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HomeMy WebLinkAbout2009 11 09 Regular 603 Municipal Services Agreement Between The City And Winter Springs Senior Center COMMISSION AGENDA Consent ITEM 603 Informational Public Hearing Regular X November 9, 2009 Meeting 1 3a lo5 Mgr. Att. Dept. p REQUEST: The City Attorney, City Manager and Parks and Recreation Director present a proposed Municipal Services Agreement between the City and Winter Springs Senior Center, Inc. for senior services to be provided at the Winter Springs Senior Center. PURPOSE: The purpose of the Municipal Services Agreement between the City and Winter Springs Senior Center, Inc. (WSSC) is to memorialize, in writing, the programs, functions, and services that the WSSC will be providing at the Winter Springs Senior Center. The purpose of the Agreement is to also memorialize operational and facility rules and requirements that are relevant to the programs, functions, and services being provided by the WSSC. APPLICABLE LAW AND PUBLIC POLICY: 1. Florida Municipal Home Rule Powers Act. 2. Opinions of the Florida Attorney General, 2006 -40; 2006 -12, 1983 -06. 3. Article VII, Section 10, Florida Constitution. Page 1 of 6 CONSIDERATIONS: 1. The City of Winter Springs owns public facilities on Edgemon Drive that have been used as a community senior and civic center for over 20 years. This facility has been extremely successful and is a vital part of the Winter Springs community, as more recently evidenced by the infrastructure investments (e.g. therapy pool) approved by the City Commission. 2. At the request of the City Commission, the City Commission was thoroughly briefed on February 23, 2009 regarding the on -going operations at the Winter Springs Senior Center, including the fact that Winter Springs Senior Center, Inc. "Corporation), a Florida non profit corporation, has been operating out of the Winter Springs Senior Center for over 20 years. 3. At the conclusion of the briefing on February 23` the City Commission directed that the City Attorney and City Manager negotiate a written agreement with the WSSC in order to memorialize the programs, functions, and services that the WSSC will be providing at the Winter Springs Senior Center. In addition, the City Commission directed that the agreement memorialize operational and facility rules and requirements that are relevant to the programs, functions, and services being provided by the WSSC. 4. As a general principle of law, Florida recognizes that non profit corporations can be effectively used to assist the City in providing activities and programs that serve a municipal purpose. See Fla. Op. Atty Gen'l 83 -06 (city could fund a pop -warner football program operated by a non profit corporation). Undoubtedly, the operation of the Winter Springs Senior Center serves a municipal purpose. Therefore, the WSSC can be used to assist the City in fulfilling the municipal purpose of operating the Winter Springs Senior Center and providing programs, functions, and services to seniors. Importantly, the WSSC and its members can also be used to help the City defray the costs associated with operating the Winter Springs Senior Center. 5. Subsequent to the February 23` Commission meeting, the City Manager, City Attorney, City Parks and Recreation Director, and the City Seniors Manager met with representatives of the WSSC to discuss and negotiate a written agreement in accordance with the City Commission's direction. 6. The discussions and negotiations resulted in the WSSC and the City mutually agreeing to present the attached Municipal Services Agreement to the City Commission for final approval, with the exception of insurance requirements which are set forth in paragraph 37.0, Insurance Requirements. The insurance requirement is addressed below and three options are presented by City staff to in order to address the City Attorney's recommendation regarding the insurance requirement. 7. The specific details of the agreement are set forth in the attached Municipal Services Agreement. In summary, however, the Municipal Services Agreement provides: A. WSSC will, at its expense, coordinate and provide programs, functions, and services for senior citizens at the Winter Springs Senior Center including, but not limited to: Page2of 6 a) Educational classes and seminars related to computers, driving, internet usage, Art, AARP sponsored programs, medical issues, and other informative topics deemed reasonable for a cultural and recreational senior center. b) Exercise classes such as Tai Chi, Yoga, Jazzercise, swimming, and similar type activities. c) Dance classes and events. d) BINGO. e) Recreational games such as Bridge, Billards, Cards, BUNCO, and similar type activities. f) Organized breakfasts, luncheons and dinners. g) Field trips to museums, events, or other attractions. h) Book and movie clubs. i) Other programs, functions, and services approved by WSSC and the City. B. In addition, WSSC will provide, at its expense: a) A number of computers and printers for use by seniors, with internet connection and supplies. b) A monthly calendar of senior programs, functions, and services. c) An adequate stock of miscellaneous beverage supplies lies for the kitchen at the Senior Center q g including coffee, tea, creamers, and milk, as well as miscellaneous paper products for the kitchen at the Senior Center such as paper plates and utensils, paper towels, and napkins d) Other equipment and furniture at the Senior Center with the City prior approval. C. The Agreement also addresses relevant operational rules such as: a) Gambling at the Senior Center is prohibited, except for BINGO and Penny -ante games authorized by Florida law. b) The City's priority right to use the Senior Center for other municipal purposes and to maintain the Center. c) WSSC's right to continue to accept members. However, such membership shall not be Page3of 6 required for a person to use the Senior Center. d) To the extent required by the City or law, WSSC will conduct background checks on officers. employees, and volunteers hired or retained by WSSC. e) The City's sole and absolute discretion to adopt additional rules and procedures for the use of the Senior Center, and WSSC obligation to abide by said rules and procedures. [The Parks and Recreation Director is working on finalizing an update to these rules and procedures] D. While there is not a definitive term set forth in the Agreement, the City may terminate the Agreement with at least 7 days written notice, without penalty, or immediately for cause. general During discussion with WSSC, the City learned that the WSSC does not currently have b eneral liability or 0 E insurance coverage. The City's current policy requires persons and entities contracting with the City to provide some acceptable level of insurance coverage as a condition of contracting with the City. The insurance is required to cover the City' s potential liability from any injury or loss sustained at a private event or for actions taken by private entities in furtherance of their performance under a contract with the City. Consistent with this sound policy, Paragraph 37, as currently written, requires WSSC to provide general liability insurance with minimum coverage limits in the amount of $1,000,000. 9. At the latest meeting between City staff and representatives from WSSC, the City Manager offered to assist WSSC with securing a quote for general liability insurance coverage by requesting a quote from the Florida League of Cities. WSSC also agreed to shop the market for insurance coverage. 10. After the City Manager and City Attorney responded to numerous questions received from the Florida League of Cities for quoting purposes, the Florida League of Cities provided the City Manager with a quote from Nautilus Insurance Company. The insurance coverage would cover WSSC for commercial general liability. The City would be named as an additional insured under the WSSC policy. The annual premium for the commercial general liability policy was quoted as $3,744.27 including terrorism coverage, and $3,611.64 without terrorism coverage. The Florida League of Cities also quoted an accidental death dismemberment, paralysis, and medical expense benefit for two options with a cost of $2,500 and 3,000. This entire quote was forwarded to WSSC for consideration. As of the date of this agenda item, WSSC has not presented any quote to the City, nor have they committed to accept any of the coverage quoted by the Florida League of Cities. 