HomeMy WebLinkAboutLIGHTNING YOUTH ACADEMY (2)INSURANCE ON FILE N-2024-156
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
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0� ppv-s t) CITY OF SANTA ANA
CS . B�;�lywfl' RECREATION SERVICES AGREEMENT WITH LIGHTNING YOUTH ACADEMY
THIS AGREEMENT is made and entered into on this 16th day of April 2024 by and
between Lightning Youth Academy, a California nonprofit public benefit corporation
("Provider"), and the City of Santa Ana, a charter city and Municipal Corporation organized and
existing under the Constitution and laws of the State of California ("City"). City and Provider are
also referred to as "the Parties."
RECITALS
A. The City desires to retain a recreation service provider having special skills, resources and
knowledge to provide running and mental health programming in its recreation class program.
B. Provider represents that it is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Provider represents that he is
knowledgeable in his field and that any services performed by Provider under this Agreement
will be performed in compliance with such standards as may reasonably be expected.
D. The Parties acknowledge that the City intends to provide recreational activities to the public
but must balance the need to comply with all COVID-19 guidance and restrictions.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terms and conditions hereinafter set forth, the parties agree as follows:
1. SCOPE OF SERVICES
a. Provider shall perform those services as set forth in Exhibit A to this Agreement.
b. All classes operated pursuant to this Agreement for conducting recreation classes at
City facilities, including parks, will comply with all applicable guidance and public
health orders, including those from the Centers for Disease Control ("CDC"),
California Department of Public Health ("CDPH"), the Orange County Health Care
Agency ("OCHCA") and the City itself for as long as those orders and guidance remain
in place. Provider will remind participants of these guidelines. To the extent that
Provider needs assistance with enforcing any rules or requirements, Provider will
contact a City Parks' employee or City security for assistance.
c. Provider shall not attend a class or teach any class if Provider is sick or has any
symptom(s) associated with COVID-19 including but not limited to, fever above 100.4,
chills, cough, shortness of breath loss of taste or smell, nausea, muscle or body aches,
vomiting, headache, sore throat or diarrhea.
d. Provider will not attend class or teach a class if Provider or any member of Provider's
household has been asked to quarantine or self -isolate due to symptoms of COVID-19
or a positive test result for COVID-19.
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e. Provider acknowledges that, to the extent that City is able to and chooses to conduct
classes indoors, this Agreement will also cover classes conducted at one of City's
recreational centers during the term of this Agreement.
f. City reserves the right to change the location(s) at which the services contemplated by
this Agreement are provided.
g. Provider shall comply with the City's recreation classes policy manual and any other
City rules and regulations regarding the operation of recreation classes.
2. COMPENSATION
a. hi consideration for the provision of the programs set forth in Exhibit A, City agrees
to pay, and Provider agrees to accept as total payment for their services for the City,
seventy percent (70%) of all gross revenue received from program participants. Total
annual revenue to Provider shall not exceed Twenty -Five Thousand Dollars and Zero
cents ($25,000).
b. Payment to Provider shall be made monthly within thirty (30) days following
completion of the last class taught by Provider the prior month. City shall be
responsible for collecting all fees from program participants. Provider shall not collect
fees but will refer all interested participants to City for registration information.
c. Provider agrees that City shall retain thirty percent (30%) of all gross revenue received
from program participants as an administrative fee.
d. City and Consultant agree that all payments due and owing under this Agreement shall
be made through Automated Clearing House (ACH) transfers. Consultant agrees to
execute the City's standard ACH Vendor Payment Authorization and provide required
documentation. Upon verification of the data provided, the City will be authorized to
deposit payments directly into Consultant's account(s) with financial institutions.
e. Payment need not be made for work that fails to meet the standards of performance set
forth in the Recitals which may reasonably be expected by City.
