Loading...
HomeMy WebLinkAboutPK13-035 - Original - Highline School District No. 401 - Camp Waskowitz - 01/09/2013 „ - a Records Mana`g*�emont% KENT Document WASHINGTON CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Hlghline School District No. 401 Vendor Number: JD Edwards Number Contract Number: i/�/3-0J5,S This Is assigned by City Clerk's Office Project Name: Camp Waskowitz Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 1/9/2013 Termination Date: 12/31/2013 Contract Renewal Notice (Days): 0 Number of days required notice for termination or renewal or amendment Contract Manager: Julie Stangle (tp) Department: Parks Youth & Teen Detail: (i.e. address, location, parcel number, tax id, etc.): Annual contract to rent property for camp S Pub lic\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 Highline School District No.401 Camp Waskowitz Rental Agreement 45505 S.E. 150te St,North Bend,WA 98045 Seattle—(425)277-7195 North Bend—(425)888-0681 Mailing Address. Camp Waskowitz, 15675 Ambaum Blvd S W,Burien,WA 98166 (206)631-7626 Applicant Kent Parks In Charge Julie Stangle Organization At Camp Address 525 Fourth Ave No. Kent WA 98032 Phone ( 253 ) 856-5030 Age of Est No. Est Total Campers Youth Girls Boys Adults M F No Campers 190 Arrival Monday August 5 2013 @ annrox 11.00 a.m. Dinner First Meal(Breakfast 8 00,Lunch 12 00,Dinner 5 30 Departure Fnday,August 9.2013 @ approx.2:00 p in Lunch @ 11 00 a m. Date Time Last meal (Breakfast,Lunch,Dinner) 75-124 people=$224.00 per person, 125-149 people=$216 00 per person Cost Quote on Estimated Total: $ 21200 per person for 4 niaht(s)and 12 meal(s) Additional charges/fees Total Charge $ Less Deposit $ Date Certificate of Insurance received / / Amount Due $ Month/Day/Year CERTIFICATE OF INSURANCE. The lessee,at its own cost,shall maintain public liability insurance for bodily injuries (including sickness or death)and property damages in the minimum amount of$1,000,000 combined single limit per occurrence,and in the minimum amount of$2,000,000 in the aggregate Employers Liability(Washington Stop-Gap)in the amount of no less than $1,000,000 per accident for owned,non-owned and hired automobiles Prior to using the site,the lessee shall furnish the Camp Waskowitz office with a Certificate of Insurance evidencing this coverage and naming the Highlme School District as an additional insured and as the certificate holder HOLD HARMLESS AGREEMENT To the fullest extent permitted by law,the lessee releases and shall defend, indemnify and hold harmless the Highlme School District and its directors, agents,employees,successors and assigns from and against all claims, damages,losses and expenses,direct and indirect,or consequential,including but not limited to costs and attorneys' fees incurred on such claims and in proving the right to indemnification,arising out of or resulting from the acts or omissions of the lessee or its agents and anyone directly or indirectly employed by them or anyone for whose acts they may be liable POOL USE Any rental group using the pool is responsible for furnishing a qualified life guard while the pool is in use. A qualified life guard shall mean any person over 18 years of age,in good physical condition,having a current registered WSI,Red Cross or other approved lifeguard certification,and having no other duty to perform while in attendance at the pool A copy of the certificate with i current date must be submitted prior to pool use Pool use shall be during daylight hours only(8-00 am to 8.00 p.m) Failure to comply with any of the rules will necessitate the closure of the pool 1 have read and understand the rules and regulations listed on the back of this application and agree to abide by them. HIGHLTNE SCHOOL DISTRICT#401 L t t o-( Ka11-i— Organization ` Organiz ticA By 15 VL_ By Signature ignature Date Date_ at1n 19 0�3 Please read the back side of this form Rev 8102 APPLICATION PROCEDURES Please Read Carefully 1. Deposit This agreement must be accompanied by a deposit 10°jo of the estimated total cost or$250 00,whichever is greater,in order to assure the reservation. Retain(1)copy for your records 2. Cancellation Policy • Notification of cancellation 60-90 days prior to scheduled date will result in loss of deposit. • Notification of cancellation 45-59 days prior to scheduled date will result in a charge of 25%of estimated cost. • Notification of cancellation 30-44 days prior to scheduled date will result in a charge of 50%of estimated cost • Notification of cancellation 14-29 days prior to scheduled date will result in a charge of 75%of estimated cost • Notification of cancellation less than 14 days prior to scheduled date will result in a charge of 100%of estimated cost- 3 Unless the Waskowitz District Office is notified of a decrease in the total number attending at least two work days before the first scheduled meal at Camp,the group will be charged on the basis of"Est Total No. Campers" or actual number of Campers, whichever is higher. 