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2007 Skyfire Service AgreementDEPARTMENT OF FINANCE TELEPHONE (785) 309 -5735 AND ADMINISTRATION FAX (785) 309 -5738 Rodney Franz, Director P TDD (785) 309 -5747 300 West Ash, P.O. Box 736 hlldis E -MAIL rod.franz @salina.org Salina, Kansas 67402 -0736 u Sd��11d Vvebsite: wvvw.salina- ks.gov Service Agreement This agreement entered into on the 1st, day of January, 2007 is made by and between the City of Salina, Kansas, whose address is 300 West Ash Street, Salina, Kansas, referred to as "City ", AND the Salina Ambucs, whose address is 645 Sylvan Place, Salina, Ks 67401, referred to as "Provider." Section 1: Services. The company hereby employs the provider to perform the following services in accordance with the terms and conditions set forth in this agreement: The Salina Ambucs will provide a public fireworks display in celebration of Independence Day, on or about July 4, 2007 Section 2: Term of Agreement. This agreement will begin on the 1st day of January, 2007 and will end on the 31st day of December, 2007 . Either party may cancel this agreement upon thirty (30) days notice to the other party in writing, by certified mail or personal delivery. Section 3: Amount of Agreement: The amount of the agreement is: $2,500.00 Section 4: Payment to Provider. The provider will be paid pursuant to the following terms and conditions: Payment will be issued upon request of provider Section 5: Status of provider: The provider is a: Not for profit organization Section 6: Performance Reporting. The provider shall file performance reports as noted: Other. Pleas specify By March 31, a request for renewal funding is due to be submitted to the City Clerk's Office Section 7: Financial Reporting. The provider shall file financial reports as noted: No Report Required Section 8: Nonperformance. In the event of provider non - performance or non- compliance with any section in this agreement, this agreement may be cancelled with 30 days written notice, or in lieu thereof the City may elect to reduce payments to provider. Section 9: Compliance with applicable law. Provider shall comply with all applicable Federal, State, and Local law and regulation. Section 10: City indemnified. Provider shall indemnify and save harmless the City, its officials, agents, servants, officers, directors and employees from and against all claims, expenses, demands, judgments and causes of action for personal injury, death, and /or damage to property where and to the extent to which such claims, expenses, demands, judgments and causes of action arise from the Provider's negligent acts. Provider shall notify the City upon the receipt of any claim in excess of $1,000 in connection with this contract. Provider shall file with City, prior to any payment being made, proof of insurance as follows: ❑ No proof of insurance required ❑ Other (Please specify): ® Commercial General Liability Comments: ❑ Automobile Liability ❑ Professional Liability- Errors and Omissions All insurance is to provide a minimum of $500,000 single ❑ Workers Compensation Insurance limit coverage. (statutory). ® City if Salina required as additional named insured on policy. Print Name I City of Salina Standard Contract for Service; Page 1 o 2 Print Name Section 11: Equal Opportunity /Affirmative Action. For agreements in which the value exceeds $20,000, provider shall comply with the Equal Opportunity /Affirmative Guidelines attached. Section 12: Independent Contractor. Both the City and the provider agree that the provider will act as an independent contractor in the performance of its duties under this contract. Accordingly, the provider shall be responsible for payment of all taxes including Federal, State and local taxes arising out of the provider's activities in accordance with this contract, including by way of illustration but not limitation, Federal and State income tax, Social Security tax, Unemployment Insurance taxes, and any other taxes or business license fees as required. Section 13: Attachments incorporated. The following attachments and supplemental documents are incorporated herein and made an integral part of this