improve ciz,v e c • 3—oafs Svf / 1 ® DATE(MMIDDNYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 09/20/2018 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(ies)must have ADDITIONAL INSURED provisions or 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 NAME: Jo Watson , Roach, Howard, Smith and Barton PHONE FAX 8750 N. Central Expressway, Suite 500 (AIC.No.Ext): (972) 231-1300 (A/C,No):(972) 231-1368 E-MAIL ADDRESS: lwatson@rhsb.com Dallas TX 75231 INSURER(S)AFFORDING COVERAGE NAIC A INSURER A:Chubb Indemnity Co 12777 INSUREDINSURER B:Philadelphia Indemnity 18058 Skyhawks Sports Academy LLC INSURER C: 9425 N. Nevada St., Suite 210 INSURERD: Spokane WA 99218 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 42510 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. ICY EXP LTRR ADDL TYPE OF INSURANCE NSD SWVD, POLICY NUMBER (MUBR M1DD/YYYY) (MEFF M/DDIYYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GE TO CLAIMS-MADE X OCCUR PHPK1866344 09/23/2018 09/23/2019 PREMSES EaENTED occurrence) $ 100,000 MED EXP(Any one person) $ Excluded PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: Abuse/Molestation $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B ANY AUTO PHPK1866344 09/23/2018 09/23/2019 BODILYINJURY(Perperson) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY % AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY $ B X UMBRELLALIAB X OCCUR PHU13643163 09/23/2018 09/23/2019 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ A WORKERSCOMPENSATION YIN 71754023 03/31/2018 03/31/2019 X STATUTE PER ER AND EMPLOYERS'LIABILITY ANYPROPRIEiOR/PARTNER/EXECUTIVE I I N/A E.L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 $ S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) General liability and Automobile liability policies include a blanket automatic additional insured endorsement or provision that provides additional insured status to the certificate holder when required by written contract or agreement. General liability and Automobile liability policies contains a special endorsement or provision with "primary additional insured" wording. General liability, Automobile Liability and workers compensation policies include a blanket automatic waiver of subrogation endorsement or provision that provides this feature only when there is a written contract between named insured and certificate holder that requires it. 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 AUTHORIZED REPRESENTATIVE Spokane WA 99216 I 1 vaR i ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • POLICY NUMBER: PHPK1866344 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 • THIS ENDORSEMENT CHANGES.THE POLICY. PLEASE READ !T CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): Blanket Additional Insured • • Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With,respect to "the instwance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Lim:ts Of Insurance: with respect toliability for"bodily injuryTM, "property If coverage prov°ded to the additional insured is damage or "personal and advertising injury" required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement; or 1. In the performance of your ongoing operations; or 2. Available under thr.! applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable' Limits of Insurance shown in the Declarations. insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the • insurance afforded to such additional insured will not be broader than that which you are • required by the contract or agreement to provide for such additional insured. • • CG 20 26 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 • PI-MANU-1 (01/00) • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CG2026 Blanket Additional Insured "Any person or organization where required by a written contract that was executed prior to the occurrence of a loss, but only for liability arising out of the negligence of the named insured." • • • • • • • • All other terms and conditions of this Policy remain unchanged. Page 1 of 1 PI-AS-009 (04/04) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposures are provided under this policy. If such specific coverage applies,the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy. Throughout this endorsement the words"you"and"your" refer to the Named Insured shown in the Declarations. The words"we,""us" and"our" refer to the Company providing this insurance. • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE The following is a summary of the Limits of Insurance and additional coverage provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. A. Supplementary Payments—Bail bonds increased to$2,500/Loss of earnings indreased to$500 each day; B. Tenant's Legal Liability—for Fire, Lightning, Explosion, Smoke and Leaks from Sprinklers—Limit increased to$300,000; C. Broadened Definition of Who Is An Insured; D. Amended Duties In the Event Of Occurrence, Claim Or Suit; E. Broadened definition of Advertising Injury—includes Televised Or Videotaped I3 iblication; F. Amended definition of Bodily Injury to include