SORS 8/5/2005 Page 3 of 4
Rev 8/15/2019: Updates to include Protection of Minors Requirements
Rev 7/31/2020: Inclusive of SRC, Patty Ice, Patty Pool
Permittee expressly waives any and all claims of whatever nature, for any and all loss or damage sustained from any cause
whatever, prior, during, or subsequent to the rental period, by reason of any defect, deficiency, failure, or impairment of
the premises, including, but not limited to the water supply system, heating system, wires leading to or inside the premises,
gas, electric, or telephone systems, automatic sprinkler systems or from any other source whatsoever. UA is not liable or
responsible for any financial loss incurred by the Permittee due to unforeseen, extenuating or uncontrollable events, which
cause failure of any or all of the facilities to operate or function during the period of this Agreement.
6. INSURANCE. Without limiting its indemnification, and at least two weeks prior to the intended use, Permittee will
furnish UA with a Certificate of Insurance evidencing insurance coverage as indicated below:
6.1 Check either (A) or (B) below:
(A) Permittee’s policy of commercial general liability insurance with a minimum limit of $1,000,000 per
The commercial general liability insurance must include coverage for liability assumed under an insured
contract (including defense costs assumed under contract) and shall name UA as an additional insured. This
insurance shall apply as primary insurance with respect to any other insurance or self-insurance programs
afforded to UA.
(B) Permittee shall purchase liability insurance from the UA for a price of $____________ (see rate schedule).
6.2 Workers Compensation insurance meeting the required statutory limits unless Permittee provides:
I) A certificate of waiver approved by the Alaska Department of Labor; or
II) Other sufficient written proof and/or affidavit that establishes to the satisfaction of UA that
Permittee does not have any employees covered by the Alaska Workers Compensation Act.
Permittee shall purchase at its own expense, and maintain in force at all times during the term of this Agreement, the
insurance required in this section. Failure to furnish satisfactory evidence of insurance, lapse of a policy, or inadequate
limits, is grounds for termination of this Agreement. All insurance limits are minimum. If the Permittee’s policies contain
higher limits, the UA shall be entitled to coverage to the extent of such higher limits.
See page 1 footnote 1 of this agreement for additional insurance requirements as they pertain to minors.
7. PERSONAL PROPERTY. Permittee, not UA, is responsible for loss of, or damage to, any personal property of
Permittee, its guests, agents, employees, or invitees located within or on UA property, before, during, or after the term of
8. USE OF UA NAME OR LOGO. Permittee agrees not to use the name or logo owned by or associated with the UA or
the name of any representative of the UA in any form of publicity without the written permission of the UA in each
9. CLEANING-VANDALISM. During the periods of facility/premises use by Permittee, Permittee shall be responsible for
vandalism or damages occurring during its use. Permittee shall be responsible for the expense of cleanup at the conclusion
of each use.
10. ADDITIONAL SERVICES. Permittee shall reimburse UA for any and all services not included in this Agreement but
requested by Permittee or required to fulfill Permittee’s responsibilities under the terms of this Agreement including, but
not limited to, cleanup not accomplished by Permittee.
11. RENT. Permittee agrees to pay to UA the sum of $_________________________ for the use of the facility/premises.
Said sum will be paid at least seven (7) days before the intended use of the facility/premises, or if pre-approved by the
appropriate UA fiscal officer, multiple pre-scheduled payments for rental time periods of a month or more. Charges for
cleaning and damages will be billed to the address of the Permittee as shown below and are due in full upon receipt of the
12. ASSIGNMENT. No benefit under this Agreement may be assigned nor may any duty under this Agreement be delegated
without the written consent of the other party.