11. Moreover, as of the date of this agenda item, it is uncertain whether or not WSSC will agree to providing the insurance coverage required by City policy due to the cost of acquiring the coverage. 12. If WSSC does not provide the insurance coverage as set forth in Paragraph 37, the City Commission could choose one of the following options: Page4of 6 a) The City Commission could waive the insurance coverage requirement and delete paragraph 37 in its entirety. [The City Attorney highly recommends against this option] b) The City Commission can require the insurance coverage as set forth in paragraph 37, and if WSSC refuses to provide it, WSSC will no longer be able to provide the programs, functions, and services it currently provides at the Senior Center. c) The City Commission can agree to pay the entire cost of the insurance policy if the City Commission determines that the dedication of public funds to acquire the insurance policy to cover liability of both the City and the WSSC serves a municipal purpose. See Opinion of the Florida Attorney General, 2006 -12 (the town's dedication of public funds to pay for insurance to cover liability of the City and a non -profit homeowner's association's use of the town's community hall appears to be permissible if the city commission determines the dedication serves a municipal purpose). d) The City Commission and WSSC can agree to split the cost of the insurance policy in some equitable manner. See Opinion of the Florida Attorney General, 2006 -12. BUDGETARY IMPACT: The WSSC has agreed to continue to provide the programs, functions, and services at the Senior Center at their own expense. Therefore, there is no budgetary impact for the services provided by WSSC. However, depending on City Commission's decision on the insurance options outlined above in paragraph 12, there may be a budgetary impact related to acquiring insurance coverage for the WSSC and the City as an additional named insured. If the Commission chooses to pay all or part of the insurance premium, the City Manager will have to identify a City funding source. STAFF RECOMMENDATION: The City Attorney, City Manager, and Parks and Recreation Director recommend that the City Commission approve the Municipal Services Agreement, with whatever modifications deemed necessary by the City Commission. The City Attorney, City Manager, and Parks and Recreation Director also recommend that the City Commission provide direction on the insurance coverage issue identified above and select one of the options set forth in paragraph 12 of this Agenda Item. Said option will be incorporated into paragraph 37 of the Municipal Services Agreement. ATTACHMENT: 1. Municipal Services Agreement Page 5 of 6 2. Insurance quote provided by the Florida League of Cities. COMMISSION ACTION: On February 23, 2009, the City Commission directed that the City Attorney and City Manager prepare a municipal services agreement with the WSSC for providing programs, functions, and services at the Senior Center.. Page 6 of 6 MUNICIPAL SERVICES AGREEMENT THIS AGREEMENT is made and entered into this day of 2009, by and between the CITY OF WINTER SPRINGS, FLORIDA, a Florida municipal corporation "City and WINTER SPRINGS SENIOR CENTER, INC., Florida nonprofit corporation "Service Provider RECITALS: WHEREAS, the City desires to continue providing wholesome and entertaining programs, functions, and services to its senior citizens; and WHEREAS, the City finds that these programs, functions, and services serve a public purposes; and WHEREAS, the Service Provider is a not for -profit Florida corporation, which desires to continue providing senior programs, functions, and services for the benefit of the citizens of the City of Winter Springs; and WHEREAS, the City Council believes the programs and services to be provided through the programs of the Service Provider within the City of Winter Springs have and will continue to benefit all residents of the City, especially the seniors; and WHEREAS, the Service Provider has requested to assist the City in off setting the costs associated with providing the programs, functions and services necessary to meet the needs and desires of the residents of the City; and WHEREAS, the parties recognize, this Agreement is necessary to ensure that the programs, functions and services provided pursuant to this Agreement ultimately serve the aforesaid public purpose; and WHEREAS, the parties agree that the services provided by the Service Provider hereunder are for the benefit of the public health, safety, welfare, convenience and morals of the citizens of the City of Winter Springs. NOW THEREFORE, in consideration of the mutual promises and covenants herein, and other good and valuable consideration which the parties agree has been exchanged and received the parties agree as follows: 1.0 Recitals. The foregoing recitals are deemed to be true and accurate and are fully incorporated herein by this reference. Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 1 of 13 2.0 Definitions. For purposes of this Agreement, the following terms and words shall have the meaning ascribed to them, unless the context clearly indicates otherwise: (a) "Agreement" or "Contract" shall be used interchangeably and shall refer to this Agreement, as amended from time to time, which shall constitute authorization for the Service Provider to provide the Municipal Services stated herein. (b) "City" is the City of Winter Springs, a Florida municipal corporation. (c) "Effective Date" shall be the date on which the last signatory hereto shall execute this Agreement, and it shall be the date on which this Agreement shall go into effect. The Agreement shall not be effective against any party until said date. (d) "Facilities" shall mean the senior center owned by the City and located on Edgemon Drive in Winter Springs, Florida. (e) "Funds" shall mean the monies paid by the City to the Service Provider in accordance with paragraph 4.0 of this Agreement, if any. (f) "Public Record" is as described in Section 119.011(1), Florida Statutes. (f) "Service Provider" is Winter Springs Senior Center, Inc., a Florida non profit corporation. (g) "Work" or "Municipal Services" shall be used interchangeably and shall refer to the performance of the services outlined in paragraph 5.0 of this Agreement. (h) "Wrongfully Expended Funds" is defined in paragraph 15.0 of this Agreement. 3.0 Engagement. The City desires to maintain a recreational and cultural program for seniors which will be hosted primarily at the Facilities. In furtherance of this desire, the City hereby engages the Service Provider and the Service Provider agrees to perform the Municipal Services outlined in paragraph 5.0 of this Agreement under the terms and conditions herein. 4.0 Funds; Use of City of Winter Springs Senior Center Facilities. (a) The City is not be responsible for funding the municipal services provided by Service Provider under this Agreement. The parties recognize that Service Provider raises revenue through membership dues, donations, fees, and surplus proceeds earned through programs, services, and functions held by Service Provider from time -to -time ("Revenue Service Provider agrees that this Revenue, less Service Provider's reasonable business expenses and charitable donations, will be used Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 2 of 13 to fund programs, services, and functions provided by Service Provider under this Agreement. However, at the City's sole and absolute discretion, the City may choose to also fund, in whole or in part, other or supplemental programs, functions, and services for seniors at the Facilities. Said programs, functions, and services may be performed independent of those programs, functions, and services provided by Service Provider, or alternatively, they may be performed together with the Service Provider. Any funds provided by the City under this Agreement must be lawfully budgeted and appropriated for such purpose during the City's current fiscal year. (b) Subject to the provisions of Paragraph 8.0 of this Agreement, Service Provider shall have the use of the Facilities to provide the programs, functions, and services required by this Agreement. It is understood that the Service Provider may have the use of the Facilities for their membership activities provided said activities are in furtherance of and consistent with, the programs, functions, and services required by this Agreement. 