4.03 4.3
RACES&WALKS\Reindeer Run at SUNY Adirondack-Camp Comfort—11-5-18
RESOLUTION AUTHORIZING ADIRONDACK RUNNERS'
4 MILE REINDEER RUN AND JR. REINDEER RUN
RESOLUTION NO. ,2018
INTRODUCED BY:
WHO MOVED ITS ADOPTION
SECONDED BY:
WHEREAS, the Adirondack Runners has requested authorization from the Queensbury
Town Board to conduct its annual 4 Mile Reindeer Run and Jr. Reindeer Run to benefit Cindy's
Camp Comfort and the Adirondack Runners Scholarship Fund as follows:
SPONSOR Adirondack Runners
EVENT 4 Mile Reindeer Run and Jr. Reindeer Run
DATE Sunday, December 2 rid, 2017
TIME 9:10 a.m./9:35 a.m.
PLACE SUNY Adirondack—640 Bay Road, Queensbury
NOW, THEREFORE, BE IT
RESOLVED, that the Queensbury Town Board hereby acknowledges receipt of proof of
insurance from the Adirondack Runners Club and therefore approves and authorizes the 4 Mile
Reindeer Run and Jr. Reindeer Run within the Town of Queensbury to benefit Cindy's Camp
Comfort and the Adirondack Runners Scholarship Fund on Sunday, December 2"d, 2018, and
BE IT FURTHER,
RESOLVED, that the Town Board hereby approves this event subject to the Town
Highway Superintendent's approval of the race, which approval may be revoked due to concern for
road conditions at any time up to the date and time of the event.
Duly adopted this 5`h day of November, 2018, by the following vote:
AYES
NOES
ABSENT:
To-tun, 0 f'QZI.G'ensbu7y David Duell
.,- . l�li-hwa4 Superintendent
Highway = t:>14) �r11-S`21'2
Department
i\4arl: Benwat e
,+2 Ba.), Road—Queensbury,AY 12801. Deputy Highway Superintendent
P11011e: (:718) ,61-5'21 1 �te 18) 76 1—82 10
l'as: (:i IS) 7.16-1-1-W;
TO: TOWN BOARD
FROM: DAVID DUELL
DATE: OCTOBER 19, 2018
RE: ADIRONDACK RUNNERS'4 MILE REINDEER RUN
I have reviewed the request by the Adirondack Runners, which will hold their 4 Alile Reindeer Run
run/walk event on Sunday, December 2nd to benefit Cindy's Comfort Camp and Adirondack
Runners.
Weather permitting, I hereby grant my approval for this event to be held on the following
roadways that are under my jurisdiction: Meadowbrook Road and Cronin Road. The remaining
roadways are not in my jurisdiction and may require additional authorization.
�AU-a
David Duell
Highway Superintendent
Town of Queensbury
�-ON° 4 Mile Reindeer Rut)
o � Jr. W!ndeer Run
9
Sunday,December 2ai1,2018
(/M N Ire,
" 9:35 a.m. _ .71�f,['vIL CD177
SUNY Adirondack,640 Bay Road,Queensbury,NY
REGISTRATION: Online at Active.com(ends 12:00pin 12/1)
Race Day Registration&Packet Pick-up 8:15-9:15 in Student Center
ENTRANCE FEES: $22.00-Pre-Registration(Adirondack runners$18.00)
$25.00-Race Day Registration
T-SHIRTS: Souvenir Long sleeve T's first 150 Entrants—sizes not guaranteed
INFORMATION: Race Directors:Lance Decker&Paul Stevens
Email:reindeernin(@.adirondackrunners.org
Websitc:www.adirondackrunners.orp
TO BENEFIT: Cindy's Comfort Camp and Adirondack Runners Scholarship Fund
AWARDS: Over All: 1"-3`d Male&Female
AGE GROUPS: Male&Female as follows: 1-9, 10-14, 15-19,20-24,25-29,30-34,35-39,40-44,45-49,50-54,
55-59,60-64,65-69,70-74,75-79,80-99
Reindeer Run Jr: 9:10 am prior to the 4 mile run \p/RoadiD'
Kids Run $5.00-1 mile Children's fun run for ages 12 and under
Finish Medal to all finishers.(NO shirts)
Reindeer Run2018 SHIRT SIZE
LAST NAME FIRST SM M LG XL
ADDRESS (PHONE (�
W J 1 1 1 1
CITY STATE/PROVINCE ZIP/POSTAL CODE
m
EMAIL
Date of Birth AGE(Race Day) SEX(M/F) 4 Mlle Run Kids Run
—� I _ 1 Mie Jr Run donation suggested$5.
