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HomeMy WebLinkAboutCHALLENGER SPORTS CORPORATION - CONTRACT - AGREEMENT MISC - CHALLENGER SPORTS CORPORATION (2)Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 1 of 9 CITY OF FORT COLLINS INDEPENDENT CONTRACTOR AGREEMENT THIS AGREEMENT, dated this 1st day of February, 2023, is made and entered into by and between THE CITY OF FORT COLLINS, COLORADO, (“City”), a municipal corporation, and CHALLENGER SPORTS CORPORATION hereinafter referred to as CONTRACTOR. 1. SERVICES. The Contractor agrees provide services in accordance with the scope of services attached hereto as Exhibit A, consisting of two (2) pages and incorporated herein by this reference. 2. AGREEMENT TERM. This Agreement shall commence the day and year set forth above and shall continue in full force and effect until January 31, 2024, unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed four (4) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. Written notice of renewal shall be provided to the Professional and mailed no later than thirty (30) days prior to contract end. 3. EARLY TERMINATION BY CITY. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Contractor. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Contractor: City: Copy to: Challenger Sports Corporation Attn: Grant Hall 12892 Harmony Parkway Westminster, CO 80234 ghall@challengersports.com City of Fort Collins Attn: Matt McCarthy PO Box 580 Fort Collins, CO 80522 mmccarthy@fcgov.com City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 purchasing@fcgov.com In the event of any such early termination by the City, the Contractor shall be paid for services rendered prior to the date of termination, subject only to the satisfactory performance of the Contractor’s obligations under this Agreement. Such payment shall be the Contractor's sole right and remedy for such termination. 4. COMPENSATION. In consideration of the services actually rendered by the Contractor under this Agreement, the parties agree to a revenue share compensation format as set forth in Exhibit A consisting of two (2) pages, attached hereto and incorporated herein. The Contractor shall maintain, and make available to the City upon request, a log of all hours worked under this Agreement. The Contractor will pay the City its revenue share for each camp upon the conclusion of camp programing each week. Checks shall be sent to City of Fort Collins – Recreation Department, Attn: Matt McCarthy, 241 E. Foothills Parkway, Fort Collins, CO 80525. DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 2 of 9 Payment to the City shall be accompanied by an itemized revenue share statement detailing all registrations for each week’s camps and the corresponding proceeds. Neither the Contractor nor its officers, employees, or agents shall be entitled to compensation for overtime, nor will the City be responsible for withholding any portion of the Contractor’s compensation for taxes, FICA, Workman’s Compensation insurance, unemployment compensation insurance or any other benefits. The Contractor shall not assign any benefit or responsibility nor delegate any duty arising under this Agreement without the prior written consent of the City. The City pays invoices on Net 30 terms. 5. APPROPRIATION. To the extent this Agreement or any provision in it constitutes a multiple fiscal year debt or financial obligation of the City, it shall be subject to annual appropriation by City Council as required in Article V, Section 8(b) of the City Charter, City Code Section 8-186, and Article X, Section 20 of the Colorado Constitution. The City shall have no obligation to continue this Agreement in any fiscal year for which no such supporting appropriation has been made. 6. INDEPENDENT CONTRACTOR. The parties agree that the services rendered by the Contractor, its officers, employees and agents under this Agreement are those of an independent contractor and not an employee of the City. Accordingly, neither the Contractor nor anyone on its behalf is authorized in any manner whatsoever to bind or otherwise represent themselves as an agent of the City. The Personnel Policies and Procedures of the City do not apply to the Contractor, and the Contractor, its officers, employees and agents receive no rights or benefits by reason of this Agreement. The Contractor shall direct and control the details of the performance of the services provided by the Contractor within the general requirements established by the City. As an independent contractor, the Contractor is not entitled to unemployment insurance benefits or workers’ compensation benefits and is obligated to pay federal and state income and other applicable tax on any monies paid to the Contractor. Contractor is solely responsible for providing workers’ compensation benefits for the Contractor’s employees as may be required by law. 7. PROHIBITION AGAINST UNLAWFUL DISCRIMINATION. The City, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 US.C. §§ 2000d to 2000d-4) and the Regulations, affirmatively ensures that for all contracts entered into with the City, disadvantaged business enterprises are afforded a full and fair opportunity to bid on the contract and are not to be discriminated against on the grounds of race, color, or national origin in consideration for an award. The City strictly prohibits unlawful discrimination based on an individual’s gender (regardless of gender identity or gender expression), race, color, religion, creed, national origin, ancestry, age 40 years or older, marital status, disability, sexual orientation, genetic information, or other characteristics protected by law. For the purpose of this policy “sexual orientation” means a person’s actual or perceived orientation toward heterosexuality, homosexuality, and bisexuality. The City also strictly prohibits unlawful harassment in the workplace, including sexual harassment. Further, the City strictly prohibits unlawful retaliation against a person who engages in protected activity. Protected activity includes an employee complaining that he or she has been discriminated against in violation of the above policy or participating in an employment discrimination proceeding. The City requires its vendors to comply with the City’s policy for equal employment DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 3 of 9 opportunity and to prohibit unlawful discrimination, harassment and retaliation. This requirement applies to all third-party vendors and their subcontractors at every tier. 8. GOVERNMENTAL IMMUNITY ACT. No term or condition of this Agreement shall be construed or interpreted as a waiver, express or implied, of any of the notices, requirements, immunities, rights, benefits, protections, limitations of liability, and other provisions of the Colorado Governmental Immunity Act, C.R.S. § 24-10-101 et seq. and under any other applicable law. 9. COLORADO OPEN RECORDS ACT. The City is subject to Sec. 24-72-201 et seq. of the Colorado Revised Statute (CORA). This Agreement is subject to public disclosure in whole pursuant to CORA. 10. REPRESENTATIONS. Contractor represents that it has the skill and training necessary to perform the services and Contractor will not receive any training from the City. 11. SERVICES NOT EXCLUSIVE. The Contractor operates its own business and may engage in any outside contracting/employment other than that provided for by this Agreement without prior approval by the City. 12. RELEASE AND INDEMNIFICATION. In consideration of the foregoing exchange of promises and in further consideration of the compensation to be paid to the Contractor under this Agreement, the Contractor, its officers, employees and agents hereby release the City, its employees, agents and assigns from any and all present and future liability, claims, causes of action, losses, costs or expenses of any kind whatsoever stemming from or in any way relating to the Contractor’s performance under this Agreement. The Contractor, its officers, employees and agents further specifically agree to hold the City harmless and indemnify the City against any claims, demands, liabilities or causes of action whatsoever brought by or on behalf of any third party for damages, losses, costs, expenses or injuries sustained by any such third party arising from or in any way relating to the negligent acts or omissions of the Contractor, its officers, employees or agents in the performance of its obligations under this Agreement. Without limiting any of the Contractor's obligations hereunder, the Contractor shall provide and maintain insurance coverage with the limits specified within Exhibit C, consisting of one (1) page, attached hereto and incorporated herein by this reference. The Contractor before commencing services hereunder, shall deliver to the City, one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. The Contractor is required to submit proof of insurance coverage upon request by the City. The City will not be responsible for providing any insurance and the Contractor will not receive the protections of governmental immunity. 13. DEFAULT PERIOD. Each and every term and condition of this Agreement shall be deemed to be a material element hereof and, in the event of default by either party, the non-defaulting party shall be entitled to all rights and remedies at law and in equity, including , but limited to, the award of reasonable attorney’s fees and costs incurred because of the default. 