3. TERM
This Agreement shall commence on June 1, 2024 and end on May 31, 2025 unless
terminated earlier in accordance with Section 14 below. The term of this Agreement may be
extended for up to one (1) one-year period upon a writing executed by the City Manager and City
Attorney.
4. INDEPENDENT CONTRACTOR
Provider shall, during the entire term of this Agreement, be construed to be an independent
contractor and not an employee of the City. This Agreement is not intended nor shall it be
construed to create an employer -employee relationship, a joint venture relationship, or to allow the
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City to exercise discretion or control over the manner in which Provider performs the services
which are the subject matter of this Agreement; however, the services to be provided by Provider
shall be provided in a manner consistent with all applicable standards and regulations governing
such services. Provider shall pay all salaries and wages, employer's social security taxes,
unemployment insurance and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes. Provider is not an agent, representative or employee of City and
Provider shall have no authority to act on behalf of the City.
5. INSURANCE
Prior to undertaking performance of work under this Agreement, Provider shall maintain
and shall require subcontractors, if any, to obtain and maintain insurance, as described below, for
the entire term of this Agreement, against claims for injuries to persons or damage to property
which may arise from or in connection with services, products and materials supplied. Total cost
of such insurance shall be borne by Provider.
a. Minimum Scope and Limit of Insurance
1. Commercial General Liability (CGL). Insurance Services Office ("ISO")
Form CG 00 01 covering CGL on an "occurrence" basis, including products
and completed operations, property damage, bodily injury and personal &
advertising injury with limits no less than $1,000,000 per occurrence and
$2,000,000 aggregate..
2. Automobile Liability. Insurance Services Office (ISO) Form CA 00 01
covering Code 1 (any auto), with limits of no less than $1,000,000 per accident
for bodily injury and property damage. In the event Provider does not maintain
commercial automobile liability insurance, City will accept evidence of
personal automobile insurance as compliance with this requirement.
3. Workers' Compensation. As required by the State of California, with
Statutory Limits, and Employer's Liability Insurance with limit of no less than
$1,000,000 per accident for bodily injury or disease.
4. Sexual Abuse or Molestation Liability (SAME). If the work will include
contact with minors, and the CGL policy referenced above is not endorsed to
include affirmative coverage for sexual abuse or molestation, Provider shall
obtain and maintain a policy covering Sexual Abuse and Molestation with a
limit of no less than $1,000,000 per occurrence or claim.
5. Broader Coverage. If the Provider maintains broader coverage and/or higher
limits than the minimums shown above, the City requires and shall be entitled
to the broader coverage and/or the higher limits maintained by the Provider.
Any available insurance proceeds in excess of the specified minimum limits of
insurance and coverage shall be available to the City.
Page 3 of 10
b. Other Insurance Provisions
The above required insurance policies are to contain or be endorsed to contain the
following provisions:
Additional Insured Status. The City, its officers, officials, employees, and
volunteers are to be covered as additional insureds on the CGL policy, with
respect to liability arising out of work or operations performed by or on behalf
of the Provider including materials, parts, or equipment furnished in connection
with such work or operations.
2. Waiver of Subrogation. Provider's insurance company(ies) agree(s) to waive
all rights of subrogation against City, its City Council, its officers, officials,
employees, agents, and volunteers for losses paid under the terms of any policy
which arise from work performed by Provider under this Agreement.
3. Primary Coverage. For any claims related to this Agreement, Provider's
insurance coverage shall be primary and any insurance maintained by City, its
City Council, its officers, officials, employees, agents, or volunteers shall not
contribute to it.
4. Severability. A severability of interest provision must apply for all the
additional insureds, ensuring that Provider's insurance shall apply separately to
each insured against whom a claim is made or suit is brought, except with
respect to the Provider's limits of liability.
5. Cancellation. Insurance policy(ies) herein shall provide that coverage shall not
be canceled, suspended, voided, reduced in coverage or in limits, non -renewed
by the carrier, or materially changed except after thirty (30) days prior written
notice has been given to City. Ten (10) days prior written notice shall be
provided to City for policy cancellation or non -renewal due to non-payment.
