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AG 11-159RETURN TO: EXT: 2"1 � CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM �--� .=,ti �. l. ORIGINATING DEPT./DIV: �' �. �. ? 2. ORIGINATING STAFF PERSON: j�� ��?c� � r�..p �1»u,': `".;^-�"�, EXT. �;�-� r;� - 3. DATE REQ. BY: ���� 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. sorrD �LaTED �ocu�NTS> ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL �T' OTHER �.�C�� i 5. PROJECTNAME: � ���'�"l `�'; -; �����1'i v { r C� �"�- 6. NAME OF CONTRACTOR -�- ,-+ ti'1� "; � 1 G� � t a i, { f- � Ci� c•. ( C;� ADDRESS: � .��,'� � �-j� =�, ` -• �. t ': ',��.1 Lt� �� �i �" ��-r ? TELEPHONE ;�tti, ��`74� J �t �i r E-MAIL: ,,, ��� �,�, � �: �p��. -�r�� -,�. FAX: SIGNATU NAME: t i�,�- r� t;�� i l:-�� �. s, _ 1� TITLE �' � � U ts=�- �'� ; 7. EXHIBITS AND ATTACHMENTS: � SCOpE WORK OR SERVICES ❑ COMPENSATION �INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: � �� z 9. TOTAL COMPENSATION $ :/` � (INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR C ARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑�s ❑ No IF YES, MAxtivt[1�v1 DoLL,�R.�tvtoUtvT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: � CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT/CONTRACT REVIEW )�� "p'-PROJECTMANAGER ~���.'? � DIRECTOR ❑ RISKMANAGEMENT (iFarPLtcABt,E) �I ` i�. LAW 11. COUNCIL APPROVAL (IF aPPLICaBLE) INITIAL / DATE REVIEWED INITIAL / DATE APPROVED r r.> '' ` �. � � � e .�/r.0 11 ��� --,-- �P 1-I -I I COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: ' 12. C TRACT SIGNATURE ROUTING /7 �.- I � I SENT TO VENDOR/CONTRACTOR DATE SENT: � DATE REC'D: �rS ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFI A, LICENSES, EXHIBITS � � LAW DEPARTMENT SIGNATORY (CM OR DIRECTOR� � CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED �-ll -lll�z_=-i�7 -- INITIAL / DATE SIGNED 1`� c' � r AG# �_ �� � L DATE SENT: `���� � � � li< MEMORANDUM OF UNDERSTANDING BETWEEN FITNESS FANS OF AMERICA AND THE CITY OF FEDERAL WAY, WASHINGTON THIS MEMORANDUM OF UNDERSTANDING ("MOU") is made this 13th day of June 2011 by and between the undersigned representatives of the City of Federal Way ("City"), a Washington Municipal Corporation, and Fitness Fans of America, LLC., a Washington Corporation. WHEREAS, the City will provide personal training services, memberships and space for youth enrolling in the Fitness Fans of America Summer Fitness Program. NOW, THEREFORE, in consideration of the mutual agreements and covenants contained herein and for other good and valuable consideration, the receipt and sufficiency of which hereby are acknowledged, it is mutually agreed and covenanted, by and between the parties to this Agreement, as follows: 1. Personal Training Services will be rendered on the indoor track starting July 6, 2011 and will run for 12-weeks until September 24, 2011. Training times will be held on Wednesday and Friday evenings from 5-6pm and every other Saturday from 3-4pm. It is the intention of both parties to continue Fitness Fans of America as an ongoing program with rolling enrollment at a minimum class size of 10 kids at any one time charged at the negotiated price. The FWCC can discontinue service at any point for any reason (unused training balances would be refunded to Fitness Fans of America if service is discontinued). 2. The City of Federal Way will collect $318.00 for youth enrolling in the Fitness Fans of America Summer Fitness Program for personal training services and an additional $82.00 per youth/teen enrolling in the summe�;,f tness program who are not members at the Federal Way Community Center. All payments will be rendered by in advance and in full for a minimum of 10 youth or teens. 3. The City of Federal Way will provide a meeting space for the children and parents enrolled in the Fitness Fans of America Summer Fitness Program on Wednesday evenings from 6-7pm for 12 weeks from July 6-Septeber 21 St . The same space is not guaranteed each week. This space will continue to be provided as it is available with an ongoing program. 4. Fitness Fans of America guarantees that at least 10 youth or teens will enroll in the Summer Fitness Program. Fitness Fans of America will pay $318.00 for any youth or teens they fall short of 10 in order to guarantee significant wages for the personal training staff. 5. It is the intention of both parties to do co-promotion of the program through available acquisition channels as agreed upon. Currently this includes advertisement in the quarterly catalog, links on the Federal Way Community Center website and flyers displayed at the community center. 