In consideration of the opportunity to participate in this race I hereby a ehy release and forever the sponsoring agents,their members&any other persons statfing this race in any
claims,costs&demands as a result of participating In this event.1 also certify that I am In good physical shape for the event.Further,I here by grant full permission to any and all the
foregoing to use any photographs,video tapes,motion pictures,recordings,or any other record of this event for any legitimate purposes.I realise there are dangers associated with
running,including but limited to street conditions,weather and tralfx:.I hereby lot myself,heirs,executors,or assigns
waive&release any and all claims I may have against Road Aunners,the sponsors,SUNY Adirondack,Town of Queensbury,
Warren Counhy,Adirondack Runners,its officers and any race official for any Injury,illness or property loss which might ENTRY $
occur to me while competing in,traveting to,or returning from the events on December,2'4 201&
SIGNATURE DAT9 ADDITIONAL DONATION $
SIGNATURE OF PARENT f if under 18
AMOUNT ENCLOSED $
Make Checks Payable To:THE ADIRONDACK RUNNERS
Mail Entries To: Reindeer Run 2018
Adirondack Runners/Lance Decker,70 Tanager Way,South Glens Falls,NY 12803
Mile R
Course Map
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Student
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' k. CERTIFICATE OF LIABILITY INSURANCE °A0/lS 2018)
�� 10/15/2018
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(los)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 ondorsomon s
PRODUCER CONTACT
NAME Margaret Mayers
Insurance Management (croup PHONE (260)338-2925 FAX 12730 Coldwater Road Town of Queensbury (7657 66a-0761
%"AIhsS:mmayerB@inamgt.com Arc Ne:
Fort Wayne IN 46845 OCT 19 2013 INSURERS AFFORDING COVERAGE NAICA
INSURED INSURER A:National Casualty Company 11991
INSURERBNationwide Life Insurance Co. 66869
Road Runners Club of Americal,2018 ands{is INSURERC:
Member Clubs �iIghway Department INSURERD:
1501 Lee Highway, Suite 140 INSURERE:
Arlington VA 22209 INSURERF:
COVERAGES CERTIFICATE NUMBER:2018 $114 A.Z. REVISION NUMBER:
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 POLICY NUMBER POVUOCO EFF MPNOLICjpD/y XP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
A CLA MS-MADE ED OCCUR Abu T R NT
PREMISES aomarence S 500,000
X Legal Liability to KROOODO007170900 12/31/2017 12/31/2028 MEDEXP(Any one Penton) S 5,000
Participant $1.000,000 1201 AN 1201 AH PERSONAL&ADV INJURY $ IL,000,000
GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S Unlimited
X POLICY❑JECT El LOC Abuse & tsoleatation -PRODUCTS-COMP/OPAGG S 1,000,000
OTHER: Aggregate $5,000.000 1ADuse and Moleslation S 500,000
AUTOMOBILE LIABILITY MEIN D SINGLE LIMIT
aacod i S 1,000,000
AIX
ANY AUTO BODILY INJURY(Per person) S
AUTOOWNED SS SCHEDULED
AUTOS KRODD00007170900 12/32/2017 12/31/2028 BODILY INJURY(Per aWdent) S
NOWOHIREDAUTOS )( AUTOS ED PROPERTYDAMAGE
AUTOS 12rO1 AK 12s01 AN peracddent S
S
UMBRELLA LIAR OCCUR EACH OCCURRENCE S
EXCESS LIAO CLAIMS•MADE AGGREGATE S
OED I I RETENTIONS $
WORKERSCOMPERSA710M PER O F1
AND EMPLOYERS LIABILITY YIN STATUTE ER
ANY PROPIUETOPJPARTNERIFXECUTIVE E.I.EACH ACCIDENT S
OFFICERIMEMBER EXCLUDED? NIA
(Mandatory In NH) E.L.DISEASE-EA EMPLOYE S
I( es.doaulbo under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
B Excess Medical & Accident SPX0000028554500 12/32/2027 22/31/2019 Excess Medical $10,000
1$250 Deductible/Claim) 1201 AN 12r01 AM AD&SpearxLoss $2,500
DESCRIPTION OF OPERATIONS r LOCATIONS r VEHICLES(ACORD 101.Additional Remarks ScMdule,may ba attachod It mom space is requited)
The Town of Queensbury and its respective officers, agents and employees are NAMED AS AN ADDITIONAL
INSURED AS RESPECTS TO THEIR INTEREST IN THE OPERATIONS or THE NAMED INSURED. DATE OF EVENT(S)t
12/02/18 4 Mile Reindeer Run and Jr. Reindeer Run INSURED RRCA CLUB/EVENT MEMBER: The Adirondack
Runners, Attan: William Venner, PO Box 2245, Glens Falls, NY 12801 Effective 10/18/18 this voids and
replaces any previously issued certificate
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
12/02/18 Town of Queenabury THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attached: PCN0643-CG2404 & KRGL79 ACCORDANCE WITH THE POLICY PROVISIONS.
