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CAG2023-273 - Original - Highline School District No. 401 - Camp Waskowitz 5th-7th Grade Sleepaway Camp - 07/31/2023
FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form DirAsst: • For Approvals,Signatures and Records Management Dir/Dep: KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover (optional) WASHINGTON Sheet forms. (Print on pink or cherry colored paper) Originator: Department: Julie Stangle Parks, Recreation & Community Services Date Sent: Date Required: c 04/21/2023 05/30/2023 QAuthorized to Sign: Date of Council Approval: Q �✓ Mayor or Designee N/A Budget Account Number: Grant? Yes No�✓ 10006234 Budget?❑✓ Yes Type N/A Vendor Name: Category: Highline School District No. 401 Contract _MW" Vendor Number: Sub-Category: 37911 Original Q 0 w Project Name: 2023 Summer Sleepaway Camp 3- Project Details: Slee awa Cam for youth 5th-7th grades in Fall 2023 at Cam Waskowitz 0 Sleep away p Y 9 P C facility in North Bend, July 31 - August 4, 2023. Revenue collected for camp 40 covers rental fee. C (11.111 Basis for Selection of Contractor: E Agreement $28 092 Other �r *Memo to Mayor must be attached .1111 lm Start Date: 107/31/2 Termination Date: 08/05/2023 a Local Business? Yes ✓�No*If meets requirements per KCC 3.70.100,please complete"Vendor Purchase-Local Exceptions"form on Cityspace. Business License Verification: ❑YesF]In-Process F-11Exempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: Yes❑No CAG2023-273 Comments: IM C C 3 0 N a Date Received:City Attorney: 4/21/23 Date Routed:Mayor's Office 4/27/23 6ty Clerk's Office 5/1/23 adccW22373_7_20 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 Highline School District No. 401 Camp Waskowitz Rental Agreement 45505 S.E. 150"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 525 Fourth Ave N Organization Kent Parks Address Kent, WA 98032 Billing Contact Phone 253-856-5030 IiC Denee Naefus BC Phone 253-856-5030 BC Email dneafus@kentwa.gov Camp Point (CP) Julie Stangle CP Phone 253-856-5030 CP Email jstangle@kentwa.gov CAMPER INFORMATION Age of Campers: 80 Youth #Female Campers: TBD Wale Campers: TBD Total Adults: 20 #of Female: TBD #of Male: TBD Total Number: 80 campers and 20 staff=estimate of 100 total • 4 Night Camp Group • Closed campus-no guests unless prearranged with Waskowitz staff Notes: • Pool usage included in facility fee. Group MUST provide certified lifeguard to use, TIMING/MEAL INFORMATION Arrival Date: 7/31/23 Time: 10:OOAM First Meal: Lunch 7.31 Departure Date: 8/4/23 Time: 1:0013M Last Meal: Lunch 8.4 Total Meals Breakfast(s): 4 Lunch(es): 1 5 Dinner(s): 4 "Please let us know no later than 7/18/22 for food restrictions and/or meal Meal Notes: accommodations" Lodging$44 per person, per night(group of 50-100) OR$36 per person per night(group of 101-200) Meals: Breakfast$9 per plate, Lunch: $9 per plate, Dinner$11 per plate facility Use: @$298/per day Estimate$28,092.00 (based on 101-200) Total Charge $TBD Date Insurance Deposit 250.00-pending Certificate Received pending Amount Due $TBD C'ER'l'IFICA1 E OF INSURAN(i:: The lessee,at its own cost,shall maintain public liability insurance for bodily injuries(including sickness or death)and property damage in the minimum amount of S 1.000,000 combined single limit per occurrence•and in the minimum amount of$2,000.000 in the aggregate. Employers Liability(Washington Stop-Cap)in the amount of no less than S 1,000.000 must be in place. If lessee or employee autos will be driven to the camp,then lessee will demonstrate coverage of at least S 1.000,000 in Automobile coverage,including Hired and Non-Owned autos. Lessee's policies must also include Non-Contributory and Waiver of Subrogation clauses and forms must be attached to the Certificate of Insurance. Prior to using the site,the lessee shall furnish the Camp Waskowitz office with a Certificate of insurance evidencing the above coverage and naming Highline School District 4'401 as an additional insured and as certificate holder. See the cr/luched checklist caul ceraihcale example fnr.epecijic•details. IIULD IIAR�l LESS:1GREE1IE:NT: To the fullest extent permitted bylaw,the lessee releases and shall defend,indemnity and hold harmless the Highline 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. I have read and understand the rules and regulations listed on both sides of this application and agree to abide by them. POOL USE June-September only.Any rental group using the pool is responsible for furnishing a qualified lifeguard while the pool is in use. A qualified lifeguard 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 current date must be submitted prior to pool use. Pool use shall be during daylight hours only(8:00 a.m.to 8:00 p.m.) Failure to comply with any of the rules will necessitate the closure of the pool. Deposit:This agreement must be accompanied by a deposit of 10%of the estimated total cost or$250.00,whichever is greater, in order to assure the reservation. Retain(1)copy for your records 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. 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. Billing Regulations: 1. 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 may be provided at an additional charge. 2. A statement of charges will be sent to the lessee shortly after the rental period ends. Prompt payment should be made to Highline School District and sent to Highline School District, 15675 Ambaum Blvd.S.W.,Burien,WA 98166. 3. 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. 4. 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. 5. 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. 6. Meal menus will be developed by Camp staff. Special requests should be arranged with the Head Cook at least 3 weeks prior to arrival. 7. Groups under 75 participants are subject to sharing camp with any other group at the camp staff's discretion. 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 of the 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.e.towels,clothing,posters,etc.,should be hung over or near heaters or lights at any time. 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. Swimmers 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 a qualified lifeguard 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.m., 12:00 noon,and 5:30 p.m. Dinners after 5:30 p.m.will result in an additional charge. 11. 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. Highline School District No. 401 Camp Waskowitz Rental Agreement 45505 S.E. 150`h 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 15. The Waskowitz phones are for our business purposes. Please provide your group with a cell phone number to use while at Waskowitz. Organization: Camp Waskowitz Organization 'ont Parks Signature: gautor Signature: Date: 4.12.2023 Date 04/27/2023 74/21/2023 (MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE IY 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: Jamie Arnold) Seattle-Alliant Insurance Services, Inc. PHONE FAX 1420 Fifth Avenue, Suite 1500 A/C No Ext: 949-627-7000 A/c No), Seattle WA 98101 ADDRESS: Jamie.Arnoldi@alliant.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Safety National Casualty Corpo 15105 INSURED KE583802 INSURER B: City of Kent 220 Fourth Avenue South INSURERC: Kent WA 98032-5895 INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:1096768014 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 LTR INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY XPR4067991 1/1/2023 1/1/2024 EACH OCCURRENCE $1,000,000 F_V� DAMAGE TO CLAIMS-MADE OCCUR PREMISES (E.occur ante) $500,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑ PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: SIR $1,250,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: Renting Camp Waskowitz facility from July 31,2023 to August 4,2023.80 youth going into 5-7 grade fall 2023 and 24 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 No.401 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jennifer Hirayama 15675 Ambaum Blvd SW AUTHORIZED REPRESENTATIVE Burien WA 98166 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD