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RM-13 Rev. 3 Insurance, Bonding, Indemniciation Requirements for ContractsDEPARTMENT: SUBJECT: REVISION: APPROVED BY: PURPOSE CITY OF DELRAY BEACH ADMINISTRATIVE POLICIES AND PROCEDURES Risk Management POLICY NUMBER:RM-13 Insurance,Bonding &SUPERSEDES:RM-13,Rev.2 Indemnification uirements for Contracts FFECTIVE DATE: Terrence R.Moore,ICMA-CM,City Manager The City of Delray Beach in transacting its normal course of business activities must enter into contractual agreements with other entities (OE);otherwise known as contractors,vendors,and applicants.These agreements (P.O.'s,building maintenance or construction contracts,lease/rental agreements,special events contracts,management services contracts,etc.)create legal liabilities for both the City and the OE. This policy will define the City's requirements of the OE related to the insurance,bonding and indemnification provisions of the contract and the requirement to show evidence that they can pay insurance related claims which may result from work performed under City contract. Although other contract wording can be used City departments should adhere to the general intent of this policy.If not required by City ordinance or State statute,this policy is to be applied at the discretion of management in the best interest of the City and in accordance with other City policies and procedures. While this policy cannot address all transactions,it attempts to address and explain those most common to City operations and activities (Attachment I,Table of Contents). POLICY A.Responsibility of Departments Contracting with Other Entities (OE) 1.Any City department,or division which enters into a contractual agreement with an OE,should ensure that the intent of this policy is followed and maintained.Any questions,issues,or problems should be referred to Risk Management or the City Attorney. 2.The requirements of this policy are necessarily comprehensive in scope.The Risk Manager can be contacted to discuss the extent to which such requirements are justified by the actual risk of loss. 3.At the discretion of management,an exception to the requirements of this policy may be considered if: •The risk is not exceptional or severe (e.g.,no greater than if an employee could,and would do the task). •Other "insurance qualified"OEs are not reasonably available or are not being considered for other reasons. •The OE will be monitored by the City during the duration of the contract. •The duration of the contract is relatively short. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 2 of 43 B.Risk of Loss 1.The type(s)and limit(s)of insurance required under a specific contract will be determined by the "risk of loss"created by the contracted work.What can happen because of the OE's operation? For example,if the OE does not even come onto City property (simply sends a product);the risk of loss is minor.If the OE must deliver a product to the City,the risk is more significant (the OE will drive a vehicle on premises and move product into City buildings).The risk of loss also can be related to frequency of risk (one-time delivery v.Office Depot contract)and the product involved (paper product v.a new fax machine). 2.The location of contracted work also will determine risk.Painting a remotely located pump building does not create the risk that painting the City water tower does.The latter,for example,involves the risk of spraying employee vehicles parked in the lot. 3.Therefore,the risk involved with any contract must be determined before the type(s)and limit(s)of insurance required of an OE is decided. C.Insurance Limits 1.An OE contracting with the City must show evidence through a Certificate of Insurance (Attachment II)that they can provide insurance as required by the City in the contract. 2.Guidelines which relate various contract risks to insurance limits are shown in Attachments Ill (GL), IV (AL)and V (WC).The next higher insurance limit can be used if the involved OE is considered to create a risk greater than the "average".Contracts involving a high degree of risk (busing operations,major construction,underground work,etc.)will require specific review and evaluation by the contractingCity department. 3.The insurance limits shown in Attachment Ill -IV are minimums and are intended only as a guide. Please be advised that requiring one million dollars per occurrence limits for general liability insurance from most OE's is not unreasonable and is recommended.OE's unable to provide this level of insurance should be carefully evaluated.To allow for the contracting of lower risk,routine business activities,you will note that lesser limits have been authorized.In such instances,the department is expected to maintain a close monitor of the OE's conduct. 4.When contracting lower risk,routine business activities,you will note that lesser limits have been authorized.In such instances,the department is expected to closely monitor the OE's conduct. D.Purchase Orders 1.Attachment VI (2 pages)is a copy of the City's "Purchase Order (P.O.)"agreement.Except for certain types of transactions as identified in Administrative Policy BF-12,Check Requests,a P.O. is issued for all contracting done by the City.Generally,when services or products of significant value are to be purchased,the P.O.is used together with a formal contract.While the P.O.requires "liability insurance,including contractual liability coverage,with minimum limits of $300,000 combined singlelimits",the contract specifically related to the P.O.would dictate the required insurance coverage and limits as is directed by this policy. 2.Even without a specifically related formal contract,this policy directs that limits greater than the Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 3 of43 P.O.minimum can be required if considered necessary due to the risk involved. E.Insurance Coverage -General Liability 1.The Commercial (used to be called Comprehensive)General Liability Insurance Policy (CGL), which is typically that by which OEs are covered,can be assumed to include the following:premises and operations,contractual liability,independent contractors,products/completed operations,and personal injury (libel/slander).Therefore,although the certificate may simply indicate CGL coverage,these coverages are implied.However,other insurance coverages which are required by contract must be specifically shown on the certificate. 2.Additional Insured Endorsement:All contracts of the City must require that the City be named as an "additional insured"on the OE's general liability insurance policy.Although some OE's might hesitate to provide the same on their auto liability insurance policy,it should be required in the contract.In effect,this endorsement is intended to give the City insurance protection against negligent actions of OE for which the City is alleged also to be liable.Workers'compensation and professional liability insurance policies will not provide the additional insured endorsement. NOTE:Insurance Service Office (ISO)has numerous endorsement forms dependent on the type of insured. 3.The following is a brief description of the various coverages typically under general liability insurance: •Premises and Operations:This insurance essentially covers the OE's general business activities,including actions of employees,which may result in legal liabilities for bodily injury or property damage to a third party,whether occurring on the OE's premises or as a result of off- premises business activities. •Contractual Liability Insurance (Broad Form):This insurance is intended to pay for claims against the City resulting from negligent OE actions as is required by the indemnification agreement in the contract. •Independent Contractors Insurance:Also called "owners and contractors protective",this insurance protects a project owner (e.g.,City)or the general contractor against legal liabilities incurred because of subcontractor activities. •Products/Completed Operations Liability Insurance:After a contractor has completed the contracted project,completed operations liability insurance is intended to cover liabilities which subsequently are incurred as a result of the contractor's faulty workmanship or defective materials used.This insurance is typically included with general liability insurance,and the contract should require that such coverage be kept in force for at least one (1)year after completion of the project. •Personal Injury Insurance:This insurance is intended to protect the OE against a claim of libel or slander.This is not bodily injury insurance. •Liquor Liability Insurance:This insurance is required of an OE who will sell or will have sub- contractors sell liquor during an event. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 4 of 43 •"Host"Liquor Liability Insurance:This insurance is required when liquor is provided at no charge. •"XCU"Insurance:This insurance is required of an OE who enters into a contract which involves the risks of explosion ("X"),building collapse ("C")or anunderground hazard ("U"). •Standard Loss Payee Endorsement:This endorsement is used when a City building (i.e.,lease agreement)is to be insured under the OE's property damage insurance and effectively allows the City to collect directly from OE's insurer for insured property damages. •Broad Form Property Damage Insurance (typically not required):This insurance is required if the OE will be "working"on or around high values of existing City property,(e.g.,major renovation).General liability insurance does not cover City property which is in the contractor's "care,custody and control".Limits of atleast $50,000 are required to coverthe City's self-insured retention on property damage insurance. •Fire Legal Liability Insurance (typically not required):This insurance covers fire damage to City property caused by the negligence of a contractor while "occupying"a City facility (e.g.,food vendor at tennis complex,leased or rented City property),which is not typically covered under general liability insurance.Limits of at least $50,000 are required to cover at least the City's self- insured retention on property damage insurance. F.Insurance Coverage -Auto Liability 1.This insurance should include the following risks,as applicable: •Any vehicle •Owned vehicle (owned by OE) •Hired vehicles (leased or rented by OE) •Non-owned vehicles (OE employee or subcontractor-owned vehicles) NOTE:Construction vehicles/equipment liability could be insured under a general liability policy depending on if it is "off the road".If construction vehicles/equipment is involved,coverage should be addressed in the Certificate of Insurance. G.Insurance Coverage -Workers'Compensation 1.Worker's compensation law requires the employer provide statutory medical and wage loss benefits to an employee injured-on-the job regardless of any negligence(fault)of the employee.In return, the employee is prohibited from suing the employer based on negligence (fault). 2.Workers'compensation insurance provides for "statutory limits".In effect,such limits are unlimited in that the workers'compensation law and not the insurance policy define the benefits to be paid. 3.You will also note that sub-limits,employers'liability insurance,also are included under workers' compensation insurance.This insurance protects the employee against claims which are not covered by the workers'compensation statutes.For example,allegations that the employer negligently maintained equipment ("third party over actions");or the employee's family was also exposed,such as to workplace chemicals.Such claims occur infrequently. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 5 of43 4.In general,the workers'compensation law does not require employers with three (3)or fewer employees to purchase workers'compensation insurance.Construction employers,however,with even one (1)employee are required to purchase workers'compensation insurance. 5.A major concern is that an OE who does not provide workers'compensation insurance exposes the City to possible legal liability or even workers'compensation liability if the OE cannot provide workers'compensation benefits as required under the law.Another concern is that an OE without workers'compensation insurance has an inequitable bid advantage over an OE that incurs the premium expense of providing workers'compensation insurance.Therefore,the City should require workers'compensation insurance of all OE's. 6.The only exceptions would be an OE who provides a unique service/product and other insurance qualified OEs are not reasonably available;or an OE who is a "one person operation"(e.g.,trainer) and/or an independent contractor.In such instance,if we must contract with an OE who does not provide workers'compensation insurance,a fully executed "Indemnification Agreement due to Contractor's Election to be Exempt from State's Workers'Compensation Law"(Attachment VII) must be obtained from the OE. H.Insurance Coverage -Other 1.The only exceptions would be an OE who provides a unique service/product and other insurance qualified OEs are not reasonably available;or an OE who is a "one person operation"(e.g.,trainer) and/or an independent contractor.In such instance,if we must contract with an OE who does not provide workers'compensation insurance,a fully executed "Indemnification Agreement due to Contractor's Election to be Exempt from State's Workers'Compensation Law"(Attachment VII) must be obtained from the OE. 2.Builder's Risk Insurance:This insurance is required of an OE who is erecting a new building or an addition of significant value and provides property damage coverage while under construction but not as yet signed over to the City.Such insurance would allow re-construction of damaged property.The limit should be for the total value of the building or addition. 3.Inland Marine Insurance:This insurance is property damage insurance covering construction materials in transit and stored on the site,prior to being used and should also be required if this risk of loss is significant (coverage may be included within the builder's risk insurance). 4.Transit Insurance:This insurance provides coverage for damage to City property while being transported.City insurance only provides coverage if shipments are made on a City owned or leased vehicle.If by common carrier the terms of the shipping agreement would apply.The City does not ship often by common carrier and the values shipped are not high.The City would pay for a shipping loss only up to its deductible of $50,000 (the department would be charged a $500 deductible).The shipping department should therefore decide if the shipping agreement,proper packaging,and a reputable common carrier provides enough loss control or if transit insurance can be cost effectively purchased through the carrier. 5.Property Insurance:Although unlikely,this insurance is required of an OE who will assume the risk of loss for City property which is in their "care,custody and control".Most likely an OE does not have an "insurable interest"in City property.Typically,under a lease agreement,City property losses (e.g.,premiums)are included in the cost of the lease. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 6 of43 6.Professional Liability Insurance:This insurance is required of an OE who provides a specialized service requiring a professional degree or training (e.g.,environmental,engineering,accounting, architectural,etc.)and covers any legal liability resulting from an "error or omission"in providing that service.The limit should be one million dollars per occurrence,minimum.Note:This type of insurance does not allow the additional insured endorsement. 7.Crime Insurance (two-party)/Fidelity Bond (three-party):Whenever an OE's employees or agents will be handling City money (e.g.,tennis tournaments),the OE should provide evidence that insurance is provided to protect against theft and embezzlement of City money by its employees and agents.The limit should be at least the maximum amount of cash which might be exposed at any one time. 8.Bid,Performance and Payment Bonds:The bid bond guarantees that the OE who isbidding on a construction project will actually enter into a contract at the price quoted.F.S.337.17 requires such bonding,or other forms of bid guaranty,to a maximum of 10%of construction contracts which are greater than $150,000.The performance bond and payment bond are provided by the OE who is awarded the construction project. The performance bond guarantees that the OE will complete the project as per the contract;and the payment bond (sometimes called a "labor and materials"bond)guarantees that the OE will pay all accounts arising out of the contract.A maintenance pond,which may be included within the performance bond,guarantees against faulty workmanship,typically for one year.ES 255.02 requires such bonding for construction contracts or repair of public buildings greater than $200,000.If less and non-performance does not create significant hazards,bonding can be waived at the discretion of the City.All construction contracts over $200,000.00 will require such bonding.(NOTE:The primary service of the surety issuing the bond is to "pre-qualify" the OE and effectively "guarantee"that the OE will perform as required under the contract). 9.Pollution Liability:Whenever a contractor performs work which,directly or indirectly,creates a potential pollution risk (e.g.,fuel storage tanks,disposal of hazardous waste),pollution coverage is required at a limit of one million dollars per occurrence. 10.Garage Liability and Garage Keepers Insurance:An OE that parks vehicles have a unique terminology because of the unique exposure.Their commercial liability insurance is called "Garage Liability Insurance"(covers customers who trip in the parking lot,etc.).Damages to vehicles.in their care,custody,and control (not simply a "park your own car"public parking garage)are covered under "Garage Keepers Insurance";for example,minimum limits could be $50,000 per vehicle/$150,000 annual aggregate. I.Other Insurance Requirements and Considerations 1.Indemnification (Hold Harmless)Agreement:All contracts of the City will require theOE to defend the City and pay any damages if a legal liability is incurred by the City because of the actions of the OE related to the contract work.Attachment VIII (Sample Contract)has recommended wording for the indemnification agreement for both privately owned and government entities. 2.Notice of Cancellation:The Certificate must indicate that at least 30 days written notice will be provided to the City should any of the insurance coverages be materially changed or cancelled. The "Contractor"(not the "Insurer")should be required to notify the City. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 7 of43 3.Description of Operations:The Certificate must indicate (typically in the "Description of Operation"section)a reference to which the insurance applies (Contract number,event name and date(s),etc.). 4.Aggregate Limits:The insurer limits its maximum policy exposure through aggregate limits. While agreeing to pay a specific amount for any one occurrence (e.g.,one million dollars per policy year),the insurer will stipulate that ii will pay,no matter howmany occurrences,no more than a total,or aggregate amount (e.g.,two million dollars).High risk contracts require this aspect be given specific attention (see Attachment II). 5.Independent Contractors:To avoid any "gray areas"of liability to the City (Separation of lnsured/Severability of Interest)(e.g.,OE vehicle injures a City employee in the parking lot)at least General Auto Liability/Workers'Compensation insurance should be required of an IC, especially if they will visit the City premises.This effectively requires that OE insurer will not deny coverage to the City as an additional insured for liability alleged by another insured under the same liability or workers'compensation policy of insurance.For example,the OE would have to holdharmless the City (additional insured)if an OE employee (insured)brought tort action against the City.Most primary insurance policies contain this provision; endorsement",issuance under such wording may actually exclude intendedseparation of insured. 6.Waiver of Subrogation Endorsement:OE's insurer agrees that if they have to settle an OE claim for property damage,liability,or workers compensation,they will not attempt to obtain reimbursement from the City through subrogation (e.g.,insurer assumes this right of OE). 7.OE Cannot Provide Required Insurance Limits or Insurance Coverage:In the normalcourse of business,there will be situations in which an OE cannot provide the required limits of insurance or does not carry any insurance coverage.The simplest example would be a local volunteer group that wants to use a City facility for a meeting or small event,but they have no insurance coverage. A more complex example would be an OE that,for good business reasons,the City wants to hire but the OE cannot provide required insurance limits. In such situations,in general,an exception can be made based on the followingconsiderations: •The risk is not exceptional or severe (e.g.,greater than if an employee could,and would do the task). •Other "insurance qualified"OEs are not reasonably available or are not to beconsidered for other reasons. •The OE will be monitored by the City during the duration of the contract. •The duration of the contract is relatively short.Risk Management must beadvised of such exceptions which involve risks of a more significant nature. 8.Subcontractors:The OE will assure that all subcontracted will essentially require their subcontractors to adhere to the same insurance,safety,and indemnity provisions as in the City contract,or otherwise the contractor will assume the legal liabilities of such subcontractors. 9.Independent Contractors:To avoid any "gray areas"of liability to the City (e.g.,OE vehicle injures a City employee in the parking lot)at least general and auto liability,and workers'compensation Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 8 of 43 insurance should be required of an independent contractor,especially if they will visit City premises. 10.Occurrence v.Claims Made Insurance Coverage:Occurrence coverage requires only that the accident occur during the policy period,even if reported years later,andis the preferred coverage. Claims-made coverage requires that only claims reported during the policy period are covered, regardless of when they occurred.If any liability insurance is issued on a claims-made basis for higher risk contracts,the OE must agree to maintain uninterrupted coverage for a minimum of one (1)year following the completion and acceptance of the work,either through the purchase of an extended reporting provision,or through the purchase of successive policy renewals with a retroactive date not later than the beginning of the performance of work for the City. 11.Safety Practices/Hazardous Waste:Each contract will require that the OE assume legal responsibility for the safe work practices of their employees and agents,and forthe quality of services and/or products supplied. 12.Financial Stability of Insurers (including Sureties):Considering that the OE will rely on an insurance company to pay the insurance related claims,the City needs to be concerned with the ability of the insurance company to pay the claim(s)made by the OE. To this end,the City will rely on the AM.Best insurance rating system which rates insurance companies'financial strength (A++to B+being "secure"categories)and financial size (ranging from XV as the largest,and I as the smallest).The City should require,as a minimum, insurance companies with and A-NII Best rating,especially with major risk contracts,such as construction,or special events.A.M.Best ratings can be obtained at no cost at www.ambestcom. 13.SIR and Deductibles:An OE may elect to reduce premiums by assuming some of the initial costs through the use of a self-insured retention (SIR)or a deductible.Generally,with an SIR the insured settles any claim up the SIR limit.With a deductible,the insurer settles the claim, and the insured reimburses the deductible amount.The greater the financial capacity of an OE,the more acceptable a large SIR/deducible for insurance purposes.On high-risk work,the SIR/deductible shouldbe shown on the Certificate of Insurance. J.Special Events A special event is a non-routine happening or social activity bringing a large number of people together in a defined area on City facilities,right-of-way,or private property which requires City services.Special events include activities such as festivals,concerts,sporting events,parades, walks and runs,etc.This definition does not apply to events held at the Tennis Center,which require a separate contract.Special events require certain insurance as required in the "Policies and Procedures"and "Application"which can be obtained through the City's website,yyw mydelraybeach.com under "Department","Administrative Services"). K.Parks &Recreation Contracting Parks and Recreation has a significant number of various activities which involvecontracting unique to their operations and thereby creates an exposure for loss to the City:classes, instruction,tennis,swimming,rentals,public use,etc.While contracting with third party vendors is covered in this procedure,the P&R exposures are too numerous to address all within this section of Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 9 of 43 the procedure and therefore management discretion is required.This section will address the more significant P&R exposures,and will address forms/contracts typically used by P&R. 1.Waiver and Release of Liability (Attachment VIII):Participants in a City sponsored/supervised activity,whether a major beach event or an after-school affair can become injured,and the City could incur related legal liabilities.A Waiver signed by a legal participant or parent/guardian evidence that they are at least aware of the injury potential and intends not to bring related legal action against the City in return for the City's agreement to allow their participation. This Waiver is required for all City sponsored/supervised activities. 2.Accident (Medical Care)Insurance:The City provides accident (medical care)insurance for specific activities.This insurance either provides a limited excess medical coverage if medical insurance is available to the injured participant or will provide a primary medical coverage if the participant does not have medical insurance.In either case,the intent is to make sure the participant at least has some basic type of medical insurance and therefore is less likely to seek legal action against the City for injury related costs. 3.Liability Insurance:A policy of liability insurance,separate from that of the City,is purchased for the Delray Rocks Football and Cheerleaders Program to protect against the legal liabilities which could be incurred by the program (e.g.,actions of volunteers,coaches,etc.).This is not accident (medical) insurance.The administration and claims related to this policy are coordinated between the P&R and the Program. 4.Class Instructor Application and Agreement Form (Attachment IX,2 pages):Those instructors who charge for activities and are required to complete an Instructor Application also may be required by P&R to evidence $1 million per occurrence of liability insurance and name the City as an additional insured. 5.Independent Contractor Agreement (Attachment X,5 pages):Whenever P&R requires the specific services of an independent contractor (e.g.,referee,umpire,after schoolteacher,etc.),this Agreement is used.While no insurance is required,the independent contractor should be advised that they may incur a liability (e.g.,fight injury during a game,student injured while in class,etc.) and should take appropriate action such as purchasing liability insurance.Otherwise,the City may incur this liability and possibly without the protection of sovereign immunity. 6.Use of City Facilities:The following forms may be required by P&R when general public uses a specific City facility;Facility Rental Application (Attachment XI,4 pages);Pavilion Permit (Attachment XII);Field Permit (Attachment XIII);AquaticsDivision,Facility Use Application (Attachment XIV). L.Approvals 1.Approval of Contracts:The City Charter requires that all contracts/agreements issued by the City be reviewed and approved by the City Attorney (or Assistants)as to legal sufficiency and form. 2.Property Risk:Risk Management must be notified of the purchase,lease or rental of any property, or property for which the City has "care,custody and control";to make sure appropriate City property insurance is provided. 3.Sample Contract Wording:Attachment XV shows authorized insurance and contractual wording Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 10 of 43 discussed in this procedure for your reference and use.The contracting department must evaluate each contract and determine the extent to which such conditions apply to their specific project. 4.Approval of Certificates of Insurance:This procedure should allow a contracting department to request and evaluate the adequacy of the limits of insurance,and certificates of insurance required and received by the Department.Risk Management should be contacted if questions arise.As required in Attachment II and Ill,"High Risk"exposures must be specifically evaluated to determine if higher insurance limits are required. M.Certificates of Insurance Received by the City 1.Certificates received by a department which are related to a Contract can be sent to Risk Management to review and monitor. 2.The following should be included: •Copy of Certificate(s)of Insurance •Copy of contract.NOTE:Only a copy of the cover page (which shows the names of parties to contract,contract number,and contract date),insurance and hold harmless paragraphs,and any attachments/addendums which relate to the insurance requirements are necessary. 3.Risk Management would determine if additional information is required of department,or of OE. 4.Purchasing Division and the Department will monitor insurance coverage and contract dates to make sure insurance policies are effective as required by the contract. 5.Certificates(s)of Insurance received by a department which are related to ONLY a Purchase Order (e.g.,no other contract involved)need not be sent to Risk Management. 6.If the Department has any questions regarding the insurance and/or hold harmless requirements of a contract,or a purchase order,Risk Management should be contacted. N.Certificates of Insurance Issued by the City 1.The City may be required to evidence to an OE that it has certain insurance coverage.The City desires to issue Certificates of Insurance in a manner that does not waive its Sovereign Immunity or otherwise increase the limits of liability or indemnify or ensure another party for the other party's negligence or assume another party's negligence. 2.The City can name another governmental entity as an additional insured,but only to the extent allowed by F.S.768.28. 3.The City's current insurer,FMIT,will not issue to a non-governmental entity a Certificate of Insurance with additional insured wording/endorsement.If necessary,the purchase of a separate policy of liability insurance for the non-governmental entity to satisfy such a requirement would need to be considered. 4.If the City is required to name a governmental entity an additional insured,the following wording should be stated in the Contract,and if possible,on the Certificate of Insurance provided by the Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 11 of 43 City: "Not withstanding any laws to the contrary,the (entity name)is an additional insured but only to the extent of monetary limits as set forth by Florida Statute 768.28 and the Florida Constitution. Nothing contained herein shall be deemed a waiver of the City's Sovereign Immunity". 5.All Certificates of Insurance which are contractually required of the City will be issued through Risk Management. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 12 of 43 Attachment I TABLE OF CONTENTS INSURANCE BONDING AND INDEMNIFICATION REQUIREMENTS FOR CONTRACTS RM13.0 Purpose RM13.1 Policy A Responsibility of Departments Contracting with Other Entities B.Risk of Loss C Insurance Limits D.Purchase Orders E.Coverage -General Liability 1.Commercial General Liability (CGL) 2.Additional Insured Endorsement 3.Various Coverages: •Premise and Operations •Contractual Liability Insurance •Independent Contractors Insurance •Products/Completed Operations Liability Insurance •Personal Injury Insurance •Liquor Liability Insurance •"Host"Liquor Liability Insurance •"XCU"Insurance •Standard Loss Payee Endorsement Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 13 of43 •Broad Form Property Damage Insurance •Fire Legal Liability F.Insurance Coverage -Auto Liability G Insurance Coverage -Workers'Compensation H.Insurance Coverage -Other 1.Excess Liability Insurance 2.Builder's Risk Inland Marine Insurance 3.Inland Marine Insurance 4.Transit Insurance 5.Property Insurance 6.Professional Liability Insurance 7.Crime/Fidelity Bond 8.Bid,Performance and Payment Bonds 9.Pollution Liability Insurance 10.Garage Liability &Garage Keepers Legal Liability I.Other Insurance Requirements and Considerations: 1 Indemnifications (Hold Harmless)Agreement 2.Notice of Cancellation 3.Description of Operations 4.Aggregate Limits 5.Separation of Insureds (Severability of Interest) 6.Waiver of Subrogation 7.OE Cannot Provide Required Insurance/Coverage 8.Subcontractors 9.Independent Contractors 10.Occurrence v.Claims-Made Insurance Coverage 11.Safety Practices/Hazardous Waste 12.Financial Stability of Insurers 13.SIR and Deductibles Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 14 of43 J.Special Events K.Parks &Recreation Contracting 1.Waiver and Release of Liability 2.Accident (Medical Care)Insurance 3.Liability Insurance 4.Class Instructor Application and Agreement Form 5.Independent Contracting Agreement 6.Use of Facilities L.Approvals 1.Approval of Contracts 2.Property Risk 3.Sample Contract Wording 4.Approval of Certificates of Insurance M Certificates of Insurance Received by the City N.Certificates of Insurance Issued by the City Attachments Attachment I: Attachment II: Attachment Ill: Attachment IV: Attachment V: Attachment VI: Attachment VI I: Attachment VI 11: Attachment IX: Attachment X: Attachment XI: Attachment XII Attachment XIII: Attachment XIV: Attachment XV: Table of Contents Certificate of Insurance,Sample (3 pages) General Liability,Insurance Limit Guidelines Auto Liability,Insurance Limit Guidelines Workers'Compensation,Insurance Limit Guidelines Purchase Order (2 pages) Indemnification Agreement due to Contractor's Election to be Exempt from State Workers'Compensation Law Waiver and Release of Liability Class Instructor Application and Agreement Form (2 pages) Independent Contractor Agreement (5 pages) Parks &Recreation Facility Rental Application (4 pages) Parks &Recreation Pavilion Permit Parks &Recreation Field Permit Facility Use Application Sample Contract Wording (5 pages) Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 15 of 43 Attachment II,I of 3 (Front) r ACORD,CERTIFICATE OF LIABILITY INSURANCE I trurn Ft.a THIS CERTRCXTE IS ISSUED KS A MATTER CF WFORITIOONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHo2R.,Ts_cErFcAT_os A9r_eN,_pxtgyD oR ALTE R IE COVERAGE AFFO R DED BY THE POLICIES BELOW., INSURERS AFFORDINGCOVERAGE NAIC t weuwfo sLura,A 4gggf9 srRC; SURERLC: I MNanE:..- COVERAGES IPOLICIESTIWGURNWCLBSTEDO BEL.OWHAVEBEENISSUEDTOTEMSUEDMMDADOEFORIE POUCYPEFIOOIHCACATED,NOTWIHSTAMCGynT.,If,,S!@?mn geecomgr_o_om_xgcgr_r seer ro vu ns cntcAr_ur_ue_rssueooiirPnni,rir iuiu isoRi YHEPCsDESCRIBED HERER IS GU.±CTYOALLTHEIRAS,EXUSIONSNOCONJTIONS OF SAC+ OUCE3.AGGREGATELIMSTSS-ONLAYNFOFNREUGEDBYPJOCLAIM3. %z :z-.,,~.~·-PUEYHIER pey »#tr ,ptTAnl)uMTs [Gortumum t4cwourerwert OU,aMLGEN.Lu#TY GI:>"-I>--las»see [lo itPer urorad '..- !-]L y4puff I -/(gL AGO#EATE » re r LueAPs,Rt POAT +COM MG 1al±[1e LSorLat.uv OMODO€94GFwT 'NYAUTO (€a»x)..,___ -Mu,Qmors ~ Yl'Ul.ffl''6at±uLoroes pan)--woour0$to.tar 1-Oro un1as w alto? 'le II FOERTYDAME s °Peraridsut} aAG€LITT Sanrple -utcor.r·teA.AreNT $ls OT%MN AALIt ITOCh Ai0 s-rs""#er""..'EAOCURN"E 1 i [ocoo [aw«woe AMO3ATE '~R-IJ'lE 1 -#Enon 1,1 WOOICrENAT0)M.AMo 1%;5/I¥,I P4uoaruAnnuTYis5rPROPTQFAATNRVEME.UTT ,,Dt-fAurnr]s'trzrurunixoU?. IE£2g-.±:..-.tL.orsr.#curtier]r oat ..·..._ 'scar orNAIEETL.GAPOON'VEH.AA8+E348904»Apo t #boore-2NT+erectPNO933 0pt1on I:This certificate is issued as required by Contract .· 0pt1on 1I:This certificate 1s Issued for the (event name)..,including ,set up and tear don Certificate holder 1s named a8 an additional Insured.See attached endorsement. CERTIFICATE HOLD.CANCEL LATIO £O urtorTitAh OStat.DPOSSCA.ELKO OFORTTREMU-AA 4t TB£Of,IHt tunsutu wL.vtt4voa rsa.•04ts wars H9TM79TS STE4t#.DoMMtretrtr,rrt unrrobooLu et HO Q833A TON R LMuuunr c lr Ni u#tit asanur,a #tnr3 0# RCPRLLTAINE NUT}RE.O REPHEBrAInL t Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 16 of 43 Attachment II,2 of 3 IMPORTANT l the certfcata holtor ls a ADO[TONAL INSURED,tho piy(es)must be endorsed.A statement ono this coertifka@to doos notconfer rightsto the certificate holderin lieuofuh endorsement(s}, Il SUBROGATION IS WAVED,sub]ea to ho terms and conditions of tho polloy,certain pokches may require en endorsement A statement on his cerifegte does not confer fights to the certificate holderin ieuof such endoroorants] DISCLAIMER Tho Certificato a l Insurance an the reverseside o ths formd oos not constitute a con tract between tho lssulng insuror(as},authorized representetlve or producer,and the certificate holder,nor does a/ratvoly or negatively amend,extend or aster the covaroge efforded by the po#des lated ttaron. RD25{2001/06) Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 17 of43 POLICY NUMBER: Attachment II,3 of 3 COMMERCIAL GENERAL LIABILITY CG 20 2607 04 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insuranceprovided underthe flowing. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Mamo OfAdditional insured Parson(s)Or Organization(s) Information required to completethis Schedule,if notshown above,wll be showntntheDeclarations. Se c ti o n l l .Who ls An lnsured is amended to l- ctude as an addtonal hnsured the person(s)or organi- zalion(s)show in the Schedule,but only with respect to liability for "bodily Injury","property damage"or "personal and adverlslng injury"caused,in whole or in part,by your acts or omissions or tho acts or omle- slone of those acting on your behalf: A.In the performanceofyour ongoing operations,or B.In connection with your premlses owned by or rented to you. (Most preferred,but there are other IS0 endorsement forms that may be more appropriate) CG 20 26 07 04 ISO Properties,Inc.,2004 Pago tot1 DI Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 18 of 43 Attachment 111 GENERAL LIA61LITY INSURANCE LIMIT GUIDELINES Degree of Risk Low Moderate Example of Risk Clerical Minor use of City facilities (1) Minor repairs (e.g,painting office equipment,delivery) PeTrred T7inimum nuTE! $300,000 per occurrence, $600,000 aggregate, combined single limit minimum.· $500,000 perDcc, $1,000,000 aggregate, combined single limits, minimum. Acceptable Limits $300,000 bodily injury per pe(SOD, $50,000 property damage per occ NIA High (3)General contracting Major construction &repairs Fireworks display Major City events (e.g.Roots Cultural Festival,Hot AirBalloon Race,Delray Affair,etc.) Restaurants,sidewalk cafes,etc $1,000,000 per 0cc,$2,000,000 NIA annual aggregate, combined single limits,minimum (If "specific event'policy purchased by OE $1,000,000 annual aggregate acceptable) Notes. 1.Family use of park facilities,lecturers,small events which tend to benefit the employees and community may not require insurance or lesser limits Risk Management should be consulted. 2 "Combined single limits"cover both bodily injury and property damage. 3.AII high risks must be evaluated to determine if higher insurance limits are required Risk Management should be consulted. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 19 of 43 Attachment IV AUTO LIABILITY INSURANCE LIMIT GUIDELINES Degree of Risk Low (1) Moderate High (2) Notes: Examples of Risk Automobiles,smalltrucks/vans Generalcontracting Large trucks/vans and small contractortype equipment Major construction projects Transportation services for City,eg,busing,vans,etc. Preferred Minimum Limits $300,000 per occurrence combined single limits, minimum. $500,000 per occurrence combined single limits. minimum $1,000,000 peroccurrence combined single limits, minimum. (NOTE:TRANSPORTATION SERVICES MAY REQUIRE HIGHER LIMITS) Acceptable Limits $300,000 bodily injury per person/ per occurrence $100,000 property damage peroccurrence $500,000 bodily injury per person! per occurrence $100,000 property damage peroccurrence NIA 1.One-person "clerical"jobs (lecturers,etc.)are not required to show evidence of auto insurance.Personal insurance (copy of personalauto policy)acceptable for small,one-person contractors. 2 AII high risks must be evaluated to determine ithigher insurance limitsare required.Risk Management should be contacted. atac.el Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 20 of 43 WORKERS'COMPENSATION INSURANCE LIMIT GUIDELINES Certificates of Insurance -Workers'Compensation/Employer's Liability: Attachment V Degree of Risk Low Medium -High Notes: Examples ofRisk Minor repairs (e.g,office equipment,painting) General contracting. Any OE with employees visiting City facilities to do work. RequiredLimits(1) Statutory limits. Employer's Liability limits of $100,000 each accident. Occupational disease limits of $100.000 per employee/$500,000 aggregate,minimum Statutory limits. Employer's liability limits of $500,000 each accident Occupational disease limits of $500,000 per employee/$500,000 aggregate,minimum. No Insurance "One person operation", independent contractor,or uniquely qualified OE Fully executed Indemnification Agreement (Attachment V) required Not allowed,WC 1.Certificates not required for 1-3 person type clerical,lecturer etc.operations. cert Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 21 of43 Attachment VI PURCHASE ORDER DATE: BL.LTO. CIY OF DELRAY BEACH ACCOUNTSPALE too nw 1srAvrue DELRAYOEACM,FL3M44 FLO#IA STATE8ALESIX EXEMPTION CFHFICATEM0 0M-%01282196-4 EXPIRATIONDATE 0312012 City of Delray Beach PURCHASING AISIN 100 NWFIRSTAVENUE DELRAYBEACH,FLORIA33444 561243-711 SHIPTO: rram 6 NU£R uST PEAR O MALVOICE8,PM.CKJGUST,LA8,ELLSorLAGANOCONES+CMNC. APPROVED: AUTHOHIZFD SIGNATURE ORDERSUBJECT TO TERRSANDO CONDITIONSAS ON REVERSEORATTACHED. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 22 of43 CONDITIONS OF PURCHASE t. 8 3 1. ALC'FPIANCEt Mi ordr is frthpu«ch»weofpodsdvorervices Nereie rerred co a "te Aricks"dribedon the rot side beret).Thbuyer's fr to the Sallersd t$Seber'scknow»ledgers i de Iyerhall eentituleSeller'a wcepane±ofch ao#ere luding w/ofthe tam and ditionsherein wt out.iw the sleoe ofsueh inwked'gent.comecementaf'delivery ofthe Artiles ad'er services and arcoeptaoe of uh deliveriesbyBuyer shall astute nm coot o the tmmeaod coeditios hereof.This oder inmobjeet toe flowing terms tnd renditions ad no others unless there is a signed ageerentbeteenhe pear@espovithiogherwit WARRANTY-PRODUCT:Thu Seller expressly weranos hunt the Autlckes shall be merciaetee wide de neaig ofMt&els 2-21 {2)fhe hfores Cronereial Coda provide by FaridLaw md iefton tho dee efthis order.Lu addition toall warranties which maybe pescnbed by lwwthe uicls halt canone specifiafions,daring.inderiptie andhaltbe fee feet defeetitmkriwls arid wetmsship.eiinralso wamrwetslast the vteet the Articles irenot meof:4urd punnettodefleddesigu furnished byBuyer,hut dey wii be fee fodefeetahdeslga.Suh warranties,irehudiag war»ties presered byMw shall runo Beyer,ts s uccor .sign4,a ndc urers,and ionenafthe Areels f r o periodofone (1}yerer delivery unless otherwise «wed. INDEMNITY ANI INSURANCE:{}Setler shall d efend ,Lutemeify ad hold Dyer,Its eploys,is oertcnons zud wens ol tte purchased Mieles, hanssfran any propertytom@,peonal in]rim.or dh arising cul etRallr'{or liar«be@tractor's}work orperforonos brounderawlill pgee md maintainlobilly insure,irehdlng,cownual liabilitycoverge,wth minlimnLindtf$3C0,000eobieedekelimitstn beeffeetiweduring periodof weestywith eh hlgbes limits Buyes shall rcostly request otSeller,Seller «bull au er etoredelivery ofhe Arletes puntased heseunder,tumlh eo Byera Cefica le cfleturace nikring he foroping cerrawwd limits.(b)StMr halldefend,indemnity ad hold (uyerhmlss from the esemens byany third partyofmy liquid«dtestes t proven 4ctasl dnags rigout ofMe flwrefSeller+timely deliverhe riehpre#sod Mered te) %#er ball defend,irkallyad Mold hanlcs buyer,th off6eera.secs,a4gents ad ea»ployces tromn adagust y ud »ll danuga,chores,lo4es, {clodigthe eo ofuy Artieslost bylhel.cocoadenation,or rkunary real)ctiomes,dproceediraboghtbytheUnited 3tuesofAria,oar any State p e n t ar ay encyor ie trve na lity thereofagut Bay.itsoffices,dineons,amt,andr «ea9oynu o ipw on u h Arila by noon ofa ny ellmor findings yMud oldpubllewuthritythutay neeh MA+iefei sueaotau hereinusaoteed. TE.RAIATIO;{a)Buyer may terime his onhr,in wleori partwithotliability ta Hluyer,ifdellveris are t sde de beeadin de quantities peeidledor inta wet ofstreoilorDuneofmy ofhn othrrsor6conditions Merel.{b)nyernor rlino this enderin whomor inpor,atwuy time fr is woimor,bynoticingo Selleri whit.Oo reeat MySellerf uh tee,efer»bull,aud tothe etentpeeifiedtherel,p werkhereunderand pg he ptee elsoeeuaetons,terminate work swdersubcotcs outstanding humor.wad takes aey ecssuy aerloon to protect property in seller"s posseuia ii»which BuyerLas arayacquire»itenet.Anysinetis clainmnst be rubnitoedoboyer within sixty (60)dysfertheefictivedte ofdo nit tion.(c]Anyninefianby uyer,weer he defltetofteris,«hull be witheutpnegulleeoe Myci»lnu fer dmugser otherrights4fBryeri@hast Selle,(d}Dyer shall hve the right toadit all elemntsofay tenelo ellsadSeder hill mkesalable lo Byer on eqeestall books,cods,and popes elatlng hereto.' COM?LLANCE WITiI LAW8:Seller guraces »Buyerfiat th niela orly wiih alt fdeat,awe.nnd le»l ls,ruluirau.drelrotiuw, itetprettiott,ad ordersbusedhereunder. CONTROLL.ING LA;1iierad the permmunoo oftheparties kerewader«hultecontrolled ad goverd y the lw ofthe Ste ofPaid,md hes veuesell be inPhDachCy.Floris, GENERAL:Al wrietsh»ti beeons'reedasconditlensat well uswanwfies .No ow@wetofa brue ar aayprovisonoftsender hall ecueswalver oay hr brr«hor provisi,Me mdilie»ion wt«hwe in,or departure fem,er waives of he po«isof di ender ihllhe vlid rbinfeg wle# tppoed by Bryer In thg,Thiaorder shuli constirute the eet/re agreeriet between tapwrtles.The Geller expressly sgeetthuu iuy oemu ar cedit.bans cutoined en ay fonu oragreetuenrt oder thn thispet,eless specificallyaged io terwieMySeller wod Buyer,which e not in Mt acend with the above stdngruntandits terms,stallbe nullrd wit ALL0CATION OP RI8:Trit fut away deitgetoordenrsalonof e gods shall te bere bytheSetler l dmnes etu deliveryo theeontrelefthe Huyer,huhlat be le pointat ahichthe buyeractuallyrecoelwthegodsfrseadbasasoeped soch. COUSE O¢PROM,ANC;TMftdet »party may aoptor sqwiseei o sorofpfuse «nuke thisagreementduwtsfft theecaig of thisagreement«vu though he eeptlnpheqale.lg,pety lswasfthe matuneofe perforsoce a!has a epportaelry io oheet so it.(Withvesperus «hhcureofpetonaepyrolsio,ay bmea individualatepr is erfininunder thecoot ia a nwaverwhich ls uot l cantwitb the erms of the cooetact, the Citywurstpupttyobject to e numrofperforce.) Id PAST PRACTICES:Th priusso wdprtiesofbepar#ishereto viral/tot bedeemed#wivtrormodifeint oftherwhereof. l REPA[ls -NON ACCIFTANCE:itanyefhe good sre delved is adetecttweoraon-weking «tea,e/ors eftsAuyerio corer sochdefeet halt net constitute ao pouruwherocuwirlhy reaesoabbe inenet aodcost,so hatthe Buyer na y willjetthe goods where theateurpMoepairhas peoed neucoesful. 