6. Certificate Holder. The certificate holder on each evidence of insurance
certificate shall be: City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA
92701.
C. Acceptability of Insurers. Insurance is to be placed with insurers authorized to
conduct business in the state with a current A.M. Best's rating of no less than
A:VII, unless otherwise acceptable to the City.
d. Verification of Coverage. Provider shall furnish the City with original Certificates
of Insurance including all required amendatory endorsements (or copies of the
applicable policy language effecting coverage requiredby this clause) and a copy of
the Declarations and Endorsement Page of the CGL policy listing all policy
endorsements to City before work begins. However, failure to obtain the required
documents prior to the work beginning shall not waive the Provider's obligation to
provide them.
Page 4 of 10
The City reserves the right to require complete, certified copies of all required
insurance policies,including endorsements required by these specifications, at any
time.
e. Special Events Coverage. Special events coverage is available and can be
purchased by Provider. Use this link to learn more: www.2sparta.com.
Special Risks or Circumstances. City reserves the right to modify these
requirements, including limits, based on the nature of therisk, prior experience,
insurer, coverage, or other special circumstances.
6. INDEMNIFICATION
Provider agrees to defend, and shall indemnify and hold harmless the City, its officers,
agents, employees, Providers, special counsel, and representatives from liability: (1) for personal
injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims
for personal injury, including death, and claims for property damage, which may arise from the
negligent operations of the Provider or its contractors, subcontractors, agents, employees, or
other persons acting on their behalf which relates to the services described in section 1 of this
Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution,
judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement,
to the extent that the injury, damages, just compensation, restitution, judicial or equitable relief is
caused by the negligence of the Provider. This indemnity and hold harmless agreement applies to
all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or
alleged to have been suffered, by reason of the events referred to in this Section or by reason of
the terms of, or effects, arising from this Agreement. City may make all reasonable decisions
with respect to its representation in any legal proceeding. In no case will Provider be required to
indemnify or hold harmless the City from injury, damages, just compensation, restitution,
judicial or equitable relief caused by the negligence of the City.
CONFIDENTIALITY
If Provider receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary, Provider agrees that it shall not use
or disclose such information except in the performance of this Agreement, and further agrees to
exercise the same degree of care it uses to protect its own information of like importance, but in
no event less than reasonable care. "Confidential Information" shall include all nonpublic
information, including but not limited to student records. Confidential information includes not
only written information, but also information transferred orally, visually, electronically, or by
other means. Confidential information disclosed to either party by any subsidiary and/or agent of
the other party is covered by this Agreement. The foregoing obligations of non-use and
nondisclosure shall not apply to any information that (a) has been disclosed in publicly available
sources; (b) is, through no fault of the Provider disclosed in a publicly available source; (c) is in
rightful possession of the Provider without an obligation of confidentiality; (d) is required to be
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disclosed by operation of law; or (e) is independently developed by the Provider without reference
to information disclosed by the City.
8. COVID-19 ASSUMPTION OF RISK AND WAIVER
Provider acknowledges that Provider could be exposed to persons that may have COVID-
19 providing services pursuant to this Agreement. Provider understands that interacting with any
person currently comes with the inherent risk of exposure to COVID-19 and that COVID-19 is
highly contagious. Provider assumes the risks associated with providing services pursuant to this
Agreement, namely potential exposure to COVID-19. Provider acknowledges that while some
people have no symptoms or mild symptoms from COVID-19, some people have become seriously
ill requiring hospitalization and that some people have died from COVID-19. Provider
acknowledges that persons over the age of 65 and persons with underlying health conditions are
at greater risk of contracting COVID-19 and are potentially risking serious injury or death.
Provider is agreeing to provide classes pursuant to this Agreement and does so of Provider's own
free will.
