2.08 2.8
RACES&WALKS\SHAMROCK SHUFFLE 2018-2-12-18
RESOLUTION AUTHORIZING ADIRONDACK RUNNERS TO CONDUCT
32ND ANNUAL SHAMROCK SHUFFLE ROAD RACE AND
LEPRECHAUN LEAP CHILDREN'S FUN RUN
RESOLUTION NO. ,2018
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, the Adirondack Runners Club has requested authorization from the Queensbury
Town Board to conduct its 32nd Annual Shamrock Shuffle Road Race and Leprechaun Leap Children's
Fun Run to benefit the Warren-Washington Counties (Area 37) Special Olympics as follows:
SPONSOR The Adirondack Runners Club
EVENT 32nd Annual Shamrock Shuffle Road Race
DATE Sunday, March 25d', 2018 commencing at approximately
10:00 a.m.
PLACE Beginning and ending at Glens Falls High School- course
partially within the Town of Queensbury
(Letter and maps depicting course attached);
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby acknowledges receipt of proper proof
of insurance from the Adirondack Runners Club to conduct its 32nd Annual Shamrock Shuffle Road
Race and Leprechaun Leap Children's Fun Run partially within the Town of Queensbury as set forth in
the preambles of this Resolution, and
BE IT FURTHER,
RESOLVED, that the Town Board hereby approves this event subject to approval by the
Town Highway Superintendent, which may be revoked due to concern for road conditions at any time
up to the date and time of the event.
Duly adopted this 12ffi day of February, 2018,by the following vote:
AYES
NOES
ABSENT:
Town of Queensbury
Thomas R. VanNess
Highway4,z _
�.-4,rt ?,,, Highway Superintendent
Department y -.
742 BayRoad Queensbury,NY l
—Q Y ''�� David Duell
12804
�' - _ Deputy Highway
Phone: (518) 761-8211 �. Superintendent
Fax: (518) 745-4466
TO: QUEENSBURY TOWN BOARD
FROM: THOMAS VAN NESS
DATE: JANUARY 11, 2018
RE: 2018 SHAMROCK SHUFFLE ROAD RACE & LEPRECHAUN LEAP CHILDREN'S FUN RUN
I have reviewed the request for the Adirondack Runners to hold their 32ND Annual Adirondack
Runners Shamrock Shuffle 5-mile Road Race and Leprechaun Leap Children's Fun Run on Sunday,
March 25th, 2018.
I hereby grant my approval for the race to be held on the following roadways: Sherman, Upper
Sherman Avenue, Heresford, Wintergreen Road, Old Forge Road and Dixon Road. Any additional
roadways are not within my jurisdiction and may need further approval. This approval is also
contingent upon the receipt of a certificate of insurance.
Sincerely,
s L !t• am.
Thomas R. Van Ness
Highway Superintendent
32nd ANNUAL ADIRONDACK RUNNERS SHAMROCK
SHUFFLE 5-MILE ROAD RACE AND
' LEPRECHAUN LEAP CHILDREN'S FUN RUN
THE ADIRONDACK RUNNERS - P.O. BOX 2245
GLENS FALLS, NY 12801
December 15, 2017
Superintendent of Public Works
Town of Queensbury
Bay and Haviland Roads
Queensbury,NY 12804
Dear Superintendent:
We have finalized plans for our annual benefit road race, The 32"d Annual Adirondack
Runners Shamrock Shuffle 5-Mile Road Race and Leprechaun Leap Children's
Fun Run, held each year since 1987 for the benefit of Warren-Washington Counties
(Area 37) Special Olympics. This year's event is scheduled for Sunday, March 25,
2018, beginning and ending at the Glens Falls High School, passing at points through the
City of Glens Falls and Town of Queensbury. The Leprechaun Leap begins at 10:00 a.m.
and the Shamrock Shuffle starts at 11:00 a.m.
We request permission from the Town of Queensbury to once again conduct this race,
and are arranging for the necessary liability insurance. A "Certificate of Insurance" will
be delivered to your office by March 15, 2018. As in the past, we will appreciate the
support and participation of the Warren County Sheriffs Department for "escort and
traffic control", as well as the Department of Public Works in the event that the weather
is adverse for "snow plowing and sanding". I have attached a copy of the race
application and course map for your review.
Please contact me with any questions or concerns via my personal information as listed
below. I look forward once again to your favorable response to our request.