12.PACEOF DELIVERY:TMjotshelfe delivered iede Cly ofDelay Beak,Fridu,al addes u seated oo font. I3.INSPECTIONGOOS:Th Byerlull lase tle rigs to inspectall goos beforeaeptindellwwryormwklgpynut bore~re.Jre}ectot,thezoods wit be retunedat Sellersrisk,adal hndfingan8 tsporttion rpmws.bethways,will be borebyadruedby Seller.WW'henmatrial hasbca ejoed by byer and rtered for weplieem #i eetiul buss Setterreceive ew hippingionuetloos rem Buyerbefre nosking the replueneat.lippetio and aptqwi fercognonee tltbeade ythe appriuteuserdepartment.The espense ofispecen hall be boneby th Hye rexcept asto goodswhich ara popenly jettedan aon-coloring Inspectiom hd bemohowithin furn{/4)calendardwyofthedeliveryofgoods. A4.NOTICE OP DECT:l is sprawly nrelthatll elain»er Allegedhope 4rdefeetlvepoohs,tho»tops,or other «ateshall bmndwuhved nlea9 make iit writing ment byBuyerwllhintwenty(2)ealedswdays afterBuyer leansof thallrgeddefer,de»ge,storage,oroterensue yistgrise to the elia,uvlded,hoecver,htanytefcts icapable cf'disawaydiell not beloemet aired bythe provisosbereiu.d.prided fuuther,tat this provision di r befemcd as waiwrof aywatis et6obhereia erity modificatiro tothisagtam0et, LS.,#Ess Pof PART€Cut.AIPUP0f;buyermakes no wnrtis ox«pt Ms t Rrh brin.proibd,however,th soritlrtandig any ortwere pciio to Abe ani/wry Mervin.,Boyt myMarve @ugh theespritwf Seier ith esp=t o the fuea fr a pertiethsrpurpoe of thsabjetgodspdiu prhting.id god,a'y huwe nliedpo he representstieu ofSetlerr atexpert with repest s theuse ofchgoods.In thu event,Seller erey gees du say doiuieidestagarqwest by Buyer far poodu forapariulrpurpose,aeeaceby Bwyrervpwon harporigofSellerwihi respectto he eofho goods.or my oder similarsuch roqucot or neliswre all cos@ta a odifiration to tho terrs of thie agreunet whirl hull effect a wnrmny of[ivies for s perticsluryrpee. I6 CONSEQUENTIAL,DAMAGE:Selleracknowledges htPyerhes iufretMiu1tut thegods areiohe usedby Buyes sud tutallure ofSetler ottftt ie emus o f'hls ntrat y nault in c useqerial dugs to Buyr beaus of b e int udduso kobe makefthegooksl o thoDpen, 17.TAX EXEMPT'ION;Th City ofDlny Bech i»«pt 0r»Flew!EelTi«ea.Wheretsapplier inwlee mt«how pis,prds,moo4of#u,net pti«Fav«wptloncertifate wiltbesipaetupon request. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 23 of43 Attachment VII CITY CF DELRAY BEACH INDEMNIFCATION AGREEMENT DUE TO CONTRACTOR NOT PROVIDING WORKERS'COMPENSATION INSURANCE FOR ITS EMPLOYEES Contractoraffirms that In accordanceilh Chapter440 of the Florida Statutes ("Workers' Compensation Law"): f.Contraolor dooc not omploy more than throo (3)employ0so. 2.Contractor is not in the construction Industry. 3.Contractor doss not provide workers'compensatlon insurance for Its ermploye0s. 4.Contractor immediately will obtain worker's compensatlo Insurance if moo than three (3)employees are employed and will notity the Cly of Delray Beach,Risk Maragoment. 5.Contractor has advised al of Its employees that workers'compensation insurance ls not provided. Therefore,Contractor agrees to deferd,indemnify,save harmless,and exempt the City, its officers,agents,servants,and employees from and against any and all lawsuits, actions,legal proceedings,calms,demands,damages,costs,expenses,and attorney's fees resulting from injury to or death of persons or damage to property arising out of or resulting from failure to maintain workers'compensation insurance as required by Chapter 440 of tho Florida Statutes ("Workers'Compensation L.aw'). THE UNDERSIGNED HAS READ TH FOREGOING RELEASE AND FULLY UNDERSTANDS IT S igned ,selad and delivered thls d a y o f ,2 0 CAUTION:READ BEFORE SIGNING BELOW. J[fess.'_ ript barre. ,rraciof.'. Print Nare: STATE OF FLORIDA COJNTY gF The foregolng instrument was acknowledged before me tls_day of ,2)Dy({name of per8on acknowledging),who is personally known to me or who has produced (type of Identification)asidentification. Signature of Notary Public Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 24 of43 Attachment VII CITY OF DELRAY BEACH,FLORIDA WAIVER AND RELEASE OF LIABILITY I,the undersigned,intending to be legally bound,do hereby for mys~f,my dependents, heirs,and executors,waive and release any and all rights and claims for damages which I may have against the Clty,their employees,representatives and agents for any injuries which I may suffer in connection with my participa tion in~·~-o(dale).- Do you have dependents who will be participating in the event? if yes,list their names and birthdales below: t. Yes No ~------~-------------------- 2 3 -------------------------- Do you or any dependents have any disabillly,handicap or other condition,temporary or permanent,or take any medication,which could prohibit participatlon in the event7 Yos No lfyes,please dotall any spacial assistance necassary. Sign Name Date watwsreleaadpc Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 25 of43 Attachment IX (front)~t#At Ac Parks &G Recratrln ~-7•-' City of Delray Beach Parks and Recreation Department SSTeet Cterinr ContainityenterStrongPukCentre NameofRooms)Requested: Pompey Pr eras Park eE1333%225£.9%9%,/42F5%4595%-595%%%86£1£r6224»/865€E30%-988%-95283372.E8.537E2838%28%3%9% instructor Nine: City,Se,Zip (other)(cell)Pho:(Mone) Email Address: pg±sgeass.mg%gg«.gs@Gaa5#4.aGA733#cg2GE#ii#ii@i6iE5g3.g224,GEgJ7E.9Egg2,5.37%3pg,959293ggE3EE38d.32±EI'et+252¥95,1%42347210I/OM93382515-35!S5G383899351.3 Class Te: Class Description: --------------- ClassDay(s):cheek alt that apply Mody Taresday Wedsiuy $cs6a iyica oe Annool (oagoing) Class 'Time: Querterly(3 months persession) Fran,- WI you need set np or lean up tHue?Yes 1,Eplin: kqulpment needed: Roon Set up (plaseexplain nnd attch digram}: Marimnm Number Participants: Br when'?.htil when? No Feiiss Pr sessionweek:s_) Supply Costs:$Tl ResidentCosts:$ Supply Costs Tal Non-ResidentCosts $ Minimum nmber pnrtieipants: e of prtklants; Programs Costs:Cheek one Resident Pee:S Non-Reside Fe;$ Doyou require pre-registration?Yes Doyou acceptlateregistration""Yes _"° Tentative start date (give at least 3 wee)s from date of'this application)} Page 1 6f2 9/2n2009 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 26 of 43 2 3 4 5 6 1 8 -a tooItemehe&t If attached Camile@ wFa --- Copy of valid Florida driver's license Resume lot -------------Letters ofrecommendetio CAss outline +samples oiany cless material ' References (3) .--a o- Roomset up chart Dackgounud chick form &copy of socialseclty cud (if wonklg withliitdren)-----,_ iiG'i4,3.3,z42334gs2@±.4Gk3 <±7gyp3g;3gg gag;2gzg;a4Ng4'JS4-8£9P9lYPW4PHOHO99?NW-W?18.\59994411M409RF5-901J'414779Y5l "»Polley •lnltbls I AI ciss participants will register with the City.Instructors should tot under any circunstnes betaking payments for classes. 2 instructors will be paid by The CiyofDtay Bach session is complete check st theend ofcuch session(approximately 2 weeks after 3 Instructos willbe paid 75 ofregistration fees collected by residentparticipants ad 6$%of registration feescollected by nonresident participants. I nst ructory can.'bepa id ia comp'std and wlid w9 f o r is on 5 le w it h the CitygfD-}Rh:'I In4tntorcannot waive feesfor their class.Allfeewaivers must xe approvcdby theDirectorofParkst Recreation. Participarts mst be pid endcompletea reg±stria fora for yourcass each session. 7 supervisor's fe of $23.00 pr hour (pcr supervisor required)will be charged for classes hld after hoursadwill be deducted om the arout id to theInstructor.. 8 Pense folbownil ruis and r 9 10 i,iho uairs&net tend toe belly ound,de bercbyfr nyelf,ity,euni@die,#iiR iii and sdminisators,waive snd rleasc any and al nightsandclairs for damages,which I/we my have against the City of DelrayBeach,their representatives,successors and employees for any jukes whichl/we mnaysuffer in conn»tio with my/our uso cf this facility.At various times theCityof Delray Beach videotapes nd phot«graphs events to besubmitted to the local redi.By using this fcility,/we herely athrietheCityofDelray Beach reproduce,copy,ehibit, publish,brodcast,or distribute myand ail such tapes orphotographs .{have red the bored understand the rues and __b_th-at i.~"'°boeonmad.eamflnbtc.~me. I have rend theloveand a&era ke riles and rgulstinssfthe{·lay Beathcility rental Appleton tha: have beemde available to me., 4 5 6 Applicant Siture @ IStrts%6rks a OFFICE USEONLY:pprovedRejected.reason)..-- Authorized My+Re.Super#tDtt:Re Superintendentate:P&Rrear Dste: Martin For W3Fort.Ha:krone ±eek:akgroundele#red dte: 9/2/2009 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 27 of 43 Attachment X Reviewed by )g[.,- INDEPENDENT CONTRACTOR AGREEMENT THIS AGREEMENT made and entered into this day of 2008,by and between the CITY OF DELRAY BEACH,a Florida municipal corporation, hereinafter referred lo ag "City",and-,an Independent Contractor,hereinafter roferred to as "Contractor". WHEREAS,the pates desire to enter into an ayeoment to provide certain classes tot the City of Delray Beach Parks and Recreation Department's programs;and, WHEREAS,the City and Contractor desire to clarify and define their responsibilities with regard to providing said classes. NOW,THEREFORE,for and in consideration ofthe mutual covenants and promises set forth herein,the parties lo this Agreement do hereby aarea as follows: 1,The City hereby retains the services of Contractor for the purposeof --ad--_ -,San independent ,on{2CRf, al Contractor is neither an officer,nor an employee ofthe City.Contractor must provide a Federal Tax I.DO.number if appllcab,otherwise,Contractor mus!provide social security number.Contractor must submit a completed W-9 form at the time of tho submission of tho first invoice. 2.Torm:The class or activity will begin on--.209 and will meet thereafter on aftemoon(s)each week between the hours of p .m and pm al This schedule may be changed by the mutual consent ot the parles.tho term ot thus Agreement shall commence on thedate written above until Septembg 39,2010.However,the Agreement Page I CDo wnets end Serive3esL.ocal Settings\Tempo»wryLane Fik3OLK 1INDEPENDENT CONTRACT AGREEMENT-AFTERSCHO.10-7-2009 fm.do 10'7/20094:52PM Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 28 of43 may be terminated by either party without cause by giving five {5)days written notice to the other,If the Agreement is terminated by the City,the City snail only be responsible to compensate Contractor for fees billed up to the date of terminaion. 3.The Contractor's fee shall be the sum of $20.Q per hour actually conducted by Contractor.The Contractor shall submit an invoice to the City for servics rendered by Contractor every two weeks,for classes tauht in the previous two week period.The City shall issue a check within five ()business days after receipt of invoice in the Finance Department.Tho City shall reimburse Contractor In the amount of $0,00 per cdass for supplies.,The unreimbursed amounts for supplies are solely the responsibility of the Contractor. 4.This Agreement does not create an employer/emphyee relationstip between t h e parties.C o n t r a c t o r is n o t nttled t o a n y ben e fi t s paid l o C i ty emp l o yee s l t is tho intent of the parties that under this Agreement,an Independant Contractor is not an employee ofthe City for all purposes,including but not limited to,the application of the Fal Labor Standards Act minimum wage and overtime payments,Federal Insurance Contribution Act,the Social Security Act,the Federal Unemployment Tax Act,the provisions of the Internal Revenue Coda,the State Worker's Compensation Act,and the State Unemployment Insurance Law 5.Contractor shall be responsible tor all taxes of any kind.An IRS W-2 form will not be provided,The City will provide an IRS For 1099 required by law.Contractor recognizes that no Federal Income Tax or Social Security will be withheld.However,if Contractor requests in writing that Federal Income lax be withheld,the City will deduct the Federal Income taxwithhold and remit to the IRS. -Page 2 CD«messnn4 Setinysts'4el Savio'TempowyJnteset Files4kIA'INDEPENDENTCY)NTACTAGREEMENT- AFTFRSHAOL 16-3.-24009 fm.due 7013008 4:2 H Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 29 of 43 8.That Contractor shall indemnity,save and hold harmlass the City,its agents and omployoos from any claim,domand,suit,losa,cost of,oxponso or damage which may be asserted,claimed o recovered against or fron City or City's agents or employees,by reason of any damage to property or person,including death sustained by any person whomsoever,which damage is incidental to,occurs as a result of,ot arises out af the negligent or wrongful act(s)of Contractor. 7.That City shall not be responsible for any property damage or personal injury sustained by Contractor from any cause whatever,prior,dung,or subsequent to the period of time during which thls Agreement ls in effect.The Contractor hereby waives, discharges,and releases the City,its agents and employees fron liability fort the negligent acts cf City or its employees and agents. 