Provider intends to be legally bound by this assumption of risk, release and waiver and to
bind Provider's heirs, personal representatives, next of kin and anyone who may make a claim on
Provider's behalf. Provider knowingly releases and waives any and all claims that Provider may
have or could have in the future and includes any claims resulting from potential exposure or actual
exposure to COVID-19, this includes claims for personal injury, transmittal of COVID-19 to
others, and/or wrongful death. Provider agrees to hold harmless, defend and indemnify the City,
its public officials, officers, employees, volunteers, and agents from any and all claims for liability
or damages, including those for exposure to or diagnosis with COVID-19 as a result of providing
services pursuant to this Agreement.
9. CONFLICT OF INTEREST
Provider covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under this
Agreement.
10. BACKGROUND CHECK
Provider shall ensure that all employees, subcontractors, and any volunteers are
fingerprinted and background checked prior to conducting any work pursuant to this Agreement.
Provider shall not assign any employee, agent, subcontractor, volunteer or the Provider personally
to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer,
or the Provider personally are required to register as a sex offender under California Penal Code
Section 290 et seq, have a conviction for any crime of moral turpitude, have a conviction for a
sexual based crime, have a conviction for a violent felony as defined in California Penal Code
Section 667.5(c), or has a conviction for a serious felony as defined in California Penal Code
Section 1192.7(c). Disqualifying convictions include but are not limited to, violations of California
Penal Code Sections 37, 128, 136.1 with Section 186.22, 187, 190-190.4 and 192(a), 205, 206,
207-209.5, 211, 212, 212.5, 213, 214, 215, 218-219, 220, 236.1(b) or 236.1(c), 243.4, 261, 261.5,
273.5, 262, 264.1, 266, 266c, 266h, 266i, 266j, 267, 269, 272, 273a, 273ab, 273d, 285, 286, 288,
Page 6 of 10
288a, 288.2, 288.3, 288.4, 288.5, 288.7, 289, 290, 311.1, 311.2, 311.3, 311.4, 311.10, 311.11, 314,
347(a), 368, 417(b), 451(a),518 with 186.22, 647.6, 653f(c), 664 and 187, 667.5(c),18745, 18750,
or 18755, 12022.53, 11418(b)(1) or (b)(2); Business and Professions Code Section 729.
11. NOTICE
Any notice, tender, demand, delivery, or other communication pursuant to this Agreement
shall be in writing and shall be deemed to be properly given if delivered in person or mailed by
first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in
the manner provided in this Section, to the following persons:
To City: City Clerk
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Fax (714) 647-6956
With copy to: Executive Director
Parks, Recreation and Community Services
City of Santa Ana
20 Civic Center Plaza (M-23)
P.O. Box 1988
Santa Ana, California 92702
Fax (714)571-4211
To Provider: Lightning Youth Academy
Attn: Jose Antonio Cholula Bruno
600 W Santa Ana Blvd., Suite 530A
Santa Ana, CA 92701
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication shall be addressed and transmitted to the new address. If sent by mail,
communication shall be effective or deemed to have been given three (3) days after it has been
deposited in the United States mail, duly registered or certified, with postage prepaid, and
addressed as set forth above. If sent by fax, communication shall be effective or deemed to have
been given twenty-four (24) hours after the time set forth on the transmission report issued by the
transmitting facsimile machine, addressed as set forth above. For purposes of calculating these
time frames, weekends, federal, state, County or City holidays shall be excluded.
12. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Provider regarding the subject matter herein, and supersedes any and all other agreements, oral or
written, between the parties. In the event of a conflict between the terms of this Agreement and
any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be
modified except by written instrument signed by the City and by an authorized representative of
Page 7 of 10
Provider. The parties agree that any terms or conditions of any purchase order or other instrument
that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or
obligate Provider or the City. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which is not embodied herein.
