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Single Source Contract- Play-Well TEKnologies - Lego Camps 1.1.26-12.31.28 $24,000
To: Luke Stowe, City Manager From: Audrey Thompson, Director Parks & Recreation Tim Carter, Division Manager Subject: Approval of Single Source Contract with Play-Well TEKnologies Date: November 20, 2025 Recommended Action: Staff recommends the City Manager approve a single source contract with Play-Well TEKnologies (216 Greenfield Ave., Ste. B, San Anselmo, CA 94960) for instruction of youth engineering LEGO camps. The agreement period will run from January 1, 2026, through December 31, 2028, with an option to renew for an additional 2 years. The purchase order shall not exceed $24,000. Funding Source: Revenue from program registrations are deposited into the General Fund Account, Chandler-Newberger Center Business Unit 130.30.3035.53565 Instructional expenses are paid from Chandler-Newberger Business Unit 130.30.3035.62505 which has a $600,000 budgeted allocation. Compensation for the vendor is based on the following amount of revenue collected: Program Vendor Revenue City Revenue Camps and Classes 70% 30% For 2026, staff is projecting $34,500 in revenues and $24,000 in expenses. For 2025, revenue for Play-Well camps and classes was approximately $27,500 and expenses were approximately $18,919. Summary: RFP 24-49 was sent out and received no responses. Play-Well TEKnologies has been the vendor providing instruction at camps for engineering based LEGO instruction since 2012. LEGO camps are held during spring and summer school breaks, and are hel d for children ages 5-12 years. The curriculum taught by Play-Well TEKnologies allows participants to walk away understanding the fundamental principles of engineering and physics. The curriculum is designed to boost participant’s confidence, creativity an d encourages collaboration; they have a substantial investment in growing the program. Memorandum Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 2 of 2 The curriculum taught by the Play-Well staff is designed specifically toward the department’s program offerings, including adjusting the programs to the type of camp th at is being offered. Additionally, Play-Well provides all necessary equipment for the program. Play-Well TEKnologies has done excellent work in providing instruction. Attachments: Agreement Certificate of Insurance Approved: _______________________ Luke Stowe, City Manager Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 1 of 9 Revised 3/11/2024 CITY OF EVANSTONCONTRACTOR (Vendor Name) Official SignatureSignature Printed Name Title Date Address Phone Fax E-mail Printed Name Title Date Designee Signature Printed Name Title Address PARKS, RECREATION & COMMUNITY SERVICES DEPARTMENT VENDOR CONTRACT FOR SERVICES: UNDER $25,000 The Parties to this Agreement are the City of Evanston and . This Agreement, consisting of the signature page and numbered sections listed below and any attachments referenced in this Agreement, constitutes the entire Agreement between the Parties concerning the subject matter of the Agreement, and supersedes all prior proposals, Agreements and understandings between the Parties concerning the subject matter of the Agreement. This Agreement can be signed in multiple counterparts and signature may be electronic or digital upon agreement of the Parties. 1.TERM AND TERMINATION 2.DESCRIPTION OF SUPPLIES AND SERVICES 3.PRICING AND PAYMENT 4.STANDARD BUSINESS TERMS AND CONDITIONS 5.STANDARD CERTIFICATIONS 6.DISCLOSURES AND CONFLICTS OF INTEREST 7.SUPPLEMENTAL PROVISIONS In consideration of the mutual covenants and agreements contained in this Agreement, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree to the terms and conditions set forth herein and have caused this Agreement to be executed by their duly authorized representatives on the dates shown below. Play-Well TEKnologies Katie Haberman Program Area Manager - Chicago 11/18/2025 216 Greenfield Ave, San Anselmo, CA 94960 224-571-2104 katie@play-well.org Play-Well Teknologies Approved as to form: Alexandra B. Ruggie Corporation Counsel Luke Stowe City Manager 11 / 25 / 2025 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 2 of 9 Revised 3/11/2024 1. 1.1 TERM AND TERMINATION TERM OF THIS AGREEMENT: This Agreement has an initial term of January 1, 2026 through December 31, 2028. . If a start date is not identified, the term shall commence upon the last dated signature of the Parties. This Agreement cannot be terminated less than thirty (30) days before the agreed start date as indicated below. Any termination less than thirty (30) days before the agreed start date must be with the written consent of the Department of Parks and Recreation. Request for termination, either before or after the thirty (30) day period must be made in writing and submitted to the appropriate representative of the Department of Parks and Recreation. 1.2 RENEWAL: Subject to the maximum total term as identified above, the City has the option to renew for the following term(s): If the vendor fulfills the contractual requirements, the contract may be extended for an additional two years. Pricing for the renewal term(s), or the formula for determining price is shown in the pricing section of this Agreement. Any renewal is subject to the same terms and conditions as the original Agreement except as stated below in this subsection. The City may renew this Agreement for any or all of the option periods specified; may exercise any of the renewal options early and may exercise more than one option at a time based on continuing need and favorable market conditions when in the best interest of the City. The Agreement shall not renew automatically nor shall the Agreement renew solely at Vendor’s option. 