HomeMy WebLinkAboutCHALLENGER SPORTS CORPORATION (3)-2017City of Santa Ana
Clerk of the Council coTc office use only I
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AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and all
1n':9 AUG 22 Pit 4-107
amendments (if any) are no longer in effect. CITY Or SANTA ANP
Note: If your agreement is grant related, please ensure that all grant retention requirements j CLERK OF COUNg11-
have been satisfied prior to signing the termination form.
Is the agreement(s) a permanent record? Yes No
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
N-2017-093
No. was completed on -%m and final payment has been made.
Use space below if needed.) p
Department: - t
PzgJA
Phone/Ext.:
Signature:eRhQAja,n
Date:) lid
(List all amendments.
Revised: 10-18-16
IAURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
/- / -/8
LERK OF COUNCIL
&(/CDATE: Ajay 19 2011
N-2017-093
RECREATION SERVICES AGREEMENT
0: PRCS (/ )
Silvia Cuevas THIS AGREEMENT is made and entered into this 27a" day of April, 2017 by and
between Challenger Sports 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=').
RECITALS
A. The City desires to retain a recreation service provider having special skills, resources and
knowledge to provide various fitness classes in its recreation class program.
B, Provider represents that he/she/it is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Provider represents that he/she/it is
knowledgeable in their field and that any services performed by Provider under this
Agreement will be performed in compliance with such standards as may reasonably be
expected.
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
Provider shall perform those services as set forth in Exhibit A to this Agreement.
2. COMPENSATION
In consideration for the provision of the programs set forth in Exhibit A, City agrees to
pay the Provider seventy percent (70%) of all gross revenue received from program participants.
Total revenue to Provider shall not exceed $25,000.00 annually. 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. Provider agrees that City shall retain thirty percent (30%) of all gross revenue
received from program participants as an administrative fee.
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This Agreement shall commence on July 1, 2017 and end on June 30, 2018 unless
terminated earlier in accordance with Section 12 below. The term of this Agreement may be
extended by a writing executed by the City Manager and the 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 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 its subcontractors, if any, to obtain and maintain insurance as described below:
a. Commercial General Liability Insurance. Provider shall maintain commercial general
liability insurance which shall include, but not be limited to protection against claims arising
from bodily and personal injury, including death resulting therefrom and damage to property,
resulting from any act or occurrence arising out of Provider's operations in the performance of
this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance
shall be not less than the following: single limit coverage applying to bodily and personal injury,
including death resulting therefrom, and property damage, in the total amount of $1,000,000 per
occurrence and $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers,
employees, agents, volunteers and representatives as additional insured(s); (b) be primary and
not contributory with respect to insurance or self-insurance programs maintained by the City;
and (c) contain standard separation of insured's provisions.
b. Worker's Compensation Insurance. In accordance with California State law, Provider,
if Provider has any employees, is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing the performance of the work
under this Agreement, Provider agrees to obtain and maintain any employer's liability insurance
with limits not less than $1,000,000 per accident,
c. The following requirements apply to the insurance to be provided by Provider pursuant
to this section:
(i) Provider shall maintain all insurance required above in full force and
effect for the entire period covered by this Agreement. Certificates
of insurance shall be furnished to the City upon execution of this
Agreement and shall be approved in form by the City.
(ii) Certificates and policies shall state that the policies shall not be canceled
or reduced in coverage or changed in any other material aspect without
thirty (30) days prior written notice to the City.
d. If Provider fails or refuses to produce or maintain the insurance required by this section
or fails or refuses to furnish the City with required proof that insurance has been procured
2
and is in force and paid for, the City shall have the right, at the City's election, to terminate this
Agreement. Such termination shall not affect Provider's right to be paid for its time and
materials expended prior to notification of termination. Provider waives the right to receive
compensation and agrees to indemnify the City for any work performed prior to approval of
insurance by the City.
6. INDEMNIFICATION
Provider agrees to and shall indemnify, defend and hold harmless the City, its officers,
agents, employees, consultants, 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.
7. 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.
8. LIVE SCAN BACKGROUND CHECK
Provider, and any employees, subcontractors or substitutes, in contact with minors under
eighteen (18) years of age shall arrange for and submit to a Live Scan electronic background
check for criminal history available through the California Department of Justice as a condition
of this Agreement and provide proof of compliance prior to performing services hereunder.
9. 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: Clerk of the Council
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 of 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: Oli Sharp
Challenger Sports Corporation
707 Civic Center Dr„ Ste 208
Vista, CA 92084
Phone: 760-536-4468
Email: osharp@challenaersports.com
Agent for Service: National Registered Agents, Inc.
818 W. Seventh Street
Los Angeles, CA 90017
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.
10. 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 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.