0
.,-,4 ,
Sinc- el your_. , '"
evin . Su iv , Race Director
Ai\fiL' 60
)')il ' oS119ii
13L. , on e
ns Falls,NY 12801
(H) 798-9593 or (W) 824-4619
ksullivan@queensburyschool.org ti
THE ADIRONDACK RUNNERS 32nd ANNUAL
of �o 1� ) ilii Nbr, !,� ,Llai i _�JI of ,o
v �„
,�ONo 1 EA 3j MARCH 25, 2018 - 11:00 AM vgaA 3j ONo
°gi' GLENS FALLS HIGH SCHOOL p - Q' ;r F
Special 0/ymplcs TO BENEFIT Speclallalymplcs �:' ,,y
.1.\----1_,--'--- A' New York New York \
NNt WARREN-WASHINGTON NYS SPECIAL OLYMPICS G •
•
CORPORATE SPONSORS RRCA.t
CARRIAGE TRADERS AWARDS
WARREN TIRE SERVICE >a 10A0a"a""�0/AMOUL (Male&Female)
GLENS FALLS NATIONAL BANK&TRUST L
ROSE&KIERNAN INSURANCE,INC. UnderdoglRace Overall(Male&Female)
GE GLOBAL RESEARCH Timing 1st,2nd,3rd
LOCATION: Glens Falls High School—10 Quade Street,Glens Falls,NY,12801 Age Groups(10 Yr.,Male/Fen.)
CHECK IN: Starts 8:30am—10:30am race day at the Glens Falls High School Gymnasium 1st,2nd,3rd
COURSE: 5 Miles-basically flat&fast loop course—www.AmericasRunningRoutes.com Masters(40+Male&Female)
PRE-REGISTRATION:Received by Tues.March 20th-$25.00($20.00 Member Adirondack Runners) 1st Male&Female
RACE-DAY REGISTRATION: $30.00(closes 10:30 am sharp!)
RESULTS: Chip-Timing&Results by Underdog Race Timing Wheelchair(Male&Female)
T-SHIRTS: High Quality,Custom T-Shirts(First 300 Shamrock Shuffle Entrants) 1st,2nd,3rd
DONATIONS: All proceeds benefit Warren-Washington Counties NYS Special Olympics Programs No Duplicates
FACILITIES: Glens Falls High School-Showers&Restrooms available
INFORMATION: Kevin Sullivan,Race Director-(518)798-9593 or shamrockshuffle@roadrunner.com or www.adirondackrunners.org
The Leprechaun Leap >
CHILDREN'S(12&Under)FUN RUN-7/8 Mile Run—Donation:$3.00
Registration: 8:30am-9:45am-Start 10:00am.—Custom Medals For ALL Finishers!!!!
---------Detach Here--------- -^----------------------------
SHIRT SIZE
LAST NAME FIRST MIDDLE INITIAL SM MED LG XL
ADDRESS PHONE Sex(MIF)Wheelchair
CD
CITY
STATE/PROVINCE ZIP/POSTAL CODE A9re Race Da DOB mmlddlyy
/ /
I know that participating in The Adirondack Runners events is a potentially hazardous activity.I agree not to enter and participate unless I am medically able and properly trained.I agree to abide by any decision of an
event official relative to my ability to safely complete the event.I am voluntarily entering and assume all risks associated with participating in the event,including,but not limited to,falls,contact with other participants,
spectators or others,the effect of the weather,including,snow,sleet and rain traffic and the conditions of the course,all such risks being known and appreciated by me. I grant to the Adirondack Runners its designee
access to my medical records and physicians,as well as other information,relating to medical care that may be administered to me as a result of my participation in this event.Having read this Waiver and knowing
these facts,and in consideration of your acceptance of this application,I,for myself and anyone entitled to act on my behalf,waive and release The Adirondack Runners,Road Runners Club of America,theCity of
Glens Falls,Town of Queensbury,Glens Falls City School District,and their agencies and departments,and all sponsors,and their representatives and successors,from present and future claims and liabilities of any
kind,known or unknown,arising out of my participation in this event or related activities,even though such claim or liability may arise out of negligence or fault on the part of any of the foregoing persons or entities.I
grant permission to the foregoing persons and entities to use or authorize others to use any photographs,motion pictures,recordings,or any other record of my participation in this event or related activities for any
legitimate purpose without remuneration.
SIGNATURE DATE
Entry Fee $
EMAIL ADDRESS
Add.'Donaton$
SIGNATURE OF PARENT(if under 18) .
Make Checks Payable To: ADIRONDACK RUNNERS
MAIL ENTRIES:SHAMROCK SHUFFLE,13 Lawton Ave.,GLENS FALLS,N.Y.12801 1TS !OUR RACE Amount Enc. $
Register online today!!! http://Qlensfallsshamrockshuffle.itsyourrace.com/event.asox?id=8516
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• THE LEPRECHAUN LEAP
tRACE COURSE DIRECTIONS: h 47 b.