5.0 Municipal Services Provided by Service Provider. In cooperation with the City, the Service Provider agrees, at its expense, to coordinate and provide programs, functions, and services for senior citizens at the Facilities. Said senior programs, functions, and services shall include: 5.1 Educational classes and seminars related to computers, driving, intemet usage, Art. AARP sponsored programs, medical issues, and other informative topics deemed reasonable for a cultural and recreational senior center. 5.2 Exercise classes such as Tai Chi, Yoga, Ja77ercise, swimming, and similar activities. 5.3 Dance classes and events. 5.4 BINGO pursuant to the terms and conditions of paragraph 7.0. 5.5 Recreational games such as Bridge, Billards, Cards, BUNCO, and similar activities subject to the terms and conditions of paragraph 7.0. 5.6 Organized breakfasts, luncheons and dinners. 5.7 Field trips to museums, events, or other attractions. 5.8 Book and movie clubs. 5.9 Other programs, functions, and services approved by Service Provider and the City. Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 3 of 13 6.0 Additional Responsibilities of Service Provider. 6.1 Service Provider will provide and maintain a number of computers and printers for use by seniors at the Facilities. Said computers will have an internet connection. Service Provider agrees to provide, at its expense, the internet service and computer supplies such as paper, ink, and other supplies for the computers and printers. 6.2 Service Provider will provide an updated monthly calendar of senior programs, functions, and services. 6.3 Service Provider will provide and maintain an adequate stock of miscellaneous beverage supplies for the kitchen at the Facilities including coffee, tea, creamers, and milk. In addition, Service Provider will also provide and maintain miscellaneous paper products for the kitchen at the Facilities such as paper plates and utensils, paper towels, and napkins. The beverage supplies and paper products provided by the Service Provider shall only be used for the senior programs, functions, and services. 6.4 With the City's prior written approval, Service Provider may also provide and maintain other equipment and furniture at the Facilities. However, to the extent that the equipment and furniture is not donated to, and accepted by, the City, said equipment and furniture must be inventoried at all times by mutual agreement of the parties. In addition, such equipment and furniture, to the extent physically feasible, must be properly labeled by Service Provider with an identification tag or permanent marker evidencing Service Provider's ownership. Any of Service Provider's equipment or furniture located at the Facilities prior to the effective date of this Agreement, will be inventoried and tagged, or marked within thirty (30) days by mutual agreement of Service Provider and City. The City shall not be liable for any loss or damage to Service Provider's equipment and furniture located at the Facilities, unless such loss or damage was directly caused by a City employee. 6.5 Service Provider will be responsible for routine clean-up after every program, function, or service provided by Service Provider at the Facilities including, but not limited to, disposing of trash, removing debris from tables and the floor, washing dishes, pots, and utensils, and putting away items in their assigned place. 7.0 Gambling Prohibited. Gambling at the Facilities is strictly prohibited. In furtherance of this prohibition, Service Provider agrees to periodically advise its members of this prohibition at appropriate times, and to take such actions that are necessary to prohibit its members and any invitee thereof from gambling at the Facilities. Notwithstanding, in accordance with Florida law, the following activities shall not be considered gambling: (1) BINGO provided the BINGO activity is conducted in accordance with section 949.0931, Florida Statutes, as may be amended; and (2) Penny -ante games defined and conducted in accordance with section 849.085, Florida Statutes, as may be amended. Service Provider shall familiarize itself with the aforementioned statutes. A Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 4 of 13 copy of the current applicable statutes are attached hereto as EXHIBIT "A." 8.0 City's Use and Maintenance of Facilities. Service Provider understands and agrees that the Facilities are owned by the City, and that as owners, the City has the priority right to use the Facilities for other municipal purposes, and to maintain said Facilities. Service Provider also understands and agrees that the municipal services provided by Service Provider hereunder may need to be rescheduled because of or coordinated in advance with, the City's other scheduled events for the Facilities or the City's maintenance of the Facilities. Service Provider agrees to fully cooperate with the City in scheduling and conducting any programs, functions, and services at the Facilities. 9.0 Association Membership. The parties recognize that Service Provider has adopted By -Laws whereby individuals, who are fifty -five years of age and older and residents of Seminole County, are eligible to become members of the association organized and managed by Service Provider. In addition, members are required to pay annual dues to become a member of the association. The City understands that this is a private membership organized under Florida corporate law. Further, the City agrees that the Service Provider may continue to offer this private membership opportunity in conjunction with the services provided hereunder. However, Service Provider understands and agrees that individuals do not have to become members of the association in order to use the Facilities. While Service Provider may explain the benefits and privileges of becoming a member of the association, Service Provider shall not represent to any individual, under any circumstance, that membership in the association is a condition for using the Facilities, or participating in a senior function, program, and service provided by the City under this Agreement. 10.0 Background Checks; Employment Restrictions. 10.1 To the extent required by the City or law, Service Provider shall conduct criminal, civil and employment background checks on the officers, employees, and volunteers hired or retained by Service Provider. Upon request by the City, the results of these background checks shall be made immediately available to the City for inspection. 10.2 Service Provider shall not allow any of its officers, employees or volunteers to perform any services that are provided hereunder if said officer, employee or volunteer has been convicted, or found in violation of, any elder abuse statute including, but not limited to, section 825.102, Florida Statutes and chapter 415, Florida Statutes. For purposes of this subsection, the terms "convicted" or "found in violation of shall include not only a court adjudication of guilty or civil judgment in violation, but shall also include a plea of nolo contendere and any pending formal criminal charge or pending civil action brought against an officer, employee, or volunteer of Service Provider. 11.0 Facilities Rules Adopted by the City. The City has the sole and absolute discretion to adopt rules and procedures for the use of the Facilities. Service Provider agrees to Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 5 of 13 familiarize itself with the rules and procedures and to abide by them at all times. Moreover, Service Provider will enforce said rules and procedures against individuals or its members to the extent said individuals or members are participating in any services, functions, or programs provided by Service Provider hereunder. 12.0 Professionalism and Standard of Care. The Service Provider shall do, perform and carry out in a professional mariner all services required to be performed by this Agreement. Service Provider shall also use the degree of care and skill in performing the services that are ordinarily exercised under similar circumstances by reputable members of Service Provider's profession working in the same or similar locality as Service Provider. 13.0 Submittal of Progress Reports. On an annual basis, the Service Provider shall provide an annual financial report to the City. In addition, Service Provider shall submit upon request of the City a written progress report as to the status of all services set forth in this Agreement and to the success of the project. The report shall in a sufficient manner demonstrate that any Funds expended were used to provide senior programs, functions, and services to Facilities. If the detail in any report is not sufficient in the City Manager's reasonable discretion to permit the City to determine the financial status of the Service Provider, services performed or the manner in which services are being performed, the City may seek more detailed information from the Service Provider. Service Provider agrees to provide that infoiniation within a reasonable time period. 14.0 Warranty of Professional Services. The Service Provider (for itself and any of its employees, contractors, partners, and agents used to perform the services provided hereunder) hereby warrants unto the City that all of its employees (and those of any of its contractors, partners, and agents used to perform the services) have sufficient experience to properly complete the services specified herein or as may be performed pursuant to this Agreement. In pursuit of any services, the Service Provider shall supervise and direct the services, using its best skill and attention and shall enforce strict discipline and good order among its employees. The Service Provider shall comply with all laws, ordinances, rules, regulations, and lawful orders of any public authority hearing on the performance of the services. 15.0 Services are a Private Undertaking. With regard to any and all services performed hereunder, it is specifically understood and agreed to by and between the parties hereto that the contractual relationship between the City and Service Provider is such that the Service Provider is an independent contractor and not an agent of the City. The Service Provider, its officers, contractors, partners, agents, volunteers, and their employees are independent contractors and not employees of the City. Nothing in this Agreement shall be interpreted to establish any relationship other than that of an independent contractor, between the City, on one hand, and the Service Provider, its officers, contractors, partners, employees, volunteers, or agents, during or after the performance of the services under this Agreement. 16.0 Compliance Monitoring. Service Provider agrees that City control and monitoring Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 6 of 13 III of any Funds provided by the City hereunder is necessary to insure that Service Provider is expending said Funds in furtherance of the public purposes declared by the City under this Agreement. 17.0 Public Records. Service Provider agrees that all documents, transactions, writings, papers. letters, tapes, photographs, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to this Agreement, or in connection with any Funds provided by the City and expended by Service Provider pursuant to this Agreement, are considered public records pursuant to Chapter 119, Florida Statutes. All public records shall be retained for a period of three (3) years after the termination of this Agreement, or after resolution of all on -going state or local audits, whichever occurs later. 18.0 Audit and Inspections. All Service Provider's records with respect to any matters covered by this Agreement shall be made available to the City, at any time during normal business hours, as often as the City deems necessary, to audit, examine, and make excerpts or transcripts of all relevant data. If said records are located on property owned, leased, or used by Service Provider or its officers, the City shall be given a right of entry onto said property for purposes of performing the audit and examination authorized by this paragraph. Any deficiencies noted in audit reports must be fully cleared by the Service Provider within thirty (30) days after receipt by the Service Provider. Failure of the Service Provider to comply with the above audit requirements will constitute a material breach of this Agreement and may result, at the sole discretion of the City, in the withholding of future Funds or immediate return to the City any Funds provided by this Agreement. 19.0 Civil Rights. The Service Provider agrees to comply with any and all federal, state and local civil rights laws, including, but not limited to Title VI of the Civil Rights Act of 1964 as amended; Title VII of Civil Rights Act of 1968 as amended; Section 109 of Title I of the Housing and Community Development Act of 1974; Section 504 of the Rehabilitation Act of 1973; the Americans with Disabilities Act of 1990; the Age and Discrimination Act of 1975; Executive Order 11063; and with Executive Order 11246 as amended by Executive Orders 11375 and 12086. 20.0 Nondiscrimination. The Service Provider will not discriminate against any person because of race, color, creed, religion, ancestry. national origin, sex, disability or other handicap, age, marital status, or status with regard to providing services under this Agreement. The Service Provider will take affirmative action to insure that all employment practices and services provided hereunder are free from such discrimination. Such employment practices include, but are not limited to, the following: hiring, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. The Service Provider agrees to provide notice to all its existing and prospective officers, employees, and volunteers of the provisions of this nondiscrimination clause. 21.0 Representation and Warranties. Service Provider represents and warrants that it shall use any and all Funds received from the City under this Agreement for the sole purpose of Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 7 of 13 performing the services provided in paragraph 5.0 herein. In the event the City provides said Funds, and Service Provider then fails to expend such Funds for said purpose (Wrongfully Expended Funds). Service Provider shall fully reimburse the City the Wrongfully Expended Funds plus interest calculated at maximum rate allowable under Florida law per annum. If the City must take any legal action to collect any Wrongfully Expended Funds, the Service Provider shall be liable for all costs incurred by the City to collect such Funds including, but not limited to, reasonable attorneys fees, filing fees, and other costs. 22.0 Severability. Should any paragraph or any part of any paragraph of this Agreement be rendered void, invalid, or unenforceable by any court of law, for any reason, such a determination shall not render void, invalid, or unenforceable any other paragraph or any part of any paragraph in this Agreement. 23.0 Choice of Law; Venue. This Agreement has been made and entered into in the State of Florida, County of Seminole, and the laws of such state shall govern the validity and interpretation of this Agreement and the performance due hereunder. The parties agree that venue shall be exclusively in Seminole County, Florida, for all state court actions or disputes which arise out of or based upon this Agreement, and in Orlando, Florida for all federal court actions or disputes which arise out of or are based upon this Agreement. 24.0 Integration; Modification. The drafting, execution, and delivery of this Agreement by the Parties has been induced by no representations, statements, warranties, or agreements other than those expressed herein. This Agreement embodies the entire understanding of the parties, and there are no further or other agreements or understandings, written or oral, in effect between the parties relating to the subject matter hereof unless expressly referred to herein. Modifications of this Agreement shall only be made in writing signed by both parties. 25.0 Attorney's Fees. Should either party bring an action under the terms and conditions of this Agreement, each party agrees to bear their own attorney's fees and costs in said action. 26.0 Headings. All headings in this Agreement are for convenience only and shall not be used to interpret or construe its provisions. 27.0 Waiver. Any waiver by City of any breach or violation of Service Provider's obligations under this Agreement shall not be construed as a continuing waiver or consent to any subsequent breach or violation. 28.0 Corporate Representations. Service Provider makes the following representations to City: 28.1 Service Provider is duly organized and in good standing under the laws of the Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 8 of 13 State of Florida, and is duly qualified and authorized to carry on the functions, responsibilities, and obligations in this Agreement. 28.2 The undersigned signatory for Service Provider has the power, authority, and the legal right to enter into and perform the obligations set forth in this Agreement and all applicable exhibits thereto, and the execution, delivery, and performance hereof by Service Provider has been duly authorized by the board of directors and/or president of Service Provider. In support of said representation, Service Provider agrees to provide a copy to the City of a corporate certificate of good standing provided by the State of Florida prior to the execution of this Agreement. 29.0 No Joint Venture. No provision contained herein shall be construed as creating a joint venture between the parties. 30.0 Notices. Communication and details concerning this Agreement shall be directed to the following contact representatives: Attn: City Manager Attn: Gary W. Coffman, President City of Winter Springs Winter Springs Senior Center, Inc. 1126 East S.R. 434 400 North Edgemon Avenue Winter Springs, Florida 32708 Winter Springs, Florida 32708 (407) 327 -5957 (407) 327 -4031 with copy to Anthony A. Garganese, City Attorney Brown, Garganese, Weiss D'Agresta, P.A. P.O. Box 2873 Orlando, Florida 32802 -2873 407 425 -9566 The foregoing addresses and representatives may be amended by any party at any time during the term of this Agreement by providing the other party written notice of said amendment. 31.0 Time of Performance/Term. Time is of the essence under this Agreement. The services provided by the Service Provider shall begin immediately upon execution of this Agreement. To the extent that the City has provided any Funds to Service Provider under this Agreement, and Service Provider has failed to expend all the Funds appropriated within a given year, the City, at its sole discretion, may require Service Provider to immediately return to the City any and all Funds not properly expended or allow Service Provider additional time to properly expend the Funds pursuant to this Agreement. Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 9 of 13 32.0 Termination by City; Curing Defaults. 32.1 The City may terminate this Agreement at any time, without penalty, by providing Service Provider with at least seven (7) calendar days written notice. However, the City may immediately terminate this Agreement if Service Provider has materially failed to comply with any term of this Agreement or discontinues (in the sole opinion of the City) providing the services required by this Agreement. Upon termination, Service Provider shall: (i) discontinue providing the services provided hereunder; (ii) remit to the City any Funds provided by the City that have not been expended; (iii) remove its property from the Facilities under the supervision of the City; and (iv) notify in writing its members, officers, employees, volunteers, and contractors of the termination. 32.2 If Service Provider is in default of any provision set forth in this Agreement, the City shall provide Service Provider with at least five (5) calendar days to cure the default prior to termination. If default has not been cured, to the satisfaction of the City, within the cure period, the City may, at its sole option, extend the time period to cure the default or terminate this Agreement. If the City terminates this Agreement for cause, it can elect any remedy provided by law, including, but not limited to, immediately requiring repayment of any and all of the Funds provided in paragraph 4.0 herein. In addition, the City may declare Service Provider ineligible to participate in any other City program, service, and function. 33.0 Indemnification and Hold Harmless. For all services performed pursuant to this Agreement, the Service Provider agrees to the fullest extent permitted by law, to indemnify and hold harmless the City, its employees, attorneys and officers, from and against all claims, losses, damages, personal injuries (including but not limited to death), or liability (including reasonable attorney's fees), directly or indirectly arising from, or out of the following: (a) the acts, errors, omissions, intentional or otherwise, arising out of or resulting from Service Provider's and its officers, employees, partners, contractors, volunteers, and agents performance ofthe services being performed under this Agreement; (b) Service Provider's, and its officers, employees, partners, contractors, volunteers, and agents failure to comply with the provisions of any federal, state, or local laws, ordinance, or regulations applicable to Service Provider and its officers, employees, partners, contractors, volunteers, and agents performance under this Agreement; (c) any fraud and misrepresentation conducted by Service Provider and its officers, employees, partners, contractors, volunteers, and agents against the City or any person participating in any program, function, and service conducted pursuant to this Agreement; (d) Service Provider's and its officers, employees, partners, contractors, volunteers, and agents failure to properly expend any Funds provided by the City pursuant to this Agreement. The indemnification provided above shall obligate the Service Provider to defend at its own expense or to provide for such defense, at the option of the City, of any and all claims of liability and all suits and actions of every name and description that may be brought against the City or its Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 10 of 13 employees and officers which may result from the services performed under this Agreement whether the services are performed by the Service Providers, its officers, employees, contractors. partners, volunteers. and agents or anyone directly or indirectly employed by the Service Provider. In all event the City shall be permitted to choose legal counsel of its sole choice, the fees for which shall be reasonable and subject to and included with the indemnification provided herein. 34.0 Assignment. This Agreement shall not be assigned by Service Provider. 35.0 Bankruptcy. The Service Provider hereby warrants and guarantees unto the City that it has not filed for bankruptcy or is subject to appointment of a receiver as of the Effective Date hereof. If Service Provider has filed for or files for bankruptcy, should be adjudged bankrupt, is subject to appointment of a receiver, or makes a general assignment for the benefit of creditors, the City, upon not less than three (3) days written notice to the Service Providers, without prejudice to other remedies or rights that the City may have, may terminate this Agreement and require immediate repayment of any Funds provided by the City that have not been expended by Service Provider pursuant to this Agreement or Wrongfully Expended Funds. 36.0 No City Obligation for Future Funds. No provision in this Agreement shall be construed as requiring the City to provide any funds for municipal services under this Agreement or at any time in the future, other than as specifically Y P rovided herein. 37.0 Insurance Requirements. For all programs, functions, and services provided by Service Provider under this Agreement, including any and all programs, functions, and services provided and performed by Service Provider and by authorized contractors hired by Service Provider hereunder, the Service Provider shall purchase and maintain, at its own expense, such general liability insurance to cover claims for damages because of bodily injury or death of any person or property damage arising in any way out of the programs, functions, and services performed by Service Provider and its authorized contractors under this Agreement. The insurance shall have minimum limits of coverage of $1,000,000.00 per occurrence combined single limit for bodily injury liability and property damage liability. All insurance coverage shall be insurer(s) approved by the City Manager and licensed by the state of Florida to engage in business of writing of insurance. The City shall be named on the foregoing insurance policies as "additional insured." The Service Provider shall cause its insurance carriers to furnish insurance certificates and endorsements specifying the types and amounts of coverage and effect pursuant hereto, the expiration date on such policies, and the statement that no insurance under such policies will be cancelled without thirty (30) days prior written notice to the City in compliance with other provisions of this Agreement. The Service Provider shall be solely responsible to pay any deductible, if any, relating to any claim made against the insurance coverages and policies provided under this Agreement. If the City has any objection to the coverage afforded by or other provision of the insurance required to be purchased and maintained by the Service Provider in accordance with this paragraph on the basis of its not complying with the Agreement, the City shall notify the Service Provider in writing thereof within thirty (30) days of the date of deliver of such certificates and endorsements to the City. For all Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 11 of 13 programs, functions, and services permitted and occurring under this Agreement, including any and all programs, functions, and services provided and performed by Service Provider and by authorized contractors, the Service Provider shall continuously maintain such insurance in the amount, type, and quality as required by this paragraph. [Intentionally Left blank, execution on the following page] Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 12 of 13 IN WITNESS WHEREOF, this Agreement is entered into as of the day and year the last party signs this Agreement as stated below. WITNESS: WINTER SPRINGS SENIOR CENTER, INC. Print Name: Print Name: By: Gary W. Coffman Its: President Date: ATTEST: CITY OF WINTER SPRINGS: Andrea Lorenzo- Luaces, City Clerk By: John F. Bush, Mayor Date: Municipal Services Agreement City of Winter Springs and Winter Springs Senior Center, Inc. Page 13 of 13 Insured: Winter Springs Senior Center Inc Insurer: Nautilus Insurance Company Scheduled Location: 400 North Edgemon Avenue Winter Springs FL 32708 Coverage: Commercial General Liability Limit of Liability: $1,000,000 Each Occurrence $2,000,000 General Aggregate $2,000,000 Products /Completed Operations Aggregate $1,000,000 Personal and Advertising Injury $100,000 Fire Damage (any one fire) $5,000 Medical Payments (any one person) Policy Term: One year from inception Conditions: Exclusions: Liquor Liability; Assault Battery; Violation of Statutes; Certain Completed Related Losses; Employment Related Practices; Total Pollution $500 Deductible Additional Insured(s): Club Members 25% Minimum Earned Premium No Flat Cancellation OCCURRENCE FORMAT This Quote Expires: 10/28/2009 Required in order to bind coverage: Completed, signed and dated application Completed, signed and dated terrorism form Premium option Other terms, conditions and exclusions as described in policy Premium: $3,194.00 Premium $35.00 Policy Fee $175.00 Inspection Fee $125.00 TRIA Premium $176.45 Surplus Lines Tax (5 $3.53 Surplus Lines Stamping Fee (0.1%) $35.29 1% Florida Hurricane CAT Fund Surcharge $3,744.27 Total Premium with TRIA $3,611.64 Total Premium without TRIA Payment Terms: Premium in full prior to binding The Nautilus Insurance Company is an approved, non licensed insurer in the State of Florida. It. is not subject to the Guaranty Fund. The A.M. Best rating is A+ IX. ---.N ERC IAL INSURANCE APPLICATION ACOR COMMERCIAL DATE (MMIDD /YYYY) APPLICANT INFORMATION SECTION 09/23/2009 AGENCY CARRIER NAIC CODE Florida League of Cities PO Box 530065 COMPANY POLICY OR PROGRAM NAME PROGRAM CODE Orlando FL 32853 -0065 POLICY NUMBER CONTACT Ms. Melissa Solis, Underwriter UNDERWRITER UNDERWRITER OFFICE PHONE 800 x1831 (A/C, No, Ext): FAX 407 425 9378 (A/C. Nol: QUOTE ISSUE POLICY RENEW E MAIL 1 flitl m S0 5 ce S.COm STATUS OF ADDRESS: TRANSACTION BOUND (Give Dale and/or Attach Copy): CODE: I SUBCODE: I CHANGE DATE TIME AM AGENCY CUSTOMER ID: CANCEL 7 PM SECTIONS ATTACHED INDICATE SECTIONS ATTACHEE PREMIUM PREMIUM I PREMIUM ACCOUNTS RECEIVABLE I ELE DATA PROC S r TRANSPORTATION VALUABLE PAPERS MOTOR TRUCK CARGO BOILER MACHINERY 5 EQUIPMENT FLOATER TRUCKERS MOTOR CARRIER BUSINESS AUTO GARAGE AND DEALERS S UMBRELLA BUSINESS OWNERS 1 GLASS AND SIGN S YACHT S J, COMMERCIAL GENERAL LIABILITY 5 i INSTALLATION BUILDERS RISK CRIME I MISCELLANEOUS CRIME OPEN CARGO DEALERS S PROPERTY S ATTACHMENTS ADDITIONAL INTEREST PREMIUM PAYMENT SUPPLEMENT ADDITIONAL PREMISES I PROFESSIONAL LIABILITY SUPPLEMENT APARTMENT BUILDING SUPPLEMENT RESTAURANT TAVERN SUPPLEMENT CONDO ASSN BYLAWS ((or D &O Coverage only) STATEMENT SCHEDULE OF VALUES CONTRACTORS SUPPLEMENT STATE SUPPLEMENT (If applicable) COVERAGES SCHEDULE VACANT BUILDING SUPPLEMENT DRIVER INFORMATION SCHEDULE I VEHICLE SCHEDULE INTERNATIONAL LIABILITY EXPOSURE SUPPLEMENT INTERNATIONAL PROPERTY EXPOSURE SUPPLEMENT LOSS SUMMARY POLICY INFORMATION PROPOSED EFF DATE PROPOSED EXP DATE BILLING PLAN PAYMENT PLAN METHOD OF PAYMENT AUDIT DEPOSIT MINIMUM PREMIUM POLICY PREMIUM DIRECT :N7 AGENCY S APPLICANT INFORMATION NAME (First Named Insured) AND MAIUNG ADDRESS (including ZIP*4) GL CODE SIC NAICS FEIN OR SOC SEC 11 Winter Springs Senior Center Inc 400 North Edgemon Avenue BUSINESS PHONE e: 407- 327 -5957 WEBSITE ADDRESS Winter Springs FL 32708 CORPORATION i JOINT VENTURE :V i NOT FOR PROFIT ORG SUBCHAPTER "S" CORPORATION INDIVIDUAL LLC NO OF MEMBERS AND MANAGERS- PARTNERSHIP TRUST NAME (Other Named Insured) AND MAILING ADDRESS (including ZIP +4) GL CODE SIC NAICS FEIN OR SOC SEC 5 BUSINESS PHONE It: WEBSITE ADDRESS CORPORATION JOINT VENTURE NOT FOR PROFIT ORG SUBCHAPTER "S' CORPORATION INDIVIDUAL LLC NO OF MEMBERS AND MANAGERS: PARTNERSHIP i TRUST NAME (Other Named Insured) AND MAILING ADDRESS (including ZIP +4) GL CODE SIC NAICS FEIN OR SOC SEC 5 BUSINESS PHONE /1: {r h WEBSITE ADDRESS CORPORATION JOINT VENTURE NOT FOR PROFIT ORG I SUBCHAPTER "S" CORPORATION INDIVIDUAL LLC d/0. OF MEMBERS AND MANAGERS: PARTNERSHIP TRUST ACORD 125 (2009/05) Page 1 of 4 ©1993 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C AGENCY CUSTOMER ID: CONTACT INFORMATION CONTACT TYPE City Manager CONTACT TYPE CONTACT NAME: Mr. Kevin Smith CONTACT NAME: PHONE HOME !J BUS _i CELL pHONE #ARY 71 HOME 7 BUS 7 CELL HOME 7 BUS 7 CELL pHONE RY HOME i_ BUS CELL 407 PRIMARY E -MAIL ADDRESS: PRIMARY E -MAIL ADDRESS: SECONDARY E -MAIL ADDRESS: SECONDARY E -MAIL ADDRESS: PREMISES INFORMATION (Attach ACORD 823 for Additional Premises) LOC STREET 400 North Edgemon Avenue CITY LIMITS INTEREST FULL TIME EMPL ANNUAL REVENUES: S 1 J INSIDE I OWNER OCCUPIED AREA: 4,697 SO FT BLD CITY: Winter Springs STATE: FL OUTSIDE VI TENANT PART TIME EMPL OPEN TO PUBLIC AREA: 4,697 SO FT COUNTY: Seminole ZIP: 32708 TOTAL BUILDING AREA: 4,697 SO FT DESCRIPTION OF OPERATIONS: ANY AREA LEASED TO OTHERS? Y/14 Y LOC it STREET CITY LIMITS INTEREST FULL TIME EMPL ANNUAL REVENUES: S INSIDE OWNER OCCUPIED AREA: S0 FT BLD CITY: STATE: OUTSIDE TENANT it PART TIME EMPL OPEN TO PUBLIC AREA: SO FT COUNTY: ZIP: TOTAL BUILDING AREA: SO FT DESCRIPTION OF OPERATIONS: ANY AREA LEASED TO OTHERS? Y 1 N LOC STREET CITY LIMITS INTEREST FULL TIME EMPL ANNUAL REVENUES: S INSIDE OWNER OCCUPIED AREA: SO FT BLD CITY: STATE: OUTSIDE TENANT PART TIME EMPL OPEN TO PUBLIC AREA: SO FT COUNTY: ZIP: TOTAL BUILDING AREA SO FT DESCRIPTION OF OPERATIONS: ANY AREA LEASED TO OTHERS? Y 1 N LOC it STREET CITY LIMITS INTEREST FULL TIME EMPL ANNUAL REVENUES: S INSIDE OWNER OCCUPIED AREA: S0 FT BLD Si CITY: STATE: OUTSIDE TENANT PART TIME EMPL OPEN TO PUBLIC AREA: SO FT COUNTY: ZIP: TOTAL BUILDING AREA: SO FT DESCRIPTION OF OPERATIONS: ANY AREA LEASED TO OTHERS? Y 1 N NATURE