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HomeMy WebLinkAboutAG 23-156 - OUTDOORS FOR ALLRETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM I . ORIGINATING DEPT./DIV: City of Federal Way - Federal Way Community Center 2. ORIGINATING STAFF PERSON: Ashriya Guptar EXT: 6950 3. DATE REQ. BY: 6/16/23 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL B OTHER MOU S. PROJECT NAME: OUTDOORS FOR ALL - KAYAKING 6. NAME OF CONTRACTOR: OUTDOORS FOR ALL ADDRESS: 6344 NE 74TH ST. STE 102, SEATTLE WA 98115 TELEPHONE 206-838-6030 E-MAIL,: KyleHQoutdoorsforall.org FAX: SIGNATURE NAME: KY TITLE PARTNER PROGRAMS MANAGER 7. EXHIBITS AND ATTACHMENTS: F SCOPE, WORK OR SERVICES A COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: 8/12/23 COMPLETION DATE: 8112/23 9. TOTAL COMPENSATION $ 0 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES 0M NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED 10YES IDNO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED A PROJECT MANAGER KH 6/13/23 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ® LAW JE 6115/23 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff' if necessary and feel free to set notification more than a month in advance if council approval is needed.) CMTIAL / DATE SIGNED AW DEPARTMENT `2- Fj SIGNATORY (MAYOR OR DIRECTOR) 1L �(pEj ❑ CITY CLERK ❑ ASSIGNED AG# AG# COMMENTS: 2/2017 ra uu ann a Outdoors for All 6344 NE 74th St, Ste 102 Seattle, WA 98115 P 1206.838.6030 x 217 E) KyleH@outdoorsforall.org Partnership Program Memorandum of Understanding I i Name: Clty of Federal Way Parks Fit email: Kevin.huLchirtsan@cityofl Name: Kayaking Dates: !f1212023 Partner Contact: Kevin Hutchinson Phone: (253)835-6927 Address: FEDERAL WAY COMMUNITY CENTER 876 S. 333RD STREET item DetalIs Cost Tax Ease Fee Kayaking 5 2.500.00 5 (Equipment Rental 5 $ 'Vendor Fee S 'Transportation Fee 5 ,Additional Fees $ $ [Financial Aid- MSCT 5 Financial Aid - Grant 5 2.500.00 Financial Aid - Outdoors for All 5 Total: $0.00 Detailed Event Milo rrtation Event Type: Kayaking Event Location: North Lake Tapps Park Liability Link: Event Time: 10am-4pm httas;l/www.ttalorrn%wm/497R39itfa 1$77=a3N560 'Transportation Provided: No 00003slY9EAl Schedule: Sam - Outdoors for All staff arrive for set-up loam - 10:15am -Introductions/Safety Checks/Kayak Set-ups 10:15am -12pm - Group Kayaking 12pm-1pm - Break for Lunch 1pm - 4pm - Continuation of Kayaking Event Narrative: Outdoors for All will provide a kayaking experience day for the participants of the City of Federal Way Inclusion North Lake Tapps Park. During this experience, One staff will be in a lead solo kayak to address any emergencies that arise. One staff member will be able to support a participant. Outdoors for All will recruit volunteers to assist with captaining additional kayaks and it is recommend the partner provide staff/volunteers as well. All participants must sign the Outdoors for All liability waiver prior to participation. It is recommended that participants bring their own towel, snacks, and water. Participants should wear clothing that is appropriate to be active. Outdoors for All Staff: 2 # of Participants: 12 Partner Staff/VOL: 2 Diagnosis: Diverse Array of Intellectual and Developmental Outdoors for All VOL: 6 to 8 Equipment: Kayak, Paddles, PFDs Ages: 16-65 Outdoors for All Contact: Kyle Hitzelberg - KyleH@outdoorsforall.org - 206.838.6030 x217 Outdoors for All agrees to: 1. EQUIPMENT: Provide adaptive and non_adaptive equipment as indicated above. 2. TRANSPORTATION: Provide transportation of equipment and/or participants to event site (as indicated above). 3. STAFF: Provide one or more Outdoors for All staff person/s (as indicated above). Staff will train the partner organization volunteers/staff on equipment operation, choice, and fitting. The Outdoors for All staff person will remain at the base camp to assist, direct, and troubleshoot the volunteers/staff or the Outdoors for All staff will lead the activity. 4. FINANCIAL AID: Outdoors for All is committed to reducing the economic barriers of our partners and participants while financial aid resources are available. Financial aid may not cover vendor fees such as: permits, venue rentals, etc. . 5. INSURANCE: Provide insurance for the Partnership Program. Outdoors for All maintains an insurance policy with Acordia Northwest. We can provide you with a "certificate of insurance" " naming you "additional insured" if needed. We would also appreciate receiving a "certificate of insurance" from your insurance company. 6. LIABILITY: Each party shall defend, indemnify, and hold the other party, its officers, officials, employees, and volunteers harmless from any and all claims, injuries, damages, losses or suits including reasonable attorney fees, arising out of injuries and/or damages caused by each party's own negligence. Partner Organization agrees to: 1. CANCELLATION/REFUND POLICY: A full refund minus a $100 administrative fee, plus the cost of any vendor fees or reservations, will be given if the partner organization cancels an event by written notice 10 days prior to the scheduled date of the event. The partner organization will be responsible for the full cost of the event if the event is cancelled less than 10 days before the scheduled date or participants drop out less than ten days before the scheduled event. Outdoors for All reserves the right to cancel an event due to unsafe weather. If a partner or participant chooses not to participate due to weather there will be no refund given. If Outdoors for All cancels an event due to dangerous weather or road conditions, a credit for the event will be given and event will be rescheduled on a mutually agreed upon date. No discounted rates will be given due to participant/partner absence or choice of non - participation. 2. VOLUNTEERS/STAFF: If necessary, the partner organization will provide an adequate number of staff and volunteers to assist participants. They will be trained by the Outdoors for All staff person on equipment operation, choice, and fitting. Staff and volunteers will support participants with disabilities as needed, to participate in the activity. The partner organization's staff/volunteers should be dedicated to the needs of the participants and group's goals. The Outdoors for All staff person(s) will remain at a base camp to assist, direct, and troubleshoot the volunteers/staff or serve as a lead during the event. 3. Financial Aid & Group Expectations: In order to receive the full financial aid amount listed above, the partner organization must meet its minimum attendance number for eligible participants (as noted in the Detailed Event Information section, "q of participants"). Outdoors for All cannot give away financial aid to have little or no return in participation. All participants, staff, and volunteers must complete digital liability forms prior to joining the event. Each attendee must be capable of appropriately wearing the safety equipment needed for the activity. Individuals who are not able to meet the Essential Eligibility Criteria for a program/sport/activity will be asked to leave the event area. 4. PROMOTION: Promote the event according to the goals of the host organization. With prior written approval by the Partner, the Partner agrees that Outdoors for All may use any photo, video, interviews, and success stories from this event in marketing and outreach . Please return a signed copy of this MOU within 5 business dah of receipt. The Accounting Department will send a final invoice during the first week of the month following the completion of the event. Partner Signature: Outdoors for All Signature: Partner Name: KG -Via *yTC W5 J Outdoors for All Name: Date: W-1IS&ZS Date: Digitally signed by Kyle Kyle Hitzelberg Hitzelber Date:2023.06.20 09:21:19-07'00' Kyle Hitzelberg 6.20.2023 6/13/23, 1:14 PM Washington State Department of Revenue Washington State Department of Revenue < Business Lookup https License Information: Entity name: OUTDOORS FOR ALL FOUNDATION Business OUTDOORS FOR ALL FOUNDATION name: Entity type: Nonprofit Corporation UBI #: 600-348-980 Business ID: 001 Location ID: 0002 Location: Active Location address: Mailing address: 6344 NE 74TH ST STE 102 SEATTLE WA 98115-8165 6344 NE 74TH ST STE 102 SEATTLE WA 98115-8165 Excise tax and reseller permit status: Click here Secretary of State status: Click here