6. Fitness Fans of America shall indemnify and hold harmless the City and its officers, boards, commissions, employees, agents, attorneys, and contractors from and against any and all liability, damages, and claims, (including, without limitation, reasonable fees and expenses of attorneys, expert witnesses and consultants), which may be asserted by reason of any act or omission of Fitness Fans of America its employees, agents, or contractors, which may arise out of this MOU. 7. This MOU contains all of the agreements of the City and Fitness Fans of America, Inc. with respect to any matter covered or mentioned in this MOU. IN WITNESS WHEREOF, the City and Fitness Fans of America, Inc. have executed this Memorandum of Understanding as of the day and year first written above by their duly autharized representatives. CITY OF FEDERAL WAY ,� �� y�� B � / `� Cary Roe, Pu c Works and Parks, Recreation and Cultural Services Director APPROVED AS TO FORM: ATTEST: � / ,� � ; fi� C p (� } � ,%,� , City At � ey, Patricia A Richardson City Clerk, Carol McNeill , CMC FITNESS H�NS OF B �v'( v / "c%`,/ � Peter 011 art, General Counsel STATE OF WASHINGTON ) � - , �l= ) ss. COUNTY OF�'���. ) On this day personally� appeared before me Peter 011odart to me known to be the General Counsel of the Fitness Fans of America that executed the foregoing instrument, and acknowledged the said instrument to be the free and voluntary act and deed of said company, for the uses and purposes therein mentioned. GIVEN my hand and official seal��t�is �` day of'�����.' ti,�a ,�. �`� �� , 2011. �' E ,� � �1itt�li �. y ��� � �� ✓ \` , �,- ( � / �� ' �,.�. `\\ t /' /�, f ,�� � '�.•' " `,,\ ! ��'.a �� ��<�. /� 4 N ��. ^ ✓ � �\ • % �i V 3 �� y} � �!'� � " �� � � � i A I �•' i l '�,� �� �+E �'� 6 1 � <. f 1 1 �c 7C- �., �1 �'S .�. 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Lwc r� z� �. sd tbc r�, �.t*�:�i;�r, c St� en�c {�>t�t � '� � � � � =t � � � � C�rf4� 1 rciccal tk,tk - Litxn��r.�:, �, t l�z F? =,1 �:'�a�'��: ^� r�itri�-�a^;£t.. � � � � a 4 ���u � �� ; ��_. � � � � 6 ���: �. ��� A , �� '�� ��s� �., � � ,� :� � r: ��,-�� � �'�. � � �� � � �''� ���£ i �l� ���� ��� � �; �� � � � n : . x r i . y �� y � 3 . _ y : ' x' :_ � ' . �. �� � �. 3 ' r . P ..Z k�+S�1tA VL��L�i`�IZ�{ � f ' ' ' � �t� r"� ��. 3 9 �'�'�� F'� z �; ; , � ��'`�`€"° ��`� ���:#�2 x � �. f� `F; `- R � �; �,. . . . ; '` 1 � -1` � � eY . . � �.. � kti�" ;�`s.., , . �� x �, . .. . ... �. �- "��'�' �'"p� '� �� .,..:� Client#: 67177 FITNFAN ACORD,� CERTIFICATE OF LIABILITY INSURANCE 6/03/2011�� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bell-Anderson Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 600 SW 39th Street, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Renton, WA 98057 425 291-5200 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: GP@dtAl11QPIC811IIlSUfBflC@COtllp811 Fintess Fans of America INSURER B: 79678 SE 310th Place INSURERC: Covington, WA 98042 INSURER D: � INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN R DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR DATE MM/DDIYYYY DATE MM/DD/YYYY A GENERAL LIABILITY GLP1438094 03/15/2011 03/15/2012 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $� OO OOO CLAIMS MADE � OCCUR MED EXP (Any one person) $rj QQQ PERSONAL & ADV INJURY $� OOO OOO GENERALAGGREGATE $2 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2 OOO OOO POLICY PR � LOC JECT AUTOMOBILE LIABILITY � COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITV AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR � CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE � E.L. EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The certificate holder is additional insured for general liability, but only if required by written contract or written agreement per the attached endorsement #CG8224 12/1 10 Davs for SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Federal Way Community Center DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _�_ DAYS WRITTEN 876 S 333rd St NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Federal Way, WA 98003 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE � ry � ACORD 25 (2009/01) 1 of 2 #S326686/M326685 O 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD K� IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) 2 of 2 #S326686/M326685