Loading...
Boulder Indoor Soccer - 20200827-7050 8/27/2020 Contract Tracking>Thank You ORK Service Excellencefor an inspired Futu tu OULDER STANDARD Contract Routing Cover Sheet Please print and attach to your document You can view the status of your contract using the Contract Tracking Status Page. Routing Number 20200827-7050 Originating Dept Parks &Recreation Contact Person Charlotte O'Donnell Phone Number 7203018376 Project Manager/ Contract Connor Bulger E-mail bulgerc@bouldercolorado.gov Administrator Counter Parties Boulder Indoor Soccer Contract Title / Type Services Contract for a Recreation Program Number Description Indoor soccer programming provided by contractor. Contractor will collect revenue and provide correct percentage to City. Special Instructions Amount Varies Expense Type INCOMING . Dept. Head Signature �,L NOTE; Originating Department: Identify with a check mark all areas document needs to be routed. • Purchasing • Budget • Sales Tax . CAO Type text here • City Manager • Central Records Contract Tracking Home I Signature Routing Form I Track Contract Status I Update Contract Status https://work.bouldercolorado.gov/ContractTracking/serviet/Controller 1/1 CITY OF BOULDER SERVICES CONTRACT FOR A RECREATION PROGRAM CITY OF BOULDER PARKS AND RECREATION September THIS CONTRACT made and entered into this 2nd day of A-gu-st 2020, by and between the City of Boulder, (the "City"), and Boulder Indoor Soccer, a Colorado corporation, ("Contractor"). The City and Contractor may hereinafter be referred to individually as a"Party" or collectively as the "Parties." RECITALS The City is desirous of contracting with Contractor for services associated with the operation of a Recreation Program on behalf of the City of Boulder Parks and Recreation for the period from August 1, 2020 to June 30, 2021 (the"Recreation Program"). Contractor is fully qualified to perform the services needed by the City in connection with the Recreation Program. COVENANTS In consideration of the terms, conditions and covenants herein stated, the parties agree as follows: 1. SCOPE OF WORK 1.1 The City agrees to use Contractor's services in connection with the Recreation Program for the period from August 1,2020 to June 30, 2021, inclusive, and Contractor covenants and agrees to provide said services as required and requested by the City during said period. The City reserves the right to extend this Contract as mutually agreeable by both parties. Such renewals shall be in writing and signed by both Parties. 1.2 The City will provide the facility for the operation of the Recreation Program, Sanctioned Adult Soccer Leagues, which facility is known as Pleasant View Fields Sports Complex (the "Facility"), and is located at 3805 47"' Street in Boulder. Contractor is responsible for maintaining the Facility in a clean and orderly fashion. Facility space will be provided by the City based on historical needs for the Recreation Program. Additional space needed for the Recreation Program will require approval by the Program Manager. If the Facility to be used by Contractor is a Boulder Valley School District(BVSD)property, Contractor shall be bound to the same obligations as the City related to compliance with BVSD rules, regulations, and policies as more fully detailed in the current BVSD/City Joint Use Agreement. 1.3. In connection with the Recreation Program, Contractor shall undertake the duties and responsibilities and provide the services described in Appendix A, "Scope of Work,"which is attached and incorporated herein. January 2020 Contractor Collects Revenue 1.4 Contractor is responsible for providing inclusion services. If a participant in the Recreation Program requests an accommodation, Contractor is responsible for providing any such accommodation in accordance with Americans with Disabilities Act (ADA) requirements. By way of example, accommodations may include hands on teaching techniques in addition to verbal instructions, one-on-one staffing assistance, two-on-one staffing assistance, interpreter etc. Contractor is responsible for all costs associated with providing the accommodation. Contractor shall contact the City's Exciting Programs Adventures and New Dimensions (EXPAND) at 303-413-7256, for additional information or training regarding accommodations and the inclusion process. 1.5 In addition to those duties outlined in Appendix A, Contractor shall provide adequate supervision of the Facility at all times, ensuring at least one staff member is present for all adult leagues. Contractor's staff member will be trained by the City of Boulder to monitor the fields and maintain all Facility regulations. Contractor, at its own cost, shall obtain a background check on each employee prior to working with any of the Recreation Program participants. All background check information, as well as CPR certificates, shall be on file with the City by September 1, 2020. 