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AG 14-067RETURN TO: M 2� .--K EXT: L, --i G 1 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT/DIv: PRCS / V- Q) C, L- 2. ORIGINATING STAFF PERSON: Ki rh hlel bl' 1 EXT: 699 -� Z 3. DATE REQ. BY: ' 4 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 X OTHER N't 0 L 5. PROJECT NAME: ( e SS TW �" eS L J rS k ( c�i`j 6. NAME OF CONTRACTOR: t J 1 GYIA .3tC�tIVG r Pat+ ! jky-nu � ADDRESS: TELEPHONE: E -MAIL: FAX: SIGNATURE NAME: 'D 1 &o A- d� %% s� _ u y nta"\ TITLE: 0!2aAM.1 Z2.✓S 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 CFW LICENSE # BL- ,EXP. 12/31/_ UBI # EXP. S. TERM: COMMENCEMENT DATE: --7 I f � I I q COMPLETION DATE: -I I l I 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 I�&O IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED: ❑ YES I &O IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: IJ ! f - 10. DOCUMENT/ CONTRACT REVIEW PROJECT MANAGER • SUPERVISOR • DIRECTOR • RISK MANAGEMENT (IF APPLICABLE) • LAW DEPT INITIAL / DATE REVIEWED M 14 `! 1IL4 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ��• LAW DEPT SIGNATORY (MAYOR OR DIRECTOR) It CITY CLERK jL ASSIGNED AG # SIGNED COPY RETURNED ❑ RETURN ONE ORIGINAL COMMENTS: INITIAL/ DATE APPROVED COUNCIL APPROVAL DATE: DATE REC'D: 1/9 MEMORANDUM OF UNDERSTANDING BETWEEN DIANA STEWART & PAT DYHRMAN AND THE CITY OF FEDERAL WAY, WASHINGTON FOR MILES FOR MESO WA MEMORIAL 5K RUN/WALK THIS MEMORANDUM OF UNDERSTANDING ( "MOU") is made this 28th day of January 2014 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 5K Run/Walk ( "Event "). WHEREAS, the City has desired to host a 5K fun run event in conjunction with the Red White and Blues Festival held annually on the 4`h of July; and WHEREAS, the City was approached by the Organizers to operate a 5K fun 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 together 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, 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. Event Details. The Event will take place on Fri., July 4`h, 2014 at 9:00am. The Organizers will have access to the Community Wing of the Federal Way Community Center starting at 6:00am. Event registration will open at 7:00am and the entire event will be concluded by 12:00pm. 2. City's Responsibilities: a. The City of Federal Way will collect event registration fees at the Federal Way Community Center and via www.raceroster.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) staff person to manage volunteers at the event registration table. The City will be unable to provide a staff person to manage the pancake breakfast in 2014. C. Tables, chairs, garbage service, restrooms and stereo with microphone will be provided for the Event at no charge. 3. Organizers' Responsibilities: a. The Organizers shall provide course safety equipment to include: • Police presence on 1" Ave. S., • Barricades and cones on all intersections where runners may come in contact with moving vehicles. • On -call medical support available and alerted to the event in case of emergency. b. The Organizers shall provide marketing posters and flyers, event timing, volunteers, 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 all participants with courtesy and respect. d. The Organizers will ensure that all areas of the Community Center used for the Event are cleaned and returned 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 shall continue until the completion of all obligation under this MOU, but in any event, no later than July 31, 2014. ( "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 limitation, reasonable fees and expenses of attorneys, expert witnesses and consultants), which may be asserted by reason of any 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 expiration or termination of this MOU. 7. Insurance. The Organizers agree to carry as a minimum the following insurance in such forms and with such carriers who have a rating that is satisfactory to the City: a. Commercial general liability insurance with combined single limits of liability not less than $2,000,000 for bodily injury including 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 shall 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 shall be primary insurance as respect the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the Organizers' insurance and shall not contribute with it. The City shall be named as additional insured on all commercial general liability insurance policies. Concurrent with the execution of this Agreement, the Organizers shall provide certificates of insurance for all commercial general liability policies attached hereto as Exhibit "A" and incorporated by this reference. At City's request, the Organizers shall furnish the City with copies of all insurance policies and with evidence of payment of premiums or fees of such policies. If the Organizers' 2 insurance policies are "claims made," the Organizers shall be required to maintain tail coverage for a minimum period of three (3) years from the date this MOU is actually terminated. 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 day and year first written above by their duly authorized representatives. Cary Roe, Director of Parks, Public Works & Emergency Management CITY OF FEDERAL WAY By K4 r1 woe, Director of Parks, APP OVED AS TO FORM: City Atto , Patricia A Richardson ORGANIZERS Diana r _ STATE OF WASHINGTON ) � ) ss. COUNTY OF ) 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. GIVEN my hand and official seal this Z81' day of '�� , 2014. (6naL- T. lc:,�k, (typed/printed name of notary) Notary Public in and for the State of Washington My co NOWY PUIik 8" of WN1000 AftsWftV bon Oot to, got: ATTEST: a-A-0 ft)CC�, il ODIA City Clerk, Carol McNeill y, CMC STATE OF WASHINGTON ) 1, COUNTY OF Inc ) ss. ) On this day personally appeared before me, Pat Dyhram, 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. GIVEN my hand and official seal this 20- day of T-Q1*Aa 2014. (typed/printed name of notary) Notary Public in and for the State of Washington My commission expires: GT (y, 2d l 7 n NO" Pvbk MUN THANK KAM= 3 M►Mra 90M 08119.2917 DATE: 3/24/2014 CERTIFICATE OF INSURANCE CERTIFICATE NUMBER: 20140306236752 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 & Field, Inc. Miles for Meso/Washington Memorial INSURER A: Philadelphia Indemnity Ins. Co. 132 East Washinaton Street. Suite 800 Indianapolis IN 46204 EVENT INFORMATION: Washington Memorial Miles for Meso 5K RunAlValk (714f2014 - 7/5/2014) POLICY/COVERAGE INFORMATION: 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. - INS TYPE OF INSURANCE, POLICY NUMBER(S): j EFFECTIVE: j , EXPIRES: LIMITS: A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY PHPK1092686 11/1/2013 12:01 AM 11/11/2014 12:01 AM GENERAL AGGREGATE (Applies Per Event) $3,000,000 EACH OCCURRENCE $1,000,000 X Occurrence DAMAGE TO RENTED PREMISES (Each Occ.) $1,000,000 MEDICAL EXPENSE (Anyone person) — —EXCLUDED PERSONAL & ADV INJURY $1,000,000 PRODUCTS-COMP/OP AGG $3,000,000 PROVISIONS: DESCRIPTION OF OPERATIONS/ LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL Coverage applies to USA Track & Field sanctioned events and registered practices, including any directly related activities, such as event set-up and tear-down, participant 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- 333rd St Federal Way WA 98003 notice will be delivered in accordance with the policy provisions. 'AUTHORIZED REPRESENTATIVE: