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CITY OF CLEARWATER SELF INSURANCE PROGRAM 2016-2017October 3, 2016 (, 1 '1' Y O 1. i, 1. I', :\ R \\' A '1' I R 1 n, 1 t( t,..t.,Ir,, tt, 14 1 t. „ _1t. 1iv 111 tr, .I�t�t� It n '. ►;(t, I Re: City of Clearwater Self- Insurance Program, 2016 - 2017 To Whom It May Concern: Please accept this letter as certification the City of Clearwater Is Insured (or self - insured) for liability and workers' compensation coverage as shown below. The City has been approved by the State of Florida as a self - insured municipal government. The state audit number for the City as a self - insured Florida municipality is 9173. This certification is issued as a matter of information only and confers no rights upon the holder. The insurance coverages named below do not extend the limits of liability beyond the statutory limits of $200,000 per person /$300,000 per occurrence as governed by the provisions of section 768.28, Florida Statutes. The City's major insurance coverages and limits are as follows: 1. Auto Liability, General Liability, Police Professional Liability, and Public Official Liability: Excess Insurance: $7,000,000 ($14,000,000 Aggregate) with BRIT /Lloyds of London with self - insured retention of $500,000 for the policy period 10/01/16- 10/01/17. 2. Workers' Compensation: Statutory coverage per Occurrence with self - insured retention of $600,000 Excess Insurance via Safety National for the policy period 10/1/16- 10/01/17. 3. Emergency Medical Services (EMS) Medical, Professional Liability and Commercial General Liability: $7,000,000 per Occurrence limit/$14,000,000 Aggregate with BRIT /Lloyds of London with a self - insured retention of $25,000 for the policy period 10/01/16- 10/01/17, If you have any questions about this information, please don't hesitate to contact me. Since Ric J. • sorio, AI , C Risk Manager, City of Clearwater Ph. (727) 562 -4655 E-mail: rick.osorio @myclearwater.com Doreen Caudell. ('extncilnrembcr Dr. Bob Cundill', Cuuncilmetnbcr George N. Cretekos, Alayut I iU ionaon, Councilmernber I lolt 11.unilton, Councibnember • Equal Employment and Affirmative Action Employer" #4301 - Gulf -to -Bay & Belcher Clearwater, FL LICENSE AND INDEMNITY AGREEMENT THIS AGREEMENT (This "Agreement ") is made as of the day of October, 2016, by and between Albertson's LLC, a Delaware limited liability company ( "Licensor "), and the City of Clearwater, Florida ( "Licensee ") WHEAREAS, Licensor leases a retail building and parking lot at 2170 Gulf -to -Bay, Clearwater, FL (the "Store Premises "); and WHEAREAS, Licensee desires to enter into the building and parking lot of the Store Premises (the "Licensed Premises ") for the sole purpose of practicing team movement drills, search and rescue, and other fire training purposes. NOW, THEREFORE, Licensor and Licensee agree as follows: 1. In consideration of the covenants herein made by Licensee, Licensor does hereby grant to Licensee the privilege and license to use the Licenses Premises for a period commencing on the date hereof and continuing until terminated according to Section 6 of this Agreement. Licensee will notify Licensor at least forty -eight (48) hours prior to entering the Licensed Premises by giving email notice to Joe Mandarine at Joseph.Mandarine a,albertsons.com or such other person designated by Licensor. Licensee may use the Licensed Premises only for the sole purpose of conducting practicing team movement drills, search and rescue, and other fire training. Licensor agrees to waive a License Fee. 2. Licensee shall at all times during the term of this Agreement keep the Licensed Premises in a clean, neat and safe manner. At all times while upon the Licensed Premises, all agents and employees of Licensee will observe all reasonable rules and regulations which Licensor my prescribe for the protection of the public, its personnel and property, including but not limited to safety rules and provisions against smoking. Notwithstanding anything to the contrary herein, Licensee, and not Licensor, shall be obligated to provide all security services necessary or appropriate for the safe and secure use of the Licensed Premises and on the ways immediately adjoin the Licensed Premises by Licensee and Licensee's agents and employees, and for the protection of all persons using the same pursuant to this License or allowed to enter the Licensed Premises and on the ways immediately adjoin the Licensed Premises by Licensee and for the protection from theft, damage or vandalism of their automobiles and other property, and Licensor shall have no responsibility or obligations in connection with such safety or security. 