agreement.: ❑ Equal Opportunity /Affirmative Action Requirements ❑ Other: Please Specify ® Provider Proposal ❑ Certificates of Insurance ❑ W -9 Form ® Proof of Non - profit status (501c3 letter) Section 14: Official contacts for the City and the provider are: City: Name: Name: Lieu Ann Elsey Title: City Clerk Address: 300 West Ash, P. O. Box 736 City, State, Zip Salina, KS 67401 Telephone: 785- 309 -5735 Fax: 785 - 309 -5738 E -mail LieuAnn.Elsey @salina.org Section 15: Executed on the 1s' day of January, 2007 . For the City of Salina: Jason Gage, Coi y Manager For the Provider: runt IN di Cka.Tty�/Yy ikh�'r,z Title Provider: Name: John P. Ziegler Title Skyfire Ambucs Address: 654 Sylvan Place City, State, Zip Salina, KS 67401 Telephone: 785- 823 -2336 E -mail: Attest: Penny Day, De Ity City Cler Attest: City of Salina Standard Contract for Service; Page 2of 2 Internal Revenue Service National AMBUCS, Inc. P.O. Box 5127 High Point, NC 27262 Internal Revenue Code: Employer Identification Number: Key District: Service Center: Accounting Period Ending: Foundation Status Classification: Form 990 Required: Dear Applicant: Department of the Treasury Washington, DC 20224 Person to Contact: Ward L. Thomas Telephone Number: (2 0 2) 622 -6142 Refer Reply to: CP : E : EO : T : 5 Date: 501 (c) (3) 58- 2152221 Southeast (Baltimore, MD) Atlanta, GA May 509 (a) (2) Yes We have considered your application for a group exemption letter recognizing your subordinates as exempt from federal income tax under section 501(a) of the Internal Revenue Code as organizations described in section 501(c)(3). Our records show that you are recognized as exempt from federal income tax as an organization described in section 501 (c) (3) of the Code. Based on the information supplied, and assuming the operations of your subordinate organizations will be as stated in your application for recognition of exemption, we have determined that your subordinates are exempt from federal income tax under the provisions of the Internal Revenue Code indicated above. Exemption is effective as of December 27, 1994, as you have agreed. This determination supersedes any prior exemption letters issued to those subordinates which are included in this group exemption; you should notify each such subordinate and the key district director of each such subordinate that the subordinate's individual exemption letter is superseded. This determination is based in part on your representations that the subordinates will amend their organizing documents to comply with the organizational test of section 1.501(c)(3) -1(b) of the Income Tax Regulations, and that you will merge with The National Association of American Business Clubs, Inc. and be the surviving entity. We have further determined that your subordinate organizations are not private foundations within the meaning of section 509(a) of the Code, because they are organizations described in the section indicated above. request to city comm for 2006 To: Salina City Commision From: Jahn Ziegler, Chairman skyfire Ambucs Re: 2007 funding This is a request for you to continue funding Salina's only public fireworks display Skyfire in 2007 at the current level of $2,500. If you have any questions I will be happy to appear and answer them. Thank You 14n P Ziegl r fire Ambucs 654 sylvan Place Salina Ks 67401 785 - 823 -2336 Page 1 Fireworks Display Permit sauna Date: June 22, 2007 Name of Organization: Salina Ambucs Location of Display: Salina Municipal Golf Course Date of Display: July 4, 2007 Time of Display: 10:00 p.m. In accordance with the Salina Code, Chapter 14, Section 14 -51 through 14 -58. Approval is hereby granted for a supervised public fireworks display to be conducted by the above named organization (the "permittee ") at the location and date given. The fireworks will be discharged by John Ziegler who has furnished evidence of his or her competence in accordance with the Salina Code, Sections 14 -53 and 14 -54. As required by Salina Code Section 14 -54g, the permittee has on file with the City Clerk proof o liability insurance in the minimum amount of $500,000.00 for the payment of any and all damages which may be