14. BINDING EFFECT/NO ASSIGNMENT/NO THIRD PARTY BENEFICIARY. This Agreement shall be binding upon the City and the Contractor, their legal representatives, successors and, assigns, if any, and shall not be assigned by either party without the written consent of the other party. This Agreement is made for the sole and exclusive benefit of the City and the Contractor and is not made for the benefit of any third party. DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 4 of 9 15. PROFESSIONALISM. The Contractor must manage and conduct all activities and services hereunder in a fair, nondiscriminatory, professional, and competent manner, consistent with the requirements of the Americans with Disabilities Act, and the Colorado and Fort Collins human rights laws, and otherwise in compliance with all applicable laws and to the reasonable satisfaction of the City. 16. GOVERNING LAW AND ENTIRE AGREEMENT. This Agreement shall be governed by the laws of the State of Colorado, and the parties agree that venue for any action hereunder shall be in Larimer County, Colorado. This writing constitutes the entire agreement between the parties. 17. CONTACT INFORMATION. Contractor agrees that its name and phone number may be published or released to participants for use in relationship to the program/project described herein. 18. LEGAL COMPETENCE. The Contractor warrants that he/she is legally competent to execute this Agreement. If Contractor is a corporation or other entity, the person signing on behalf of the Contractor affirmatively states that he or she has authority to act on behalf of the Contractor and to bind the Contractor to this contract. 19. BACKGROUND CHECK. The Contractor and the City acknowledge and agree that certain services provided by Contractor constitute acting in a position of trust which entail direct contact with youth and other members of the general public. Accordingly, Contractor represents that it has voluntarily submitted to background screening, completed at the Contractor’s expense, prior to commencing services under this Agreement. 20. PERSONNEL. Contractor shall control the conduct and demeanor of its agents and employees. If the City so requests, Contractor agrees to supply and require its employees to wear or carry badges or other suitable means of identification, the form of which shall be subject to prior and continuing approval of the City. The Contractor agrees to provide to the City at all times a current list of employees, volunteers, and other representatives or agents of Contractor that will be working on behalf of Contractor in providing services to the City under this Agreement. The Contractor and the City acknowledge and agree that certain services provided by Contractor may require that employees, volunteers, and other representatives or agents of Contractor act in positions of trust which entail direct contact with youth and other members of the general public. Accordingly, Contractor agrees that all employees, volunteers, and other representatives or agents of the Contractor in positions of trust shall be background screened, at Contractor’s expense. In the event that a background check, or any other information available to the Contractor or the City, raises questions about the trustworthiness, fitness for provision of services under this Agreement, competence or suitability of any individual for a position of trust of any kind, including handling of funds, City equipment or property, or working with youths or other members of the general public, such individual shall not be employed or allowed to volunteer in connection with the services or activities required or permitted under this Agreement, or in a manner that would permit contact by that person with the funds, equipment, property associated with the provision of services hereunder, or persons participating in programs or services provided under this Agreement. DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 5 of 9 Upon receipt of written notice from the City of any reasonable objection from the City concerning trustworthiness, fitness for provision of services under this Agreement, competence or suitability of any individual for a position of trust of any kind, or c oncerning conduct, demeanor or competence of any employee or volunteer of Contractor , the Contractor shall immediately take all lawful steps to remove or otherwise address to the City's reasonable satisfaction the cause of the objection or to remove such individual from the performance of any services provided hereunder. The following constitute unacceptable personal conduct that the parties acknowledge and agree shall be subject to reasonable objection by the City. The parties acknowledge that other conduct not listed in this Section may be determined by the City to be reasonably expected to impair Contractor’s ability to provide satisfactory services under this Agreement, and may also give rise to