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HomeMy Public PortalAboutSelect Board Meeting Packet - 09.15.2021Brewster Select Board Meeting of September 15, 2021 Consent Calendar Items 1 6 Consent Agenda ď‚·Facility Use Application; Brewster Ponds Coalition- Sheep Pond Woodlands Walk The Brewster Ponds Coalition will be offering a guided walk-through Sheep Pond Woodlands, preserved by Brewster Conservation Trust. Walkers are requested to bring water and/or medications that may be necessary and to wear comfortable walking shoes. The start time is 10am and should last about an hour. This event is free to Brewster Ponds Coalition members and $10 for all others, sign up is available on their website. ADMINISTRATIVE RECOMMENDATION We recommend that the Board approves this request. Archive d: Monday, September 13, 2021 2:49:31 PM From: Susan Bridges Se nt: Mon, 13 Sep 2021 17:55:26 To: Erika Mawn Cc: K onrad Schultz Subje ct: Re: Sheep Pond Woodlands Walk Se ns itivity: N ormal Attachme nts : BPC app for facility use.pdf; Brewster Pond- TOB updated CO I.pdf; Hi Erika, Thank you for helping us navigate the town approval process for the Brewster Ponds Coalition's Sheep Pond Woodlands walk this Saturday! I have attached the completed Application For Facility Use form and the BPC's Certificate of Insurance (the town should already have this on file). The BPC also has a liability waiver that we ask participants to sign. I will bring copies of both the town waiver and the BPC waiver to our meeting point and have all participants sign them before the walk begins. Only four people have signed up so far, for a total of six including 2 BPC guides. We will likely get a few more people, but probably not more than ten in total. Please let me know if you need anything else. Best, Susan Susan Bridges Presi dent Brewster Ponds Coalition P.O. Box 459 Brewster, MA 02631 susan.bridges@brewsterponds.org 908-963-1389 On Mon, Sep 13, 2021 at 9:45 AM Erika Mawn <emawn@brewster-ma.gov> wrote: Good morning, I hope you both had a nice weekend. We have been notified that you will be hosting a Sheep Pond Woodlands Walk on Saturday September 18. In accordance with our policies, since this is located on Town property, we will require you to obtain approval from the Select Board. Since we are close to the walk, we would be able to put this on our agenda for the meeting on Friday 9/17 at 9am. I have included the forms that will need to be completed and submitted to me asap. These include a Brewster Facility Use application, Certificate of Insurance from Brewster Ponds Coalition and Liability waivers for each attendee of the walk. For the liability waivers, these can be completed prior to the walk and submitted to me as one packet. Please let me know if you have any questions. Thank you, Erika ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 9/2/2021 License # 0C36861 (703) 397-0977 20281 Brewster Ponds Coalition, Inc. PO BOX 459 Brewster, MA 02631 A 1,000,000 X 36043834 6/16/2021 6/16/2022 1,000,000 10,000 1,000,000 2,000,000 Included 1,000,000A 36043834 6/16/2021 6/16/2022 The Certificate Holder is an additional insured with respect to the General Liability as required by written contract. Town of Brewster Attn: Town Administrator 2198 Main Street Brewster, MA 02631 BREWST0002 ELEWIS Chantilly-Alliant Ins Svc Inc. 4530 Walney Rd Ste 200 Chantilly, VA 20151-2285 Edye Lewis edye.lewis@alliant.com Federal Insurance Company X X X X X