Mental Anguish; G. Broadened definition of Personal Injury—includes Abuse Of Process/Discrimination; H. Amended Unintentional Failure To Disclose Hazards; I. Amended Liberalization Clause J. Added Employee Indemnification Defense Coverage—We will pay up to$25,000 in defense costs for an "employee"in a criminal proceeding(subject to established criteria); K. "Property Damage"-Removed exclusion for"Property damage"resulting from the use of reasonable force to protect persons or property; L. Added blanket Additional Insured—Funding Source; M. Added blanket Additional Insured—Managers or Lessors of Premises; N. Non-owned Watercraft—coverage length is increased to 58 ft. Page 1 of 5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. • • PI-AS-009 (04/04) A. Supplementary Payments • In the Supplementary Payments—Coverages A. and B. provision: 1. The limit for the cost of bail bonds is changed from$250 to$2,500; and 2. The limit for loss of earnings is changed from$250 a day to$500 G day. B. Fire, Lightning, Explosion,Smoke and Leaks from Sprinklers If damage by fire to premises rented to you is not otherwise excluded from this coverage Part,the word"fire"is changed to"fire, lightning, explosion,smoke,or leakage from automatic fire protective systems"where it appears in: 1. The Limits of Insurance section of the Declarations as the Fire Damage Limit. That limit: • a. Is changed subject to all the terms of Limit of Insurance(Section III)tc;the greater of: (1) $300,000; or (2) The amount shown in the Declarations as the Fire Damage Limit, b. Subject to a. above is the most we will pay to all damage proximately caused by the same event,whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof., 2. The last paragraph of Coverage A. (Section I)after the Exclusions; 3. Paragraph 6. of Limits of Insurance(Section III); 4. Paragraph b.(1)(b)of the Other Insurance Condition(Section IV); and 5. Paragraph a.of the definition of"insured contract." C. Who Is An Insured Who Is An Insured (Section II) is changed as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Coverage Part, paragraph 3.a. is changed to read: a. Coverage under this provision is afforded until the end'of the policy period. D. Duties In The Event Of Occurrence,Claim Or Suit 1. The requirement in Condition 2.a. (Conditions, Section IV)that you must see to it that we are notified as soon as practicable of an"occurrence"or an offense, applies only when the "occurrence"or offense is known to: (a) You, if you are an individual; (b) A partner, if you are a partnership; or (c) An executive officer or insurance manager, if you are a corporation. Page 2 of 5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. • • PI-AS-009(04/04) 2. The requirement in Condition 2.b.that you must see to it that we receive notice of a claim or "suit"as soon as practicable will not be considered breached unless the broach occurs after, such claim or"suit"is known to: (a) You, if you are an individual; • (b) A partner, if you are a partnership; or (c) An executive officer or insurance manager, if you are a corporation. E. Advertising Injury—Televised Or Videotaped Publication 1. The definition of"Personal and Advertising Injury" items 14. d., e.,f. and g. is changed to read: "Personal and Advertising Injury" means injury arising out of one or more of the following offenses: • d. Oral,written, televised or videotaped publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral,written, televised or videotaped publication of material that violatesia person's right of privacy; f. Misappropriation of advertising ideas or style of doing business; or g. Infringement of copyright,title or slogan. . 2. 2. Exclusions b.and c.of Coverage B., Personal And Advertising Injury Lia ility, are changed to read: b. (2)Arising out of oral,written,televised or videotaped publication of material, if done by or. • • at the direction of the insured with knowledge of its falsity; c. (3)Arising out of oral,written,televised or videotaped publication of material whose first publication took place before the beginning of the policy period. F. Bodily Injury—Mental Anguish The definition of"bodily injury"is changed to read: "Bodily injury": • a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing(Item a. above)at any time. G. Personal Injury—Abuse Of Process/Discrimination • If Personal and Advertising Injury Liability Coverage(Coverage B.) is not otherwise excluded from this Coverage Part: 1. The definition of"Personal and Advertising Injury" is changed by: • Page 3 of 5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. PI-AS-009(04/04) a. Revising Item b..of that definition to read: Malicious prosecution or abuse of process; • b. Adding the following: "Personal Injury"also means discrimination based on race, color, religion,.sex, age or national origin, except when: • (1) Done intentionally by or at the direction of, or with the knowledge or consent of: (a) Any insured; or (b) Any executive officer, director, stockholder, partner or member of the insured; or (2) Directly or indirectly related to the