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AG 13-125�TUxlv To: r�„�� EXT: �--ll�� CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: J_ 2. ORIGINATING STAFF PERSON: ��� EXT: �Z 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.c. soxn �raTEn nocvMErrrs> ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL �OTHER i�lo c--1 5. PROJECT NAME: M,L �2J � �Z�3� ��L 6. NAME OF CONTRACTOR: � iQ.� �t�C.w W�}- +- ��,�- ��1�t,ct�� ADDRESS: ^ TELEPHONE E-MAIL: FAX: SIGNATURE NAME: TITLE 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION �URANCE REQUIItEMENTS/CERTIFICATE ❑ ALL OTf�R REFERENCED EXHIBTTS ❑ PROOF OF AUTHORTI'I' TO SIGN ❑ REQUIRED LICENSES ❑ PffiOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: ���� 1 3 COMPLETION DATE: �� I 3� i�✓ 9. TOTAL COMPENSATION $ D �INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TTTLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ rro IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY " ❑ PURCHASING: PLEASE CHARGE TO: 10. D�O�C �ENT/CONTRACT REVIEW �PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (u' �PL1C.�B�.E) �f LAW ��� 11. COLTNCILAPPROVAL (IF APPLICABLE) I1�TITIAL / DATE REVIEWED � n I1�TITIAL / DATE APPROVED �� 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 �,�LAW DEPARTMENT �6IGNATORY (cM oR D�c � CITY CLERK ❑ ASSIGNED AG# � SIGNED COPY RETURNED COMMENTS: � AG# l:'S�1 DATE SENT: 11/9 MEMORANDUM OF UNDERSTANDING BETWEEN DIANA STEWART & PAT DYHRMAN AND THE CITY OF FEDERAL WAY, WASHINGTON FOR NIILES FOR MESO WA MEMORIAL 5K RUN/WALK THIS MEMORANDIJM OF LTNDERSTANDING ("MOU") is made this 18th da.y of March 2013 by and between the undersigned representatives of the City of Federal Way ("City"), a Washington Municipal Corporation, and Diana Stewart & Pat Dyhrman; {"Organizers"), the individuals who will be organizing the Miles for Meso WA Memorial SK Run/Walk ("EvenY'). WHEREAS, ti�e City has desired to host a SK fun run event in conjunction with the Red White and Blues Festival held annually on the 4�' of July; and WHEREAS, the City was approached by the Organizers to operate a SK fiw run event that will be sponsored by Simmons Mesothelioma Foundation, a non-profit foundation dedicated to helping patients and families affected by mesothelioma and would benefit the Mesothelioma Applied Research Foundation located. in Puyallup, WA; and • WHEREAS, Federal Way residents have benefited from the work of the Simmons Mesothelioma Foundation; and WHEREAS, this event will build awareness through bringing the Federal Way community tagether to show support for patients and families dealing with mesothelioma; and WHEREAS, this event will promote fitness and generate good public relations for the Federal Way Community Center and its programs; NOW, THEREFORE, in consideration of the mutual agreements and covenants contained herein and for other good and valuable consideration, t�►e 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. Event Details. The Event will take place on Wed., July 4�`, 2013 at 9:OOam. The Organizers will have access to the Community Wing of the Federal Way Community Center starting at 6:OOam. Event registration will open at 7:OOam and the entire event will be concluded by 12:OOpm. 2. City's Responsibilities: a. The City of Federal Way will collect event registration fees at the Federal Way Community Center and via www.si� eup.com. Once all fees have been collected, a check will be written to the Mesothelioma Applied Research Foundation, 7606 84th Street East, Puyallup, Washington 98371 for the entire balance. b. The City of Federal Way will secure permits to hold the Event. They will also provide one (1) staff person for course set-up and to manage course volunteers, one (1) staii person to manage volunteers at the event registration table and one (1) person to manage volunteers for the pancake breakfast. c. Tables, chairs, garbage service, restrooms and stereo with microphone will be provided for the Event at no charge. ; 1 3. Organizers' Responsibilities: a. The Organizers sha11 provide course safety equipment to mclude: o Police presence on lst Ave. S., o Barricades and cones on a11 intersections where runners may come in contact with moving vehicles. o On-ca11 medical support available and alerted to the event in case of emergency. b. The Organizers sha11 provide marketing posters and flyers, event riming, volu.nteers, racing bibs, event t-shirts, vendors to provide give-aways for participants, and arrange for either medals or trophies for winners in overall and age categories. c. The Organizers shall ensure that it has appropriate staff and volunteers to provide the highest quality customer service and shall treat a11 participants with courtesy and respect. d. The Organizers will ensure that all areas of the Community Center used for the Event aze cleaned and retumed to their original condition by the end of the Event. 4. Shared Responsibilities. 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. 5. Term. The term of this MOU shall commence upon the effective date written above and sha11 continue until the completion of a11 obligation under this MOU, but in any event, no later than 3uly 31, 2013. ("Term") 6. Indemnification. The Organizers 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 lirnitation, reasonable fees and expenses of attomeys, expert witnesses and consultants}, which may be asserte�i by reason of auy act or omission of The Organizers its employees, agents, or contractors, which may arise out of this MOU. The provisions of this section shall survive the eacpiration or termination of this MOU. 7. Insurance. The Organizers agree to carry as a mi.ni.mum the following insurance in such forms and with such cazriers who have a rating that is satisfactary to the City: a Commercial general liability insur�ce with combined single limits of liability not less than $2,000,000 for bodily injury includi.ng personal injury or death products liability and property damage; and b. Automobile liability insurance coverage on all owned, non-owned, hired and leased vehicles with a minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily injury, including personal injury or death, and property damage. The Organizers' maintenance of insurance as required. by the MOU sha11 not be construed to limit the liability of the Organizers to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. The Organizers' insurance coverage sha11 be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the the Organizers' insurance and shall not contribute with it. The City shall be named as additional insured on a11 commercial general liability insurance policies. Concunent with the e�cecution of this Agreement, the Organizers shall provide certificates of insurance for all commercial general liability policies attached hereto as E�ibit "A" and incorporated by this reference. At City's request, the Organizers shall furnish the City with copies of a11 insurance � policies and with evidence of payment of premiums or fees of such policies. If the Organizers' insurance policies are "claims made," the Organizers sha11 be required to maintain tail coverage for a minimum period of three (3) years from the date this MOU is actually ternlinated. 8. This MOU contains all of the agreements of the City and the Organizers with respect to any matter covered or mentioned in this MOU. IN WITNESS WHEREOF, the City and the Organizers have executed this Memorandum of Understanding as of the da.y and year first written above by their duly authorized representatives. Cary Roe, Director of Parks, Public Works & Emergency Management CITY OF FED RAL WAY By Cary Roe, Director Parks, Public Works & Emergency Management APPROVED AS TO FORM: � City Atto , Patricia A Richar on ORGANIZERS � ._I" , ,..,, � , � � -� :� STATE OF WASHINGTON ) ) ss. COUNTY O _ QC E ) On this day personally appeared before me, Diana Stewart, to me known to be the individual described in and who executed the foregoing instrument, and on oath swore that she executed the foregoing instrument as her free and voluntary act and deed for the uses and purposes therein mentioned. and official seal this �ZJT� day , 2013. (typed/pri.nted name of notary) Notarv Public in and for the �te of Washin�ton Nahry► Pu� � of IIM�I�a► KMI MADORE My Ap'oialnNpt Exp� Dec 14. 2Q1 S �� � �j ATTEST: � ity Clerk, Cazol McNeilly MC ! / �� i / �/ i/ L�I�/!�i . � , � STATE OF WASHINGTON ) ) ss. COUNTY OF �t` ) On this day personally appeared before me, Pat Dyhrman, to me known to be the individual described in and who executed the foregoing instiument, and on oath swore that she executed the foregoing instrument as her free and voluntary act and de� for the uses and purposes therein mentioned. GIVE�N�Y hand and official seal this � day of l� ��i� , 2013. � (typed/printed name of notary) Notary Public in and for t�State of Wz n �y � 8t� ot WuNn�on KARI MADORE �f► �PO�dn�nt Expi►n O�c 14. 2p15 __ __._________ _.___..____. ____._.....___.____-------__ �_____ ! ' DATE: i 5/28/2013 � CERTIFICATE OF INSURANCE � � � CERTIFICATE NUMBER: � 20130423145250 � AGENCY: ESIX Entertainment & Sports Insurance eXperts THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 5660 New Northside Drive, Suite 640 CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES Atlanta, GA 30328 NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES Phone: (678) 324-3300 Fax: (678) 324-3303 BELOW. NAMED INSURED: INSURERS AFFORDING COVERAGE: USA Track 8� Field, Inc. Diana Stewart 8 Pat Dyhrman INSURER A: Philadelphia lndemnity Ins. Co. 132 East Washington Street, Suite 800 Indianapolis IN 46204 EVENT INFORMATION: Miles for Meso, WA Memorial 5K RuNWalk (7/4/2013 - 7/4/2013) POLiCY/COVERAGE INFORMATION: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING 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. INS TYPE OF INSURANCE: POLICY NUMBER(S): EFFECTIVE: EXPIRES: LIMITS: A GENERAL LIABILITY X COMMERCIAL GENERAL PHPK935580 11/1/2012 11/1/2013 GENERAL AGGREGATE (Applies Per Event) $3,000,000 LIABILITY 12:01 AM 12:01 AM — EACH OCCURRENCE $1,000,000 X Occurrence DAMAGE TO RENTED PREMISES (Each O�.) 51,000,000 MEDICAL EXPENSE (Any one perso�) EXCLUDED PERSONAL & ADV INJURY $1,000,000 PRODUCTS-COMP/OP AGG $3,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: Coverage applies to USA Track & Field sanctioned events and registered practices, including any directly related activities, such as event set-up and tear-down, partiapant check-in and award ceremonies. The certificate holder is additional insured but only for the liability arising out of the negligence of the named insured, per the following endorsement: Additional Insured - Certificate Holders (Form PI-AM-002). CERTIFICATE HOLDER: NOTICE OF CANCELLATION: City of Federal Way Should any of the above described policies be cancelled before the expiration date thereof, 876 333�d St notice will be delivered in accordance with the policy provisions. Federal Way WA 98003 AUTHORIZED REPRESENTATIVE: �