1.3 TERMINATION FOR CAUSE: The City may terminate this Agreement, in whole or in part, immediately upon notice to Vendor if: (a) the City determines that the actions or inactions of Vendor have caused, or reasonably could cause, jeopardy to health, safety, or property, or (b) Vendor has notified the City that it is unable or unwilling to perform the Agreement. If Vendor fails to perform to the City’s satisfaction any material requirement of this Agreement, or is in violation of a material provision of this Agreement, the City shall provide written notice to Vendor to cure the problem identified within the period of time specified in the City’s written notice. If not cured by that date, the City may either: (a) immediately terminate the Agreement without additional written notice or (b) enforce the terms and conditions of the Agreement. For termination due to any of the causes contained in this Section, the City retains its rights to seek any available legal or equitable remedies and damages. 1.4 TERMINATION FOR CONVENIENCE: The City may, for its convenience and with 7 days prior written notice to Vendor, terminate this Agreement in whole or in part and without payment of any penalty or incurring any further obligation to Vendor. Vendor shall be entitled to compensation upon submission of invoices and proof of claim for supplies and services provided in compliance with this Agreement up to and including the date of termination. 2. DESCRIPTION OF SERVICES 2.1 Description of Service required: 2.2 WHERE SERVICES ARE TO BE PERFORMED: Unless otherwise specified in this section all services shall be performed in the City of Evanston, Illinois. Vendor shall disclose the locations where the services required shall be performed and the known or anticipated value of the services to be performed at each location. Location where services will be performed Location where services will be performed Any supplies/materials or other tangible items left on City property by Vendor is done at Vendor’s risk. Vendor agrees to hold harmless the City for any damage or loss to Vendor supplies, materials or other property on City property. 2.3 SCHEDULE OF WORK: Any work performed on City premises shall be done during the hours designated by the City and performed in a manner that does not interfere with the City and its personnel. 2.4 REPORTING, STATUS AND MONITORING SPECIFICATIONS: 2.4.1 Vendor shall immediately notify the City of any event that may have a material impact on Vendors ability to perform the Agreement. 2.5 ASSIGNMENT AND SUBCONTRACTING: City of Evanston Community Centers City of Evanston Park Shelters Instruction of youth engineering LEGO camps. Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 3 of 9 Revised 3/11/24 2.5.1 This Agreement may not be assigned, transferred in whole or in part by Vendor without the prior written consent of the City. 2.5.2 For purposes of this section, subcontractors are those specifically hired to perform all or part of the work covered by the Agreement. Will subcontractors be utilized? Yes No 2.5.3 Vendor shall describe below the names and addresses of all authorized subcontractors to be utilized by Vendor in the performance of this Agreement, together with a description of the work to be performed by the subcontractor and the anticipated amount of money that each subcontractor is expected to receive pursuant to this Agreement. Vendor shall provide a copy of any subcontracts within 20 days of execution of this Agreement for approval by the City. Vendor shall be responsible for the accuracy and quality of any subcontractor’s performance. Subcontractor Name Amount to be paid Address Description of work Subcontractor Name Amount to be paid Address Description of work 2.5.4 Vendor shall obtain approval from the City prior to hiring any additional or substitute subcontractors during the term of this Agreement. Vendor may, upon request of the City, provide to the City a draft subcontractor agreement for review and approval prior to the execution of the subcontract. Subontractor agreements shall provide that services to be performed under the subcontracting agreement shall not be sublet, sold, transferred, assigned or otherwise disposed of to another entity or person without the City’s prior written consent. 2.5.5 All subcontracts must include the same certifications that Vendor must make as a condition of this Agreement. 3. PRICING AND PAYMENT. 3.1 METHOD AND RATE OF COMPENSATION: The City will compensate Vendor for the initial term as follows: Hourly Monthly Annually Project Item (show unit of measure and rate) 50% Vendor/50% City of Evanston to include the following provided by the City of Evanston: AV set up Registration management Marketing of class/program to include promotion in program guide, when schedule permits, e-blasts, etc. Use of exisiting equipment owned by the City of Evanston as described as follows : o o o o AND Storage space provided, as available, by the Parks and Recreation Department, specifically described as follows: o o 60% Vendor/40% City of Evanston to include the following provided by the City of Evanston: AV set up Registration management Marketing of class/program to include promotion in program guide, when schedule permits, e-blasts, etc. Seasonal (Winter, Spring, Summer, Fall) Vendor compensation is based on Resident rate revenues collected Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 4 of 9 Revised 3/11/2024 One of the following options (please select one option only): Use of exisiting equipment owned by the City of Evanston as described as follows : o o o o OR Storage space provided, as available, by the Parks and Recreation Department, specifically described as follows: o o 70% Vendor/30% City of Evanston to include the following provided by the City of Evanston: AV set up Room set up and break down Registration management Marketing of class/program to include promotion in program guide, when schedule permits, e-blasts, etc. 3.2 TYPE OF PRICING: Pricing under this Agreement is Firm Estimated 3.3 RENEWAL COMPENSATION: If this Agreement is renewed, the price shall be at the same rate as for the initial term unless a different compensation or formula for determining the renewal compensation is stated in this section. 3.4 TAX: Payment will be made in full without local, state, or federal tax withheld. 3.5 PAYMENT TERMS AND CONDITIONS: 3.5.1 Payments, will be paid in accordance with all applicable laws and rules of the City of Evanston and the State of Illinois. Remedies provided for therein shall be Vendor’s sole remedy for late payments by the City. Payment terms contained on Vendor’s invoices shall have no force and effect. 3.5.2 The City will not pay for supplies provided or services rendered, including related expenses, incurred prior to the execution of this Agreement by the Parties even if the effective date of the Agreement is prior to execution. 4. STANDARD BUSINESS TERMS AND CONDITIONS 4.1 AVAILABILITY OF APPROPRIATION: This Agreement is contingent upon and subject to the availability of funds. The City, at its sole option, may terminate or suspend this Agreement, in whole or in part, without penalty or further payment being required, if a reduction in funding is necessary or advisable based upon actual or projected budgetary considerations. Vendor will be notified in writing of the failure of appropriation or of a reduction or decrease. 4.2 BACKGROUND CHECK AND DRUG TESTING: Whenever the City deems it reasonably necessary for security reasons, the City may conduct at its expense, criminal background checks of Vendor, including fingerprinting and DCFS authorization. Additionally, Vendor may be subjected to drug testing. Vendor shall reassign immediately any such individual who, in the opinion of the City, does not pass the background check or fails the drug testing. 4.3 POLICY MANUAL: Although Vendor is not an employee, Vendor agrees to follow the policies outlined in Chapter VI of the City of Evanston Employee Manual which outlines Ethics Rules; Workplace Harassment Policy; Drug and Alcohol Policy; Personal Appearance; Workplace Violence; and Weapons-Free Workplace. 4.4 TIME IS OF THE ESSENCE: Time is of the essence with respect to Vendor’s performance of this Agreement. Vendor shall continue to perform its obligations while any dispute concerning the Agreement is being resolved, unless otherwise directed by the City. Vendor will receive 70% of resident rate revenue Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 5 of 9 Revised 3/11/2024 4.5 NO WAIVER OF RIGHTS: Except as specifically waived in writing, failure by a Party to exercise or enforce a right does not waive that Party’s right to exercise or enforce that or other rights in the future. 4.6 FORCE MAJEURE: Failure by either Party to perform its duties and obligations will be excused by unforeseeable circumstances beyond its reasonable control and not due to its negligence including acts of nature, acts of terrorism, riots, labor disputes, fire, flood, explosion, and governmental prohibition. The non-declaring Party may cancel the Agreement without penalty if performance does not resume within 30 days of the declaration. 4.7 CONFIDENTIAL INFORMATION/FOIA: Each Party, to this Agreement may have or gain access to confidential data or information owned or maintained by the other Party in the course of carrying out its responsibilities under this Agreement. Vendor shall presume all information received from the City or to which it gains access pursuant to this Agreement is confidential. Vendor information, unless clearly marked as confidential and exempt from disclosure under the Illinois Freedom of Information Act (“FOIA”), 5 ILCS 140/7 et. seq., shall be considered public. No confidential data collected, maintained, or used in the course of performance of the Agreement shall be disseminated except as authorized by law and with the written consent of the disclosing Party, either during the period of the Agreement or thereafter. The receiving Party must return any and all data collected, maintained, created or used in the course of the performance of the Agreement, in whatever form it is maintained, promptly at the end of the Agreement, or earlier at the request of the disclosing Party, or notify the disclosing Party in writing of its destruction. Upon notification by the City that it has received a Freedom of Information Act request that calls for records within the Vendor’s control, the Vendor shall promptly provide all requested records to the City so that the City may comply with the request within the limited statutory timeframes required by FOIA. Vendor shall indemnify and defend the City from and against all claims arising from the City’s exceptions to disclosing certain records which Vendor may designate as proprietary or confidential. Compliance by the City with an opinion or a directive from the Illinois Public Access Counselor or the Attorney General under FOIA, or with a decision or order of Court with jurisdiction over the City, shall not be a violation of this Section. 4.8 USE AND OWNERSHIP: All work performed or supplies created by Vendor under this Agreement, whether written documents or data, goods or deliverables of any kind, shall be deemed work-for-hire under copyright law and all intellectual property and other laws, and the City is granted sole and exclusive ownership to all such work, unless otherwise agreed in writing. Vendor hereby assigns to the City all right, title, and interest in and to such work including any related intellectual property rights, and/or waives any and all claims that Vendor may have to such work including any so-called "moral rights" in connection with the work. Vendor acknowledges the City may use the work product for any purpose. Confidential data or information contained in such work shall be subject to confidentiality provisions of this Agreement. This paragraph does not apply to work or supplies created by Vendor prior to this Agreement and provided to the City during the term of this Agreement. 