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HomeMy WebLinkAboutFive Star Snow Trails Association, Inc-10/17/2011October 7, 2011 City of Waterloo Attn: City Clerk 715 Mulberry Street Waterloo, IA 50703 161(7 got( FIVE STAR SNOW TRAILS (oe'fr'N' ° ASSOCIATION, INC a'c l "119 1314 Washington St, Cedar Falls, IA 50613-4153 Phone: 319-266-0445 ♦ Cell: 319-231-0819 ♦ email: damelick@cfu.net Enclosed for your consideration is the Application to the Iowa Department of Transportation (IDOT) for renewal of the permit to establish and sign a snowmobile trail within the right-of-way of state highways. A portion of that trail resides within the city limits of Waterloo. The IDOT requires that each affected city approve the application before being processed by the Department. Page 3B of the application has a block for the signature of the responsible individual representing Waterloo. PLEASE USE THIS PAGE FOR THE CITY SIGNATURE. DO NOT COMPLETE THE SIMILAR SECTION SHOWN ON PAGE 1 OF THE APPLICATION. Permits are issued for one season only and must be renewed each year. This application is the same as the one which was approved last year for the city of Waterloo. Items 1, 2, 8, 9 on page 4, items #17, 18, 19, 20 on page 5 And items #21, and 22 on page 6 are the only items which affect Waterloo. If you have any questions concerning the application and related paperwork, you may contact me at: 319-231-0819(Cell) or e-mail to: damelick@cfu.net I would appreciate it very much if city action could be taken at the October 10th Council meeting, if Council action is required. The IDOT is short on staff and it could take them some time to take their action, so it is imperative that we get the application in their hands as soon as possible, so as to beat the freezing temperatures and first snowfall with signing of the trail. Please return to me in the enclosed, "postage applied" envelope as soon as possible after action has been taken by city officials. Thank you for your assistance with this matter. Sincerely, Dick Melick Five Star Snow Trails Assoc., Inc Administrative Advisor Iowa Department of Transportation Form 810028 (02-11) FOR DEPARTMENT USE ONLY Permit Number Application to Perform Work Within State Highway Right -of -Way Highway Number (SEE ATTACHED LISTING) County Black Hawk DOT Project Number N/A Expiration/Completion Date APPLICANT (INDIVIDUAL OR COMPANY ASSISTANCE FROM DEPART First Name Richard Middle Initial C Last Name Melick Phone Number (319) 231-0819 Company Name Five Star Snow Trails Association Phone Number (319) 231-0819 Street Address 1314 Washington St City/Town Cedar Falls State JA Zip Code 50613-4153 WORK TO BE ACCOMPLISHED Approval is hereby requested to enter within the state right of way and to complete the proposed work as detailed on the attachments and further described as follows: Snowmobile Trail and Trail Crossing locations as indicated on the attached listing. Trail is located partially within the city limits of Dunkerton, Janesville and Waterloo. All crossisngs shall go into effect after all signs along the highway have been installed by DOT Forces. All signs placed on Row by applicant shall be removed by applicant. WORK SITE LOCATION (SEE ATTACHED LISTING) The proposed work as described above is Range (direcfion) from on Highway No. . generally located (miles) (city, county line or other land line). Work proposed is more specifically located as being from to (Milepost#) and (Highway Station) (Milepost#) and (Highway Station) on the side of highway. Applicant Signature and Agreement The undersigned have read the stipulations of this permit agreement as stated as well as attachments which may be included and by signing this application agree to abide by all stipulations and to complete the work as proposed in compliance with the stipulations