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Backup Documents 01/24/2012 Item #16G 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLHP1 k TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the exception of the Chairman's signature, draw a line through routing lines #1 through #a complete the �h —L-li t .,,,,4 f,,.,., A — c..e �:, ,:_- — Route to Addressee(s) -- - _ ..... ... .. ...... Office ..... . ,.��.. Initials �.. njj. Date (List in routing order) appropriate. (Initial) Applicable) 1. January 24, 2012 Agenda Item Number 16G1 2. signed by the Chairman, with the exception of most letters, must be reviewed and signed 3. License Agreement for Walker Circus Number of Original 3 4. Jeff Klatzkow County Attorney I Documents Attached contracts, agreements, etc. that have been fully executed by all parties except the BCC 6-7- 5. Ian Mitchell; ice Board of County Commissioners S 1F t zC_wi t J z0'�_ C- All handwritten strike - through and revisions have been initialed by the County Attorney's I 2f� rz 6. Minutes and Records Clerk of Court's Office ((2L l� 3. The Chairman's signature line date has been entered as the date of BCC approval of the f PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created/prepared the executive summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the item.) Name of Primary Staff Debbie Brueggeman Phone Number (239) 642 -7878 Ext. 34 Contact appropriate. (Initial) Applicable) Agenda Date Item was January 24, 2012 Agenda Item Number 16G1 Approved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed Type of Document License Agreement for Walker Circus Number of Original 3 Attached resolutions, etc. signed by the County Attorney's Office and signature pages from I Documents Attached INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. (Initial) Applicable) 1. Original document has been signed /initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. This includes signature pages from ordinances,i1�� resolutions, etc. signed by the County Attorney's Office and signature pages from contracts, agreements, etc. that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 2. All handwritten strike - through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval of the f document or the final negotiated contract date whichever is applicable. 4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. t' 5. In most cases (some contracts are an exception), the original document and this routing slip N/A should be provided to Ian Mithchell in the BCC office within 24 hours of BCC approval. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 6. The document was approved by the BCC on 1 -24 -12 (enter date) and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09 16G 1 �+ MEMORANDUM Date: January 27, 2012 To: Debbie Brueggeman, Operations Coordinator Collier County Airport Authority From: Teresa Polaski, Deputy Clerk Minutes & Records Department Re: License Agreement for Walker Circus Attached for your records, are two (2) originals of the document referenced above, (Item #16G1) approved by the Board of County Commissioners on Tuesday, January 24, 2012. The Minutes and Record's Department has kept one original document as part of the Board's Official Record's of the Board. If you have any questions, please feel free to call me at 252 -8411. Thank you. 16G1 WALKER INTERNATIONAL EVENTS, INC SITE LICENSE AGREEMENT By this License, Walker International Events, Inc, herein called "Circus" and Collier County Airport Authority, whose mailing address is in care of Airport Authority Director, 2005 Mainsail Drive, Suite 1, Naples, Florida 34114, herein called the "Owner," agrees as follows: 1. Owner hereby licenses real property in Collier County, Florida, described as a portion of the open field at the Immokalee Airport, further shown on the attached Exhibit `A', hereinafter referred to as "Property," for a circus engagement to be held on February 2 & 3 2012. Circus shall be allowed to enter upon the Property for a forty -eight (48) hour period beginning February 1, 2012 at midnight. 2. Circus shall be required to obtain and pay for all costs associated with any permit(s) that are required for conducting this event. A copy of the permit(s) shall be forwarded to Owner, along with the use fee stated below by or on January 31, 2012. 3. Circus shall pay Owner One Thousand Dollars ($1000) by or on January 31, 2012, plus any applicable sales and /or use taxes for use fee of the Property. 4. Circus may cancel this License upon 30 days written notice to Owner. 5. Circus shall keep the Property in a clean and orderly condition, and shall return the Property in as good -as condition as when received, reasonable wear and tear expected. 