4.8 INDEMNIFICATION AND LIABILITY: Vendor shall defend, indemnify and hold harmless the City and its officers, elected and appointed officials, agents, and employees from any and all liability, losses, or damages as a result of claims, demands, suits, actions, or proceedings of any kind or nature, including but not limited to costs, and fees, including attorney’s fees, judgments or settlements, resulting from or arising out of any negligent or willful act or omission on the part of Vendor. Such indemnification shall not be limited by reason of the enumeration of any insurance coverage herein provided. This provision shall survive completion, expiration, or termination of this Agreement. Nothing contained herein shall be construed as prohibiting the City, or its officers, agents, or employees, from defending through the selection and use of their own agents, attorneys, and experts, any claims, actions or suits brought against them. Vendor shall be liable for the costs, fees, and expenses incurred in the defense of any such claims, actions, or suits. Nothing herein shall be construed as a limitation or waiver of defenses available to the City and employees and agents, including but not limited to the Illinois Local Governmental and Governmental Employees Tort Immunity Act, 745 ILCS 10/1-101 et seq. At the City Corporation Counsel’s option, Vendor must defend all suits brought upon all such Losses and must pay all costs and expenses incidental to them, but the City has the right, at its option, to participate, at its own cost, in the defense of any suit, without relieving Vendor of any of its obligations under this Agreement. Any settlement of any claim or suit related to this Agreement by Vendor must be made only with the prior written consent of the City Corporation Counsel, if the settlement requires any action on the part of the City. To the extent permissible by law, Vendor waives any limits to the amount of its obligations to indemnify, defend, or contribute to any sums due under any Losses, including any claims that may be subject to the Illinois Workers Compensation Act, 820 ILCS 305/1 et seq. or any other related law or judicial decision, including but not limited to, Kotecki v. Cyclops Welding Corporation, 146 Ill. 2d 155 (1991). The City, however, does not waive any limitations it may have on its liability under the Illinois Workers Compensation Act, the Illinois Pension Code or any other statute. Vendor shall be responsible for any losses and costs to repair or remedy work performed under this Agreement resulting from or arising out of any act or omission, neglect, or misconduct in the performance of his/her Work. Acceptance of the work by the City will not relieve Vendor of the responsibility for subsequent correction of any such error, omissions and/or negligent acts or of its liability for loss or damage resulting therefrom. All provisions of this Section 4.8 shall survive completion, expiration, or termination of this Agreement. 4.9 INSURANCE: Vendor shall, at its own expense, secure and maintain in effect throughout the duration of this contract, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the services and work hereunder by Vendor. If Vendor cannot secure insurance, Vendor hereby agrees to indemnify and hold harmless the City in accordance with Section 4.8 for any claims arising directly out of Vendor’s Work. Vendor expressly agrees to waive its rights, benefits and entitlements under the “Other Insurance” clause of any general liability insurance policy as respects the City. Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 6 of 9 Revised 3/11/2024 4.10 INDEPENDENT CONTRACTOR: Vendor shall act as an independent Vendor and not an agent or employee of, or joint venture with the City. All payments by the City shall be made on that basis. 4.11 COMPLIANCE WITH THE LAW: Vendor shall comply with all applicable federal, state, and local laws, rules, ordinances, regulations, orders, federal circulars and all license and permit requirements in the performance of this Agreement. Vendor shall be in compliance with applicable tax requirements and shall be current in payment of such taxes. Vendor shall obtain at its own expense, all licenses and permissions necessary for the performance of this Agreement. 4.12 APPLICABLE LAW/VENUE: This Agreement shall be construed in accordance with and is subject to the laws and rules of the City of Evanston and the State of Illinois. The Department of Human Rights’ Equal Opportunity requirements (44 Ill. Adm. Code 750) are incorporated by reference. The City shall not enter into binding arbitration to resolve any dispute related to this Agreement. The City does not waive tort immunity by entering into this Agreement. In compliance with the Illinois and federal Constitutions, the Illinois Human Rights Act, the U. S. Civil Rights Act, and Section 504 of the federal Rehabilitation Act and other applicable laws and rules, the City does not unlawfully discriminate in employment, contracts, or any other activity. Venue for any action out of or due to this Agreement shall be in Cook County, Illinois. 4.13 ANTI-TRUST ASSIGNMENT: If Vendor does not pursue any claim or cause of action it has arising under antitrust laws relating to the subject matter of the Agreement, then upon request of the City’s Corporation Counsel, Vendor shall assign to the City rights, title and interest in and to the claim or cause of action. 4.14 CONTRACTUAL AUTHORITY: The Department that signs for the City shall be the only City entity responsible for performance and payment under the Agreement. When the City’s authorized designee signs in addition to an Department, they do so as approving officer and shall have no liability to Vendor. 4.15 NOTICES: Notices and other communications provided for herein shall be given in writing by registered or certified mail, return receipt requested, by receipted hand delivery, by courier (UPS, Federal Express or other similar and reliable carrier), by e-mail, or by fax showing the date and time of successful receipt. Notices shall be sent to the individuals who signed the Agreement using the contact information following the signatures. Each such notice shall be deemed to have been provided at the time it is actually received. By giving notice, either Party may change the contact information. 4.16 MODIFICATIONS AND SURVIVAL: Amendments, modifications and waivers must be in writing and signed by authorized representatives of the Parties. Any provision of this Agreement officially declared void, unenforceable, or against public policy, shall be ignored and the remaining provisions shall be interpreted, as far as possible, to give effect to the Parties’ intent. All provisions that by their nature would be expected to survive, shall survive termination. In the event of a conflict between the City’s and Vendor’s terms, conditions and attachments, the City’s terms, conditions and attachments shall prevail. 