and attachments within one year from the date Department approval is received for said request. Failure on the part of the applicant to abide by the stipulations or to construct the work desired as stipulated and within the time frame stated shall render this agreement and request null and void. The undersigned also agrees to save harmless the State of Iowa and the Iowa Department of Transportation from any damage or losses that may be sustained by any person or persons on account of the conditions and requirements of this agreement. Applicant Name (First, M.I., Last --Print or Type) Applicant Signature (Handwritten) Date Richard C. Melick Authorized City Official for the City of (SEE ATTACHED CITY ACTION SHEETS) 10/7/2011 CITY ACTION (IF PROPOSED WORK IS WITHIN AN INCORPORATED CITY, CITY ACTION ACTION IS REQUIRED) "The undersigned city joins in the grants embodied in the above permit executed by the Iowa Department of Transportation on condition that all of the covenants and undertakings therein running to the Iowa Department of Transportation shall inure to the benefit of the undersigned city and recommends action on said permit application as noted below by the delegated city official". Recommend Approval Do Not Recommend Approval None Required Mum. Lacy tonclal blgnarure (Handwritten) Title (See attached city action sheets) Date Name of Authorized City Official (Print or Type) (SEE ATTACHED CITY ACTION SHEETS) Authorized City Official for the City of (SEE ATTACHED CITY ACTION SHEETS) FEDERAL HIGHWAY ADMINISTRATION ACTION (DEPARTMENT REPRESENTATIVES WILL REVIEW THE REQUEST AND OBTAIN FHWA ACTION, WHEN NECESSARY) Recommend Approval n Do Not Recommend Approval n None Required Authorized FHWA Representative Signature Date (DOT Final Action & Agreements on next page) Page 1 of 2 DEPARTMENT OF TRANSPORTATION FINAL ACTION Application Approved 1 1 Application Denied Permit Number Authorized Highway District Representative (Type or Pring: Signature Date Notice of intention to commence activities on the highway rights-of-way shall be submitted by the applicant a minimum of 48 hours prior to actually commencing the activities as herein granted by this approved application. Notice is to be given to the following Iowa Department of Transportation representative: Local DOT Contact Person (Type or Print Name) DOUG LICKTEIG. GARAGE SUPERVISOR Phone Number (319) 233-3055 Street Address 1875 EAST RIDGEWAY AVE. PO BOX 1888 City/Town WATERLOO State IA ZIP Code 50704 AGREEMENTS The applicant agrees that if granted a permit to do said work the following stipulations shall govern. 1. The applicant shall carry on the construction, repair, and maintenance with serious regard to the safety of the traveling public and adjacent property owners and shall save the State and the Iowa Department of Transportation harmless of any damage or losses that may be sustained by the traveling public on account of such construction, repair, or maintenance operations. 2. The applicant shall indemnify and save harmless the State of Iowa, its agencies, and employees, from any and all causes or actions, suits at law or in equity, for losses, damages, claims, or demands, and from any and all liability and expense of whatsoever nature, arising out of or in connection with the applicant's use or occupancy of the public highway. 3. The applicant shall hold the State and the Iowa Department of Transportation harmless of any damage that may result to said highway because of the construction or maintenance of the facility, and shall reimburse the State or the Iowa Department of Transportation for any expenditures that the State of Iowa or the Iowa Department of Transportation may have to make on said highway rights-of-way on account of said applicants construction or maintenance activity or lack thereof. 