6. Owner shall not license, lease or sublet the Property to another circus, carnival or outdoor amusement of the same or similar nature from the date of this License until 30 day after the event date described above. 7. Circus may operate all exhibitions, sideshows and concessions with adjacent parking on the property and shall retain all revenue derived from any such operation. Circus may photograph, exhibit and use the Property for Circus purposes in all media. 8. Circus shall provide Owner with a certificate of liability insurance providing a coverage limit of $1,000,000 and naming Owner as an additional insured. Said certificate must be delivered to Owner, along with the permit(s) and use fee, by January 31, 2012. If the certificate is not in the Owner's possession by the aforementioned date, the Owner shall have the right to cancel the event without any prior notice. 9. LESSEE, in consideration of Ten Dollars ($10.00), the receipt and sufficiency of which is hereby acknowledged, shall indemnify, defend and hold harmless LESSOR, its agents and employees from and against any and all liability (statutory or otherwise), damages, claims, suits, demands, judgments, costs, interest and expenses (including, but not limited to, attorneys' fees and disbursements both at trial and appellate levels) arising, directly or indirectly, from any injury to, or death of, any person or persons or damage to property Walker International Events, Inc. Site License Agreement for Circus at IMM February 2 -3, 2012 16G1 (including loss of use thereof) related to (A) LESSEE'S use of the Property, (B) any work or thing whatsoever done, or any condition created (other than by LESSOR, its employees, agents or contractors) by or on behalf of LESSEE in or about the Property, (C) any condition of the Property due to or resulting from any default by LESSEE in the performance of LESSEE'S obligations under this Lease, or (D) any act, omission or negligence of LESSEE or its agents, contractors, employees, subtenants, licensees, invitees or patrons. In case any action or proceeding is brought against LESSOR by reason of any one or more thereof, LESSEE shall pay all costs, attorneys' fees, expenses and liabilities resulting therefrom and shall defend such action or proceeding if LESSOR shall so request, at LESSEE'S expense, by counsel reasonably satisfactory to LESSOR. The LESSOR shall not be liable for any injury or damage to person or property caused by the elements or by other persons on the Property, or from the street or sub - surface, or from any other place, or for any interference caused by operations by or for a governmental authority in construction of any public or quasi - public works. The LESSOR shall not be liable for any damages to or loss of, including loss due to petty theft, any property, occurring on the Property or any part thereof, and the LESSEE agrees to hold the LESSOR harmless from any claims for damages, except where such damage or injury is the result of the gross negligence or willful misconduct of the LESSOR or its employees. 10. Owner warrants that it is the owner of the Property and has full right and authority to license the Property to the Circus. 11. This License shall be governed by the laws of Florida. This License shall not be construed for or against a party because that party wrote it. Any action or proceeding arising from this License shall be brought only in a state court of competent jurisdiction in Collier County. The parties waive any right to a jury trial in an action or proceeding arising out of his License. 12. The conduct of the Circus engagement shall be under the sole control of the Circus. Owner shall not be responsible for the activities of the Circus on the Property. Circus shall comply with all governmental laws and regulations enforced for the performance of this event. 13. At its own cost, the Circus shall be responsible for contracting any type of security or police protection for crowd and/or traffic control. 14. The Circus shall be allowed to utilize water on Owner's Property without any cost to Circus. 15. At its sole cost, the Circus shall be required to provide portable lavatories on the Property during the event and remove said portable following the event. 16. At is sole cost, the Circus shall be required to contract and provide dumpsters on the Property during its use of the Property. Walker International Events, Inc. Site License Agreement for Circus at IMM February 2 -3, 2012 16G1 IN WITNESS WHEREOF, the parties have hereto executed this Agreement the day and year first above written. AS TO CIRCUS: TNES (signature) « '►�,�� (prin ame) WITNESS (signature) (print name) AS TO THE OWNER: Attest: DWIGHT E. ^8qK, Clerk ti t as ta ,G ty clerk Approved ag,to #Qm ,` and legal sufficiency: By: _'l 0 0 k 1, A (signature) t Ole esident (print nami) BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, serving as the COLLIER COUNTY AIRPORT AUTHORITY By: FRED W. COYLE, CHAIRMXN l '�kaC!