4.17 PERFORMANCE RECORD / SUSPENSION: Upon request of the City, Vendor shall meet to discuss performance or provide contract performance updates to help ensure proper performance of the Agreement. The City may consider Vendor’s performance under this Agreement and compliance with law and rule to determine whether to continue the Agreement, suspend Vendor from doing future business with the City for a specified period of time, or to determine whether Vendor can be considered responsible on specific future contract opportunities. 4.18 FREEDOM OF INFORMATION ACT: This Agreement and all related public records maintained by, provided to or required to be provided to the City are subject to the Illinois Freedom of Information Act notwithstanding any provision to the contrary that may be found in this Agreement. 4.19 NON-WAIVER OF RIGHTS: No failure of either party to exercise any power given to it hereunder or to insist upon strict compliance by the other party with its obligations hereunder, and no custom or practice of the parties at variance with the terms hereof, nor any payment under this Agreement shall constitute a waiver of either party’s right to demand exact compliance with the terms hereof. 4.20 SEVERABILITY: Except as otherwise provided herein, the invalidity or unenforceability of any particular provision, or part thereof, of this Agreement shall not affect the other provisions, and this Agreement shall continue in all respects as if such invalid or unenforceable provision had not been contained herein. 4.21 COUNTERPARTS: For convenience, this Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original. 4.22 SAVINGS CLAUSE: If any provision of this Agreement, or the application of such provision, shall be rendered or declared invalid by a court of competent jurisdiction, or by reason of its requiring any steps, actions, or results, the remaining parts or portions of this Agreement shall remain in full force and effect. 5. STANDARD CERTIFICATIONS Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Revised 3/11/24 Page 8 of 9 Vendor acknowledges and agrees that compliance with this section and each subsection for the term of the Agreement and any renewals is a material requirement and condition of this Agreement. By executing this Agreement, Vendor certifies compliance with this section and each subsection and is under a continuing obligation to remain in compliance and report any non-compliance. This section, and each subsection, applies to subcontractors used on this Agreement. Vendor shall include these Standard Certifications in any subcontract used in the performance of the Agreement. If this Agreement extends over multiple fiscal years including the initial term and all renewals, Vendor and its subcontractors shall confirm compliance with this section in the manner and format determined by the City by the date specified by the City and in no event later than January 1 of each year that this Agreement remains in effect. If the Parties determine that any certification in this section is not applicable to this Agreement, it may be stricken without affecting the remaining subsections. 5.1 As part of each certification, Vendor acknowledges and agrees that should Vendor or its subcontractors provide false information, or fail to be or remain in compliance with the Standard Certification requirements, one or more of the following sanctions will apply: the Agreement may be void by operation of law, and the City may void the Agreement. Identifying a sanction or failing to identify a sanction in relation to any of the specific certifications does not waive imposition of other sanctions or preclude application of sanctions not specifically identified. 5.2 Vendor certifies it and its employees will comply with applicable provisions of the U.S. Civil Rights Act, Section 504 of the Federal Rehabilitation Act, the Americans with Disabilities Act (42 U.S.C. § 12101 et seq.) and applicable rules in performance under this Agreement. 5.3 Vendor certifies that persons having contact with any vulnerable population (any minor under the age of 18, a person who is 18 years of age or older with a disabilitiy or any person who is 60 years of age or older) must certify that they are mandated reporters by completing the CANTS 22 Form and complete the mandated reporter training prior to delivery of services under this agreement. The mandated reporter DCFS Illinois training can be found at https://mr.dcfstraining.org. Vender must provide proof of acknowledgment and training to the City on demand. 5.4 Vendor certifies that persons having contact with any community members/patrons must certify that they will abide by the Inclusion and Accessibility Policies established by the City and will complete a review of the Inclusion and Gender Diversity resource packet provided by the City prior to delivery of services under this agreement. 5.5 If Vendor, or any officer, director, partner, or other managerial agent of Vendor, has been convicted of a felony under the Sarbanes-Oxley Act of 2002, or a Class 3 or Class 2 felony under the Illinois Securities Law of 1953, Vendor certifies at least five years have passed since the date of the conviction. Vendor further certifies that it is not barred from being awarded a contract and acknowledges that the City shall declare the Agreement void if this certification is false (30 ILCS 500/50-10.5). 5.6 Vendor certifies that it and its affiliates are not delinquent in the payment of any fees, fines, damages, or debts to the City. 5.7 Vendor certifies it complies with the Section 1-12-5 of the City of Evanston Code and the Illinois Department of Human Rights Act and rules applicable to public contracts, including equal employment opportunity, refraining from unlawful discrimination, and having written sexual harassment policies (775 ILCS 5/2-105). 