employment,former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; or (3) Directly or indirectly related to the sale, rental, lease or sub-lease or prospective sales, rental, lease or sub-lease of any room,dwelling or premises.by or at the direction of any insured; or (4) Insurance for such discrimination is prohibited by or held in violation.of:Iaw, public policy, legislation, court decision or administrative ruling.; The insurance afforded by G.1.b. above does not apply to fines or penalties imposed because of discrimination. H. Unintentional Failure To Disclose Hazards It is agreed that, based on our reliance on your representations as to existing hazards, if yowshould unintentionally fail to disclose all such hazards prior to the beginning of the policy..period of this Coverage Part,we shall not deny coverage under this Coverage Part because or'such failure. I. Liberalization If we revise this endorsement to provide more coverage without additional premium charge,we will automatically provide the additional coverage to all endorsement holder,:s as of the day the revision is effective in your state. J. Employee Indemnification Defense Coverage • Under SUPPLEMENTARY PAYMENTS—COVERAGES A AND B thelfollowing is added: 3. We will pay on your behalf defense costs incurred by an"employee"in a criminal proceeding. However, you must have a prior written agreement with such"employee"whereby you agree to indemnify the"employee"for such defense costs and the agreement includes a provision for ; repayment of defense costs in the event of an adverse judgment. The most we will pay for any"employee"who is alleged to be directly involved in a criminal proceeding is$25,000 regardless of the number of employees, claims or"suits"brought or persons or organizations making claims or bringing"suits." Page4of5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. • PI-AS-009 (04/04) K. Extended "Property Damage" • SECTION I—COVERAGES,COVERAGE A, 2. Exclusions a. is deleted and replaced by the following: a. Expected or Intended Injury "Bodily Injury" or"Property Damage"expected or intended from the standpoint of the insured. This exclusion does not apply to"bodily injury"or"property damage" resulting from the use of reasonable force to protect persons or property. L. Additional Insured—Funding Source Under SECTION II—WHO IS AN INSURED the following is added: Any person or organization with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. M. Additional Insured—Managers or Lessors of Premises • Under SECTION II—WHO IS AN INSURED the following is added: Any person or organization with respect to their liability arising out of the owner:::'iip, maintenance or • use of that part of the premises leased to you subject to the following additional tixclusions: This insurance does not apply to: a. Any"occurrence"which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed•by or on behalf of that person or organization. N. Non-owned Watercraft • SECTION I—COVERAGES,2. Exclusions,paragraph g.(2) is amended to read as follows: (2) A watercraft you do not own that is: • (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge This provision applies to any person,who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available,to the insured whether primary, excess or contingent. Page 5 of 5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. • • PI-GL-005(07/12) • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 09/23/2018 Name of Person or Organization (Additional Insured): Any person or entity where required by written contract executed prior to a loss or claim • • SECTION II—WHO IS AN INSURED is amended to include as an additional insured.the person(s)or organization(s)shown in the endorsement Schedule, but only with respect to liability for"bodily injury," "property damage"or"personal and advertising injury"arising out of or relating to your,negligence in the performance of"your work"for such person(s) or organization(s)that occurs on or after the.effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization(Additional Insured), except for loss resulting from the.sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured • for a loss or"occurrence"we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III—LIMITS OF INSURANCE. All other terms, conditions, andexclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ' PI-CA-004 PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT PI-CA-004 10/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is added to SECTION IV-BUSINESS AUTO CONDITION:, B. General Conditions, 5. Other Insurance: The insurance provided by this policy for any additional insured endorsement attached to this policy is primary when primary coverage is require::;in a written contract. In addition, we will not seek contribution from any insurer vhen ir .urance on a non-contributing basis is required in a written contract for any additional insured endorsement attached to this policy. For coverage to apply, the written contract must have been executed prior to the occurrence of "loss." • This