13. ASSIGNMENT
The experience, knowledge, capability and reputation of Provider were a substantial
inducement for City to enter into this Agreement. Therefore, Provider may not assign, transfer,
delegate, or subcontract any interest herein without the prior written consent of the City and any
such assignment, transfer, delegation or subcontract without the City's prior written consent shall
be considered null and void.
14. TERMINATION
a. This Agreement may be terminated by the City immediately pursuant to any federal,
state, county or local health order related to or regarding COVID-19 making it impossible to hold
classes. For any other reason, this Agreement may be terminated by City upon thirty (30) days
written notice of termination. In such event, Provider shall be entitled to receive, and City shall
pay Provider, compensation for all services rendered prior to the effective date of termination.
b. Termination or cancellation of classes by the Provider outside of Section 1 Lb. must be
given to the City at least thirty (30) days prior to termination/cancellation. Failure to provide
adequate cancellation notice to the City may put future contracting of business with the City at risk
and will result in the City's retention of ten (10%) percent of the final payment to Provider.
15. WAIVER
No waiver of breach, failure of any condition, or any right or remedy contained in or
granted by the provisions of this Agreement shall be effective unless it is in writing and signed by
the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or
remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not
similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies.
16. RECORDS
Provider shall use attendance sheets generated and supplied by the City to record
attendance in each class. Provider shall keep these and any other records in connection with the
work to be performed under this Agreement and shall permit City, upon request, to review such
records for a period of three (3) years from the date of final payment to Provider under this
Agreement.
17. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic
Page 8 of 10
information, or military and veteran status, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization,
promotion, termination or other employment related activities or any services provided under this
Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all
applicable federal, state and local laws and regulations.
18. JURISDICTION —VENUE
This Agreement has been executed and delivered in the State of California and the validity,
interpretation, performance, and enforcement of any of the clauses of this Agreement shall be
determined and governed by the laws of the State of California. Both parties further agree that
Orange County, California, shall be the venue for any action or proceeding that may be brought or
arise out of, in connection with or by reason of this Agreement.
19. LICENSES
Provider shall, throughout the term of this Agreement, maintain all necessary licenses,
permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder
and required by the laws and regulations of the United States, the State of California, the City of
Santa Ana and all other governmental agencies.
20. SEVERABILITY
In the event that one or more of the phrases, sentences, clauses, paragraphs or sections
contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree
of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the
remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be
interpreted to carry out the intent of the parties hereunder.
21. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in
the body of this Agreement.
22. AUTHORITY
The person(s) executing this Agreement on behalf of the parties hereto warrant that they are
duly authorized to execute this Agreement on behalf of said parties and that by so executing this
Agreement, the parties hereto are formally bound to the provisions of this Agreement.
[Signature Page Follows]
Page 9 of 10
SIGNATURE PAGE FOR
RECREATION SERVICES AGREEMENT WITH LIGHTNING YOUTH ACADEMY
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and
year first above written.
ATTEST:
K4=el. Vqd,10! I MEN!! T06 E17 2i V
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By:
B on Salvatierra
Deputy City Attorney
RECOMMENDED FOR APPROVAL:
)�54hw^
Hawk Scotl (Apr 24, 2024 06 52 POT)
Hawk Scott
Executive Director of Parks,
Recreation and Community Services Agency
CITY OF SANTA ANA
Alvaro Nuhez
Acting City Manager
IUMi]T/1171I.i
i�
pr. Jose nia 8mno )Apr34,3024oe:51 PDT)
Jose Antonio Cholula Bruno
President
Page 10 of 10
EXHIBIT A
Exhibit A
SCOPE OF SERVICES
A. Provider shall conduct Lighting Youth Academy Recreational Running Classes for ages 5-
15yrs old.
B. Provider shall teach such or similar classes (1) at the times below at facilities to be
designated by the City or (2) on a schedule agreed upon by the parties for each class
session or term, including the location, specific days and hours when classes will be held,
and holidays to be observed, in accordance with City's needs.