a reasonable objection by the City to which Contractor shall be expected to respond as set forth herein. In the event that Contractor, or the individual site manager, if different from Contractor, commits any of the following examples of unacceptable conduct, or fails or refuses to take reasonable action to correct such conduct by any person providing services for or on behalf of Contractor hereunder, the City may give Contractor notice of violation and terminate the agreement as set forth in article 3. a) Theft or misuse of money or property; b) Commission or conviction of a felony or of any crime involving moral turpitude; c) Harassment of, or discrimination against, any individual based on race, religion, national origin, age, sex, sexual orientation or disability; d) Falsification, unauthorized use or destruction of City property; e) Abusive or threatening treatment of any person, including, but not limited to physical or verbal confrontation; f) Insubordination or refusal to comply with directives or assignments; g) Using, consuming, possessing, having in the body, or distributing alcohol or controlled substances during working time; h) Incompetence, inattention to duties or wastefulness while on the job; i) Failure to meet performance expectations of job or not performing duties or functions assigned; j) Engaging in personal business while on the job or engaging in outside employment which interferes with job performance; k) Repeated tardiness, absenteeism; and l) Job Abandonment (unreported absences of three days or more) DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 6 of 9 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul, Purchasing Director Date: ATTEST: APPROVED AS TO FORM: CHALLENGER SPORTS CORPORATION By: Printed: Title: Date: DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Grant Hall Vice President 1/29/2023 Assistant City Attorney 2/13/2023 City Clerk Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 7 of 9 EXHIBIT A SCOPE OF SERVICES & REVENUE SHARE STRUCTURE I. BACKGROUND & OBJECTIVE / OVERVIEW A. Objective The City of Fort Collins is engaging the Contractor to conduct summer soccer camps in partnership with the City's Recreation Department. Contractor will be expected to lead scheduled programs for children ages 3 to 14. B. Background The City of Fort Collins, Recreation Programming offers summer soccer camps in partnership with the Contractor, which provides qualified soccer coaches. Contractor is expected to lead scheduled programs for children ages 3 to 14. The goal of this program is to provide affordable, safe, and quality programming to the City where participants can learn the skills and techniques of cheer. The City will provide field and shelter space on City property. The specific locations for camps will be determined by the parties each term of the agreement and may change from year to year. The City will also advertise the soccer camps in the Recreator, providing information about the camp and how to register. The Recreation Department divides its programing into 3 trimesters per year. The Contractor will conduct its programming during the second trimester, running June to August. Specific dates, times and class locations will be negotiated each year with the Contractor. The Contractor will be expected to facilitate their designated training program(s) unless programs experience low enrollment, lack of City facility availability, or other emergencies such as a global pandemic. II. SCOPE OF SERVICES A. Scope of Work The City Recreation department desires a variety of programming options for multiple age groups. Under this Agreement, Contractor will offer the following class types:  Tiny Tykes; ages 3-5 years (M-F) , 8:00 - 8:45 am  Half Day Program: ages 5-14 years (M-F) , 9:00 am – 12:00 pm  Overtime: ages 5-14 years (M-Th), 1:00 – 3:00 PM Classes will run for one week intervals and typically have two to three coaches per class. Minimum class size is 20 participants. Contractor will ensure that there is at least one coach per every 15 children participating in each class. The Contractor is responsible for providing the following:  Registration platform  Free jersey for participants who register by early bird deadline (decided on by Challenger Soccer)  T-shirt and soccer ball for each participant  Staff to operate camp DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 8 of 9  Housing for camp staff  Information to be added to the Summer Recreator (camp info, dates, and website to register at) B. Program Deliverables The goal of this collaborative program is to provide affordable, safe, and quality programming to the community where participants can learn the skills and techniques of soccer. The Contractor will provide quality programs with high customer satisfaction. This