-':'" STATESBORO-BULLOCH COUNTY PARKS AND RECREATION DEPARTMENT AGREEMENT FOR SERVICES RENDERED Agreement made this 17th day of October,2005 by and between the Statesboro-Bulloch County Parks and Recreation Department and Perimeter Scuba (Larry kirkland) (hereinafter called "contractor") residing at 2186 Hwy 46, Pembroke, GA 31321. WITNESSETH: 1. The contractor agrees to perform the following services for the Statesboro Bulloch County Parks and Recreation Department: Scuba Diving Instruction and any other duties related to a Scuba diving class. 2. Th contractor agrees to provide the following for the Statesboro-Bulloch County Parks and Recreation Department: Buoyancy Compensator Device (BCD) for each participant Regulator with SPG and Dive Computer for each participant Wet suit, weight belt, and tanks with compressed air for each participant Proof of Liability Insurance Coverage. 3. The Statesboro-Bulloch County Parks and Recreation Department agrees to provide the following : Advertising for the program Registration for the program Pool Facility Classroom facility Lifeguard staff 3. The dates of these services to be: Tuesdays, Nov. 15,20051 Thursday, Nov. 17,20051 Tuesday, Nov. 22, 20051 Tuesday, Nov. 29, 20051 Thursday Dec. 1,20051 Tuesday, Dec. 6, 20051 Thursday, Dec. 8, 2005. 1 Tuesday, Dec. 13,2005/Thursday, Dec. 15,2005 (In the event of inclement weather, makeup days will be scheduled.) 4. The times of these services to be: 6:30pm to 8:00pm each day. (In the event of inclement weather, makeup times will be scheduled.) 5. As compensation for the services, the contractor shall receive: $235 for each paying participant 6. This agreement does not constitute an employer-employee relationship and is solely a contract for services rendered. 7. The contractor is responsible for complying with all Federal and State laws for taxes that are applicable. 8. Both the Contractor and the Statesboro-Bulloch County Parks and Recreation Department in writing must agree to any modification to this contract. In Witness whereof, the parties hereto have. hereunto set their hands and seal the day and the year first abo~e have ~ritten:, ~-;.. z;l;/ )0.,
A Proposal to Teach SCUBA Diving Throug~ SBCPRD - Splash in tbe'boro Attention: Steve Brown, Director From: Larry Kirkland, Instructor SDI-TDI Perimeter SCUBA Cost of Class: $295.00 Prerequisites: Minimum age 10 years old (will be certified as Jr. SCUBA Diver requiring accompaniment of adult diver - 18 years old or older until 16 years old). Must be able to swim 200 yards continuously - no time limit - any stroke. Must be able to tread water 10 minutes. Medical release. Liability Waiver. Prior to class personal equipment and books must be purchased. Class requires some preparation at home before pool sessions. This includes reading the textbook, completing the knowledge quest, and viewing the video. Personal equipment that must be purchased or obtained prior to class: mask with approved tempered lens, snorkel, fins, and booties. Additional equipment may be advisable, such as strap covers to minimize hair pulling, and lens clear to minimize mask fogging, equipment bag, and gloves. First Class Participant must present completed folder with medical release, liability waiver, and parental waiver if under 18 years old. Knowledge quests will be reviewed, and any questions will be clarified. Classroom equipment will be fitted and assigned. Participants will be taught to assemble and disassemble the equipment. Classroom equipment that will be provided by Perimeter SCUBA will be as follows: Buoyancy Compensator Device (BCD) Regulator with SPG and Dive Computer Wet Suit, weight belt, Tanks with compressed air Participants are expected to treat all equipment with extreme care and caution as though hislher life depends on it. IT DOES!!!!! This first classroom session will last approximately 4 hours. Second Class Participants will review previous class information. Equipment will be assembled and disassembled again. This is a vital skill and reviewed frequently. The participants will be introduced to pool session skills. These include, but may not be limited to: Weight system adjustment with proper weighting Pre-dive check of self and buddy, Mask clearing - partial and full