72 Bay Road
Queensbury, NY 12804 AUTHORIZED REPRESENTATIVE
Terry Diller/MARG
O 1988.2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025(201401)
Policy Change GU 269
Number 0643
(11-85)
THE ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IL12011185
POLICY CHANGES
POLICY NO. POLICY CHANGES COMPANY
KR00000007170900
EFFECTIVE 12j02/18 NATIONAL CASUALTY COMPANY
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 "Waiver of Transfer of Rights of Recovery
Against Others To Us"
(X) Add Form To Include Additional Insured Below:
THE TOWN OF QUEENSBURY AND ITS RESPECTIVE OFFICERS, AGENTS AND EMPLOYEES
Club: The Adirondack Runners
Event: 4 Mile Reindeer Run and Jr. Reindeer Run
Date: 12/02/18
No Premium Change RECEIVED
Town of Queensbury
OCT 19 2018
Highway Department
NLS 10/18/18
Authorized Representative Signature
Copyright Insurance Services Office,Inc., 1983
Copyright.ISO Commercial Risk Services,Inc. 1983
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 Of Person Or Organization:
THE TOWN OF QUEENSBURY AND ITS RESPECTIVE OFICERS,AGENTS AND EMPLOYEES
Club:The Adirondack Runners
Event:4 Mile Reindeer Run and Jr.Reindeer Run
Date: 12/02/18
Information required to complete 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 To 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 RECEIVED
operations hazard'. This waiver applies only to the
person or organization shown in the Schedule above. 'Own Of QueenSbUf y
L`'i 19 r
/_a 'J!
Highway Department
CG 24 04 05 09 0 Insurance Services Office,Inc.,2008 Page 1 of 1
r
ENDORSEMENT
National Casualty Company NO. 0000
ATTACHFO TO AND ENDORSEMENT EFFECTIVE DATE
FORMING A PART Of (12.01 A.M.STANDARD TIME)
NAMED INSURED AGENT NO.
POLICY NUMBER
KR00000007170900 12/31/1 i ROAD RUNNERS CLUB OF AMERICA AND ITS
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
RECEIVED
POLICY CONDITIONS Town of Queensbury
This endorsement modifies Insurance provided under the followincCT `lUl
COMMERCIAL GENERAL LIABILITY COVERAGE PART De artment
Highway p
The Other Insurance condition of this Coverage Part is replaced by the provision marked below with an"X'in the
box:
Other Insurance
U If other valid and collectible insurance with any other Insurer including any formal sell insured retention
programs is available to you covering a loss also covered by this Coverage Part,other than insurance that
is In-excess of-[he 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 shalt not apply as
respects
f� P mE UIRE_D BY CONTRACT FOR OWNERS/LESSORS-OF PREMISES ONLY -
as additional insureds.
The Cancollation condition of this Coverage Part Is amended by the addition of the following if an "X" is in the
box:'
Q Cancellation
The following Is added: It is a condition of the Policy by this Endorsement that the Policy will not be can-
celled without 3) days'prior written notice to:
*SEE and further,
that the person(s) named above are not liable for the payment of any premiums or assessments on this
Policy.
*ANY ENTITY ON.FILE WITH THE COM AN TH QUIRES pjWR NOTICE
THROUGH WRITTEN CONTRACT PERMIT OR AGREEMENT
AUTHORIZED REPRE51-N I ATIVE DATE
KR.GL-79(4-07) Page t of 1