Lightning offers this 8-week running and mental health program for youth ages 5 to 12.
The purpose of this program is to learn and develop basic running skills. This organized
program focuses on teaching basic fundamentals in running and mental health wellness.
During practice, youth practice physical exercises through a warm-up, dynamic
stretching, running workout, cool -down, static stretching, and the implementation of
mental health wellness such as mindfulness, guided imagery, and/or visualization. This
recreational activity is held on Tuesdays and Thursdays from 4:30 pm to 6:00 pm. All of
these activities will be at the front of Jerome Center. The fee for the eight -week program
is $30.00.
INSTRUCTOR: Lighting Youth Academy
LOCATION: Jerome Center, 726 S Center St. Santa Ana, CA. (714) 647-6559
• Lighting Youth Academy will consist of 8 weeks sessions, held two days per
week, 1 %a hour (Tuesday & Wednesday)
C. Provider shall provide all materials, supplies, equipment, records and personnel.
Provider shall be responsible for clean-up of the facilities and materials and shall ensure
the safety and effectiveness of instruction.
CLASS SIZE
A. Each class must have a minimum of 10 paid students and no more than 50 students.
B. No registration will be accepted after the second meeting of classes.
C. If the minimum registration has not been reached by the second class the class shall be
cancelled. Provider will be under no obligation to provide services for the cancelled
classes, and the City will have no further obligations to pay Provider compensation for
the remaining classes that were cancelled in that session.
CLASS FEES
A. Each participant shall pay class registration fees as established by City.
B. Provider may not waive class participation/registration fees.
C. Only registered participants may participate in class.
D. Any refunds to participants will be made in accordance with City policy.
E. Any materials fee shall be established by mutual agreement of City and Provider and
shall be payable directly to Provider.
NOTICE OF COMPLIANCE
CITY STAFF: PRINT III IS PAGE AND INCLUDE WITH AGREEMENT TO'rHE CLERIC OF PIE COUNCIL
Contractor Lightning Youth Running Club
Name:
Project N-2023-116
Number:
Project Recreation Services Agreement With Lightning Youth Academy
Name:
The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the
insurance requirements. No further action is required at this time.
The compliantMcoverae(s)
.__..._
P m
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TYPE OF INSURANCE
POLICY
EXPPIRATIIRATIN
ON
COI DATE
FILE NAM E
__
NUMBER
____ .__ _._.._
..__....-_
_ __.....
..... ___
___.. _. _.,
Auto Liability_Non_Use
AUTOMOBILE LIABILITY
WAIVER
08/15/2024
08/30/2023
Agreement_Requestfor
Waiver_ Lightning_2023.pdf
_......_,..___.._..............._....._._.... ......._ _._..._..
------------- _._ _.._._..._..._.
.......... .... _
. __...__._..
AAU C01_LightnIng Youth 1
GENERAL LIABILITY
S18ML00176221
09/01/2024
08/15/2023
Running Club Lightning
Youth
Academy _2023_2024_.pdf
_._ __. ._______.___...
SEXUALABUSE
_.._..___.. . ...__..__
S18MLOO176231
-.-._
09/01/2024
__._._...._.._.._..___..._.._.
09/05/2023
_..._.._ _._- _...___.7
Lightning Insurance
____._.__.....___------__._._------ --- ,----- .-_.___.._.....__------ ---- _...__
... ... _..... _.__.._..............................___....._..---..._---.._____,___._.
Renewal2023_2024.pdf
WORKERS COMPENSATION EXEMPTION
WAIVER
08/15/2024
08/15/2023
WC Declaration Rev. j
Lightning 2023.pdf
d...... ___.....___._._.._.____....._____._._........................._._.............,__......__.___...----------___...___.....___...