Second Class - continued Breathing and swimming with regulator underwater without mask BCD - inflation and deflation - orally and automatic - on surface and under water Removal and replacement of equipment (BCD-Tank-Regulator) on surface and under water Buoyancy Control- fin pivot and hover Controlled ascent and controlled descent Regulator use - breathing - clearing - recovery, at surface and at depth Alternate air source use - air sharing with a buddy while making a controlled ascent Out of air emergencies Underwater swimming with proper use of fins Entries and Exits Snorkel use Computer and Gauge use Underwater communications - hand signals Rescue Techniques - tired diver tows and cramp removal/cramp release Third Class Review of previous classes Assemble and disassemble equipment Continuation of exercises not attempted in first class Practice of skills already learned Fourth Class Review of previous classes Assemble and disassemble equipment Continuation of any exercises not attempted in first and second class Practice of skills already learned Note: Rarely will all pool exercises be completed in first class. Time limitations and class size will dictate the amount of time spent in pool. Expect the normal class to last 3 hours in pool and require 4 in pool sessions. SCUBA DIVING HAS INHERENT DANGERS ASSOCIATED WITH IT. TIDS CLASS WILL BE TAUGHT WITH SAFETY AS ITS ULTIMATE GOAL. The objective of this class is to teach basic open water SCUBA skills with SAFETY as the ultimate emphasis. SCUBA diving is enjoyable and fun but must be viewed as a risk taking endeavor. Participants who do not follow ALL safety rules may be dismissed from the class with no refund. Classroom and pool exercises are to prepare participants for a basic open water certification trip. This trip is not included in the price of the course. It will be taken on a weekend - depart Friday and return Sunday. Most certification trips will be to a fresh
Continued Water spring in Florida. The trip is approximately a five hour drive from Statesboro~ Participants will be required to provide own transportation and meals. Perimeter SCUBA will provide equipment used in classroom. It will be assigned to the participant before the trip and must be transported by the participant. An equipment agreement must be signed before the participant can obtain the equipment. Perimeter SCUBA will provide a motel room double occupancy - participants can expect to have a roommate unless otherwise arranged beforehand. Transportation of equipment by Perimeter SCUBA can be arranged for a nominal fee. All equipment is expected to be returned in clean condition. This means you must wash all equipment before returning it. If returned in an unsatisfactory condition, a repair or cleaning charge may be billed. This must be paid before obtaining certification card.?'\ i,!' Cost of Certification Trip is $3-. Group discounts are available. Class Times will be evening hours. Private classes available with prior arrangement with instructor. Advanced classes and specialty classes are available. Consult with Instructor for further information. Each participant has 6 months after completing classroom and pool exercises to attend and open water certification trip. If 6 months elapse, the participant will be required to enroll in a refresher class before attending and open water certification trip.
Perimeter SCUBA Instructor Larry Kirkland Larry Kirkland is a current instructor with SDI - TDI. He has previous training through P ADI, SSI, and NSS/CDS in various classes. He is the current dive team leader for the Statesboro Police Department DivelRescue team. He has been a certified SCUBA diver since 1986. He is a current CPRJCPROIFirst Aid! AED instructor with the Bulloch County Chapter of the American Red Cross. He is a certified DACOR equipment repair specialist. He currently is certified to teach the following classes: Basic open water SCUBA diving Advanced open water SCUBA diving Limited visibility and night diving Navigation Boat diving Deep diving Refresher courses SCUBA Plus program Master SCUBA diver Rescue diver Dive Master Assistant Instructor For Youth under required age: Future Buddies program SCUBA Discovery Program You may contact Larry through the Statesboro Police Department, or through Perimeter SCUBA, or bye-mail at divecop213@yahoo.com. Larry wants all participants to have an enjoyable experience SCUBA diving, and emphasizes SAFETY above all things.