1.6 As a general matter, Contractor shall communicate with the City about the Recreation Program only through Connor Bulger, Program Coordinator, who has been assigned by the City as the Program Manager. 1.7 The City reserves the right to cancel a Recreation Program if it fails to meet minimum participation numbers established by the City one week prior to the start date of the Recreation Program. In such event,this Contract shall terminate. 1.8 Contractor agrees to comply with the requirements of the Independent Contractor Manual of the City of Boulder Parks and Recreation Department. 1.9 The City hereby reserves the right to decide all questions arising as to the proper performance of said services, and as to the quality of the materials used. In the event that the City shall determine that the services are not being performed in accordance with the terms of this Contract, or if the services be wholly, or in part, negligently, or unsatisfactorily performed, then written notice of such defect or defects shall be given to Contractor. Contractor may be given 30 days to cure the defect. This Contract shall terminate within 60 days of delivery of such notice. 2. COMPENSATION. 2.1 The Parties will cooperate to set fees that will be charged to the Recreation Program participants. However,the City shall have final authority on price set. Contractor will pay the City on the basis of fees collected from Recreation Program participants. 2.2 Payments to the City are based on the amount of revenues collected by the Recreation Program. Such revenues are calculated from the data generated by Contractor's recreation registration software. This data includes both the number of Recreation Program participants and the amount of revenue collected year to date for the Recreation Program and is January 2020 Contractor Collects Revenue set forth in a revenue report generated by e Contractor (the "Revenue Report"). The City will be paid 10% of the revenue collected by the Recreation Program. 2.3 Contractor agrees to provide City with an initial invoice and a copy of the Revenue Report within 30 days of the conclusion of the Recreation Program. It is the responsibility of the City to review this information and to submit a final invoice to Contractor for payment. Subject to final approval by the City, Contractor shall pay the final invoice within 30 days of receipt. The City shall only pay expenses associated with the operation of the Recreation Program, as set forth on Appendix A. 2.4 Contractor will provide the City with Recreation Program registration information prior to the first class. Upon reasonable advance request,the City may inspect and copy any or all records of Contractor which would bear on any amounts charged to the City pursuant to this Contract. The Parties will share any information collected including registration information, addresses and emails of Recreation Program participants. 2.5 If Contractor is unable to meet its obligations under this Contract, and any Recreation Program participant requests a refund, Contractor may refund all or a portion of the Recreation Program fee to the participant and withhold such amount from the payment to the City. If payment to the City has already been made, Contractor will bill the City for the amount to be reimbursed, and the City will pay that amount to Contractor within two weeks of the date of such bill. If a participant chooses to drop out of a scheduled Recreation Program, the City's refund policy outlined in Appendix B,"Refund Policy,"attached and incorporated herein,will be adhered to. 3. INSURANCE. 3.1 Contractor agrees to procure and maintain in force during the term of this Contract, at its own cost, the following minimum coverages: A. Workers' Compensation and Employers' Liability i. State of Colorado: Statutory B. General Liability i. General Aggregate Limit: $2,000,000 ii. Per Occurrence: $1,000,000 Coverage provided should be at least as broad as found in Insurance Services Office (ISO) form CG0001. C. Insurance shall: i. Provide primary coverage; ii. Include the City of Boulder and its officials and employees as additional insureds as their interest may appear(except for Worker's Compensation and Professional Liability). Additional insured endorsement should be at January 2020 Contractor Collects Revenue I least as broad as ISO form CG2010 for General Liability coverage and similar forms for auto liability; iii. Include a waiver of subrogation for General Liability coverage; iv. Issue from a company licensed to do business in Colorado having an AM Best rating of at least A-VI; and V. Be procured and maintained in full force and effect for duration of work. D. Certificates of Insurance evidencing the coverages described herein, shall be forwarded to the Program Manager. Certificate Holder shall be: City of Boulder, 1777 Broadway, Boulder, CO 80306. E. Within seven days after receiving insurer's notice of cancellation or reduction in coverage, Contractor, or its insurance broker, shall notify the City. In either such case, Contractor shall promptly obtain and submit proof of substitute insurance complying with the City's insurance requirements. 