__.._.._.....__.....------
--..._...._.._....-.__..._....._....__.... ___.__._.._
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
94-011YII:II:3 f &I W L I
PRA A IC TE lR I
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Sgned
CE I AT O E The City of Santa l to P ks and RecreationA AcqV
2a Civic a,CA Pl - A i e �d.6
SantaAna,CA 9' /0 y � ��LLG
This certificate is issued as a matter of idDo
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issuin th e randcertificate holder.
R ER R CL S &CLUB
1FICATE 1D: SKSP6X67
--fYFoy Insurance Athletic Union 115 10 1 •3 r� CODE: W3DFWW
64 Portsmouth Ave ',alt Disney World Resort Lightning Youth Running Club
PO Box 1030 P.O.Box 22409 600 W.Santa Ana Blvd.Suite 530A
Exeter,NH 03833-1030 Lake Buena Vista,FL 32930-1000 Santa Ana,CA 92701
(407)934-7200
INSURER(S)AFFORDING COVERAGE
Company A United State Fire Insurance Company NAIL#21113
Company B Everest National Insurance Company NATO#10120 'For box below,INSR LTR refers to Company A or B-
COVERAGES- This is to certify that the policy(ies)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 policy(ies)described herein is subject to all the terms,exclusions,and conditions of such policy(ics),limits shown may e been reduced by paid claims.
1NSR TYPE OF POLICY COVERAGE EFF. COVERAGE EXP. COVERAGES LIMITS
LTR INSURANCE NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) dr
v
A Participant US1182730 9/01/2024 12:01 AM. 9/O1/2025 12:01 AM. Accident Medical 100,000
Accident Accidental Death and Dismemberment 20,000
B Excess S18EX00142-241 9/O1/2024 12:01 AM. 9/01/2025 12:01 AM. Each Occurrence 3,000,000
Liability Policy Aggregate 3,000,000
B General S 18 M LOO 176-241 9/01/2024 12:01 AM. 9/01/2025 12:01 AM. Each Occurrence Limit 1,000,000
Liability General Aggregate Limit 3,000,000
` Participant Legal Liability 1,000,000
§ ' Personal and Advertising Injury Limit I mo'000
Products-Completed Operations Aggregate 3,000,000
Fire Damage to premises Rented to You 1,000,000
Policy Aggregate Cap 20,000,000
Medical Expenses Limit(Any One Person) 5,000
-NIS Sexual Abuse Liability 1,000,000
Sexual Abuse Aggregate 3,000,000
ADDITIONAL INFORMATION/RESTRICTIONS/SPECIAL ITEMS
Coverage applies to Lightning Youth Runnine Club,License#5KSP6X67 Practice,Lightnnu4 Youth Running Club from
09/O1/2024 through 08/31/2025,for the gross negligence and/or liabilities of the AAU Club(s)or registered members.
For said club to have coverage,all membership requirements in the AAU Must be met.
Primary non-contributory applies as per attached endorsement ECG 24 520 04 02.
Waiver of Transfer of Rights of Recovery Against Other to Us applies per attached Endorsement ECG 24 522 04 02.
The Certificate holder shall be an Additional Insured,but only with respect to the operations of the Named Insured,subject to the provisions and limitations of
the olic ies attached CG 20 11 04 13 applies,
CANCELLATION—Should any of the above described policies be cancelled before the expiration date thereof,notice will be delivered in accordance with
the policy provisions. But,failure to mail such notices shall impose no obligation for liability of any kind upon the insurer,its agents or representatives.
REVOCATION OF MEMBERSHIP-will result in cancellation of coverage.
FACILITY OWNER SHOULD VERIFY THIS CERTIFICATE.
Go to wi .aausports.org,Membership,Insurance,Issued Third Party Certificates, Insert member club code
W EW Ma&APPent I?ivisi Y.
REVIEWED&APPROVED BY:
Certificate No.20254314 °I1111111 It F fi1-s-g�4 Aeci,44
Authorized Representative ®' Risk Management Specialist