5.8 Vendor certifies that it shall employ only persons duly licensed by the State of Illinois to perform professional services under this Agreement for which applicable Illinois law requires a license, subject to prior approval of the City. 6.0 DISCLOSURES AND CONFLICTS OF INTEREST Section 1: Conflict of Interest Prohibited Vendor shall not have any public or private interest and shall not acquire directly or indirectly any such interest which conflicts in any manner with its performance under this Agreement. Page 7 of 9 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Revised 3/11/24 Page 8 of 9 Section 2: Debarment/Legal Proceeding Disclosure (All Vendors must complete this section). Vendor must identify any of the following that occurred for it or any if its officers or directors within the previous 10 years: Debarment from contracting with any governmental entity Yes No Professional licensure discipline Yes No Bankruptcies Yes No Adverse civil judgments and administrative findings Yes No Criminal felony convictions Yes No If any of the above is checked yes, please identify with descriptive information the nature of the debarment and legal proceeding. The City reserves the right to request more information, should the information need further clarification. 7. SUPPLEMENTAL PROVISIONS 7.1 City Supplemental Provisions Definitions Required Federal Clauses, Certifications and Assurances ARRA Requirements (American Recovery and Reinvestment Act of 2009) Prevailing Wage (820 ILCS 130/1 et seq.) M/W/EBE Subcontracting Requirements Other (describe) CANTS 22 Attached Chapter VI of the City of Evanston Employee Manual (Ethics Rules, Workplace Harassment Policy, Drug and Alcohol Policy, Personal Appearance, Workplace Violence, and Weapons-Free Workplace). 7.2 Vendor Supplemental Provisions Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Page 9 of 9 Revised 3/11/2024 TAXPAYER IDENTIFICATION NUMBER I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien). If you are an individual, enter your name and SSN as it appears on your Social Security Card. If you are a sole proprietor, enter the owner’s name on the name line followed by the name of the business and the owner’s SSN or EIN. If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner’s name on the name line and the d/b/a on the business name line and enter the owner’s SSN or EIN. If the LLC is a corporation or partnership, enter the entity’s business name and EIN and for corporations, attach IRS acceptance letter (CP261 or CP277). For all other entities, enter the name of the entity as used to apply for the entity’s EIN and the EIN. Name: Business Name: Taxpayer Identification Number: Social Security Number or Employer Identification Number Legal Status (check one): Individual Governmental Sole Proprietor Nonresident alien Partnership Estate or trust Legal Services Corporation Pharmacy (Non-Corp.) Tax-exempt Pharmacy/Funeral Home/Cemetery (Corp.) Corporation providing or billing Limited Liability Company (select applicable tax classification) medical and/or health care services D = disregarded entity C = corporation Corporation NOT providing or billing P = partnership medical and/or health care services Signature: Date: Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Office of the Director 406 E. Monroe Street • Springfield, Illinois 62701 www.DCFS.illinois.gov ACKNOWLEDGEMENT OF MANDATED REPORTER STATUS I, , understand that when I am employed as a (Employee Name) , I will become a mandated reporter under the (Type of Employment) Abused and Neglected Child Reporting Act [325 ILCS 5/4]. This means that I am required to report or cause a report to be made to the child abuse and neglect Hotline number at 1-800-25-ABUSE (1-800-252-2873) whenever I have reasonable cause to believe that a child known to me in my professional or official capacity may be abused or neglected. I understand that there is no charge when calling the Hotline number and that the Hotline operates 24-hours per day, 7 days per week, 365 days per year. I understand that in an effort to help mandated reporters understand their critical role in protecting children by recognizing and reporting child abuse/neglect, DCFS administers an online training course entitled Recognizing and Reporting Child Abuse: Training for Mandated Reporters, available 24 hours a day, seven days a week. I further understand that the privileged quality of communication between me and my patient or client is not grounds for failure to report suspected child abuse or neglect, I know that if I willfully fail to report suspected child abuse or neglect, I may be found guilty of a Class A misdemeanor. This does not apply to physicians who will be referred to the Illinois State Medical Disciplinary Board for action. I also understand that if I am subject to licensing under, but not limited to, the following acts: the Illinois Nursing Act of 1987, the Medical Practice Act of 1987, the Illinois Dental Practice Act, the School Code, the Acupuncture Practice Act, the Illinois Optometric Practice Act of 1987, the Illinois Physical Therapy Act, the Physician Assistants Practice Act of 1987, the Podiatric Medical Practice Act of 1987, the Clinical Psychologist Licensing Act, the Clinical Social Work and Social Work Practice Act, the Illinois Athletic Trainers Practice Act, the Dietetic and Nutrition Services Practice Act, the Marriage and Family Therapy Act, the Naprapathic Practice Act, the Respiratory Care Practice Act, the Professional Counselor and Clinical Professional Counselor Licensing Act, the Illinois Speech-Language Pathology and Audiology Practice Act, I may be subject to license suspension or revocation if I willfully fail to report suspected child abuse or neglect. I affirm that I have read this statement and have knowledge and understanding of the reporting requirements, which apply to me under the Abused and Neglected Child Reporting Act. Signature of Applicant/Employee Date CANTS 22 Rev. 5/2019 Katie Haberman Parks and Recreation Staff 11/18/2025 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec 11/18/2025 McNamara Insurance Services, Inc. 690 De Long Avenue, Suite 200 Novato CA 94945 Michael McNamara (415) 457-7856 (415) 457-7698 Mike@4apolicy.com Tim Bowen, DBA: Play-Well TEKnologies 216 Greenfield Avenue San Anselmo CA 94960 Philadelphia Indemnity Insurance Companies 18058 The Hartford Insurance Co of the Midwest 37478 CL2591603913 A Y PHPK2603446-011 10/01/2025 10/01/2026 1,000,000 1,000,000 5,000 1,000,000 2,000,000 2,000,000 Abusive Conduct 1,000,000 A PHUB881936-011 10/01/2025 10/01/2026 5,000,000 5,000,000 B N 57WECKZ9403 10/01/2025 10/01/2026 1,000,000 1,000,000 1,000,000 A Abusive Conduct and Professional Liability PHPK2603446-011 10/01/2025 10/01/2026 EACH INCIDENT $1,000,000 AGGREGATE $2,000,000 Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the General Liability Deluxe Endorsement: Human Services PI-GLD-HS attached to this policy. City of Evanston 909 Davis Street Evanston IL 60201 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non-Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments – Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments – Bail Bonds $5,000 5 Supplementary Payment – Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement – Janitorial Services Client Coverage $10,000 limit 6 Additional Insured – Newly Acquired Time Period Amended 6 Additional Insured – Medical Directors and Administrators Included 7 Additional Insured – Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured – Broadened Named Insured Included 7 Additional Insured – Funding Source Included 7 Additional Insured – Home Care Providers Included 7 Additional Insured – Managers, Landlords, or Lessors of Premises Included 7 Additional Insured – Lessor of Leased Equipment Included 7 Additional Insured – Grantor of Permits Included 8 Additional Insured – Vendor Included 8 Additional Insured – Franchisor Included 9 Additional Insured – When Required by Contract Included 9 Additional Insured – Owners, Lessees, or Contractors Included 9 Additional Insured – State or Political Subdivisions Included 10 PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury – includes Mental Anguish Included 11 Personal and Advertising Injury – includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury “Bodily injury” or property damage” expected or intended from the standpoint of the insured. This exclusion does not apply to “bodily injury” or “property damage” resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement Contractual Liability SECTION I – COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured’s request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter’s liability insurance of the client. C. Non-Owned Watercraft SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another’s property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word “fire” is changed to “fire, lightning, explosion, smoke, or leakage from automatic fire protective systems” where it appears in: a. The last paragraph of SECTION I – COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III – LIMITS OF INSURANCE. b. SECTION III – LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V – DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (ii) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. F. HIPAA SECTION I – COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a “violation(s)” of the Health Insurance Portability and Accountability Act (HIPAA). We have the right and the duty to defend the insured against any “suit,” “investigation,” or “civil proceeding” seeking these damages. However, we will have no duty to defend the insured against any “suit” seeking damages, “investigation,” or “civil proceeding” to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate “violation(s)” by any insured. b. Criminal Acts Any “violation” which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V – DEFINITIONS is amended to include the following additional definitions: a. “Civil proceeding” means an action by the Department of Health and Human Services (HHS) arising out of “violations.” b. “Investigation” means an examination of an actual or alleged “violation(s)” by HHS. However, “investigation” does not include a Compliance Review. c. “Violation” means the actual or alleged failure to comply with the regulations included in the HIPAA. PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company G. Medical Payments – Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I – COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I – COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these. 1.d. is deleted in its entirety and replaced by the following: 1. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. J. Employee Indemnification Defense Coverage SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an “employee” in a criminal proceeding occurring in the course of employment. The most we will pay for any “employee” who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of “employees,” claims or “suits” brought or persons or organizations making claims or bringing “suits . PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company K. Key and Lock Replacement – Janitorial Services Client Coverage SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the “clients” premises due to theft or other loss to keys entrusted to you by your “client,” up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, “employees”, “managers”, directors, trustees, authorized representatives or any one to whom you entrust the keys of a “client” for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: a. "Client" means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means: (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." c. "Manager" means a person serving in a directorial capacity for a limited liability company. L. Additional Insureds SECTION II – WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators – Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors – Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your “employees” are also insureds for “bodily injury” to a co - “employee” while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named Insured – Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source – Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers – At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises – Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any “occurrence” which takes place after you cease to b e a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment – Automatic Status When Required in Lease Agreement With You – Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company organization is an insured only with respect to liability for “bodily injury,” “property damage” or “personal and advertising