3.2 Contractor agrees to indemnify and save harmless the City against any and all damages to property or injuries to or death of any person or persons arising from its performance of this Contract, including property and employees or agents of the City and shall defend, indemnify and save harmless the City from any and all claims, demands, suits, actions or proceedings of any kind or nature, including without limitation workers' compensation claims, of or by anyone whomsoever in any way resulting from or arising out of Contractor's operations in connection with this Contract, including operations of sub-contractors and acts or admissions of employees or agents of Contractor or its sub-contractor. 3.3 Notwithstanding any other provision of this Contract to the contrary, no term or condition of this Contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions of the Colorado Governmental Immunity Act, Section 24-10-101 et seq., C.R.S., as now or hereafter amended. The Parties understand and agree that liability for claims for injuries to persons or property arising out of negligence of the City, its departments, institutions, agencies, boards, officials and employees is controlled and limited by the provisions of Section 24-10-101 et seq., C.R.S., as now or hereafter amended. 4. MISCELLANEOUS. 4.1 The relationship between Contractor and the City is that of an independent contractor. Contractor shall supply all personnel, equipment, materials and supplies at its own expense, except as specifically set forth herein. Contractor shall not be deemed to be, nor shall it represent itself as, an employee, partner, or joint venturer of the City. No employee or officer of the City shall supervise Contractor. Contractor is not entitled to workers' compensation benefits and is obligated to directly pay federal and state income tax on money earned under this Contract. 4.2 Contractor shall not assign this Contract without the written consent of the City, which it may withhold at its sole discretion. January 2020 Contractor Collects Revenue 4.3 This Contract shall be subject to the provisions of the Charter,Municipal Code and Ordinances of the City of Boulder. 4.4 Termination. This Contract may be terminated by either Party if it has been materially breached by the other Parry and written notification is tendered or as set forth in paragraphs 1.7 and 1.9. In the event of a material breach, the City reserves the right to terminate within three days of tendering written notification to Contractor of the breach. City may, at any time, terminate this Contract, in whole or in part, for its own convenience. City shall pay Contractor for work satisfactorily completed, to the date of termination. The City shall determine the portion of work completed. 4.5 It is expressly understood and agreed that the enforcement of the terms and conditions of this Contract and all rights of action relating to such enforcement, shall be strictly reserved to the City and Contractor. Nothing contained in this Contract shall give or allow any claim or right of action whatsoever by any other third party. It is the express intention of the City and Contractor that any such party or entity, other than the City or Contractor,receiving services or benefits under this Contract shall be deemed an incidental beneficiary only. 4.6 The waiver of any breach of a term,provision,or requirement of this Contract shall not be construed or deemed as waiver of any subsequent breach of such term, provision, or requirement, or of any other term,provision, or requirement. 4.7 This Contract is intended as the complete integration of all understandings between the Parties. No prior or contemporaneous addition,deletion,or other amendment hereto shall have any force or effect whatsoever, unless embodied herein in writing. No subsequent notation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied in a writing executed and approved by the City pursuant to City rules. 4.8 Contractor certifies that Contractor shall comply with the provisions of Section 8- 17.5-101 et seq., C.R.S. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Contract. Contractor represents, warrants, and agrees: (i) that it has confirmed the employment eligibility of all employees who are newly hired for employment to perform work under this Contract through participation in either the E-Verify or the Department Program; (ii) that Contractor is prohibited from using either the E-Verify Program or the Department Program procedures to undertake pre-employment screening of job applicants while this Contract for services is being performed; and (iii) if Contractor obtains actual knowledge that a subcontractor performing work under this Contract for services knowingly employs or contracts with an illegal alien, Contractor shall be required to: a) Notify the subcontractor and the contracting state agency or political subdivision within three days that Contractor has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and January 2020 Contractor Collects Revenue b) Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to Section 8-17.5-102(2)(b)(I11)(A)the subcontractor does not stop employing or contracting with the illegal alien; except that Contractor shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contractor further agrees that it shall comply with all reasonable requests made in the course of an investigation under Section 8-17.5-102(5), C.R.S. by the Colorado Department of Labor and Employment. If Contractor fails to comply with any requirement of this provision or Section 8-17.5-101 et seq.,C.R.S.the City may terminate this contract for breach and e Contractor shall be liable for actual and consequential damages to the City. 4.9 Contractor warrants that the individual executing this Contract is properly authorized to bind Contractor to this Contract. [Signature Page Follows] IN WITNESS WHEREOF, the Parties to this First Amendment have caused it to be executed by their authorized officers as of the day and year first above written. This First Amendment may be executed in counterparts,each of which shall be deemed an original,but all of which together shall constitute one and the same instrument. January 2020 Contractor Collects Revenue CONTRACTOR-;: Title: t,:.�- �r��-�,�%•.y- CITY OF BOULDER ATTEST: F—D ity Manager City Clerk APPROVED AS TO FORM: li7:)a4z� Z-k � City Attorney's Office Appendix A SCOPE OF WORK A. Specific Recreation Program Information: Boulder Indoor Soccer sanctioned January 2020 Contractor Collects Revenue adult soccer leagues through Colorado Soccer Association. B. The City of Boulder agrees to provide the following services for the Recreation Program specified above: 1. Facility and location: Field usage at Pleasant View Fields Sports Complex per historical league usage and based upon Program Manager approval. Storage space onsite for one golf cart belonging to Contractor. 2. Equipment: Soccer goals and nets onsite and corner flags for each field. 3. Maintenance: The City of Boulder will provide necessary field maintenance, painting and lining per standards as dictated by City of Boulder Facility Management. 4. Advertise the course in various marketing efforts as they present themselves. 5. Provide inclusion training for the Contractor as needed. 6. Provide Contractor with orientation on the City's policies and procedures. 7. Provide training for Contractor's designated employees on opening and closing procedures of the Pleasant View Fields Sports Complex. Contractor's designated employees must be approved by Program Manager. C. Contractor shall comply with the following standard City of Boulder requirements: 1. TRAININGS. Prior to the start of the Recreation Program, Contractor agrees to participate in the City's trainings as follows: a. Contractor and/or staff will participate in pre-Recreation Program training on the City's policies and procedures and facility use. b. Contractor and its staff will attend staff training both before the start of the Recreation Program and as necessary to provide all Recreation Program services. C. Contractor and staff will attend inclusion training by the City's EXPAND as needed. 2. RECREATION PROGRAM OPERATION. Contractor will schedule and supervise all Recreation Program activities and participants with approval from the Program Manager.Such duties include but are not limited to the following: January 2020 Contractor Collects Revenue a. Contractor will hire, supervise and pay all staff of the Recreation Program. b. Contractor will brand the City of Boulder Parks and Recreation Department through marketing materials, banners, etc. consistent with all City of Boulder Parks and Recreation regulations for branding. C. Contractor will submit all promotional materials to the Program Manager for use in marketing opportunities in a timeframe determined by the Program Manager. d. Contractor will collect City Risk and Release forms from each Recreation Program participant on the first day of each Recreation Program and return to City of Boulder staff by the second day of each Recreation Program. e. Contractor will keep accurate records and provide complete and timely information for required reports on activities including but not limited to check-in and check-out procedures, incident and accident reports and injury log. f. Contractor will collect all Recreation Program participants' information for promotional materials (i.e. name, email address, physical address, phone number) and provide to the Program Manager on or before the conclusion of the Recreation Program. g. Contractor will meet with the Program Manager on a quarterly basis, or as otherwise determined by the Program Manager, to report on the Recreation Program. h. Contractor will submit incident or accident forms within 24 hours of such incident or accident. The forms will be provided to Contractor and should be faxed or turned into the Program Manager. i. Contractor will maintain an injury log that will be provided and kept at the Facility and turned into the Program Manager at the end of the Recreation Program. 