4. Traffic protection shall be in accordance with Part VI of the current Manual on Uniform Traffic Control Devices for Streets and Highways. The applicant shall be responsible for correctly using signs as needed while work is in progress. Flagging operations are the responsibility of the applicant. 5. Before beginning any work within the highway rights-of-way, it is the responsibility of the applicant to contact utility companies whose installations may be affected or encountered. Contact should be made at 1-800-292-8989, a minimum of 48 hours in advance of starting construction. If the work requested in this application should cause a need to relocate or modify an existing utility, any cost associated shall be as negotiated between the applicant and the utility owner. 6. A copy of the approved application shall be available on the job site at all times for examination by Department of Transportation officials. 7. The applicant shall seed and mulch all disturbed areas within the highway right-of-way and shall be responsible for the vegetative cover until it becomes well established. Any surfaced areas such as driveways or shoulders and sodded waterways and plantings which are disturbed shall be restored to their original condition. 8. If the proposed work results in a pool of water on the applicant's property, this pool of water will be exclusively owned, controlled, and maintained by the applicant. That part of the modification located on highway right-of-way will be maintained by the Iowa Department of Transportation for road purposes only. 9. The applicant shall maintain any drainage structure built within the right-of-way that is built for the benefit of the applicant and not necessary for highway use. 10. This permit is subject to any laws now in effect as well as any new laws which may be hereafter enacted and all applicable rules and regulations of local, state, and federal agencies. 11. This permit is subject to all the rules and regulations of the Iowa Department of Transportation, and to revocation by the Iowa Department of Transportation at any time and at no cost to the Department, when in the judgment of the Department it is necessary in the improvement or maintenance of the highway or for other reasonable cause. 12. The applicant agrees to give the Iowa Department of Transportation 48 hours notice of intention to start construction or perform maintenance on the highway right-of-way. Any modification to the proposed work shall be approved by the Department prior to making the change. 13. Unless specifically noted in item #15, all work performed within the right-of-way shall be restricted to a time frame of 30 minutes after sunrise to 30 minutes before sunset. 14. After November 24, 2008, all personnel in the highway right-of-way shall wear ANSI 107 Class 2 apparel at all times when exposed to traffic or construction equipment. 15. All proposedwork covered by this permit shall be at the applicant's expense. The applicant shall reimburse th Iowa Department of Transportation for any materials removed from the highway right-of-way described as follows: 16. The following special requirements shall apply to this permit: PLEASE NOTE: The sponsor agrees tohold harmless the State of Iowa and the Iowa Department of Transportation and to indemnify them from any claim. demand or action by or on behalf of any person or entity. arising out of or in connection with anything having to do with the snowmopbile route. including, but not limited to. its establishment. construction. use, maintenance. signing. cofiguration or existence. Disclosure Statement The information furnished on this form will be used by the Department of Transportation to determine approval or denial of the application. Failure to provide all information will result in denial of the application. Information fumished is public information and copies may be provided to the public upon request. Page 2 of 2 e CITY ACTIO! (IF PROPOSED WORK IS WITHIN AN INCORPORATED CITY, CITY ACTION IS REQUIRED) "The undersigned city joins in the grants embodied in the above permit executed by the Iowa Department of Transportation on condition that all of the covenants and undertakings therein running to the Iowa Department of Transportation shall inure to the benefit of the undersigned city and recommends action on said permit application as noted below by the delegated city official". 0 Recommend Approval 0 Do Not Recommend Approval 0 None ;-squired Auth. City Oficial Signature (Handwritten) Title %ek € . CIS §lame ; Authorized 1 (Print or type) Date 111/76 I i Authorized City Official for the City of WATERLOO 3B IOWA DEPARTMENT OF TRANSPORTATION Application to perform work within State Highway Right -of -Way FIVE STAR SNOW TRAILS ASSOCIATION Snowmobile Trail and Crossing Locations -Black Hawk County 1. Crossing of US 218 in Waterloo at Marigold Dr, milepost 176.84. 2. Marked, "ungroomed" trail along both ditches of US 218 from Marigold Dr in Waterloo, milepost 176.84, to bridge at the north Washburn city limits. 3. Crossing under US 218 by way of bridge at north Washburn city limits, milepost 175.58 (NO SIGNING REQUIRED ON ROADWAY) 4. Marked "ungroomed trail along east ditch only of US 218 from bridge listed in item # 3 to farm driveway approx 300 $ north of Washburn city limits and immediately north of residence with street number 6605. Marked, "groomed" trail along east ditch only, of US 218 from the convenience store at 7112 LaPorte Road in Washburn to East Schrock Road, southeast of Washburn. 6. Crossing of US 218 at East Schrock Road, milepost 173.74. 7. Marked, "groomed" trail along both ditches of US 218 from East Schrock Road, milepost 173.74 to LaPorte City north city limits. 8. Crossing under US 218 at Broadway St in Waterloo, mile post 185.8. (See item 9 below ) (NO SIGNS REQUIRED ON US 218) 9. Marked, "ungroomed" trail along south ditch of Broadway St from US 218 southbound "on ramp" to the US 218 northbound "off ramp". 10. *Crossing of US 218 at County C57 north of Cedar Falls. Stop signs will be placed along the trail on both sides ofthe highway requiring snowmobiles to stop prior to crossing the first two lanes and also in the median to require snowmobiles to stop before crossing the next 2 lanes. milepost 192.88. 11. **Crossing US 218 at West Gresham Road. Stop signs will be placed along the trail on both sides of the highway requiring snowmobiles to stop prior to crossing the first two lanes and also in the median to require snowmobiles to stop before crossing the next 2 lanes. 11A. This item is completely removed. 12. This item is completely removed. Black Iiawk County -2011. wpd 4 IOWA DEPARTMENT OF TRANSPORTATION Application to perform work within State Highway Right -of -Way FIVE STAR SNOW TRAILS ASSOCIATION (Coned) Snowmobile Trail and Crossing Locations -Black Hawk County (Cont'd) 21. Marked, "ungroomed" trail along the east ditch only of US 63 from Ridgeway Ave in Waterloo, milepost 159.58, south approx 500 feet to the parking lot of Heartland Inn Motel. Trail will end at that point. 22. Crossing of US 63 at Airline Highway in Waterloo, milepost 166.71. 