Splash in the Boro - Family Aquatic Center Program Proposal Form Date: October 12, 20 OS Program: ~S~c~u~b~a~d~iv~in~g~ ; Age: 10 & older Program Site: Aquatic Center Session I Start Date:_--"N",o:.;v'c..1:..::S"",.::2""00,,,S::..-_ End Date: December 1S, 200S Days: ~T",u""es~d~a~y.::s:..::&~T~h::::u:..::rn.::d",a~ys~ Time: 6:30p-8:00p # ofwks: 5 non-meeting days(if any): T.:.h"'u~rn""d:::a~y'-'N..::o"'v:..:...::2:..::4'_, 2=:0::.,:0:..::S'-- Total Hours: _-,-13"".",S""h",r,,,s_ Description of Activity: Learn to Scuba Dive at Spalsh in the boro! This class is designed for ages 10yrs and older. Participants will learn the basics of open water scuba diving such as eguipment use, pre-dive checks, entries and exits, mask clearing, breathing and swimming with a regulator, swimming underwater with proper use of fins, underwater communication, and rescue technigues. Instructors name (if necessary): Larry Kirkland Program Budget I. Revenue(AIl Sessions) Class Fee: $29S Pass Fee: Revenue Code: _,-,5::..;S.::6,-,-6::.,1:..::2::;:4:..::1,-,-3,;:4"".7:...:2:..;1:..::S,--- Estimated total # of Participants: 6 X Activity fee: $29S.00 Partie. Rev.: $1,770.00 Any Other Revenue: $0.00 $0.00 $0.00 Other Rev.: $0.00 Total Revenue: $1,770.00 II. Expenses (All sessions) estimated Staff Title fee/participant #Of participants Total Instructor $23S.00 X 6 $1,410.00 Hrlywage total hrs Lifeguard N/A X N/A $0.00 this class will use a portion of the pool at the same time as other programs lifeguards are already on duty StalfTotal: $1,410.00 Other costs Cost marketing $1S0.00 'other marketing already included in program booklet Other Cost $1S0.00 Total Expenses: $1,S60.00 Total Revenue: $1,770.00 Net Revenue: $210.00 Net revenue/registrant: $3S.00 Programmer: Steve Brown Supervisor Approval: Safari:
WilliS LARRY KIRKLAND 21860 HWY 46 PEMBROKE, GA USA 31321 July 5, 2004 Important Insurance Documents Enclosed!!! Dear SDlffDI Diving Professional, We are pleased to enclose formal insurance documents for your Instructional! Supervisory activities as sanctioned by SDIITDlissued for the term June 30, 2004 to June 30, 2005. Please review the enclosed documentation to ensure coverage has been placed as per your request. Any errors, omissions or necessary changes should be brought to Association's attention immediately or call us directly at 1-800-665-5252. Thank you.. WILLIS NORTH AMERICA SDIITDI SPONSORED INSURANCE 1. PERSONAUZE your card with a desktop printer. (~)... 0 3 ~ ~.~ TURN the card over and retum to the lam inate window - matching the short side ftrst. ~ ~ ~~ ~ BEND the sheet and peel out the card. &~ REMOVE by anchoring the card while Iffting the page upward. ~?~~~~surance Program WI I Ii s Policy No: 25045 LARRY KIRKLAND Instructor Effective: June 30, 2004 to June 30, 2005 Per Event Annual Aggregate $1,000,000.00 $2,000,000.00
willis SDIITDI -SPONSORED INSURANCE MASTER CERTIFICATE HOLDER: MASTER CERTIFICATE NO.: POLICY NO.: SDlfTDI SDlfTDI2004US 25045 This is a Policy which reflects the terms, conditions, limitations and exclusions of the Master Certificate, including Underwater Instructors Professional Liability Claims Made coverage, that has been issued to SDIITDI, and which is held at SDIITD!. Below is a summary of the Underwater Instructors Professional Liability Claims Made coverage. A full copy of the Underwater Instructors Professional Liability Claims Made coverage, as afforded by the Master Certificate, is attached. DECLARATIONS INSURER(S) NAMED INSURED ADDRESS STATUS OF INSURED TYPE OF COVERAGE PERIOD OF INSURANCE THE CATLIN SYNDICATE, LLOYD'S, LONDON LARRY KIRKLAND 21860 HWY 46, PEMBROKE, GA USA 31321 Instructor Underwater Instructors Professional Liability Insurance Claims Made Coverage Applies to Sport Diving Instruction and Supervision Only as specifically Approved and Sanctioned by SDlfTDI. go-day discovery Period. Coverage Only Provided to Claims Made Against the Insured During the Period of Insurance. Premium Fully Eamed. From: June 30, 2004 To: June 30, 2005 Both 12:01 a.m., Standard time at the above address of the Named Insured. RETROACTIVE DATE LIMIT OF LIABILITY June 30,2000 PER EVENT ANNUAL AGGREGATE $1,000,000.00 $2,000,000.00 PREMIUMIT AXES/FEES $545.00 DEDUCTIBLE NIL NOTICE OF EVENT OR CLAIM SDlfTDI, 18 Elm Street, Topsham, ME USA 04086 IN THE EVENT OF CANCELLATION OF THE MASTER CERTIFICATE OR THIS POLICY, THE UNDERWRITERS WILL GIVE 30 DAYS NOTICE OF CANCELLATION EXCEPT THAT 10 DAYS NOTICE OF CANCELLATION SHALL APPLY TO THE NON PAYMENT OF PREMIUM. THIS POLICY IS SUBJECT TO ALL THE TERMS, CONDITIONS, LIMITATIONS AND EXCLUSIONS OF THE UNDERWATER INSTRUCTORS PROFESSIONAL LIABILITY INSURANCE CLAIMS MADE COVERAGE AS AFFORDED BY THE MASTER CERTIFICATE. Willis Canada Inc., Issued through Willis of Tennessee Inc. per -"7"'-~---.?-~-.-r- --r---"'--- This confirmation of cover has been provided by lilis Canada Inc acting in an underwriting capacity on behalf of insurers who, under binding authority agreement, have given us authority to confirm insuring terms, conditions and premiums and to settle claims on their behalf.