3. MASTER PLAN GOALS. Contractor will align with the City of Boulder Parks and Recreation Master Plan goals to meet community needs, including, but not limited to,the following: a. Contractor will provide a scholarship program for Recreation Program participants who the City determines are eligible for financial assistance. Contractor is responsible for all costs associated with providing the assistance. January 2020 Contractor Collects Revenue b. In conjunction with a scholarship program, Contractor will conduct community outreach to underserved populations of the community. C. Contractor will set program plans to broaden the scope of offerings for a wide range of community opportunities. d. Contractor agrees to participate in a minimum of one City special event and appropriate "guest appearances" within current City programming and outreach efforts. e. Contractor will work with the Program Manager to maximize Facility use while exploring creative ways to use available spaces. 4. REPORTING OBLIGATIONS. Contractor shall submit a Lifecycle Management and Delivery Model Report (the "Lifecycle Report") to the Program Manager on or before November 1 of each year of this Contract. The Lifecycle Report will be generated on a form provided by the City. The purpose of the Lifecycle Report is to assist the City in the evaluation of the Recreation Program and the development of future programming. 5. PERFORMANCE BENCHMARKS. In order for the City to guarantee consistent levels of service for all its Recreation Programs, the City has established performance benchmarks as goals for Contractor. Performance measures will include participation and satisfaction rates as follows: • Educational Components; • Health Benefits; • Participation(Engagement& Activity); and • Social Relationship Building. These measures will be calculated through parent and Recreation Program participant interactions,participation surveys, and communication between the City and Contractor. If performance benchmarks are not met, then the City and Contractor will meet to discuss the future of the services offered. The performance benchmarks are as follows: 1. In 2020 an average of 75% of respondents indicate they are fully or partially satisfied with Recreation Program offerings and/or instruction on Recreation Program participant surveys; 2. In 2021 and 2022, increase or hold consistent the number of teams in 2020 and; 3. In 2021 and 2022, an average of 80% of respondents should indicate they are fully or partially satisfied with Recreation January 2020 Contractor Collects Revenue Program offerings and/or instruction on Recreation Program participation surveys. January 2020 Contractor Collects Revenue Appendix B REFUND POLICY Camps: • Two weeks before camp begins $15.00 fee • Within two weeks of first day or after first day No refund Programs: • Before second class $15.00 fee • After second class No Refund Leagues: • Before the registration close date $15.00 fee • After the registration close date No Refund January 2020 Contractor Collects Revenue 78/24/2020 E(MM/DDYYY) ACC" CERTIFICATE OF LIABILITY INSURANCE /Y 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). CONTACT PRODUCER USI Insurance Services NW NAME, 601 Union Street, Suite 1000 E FAX a/c"No Ext: 206-441-6300 A/C No: Seattle,WA 98101 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Everest Indemnity Insurance Company 10851 INSURED INSURERB: Everest Denali Insurance Company 16044 Colorado Soccer Association INSURERC: Everest National Insurance Company 10120 US Adult Soccer Association, Inc. Its Member National Affiliates, Leagues &Teams INSURERD: QBE Insurance Corporation 39217 7000 S. Harlem Ave INSURERE: Bridgeview IL 60455 INSURER F COVERAGES CERTIFICATE NUMBER: 57199903 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/DD/YYYY MM/DDIYYYY A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ S18GLO1598-201 1/1/2020 1/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE ✓ OCCUR PREMISES Ea occurrence $1.000.000 ✓ Participant Legal MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY❑ PRO- POLICY ❑ LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ B AUTOMOBILE LIABILITY S18GLO1598-201 1/1/2020 1/1/2021 (CEO, .,d.n,SINGLELIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ✓ NON-OWNEDHIRED AUTOS ONLY ✓ AUUTOS ON (Par PROPERTY TnDAMAGE $ C UMBRELLA LIAB OCCUR ,/ S18EX01297-201 1/1/2020 1/1/2021 EACH OCCURRENCE $1,000,000 ✓ EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED RETENTION$ $ 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 $ A Sexual Abuse&Molestation S18GLO1598-201 1/1/2020 1/1/2021 $1,000,000 Any One Occ $2,0005000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Colorado Soccer Association, ,4643 S.Ulster St.Suite 250 Denver,CO 80237 All Affiliated Teams and Players Certificate Holder is Additional Insured as pertains to sanctioned games/practices of the named insured its Member National Affiliates, Leagues or Member Teams. The effective date of coverage for the Affiliates, Leagues&Teams shown is the date they were accepted as a member of USASA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Pleasant View Fields Sports Complex THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3805 47th Street ACCORDANCE WITH THE POLICY PROVISIONS. Boulder CO 80301 AUTHORIZED REPRESENTATIVE '�ikkGM �µ�k4l Karin Hills ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 57199903 1 20/21 Master Certificate I Kristen Carlson 1 8/24/2020 6:30:55 PM (MDT) I Page i of 6 AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED USI Insurance Services,LLC Colorado Soccer Association US Adult Soccer Association, Inc. POLICY NUMBER Its Member National Affiliates,Leagues&Teams 7000 S.Harlem Ave Bridgeview IL 60455 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:ACORD 25 (03/16) HOLDER: Pleasant View Fields Sports Complex ADDRESS:3805 47th Street Boulder CO 80301 Primary Non-Contributory and Waiver of Subrogation apply per forms attached. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM/DOO 57199903 1 20/21 Master Certificate I Kristen Carlson 1 8/24/2020 6:30:55 PM (MDT) I Page 2 of 6 8/24/2020 Colorado Soccer Association US Adult Soccer Association, Inc. Its Member National Affiliates,Leagues&Teams POLICY NUMBER S18GLO1598-201 COMMERCIAL GENERAL LIABILII Y CG 20 11 01 96 1 HIS LNDORSLMLN I CHANGLS THL POLICY. PLLASL RLAD IT CARLFULLY_ ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following COMMFRCIAI GFNFRAI I IABII ITY COVFRAGF PART SCHEDULE 1. Name of Person or Organization (Additional Insured) Pleasant View Fields Sports Complex 3805 47th Street Boulder CO 80301 2. Designation of Premises (Part Leased to You) SEE BELOW 3. Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization shown in the Schedule but only with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions? This insurance does not apply to 1 Any occurrence which takes place after you cease to be a tenant.in that premises 2 Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the schedule. CG 20 11 01 96 57199903 1 20/21 Master Certificate I Kristen Carlson 1 8/24/2020 6:30:55 PM (MDT) I Page 3 of 6 Colorado Soccer Association US Adult Soccer Association, Inc. 8/24/2020 COMMERCIAL GENERAL LIABILITY S18GL01598-201 ECG 04 704 11 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is a summary of the Limits of Insurance and additional coverage provided by this endorse- ment. For complete details on specific coverage, please refer to policy language in this endorsement and the underlying Commercial General Liability Coverage Form. Coverage Applicable Enhancement Non-Owned Watercraft Less Than 50 Feet —Supplementary Payments— Bail Bonds $1,000 Supplementary Payments— Loss Of Earnings $500 per day Newly Acquired Organizations— Extended Coverage 180 days Subsidiaries As Insureds Included Fire Damage To Premises Rented To You $500,000 Notice To Company— Duties In The Event Of Occur- Broadened rence, Claim Or Suit Unintentional Failure To Disclose Hazards Broadened Waiver Of Subrogation Broadened Amendment to Bodily Injury Definition Broadened A. Non-Owned Watercraft C. Newly Acquired Organizations— Extended Paragraph g.(2) under Paragraph 2. Exclusions Coverage of Section I — Coverage A Bodily Injury And Paragraph 3.a. under Section II — Who Is An In- Property Damage Liability is replaced by the fol- sured is replaced by the following: lowing: (2) A watercraft you do not own that is: a. Coverage under this provision is afforded only until the 180th day after you acquire or form (a) Less than 50 feet long; and the organization or the end of the policy period, (b) Not being used to carry persons or property whichever is earlier; for a charge; D. Subsidiaries As Insureds B. Supplementary Payments— Increased Limits The following is added to Section II — Who Is An Paragraphs 1.b. and 1.d. under Supplementary Insured: Payments — Coverages A And B of Section I — Coverages are replaced by the following: 4. Any subsidiary company in which you own a b. Up to $1000 for cost of bail bonds required financial interest of more than 50% as of the