23. . Crossing of US 63 approx .25 miles north of West Bennington Rd and approx 170 feet north of the small green highway milemarker 171. This location is a highway "turn -around) with farm field driveways coming directly from both the east and west farm fields, milepost 171.03. * Item 10 is revised to show trail signing to be placed at this location. * * Item 11 is completely revised and Items 11A and 12 are completely removed due to extensive road construction near Janesville. With the changes being made, it appears at this time to be impossible to utilize last years route into Janesville. All other locations shown on this application are the same as listed on the 2010 application. Note: Marked, "groomed" trail indicates that a track driven motorized trail grooming tractor pulling a snow drag will be operating to prepare the trail for snowmobile use and special signs applicable to snowmobile trails will be installed. Note: Liability insurance for the Five Star Snow Trails Association is covered on page 4 of the "Land Owners as Additional Insureds" page on the enclosed Certificate of Insurance for the Sno Hawks Snowmobile Club. All towns involved and the Iowa Department of Transportation are covered by the additional insured listed as "THE STATE OF IOWA AND ALL OF ITS POLITICAL SUBDIVISIONS". Note: A copy of the Insurance for the Sno Hawks Snowmobile Club for the current year is enclosed. Insurance renewal for year 12-1-201 1 to 12-1-2012 is in process. Policy has not yet been issued. A copy of the approved policy will be provided to each entity involved upon receipt of the policy, which is expected to be sometime during the month of December 201 1. Black Hawk County-2011.wpd 6 moo® CERTIFICATE OF LIABILITY INSURANCE DATE (MMR)O/YYYY) 11/09/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER V & V Insurance Agency, Inc PO Box 159 103 8th St E Cresco IA 52136— CONTACT NAME: (A/C,4 No, Ext): (563) 547-2161 FAX No): (563) 547-2046 E-MAIL ADDRESS: insurance@vandvins . com PRODUCER CUSTOMER ID 0: INSURERS) AFFORDING COVERAGE NAIC 0 INSURED SNO HAWKS INC. 1314 WASHINGTON ST • CEDAR FALLS IA 50613- INSURER A Dakota Fire Insurance Co INSURER B : / / 12/01/2010 / / / / / / / / / / INSURER C : EACH OCCURRENCE INSURER D : X INSURER E : $ INSURER F : X ! CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POUCY NUMBER POUCY EFF (MM/DDIYYYY) POUCY EXP (MM/DD/YYYY) LIMITS GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY OCCUR 3031117 / / 12/01/2010 / / / / / / / / / / / / 12/01/2011 / / / / / / / / / / EACH OCCURRENCE $ 1,000,000 X DPEES (EaENTED occurrance) $ X ! CLAIMS -MADE MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L 7POLICY AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ I I JECT LOC $ AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE / / / / / / / / / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ ' WORKERS COMPENSATION ANS EMPLOYERS' LABILITYY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERMIEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS / N N / A / / / / / / / / / / / / / / / / WC STATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ / / / / / / / / DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Snowmobile Club and Trail liability insurance, including liability coverage for (1) Groomer and (1) ATV (used for trail maintenance only). Additional insured: See (4) attached sheets. Premise liability coverage is Excluded on this policy. CERTIFICATE HOLDER CANCELLATION ( ) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE XV4 ACORD 25 (2009/09) INS025 (200909) © 1988-2009 ACORD CORPORATION. ' All rights reserved. The ACORD name and logo are registered marks of ACORD CLUB NAME; SNO HAWKS, INC. LANDOWNERS AS ADDITIONAL INSURED FOR CLUB CONTRACTED TRAIL USAGE ONLY 61. Mary D. Shining Trust 5311 Hyacinth Drive Unit 64 Cedar Falls, IA 50613-6415 71. Charles Wilmot 2596 Joplin Avenue Denver, IA 50622 62. William A. Shining Trust 5311 Hyacinth Drive Unit 64 Cedar Falls, IA 50613-6415 72. Raymond & Pauline Youngblut 6732 LaPorte Road Waterloo, IA 50706 63. Ronald Steege 9321 Logan Avenue . Waterloo, IA 50703 73. Tim Youngblut 6905 East Washburn Road Washburn, IA 50706 64. Euggne E. & Jean M. Stokes 1225 Ford Road Cedar Falls, IA 50613 74. David M. & Nancy J. Zeien 4622 West Cedar Wapsi Road Cedar