UNDERWATER INSTRUCTORS PROFESSIONAL LIABILITY MASTER CERTIFICATE NO. POLICY NO. NAMED INSURED :SDIITDI2004US :25045 : LARRY KIRKLAND THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY VICARIOUS LIABILITY This endorsement modifies insurance provided under the following: UNDERWATER INSTRUCTORS PROFESSIONAL LIABILITY COVERAGE This insurance is extended to provide vicarious liability coverage to the following Entities: any retail dive facility, dive vessel, educational institution, marina, government entity, municipality, swimming pool facility, property owner, dive resort, hotel, or motel from which the Named Insured renders his/her Professional Services. This additional insured protection is strictly limited in scope and applies only to the liability of these Entities arising vicariously out of or attributable to the Named Insured's rendering of or failure to render Professional Services in his/her capacity as a diving leader, divemaster, instructor, divecon, assistant instructor or sustaining instructor providing instruction or supervision of sport diving as specifically approved and sanctioned by SDIITDI. This Endorsement does not extend coverage to any Entity for liability attributable to or allegations made against said Entity for his/her/its own conduct. This Endorsement and the coverage provided herein is subject to all of the terms, provisions, agreements, definitions, exclusions, limitations, conditions, and warranties contained in the Master Certificate and Policy to which it is attached.
SDIITDI Willis ADDITIONAL INSURED ENDORSEMENT Attached to and forming part of Policy No. 25045 of Master Certificate No. SDIITDI2004US issued by Willis Canada Inc., Issued through Willis of Tennessee Inc. on behalf of the Catlin Syndicate, Lloyd's, London. ISSUED TO: LARRY KIRKLAND THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY VICARIOUS LIABILITY This endorsement modifies insurance provided under the following: UNDERWATER INSTRUCTORS PROFESSIONAL LIABILITY COVERAGE This insurance is extended to provide vicarious liability coverage to the following Entities: Effective: June 30, 2004 SDlrrDI Effective: June 30, 2004 DEBORAH J WARD This additional insured protection is strictly limited in scope and applies only to the liability of these Entities arising vicariously out of or attributable to the Named Insured's rendering of or failure to render Professional Services in his/her capacity as a diving leader, divemaster, instructor, divecon, assistant instructor or sustaining instructor providing instruction or supervision of sport diving as specifically approved and sanctioned by SDIITDI. This Endorsement does not extend coverage to any Entity for liability attributable to or allegations made against said Entity for his/her/its own conduct. This Endorsement and the coverage provided herein is subject to all of the terms, provisions, agreements, definitions, exclusions, limitations, conditions, and warranties contained in the Master certificate and Policy to which it is attached. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED DATED: July 5,2004 Willis Canada Inc., Issued through Willis of Tennessee Inc. Page 1 of 1
DEPARTMENT MAKING REQUEST (Box 1) MEETING DA TE (Box 2) Nov. 1, 2005 RESOLUTION A TTACHED? (Box 3) Parks & Recreation / Aquatics REQUESTED MOTION OR ITEM TITLE (Box 4) Scuba Diving Instructor Contract SUMMARY/BACKGROUND ATTACH DETAILED SUMMARY, IF NEEDED (Box 5) Larry Kirkland is a current instructor with SDI-TDI. He is the current dive team leader for the Statesboro Police Department Dive/Rescue Team. He has been a certified scuba diver since 1986. FINANCIAL IMPACT STATEMENT (Box 7) BUDGETED ITEM? (7a) PRESENTA TlON (6a) YES X AMENDMENT REQURED? (7b) YES A TTACH DETAILED ANAL YSIS, IF NEEDED (7c) PUBLIC HEARING X The cost of the class will be $295.00. The instructor will n_c_o_n_s_e_n_t_(_6c_j _-+-_-I receive $235.00 for each paying participant and the SBCPRD will receive $60 for each paying participant. It--NE_W_B_U-"-S_IN_E-"-S...::...S~L +_---I Program costs will vary based on program revenues. OLD BUSINESS OTHER (6f) 1