will be measured by feedback collected from program participants through trimester surveys conducted by the City. III. REVENUE SHARE The per participant rates for the weekly courses described in Section II are set forth in the table below. The revenue share format shall be a fixed rate by class for the parties. Course Recommended Price CSC City Tiny Tikes (ages 3-5 years) $105.00 $90.00 $15.00 Half Day Program (ages 5-14 years) $215.00 $175.00 $40.00 Overtime (ages 5-14 years) $95.00 $75.00 $20.00 DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 Independent Contractor Agreement – Recreation MISC 2023 – Challenger Sports Summer Soccer Camps Page 9 of 9 EXHIBIT B INSURANCE REQUIREMENTS The Service Provider will provide the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies. In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. Insurance certificates should show the certificate holder as follows: City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522 The City, its officers, agents and employees shall be named as additional insureds on the Service Provider 's general liability and automobile liability insurance policies by marking the appropriate box or adding a statement to this effect on the certificate, for any claims arising out of work performed under this Agreement. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement. Workers' Compensation & Employer’s Liability insurance shall conform with statutory limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee, or as required by Colorado law. B. General Liability. The Service Provider shall maintain during the life of this Agreement such General Liability as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for General Liability, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1/16/2023 Twin Lakes Insurance Agency PO Box 970 Lees Summit MO 64063 816-525-2125 816-525-4049 info@twinlakesins.com Philadelphia Insurance 23850 CHALSPO-01 National Casualty Co 11991ChallengerSportsCorp 8263 Flint Street Lenexa KS 66214 Technology Insurance Company 42376 1363872752 A X 1,000,000 X 100,000 0 1,000,000 3,000,000 X PHPK2386168 3/1/2022 3/1/2023 3,000,000 B 1,000,000 X X X CKS00052340412 1/21/2022 1/21/2023 A X X 5,000,000PHUB8053933/1/2022 3/1/2023 5,000,000 C X N TWC4079220 3/1/2022 3/1/2023 1,000,000 1,000,000 1,000,000 A Sexual Abuse/Molestation Accident Participant Medical Cov PHPA093415 1/1/2023 1/1/2024 LIMIT LIMIT 1,000,000 25,000/25,000 CERTIFICATE HOLDER IS NAMED AN ADDITIONAL INSURED WITH RESPECT TO THEIR INTEREST IN THE GENERAL LIABILITY ARISING FROM THE OPERATIONS OF THE NAMED INSURED Master Certificate XXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX XX XXXXXXXXXX DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 2/8/2023 Twin Lakes Insurance Agency PO Box 970 Lees Summit MO 64063 816-525-2125 816-525-4049 info@twinlakesins.com Philadelphia Insurance 23850 CHALSPO-01 Technology Insurance Company 42376ChallengerSportsCorp 8263 Flint Street Lenexa KS 66214 State Automobile Mutual Ins Co 25135 668695272 A X 1,000,000 X 100,000 0 1,000,000 3,000,000 X PHPK2386168 3/1/2022 3/1/2023 3,000,000 C 1,000,000 X X X 10161716CA 1/21/2023 1/21/2024 A X X 5,000,000PHUB8053933/1/2022 3/1/2023 5,000,000 B X N TWC4079220 3/1/2022 3/1/2023 1,000,000 1,000,000 1,000,000 A Sexual Abuse/Molestation Accident Participant Medical Cov PHPA119128 1/1/2023 1/1/2024 LIMIT LIMIT 1,000,000 25,000/25,000 CERTIFICATE HOLDER IS NAMED AN ADDITIONAL INSURED WITH RESPECT TO THEIR INTEREST IN THE GENERAL LIABILITY ARISING FROM THE OPERATIONS OF THE NAMED INSURED Soccer Camps July 24th -28th The City of Fort Collins 215 North Mason Street Fort Collins CO 80524 DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71 PI-AS-009 (04/04) Page 5 of 5 PHILADELPHIA INDEMNITY INSURANCE COMPANY Includes copyright material of the Insurance Services Office, Inc., used with its permission. K. SECTION I COVERAGES, COVERAGE A, 2. Exclusions a. is deleted and replaced by the following: a. Expected or Intended Injury from the use of reasonable force to protect persons or property. L. Additional Insured Funding Source Under SECTION II WHO IS AN INSURED the following is added: Any person or organization with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. M. Additional Insured Managers or Lessors of Premises Under SECTION II WHO IS AN INSURED the following is added: Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased to you subject to the following additional exclusions: This insurance does not apply to: a. b. Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. N. Non-owned Watercraft SECTION I COVERAGES, 2. Exclusions, paragraph g. (2) is amended to read as follows: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. DocuSign Envelope ID: FBF0A3ED-AF65-475D-BC28-CC2216823B71