ef- because of accidents or traffic law violations fective date of this endorsement is included as arising out of the use of any vehicle to which a Named Insured. However, such organization the Bodily Injury Liability Coverage applies. We is not a Named Insured: do not have to furnish these bonds. a. If it is a partnership, joint venture or limited d. All reasonable expenses incurred by the in- liability company; sured at our request to assist us in the investi- b. If there is other similar insurance available gation or defense of the claim or "suit', includ- to it; ing actual loss of earnings up to $500 a day because of time off from work. ECG 04 704 11 13 Copyright, Everest Reinsurance Company, 2013 Page 1 of 2 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. 57199903 1 20/21 Master Certificate I Kristen Carlson 1 8/24/2020 6:30:55 9NSCREID QOPXge 4 of 6 c. If there is other similar insurance that would H. Waiver Of Subrogation be available to it, but for the termination of The following is added to Condition 8. Transfer Of the insurance or the exhaustion of its limits Rights Of Recovery Against Others To Us of of insurance; or Section IV — Commercial General Liability d. After you cease to own a financial interest Conditions: of more than 50%. We waive any right of recovery we may have E. Fire Damage To Premises Rented To You — against any person or organization because of Increased Limits payments we make for injury or damage arising Paragraph 6. under Section III — Limits of Insur- out of your operations or"your work" done under a ance is replaced by the following: written agreement that requires you to waive your rights of recovery. The written agreement must be 6. Subject to Paragraph 5. above, the most we made prior to the date of the `occurrence". will pay under Coverage A for damages be- cause of "property damage" to any one prem- I. Amendment to Bodily Injury Defini- ises while rented to you or temporarily occu- tion pied by you with permission of the owner is the Paragraph 3. Of Section V. — Definitions is greater of: replaced by the following: a. $500,000; or 3. "Bodily injury" means bodily injury, sickness, b. The Damage To Premises Rented To You mental injury, mental anguish, shock or fright Limit shown in the Declarations. sustained by a person, including death resulting from any of these at any time. However, "bodily F.Notice To Company injury" does not include injury arising out of the The following is added to Condition 2. Duties In offenses designated in the definition of The Event Of Occurrence, Offense, Claim Or "personal and advertising injury". Suit under Section IV— Commercial General Li- ability Conditions: e. Your failure to first notify us of a claim will not invalidate coverage under this policy if the loss was inadvertently reported to another insurer. However, you must report any such "occur- rence" to us within a reasonable time once you become aware of such error. G. Unintentional Failure To Disclose Hazards Condition 6. Representations under Section IV— Commercial General Liability Conditions is re- placed by the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon repre- sentations you made to us; and c. We have issued this policy in reliance upon your representations. Any unintentional error or omission in the de- scription of, or failure to completely describe, any premises or operations you intend to be covered by this Coverage Part, will not invali- date or affect coverage for those premises or operations. However, you must report any such error or omission to us as soon as reasonably possible after its discovery. Page 2 of 2 Copyright, Everest Reinsurance Company, 2013 ECG 04 704 11 13 ❑ Includes copyrighted material of Insurance Services Office, Inc. used with its permission. 57199903 1 20/21 Master Certificate I Kristen Carlson 1 8/24/2020 6:30:55 INSURED OOPXge 5 of 6 Colorado Soccer Association 8/24/2020 US Adult Soccer Association, Inc. COMMERCIAL GENERAL LIABILITY Policy# S18GLO1598-201 ECG 24 520 04 02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT ® OTHER INSURANCE (PRIMARY N®NC®NTRI UTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph a. Primary Insurance of 4. Other In- surance of SECTION N COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: a. Primary Insurance This insurance is primary except when b.below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method de- scribed in c, below, except that we will not seek contribution from any party with whom you have agreed in a written contract or agreement that this insurance will be primary and noncontribu- tory, if the written contract or agreement was made prior to the subject 'occurrence" or of- fense. I I i I 1 i ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 ® f with its permission. i 57199903 1 20/21 Master Certificate Kristen Carlson 1 8/24/2020 6:30:55 PM (MDT) I Page 6 of 6