endorsement supersedes anything to the contrary. • All other terms and conditions of this Policy remain unchanged. Page 1 of 1 • POLICY NUMBER: PHPK1866344 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. . WAIVER OF TRANSFER OF RIGHTS OF RECOVERY* AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: • BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM • MOTOR CARRIER COVERAGE FORM • TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unlesr•another date is indicated below. Named Insured: Skyhawks Sports Academy, Inc. • • Endorsement Effective Date: 09/23/2018 SCHEDULE Name(s)Of Person(s)Or Organization(s): Any person or entity where required by written contract executed•prior to a loss Information required to complete this Schedule, if not shown above,will be shown in the Declarations. • The Transfer Of Rights Of Recovery Against Oth • - ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to • the extent that subrogation is waived prior to the "ac- cident" or the"loss" under a contract with that person or organization. • • • • CA 04 44 03 10 ©Insurance Services Office, Inc., 2009 . Page 1 of 1 ❑ PI-CA-003(04/14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Ccverage Form apply unless modified by the endorsement. A. SECTION II—COVERED AUTOS LIABILITY COVERAGE,A.Coverage, 1.Who'Is.An Insured is amended by adding the following: The following are also"insureds": Any person or organization for whom you are required by an"insured contract"to.procure"bodily injury" or"property damage" liability insurance arising out of the operation of a covered"auto"with your permission. However,this additional insurance does not apply to: 1. The owner or anyone else'from whom you hire or borrow a covered "auto." This exception does not apply if the covered"auto"is a"trailer'connected to a covered"auto"you own; 2. Your"employee"if the covered"auto"is owned by that"employee"or a member of his or her household; 3. Anyone using a covered"auto"while he or she is working in a busin ass of s.:lling, servicing, repairing, parking or storing"autos"unless that business is yours; ' 4. Anyone other than your"employees,"partners(if you are a partnership), met nbers(if you are a limited liability company), or a lessee or borrower or any of their"employees,"while moving property to or from a covered"auto";or 5. A partner(if you are a partnership),or a member(if you are a limited.liability company)for• covered "auto"owned by him or her or a member of his or her household. B. The"insured contract" must be in effect during the policy period shown in the Declarations and must have been executed prior to the"bodily injury"or"property damage". C. This person or organization is an"insured"only to•the extent you are liable due to your ongoing operations for that"insured",whether the work is performed by you or.for you,and only to the extent you are held liable for an"accident"occurring while a covered"auto"is being driven by you or one of your employees. D. There is no coverage provided to this person or organization for"bodily injury"to its employees or for "property damage"to its property. E. Coverage fo'r this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. F. The defense of any claim or"suit"must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or"suit". G. A person's or organization's status as an"insured" under this endorsement ends when your operations for that"insured"are completed. Page 1 of 2 • PI-CA-003(04/14) H. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any"insured,"or to procure insurance. I. The following additional exclusions apply: The insurance afforded to any person or organization as an "insured" under .this endorsement does not apply to"loss": 1. Which occurs prior to the date your contract is effective with such person or organization; 2. Arising out of the sole negligence of any person or organization that would nOt be an"insured" except for this endorsement; or 3. Which occurs after you returned the leased or rented"auto"to the lessor or the policy period ends,whichever occurs first. • Page 2 of 2 4 r WORKERS'COMPENSATION AND EMPLOYERS'LIABILITY INSURANCE POLICY WC 124 • (4-84) WC 00 03 13 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date'of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement,effective on 03/31/18 at 12:01 A.M.standard time,forms a part of (DATE) Policy No. (19)7175-40-23 of the CHUBB INDEMNITY INSURANCE COMPANY (NAME OF INSURANCE COMPANY) issued to BLUE STAR SPORTS HOLDINGS,LLC Endorsement No. Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us' This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule • IT IS UNDERSTOOD AN:)AGREED THAT THE COMPANY, IN THE EVENT OF ANY PAYMENT, WAIVES THE RIGHTS O=RECOVERY AGAINST ANY PRINCIPAL.WHERE:SUCH WAIVER HAS BEEN INCLUDED AS PART OF.A,CONTRACTUAL UNDERTAKING BY THE NAMED INSURED, BUT THIS WAIVER SHALL NOT APPLY IN RESPECT OF OTHER OPERATIONS OR SUCH PRINCIR,AL IN WHICH THE INSURED HAS NO CONTRACTUAL INTEREST. • • WC 124(4-84) ' WC 00 0313 Copyright 1983 National Council on Compensation Insurance. Page 1 of 1