3. Licensee shall indemnify and hold Licensor and the Licensor's landlord, Westchester Religious Institute ( "Master Landlord "), and any and all affiliates an subsidiaries, harmless from and against any and all loss, damage, liability or claims (including, without limitation, costs and expense of litigation and reasonable attorneys' fees)(collectivcly, "Claims ") arising from, or connected with this Agreement. Neither the City of Clearwater nor its agents or employees shall be liable for any claim, loss, damage, cost, expense, or attorney's fees arising out of the training exercises that are attributable to any error, omission, or negligent act by Licensor or Licensor's landlord, including the officers, agents, and employees of Licensor or Licensor's landlord. Licensee hereby indemnifies, hold harmless an agree to defend Licensor and Master Landlord, and any affiliates and subsidiaries from and against all claims, damages and expenses (including without limitation, reasonable attorney's fees and investigative and discovery costs) liabilities and judgments on account of damage to or theft of property occurring on the Licensed Premises and on the ways immediately adjoin the Licensed Premises arising out of the failure to provide any such security services or the failure to repair any such damages. Licensee's obligations with respect to the indemnification hereunder shall remain effective, notwithstanding the expiration or termination of this License, as to claims arising or accruing prior to the expiration or termination of this License. Nothing herein will be construed to waive or modify the provisions of Section 768.28, Florida Statutes. 4. Licensee shall maintain at its sole cost and expense at lease the following insurance covering its obligations under this Agreement: 1. Auto Liability, General Liability, Police Professional Liability, and Public Official Liability: Excess Insurance: $7,000,000 ($14,000,000 Aggregate) with BRiT /Lloyds of London with self - insured retention of $500,000 for the policy period 10/01/16 - 10/01/17. 2. Workers' Compensation: Statutory coverage per Occurrence with self - insured retention of $600,000. Excess Insurance via Safety National for the policy period 10/01/16 - 10/01/17. 3. Emergency Medical Services (EMS) Medical, Professional Liability and Commercial General Liability: $7,000,000 per Occurrence limit /$14,000,000 Aggregate with BRIT /Lloyds of London with a self - insured retention of $25,000 for the policy period 10/01/16 - 10/01/17. Such insurance shall be issued by one or more responsible insurance carriers acceptable to Licensor and licensed to do business in Florida or through a program of self - insurance. Upon execution of this Agreement and prior to entering upon the Licensed Premises, Licensee shall provide Licensor with a Certificate of Insurance. 5. Anything to the contrary notwithstanding, this Agreement is subject to each and every term, covenant and condition of any lease (whether recorded or unrecorded) and any matter of record which affects the Licensed Premises (hereinafter the "Governing Documents "). Licensee agrees that it will not do any act or be guilty of any omission which might be or constitute a default by Licensor under the Governing Documents. If any approvals or consents are required under the Governing Documents, or any licenses or permits of any kind are required by any governmental agency in connection with Licensee's use of the Licensed Premises, Licensee shall, at its sole cost and expense, obtain same. 6. This Agreement may be terminated by Licensor for any reason in its sole and absolute discretion immediately upon written notice. Licensee shall not be entitled to, and hereby waives, any claim of damages against Licensor for revocation or termination of this Agreement, with or without cause, prior to the automatic termination date. 7. Upon termination of this Agreement, Licensee shall immediately, in a good, careful and workmanlike manner remove its property from the Licenses Premises, and return the Licensed Premises to Licensor in a good a condition as when received. 8. This Agreement is not induced by Licensor, and Licensee states by way of inducement to Licensor that Licensee has determined that there is no violation of any law being committed by Licensee or Licensor in or arising from this Agreement. 9. Licensee may not assign its rights under this Agreement to any party without the prior express, written permission of Licensor. 10. All notices given pursuant to this Agreement shall be in writing and shall be given by certified United States mail, or other established express delivery service (such as Federal Express), postage or delivery charge prepaid, addressed to the appropriate party as set forth below: Licensor: Albertsons LLC Attn: Legal Department (Re: #4301) 250 Parkcenter Blvd. Boise, ID 83726 Licensee: Clearwater Fire & Rescue Department Attn: Assistant Chief Andrew I- Iawkins 1140 Court Street Clearwater, FL 22756 The person address to which notices are to be given may be changed at any time upon written notice to the other party. 11. Licensee warrants and affirms to Licensor that any and all persons signing this Agreement for Licensee are authorized and empowered to so sign and such signing by such person or persons does bind Licensee to all the terms, covenants and conditions of this Agreement. 12. This Agreement may be executed in counterparts and the parties agree that facsimile and email signatures will have the same force and effect as original signatures. LICENSOR: AL: 'TSO L C By: Bradley R. Beckstrom Vice President LICENSEE: CITY OF CLEARWATER, FLORIDA By: (,4) d.etet44& I William B. Horne lI City Manager Approved as to form: Robert J. Assistant •ette Attorney Attest: 1,411A VI cc- e Rosemarie CaII City Clerk