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LINE; RUN/WALK THROUGH : 1 • �Y ►5 d I v �, r t i c.i- .�
-RIBBONS WILL BE PRESENTED TO EACH S �L O a y •C '�o/0;,.°� Srss 5°�• ._
FINISHER AT THE END OF CRDTET et; tr•�jt ...0
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RX DatelTime 0210112018 11:51 5188244683 P.002
02/01/2018 12:33 5188244683 HIGH SCHOOL GUIDANCE PAGE 02/05
�
re DATE(MM/DO/YYTY)
A
CO CERTIFICATE OF LIABILITY INSURANCE 1/25/2018
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 t:OATACT Margaret Mayers __ __
STAR Insurance - Fort Wayne Office tar (260)467--5689 I FIA C,N0):(260)6677-5E1_
2130 East Dupont Road canal aermaas:mar aret.ma ers@starfinancial.com
INSURER(S)AFFORDING COVERAGE -• , NAIC P
Fort Wayne IN 46825 -- _ INsuRERA:National_ Casualty company_ , :11991
INSURED
INSURER LI:Nationwide Life Insurance Co. 66869 _
Road Runners Club of America/2018 and Its INSURER C: i +
Member Clubs INSURER D
1501 Lee Highway, Suite 140 INSURER E: __---_- _• ,,,___-
Arlington VA 22209 INSURER P:
COVERAGES CERTIFICATE NUMBER:2018 $11 A.I. REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AI.L THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'INSR SUM OF INSURANCE ADDL SU ' POLICY EPF . PC61CY di' LIMITS
LTR ,. , Pol.tcYNU B R „,:Q• /DO Yv
X I COMMERCIAL GENERAL LIABILITY I I I LEACH OCCURRENCE L$ 1,000,000
I I ATO T1'EPTE
A CLAIMS-MADE I OCCUR I PMISMAGEES(ERoacurtohco) 3 500,000
X I Legal Liability to ,___. , I aR00000071TOSOO 12/31/2017 12/31/2018;MED EXP(Anyonepereon) k.1 5,000
1 Erirt4e pant_$1,000,000 I 12:01 AM 12:01 AM PERSONAL&ADV INJURY $ 1,000,000
GENT-AGGREGATE LIMIT APPLIES PER: ' GENERAL AGGREGATE Unlimited
X 1 POLICY I 128: . .1.0C ,Abnee $ Moleetetion I PRODUCTS-COMP/OP AGO $ 1,000,000
I OTHER; Aggregate 35,000,000 Abuse and Molommlon $ 500,000
AUTOMOBILE LIABILITY I COMBINED BINDLE LIMIT $ 1,000,000
(En accident).... --- —
-
A - ANY AUTO 1 . • e001LY INJURY(Far pete0n) (S
ALL OWNED SCHEDULED I XR0000007170900 I12/31/2817 12/31/2018 BODILYINJURY Pnrnualdanl I
AUTOS AUTOS ( )�$ .. _
..7.:,
HIRED AUTOS X .NONOWNED PROPERTY DAMAGE
. _AUTOS 12:01 ADI 12:01 AM (For accident) .__ I$ __..
• I i I i S
UMBRELLA LIAR OCCUR EACH OCCURRENCE S
1 EXCESS VAN CLAIMS-MADE AGORESATE $
-
DED RETENTION$ 3
WORKERS COMPENSATION I I I „ 'MUTE I 10Th „._.,,,
AND EMPLOYERS'LIABILITY Y_!N _--
ANY PROPRIETOR/PARTNER/EXECUTIVE .- NIA E.l..EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? f _•J ...
----- ----
(Mandatory In NH) E,L DISEASE•EA EMPLOYE• $
It as deetlibe under "'- -- -
SCRIP r0. OF OPERATIONS be•w • E.L.DISEASE-POLICY LIMIT $
S Excess Medical & Accident 53X0000020554500 12/31/2017i12/31/2018I Excess Moo' $10,000
($250 Deductible/Claim) 12:01 AM , 12:01 AM I ADASpeolfnLon $2,500
1 I
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLE(ACORD lot,Additional Ramarkn Schaduln,may bo attached If mere npoco in required)
The Town of Queensbury IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS TO THEIR INTEREST TN THE OPERATIONS
OF THE NAMED INSURED. DATE OF EVENT(S) : 03/25/18 Shamrock Shuffle 5 Mile Road Race & The Leprechaun Leap
7/8 Mile Kids Run and 06/30/18 The Adirondack 15K Race to the Lakes INSURED RRCA CLUB/EVENT MEMBER:
The Adirondack Runners, Attn: William Verner; PO Box 2245, Glen Falls, NY 12801
(Effective 01/29/18. This voids and replaces previously issued certificate.)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
03/25/18 The Town of Queensbury THE EXPIRATION DATE THEREOF, NOTICE W(L,L BE DELIVERED IN
Attached: PCNO148 - CG2404 & XRGL79 ACCORDANCE WITH THE POLICY PROVISIONS.