caused either to persons or property by reason of the permitted display, and arising from any act of the permittee, his agents, employers or subcontractors. It is agreed that the permittee will indemnify, hold harmless, and defend the City of Salina from all liability from loss, damage, or injury to persons or property in any manner arising out of or incident to the fireworks display permitted by his agreement, including without limitation all consequential damages. June 22, 2007 Fire Marshal (Signature) Date City of Salina Approval � A Fi hief (Signature) J lice Chief (Signature) "X ��t--" -L' Risk Managem nt (Signature) Date 7 Date Date I STATE KANSAS LICENSE #: SAFOS001 ZIEGLER JOHN P 654 SYLVAN PLACE SALINA KS 67401 Is Granted This License As: Fireworks - Public Display Operator To perform duties asa Public Fireworks Display Operator as granted by the Kansas Fire Prevention Code and adopted National. Standard NFPA 1123, 2006 Edition within the State of Kansas. As granted under the authority of K.A. R'. 22- 1 -3(x) and other provisions of the Kansas Prevention This License is valid until 5/27/2011 unless suspended, revoked or refused renewal in accordance with the provisions of KAR 22 -1 -5. Effective Dater 5127/2007 Expiration Date: 5/27/2011 Rose Rozmiarek Deputy State Fire Marshal Chief Investigator LICENSE #: SAFOS001 ZIEGLER JOHN P 654 SYLVAN PLACE SALINA KS 67401 Operators must carry this card. Please cut on solid line State Fire Marshal. State of Kansas LICENSE #: SAFOS001 As: Fireworks = Public Display Operator TO: ZIEGLER JOHN P 654 SYLVAN PLACE SALINA KS 67401 ISSUED 5/2712007 EXPIRES' /2711 r Deputy State Ere Marshal Chief Investigator ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 6/21/2007 PRODUCER Phone: 440- 248 -4711 Fax: 440 -248 -5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Britton - Gallagher and Associates, Inc. 6240 SOM Center Rd. Cleveland OA 44139 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICYEFFECTIVE DAT M D POLICY EXPIRATION DATE M DD LIMITS INSURERS AFFORDING COVERAGE NAIC # INSURED J & M Displays, Inc. 18064 170th Avenue INSURER&Lexington Insurance Co 1/15/2007 INSURERS. Granite State Insurance Co. EACH OCCURRENCE INSURERC:Arch Sipecialty Ins Co PREMISES aoccurence Yarmouth th IA 52660 INSURER D: X COMMERCIALGENERALLIABILITY CLAIMS MADE � OCCUR INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. OTWITHSTANDING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR, N POLICY NUMBER POLICYEFFECTIVE DAT M D POLICY EXPIRATION DATE M DD LIMITS A GENERAL LIABILITY 6990167 1/15/2007 1/15/2008 EACH OCCURRENCE $1,000,000 PREMISES aoccurence $50,000 X COMMERCIALGENERALLIABILITY CLAIMS MADE � OCCUR MED EXP (Any one person) $ PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X JERCT LOC B AUTOMOBILE X LIABILITY ANYAUTO CA93835136 1/15/2007 '1/15/2008 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X X HIREDAUTOS NON- OWNEDAUTOS B eracci ent) (Per accident) PROPERTYDAMAGE (Peraccident) $ GARAGELIABILITY AUTO ONLY - EAACCIDENT $ OTHER THAN EAACC 8i ANYAUTO $ AUTOONLY: AGG C EXCESS/UMBRELLALIABILITY X OCCUR 1-1 CLAIMS MADE ULP0004063 1/15/2007 1/15/2008 EACH OCCURRENCE $9,000,000 AGGREGATE $9,000,000 $ $ R DEDUCTIBLE $ X RETENTION $10,000 IM PLOYS TUABILSATIONAND RKERCOMPEN EMPLOYERS LIABILITY WCSTATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE -EA EMPLOYEE $ OFFICERIMEMBEREXCLUDED? Ifyes, describe under E.L DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES i EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS D'L INSUREDS: THE CITY OF SALINA, KANSAS, IT'S EMPLOYEES, VOLUNTEERS, OFFICERS, ELECTED OFFICIALS, PARTNERS, IIBSIDIARIES, DIVISIONS & AFFILIATES, EVENT SPONSORS & LANDOWNERS AS THEIR INTEREST MAY APPEAR IN RELATION TO THIS VIDRICKSON DISTRIBUTING (SPONSOR); SALINA MEDIA GROUP (SPONSOR). FIREWORKS DISPLAY DATE: JULY 4, 2007 IN DATE- JULY 5, 2007 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of Salina BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE 654 Sylvan Place CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO Salina KS 67401 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 25 (20011081 ....,a., ....,..