OF BUSINESS APARTMENTS CONTRACTOR MANUFACTURING RESTAURANT SERVICE Rec facility y S STARTE D (MM /D D/YYYY) STARTED CONDOMINIUMS i INSTITUTIONAL OFFICE RETAIL WHOLESALE DESCRIPTION OF PRIMARY OPERATIONS City of Winter Springs senior center being leased by Winter Springs Senior Center Inc for people 55 years or older involving senior activities and charity events. See narrative attached. INSTALLATION, SERVICE OR REPAIR WORK OFF PREMISES INSTALLATION, SERVICE OR REPAIR WORK RETAIL STORES OR SERVICE OPERATIONS OF TOTAL SALES: DESCRIPTION OF OPERATIONS OF OTHER NAMED INSUREDS Included in narrative. ADDITIONAL INTEREST (Not all fields apply to all scenarios provide only the necessary data) Attach ACORD 45 for more Additional Interests INTEREST NAME AND ADDRESS RANK: I EVIDENCE: CERTIFICATE I POLICY SEND BILL INTEREST IN ITEM NUMBER ADDITIONAL LOSS PAYEE LOCATION: BUILDING: Y_ INSURED BREACH OF MORTGAGEE City of Winter Springs VEHICLE: BOAT: WARRANTY CO -OWNER OWNER 1126 East SR 434 AIRPORT: AIRCRAFT: EMPLOYEE AS LESSOR REGISTRANT F ITEM CLASS: ITEM: LEASEBACK OWNER TRUSTEE Winter Springs FL 32708 ITEM DESCRIPTION LIENHOLDER REFERENCE 1 LOAN INTEREST END DATE LIEN AMOUNT: PHONE (A/C, No, Ext): FAX (AIC, No): REASON FOR INTEREST: E -MAIL ADDRESS: ACORD 125 (2009/05) Page 2 of 4 G AGENCY CUSTOMER ID: GENERAL INFORMATION EXPLAIN ALL "YES" RESPONSES Y 1 N 1a. IS THE APPLICANT A SUBSIDIARY OF ANOTHER ENTITY N PARENT COMPANY NAME RELATIONSHIP DESCRIPTION X OWNED lb. DOES THE APPLICANT HAVE ANY SUBSIDIARIES? N SUBSIDIARY COMPANY NAME RELATIONSHIP DESCRIPTION OWNED 2. IS A FORMAL SAFETY PROGRAM IN OPERATION'. Y SAFETY MANUAL MONTHLY MEETINGS SAFETY POSITION OSHA 3. ANY EXPOSURE TO FLAMMABLES, EXPLOSIVES, CHEMICALS' N 4. ANY OTHER INSURANCE WITH THIS COMPANY? (List policy numbers) N LINE OF BUSINESS POUCY NUMBER LINE OF BUSINESS POUCY NUMBER 5. ANY POLICY OR COVERAGE DECLINED, CANCELLED OR NON RENEWED DURING THE PRIOR THREE (3) YEARS FOR ANY PREMISES OR N OPERATIONS? (Missouri Applicants Do not answer this question) NON- PAYMENT AGENT NO LONGER REPRESENTS CARRIER NON- RENEWAL UNDERWRITING CONDITION CORRECTED (Describe): 6. ANY PAST LOSSES OR CLAIMS RELATING TO SEXUAL ABUSE OR MOLESTATION ALLEGATIONS, DISCRIMINATION OR NEGLIGENT HIRING N 7. DURING THE LAST FIVE YEARS (TEN IN RI), HAS ANY APPLICANT BEEN INDICTED FOR OR CONVICTED OF ANY DEGREE OF THE CRIME OF FRAUD. N BRIBERY, ARSON OR ANY OTHER ARSON RELATED CRIME IN CONNECTION WITH THIS OR ANY OTHER PROPERTY? (In RI, this question must be answered by any applicant for property insurance. Failure to disclose the existence of an arson conviction is a misdemeanor punishable by a sentence of up to one year of imprisonment). 8. ANY UNCORRECTED FIRE AND /OR SAFETY CODE VIOLATIONS? N OCCURRENCE RESOLUTION DATE EXPLANATION RESOLUTION DATE 9. HAS APPLICANT HAD A FORECLOSURE, REPOSSESSION, BANKRUPTCY OR FILED FOR BANKRUPTCY DURING THE LAST FIVE (5) YEARS? N OCCURRENCE RESOLUTION DATE EXPLANATION RESOLUTION DATE 10. HAS APPLICANT HAD A JUDGEMENT OR LIEN DURING THE LAST FIVE (5) YEARS? N OCCURRENCE RESOLUTION DATE EXPLANATION RESOLUTION DATE 11. HAS BUSINESS BEEN PLACED IN A TRUST? N NAME OF TRUST 12. ANY FOREIGN OPERATIONS, FOREIGN PRODUCTS DISTRIBUTED IN USA, OR US PRODUCTS SOLD /DISTRIBUTED IN FOREIGN COUNTRIES? N (If "YES attach ACORD 815 for Liability Exposure and /or ACORD 816 for Property Exposure) 13. DOES APPLICANT HAVE OTHER BUSINESS VENTURES FOR WHICH COVERAGE IS NOT REQUESTED? N REMARKS I PROCESSING INSTRUCTIONS (Attach ACORD 101, Additional Remarks Schedule, if more space is required) t ACORD 125 (2009/05) Page 3 of 4 I PRIOR CARRIER INFORMATION AGENCY CUSTOMER ID: YEAR CATEGORY GENERAL LIABILITY AUTOMOBILE PROPERTY OTHER: CARRIER New POLICY NUMBER PREMIUM EFFECTIVE DATE EXPIRATION DATE CARRIER POLICY NUMBER PREMIUM S S EFFECTIVE DATE EXPIRATION DATE CARRIER POLICY NUMBER PREMIUM EFFECTIVE DATE EXPIRATION DATE CARRIER POLICY NUMBER PREMIUM S EFFECTIVE DATE EXPIRATION DATE LOSS HISTORY Check if none (Attach Loss Summary for Additional Loss Information) ENTER ALL CLAIMS OR LOSSES (REGARDLESS OF FAULT AND WHETHER OR NOT INSURED) OR OCCURRENCES THAT MAY GIVE RISE TO CLAIMS FOR THE LAST YEARS TOTAL LOSSES: S SUBRO- CLAIM DATE OF UNE TYPE DESCRIPTION OF OCCURRENCE OR CLAIM DATE OF CLAIM AMOUNT PAID AMOUNT RESERVED GATION OPEN OCCURRENCE YIN YIN New SIGNATURE COPY OF THE NOTICE OF INFORMATION PRACTICES (PRIVACY) HAS BEEN GIVEN TO THE APPLICANT- (Not applicable in all states, consult your agent or broker for your state's requirements.) NOTICE OF INSURANCE INFORMATION PRACTICES PERSONAL INFORMATION ABOUT YOU MAY BE COLLECTED FROM PERSONS OTHER THAN YOU IN CONNECTION WITH THIS APPLICATION FOR INSURANCE AND SUBSEQUENT POLICY RENEWALS. SUCH INFORMATION AS WELL AS OTHER PERSONAL AND PRIVILEGED INFORMATION COLLECTED BY US OR OUR AGENTS MAY IN CERTAIN CIRCUMSTANCES BE DISCLOSED TO THIRD PARTIES WITHOUT YOUR AUTHORIZATION. YOU HAVE THE RIGHT TO REVIEW YOUR PERSONAL INFORMATION IN OUR FILES AND CAN REQUEST CORRECTION OF ANY INACCURACIES. A MORE DETAILED DESCRIPTION OF YOUR RIGHTS AND OUR PRACTICES REGARDING SUCH INFORMATION IS AVAILABLE UPON REQUEST. CONTACT YOUR AGENT OR BROKER FOR INSTRUCTIONS ON HOW TO SUBMIT A REQUEST TO US. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANti FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND [NY: SUBSTANTIAL] CIVIL PENALTIES. (Not applicable in CO, FL, HI, MA, NE. OH, OK, OR, VT or WA; in DC, LA, ME, TN and VA, insurance benefits may also be denied) IN THE DISTRICT OF COLUMBIA, WARNING: IT IS A CRIME TO PROVIDE FALSE OR MISLEADING INFORMATION TO AN INSURER FOR THE PURPOSE OF DEFRAUDING THE INSURER OR ANY OTHER PERSON. PENALTIES INCLUDE IMPRISONMENT AND /OR FINES. IN FLORIDA, ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE, OR MISLEADING INFORMATION IS GUILTY OF A FELONY OF THE THIRD DEGREE IN MASSACHUSETTS, NEBRASKA, OREGON AND VERMONT, ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND MAY SUBJECT THE PERSON TO CRIMINAL AND CIVIL PENALTIES. IN WASHINGTON, IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE, OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES, AND DENIAL OF INSURANCE BENEFITS. THE UNDERSIGNED IS AN AUTHORIZED REPRESENTATIVE OF THE APPLICANT AND REPRESENTS THAT REASONABLE ENQUIRY HAS BEEN MADE TO OBTAIN THE ANSWERS TO QUESTIONS ON THIS APPLICTION. HE /SHE REPRESENTS THAT THE ANSWERS ARE TRUE, CORRECT AND COMPLETE TO THE BEST OF HIS /HER KNOWLEDGE. R PRODUCER'S SIGNATURE PRODUCER'S NAME (Please Print) STATEPRODUCER LICENSE NO (Required in Florida) Michael P. Madden A161987 APPLICANTS SIGNATURE DATE NATIONAL PRODUCER NUMBER ACORD 125 (2009(05) Page 4 of 4 ----1 ACORO® COMMERCIAL GENERAL LIABILITY SECTION DATE(MM/DD/YYYY) 09/23/2009 AGENCY raC N ND Ext): 800 -445 -6248 x1831 APPLICANT FAX (First (AC, No): 407 -425 -9378 Named Winter Springs Senior Center Inc Insured) Florida League of Cities Inc PO Box 530065 EFFECTIVE DATE EXPIRATION DAT D BILL PAYMENT PLAN AUDIT Orlando FL 32853 -0065 AGENCY BILL FOR COMPANY CODE: SUB CODE: USE ONLY AGENCY CUSTOMER ID: COVERAGES LIMITS J! COMMERCIAL GENERAL LIABIUTY GENERAL AGGREGATE S 2,000,000 PREMIUMS CLAIMS MADE OCCURRENCE PRODUCTS COMPLETED OPERATIONS AGGREGATE S 2,000,000 PREMISESIOPERATIONS OWNER'S CONTRACTOR'S PROTECTIVE PERSONAL ADVERTISING INJURY S 1,000,000 EACH OCCURRENCE 1,000,000 PRODUCTS DEDUCTIBLES DAMAGE TO RENTED PREMISES (each occurrence) 5 100,000 j DAMAGE 5 500 MEDICAL EXPENSE (Any one person) S 5,000 OTHER BODILY INJURY 500 V. V. EMPLOYEE BENEFITS 5 5 ocu'ineNCC TOTAL OTHER COVERAGES, RESTRICTIONS AND /OR ENDORSEMENTS (For hired /non -owned auto coverages attach the applicable state Business Auto Section, ACORD 137) SCHEDULE OF HAZARDS LOC HAZ CLASSIFICATION CLASS PREMIUM EXPOSURE TERR RATE PREMIUM 5 p CODE BASIS PREM /OPS PRODUCTS PREMIOPS PRODUCTS 1 Operation of municipal 4,697 sq ft owned senior center RATING AND PREMIUM BASIS (P) PAYROLL PER 51,000 /PAY (C) TOTAL COST PER 51,000 /COST (U) UNIT PER UNIT (S) GROSS SALES PER 51,000 /SALES (A) AREA PER 1,000 /SO FT (M) ADMISSIONS PER 1,000 /ADM (T) OTHER CLAIMS MADE (Explain all "Yes" responses) EXPLAIN ALL "YES" RESPONSES I YIN 1. PROPOSED RETROACTIVE DATE: 2. ENTRY DATE INTO UNINTERRUPTED CLAIMS MADE COV: 3. HAS ANY PRODUCT, WORK, ACCIDENT, OR LOCATION BEEN