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3.03 3.3 RACES&WALKS\Reindeer Run at SUNY Adirondack—8-22-2022 RESOLUTION AUTHORIZING ADIRONDACK RUNNERS TO CONDUCT REINDEER RUN 5K RESOLUTION NO. ,2022 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, the Adirondack Runners has requested authorization from the Queensbury Town Board to conduct its Reindeer Run 5k within the Town of Queensbury and on Town roads to sponsor the Wait House as follows: SPONSOR Adirondack Runners EVENT Reindeer Run 5k DATE/TIME Saturday morning, December 3rd, 2022 PLACE Beginning and Ending at SUNY Adirondack—640 Bay Road, Queensbury and WHEREAS, Adirondack Runners has provided the Town with proper proof of insurance in form acceptable to the Town and the Town's insurance carrier, NOW, THEREFORE, BE IT RESOLVED, that the Queensbury Town Board hereby approves and authorizes the Adirondack Runners to conduct its Reindeer Run 5k within the Town of Queensbury to benefit the Wait House on Saturday, December 3rd, 2022, 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 22nd day of August, 2022,by the following vote: AYES NOES ABSENT: >IIt't'll s1)1(l;I David l dell Department I, li i+1 { )iC it TO: Town Board FROM: Dave Duell DATE: July 27, 2022 RE: Adirondack Runners 5k Reindeer Run I have reviewed the request by The Adirondack Runners, which will hold their 5k Reindeer Run event on Saturday, December Yl, 2022. 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. "D`a''vviid Duell ID at-"l Highway Superintendent Town of Queensbury Yk tg"fMfdr 1,S_�"Q+� t`r rpm !ISO 14 S,2,;, dSy n a iNY Cy yP',�*N a,y+eN d � ,�� T� 1�i i�u}�t.rd^'Hyir�� }' � s o��• b s? t}�'+ t,y'}4. Et"1 '� rh ;'• f 1r t y �'tl�' �.,t �� ?1 ?+fir.� } rr v >4F wfi+y,. 1 vti a f`�p A4� "�x~t n F* k. �' 4�rM � yet r d r� des g•," ,�Ux,,gn+ w,� ,�� ',5,',t� r'f "n� t nACsti r e r i �` 1� ^rory Jp"��,' y aL ,uya fy' ^te DATE(MMIDDIYYYY) v ACOR" CERTIFICATE OF LIABILITY INSURANCE ik. i 07126/2022 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 have ADDITIONAL INSURED provisions or 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 CONTACT Margaret Mayers NAME: Insurance Management Group PHONE (260}338-2925 FAX (765}664-0761 (At No Ext. AIC,Na 12730 Coldwater Road,Suite 103 E-MAIL mmayers@insmgt.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Fort Wayne IN 46845 INSURER A: National Casualty Company 11991 INSURED INSURER B: Nationwide Life Insurance Company 66869 Road Runners Club of America/2022 and its Member Clubs INSURER C: INSURER D. 1501 Langston Boulevard,Suite 140 INSURER E: Arlington VA 22209 INSURERF: COVERAGES CERTIFICATE NUMBER: 2022$1M A.I. 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDY EFF MNVDD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE15- CLAIMS-MADE �OCCUR PREMISES Me occurrence $ 500,000 X Legal Liability to 5,000 MEO EXP(Any one person) $ A Participant$1,000,000 KR00000008971200 12/31/2021 12/31/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5.000,000 POLICY ❑jR�T LOC PRODUCTS-COMPIOPAGG $ 1,000,000 x OTHER: Per Event Basis Abuse and Molestation $ 500,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A SCHEDULED ALTOS ONLY AUTOS KR00000008971200 12/31/2021 12/31/2022 BODILY INJURY(Per accident) $ AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ OED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Excess Medical&Accident Excess Medical $10,000 B ($250 Deductible/Claim) BAX0000031850400 12/31/2021 12/3112022 AD&Specific Loss $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Town of Queensbury IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS TO THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT(S):12/03/22 Reindeer Run 5K INSURED RRCA CLUB/EVENT MEMBER:The Adirondack Runners ATTN:Jim Goodspeed,P O Box 2245,Glens Falls New York 12801 ATTACHED:PCN 0291-CG2404&KRGL79 Processed by RMV CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 12/03/22 Town of Queensbury ACCORDANCE WITH THE POLICY PROVISIONS. 742 Bay Road AUTHORIZED REPRESENTATIVE ri Queensbury NY 12804 ([ - G11988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: KR00000008971200 COMMERCIAL GENERAL LIABILITY CG 24 04 06 09 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: Town of Queensbury CLUB: The Adirondack Runners DATE AND NAME OF EVENT: 12/03/22 Reindeer Run 5k PCN 0291 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 operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 13 ' � ��^��k�� , ENDORSEMENT NatioU��K��K ��|0�� nal ��~°~°==~~n�� ~~.".K==°" "� "~"=. ATTACHED TO AND FORMING A PART OF ENDORSEMENT EFFECTIVE DATE NAMED INSURED AGENT NO. POLICY NUMBER (12:01 A.M.STANDARD TIME) KRO 86220-00 12/31/20 Road Runners Club of America and its Member Clubs THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |lFCAREFULLY. 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 bon: OtherVmaucmmce [—1 If other valid and collectible insurance with any other insurer including any formal self-insured re- tention programs is available to you covering a loss also covered by this Coverage Part, other than insurance that is in excess of the 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 lim- itations of other insurance. F7lCoveraga afforded under this Coverage Part is primary insurance and Other Insurance shall not apply asrespects AS REQUESTED Aa additional insured. The Cancellation condition of this Coverage Part is amended bythe addition of the following ifa "X" ioin the box: FRIConce||aUon The following is added: It is a condition of the Policy by this Endorsement that the Policy will not be cancelled without gO days' prior written notice to: BLANKET BO WRITTEN NOTICE OF CANCELLATION AS REQUIRED BY WRITTEN CONTRACT As additional insured. and further, that the person(s) named above are not liable for the payment of any premiums or assessments on this Policy. AUTHORIZED REPRESENTATIVE cwnE NR,GL-79(4'07) Page 1of1