4 Rates quoted do not include bedding,linen,recreation equipment,or audio-visual equipment. Provision of these are the responsibility of the renting group. Camp equipment or bedding may be provided at an additional charge 5 A statement of charges will be sent to the lessee shortly after the rental period ends. Prompt payment should be made to Highlme School District and sent to Hiahhne School District, 15675 Ambaum Blvd S.W,Bunen,WA 98166 6. The rates quoted by Camp staff are arrived at on the basis that the lessee will leave the Camp in the same order and in as good condition as they found it on arrival An added charge will be made if additional work must be done to ready the Camp for the next group 7. The lessee will be held financially accountable for any damage to Camp equipment or facilities done by a member or members of the leasing group i 8. Adequate adult supervision must be provided for all youth groups. It is suggested that a minimum ratio for a mixed group of youth or teenagers should be 1 to 10. 9_ Meal menus will be developed by Camp staff. Special requests should be arranged with the Head Cook at least 3 weeks prior to arrival GENERAL RULES AND REGULATIONS It is requested that the"Person in Charge at Camp"go over the following regulations with his/her group before their arrival at Camp He/she must see that all regulations are adhered to by members of his/her group further,it is proposed that the following general regulations will be observed. 1. Firearms, air rifles,pellet guns,slingshots,look alike weapons,alcoholic beverages,illegal drugs/substances etc,are not allowed on the grounds 2 No smoking is allowed on Camp property. 3 No campfires will be set without permission ofthe Camp staff 4 Thermostats will be regulated only by Camp personnel 5. Absolutely no tampering with the fire protection sprinkler system or fire alarm boxes located in each cabin 6 No material(i a towels,clothing,posters, etc,should be hung over or near heaters or lights at any time i 7 Fire regulations state"No vehicles shall be parked in or near the vicinity of buildings". Vehicles are to be parked in the Camp parking lot only 8. No Camp equipment,i e.beds,gear boxes,mattresses,tables,chalkboards shall be moved without permission of the Camp staff If moved,they are to be returned to the original location prior to departure. 9. Swmuners must obey pool regulations(posted at pool entrance) A pool key will be provided to the"Person In Charge". The pool must be kept locked when qualified life guard is not on duty The pool is open June through August. 10. Meals are served family style or buffet style in the Dining Hall at 8.00 a in, 12.00 noon,and 5-30 p in Dinners after 5.30 p.m will result in an additional charge 1 I Pets are not allowed on Camp property 12 Guests of members of the lease group may not use the facility or will be charged as part-time users 13 Walk only on established paths or trails. 14 No trees,plants or shrubs may be cut 15. The Waskowitz phones are for our business purposes. Please provide your group with a cell phone number to use while at Waskowitz. Rev 6/08 l 1 ® DATE(MMIDDNYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 1/8/2013 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 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) CON A PRODUCER NAMECorl Alliant Insurance Services, Inc PHDNE 4 Fq/C No 720 Olive Way,Suite 1700 E-MA" Seattle WA 98101 ADDREss ¢ II n r INSURERS AFFORDING COVERAGE NAIC4 INSURER Princeton Excess&Surplus INSURED KE583802 INSURER B City of Kent INSURERC 220 Fourth Avenue South INSURERD Kent WA 98032-5895 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER 813247104 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 ADDL U R POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICYNUMBER Mld IDWYYYY MMIDD/YYYY A GENERAL LIABILITY 1-A3-RL-0000059-02 1112013 11112014 EACH OCCURRENCE $5,000,000 XDAMAGE T R COMMERCIAL GENERAL LIABILITY PREMISES Ea occirrence $ CLAIMS-MADE OCCUR Pi EXP(Any one pi $ - PERSONAL SADVINJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 17 POLICY PRO- LOD $ A I AUTOMOBILE LIABILITY Ni-A3-RL000006"2 11/2013 11112014 rEa accment 000000 X y ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acelden0 $ AUTOS AUTOS NONOPMED PROPERTY DAMAGE S HIREDAUTOS AUTOS Peraccdert UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB C.AIMS-MADE AGGREGATE $ M DES RETENTION$ $ WORKERS COMPENSATION 4bCSTATU-LIMJTS ER ,°. ANDEMPLDYERS LIABILITY YIN T ANY PROPRIETORIPAP.TNER/EXECUTIVE❑ NIA E L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NHf EL DISEASE-EA EMPLOYE $ fy es deson5eurlder DESCRIPTION OF OPERATIONStrelm EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) RE Use of the facilities Of Camp Waskowitz the week of August 5th-9th,2013 Camp for 160 children going Into the 5th,6th and 7th grades Fall 2013 Staffed by 36 adult volunteers CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Highline School District Camp Waskowitz ACCORDANCE WITH THE POLICY PROVISIONS Attn Ron Meyer 15675 Ambaum Blvd SW gUTHORIZED REPRESENT TIVE Burien WA 98166 --- bpra �._. - ©1988-2010 ACORD CORPORATION All rights reserved ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD t — —-- — ---- --