EXCLUDED, UNINSURED OR SELF INSURED FROM ANY PREVIOUS COVERAGE? -1 4. WAS TAIL COVERAGE PURCHASED UNDER ANY PREVIOUS POLICY? t EMPLOYEE BENEFITS LIABILITY 1. DEDUCTIBLE PER CLAIM: 3. NUMBER OF EMPLOYEES COVERED BY EMPLOYEE BENEFITS PLANS: 2. NUMBER OF EMPLOYEES: 4. RETROACTIVE DATE: ACORD 126 (2007/05) Page 1 of 4 ACORD CORPORATION 1993 -2007. All rights reserved. The ACORD name and logo are registered marks of ACORD CONTRACTORS EXPLAIN ALL "YES" RESPONSES (For past or present operations) YIN 1. DOES APPLICANT DRAW PLANS, DESIGNS, OR SPECIFICATIONS FOR OTHERS? N/A 2. DO ANY OPERATIONS INCLUDE BLASTING OR UTILIZE OR STORE EXPLOSIVE MATERIAL? N/A 3. DO ANY OPERATIONS INCLUDE EXCAVATION, TUNNELING, UNDERGROUND WORK OR EARTH MOVING? N/A 4. DO YOUR SUBCONTRACTORS CARRY COVERAGES OR LIMITS LESS THAN YOURS? N/A 5. ARE SUBCONTRACTORS ALLOWED TO WORK WITHOUT PROVIDING YOU WITH A CERTIFICATE OF INSURANCE? N/A 6. DOES APPLICANT LEASE EQUIPMENT TO OTHERS WITH OR WITHOUT OPERATORS? N/A DESCRIBE THE TYPE OF WORK SUBCONTRACTED 1 CONTRALTO S: SUBCONTRACTED: FU STAFF: I TIME TAFF: N/A PRODUCTS /COMPLETED OPERATIONS PRODUCTS ANNUAL GROSS SALES OF UNITS TIME IN EXPECTED MARKET LIFE INTENDED USE PRINCIPAL COMPONENTS Included in code EXPLAIN ALL "YES' RESPONSES (For any past or present product or operation) PLEASE ATTACH LITERATURE, BROCHURES, LABELS, WARNINGS, ETC YIN 1. DOES APPLICANT INSTALL, SERVICE OR DEMONSTRATE PRODUCTS? 2. FOREIGN PRODUCTS SOLD, DISTRIBUTED, USED AS COMPONENTS? (If "YES attach ACORD 815) N 3. RESEARCH AND DEVELOPMENT CONDUCTED OR NEW PRODUCTS PLANNED? N 4. GUARANTEES, WARRANTIES, HOLD HARMLESS AGREEMENTS? N 5. PRODUCTS RELATED TO AIRCRAFT /SPACE INDUSTRY? N 6. PRODUCTS RECALLED. DISCONTINUED, CHANGED? N 7. PRODUCTS OF OTHERS SOLD OR RE- PACKAGED UNDER APPLICANT LABEL? B. PRODUCTS UNDER LABEL OF OTHERS? N 9. VENDORS COVERAGE REQUIRED? N 10. DOES ANY NAMED INSURED SELL:TO OTHER NAMED INSUREDS? N 126 (2007/05) ATTACH TO ACORD 125 ADDITIONAL INTEREST /CERTIFICATE RECIPIENT ACORD 45 attached for additional names INTEREST RANK: NAME AND ADDRESS I REFERENCE It CERTIFICATE REQUIRED INTEREST IN ITEM NUMBER ADDITIONAL INSURED City of Winter Springs LOCATION: BUILDING: LOSS PAYEE 1126 East SR 434 VEHICLE: BOAT: MORTGAGEE SCHEDULED ITEM NUMBER: LIENHOLDER OTHER Wnter Springs FL 32708 EMPLOYEE AS LESSOR ITEM DESCRIPTION: GENERAL INFORMATION EXPLAIN ALL "YES" RESPONSES (For all past or present operations) YIN 1. ANY MEDICAL FACILITIES PROVIDED OR MEDICAL PROFESSIONALS EMPLOYED OR CONTRACTED? N 2. ANY EXPOSURE TO RADIOACTIVE/NUCLEAR MATERIALS? N 3. DO /HAVE PAST, PRESENT OR DISCONTINUED OPERATIONS INVOLVE(D) STORING, TREATING, DISCHARGING, APPLYING, DISPOSING, OR N TRANSPORTING OF HAZARDOUS MATERIAL? (e.g. landfills. wastes, fuel tanks, etc) 4. ANY OPERATIONS SOLD, ACQUIRED, OR DISCONTINUED IN LAST FIVE (5) YEARS? N 5. MACHINERY OR EQUIPMENT LOANED OR RENTED TO OTHERS? N 6. ANY WATERCRAFT. DOCKS, FLOATS OWNED, HIRED OR LEASED? N 7. ANY PARKING FACILITIES OWNED /RENTED? Parking at senior center Y 8. IS A FEE CHARGED FOR PARKING? N 9. RECREATION FACILITIES PROVIDED? Y Included in narrative 10. IS THERE A SWIMMING POOL ON THE PREMISES? Therapy pool Y 11. SPORTING OR SOCIAL EVENTS SPONSORED? Y Social events 12. ANY STRUCTURAL ALTERATIONS CONTEMPLATED? N 13. ANY DEMOLITION EXPOSURE CONTEMPLATED? N 14. HAS APPLICANT BEEN ACTIVE IN OR IS CURRENTLY ACTIVE IN JOINT VENTURES? N 15. DO YOU LEASE EMPLOYEES TO OR FROM OTHER EMPLOYERS? N 16. IS THERE A LABOR INTERCHANGE WTH ANY OTHER BUSINESS OR SUBSIDIARIES? N ACORD 126 (2007105) Page 3 of 4 GENERAL INFORMATION (continued) EXPLAIN ALL "YES" RESPONSES (For all past or present operations) YIN 17. ARE DAY CARE FACILITIES OPERATED OR CONTROLLED? N 18. HAVE ANY CRIMES OCCURRED OR BEEN ATTEMPTED ON YOUR PREMISES WITHIN THE LAST THREE (3) YEARS? N 19. IS THERE A FORMAL, WRITTEN SAFETY AND SECURITY POLICY IN EFFECT? 20. DOES THE BUSINESSES' PROMOTIONAL LITERATURE MAKE ANY REPRESENTATIONS ABOUT THE SAFETY OR SECURITY OF THE PREMISES? N REMARKS II I ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND [NY: SUBSTANTIAL] CIVIL PENALTIES. (Not applicable in CO, FL, HI, MA, NE, OH, OK, OR or VT. In DC, LA, ME, TN, VA and WA insurance benefits may also be denied). IN FLORIDA, ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE, DEFRAUD, OR DECEIVE ANY INSURER FILES A STATEMENT OF CLAIM OR AN APPLICATION CONTAINING ANY FALSE, INCOMPLETE, OR MISLEADING INFORMATION IS GUILTY OF A FELONY OF THE THIRD DEGREE. ACORD 126 (2007/05) Page 4 of 4 POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE You are hereby notified that under the Terrorism Risk Insurance Act, as amended, (the °Act'), that you have a right to purchase insurance coverage for bsses resulting from acts of terrorism, as defined in Section 102(1) of the Act: The term °act of terrorism' means any act that is certified by the Secretary of the Treasury —in concurrence with the Secretary of State, and the Attorney General of the United States —to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outsde the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Coverage under your New Business policy may be affected as follows: YOU SHOULD KNOW THAT WHERE COVERAGE IS PROVIDED BY THIS POLICY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS. UNDER THE FORMULA, THE UNITED STATES GOVERNMENT GENERALLY REIMBURSES 85% OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE PREMIUM CHARGED FOR THIS COVERAGE IS.PROVIDED BELOW AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. YOU SHOULD ALSO KNOW THAT THE ACT, CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED $100 BILLION, YOUR COVERAGE MAY BE REDUCED. Acceptance or Rejection of Terrorism Insurance Coverage I hereby elect to purchase terrorism coverage, subject to the limitations of the Act, for acts of terrorism as defined in the Act, for a prospective premium of 125.00, plus the following taxes and fees: SL Tax (5 $6.25 Stamping Fee (0.1 $0.13 FHCF Assessment (1%) $1.25 Total of Premium, taxes and fees is $132.63 I hereby decline to purchase terrorism coverage for certified acts of terrorism. I understand that I will have no coverage for losses resulting from certified acts of terrorism. NAItTIJ 11S INSIIRANCF COMPANY PolicyholderlApplicant's Signature Insurance Company Print Name Policy Number Winter Springs Senior Center Inc Date Named Insured E903 (02/08) Includes copyrighted material of National Association of Insurance Commissioners. with its permission. Winter Springs Senior Center BENEFIT Option 1 Option 2 Accidental Death Dismemberment Benefit Principal Sum $10,000 $5,000 Incurral Period 365 days 365 days Paralysis Benefit Principal Sum $10,000 $5,000 Incurral Period 365 days 365 days Accident Medical Expense Benefit Excess Commencement Period 90 days 90 days Deductible Amount $0.00 $0.00 Maximum Benefit Period 52 weeks 52 weeks Maximum Benefit Amount $10,000 $5,000 Annual Premium $3,000.00 $2,500 Date: November 9, 2009 The attached was provided to the City Commission during the discussion of Regular Agenda Item "603" by Ms. Isla Reiner during the November 9, 2009 Regular City Commission Meeting. 2009 SENIOR ASSOCIATION CONTRIBUTIONS TO SENIOR CENTER TO DATE Instructors Anita Roberts, Jazzercise $2,775.00 Eric Raboy, Tai Chi $2,270.00 Kathy Scharff, Water Aerobics $2,700.00 Supplies Kitchen /Food Supplies $3,119.16 Medical Screening Blood Pressure Machine $792.00 Pool Certification 3 Instructors $633.00 Computer 9 Computers, supplies, line, etc. $969.50 Miscellaneous Extra janitorial supplies, stamps, billiards, pencil sharpener, etc. $710.69 TOTAL: $13,969.35 Updated 10/29/09 2009 SENIOR ASSOCIATION DONATIONS TO THE WINTER SPRINGS COMMUNITY Each of the 5 Winter Springs Schools 4 Elementary and one Middle School ($300 Each) $1,500.00 Scholarships for seniors to join Senior Center (6) $410.00 Softball League (National) $500.00 Winter Springs Police Explorers (Splash Playground Memberships and Summer Events for needy area children) $1,000.00 Winter Springs Performing Arts (High School and 4 Scholarships) $1,000.00 Will give 3 gift certificates and turkeys to needy families at Christmas and Thanksgiving (6) $300.00 Winter Springs Police Department Shop with a Cop blankets (100) $500.00 Bus Driver (Cancer) $500.00 TOTAL: $5,710.00 Updated 10/29/09