8.The Contractor shall have sole control of the work and the ranter In which it is performed.Contractor shall furnish all necessary supplies ad teaching tools, 9,This Agroomenf is a personal service contract and an assignment of this Agreement by Contractor without the written consent of the City is void. 10.Contractor shall be free to contract for similar services to be performed for other entities or persons while under contract with the City.The provision of services provided for herein is non-excluslvo.The City may retain additional entities or persons to perform the same or similar wotk,if tn lts sole disrelin the City desires to do S0. 11.Contractor shall not discriminate on the basis of age,religion,race,sex, marital status or hardicap or concu{any class which is inappropriate for hillron in performanceof this Agreement. 12.AI notices shall be effective when maled to the following addresses: Pye 1 C:Duets nd Seriugsrlo!Sett:Terpwry JtentPe@OLK IA!NP}NDEMI CTRACT AGREEMENT. AFTERS'HOOL 10.7-2/9 rd&:177009 4-3'1 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 30 of 43 Contractor address: City address: Linda Karch,Director of Parks and Rocreation 50 N.W.fist Avenue Delray Boach,FL 33444 13.This Agreement represents the entlre understanding of the parties and Supersedes all other written or oral agreements,Modifications o thls Agreement rust be made in writing and mutually agreed to by the parties. 14.Notwithstanding Paragraph 2,Contractor understands that Contractor must comply with ail applicable laws,rules and regulations,and maintain all required qualifications to provide the services providod for under this Agreement.Thal this greenent shall be immediately deemed null and void and nofca of termination,as set forth i Section ?is not required,if,at any time during the term of this Agreement, Contractor does not abide by all applicable laws,rules or reguations,or does not meet +RS guidelines or fails to retain qualifications necessary to safety and effectively teach the class covered by this Agreement, Page 4 C:Dcsereand Stings'r\Loa!$ert0gs'1anpury lemtFies'O.}IA'INDEPENDENT COT'TACTAGREEMENT. AFTERS'POL.I6-3-200 im.4 1n9/200 4.$1 1 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 31 of43 IN WITNESS WHEREOF,the parties hereto have caused this Agreement to be executed on the day and yeat first above written. ATTEST: City Cerk Approved as to Form; City Attorney WITNESSES: Print Name. Print [arr},» CITY OF DELRAY BEACH,FLORIDA 8t _ avid T.Harden,City Manager CONTRACTOR: b, pr[- Social Security No.. O Federal Tax .No. STATE OF COUNTY of The foregoing instrument was acknowledged before me this _day of 200,by (name of person acknowl edging)who is personally known to me or who has produced (type of identification)as identification. Sgrature ot Notary Public -State of Florida Luk»yndt.fr Re.m2201 Page 5tuuncnsan!Sag+9L.el5ewags'Fuptytenet PHE'IL}4/NF.PENDENT{CONTRACTGREEM4ET. AFTERSHXL I+-7-2009im ±e 107009:1 HM Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 32 of 43 ...1..."«ta. "@ Attachment XL City of Delry Beach Prls and Recreation Department Facility RentalApplication Alapplications are subjectto approval ggazg:,,7@:4;pz.gr=9 £-ujihiif±iruiboi±,cg.a32ga,eg ±egg,%r:2/:±St;ii ±-4%%Js.r@cu,n[on 't £;}..T;3=5;±3%'.± FacilityRequested:check oe 0'. Commet Centrr Dhysrtmlu $0 Te gmarr vetrm Pr Nameof Room Requested: {5Eq4gs4gee,Sp,,3982323 ,233,£3331333327333ze;33ypp3g ;35535y5€Z55.24g5Ge,EE239413332+;F,93g33;g¢fSks%?Git#%Sf??SaleidrIif@rii@'ioiG?2sf#%%2%s%#?Sit EventDate(s): TLene:(include set up ad clean up)From Cota:t Person: Phoue:(home) I.mail Address: Will yu be nttending' Name Yes (ccll) No CM,Ste,Tip (other) If no,who will be in charge? Phoa: Type o Event:Please checkwhica best describes hcpurpose ofyour cvcent Church5err« B'sfimnted attendance 'YouthGo.o 0her- lea expial Adults •I Chwprroe2I years ofageor olr)requirei per I0 youth.Plese prov@GiuG@Garone names and mwambers. is your organization non-projt?Yes Mo Ifyes,please attach coy ofIRS taxcxcmpt certificate WEl!you ced thekitchen for prcp end/or warig?Yes No No cooking is permitted inthekitchens WIN adssion be charged for yourevent?Yes No lfyes,attachcopyof request letter.Must iwve prior approv!from Director Will yorevent have decorations?'Yes Mo lfyes,please describe: other no#es QuantityQuutty Room Set Up:Pease anch drawing on formsprovided.Indicate belowthe quantity of tables and chins. Long 'Tables:_Chis:Round Tables:POMPEYPARK ONLY) ... Additional Items:Available upon request (a«ditioal $100 &po±it applies).Notalltarsarcavailbketll fciliis Mi eroplore Co ffee Pot TVVCR Ga r es Poo l T able Podium-Screen Other Page 1of4 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 33 of43 City of Delray Beach Pa'ks and Recreation laeility Rental Application Pres radeachpolicy.telow aidinitialexttoitindicairigyou avei&id'indoder@kifititijs, -'oicy -nitils1Allrerafeesmubepidatapplicationtinetosecureyourdate,A security deposit is also required at time of resevation.Pease submit rental applicaton and payment 4 weeks ior to our event 2 Cancellation ofa rentsl or changing aconfirmed dntewith less than 4&hours notice will result in loss of deposit.All cancellations and requests for refund mst be inii.--lI 3 Decorations require priorapproval by Facility Supervisor.Nosigns or decorations willbe nailed o pcnnancntty aftxd toany Cttyof Delray each tcittty watts,ccthngs,windows ordrapes/bttrds.No glitter,rice,birdseed,confetti or other similar items will be allewed to be thrown in,around or used is dccorations st thefcili+,The ositwill aot be refunded ifdecorations are used without ar roval 4 pplist is responsible far damage toCity facility,equipmentar!property.Th deposit will nct be refunded if!here arcdmanes to the fcilit wicnt or ro 5 Animal and alcoholic beverages (beer,win,champagne,and liquor)are prohibited at all City parks and recreational fcilities 'ind09$ouUoas}--'lI 6 No smake or bubble mchinesare allowed.Ko open flame candiesare lowed inside the facilities. Smokingis also prohibited in all City facilities andparks.If snokc alarms arc activated due to the Uc of such itens,which result in the cail out ofthe CityofDelray Bech Fire Department,applicant will be rest ibie for all charges incurred y the Fire Dey mcnt and theCity of Delray Beach. 7 DPs or bands are permitted at the event;however no vulgar language ispermitted in sny of thelyrics.Music must be kept at an appropriatelevel.All music must conclude at least thirty (30)minutes prior to the end of the c v en.Rad i os n d amplified music rustbe approved prio r oan e venta t the pool by poo l supervisor at time ofny lication. 8 TheCity of Delray Beach is not responsible for articles,equipmnt,food or materials left at the conclusion of the eventTheitemswtbedisposed of at the discretion oftbeCSX:l 9 City policy prohibits nny Gty employee from acceptinggifs,gratuities,ard othercomplimentary items from ouy ar individuals usi the facili'+. 10 City staffwill not sign for any items that have been rented.Allentd items (dance floors,lights,linens,etc) will nct tobe delivered dring the renal time and pieked up during the clenn up time ofthe rental.IfItems are deiivred befbre or picked up after the renal times the appliant will be chargcd the regularhourly rat. Same ics to any other vendors or caterers used [orr@th--l] I1 'The rental ending time mema the fseility muet be empty ofall gct.Th rental eding time rearsl! decorations,food,etc mustbc removedand the facility clcaned.The clan up timmust start ro later than thirty(30)minutesprior to !he rental ending time,Trash must be putinthe proper receptaclesand the room must be cured to an "as fund"condition.The facility,perking lot,grounds andequipment shall be left in the same coditlgns$they erepH9w- 12 The City ofDelray Beach may,at itsoption,cancel the use requested byapplicant.Such notice of ancollton,wbetler written or oral,ehll bes given to the oontrt person named atove no laterthan 4£ hours prior to the scheduledevent.There maybe unforeseen circumstances that cancel the event laterthan 48hours,but will notifycontact person about the situation end co9ionsavailable inthecvent the City cancelAevent,the applicant_is ettked_to the_return of any moaey_yeid for_the "1to beiny.can:yelled I3 A certificate of insurancc end/or addition}securitymay be requied for some events or activities. 14 Ifyou arca tux cxemptorganization,you mnustshow proofof exapt statustimne »f application in order to no4 pay tuxes on the rental f.A Copy ofyoul ornizatiurstaxid number Is vcquicd.AIt payments by check or creditcard must hvc or mnizaticns name on it in order toreceive thetx cxcmr lion. 1s lfyou arechargingn entrace fee,registration,orcollectingadonation,or sellinganythingonCity property (in or outside the facility)ycu must have prior writen approval from the Director ofParks and Recreation bcfare event wit)bo aproved at the facility._-- 16 FOR POOS:Grills and glass containers areprohibited on thepol deek. 17 FOR POLS:G uests are toa b i d e by all s PoolRules and Regiae.ionswhen s w immin g a t either ool._j --I 18 In order to receive a full depsit bk,applicant is responsible forcleaning up after theirevent and ensuring they alongwitb theirguestsfollow all policies listed ns well as no misrepresenting or failingto disclose information o rental documents.Failureto adhere to policies my result in a groupbeing asked toleave tbe fcilit +,forfeitureofsecuritydeposit and rental fcrs as well as os;offuturerental privileges.lJ Page 2 of4 Upteted9209 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 34 of 43 lecrcation Center Rom _Rentals Refudable Deposit trerine roomsonly) 3-way roomor Teen Center 2wayroomor Veterans Park Singe room Kitchen ({prep&warironly) Additional Hours (mtinz,rooms only) $100 $90 ((rt 3hours) $60 (nr3 Nos $30 (tr3 Mcas} $30 (st3 Moos) $20 (pr hon) $ S $ $ s $20 x tours S GymmsiumSknateParkRentals Refundable Deposit (y@ lateark only)$200 Oymrasium or Skate Park (o dlsi}$100 (fast 3 hows) Gymnasium or Skate P?ark (lsst)$250 hr 5us0 vat mks Additional Hours (gy»t ska pkonly)$40 (prhour) $ $ PoolRentals Refundable Deposit (od only) Pol (ides2Lifeguards up o .S0 guess) $100 $100 (3bus) $ s "Additional Pool Hours $35qcr tour) Additional Lifeguard(trautuni 2s mens)$25(er hou)$25_hours $ li feguards AI!Rentnls Afcr Hours/Weckcnd Fee"$25 erhour)$25 x -hurr $ After Hours/'Wcckend St Up Fee"$60 (oee tie±fat fee)$ I Security Call Police Departmentfor rate $ Sales Tax"6.5%$ r0r1.[s AI rentalsare x 3 hourminimum charge.Additiaat Nourrwit be chirped cording to de Murty rne@,,, 4 feilitySupervisor will determine ifmere than oe suprritor is nectary Kitehems atefor prep nd waring only.Mo cookingshould bedone la any of our fellttls. Submit altet up drawingsat tieof application, Operntin plansfan wvent ad the eventitral rhalt not lntrfare withthe normal oprations fthe felllty. Page 3 of4 Ude#d 9%2409 Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 35 of 43 City ofDelray Beach PArkvs and Recreation Facility Rent!Application 33%%.±5SE2:,3±A.2:"Releasemote;3;$",5 '4%'33%5%5%%3 L,the undersigned,intending to be legally bound,do bre b y for myself,famil y ,g u a r d i a s, charge/charges,heirs,executors and administrators,waive nnd release any and all right;and claims for damages,wbiche may have against the City of Delray Beach,their representatives, successors and employes for any injutics wbich L/we may suffer in connection with my/our use of this facility.At various times the City ofDelay Beach videotapes and photographs events to be submitted to the local media.By using this facility,I/we hereby authorize the City of Delray Beach to reproduce,copy,exhibit,publish,broadcast,or distrute any and all such tapes orphotographs.I h a ve r cad th e above and u nderstand the rules and regul at i o ns ftbc C i ty o f Delray B e ach that have been made available tome. r;«e,gg5{eEgp3,5pg.E gg23&73p{3%$j{pi3jj@3g5egg3g7geog.23g9.g€gap9£p3572ii.58"is8&.8"855sis3}4st9%%85skeftijidPoller2sst?SS##is&it%j58st@?ldAnapplicantcanrequestarefwd48hourspriortoscheduledeventdate,The request must be made in writing.Ifa cancellation occurs within 48 hours ofascheduled rental,you forfeit the rental fees and deposit.All refunds will take at leest two weks and will be in the form ofa check from the City ofDelray Leach.Ifa security deposit is paid by check,refunds will only be sent after your check has cleared the bank. 4933£/%3E1984MC3$3351313.