11. ASSIGNMENT/SUBSTITUTES
a. 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.
b. Substitutes. In the event Provider is not able to teach a class due to illness or some
other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a
qualified substitute instructor to teach the class at its regular time and place. Provider shall
ensure that substitute instructors are at least twenty-one (2 1) years of age and comply with the
City's insurance and live scan requirements contained herein. Evidence of compliance with
City's insurance and live scan requirements shall be provided upon request. Provider must
immediately notify the City of the substitute instructor's name, qualifications, address and phone
number. If Provider cannot procure a qualified substitute and the City is unable to assist in this
regard, then the class shall be canceled and a make-up class must be added to the session.
Provider must notify participants as soon as possible of any class cancellation and make-up class.
Provider must personally teach at least seventy-five percent (75%) of its offered classes.
12. TERMINATION
a. This Agreement may be terminated by the 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 l l.b. 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.
13. 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.
14. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, 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.
15. 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.
16. 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.
17. 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.
18. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth
in the body of this Agreement.
19. 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.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and
year first above written.
ATTEST:
J.
Maria Dz-Huizar
Clerk'of the Council
CITY OF SANTA ANA
CYNTHIA KURTZ
INTERIM CITY MANAGER
[signatures continue on next page]
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: L
John bfink
Assistant City Attorney
RECOMMENDED FOR APPROVAL: PROVIDER:
�
Gerardo Monet Name: O i Sharp
Executive Director of Parks, Challenger Sports Corporation
Recreation and Community Services Agency
01
Exhibit A
SCOPE OF SERVICES
A. Provider shall conduct Soccer Camp for children 3 — 6 years.
B. Provider shall teach such or similar classes (1) at the times below at a facility to be designated by
the City or (2) on a schedule otherwise 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.
• Tiny Tykes Soccer will consist of a 7 week session, held 5 days per week, 45 minutes per
day, ages 3-4 yrs. $85/lwk
• Tiny Tykes Soccer will consist of a 7 week session, held 5 days per week, 45 minutes per
day, ages 5-6 yrs. $85/lwk
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. All Soccer Camp classes mentioned above must have a minimum of 4 paid students and no more
than a maximum of 20 paid students.
B. If the minimum registration has not been reached by the second class, the class maybe cancelled
by mutual agreement of Provider and City. 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.
CLASSFEES
A. Each participant shall pay class registration fees as established by City.
B. Any materials fee shall be established by mutual agreement of City and Provider and
shall be payable directly to Provider.
C. Only registered participants may participate in class.
D. Any refunds to participants will be made in accordance with City policy.
ACC)R o® CERTIFICATE OF LIABILITY INSURANCE
DATE
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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).
PRODUCER
Risk 6 Insurance Consultants, Inc
5416 Glenridge Drive
Atlanta GA 30392
CONTACT
NAME: pool HLOuBSdrd
ac No,.Enl; (404) 459-5975 !PNC Nal (AOq Q&9-6976
"DUBS: pbroussard@riskinsuranceco.com
INSURERS AFFORDING COVERAGE NAIC9
INSURER A:SCOtiSdale Insurance Company 41297
INSURED
Challenger Sports Corp
8263 Flint St
Lenexa KS 66214
INSURER a Nationwide Mutual Insurance Co 123787
INSURER c Technology Insurance Company 42376
INSURERD., BE Ins -Corp !39217
NSURER E:
IINSURERF:
COVERAGES CERTIFICATE NUMBER:17 18 rev MASTER REVISIONNUMBER:
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,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NI
TYPE OF INSURANCE
ADDLSQB'' POLICY NUMBERMU,ocD
POLICY EFFSR
!MOODY EXP LIMITS
R iCOMMERCIALGENERALLUIBWTY
I
EACH OCCURRENCE 1E
1,000,000
A GIAIM$MOCCUR
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EMISES.(Ed-Qaun'.ence} L S
3(10,000
X 1LTUCS0000006678900
1/1/2017
! 1/1/2018
MED EXP (Ay one person) IS
1,000
PERSONAL&ADV INJURY 1E
1,000,000
AGGREGATE E
2,000,000
GENL AGGREGATE UMITAPPLIES PER:GENERAL
X1 POLICY E jEa LOC
I PROOUCTE-COMP/OP AGG 1$
2,000,000
OTHER:
'Employee Benefits LiabRy Is
1,000,000
AUTOMOBILE LIABILITY !