742 Bay Road
Queensbury, NY 12804 AUTHORIZED REPRESENTATIVE
Terry Diller/LKR "5-^_^n-� - , ...dQ✓zIPc.4_1
M1988-2014 ACORD CORPORATION, AI)rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025(201401)
SRX Date/Time 02/0112018 11:51 5188244683 P.003
02/01/2018 12:33 5188244683 HIGH SCHOOL GUIDANCE PAGE 03/05
Policy ChangeGUGU 269
Number _ 8 (116)
THE ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IL 12 01 11 85
POLICY CHANGES
POLICY NO. POLICY CHANGES COMPANY
EFFECTIVE NATIONAL CASUALTY COMPANY
KR00000007170900 03/25/18
NAMED INSURED AUTHORIZED REPRESENTATIVE
ROAD RUNNERS CLUB OF AMERICA AND ITS K&K INSURANCE AGENCY,INC.
COVERAGE PARTS AFFECTED PAGE 01 OF 01
Commercial General Liability
CHANGES
Form Number: CG2404 "Waives: of Transfer of Rights of Recovery
Against: Others To Us"
(X) Add Form To Include Additional Insured:
THE TOWN OF QUEENSBURY
Club: The Adirondack Runners
Events/nates:
Shamrock Shuffle S Mile Road. Race & The Leprechaun Leap 7/8 Mile Kids
Run-03/2S/18
The Adirondack 15K Race to the Lakes-06/30/18
No Premium Change
Ai
I.
NLS 01/31/18 4 WSW
Authorized Representative Signature
Copyright Insurance Services Office,Inc.,1983
Copyright,ISO Commercial Risk Services,Inc,1983
RX Date/Time 02/01/2018 11:51 5188244683 P.004
02/01/2018 12:33 5188244683 HIGH SCHOOL GUIDANCE PAGE 04/05
•
POLICY NUMBER: KR00000007170900 COMMERCIAL GENERAL LIABILITY
CG 24 04 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name 01 Parson Or Organization:
THE TOWN OF QUEENSBURY
Club:The Arirondack Runners
Events/Dates:
Shamrock Shuffle 5 Mlle Road Race&The Leprechaun Leap 7/8 Mlle Kids Run-03/25/18
The Adirondack 1 5K Race to the Lakes-06/30/18
Information re•uired to com'kite this Schedule, if not shown above,will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others Ta Us of Sec-
tion IV—Conditions:
We waive any right of recovery we may have against
the person or organization shown in the Schedule
above because of payments we make for injury or
damage arising out of your ongoing operations or
°your work" done under a contract with that person or
organization and included In the 'products-completed
operations hazard". This waiver applies only to the
person or organization shown in the Schedule above.
CG 24 04 05 09 Insurance Services Office,Inc.,2008 Page 1 of I
RX DatelTime 02101!2018 11:51 5188244683 P.005
02/01/2018 12:33 5188244683 HIGH SCHOOL GUIDANCE PAGE 05/05
ENDORSEMENT
National Casualty Company NO. woo
ATTACHED To AND -� ENp4ps6HeN7 EFFECTIVE DATE NAM@O mm...—._ - - liii_ iIH
[KR0000000717O'40t) t2/51/17 ROAD RUNNERS CLUE OF AMERICA AND ITS .
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:
Other Insurance
I. If other valid and collectible insurance with any other insurer including any formal self-insured retention
prograrns is available to you covering a loss also covered by this Coverage Part,other then insurance that
Is in eXcass of the insurance afforded by this Coverage Peri. 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
8§3FO 1..I ED BY CON„I,;FIAGT C OWNERS _CSS0_B5 C)FPREMISE,S QNLY._,,,_ ,
as additional insureds
The Cancellation condition of this Coverage Part is amended by the addition of the following II an "X" Is in the
box:
Lei Cancellation
The following is added: It Is a condition of the Policy by this Endorsement that the Policy will not be can-
celled without 30__ -.-----"- ._days'prior written notice to:
__ and further,
that the person(s) named above are not liable for the payment of any premiums or assessments on this
Policy.
"ANY NTlrLON FILE wfTFlaLE,COMP/ lY THAT REQUIRES PRIOR_NOTIC.,___,,_�
TI-�[-1gUG1�l W( iTMR CONITFiACT. PERMIT Q11 AG8,E.E,_MC. Iw ._,_ ----. —
_-__., AUTHORIZED REPRESENTATIVE DATE
KR-GL-79(4-07) Page 1 of 1