injury” caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person’s or organization’s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any “occurrence” which takes place after the equipment lease expires. h. Grantors of Permits – Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors – Only with respect to “bodily injury” or “property damage” arising out of “your products” which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub-paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor – Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract – Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations l. Owners, Lessees or Contractors – Any person or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company m. State or Political Subdivisions – Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products-completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the “occurrence” or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or “suit” is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer’s rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. Bodily Injury – Mental Anguish SECTION V – DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: “Bodily injury” means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury – Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of “personal and advertising injury” is amended as follows: 1. SECTION V – DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V – DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec PI-GLD-HS (10/11) Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. © 2011 Philadelphia Indemnity Insurance Company c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. PHPK2603446-11 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec SOLE/ SINGLE SOURCE JUSTIFICATION (Requester completes Section A and B) SECTION A – SOLE/SINGLE SOURCE PURCHASE: Complete if sole/single source purchase is $2,500 or over, AND competition is not available. Sole/Single Source approvals are valid one year from approval date, unless specified elsewhere. PO No. (if applicable): Amount: | Date: Supplies/Services Required (be specific): Proposed Vendor Name and No: _______________________________________ Requested by: (Name and Signature) _________________________________________ Prepared by: (Name and Signature) I certify that justification/ information is accurate and complete to the best of my knowledge and that I have no personal interests relative to this request . Dept. Name/ Ext: Check One: The requested supply/service is a sole/single source procurement due to: AVAILABILITY/ONE OF A KIND No competitive product exists or is available from another vendor. COMPATIBILITY Must match existing piece or brand of equipment and is available from only one vendor. REPLACEMENT/MAINTENANCE Repair or maintenance for specific brand of existing equipment and is available from only original equipment manufacturer or designated servic e dealer. OTHER Provide a full explanation/detail of above selection: complete descriptions, and relevant reasons to support the justification: SECTION B - REQUESTER CERTIFICATION: By submitting this request, I certify that the above justification/information is accurate and complete to the best of my knowledge and that I have no personal interests relative to this request. ___________________________________________________ ______________________________ (Name and Signature of Requester) (Date) _________________________________________________ ______________________________ (Name and Signature of Department Director) (Date) SECTION C - TO BE: COMPLETED BY PURCHASING MANAGER: Based on the information provided in Section A and attached supporting documents, I concur / do not concur (see below) with purchase to be a Sole Source. Do not concur for the following reason(s): (Name and Signature of Purchasing Manager or Authorized Designee) (Date) X Digitally signed by Eichholz, Eric DN: DC=org, DC=cityofevanston, DC=local, OU=COE Users, OU=Parks Forestry & Recreation, OU=Offsite Recreation, CN="Eichholz, Eric", E=eeichholz@cityofevanston.org Reason: I am the author of this document Location: Date: 2024.11.13 11:48:14-06'00' Foxit PDF Editor Version: 2024.3.0 Eichholz, Eric Digitally signed by Eichholz, Eric DN: DC=org, DC=cityofevanston, DC=local, OU=COE Users, OU=Parks Forestry & Recreation, OU=Offsite Recreation, CN="Eichholz, Eric", E=eeichholz@cityofevanston.org Reason: I am the author of this document Location: Date: 2024.11.13 11:50:46-06'00' Foxit PDF Editor Version: 2024.3.0 Eichholz, Eric 11/20/25 Digitally signed by Eichholz, Eric DN: DC=org, DC=cityofevanston, DC=local, OU=COE Users, OU=Parks Forestry & Recreation, OU=Offsite Recreation, CN="Eichholz, Eric", E=eeichholz@cityofevanston.org Reason: I am the author of this document Location: Date: 2024.11.13 11:48:29-06'00' Foxit PDF Editor Version: 2024.3.0 Eichholz, Eric 11/20/25 Lego Camp Instruction Parks and Recreation/8685 Play-Well Teknologies 294162 $24,000 RFP 24-49 was sent out and received no responses. Play-Well Teknologies is a camp vendor that we work with over the summer for unique camp instruction. Their camps are STEM based and run out of the Chandler-Newberger Center and park shelters. The camps are for ages 5-12 years. Play-Well Teknologies provides unique programming that fits with the City’s Community Center’s schedule. 11 / 25 / 2025 Doc ID: 76cacb1942cda30a029b9f0282d5f812d19fbaec Single Source Contract with Play-Well TEKnologies $24,000 Play-Well_TEKnologies_Memo-2026.docx and 1 other 76cacb1942cda30a029b9f0282d5f812d19fbaec MM / DD / YYYY Signed 11 / 25 / 2025 08:12:17 UTC-6 Sent for signature to Alexandra Ruggie (aruggie@cityofevanston.org) and Luke Stowe (lstowe@cityofevanston.org) from lthomas@cityofevanston.org IP: 50.171.242.186 11 / 25 / 2025 10:05:00 UTC-6 Viewed by Alexandra Ruggie (aruggie@cityofevanston.org) IP: 50.171.242.186 11 / 25 / 2025 10:05:27 UTC-6 Signed by Alexandra Ruggie (aruggie@cityofevanston.org) IP: 50.171.242.186 11 / 25 / 2025 15:16:50 UTC-6 Viewed by Luke Stowe (lstowe@cityofevanston.org) IP: 50.171.242.186 11 / 25 / 2025 15:18:07 UTC-6 Signed by Luke Stowe (lstowe@cityofevanston.org) IP: 50.171.242.186 The document has been completed.11 / 25 / 2025 15:18:07 UTC-6