JCO EDISINGLE LIMIT!E
1,000,000
B R'ANY AUTO
!BODILY INJURY (Per person) Is
_ AUTOS I IAUTOSULED 1LXR5001)0I106679000
r—t
1/1/2017 1/1/2D18 BODILY INJURY (Peraodden0I5
NON OWNED
X HIRED AUTOS I X AUTOS
PiiOPERTY DAMAGE
! �_LParedenl E
Unnwred Matanet Is
1,000,000
X UMBRELLA UAB R OCCUR
EACH OCCURRENCE Is
5,000,000
A r— EXCESS UAB CLAIMSMADEI
I ! AGGREGATE S
5,000,000
OED I R I RETENTIONS 0: 11=000000667890D
1/1/2017 i 1/1/2018 ! S
WORT ERSCOMPENSAUON
ANO EMPLOYERS' LIABILITY I
IR PER 0TH -
4STATUIE � EN
_
YI N
ANY PROPRIETORIPARTNERIEXECURVE
OFFICERIMEMBER EXCLUDED? JiNIA!
EL EACH ACCIDENT is
1,000,000
C (Mandamry In NHl
;THC3603036
1/1/2017 1/1/2018 1 E DISEASE - EA EMPLOYEE S
1,000,000
Iyyes, des
IESCRIPTION ION OOF F OPERATIONS bebw
0
( IEL DISEASE -POLICY LIMIT 15
11000,000
D Participant Accident
�AB8006104
11/1/2017
i
1/1/2018 Aeddenl/Medal
$25,000
DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES(ACORD 101, AdWdonal Remarks ScWule, may be efhched if more spaAk,,n
City of Santa Ana is additional insured, with regards
to General Li'vi-Xty, as per itten contract.
TinyTykes
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Dates: Feb 15th -May 20U, 2017
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British Soccer Camp
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Dates: July 16th - 22nd, 2017
•\�\a.CJ Ad�
SCuevas@santa-ana.org
City of Santa Ana
ATTN: Silvia Cuevas
726 S Center Street
Santa Ana, CA 92704
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
teve Molina/BECKY-'- ---�
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 fMl4mi
Additional Named Insureds
Other Named Insureds
Camsie Leasing LLC
Challenger Sports Canada
Challenger Sports Corp
Challenger Sports Teamwear LLC
Complete Players Program LLC
DBA Challenger Teamwear
SMG Enterprises, LLC
SOCCerPlus Camps, Inc
Tetra Brazil Soccer LLC
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OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC
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COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — DESIGNATED
PERSON OR ORGANIZATION
This endorsement modlfles insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
CITY OF SANTA ANA, IT OFFICERS, AGENTS, AND EMPLOYEES
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92701
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured Is amended to
Include as an additional insured the persons) or
organization(s) shown in the Schedule, but only
with respect to liability for 'bodily Injury', 'property
damage° or 'personal and advertising injury'
caused, in whole or In part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
However:
1. The Insurance afforded to such additional
Insured only applies to the extent permitted by
law; and
2. It coverage provided to the additional Insured is
required by a contract or agreement, the
Insurance afforded to such additional Insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III—Limits Of Insurance:
It coverage provided to the additional insured Is
required by a contract or agreement, the most we
will pay on behalf of the additional insured 1s the
amount of Insurance;
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shell not increase the applicable
Limits of Insurance shown in the Declarations.
CG 20 26 04 13 0Insurance Services Office, Inc., 2012 Page 1 of 1
J o%�, SCOT"TSDALE INSURANCE COMPANY"
ENDORSEMENT
NO. 0004
ATTACHED TO ANO
FORMING A PMTOf
ENOOgSENENT EFFECTIVE DATE
NAMED INSURED
AGENT N0.
POLICY NUMBER
(R51M.STANDARD TINE)
KKS0000006678900
01/24/17
CHALLENGER SPORTS CORP
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CONDITIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The Other Insurance condition of this Coverage Part Is replaced by the provision marked below with an "X" in the
box:
Otherfnsurance
❑ If other valid and collectible insurance with any other Insurer including any formal self-insured retention
programs Is available to you covering a loss also covered by this Coverage Part, other than insurance that
Is in excess of the insurance afforded by this Coverage Part, the insurance afforded by this Coverage Part
shall be in excess of and shall not contribute with such other insurance. Nothing herein shall be construed
to make this Insurance subject to the terms, conditions and limitations of other insurance,
❑X Coverage afforded under this Coverage Part is primary insurance and Other Insurance shall not apply as
respects
AS REQUIRED BY WRITTEN CONTRACT
as additional insureds.
The Cancellation condition of this Coverage Part is amended by the addition of the following if an 'X' is in the
box:
❑ Cancellation
The following Is added: It is a condition of the Policy by this Endorsement that the Policy will not be can-
celled without
days' prior written notice to:
edp�.
and further, that the person(s) named above are not liable for the payment of any premiums or assess-
ments on this Policy.
KRS-GL-79 (4-07) Page 1 of 1