Endorsements Endorsements held i License # Count Details Minor Work Permit :/Isecure.dor.wa.gov/gteunauth/—/#2 U New search Back to results Status Expiration First issua Active Jan-31-2C May-10-2 '3 6/13/23, 1:14 PM Washington State Department of Revenue Endorsements held i License # Count Details Status Expiratior First issua Governing Peo p I e May include governing people not registered with Secretary of State Governing people BRONSDON, ED EFROYMSON, AMY ESTEP, TOM INSLEE, CONNOR REYNOLDS, ROGER ZYLSTRA, THERA Registered Trade Names Registered trade names Status OUTDOORS FOR ALL FOUNDATION Active Title First issued Dec-16-2019 View Additional Locations The Business Lookup information is updated nightly. Search date and time: 6/13/2023 1:13:53 PM https://secure.dor.wa.gov/gteunauth/_/#2 2/3 6/13/23, 1:14 PM Corporations and Charities System BUSINESS INFORMATION Business Name: OUTDOORS FOR ALL FOUNDATION UBI Number: 600 348 980 Business Type: WA NONPROFIT CORPORATION Business Status: ACTIVE Principal Office Street Address: 6344 NE 74TH ST STE 102, SEATTLE, WA, 98115-8165, UNITED STATES Principal Office Mailing Address: 6344 NE 74TH ST STE 102, SEATTLE, WA, 98115-8165, UNITED STATES Expiration Date: 01/31/2024 Jurisdiction: UNITED STATES, WASHINGTON Formation/ Registration Date: 01/23/1979 Period of Duration: PERPETUAL Inactive Date: Nature of Business: CHARITABLE Charitable Corporation: R Nonprofit EIN: 91-1085999 Most Recent Gross Revenue is less than $500,000: Has Members: Public Benefit Designation: R Host Home: REGISTERED AGENT INFORMATION Registered Agent Name: OUTDOORS FOR ALL FOUNDATION Street Address: 6344 NE 74TH ST STE 102, SEATTLE, WA, 98115-8165, UNITED STATES Mailing Address: https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1/2 6/13/23, 1:14 PM Corporations and Charities System GOVERNORS Title Governors Type Entity Name First Name Last Name GOVERNOR INDIVIDUAL ED BRONSDON GOVERNOR INDIVIDUAL ROGER REYNOLDS GOVERNOR INDIVIDUAL TOM ESTEP GOVERNOR INDIVIDUAL AMY EFROYMSON GOVERNOR INDIVIDUAL CONNOR INSLEE GOVERNOR INDIVIDUAL THERA ZYLSTRA https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 2/2 SKI43613 aco>�ro ® CERTIFICATE OF LIABILITY INSURANCE DATE/20/2D/YYYY) 620/2023 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 Safehold Special Risk, Inc. (877) 281-5690 CONTACT NAME: PHONE FAX AMC Noll: E-MAIL ADDRESS- Safehold Special Risk, Inc. (CA DOI # OG13561) INSURER(S) AFFORDING COVERAGE NAIC# 601 Union St, Suite 1000 INSURER A: NOVA Casualty Company 42552 Seattle, WA 98101 INSURED INSURER B : INSURER C Outdoors For All Foundation INSURER D: 6344 NE 74th Street, Suite 102 INSURER E : _ INSURER F : Seattle, WA 98115 COVERAGES CERTIFICATE NUMBER: 15738131 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MMIDD Y POLICY EXP MWDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X WFR-GL-10000044-05 10/01/22 10/01/23 EACHOCCURRENCE $ 1,000,000 DA AG TO RENTED P MISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ Not Covered WA Stop Gap Employers Liability X $1,000,000 Limit PERSONAL & ADV INJURY S 1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ None PRODUCTS - COMPIOP AGG $ 2,000.000 POLICY �. LOC SEXUAL MISCONDUCT S 1,000,000 OTHER: AUTOMOBILE LIABILITY GOMBiNE-DSINGLE LIMIT Ea a S BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) S PROPERTYDAMAGE Per aocid l $ $ A UMBRELLA LIAB X OCCUR X WFR-XS-10000041-05 10/1/22 10/1/23 EACH OCCURRENCE S 4.000,000 X AGGREGATE S 8,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTIONS S 'WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE PER OTH- STATUTE ER E.L. EACH ACCIDENT S E.L DISEASE - EA EMPLOYEE S OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A` E L. DISEASE - POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is an Additional Insured when required by written contract, agreement, lease, or permit, as respects liability arising from the operations of the Named Insured. CERTIFICATE HOLDER CANCELLATION City of Federal Way SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Kevin Hutchinson ACCORDANCE WITH THE POLICY PROVISIONS. 876 S 33rd St. Federal Way, WA 98003 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103)