The URL can be used to link to this page

Home My WebLink About2013 CON Pine Valley Bible Conference Center - "Every Fifteen Minutes Event"APPROV • A TO FORM: 14 ■ rlfir VALLCT • olol.r canrrRrncr crNTrR GuClau t* G. Silva Terence Reservation Agreement Pine Valley Bible Conference Center, P.O. Box 400, Pine Valley, CA 91962 - (619) 473-8879 - Fax (619) 473-8891 - ix.neI This agreement is between Pine Valley Bible Conference Center (PVBC) and the Guest Sponsor designated below. PVBC will agree to hold facilities, provide meals and other designated conference and recreation services herein detailed and agreed upon for the exclusive use of the Guest Sponsor for the dates and times specified. In consideration for the time, facilities, and conference services held by PVBC for the Guest Sponsor's use designated herein, Guest Sponsor agrees to pay a guaranteed minimum specified herein based on an agreed upon per person rate multiplied by the minimum expected guests designated by the Guest Sponsor. This agreement must be signed by an officer of the Guest Sponsor organization and postmarked by the return date specified below before PVBC will reserve time, facilities, and services as designated. A 10% deposit specified herein must accompany the signed original agreement before an agreement confirmation will be issued by PVBC. A copy of the signed agreement will be returned to the Guest Sponsor with a "PVBC Confirmed" signature indicating agreement confirmation. Agreement supplement on subsequent pages is part of this agreement. AGREEMENT DATE: 03/14/2013 SIGNED AGREEMENT RETURN DAI'h: 03/25/2013 AGREEMENT DEPOSIT: $$0.00 Deposit Received Confirmation: AGREEMENT RECEIVED DA I'L: PVBC Confirmed: GUEST SPONSOR Organization: National City Police Dept Group Attending: Sweetwater H.S. Every 15 minutes Address: 1200 National City Boulevard, National City, CA, 91950 Telephone: GUEST SPONSOR COORDINATOR Name: Marcus Macias Address: 1200 National City Boulevard, National City, CA, 91950 Home Phone: Work Phone: 619-336-4357 Cell Phone: CONFERENCE. DATES, TIMES. MEALS Beginning Date: 05/15/2013 Ending Date: 05/16/2013 GROUP Arrival Time: Wednesday, May, 15 , 03:00:00 PM DURATION: Nights: 1 Meals: LEADERS Arrival Time: DEPARTURE Date/Time: Thursday, May, 16 , 08:00:00 A First Meal: Last Meal: CONFERENCE. ATTENDEES AND FACILITIES RESERVATION #ShMin #PvtMin #ShMax 0 0 0 0 LODGES: DORMS: 20 MEETING ROOMS: As Available 30 GUARANTEED MINIMUM FINANCIAL OBLIGATION TO PVBCC # Pvt Max P/Person Rate Extension $800.00 If conference attendance falls below the minimums for all or part of the conference duration, Guest Sponsor agrees to pay the full guatan minimum to PVBCC prior to departure date and time of the conference. CANCELLATION: If Guest Sponsor elects to cancel this agreement within 180 days of conference beginning date, Guest S ! :. agrees to pay a Late Cancellation penalty equal to 70% of the Guaranteed Minimum Financial Obligation to PVBCC. SIGNATURES PVBC: ei9 Official Capacity: Date: \\- Ls Guest Sponsor: Coordina Guest Sponsor: Officer Official Capaci Date: 4l )4t>) 3 Health Supervisor --PVBCC does not provide medical services to Guest Groups. Guest Sponsor, in accordance with California Code of Regulations Title 17, Subchapter 6, Section 30750, is required: (a) furnish a health history form for all individuals entering PVBCC. (b) Provide a signed Medical Release form for all minors not accompanied by their parents. (c) Provide a full-time Adult Health Supervisor charged with health supervision at camp when campers are present. A Health Supervisor is a person who is either a MD, RN, LVN who is licensed pursuant to Division 2 of the Business and Professions code or a person who is trained in accordance with section 1596.866 of the Health and Safety Code: The training shall include the following components: (A) Pediatric first aid. (B) Pediatric cardiopulmonary resuscitation (CPR). (C) A preventative health practices course or courses that indude instruction in the recognition, management, and prevention of infectious diseases, including immnni7ations, and prevention of childhood injuries. (d) Conduct health screening under the supervision of their Health Supervisor for all individuals within 24 hours of entering PVBCC. (1) Provide a. medical logbook maintained by the Health Supervisor. (g) The Health Supervisor to report food borne illnesses. (h) The Health Supervisor to dispense medication. (i) A written health care plan developed and maintained by the Health Supervisor. Provision for Adjustment to Guaranteed Minimum Guest Sponsor will be permitted to make up to a 30% reduction in the Guaranteed Minimum without penalty, no less than 90 days from the beginning date of the conference. Request should be made in writing and should be postmarked no sooner than 90 days from Beginning Date of conference. Provision