£39'£,2224,3,79%92229g63013E.1913249,8519283.5%%2FA£%,3#2.852£23330es.ii#e%#3le:sS#S'le&iii3bi?iii&if:Sl?&"?she-t'ifs;Sf$5$@:7#s@@slikaaiheaboveandunderstandth:rubes and regulations of theCiy of Delray si paciiitj Rcnte!Application that bave bcn madc available to me. Applicant Sigaure Dtc 486.#REM5AIRE±AES±Me852m0,2%&E2±GEM%a#TISA».GR«REE2HNA#7Roes Community Center Deltuy Swim Club Pompey Park 50 NW !"Avenue 2350 Jaeger Drive I1ONw2 steet (561)243-7250 (61)243-7358 {561)243-7356 Pompey Park Pool 10I NW 2"sueet (561)243-7358 505 TcCenter 505 SE 5S Avenue (561)243-7158 Please contat facility for their operatinghours. Veterans Park 302 NE I"Street (561)243-7350 OIICEUSE ONLY: Approvedlejectal ({renso} Insurance required:.[lye:Elno [Ge n e ral liabilityi nsur a n c e @$I rillion/ourene,c ombi nedsi ngh l i mi t []City named as additionally insured [_Copy ofcertificate ofinsurance Rec Trac #:_Date Pid:DepositRefundRequestedon. Authorized by: (Recreation Supervisor) Page 4 of 4 )a., Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 36 of43 ##iF' !%334%3%% Applicant Nne: Address: Attachmente x11 Stg,gs City of Delray Beach ...<...irks :.ts6 M«a""aParksadRecreationDepartunent{l8$% Pavilion Permit 5±%+8.32:/3E ±37=.5338E ".7;3."36,,3.•·±1#2231 ··•·'Phone (he)cein $et ---iiy.see,2,"" $5.31719998632304453.i68783-7,8a9±.39i38Cl3+135%4%ere%$%4i.%8$e5#a#±%3e4 PAVILIONREQUESTED. [Alstic Dunes [Eagle Pauk f ropey Park12 f eteraoWnukGebo f"Lukrview Pntk:#I-) [Milo MabelBoy Scout Pak F orchard View Pauk1-6 4,Pie GovePark [Barvick Park f"pe4y Tl Convnuity Pwrk ald f Catherine Strong Sp0n Pvikin [aatbrineStrong Spluh Favian Pavilion #(ifapplicable) Dare Requested:Time:From a'pm To am/pm lg'egg,sr»a,27$$£5.±.cos#anasnawnna» PARKRULESAND REGULATIONS: L.)Nl parks open at &:00AMrd closetdust.Pool hours ereposted at the pca. 2.)No dogs,pony rides,boune houses,golfing,et.allowed in prk 3.}Alcoholic beverages re prohibitedat alt Clyprksand faeilies.Glass canners re prohibitedon the pool deck. 4.)No motorized vchicles in park beyond parking area. 5.)No op wning fires,excptin grills.Glls are prohibited on tbe pool deck. 6.)No lowd ndio,npe arTV lying. 7)Arca mus be left in the same condition s when ycu srrlved, .)0nly the pavilioncnan be reserved;tho rest ofthe park/pool is op9en tothe enr!public at all tire 9.)All rental fees mast be pit!application tine (at /east 2 busness days priorrental date)to reserve the requerd pavilion. 10,)If you a r e ax cxmp,you must s h owpoo'ofe x empt tuxat t in c o f appllatdoa I n o rder to tp a y tx e s on ti e r an¢al fe. II)in order oreelve a refund tor cancellation ofpavilion rcrtal,peasput refund requestin writng, I2.)PompeyPark Pavilions canot bereserved Modey -Fridayfrom 2 to6 pm wile the Oatof School programs a in session. I3.)VeteransParkGazebo renals arc limited to2 hours dueto s 2 hourpakinglinit in tbe public parklag lot Monday -Saturday. 14.)Catherine StrongPsvliorental dunesaretetween A0am-2pn or 3-&$pm. 1.)Pool ruls and regulationsapply to allguesssing thepool nopy.Sen posted sign forrules capool deck. 5)_rtifis+ofienee dlor_addition!egritPg2grdfgggmevent«or tivitirz.__WR09%3AF+eE3,3RA2A828%1£.3883939.28$224789%8&23.%5%68%%e n rs 2: RENTAL.FEES:(PI«as 6.5%+trtax) Farwick Park,Bexley Trail Pauk NI-4,Catherine Strong Sports Feld or Splash Pr Pavilion,Egle Pk,Lakeview Park,Mke Macek Park,Orchard View tI-6,Pine Grove Park,PompeyPk:#1-2,PompeyPool$5(4 Hours)or $9{AIL Day) Veterns ParkPavilion -S40 (3hours)Veras Pauk Gazlo -$110(2 hour)or $200 (4 hours) Atlantic Dues -$110 hour)or $200 {4 hours Your Rental Ree is:$ass 3#±92?44es±.±s.ere »sn REI.EASE WAIYER l,the undersigned,intcding to be legallybound do hereby for myself,fmily,guntdians,children,charges,heirs,ex«cutors,nd dministr t orswa i ve ad releass any and allrig#ts and c l a ims fordamages which we may h a v e salt t he Cy of Delray Beach, their rep resentati ve s,s uccess or a nd employeespr any injuries ich w e may ffr nconnection vith ouruse ofthis facility.I tavered the above nd underssnd the rules ad regulations that iavc been mnedearsilabieto me. S[GNAT1RE:.DATE: OFFICE USE ONLY':Fee Paid:Rec'Tac#:Dato:- DISTRIBUTION:,Pr±s Divisio();Park Rangrs (),Police Department ()Fil() P'a NI,¥:4slaw City Mgr {};VetrsvPart)r AIPNL.O«an Pue() Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 37 of43 Attachment XIII t pplicaat Name: Address: City of Delray Beach Parks and Recreation Department Field Pernit Phone:home)(eell)- City,State,Zip To am/pm f"Lines es fei4 Yu l Yea No---lfys,wht are tey?--ho FIELD REQUESTED: Yes Field/ParkRequested: Date Requested:'Time :From r/pn Type ofActivity:-----Estimated Attendance:-Age Group: FacilitiesNeeded:Gairi9 T Restrooms Fightu [Pea Box [»nession Stand Is organizatior no4-profit?(lyes,us »th copy fIRSaxex«optcertificate) ls this aToure? Do you hve ugis(ration fs? Counts: PARKRUL.RSAND REGULATIONS I.)Alcobolic ievcrags arc prohibitedst all Citypals and facilities. 2,)Nodogs,pony rides,bouncehouses,golug,cc.tllowcd inu park. 3.)Nomotorid vehicles in park bcyond parting area 4.}Are must le le?in the sare condition as hen you arrired. S.)l order to rive a refund,a 48 hourotioeis rquired,You need toput your cancellatinandrefundrequetinwriting. 6.)T o um s cn tccsts mas t be iu writing o Directoro f P auls snd Recra t ion. FieldRenata!-$3.,00/2hrs9rgrvgFe-5s.00we ·Ehn $10,00hr RENTL PEES AI ields requireS100 refundablesecurity deposit." Lines -Soccer $35/field 'Tour#meat --25ofregistration fees LinsBaseball $2$/55ld Salestux 6.$% Concession --25%ofgross Your Rent!Fee is:S$ RELEASE WWAIVER I,tbe undersigned,intending to be legallybound,do Neb for myself,family,guardians,cbare/rges,heirs,executers and administrators,waiveandreleaseany and all rights sndelms fr dunages,which Ile may hrve against theChtyof Ddray Beach, their representatives,sesorsadcuploresforany injmies which [/we mer suffer ioconnectioswithnary/ouruse oftbis facility. AI various tines tCityafDelrayBach vidoper mdphotographs eventstob:submittedtothelocal media.Byusing this fclity,we hereby authorize the CityofDelray Besch to product,copy,exhibit,publish,broadcast,or distribute suyud alscb tapesphotographs.I heve rd the wovo and udrattherls and regulationsofthetty of Delray teactthat harebeen mad availblcto m. Applicant Signature DMc Fcilry Spervier Apprral ~r OFFICE lJSE O~LY: Fc.Pd.'[po#-[la['- DISTRIBUTION:Customer (;Pk Rangers ()Fed Supervisor(),hue() Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 38 of 43 City of Delray Beach Facility Usc Application O Artaclnwent XIV Parks and Recreation Aquatics Division Street A#dress City Type ofEva N Pompey Park Pool t 110I N,,2'greet''Delay Bevel FI 33444 3P $61.243.7358 I Delray Swim Club 3¥2350Jager Drive Delray Beach,F133444 3'1 P:61.243,7079 Dote;Time Starting From:AM/PM Ending By;AM /PM Food /Beverages:J es LI No Ifhlsr lsa rt!fer n Group !Orguiationplease complete thefollet+ Number ofguests attending. Name ofCroup /Ogaiztlon. tiNy 7i, TypeofEst Radiossnd uenllfd tusle mustbeapproved rlo o theevent through w written request and approved rir to he daleothe event. •Gene ral st-nup will be donebuythestaff,however,breakdown and disposal frtrash will le dcne by the appicnt •Grills,less ccontains,alcoholicbeverages or snaking on the pool dect ls not perenittced at either quntic fscility. Geests reto abideby all Pol Rulesnd Regulationswhenswimming t either aquaticfility. Felllty FeesdiDeposit qutioFailityRantulBatis$100,08 fur tbsfirsle (3)haws ad $).5.00fa cachsJditioal out afir. 1hls fe ieludcs (2)certifed lifeguards on site during your eet.Groups or 50 will requiran additional Ldeguard al $25,00 prbaur for eachdeitional(23)uats.Legard/Paron Ratio:1/25. A$0.00 [ahonly)depcsi upnt contract approval toreervedatesismandatoryand will be refunded upon ins.pcdicn ofthe feility after theevent.A pliant is responsiblefor damage to City equipment and property. Thisapplation shouldbe baitedfor oppvoval at leastthe)wretrprivto the event.Fees must be paid a!lest two wks pricr to the vent.Fens may be refundedife week's notice ofcarcellatln ls received. The City ofDelray Bach may,at its opion,cancel the use requested by appi«ant.Such notie of cancclitior,whether written orsal,shall be gire lo thec@tatperson namedaboveno Ster han seven days priortothescheduled event.l the event he City caccls en event,the applicst is entitled to thereturnofry depositsss liquidated dimages, RELEASEWAIVER l,the uwdersigner,intendingtobe legally owd,do herebyformyself,family,gsarans,chiliehldrer,heirs,exeutarr and otundstra'ors,waive andre'ease anyand allrights andeliskrdamages,wheh,we mayha ogalst the CyofDelray beach,ts repreenattvs,mcsovs andefoyersforany tintswhutch wemay naffer nu corneeiton wthmy'ourseof thisfoetkty.!have read the above andundersnd therulesandregulationsofMe Cyof Detray3eoch that have beenmade awa#ladle to me. Admission Charged:7 No l Yes ffyes,amount:_ Applicant's Signature Aquatics Operations Supervisor DirectorofParksandRecreation Date Date Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 39 of 43 Attachment XV SAMPLE CONTRACT WORDING "Insurance/Bond Requirementsand Conditions:. During the term othls Contract with the City,except as ctherwise stated in this Contract, the Contractor shall procure and maintain insurance andbonds,if required,of the types and to the limits and conforming to requirements as specatled in the tollcwng paragraphs.No work under tis Contract shall begin until evidence oft these financial guarantees is delvered by Contractor as is directed under this Contract. "Indemnification: The following wording is recommendedfor contracting with a private entity. In consideration of ten dollars ($10.00)",the Contractor shall defend,indemnify, save harmless,and exempt the City,its oficers,agents,servants,and employees from and against any and all suits,actons,legal proceedings,claims, demands,damages,costs,expenses,and attorneys fees resulting from injury to or death of persons or damage to property arlsng out of or resulting from the Contract or from work done by the Contractor or subcontractors in the performance of the Contract except to the extent caused by the sole negligence of or breach of contract by the City.In connection with any legal proceedings arising hereunder,the City reserves the right to retain counsel of its choice and at its own expense,or,in the alternatve;City approved counsel obtained by the Contractor.Nothing in this contrad shall be deemed to adversely affect the rights,priwleges and immunities of the City as set forth in Florida Statute 768.28. ·In consderation of ten dollars ($10.00)..."is only required in construction contracts. The following wording is recommended for contracting with another public entity. Each party shall be liable for it own actions and negligence.The City shall indemnity,defend and hold harmless the (other public entity)arising out ct the City's sole negligence In connection with this contract,and the (other public entity)shall indemnity,defend and hold harmless the City against any actions, claims or damages arising out of the (other public entity's)sole negligence in con nection with this contract.The foregoing indemnification shall not constitute a waiver of sovereign immunlty boycnd the limits set forth in Florida Statutes, Chapter 78.28,nor shall the same be construed to constitute agreement by either party to indemnity the other for such other party's negligent,willful or intentional acts or omissions.I connection with any legal proceedlngs arising hereunder,the City reserves the right to retain counsel of its choice and at its own expense,or,in the alternative,approve counsel obtained by the (other public entity).Nothing in this Contract shall be ceemed to adversely affect the rights,priveges and immunities of the City as set forth in Florida Statute 768.28. Each party shall only be required to indemnify,defend and hold harmless the other,as sat forth above,in an amount not to exceed $100,000. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 40 of 43 "GQmIJl@!lg!General Llaillty insurance.Shall be provided and maintained on he most current ISO Occurrence Form,or equivalent,to cover legal liabilities arising from premises and operations,Independent contractors,contractual (indemnification) agreements,products and completed operations,liquor liability,personal Injury to include libel or slander,and XCU""exposures as required by the work to be performed under this Contract,unless waived by the City.The combined bodily injury and property damage limits shall not be less than $xx per occurrence with an annual aggregate of $xx.Excess insurance which provides the same coverage as the underlying irsurance may be provided and maintained to satisfy this insurance requirement.Contractor will notify the City if incurred losses covered by this insurance exceeds 75%of the per occurrence limit. ·Certificate must specifically state his coverage itapplicable. Under any construction Contract,the following should be added:"Contractor will maintain the completed operations insurance for a period of three (3)years after the work performed underthis Contract has been completed and accepted by the City'. "Automobile Liability hsurange:Shall be maintained in accordance with the laws of the State cf Florida to cover the ownership,maintenance and/or use of all owned,non- owned,or hired vehides as required by the work to be pertormed under this Contract. The combined bodily injury and property damage limit shall not be less than $xx per occurrence.Excess insurance which provides the same coverage as the underlying insurance may be provided and maintained to satis'ythis insurance requirement. ·y g r k ars'Comp9ng9ion lD@urangg:S h a l l b o provided a n d m a h t ain o d i n accordanco with statutory requirements of the State of Florida.Included shall be Employee's Llability Insurarce to protect against on-the-job injury or llness which may not fall within the provisions of the Florida State's Workers'Compensation Law.The limits shal be no less than $xxx each accident,and an occupational disease limit of $xx per employ9e/$aggregate MOTF-If ny ofth n trartni work will occur ovor,near or contiguous to any navigable bodies of water,this insurance coverage shall be endorsed a s per the US Longshore and Harbor Worker s'Act and Merchant Ma r i n e Act (Jones Act). "A d d i t i nalInsured;The City of Delr a y B e a ch shall b e i n c luded as a n a d d ition a l nsured by way of the most appropriate,and current (8O (Insurance Gervies Office) endorsement,or its equivalent,on the contractor's liability insurance policies as required under this Contract. EvidenceofInsurance:Prior to the commencomont by Contractor or subcontractor of any work under this Contract,the City must receive and approve Certificates of Insurance evidencing 'he insurance coverages and requirements as required by this Contract.Certified copies of the policies will be provided it requested by the City. Renewal Certificates shall be provided to the City at least ten (10)days prior to the expiration ofany policy. lf at any time the Contractor fails to maintain,or provide evidence of insurance coverage required by this Contract,all work may be halted bythe City.The City,at its option,may procure and maintain such required insurance and demand from Contractor Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 41 of43 reimbursement of premiums paid,including reasonable nterest until he reimbursement is recovered from tho Contractor by the City. "Cancellation!Changes/Renewal:At least thirty (30)days written notice must be given by Contractor (not the Insurer or Broker/Agent)to the Cty ot any cancellation,intent to non-renew,or material reduction or change in insurance coverage. Primary Pglicigs The Contractor's insurance will be primary and non-contributory to the City's insurances or self-insurance programs. "Saparatlon_of.Insureds:Shall bo provided and maintained by tho Ccntractor under the liabiity insurance policy to warrant that such insurance will apply separately to each insured except for the limits. NOTE:'These insurance conditions required in all contracts."Higher risk"Contracs will include additional conditions and/or insurance as deemed necessary. Waiver of Subrogation Endorsement:The Contractor and it's insurer(s)waive all rights of subrogation against the City,its employees,officers,directors and agents far the recovery of damages to the extent such damages are covered under any of the City's general liability,automobile liability,workers'compensation,excess liability or property insurance and sef-insurance programs.The City must be notified if its insurer(s)wll not so endorse their policy(s). Insurance Ralings:.All insurers of the Contractor shall be authorized to do business in Florida,and shall have an A.M Best rating oft A-NVIl or equivalent. Deductibles.and Self-Insured Retentions The Cortractor is responsible fr al deductibles and self-insured retentions.Such amounts should be indicated on the Certficate of Insurance.ln the event of loss which would have been covered but for the deductible or self-insured retertion,the Citymay withhold from payment to Contractor an amount equal to he deductible or self-insured retention should the ful loss recovery not be obtained under the Contractors insurance as a result. Legal Defense:The Contractor will provide to the City any legal defense,and will pay al related expenses,as required by this Contract for legal actions,actual and alleged, brought against the Contractor and/or the City for Contractor activities related to his Contract.This City wlll not be prohibited from using its own independent legal counsel, independent of legal actions taken by the Contractor,and will be entitled to all documents and information asdeveloped by the Contractor,its insurer,s)and their legal courcil(s).'The City will not be obligated to pay any premum or contribution for such services and/or claim settlements. Claims-Mada Policies:If any liability insurance is issued on a claims-made form (suh as general,professional and pcllution liabilities)the Contractor agrees to maintain uninterrupted coverage for a minimum ofone (1)year following completion and acceptance ofthe work under the Contract either through the purchase of an extended reporting provision,or through the purchase of successive renewals with a retroactive date not laterthan the beginning of performance ofwork. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 42 of43 Subcontractor Proyision:The Contractor wii assure that all subcontracted work essentially requires the subcontractor(s)to adhere to substantially the same insurance, safety and indemnity provisions as in this Contract,or otherwise the Contractorwill assume the legal liabilities of such subcontractor(s)as provided for elsewhere in this Contract. Safety Practices/Hazardus WV''aste Agreement The Contractor warrants that work practices of employees and agents of the Contractor,and the services and/or products supplied by the Contractor to the City under this contract will be provided and/or used in compliance with,although not an exhaustive reference the standards set forth in the Occupational Safety and Heath Act of 1970 and its amendments,Federal and State environmental pollution laws,and the policies and procedures of the City.The City retains the righ t to stop Contractor work if such compliance is not maintained by Contractor. J u r isdiction (Governing L aw):The laws of the State of Floridawill govern t h e v a li cati on this Contract,its interpretation and performance.Any litigation arising in any way from this Contract shall be brought inPalm Beach County. Performance and Payment Bonds:Contractor shall upon delivery of the executed contract to tho City furnish a Performance Bond (including a Maintenance Bond)srd a Payment Bond each in an amount at least equal to the Contract Price as security for the faithful performance and payment of all Contractor's cbligations under this Contract. These Bonds shall remain in effect at least until one year after the date when final payment becomes due,except as otherwise provided by Law or Regulation or by the Contract Documents.The premiums for these bonds will be paid by the Contractor.The form and conditions of the Bonds and the Surety shall be acceptable and satisfactory to the City. These bonds shall be in a Surety Company licensed o do business in the State of Florida,shall have a resident agent in the State ot Florida and shall have a currentA.M. Bestfinancial rating of at least A-NV. No work under his contract shall commence until the properly executed Bond is received and approved by the City. lf the Surety on any Bond furnished by Contractor is declared bankrupt or becomes insolvent or its right to do busness is terminated in the state of Florlda or it ceases to meet the requirements of the above paragraph,Contractor shall within five days thereafter substitute another Bond and Surety,both of which must te in conformance with the above paragraph. ·"Pollution Liability Insurance:;Shall be provided and maintained by Contractor to cove the legal [abilities for bodily injury and property damage,and environmental damage resulting from pollution and related cleanup costs incurred,al arising out cf the work performed under the Contract.Coverage shall be provided or both the work perfarmed on site,as well as the transport and disposal of hazardous materials. Insurance limits shall not be less than $1,000,000 per occurrence with an aggrcgcte of $2,000,000. Insurance,Bonding &Indemnification Requirements for Contracts RM-13,Rev.3 Page 43 of 43 ·++·Property Damage lnsurancg:Shall be provided and maintained by Contractor under an all risk"coverage including flood and wind up to the replacement value of real or personal property of the City for which the Contractor is liable under this Contract.The C i t y wii be named as loss payee,as interests may appear ({A/MA).Nothing herein will relieve Contractor of any liabilities to non-contract rclatcd damag0s. ·+Aiders _Risk_Insurance:Shall be provided and maintained by Contractor during the work performed under this Contract and shall be an all risk coverage,to include wind storm and flood,as required by the City,with limits equal to 100%of the replacement value of the completed structure.This insurance shall Include Irland Marine Insurance or be separately maintained by Contractor,to provide all risk coverage for related property,to include materials and equipment,while in transit or being stored at the work s i t e .I f necessary,the insurance poicy will con tain a wa iv er of o c cup a ncy cl a u se which would allow the City or Contractor to occupy the structure as stipulated in the Contract withoutjeopardizing the insurance coverage.The City will be named as a loss payee,as interests may appear (AIMA).Nothing herein will relieve Contractor of any liabilities to non-contract related damages. ·"Broad.Form .Property.Damage lsurange:Shall be provided and maintained by Contractor during the work performed under this Contract In an amount of at least $50,000 per occurrence. ·"Fire Legal.Liability.Insurance :.Shall be provided and maintained by Contractor during the work performed under this Contract in an amount of at least $50,000 per occurrence. ····Proessiona]_Liability Insurance:Shall be maintained during tne lite of this Contract to cover the "errors ard omissions"cf the Contractor,or any persons employed car acting on the Contractor's behalf,including but not limited to subcontractors,ln an amount of at least $1,000,000 per occurrence/$2,000,000 annual aggregate,combined single limits, or the same limits on a claims made basis. ·""Fidelity Bond:Shall be provided and maintained by Contractor to cover the loss of cash receipts responsible to Contractor under this Contract caused by dishonest or fraudulent acts of its employees,subcontractors,or agents in an amount of at least %per any one loss. NOTE:""These are specialized insurance coverages.Call Risk Management or the Clty Attorney's Office to discuss. sampiecartrat.doc