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CAG-23-305 Approved by Alex Tuttle via 8/10/2023 email 1 Aaron Colby From:Alex Tuttle Sent:Thursday, August 10, 2023 8:05 PM To:Aaron Colby Cc:Legal Admin Subject:Approved Contracts Attachments:Recreation Instructors Agreement - Afterglow Fitness APPROVED.pdf; Recreation Instructor Agreement - Katzen Meditation APPROVED.pdf; Recreation Instructors Agreement Fitlot - Linda Mounts APPROVED.pdf; Recreation Instructor Agreement - Linda Mounts APPROVED.pdf Hello: The following attached contracts are hereby approved as to legal form. Please include this approval email in the submission to the City Clerk’s Office. Sincerely, ALEX TUTTLE | Senior Assistant City Attorney 1055 S. Grady Way | Renton WA 98057 ATuttle@RentonWA.gov | (425) 430-6492 1 Aaron Colby From:notifications@origamirisk.com Sent:Tuesday, August 15, 2023 8:54 AM To:Aaron Colby Subject:Approval for COI: Linda Mounts with expiration date: 4/1/2024 Attachments:Linda Mounts_COI Approval Memo_Aaron Colby.pdf Attached is the COI Approval Memo for: Linda Mounts with expiration date: 4/1/2024 Thank you, Risk Management Replies to this email message will be saved with our email records. To help protect your privacy, Micro so ft Office prevented automatic download of thi s pi ctu re from the In ternet. CAUTION: This email originated from outside the City of Renton. Do not click links, reply or open attachments unless you know the content is safe. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 03/22/2023 Next First Insurance Agency, Inc.PO Box 60787Palo Alto, CA 94306 Linda MountsLinda Mounts20419 SE 287th StKent, WA 98042 (855) 222-5919 support@nextinsurance.com 536298371 A X X X 04/01/2023 04/01/2024 1,000,000.00 100,000.00 10,000.00 3,000,000.00 1,000,000.00 A Renton1055 S Grady WayRenton, WA 98057 1,000,000.00 04/01/2023 NXTHH7WLCJ-00-GL 04/01/2024 Each Occurrence: Aggregate: $1,000,000.00 $3,000,000.00NXTHH7WLCJ-00-GLProfessional Liability X State National Insurance Company, Inc.12831 The Certificate Holder is Renton. This Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement. AllCertificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured, and are subject to policy terms and conditions. /,9(&(57,),&$7( &OLFNRUVFDQWRYLHZ Human Resources & Risk Management Memorandum DATE: August 15, 2023 TO: Aaron Colby, Parks & Recreation, Recreation FROM: Risk Management SUBJECT: Insurance Review/ Linda Mounts RE: Risk Management has reviewed the certificate of insurance for the above-named entity. The insurance certificate meets the City of Renton’s risk management requirements. Corresponding with the COI expiration, this approval memo is valid until 4/1/2024, or until changes in the contract or work invalidate the insurance coverage.