for Agreement Cancellation Guest Sponsor has 180 days from Beginning Date of scheduled event to cancel this agreement without penalty. Request are to be made in writing and are to be postmarked no later than 180 days from Beginning Date of conference. Cancellation inside of 180 days and up to 30 days from Beginning Date of scheduled event carry a 70% penalty against the agreement Guaranteed Minimum. The full Guaranteed Minimum is due for all cancellations within 30 days of scheduled event. Weather conditions are not a valid reason for cancellation, however, if I-8 is impassable before the Pine Valley exit according to Cal -Trans and no alternate route is available, Guest sponsor will be permitted to postpone their scheduled event. Pine Valley Bible Conference Center will work with Guest Sponsor to reschedule an event under these extreme circumstances no later than 120 days from original schedule date. Deposits are not refundable. Acknowledgement I have read the Guest Conference Reservation Agreement, specifications, deadlines, and responsibilities as stated in Guest Sponsor Coordinator Signed: ectr APPROVED AS TO FO a G. Silva City Attorney editions, and Provisions in fill. I understand and agree with the agreement and supplement. Date:04/6./3 Page 2 of 2 CODITIONS AND PROVISIONS Pine Valley Bible Conference Center Guest Conference Reservation AGREEMENT SUPPLEMENT Guest Sponsor Responsibilities Ada i:nistf:oriaa of TMreeroco _ - Once Guest Conference Reservation Agreement is received, Guest Sponsor Coordinator should review the document for accuracy_ PVBCC should be immediately notified of any adjustments necessary so new documents can be sent. Please do not make hand written adjustments on the agreement. Once agreement is confirmed to be accurate, sign and have Guest Sponsor Organization Officer sign and date agreement. Send original agreement with Advance, Non-refundable Deposit of $ 80 AU to PVBCC in return envelope postmarked by Signed Agreement Return Date . Guest Conference Reservation Agreement will not be confirmed until PVBCC has received agreement deposits and required signatures. In other words, a `Reservation" for Conference time will not exist until the deposit and properly signed Agreement are received by PVBCC. Copy of confirmed agreement will be sent to Guest Sponsor by mail. Rates specified on this agreement are time sensitive and are subject to incremental increases if the signed agreement is not returned by the specified return date of 3J J2ot3 . Guest Sponsor Event Schedule — Guest Sponsor agrees to provide PVBC with a written conference schedule no later than 10 days prior to beginning date of conference. This schedule is important towards coordinating facility usage with other concurrent users enabling PVBC conference setvices staff to be fully prepared for your event. Terms of Payment — Guest Sponsor agrees to pay the Guaranteed Minimum of $ gOC o O 10 days prior to arrival. The advance deposit will be deducted from the Guaranteed Minimum payment Amounts due to PVBC exceeding event Guaranteed Minimum will be paid prior to departure. Anticipated Actual Attendance — Guest Sponsor agrees to provide PVBCC with anticipated actual attendance no later than 5 days prior to beginning date of conference. Notice should be communicated by phone with the PVBCC Event Coordinator at (619) 473-8879, fax (619) 473-8891, or through E-Mail. California State Regulations — A complete list of names, addresses, and phone numbers of all conference attendees must be submitted by the Guest Sponsor Organization to PVBCC prior to departure. PVBC "User Regulations — Guest Sponsor agrees to faithfully comply with PVBCC rules posted on the grounds, written in the Guest Group Coordinator handbook, and any accompanying literature. Shared ` f-e f Conference Grounds — Unless granted exclusive use of PVBCC grounds and facilities, Guest Sponsor will be using PVBCC facilities and grounds concurrently with other Guest Sponsors. Guest Sponsor agrees to be mindful and sensitive to other groups considering proximity to others and volume of activities. PVBC is under a Pine Valley Noise Ordinance that requires outside noise to be minimized after 10:00 PM. Dzy Guests — Any additional guests on the premises during day hours (for at lest 4 hours) but do not stay overnight will be charged $12.00 per person per day. Any meals would have an additional a la cart charge for Breakfast, Lunch and Dinner. PITB CC Activity Release Form — Groups are required to bring a copy of the PVBCC's Activity/ Liability Release form filled out in its entirety and signed by the appropriate person for all registered guests entering camp. Certificate of Insurance —A certificate of insurance naming Pine Valley Bible Camp as an additional insured, with a minimum $1 million limit, must be received by PVBCC from guest groups prior to the use of the camp. 74 Guest Group Representative Initialed Agreement Penn 1 nF 9 MEMORANDUM OF INSURANCE ISSUE DATE 4/16/2013 ALLIANT INSURANCE SERVICES, INC. P.O. BOX 6450 NEWPORT BEACH, CA 92658-6450 Ph (949) 756-0271 / Fax (949) 756 2713 License No. 0C36861 THIS MEMORANDUM IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE MEMORANDUM HOLDER. THIS MEMORANDUM DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE SHOWN BELOW. SAN DIEGO POOLED INSURANCE COVERAGE AFFORDED BY * INSURED PROGRAM AUTHORITY AND MEMBER AGENCY OF: LETTER A: INDIVIDUAL CITY'S SELF -INSURED RETENTION CITY OF NATIONAL CITY 1243 NATIONAL CITY BLVD. NATIONAL CITY, CA 91950 LETTER B: San Diego Pooled Insurance Program Authority, A Public Agency." MEMBER AGENCY OF THE SAN DIEGO POOLED INSURANCE PROGRAM AUTHORITY COVERAGE PER CA. GOVERNMENT CODE SECTION 990.4(a), 990.8(c) THIS IS TO CERTIFY THAT A MEMORANDUM OF INSURANCE BELOW HAS BEEN ENTERED INTO BY INSURED NAMED ABOVE AS AUTHORIZED BY CALIFORNIA GOVERNMENT CODE SECTION 990.4(a) AND 990.8(c) FOR THE PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MEMORANDUM MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE CONTRACT DESCRIBED HERE IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF THE SUCH CONTRACT. LTR TYPE OF COVERAGE MEMORANDUM NUMBER MEMORANDUM EFFECTIVE DATE MEMORANDUM EXPIRATION DATE LIABILITY LIMITS EACH OCCURRENCE AGGREGATE A GENERAL AND AUTOMOBILE LIABILITY INCLUDING: ALL OWNED, HIRED AND NON -OWNED AUTOS SELF INSURED 07/01/12 07/01/13 BI & PD COMBINED 250,000 N/A PERSONAL INJURY INCL. B EXCESS LIABILITY" SDC 0027 07/01/12 07/01/13 BI & PD COMBINED 2,250,000 * * THE ABOVE NOTED MEMORANDUM OF INSURANCE IS A CLAIMS -MADE CONTRACT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS AS RESPECTS USE OF PINE VALLEY BIBLE CONFERENCE CENTER FACILITY FOR NATIONAL CITY POLICE DEPARTMENT SPONSORED PROGRAM "EVERY 15 MINUTES" BEING HELD MAY 15, 2013. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO LIABILITY ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED PER ATTACHED ENDORSEMENT. SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS Al MEMORANDUM HOLDER CANCELLATION PINE VALLEY BIBLE CONFERENCE CENTER P.O. BOX 400 PINE VALLEY, CA 91962 SHOULD ANY OF THE ABOVE DESCRIBED CONTRACTS BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE AUTHORITY WILL ENDEAVOR TO MAIL 30 DAYS" WRITTEN NOTICE TO THE HOLDER NAMED HEREON BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORITY, OR ITS REPRESENTATIVES. EXCEPT 10 DAYS FOR NON-PAYMENT OF PREMIUM. AUTHORIZED SIGNATURE G:1_Client Files1San Diego Pooled Insurance Program Authority (SANDPIPA)1Sandpipa\Sd-Liability\Sd-Liab-cer1_12-13 E U Endorsement Per Contract Effective 7/1/12 Contract Number SDC 0027 ADDITIONAL INSURED ENDORSEMENT In consideration of the payment of premium, it is agreed for claims occurring and reported after 7/1/98, that the following amendments / additions apply: 1. Section III — Persons and/or Entities Covered, is amended to include any person(s) or organization(s) when required in a written contract or agreement to provide coverage but only for Personal Injury or Property Damage liability which: a. is covered by this Memorandum of insurance; and b. arises out of: 1. the normal course of the Named Covered Party's operations; or 2. ownership, maintenance or use of that part of the premises or land rented to or leased to and occupied by, the Named Covered Party; or 3. work performed for that Covered Party by the Named Covered Party; or 4. that Covered Party's financial control of the Named Covered Party; or 5. the maintenance, operation or Use by the Named Covered Party of any equipment or Automobile leased to you by such person(s) or Organization(s). 2. The limits of coverage afforded to such person(s) or organization(s) will be: a. the minimum limits of coverage which the Named Covered Party agreed to provide; or b. the limits of coverage of this Memorandum of Insurance, whichever is less. 3. Coverage provided under this Endorsement may be primary over any applicable insurance, and the Authority may provide a notice of cancellation if requested. 4. Coverage provided under this Endorsement expires: a. when the written contract or agreement ceases; or b. when the Named Covered Party ceases to be a tenant in the premises. Attached to and forming part of Contract number SDC 0027 of the San Diego Pooled Insurance Program Authority Memorandum of Insurance. Dated at: Newport Beach this 16 day of By: April , 2013. Authorize P` epre • : ntati CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950 619-336-4228 phone / 619-336-4229 fax Michael R. Dalla, CMC - City Clerk PINE VALLEY BIBLE CONFERENCE CENTER "Every Fifteen Minutes" Event Sweetwater High School May 15 - 16, 2013 Ronni Zengota (Police) Forwarded Copy of Agreement to Pine Valley Bible Conference Center