Falls, IA 50613 65. Tall Pine Farms, Inc. 7411 North Raymond Road Dunkerton, IA 50626 75. The State of Iowa & All of its political Subdivisions Wallace State Office Building Des Moines, IA 50319 66. Michael & Kathy Tellinghuisen 7611 North Union Road Janesville, IA 50647 76. Five Star Snow Trails Association 5912 Aster Lane Waterloo, IA 50701 67. Clifford R. & L. Marcella Trent 8339 Leversee Road Cedar Falls, IA 50613 77. City of Janesville Iowa 227 Main Street Janesville, IA 50647 68. Ala. & Marilyn Walker 1303 East Bennington Road Waterloo, IA 50703 69. Washburn BP Store 7305 LaPorte Road Washburn, IA 50702 70. Warrioo Industrial Development ' ' 19 West 4th Street Waterloo, IA 50701 Page 4 of 4 MASTER POLICY NAME: IOWA STATE SNOWMOBILE POLICY # 3D31117 --I1 ASSOCIATION * SNOWMOBILE CLUB CERTIFICATE * CARRIER: DAKOTA FIRE INSURANCE COMPANY EFFECTIVE DATE: 12-01-10 TO: 12-01-11 RETROACTIVE DATE: 11-30-04 CLUB #: 029 CLUB NAME: SNO HAWKS INC ENDORSEMENT#: 01 ADDRESS: 1314 WASHINGTON STREET CEDAR FALLS, IA 50613 COVERAGE : SNOWMOBILE CLUB ONLY ® SNOWMOBILE/ATV CLUB ❑ TRAIL LIABILITY EXPOSURE: Z YES ❑ NO PREMISES LIABILITY EXPOSURE ❑ YES NO PREMISES LOCATED AT: #GROOMERS: l #/USE OTHER CLUB PREM $1040.00 MP ENDST FILING FEE +[]APPLIES SURPLUS LINES TAX +ZAPPLIES STAMPING FEE TAX +❑APPLIES SL SERVICE CHARGE +❑APPLIES EQUIPMENT: 1 - ATV USED FOR TRAIL MAINTENANCE ONLY #EMERGENCY SLEDS: 0 (EMERGENCY SLED) IS A SPECIFIC SLED ATTACHED TO A SNOWMOBILE TO CARRY INJURED PEOPLE TO AN EMERGENCY VEHICLE WHEN DUE TO WEATHER THE EMERGENCY VEHICLE CANNOT GET TO THE INJURED PARTY. ***WARRANTED THAT AN EMT OR PARAMEDIC MUST ACCOMPANY OUR SNOWMOBILE CLUB DRIVER. (NO PROFESSIONAL LIABILITY COVERAGE IS PROVIDED) COVERED CLUB ACTIVITES: SEE ATTACHED SCHEDULE OF SPECIFICALLY COVERED ACTIVITIES ****************************************************************************** THIS CLUB IS MADE UP OF OTHER INDIVIDUAL CLUBS WHO EACH CARRY THEIR OWN CLUB LIABILITY POLICY FOR MEM ACTIVITIES. ❑ YES ® NO IF YES, THE FOLLOWING EXCLUSION APPLIES TO THE COVERAGE PROVIDED FOR THE CLUB LISTED ABOVE. EXCLUSION: IT IS HEREBY AGREED AND UNDERSTOOD THAT "NO COVERAGE" EXISTS FOR ANY ACTIVITIES OF THE INDIVIDUAL CLUBS WHICH MAKE UP THE CLUB: ADDITIONAL INSURED'S FIND ZYES SEE ATTACHED ENDORSEMENT **OTHER THAN CLUB CG7501 (1-06) CONTRACTED LANDOWNERS FOR USE OF TRAILS ONLY LIMITS: $1,000,000 OCCURRENCE $1,000,000 GENERAL AGGREGATE **COVERAGE IS FOR SPECTATOR LIABILITY ONLY. COVERAGE FORMS APPLICABLE ARE THE SAME AS SCHEDULED ON THE MASTER ASSOCIATION POLICY. IF YOU HAVE ANY QUESTIONS YOU SHOULD REFER TO THE ASSOCIATION FOR POLICY INFORMATION. DATE ISSUED: 12/13/10 HB 'sU INSURANCE AGENCY Highway 9 East P.O. fox 159 Cr... Iowa 571:41 Phone (553) 5:72151 Fax No. (563) 5.7 2046 insuranco@vandvine..com DALE VAGTS SCHEDULE OF SPECIFICALLY COVERED ACTIVITIES CLUB NAME: 029 - SNO HAWKS INC GENERAL MEMBERSHIP/CLUB MEETINGS BOARD MEETINGS/CHAPTER MEETINGS ANNUAL CONVENTIONS/STATE CONVENTIONS — attending not sponsoring event SNOWMOBILE TRAIL/CLUB RIDES POKER RUNS/FUN RUNS SAFETY CLASSES RADAR RUNS DISPLAYSBOOTHS/RAFFLES BANQUETS/LANDOWNER DINNERS DANCES SCAVENGER HUNTS SWAP MEET -attending not sponsoring entire event FLEA MARKET — attending not sponsoring entire event PARADES HAYRIDES CAMP -OUTS CHRISTMAS PARTY CLUB COOK OUTS/PICNICS/CHILI FEEDS/DINNERS PANCAKE BREAKFAST CHRISTMAS TREE SALES TRAIL MAINTENANCE AND TRAIL GROOMING— TRAILS INCLUDE OWNED OR LEASED PROPERTY WITHIN DESIGNATED TRAILS ONLY CONCESSION STAND - JUNE 24, 25 & 26, 2011 AND AUGUST 5, 6 & 7, 2011 **IF RADAR RUNS ARE SCHEDULED ABOVE — THE FOLLOWING WARRANTY APPLIES TO THIS EVENT: **Coverage is hereby warranted for this event that no one under 18 is allowed to participate.** **COVERAGE APPLIES ONLY TO THOSE SPEFICALLY SCHEDULED ACTIVITIES LISTED ABOVE