/�C�Ill #ZAJ A>;SiISiA✓i� �J n� Jeffrey A. Klatzkow, County Attorney Walker International Events, Inc. Site License Agreement for Circus at IMM February 2 -3, 2012 ti COLLIER COUNTY AIRPORT AUTHORITY CONTRACT INSURANCE REQUIREMENTS 16G 1 FORM 2- Commercial Activities License /Sublease of Land /Low Hazard or Short Term /Non Aviation Related TYPE LIMITS Check X Workers' Compensation Statutory Limits of Florida Statutes 440 and Federal Government Statutory Limits and Requirements X Employer's Liability X $500,000 $1,000,000 X Commercial General X $500,000 per occurrence $1,000,000 per occurrence Liability (Occurrence Form) bodily injury and property bodily injury and property patterned after the current damage damage ISO form with no limiting endorsements. Airport Liability Insurance $500,000 per occurrence $1,000,000 per occurrence bodily injury and property bodily injury and property damage damage Han arkee ers Liability $500,000 per aircraft $1,000,000 per aircraft Aircraft Liability Insurance $500,000 per occurrence $1,000,000 per occurrence bodily injury and property bodily injury and property dama a damage Business Automobile $500,000 per occurrence $1,000,000 per occurrence Insurance bodily injury and property bodily injury and property dama a damage Pollution Liability Insurance $500,000 per occurrence $1,000,000 per occurrence bodily injury and property bodily injury and property dama a damage Property Insurance Replacement Cost- All Risks of Loss INDEMNIFICATION: To the maximum extent permitted by Florida law, the ContractorNendor /Consultant shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the ContractorNendor /Consultant or anyone employed or utilized by the ContractorNendor /Consultant in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. Collier County Board of County Commissioners shall be named as the Certificate Holder. NOTE - -The "Certificate Holder" should read as follows: Collier County Board of County Commissioners Naples, Florida No County Division, Department, or individual name should appear on the Certificate. No other format will be acceptable. Thirty (30) Days Cancellation Notice required on Agreements exceeding 6 months. The contract name and number shall be included on the certificate of insurance. Collier County shall be shown as an "ADDITIONAL NAMED INSURED" on property policies where an interest in improvements and betterments is made, as its interests may appear. Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability and /or Airport Liability where required. FORM 2- Commercial Activities License /Sublease of Land /Low Hazard or Short Term /Non Aviation Related CJ Ql X UJ co ue: tf 16G 1 < — t () q r + V3 V V V MCI G� w C� O IAA, W uu^ t^ A^ W ^NA cl a 16G1 17, AC °� CERTIFICATE OF LIABILITY INSURANCE I () r_1 I DATE (,MM /DD/YYYY) I-- - / 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(ies) 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 Allied Specialty Insurance, Inc. 10451 Gulf Boulevard Treasure Island, FL 33706 -4814 1- 800 - 237 -3355 CONTACT PHONE FAx AI No Ex A/C No A' DRIESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: T.H.E. Insurance Company 12866 INSURED Walker International Events, Inc. and Mammoth Equipment Leasing Corp. 3618 Webber Street, Suite 102 Sarasota, FL 34232 INSURER B: INSURER C: 0211512011 INSURER D: E OCCURRENCE INSURER E DAMAACH G E(RENTED PREMISES S Ea occurrence INSURER F: MED EXP (Any one person) 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR CPP0100315 -01 0211512011 02/15/2012 E OCCURRENCE $ 1,000,000 DAMAACH G E(RENTED PREMISES S Ea occurrence 50 000 $ r MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION WC STATU- _7H- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? F N I A I ER _. E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) EFFECTIVE FROM 2/02/12 THROUGH 2/03/12 ADDITIONAL INSURED: COLLIER COUNTY AIRPORT AUTHORITY; COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS AS RESPECTS TO THE OPERATIONS OF THE NAMED INSURED ONLY LOCATION: IMMOKALEE AIRPORT PARK, IMMOKALEE, FL VCKI Irit mIC r1VLUCK I AN%,.CLLAI IVIV COLLIER COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BOARD OF COUNTY COMMISSIONERS THE EXPIRATION DATE THEREOF, NOTICE WILL BE=DELIVER IN NAPLES, FLORIDA ACCORDANCE WITH THE POLICY PROVISIONS. 7a� ©1988 -2010 ACORD CO PORATION- All rights ranampri ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD