ECCBoardofTrustees

ExecutiveSummary 

 

Date:  August 31, 2017  

Subcommittee:  Consent 

Agenda Item:  Internship Agreements requested between ECC with both the Gloria J. Parks Community Center and People, Inc., for the Human Services Certificate Program 

This item is for:    For Board's Approval Backup Documentation:  Attached to this document 

   Background Information: 

The Human Services Certificate Program Internship Coordinator Carl Stokes requests Internships with 

two sites; the (1) Gloria J. Parks Community Center and (2) People, Inc.  These agreements will provide 

students with needed competencies and standards of proficiency required for program completion. 

Reasons for Recommendation: 

To provide students access to required experience and training directly related to the successful 

completion of the curricula. 

Fiscal Implications: 

Required courses for student graduation. 

Consequences of Negative Action: 

Students would not have access to required learning experiences. 

Steps Following Approval: 

Review and approval by ECC Legal Counsel Leslie Ortiz Fogg, Assistant County Attorney, Erie County. 

Contact Information If Any Questions: 

Richard C. Washousky, Provost and Executive Vice President 

Phone:  (716) 851‐1500     /     E‐Mail:  washousky@ecc.edu  

ERIE COMMUNITY COLLEGE AND

Gloria J. Parks Community Center

INTERNSHIP AGREEMENT

THIS INTERNSHIP AGREEMENT is made this Tuesday June 20th, 2017 by and between Erie Community College ("ECC") having its principal offices and place of business at 121 Ellicott St., City of Buffalo, County of Erie and State of New York and Gloria J. Parks Community Center 3242 Main Street 14214, City of Buffalo, County of Erie and State of New York ("Sponsor'').

The principle objective of this Internship program is to combine the knowledge acquired in the classroom with the practical experience gained from on- the- job training and mentoring. By associating local ECC students who are fully matriculated in the Human Services Certificate program with WNY businesses or organizations interested in securing a talented future workforce, ECC hopes to create an opportunity to fill the ever-increasing demands for professional employees in the Western New York community.

In consideration of the mutual promises and obligations set forth herein, the Parties hereby agree as follows:

TERMS AND CONDITIONS

1. Definitions The following definitions apply a. "Internship" means a program of study as part of ECC's course or degree

requirements, conducted in cooperation with the Sponsor, at its place of employment, whereby Interns receive supervised experience and instruction in a

professional setting. b. "Sponsor'' means an individual or Company/Organization. c. "Supervisor'' means that person employed or retained by the Sponsor

responsible for the development and administration of the Internship affiliation

with the College. d. "Intern" means a student enrolled in an ECC course or degree program who is to

perform the Internship. e. "Coordinator of Internships" means the person employed or retained by the

College who is responsible for the development and administration of this Internship affiliation with the Sponsor.

f. Learning Agreement is the agreement between the Sponsor's Supervisor, the student intern and the ECC faculty supervisor stipulating the obligations of each party relative to an Internship.

2. Purpose As part of ECC's course or degree educational requirements or as required for the award of a certificate in particular areas of study, students must complete

supervised field experience, such as this Internship.

3. Term The term of the Agreement shall be from 6/20/17 to 6/20/20 and may be

extended by mutual written agreement of the Parties. In the event of expiration or termination of this Agreement, Interns shall be permitted to complete all Internships that began prior to the termination date, and with respect to such internships, all

terms

and conditions of the Agreement shall apply until the last Internship is completed.

4. The Sponsor's Obligations

a. The Sponsor agrees to provide training to each Intern for a minimum of one hundred and thirty-five (135) hours, or as required by the ECC curriculum, during the internship period.

b. The Sponsor agrees to provide the student with practical experience in his/her area of academic interest during the internship period. The Sponsor's personnel will also provide mentoring and instruction that are directly related to the academic criteria of the ECC department.

c. The Sponsor agrees to modify planned tasks during the internship period, as may be required, given changes in the Sponsor's circumstances; however, the Sponsor will make every reasonable effort to ensure that the Intern is working in a position which exposes him/her to curriculum-related tasks.

d. The Sponsor agrees to provide adequate supervision and evaluation of the Intern during the internship program. To accomplish this task, the Sponsor agrees to review and sign off on the intern's weekly summary of activities. In addition, the Sponsor agrees to complete an evaluation at the end of the internship in the form and manner attached hereto as Exhibit "A" .

e. The Sponsor agrees to provide a safe work environment for each intern.

5. The College's Obligations

a. The College agrees to recommend for placement in the internship program only those students who have earned a satisfactory record and have met the minimum requirements established by ECC and its Internship committee

b. Upon request by the Sponsor, the College agrees to provide the Sponsor with copies of current course outlines, course objectives, curriculum philosophy, and a list of faculty and their respective qualifications.

c. Upon request by the Sponsor, the College agrees to provide opportunity to the Sponsor to visit with the course faculty/students of ECC for consultation or other purposes.

2

d. The College agrees to assist the Sponsor in selection of students for Internships

with the student's knowledge and consent. e. The College agrees to advise students of their responsibilities regarding

participation in Internship, including, but not limited to, expected professional conduct, the requirement to follow rules and standards set by the Sponsor and ECC, and their requirement to sign the Learning Agreement. Also the College will inform the Interns of their responsibility to provide any transportation, meals, and lodging related to the Internship.

f . The College agrees to dismiss an Intern during the internship period, from the internship, if, in the opinion of ECC and the Sponsor, the Intern is not making satisfactory progress or is not meeting the expectations set forth by the parties. Prior to ECC dismissing an Intern, the College Professor and the Supervisor will have conferred regarding the lntern's performance and will have exhausted any possible solutions that would have avoided dismissal. When dismissal is required, the ECC Coordinator of Internships and Co-ops, in collaboration with the ECC Faculty Instructor, will dismiss the Intern from the Internship. Any dismissed Intern who does not satisfactorily complete the Internship, or any portion thereof, may repeat the Internship with the same Sponsor only with the written approval of both the Sponsor and ECC.

6. Joint Obligations

a. Both the Sponsor and ECC agree that in compliance with federal and New York State laws, including, but not limited to, the provisions of Title IX of the Education Amendment of 1972, Sections 503 and 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, the parties hereto will not discriminate on the basis of race, sex, religion, age, disability, sexual orientation or military service, or any other category protected by federal or New York State Law in its admissions and/or employment policies or the administration of its other policies, programs, or activities.

b. The parties agree to openly communicate and, when necessary, schedule meetings between the parties to this agreement to ensure understanding of the expectations and roles of both parties in providing the internship experience for students and to coordinate and improve internships. ECC and Sponsor mutually agree to waive all claims for consequential damages arising out of or related to this agreement, including damages associated with losses of income, profit, and reputation, whether based on contract, tort, negligence, strict liability, otherwise.

3

7. Insurance and Defense and Indemnification

ECC, through the County of Erie is largely self-insured with regard to automobile

liability, general liability, medical malpractice liability, and workers'

compensation matters. In the event that the Sponsor receives notice of any

claim arising out of or related to internship and training provided under this

Agreement, the Sponsor will immediately give notice thereof to ECC, by sending

notice to the Executive Vice President of Operations at ECC-City Campus at 121

Ellicott Street in Buffalo, New York 14203.

During all time periods when ECC students are assigned to the Sponsor's

facilities, the Sponsor will maintain in force and effect policies of general liability,

automobile liability, professional liability and workers' compensation insurance.

The Sponsor will also provide ECC with evidence of such insurance coverage, on

ACORD or equivalent insurance certificate forms, and copies of said insurance

certificates will be attached to this Agreement.

The Sponsor agrees to defend, indemnify, and hold harmless ECC, to include the

County of Erie, and its agents and employees from and against all claims,

damages, losses or causes of action arising out of or resulting from actions or

omissions, materials provided, services rendered or other performance of or by

the Sponsor, its agents, employees or volunteers, pursuant to this Agreement.

ECC, to include the County of Erie, agrees to defend, indemnify and hold

harmless the Sponsor and its agents and employees from and against all claims,

damages, losses and causes of action arising out of or resulting from actions or

omissions, materials provided, services rendered, or other performance of or by

ECC, its agents, employees or volunteers, pursuant to this Agreement.

8. Notices Other than as outlined in paragraph 7, any notice necessary relative to this

Internship program shall be provided as follows:

Richard C. WashouskyProvost and Executive Vice PresidentErie Community College - North Campus6205 Main StreetWilliamsville, New York 14221

Michael Pietkiewicz

Executive VP of Operations

Erie Community College - City Campus

121 Ellicott Street

Buffalo, New York 14203

4

Dr. Jamie Smith

Dean - Liberal Arts

Erie Community College - North Campus

6205 Main Street

Williamsville, New York 14221

To the SPONSOR

Michael Tritto

Human Services and Operations

Gloria J. Parks Community Center

3242 Main Street

Buffalo, NY 14214

(716) 832-1010 ext. 213

5

INTERNSHIP AGREEMENT SPONSOR CONTACT INFORMATION:

Company: Gloria J. Parks Community Center

Contact Name: Michael Tritto

Address: 3242 Main Street Buffalo NY, 14214

Phone: (716) 832-1010 ext. 213

ACCEPTED AND AGREED:

STATE OF NEW YORK

COUNTY OF ERIE

Erie Community College

President

Signature

Date

On the 3 0 day of ~l 1 l').g._ , 0, (')\-'l before me personally came Micha;itto, to me known to be the individual described in, and who, ?:1::' the foregoing instrument and acknowledge that he executed the same.

~Do;!zi. &- \. l)o J-Notary Public

HARRIT A L. WEST Notary Public, State of New York

Qualified in Erie County Reg. No. 011/vE6274199

My Commission Expires 12/31/2020

6

Dr. Dan Hocoy

STATE OF NEW YORK COUNTY OF ERIE

On the day of before me ~~- -~~~~~~- -~~~~~~~~~~~~~-

personally came Dr. Dan Hocoy, to me known to be the individual described in, and who, executed, the foregoing instrument and acknowledge that he executed the same.

Notary Public

APPROVED AS TO CONTENT:

Richard C. Washousky

APPROVED AS TO FORM:

Leslie Ortiz Fogg, Assistant County Attorney, Erie County

Signature

Date

ECC Document No.

7

UNIVE-3 OPID:SI

ACORD- CERTIFICATE OF LIABILITY INSURANCE I DATE (-,ODIYYYY)

~ 07/06/2017 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 ADDITlONAL INSURED, tho pollcy(les) 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 conr.r rights to the certificate holder In lieu of such endorsement(s).

PRODUCER NXME°'.'"' Shella Mack United Insurance Agency, Inc.

r_.'ll:?NJ'o. c:.+1: 716-632-6118 I r.va Nol: 11M31-5045 90 Bryant Woods South Amher9t, NY 14228 i~, smack«lulai.com David M. Naples

INSURER/SI Al'FORDING COVERAGE NAIC#

INSURER A: Philadelphia lndemnltv Ins. Co INSURED University District Community 1N1URERa :AmTruat Ins Co of Kansas

Development Association Inc INSURER c : Wesco Insurance Comoanv 3242 Main St Buffalo, NY 14214-1324 INSURER D, Mount Vernon Fire Ina Co.

INSURERE : INSURERF :

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 WrllCH 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.

r.;; TYPE OF INSURANCE IMtn - POLICY NUIIIIE!t ~ .,. .. ,;.ul.l<-• "" .. UMITII .

A x COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,00 - D Cl.AIMS-MADE [!] OCCUR PRE°Mis'M 'i'E";~" I t:.U PHPK15983SO 01/14/2017 01/1412018 $ 1,000,00 -MED E.XP (Anv one person) $ 20,00 -PERSONAL & ADV INJURY $ 1,000,00 -GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00

~ D PRO- DLoc PRODUCTS . COMP/OP AGG $ 2,000,00 POLICY JECT OTHER: $

AUTOMOBILE UABIUTY IE.a aoddentfiNVLE LIMII $ 1,000,00 A X ANYAUTO PHPK1598360 01/1412017 01/1412018 BOOIL Y INJURY (Per person) $ - ALL OWNED - SCHEDULED

AUTOS AUTOS BODILY INJURY (Per accident) $

x x NON-OINNED IP~~r"'Aut: $ HIRED AUTOS AUTOS - -$

x UMBREL.I..AUAB M OCCUR EACH OCCURRENCE $ 1,000,00

A EXCESS LIAS CLAIMS-MADE PHUB569654 01/1412017 01/14/2018 AGGREGATE $ 1,000,00 OED I x I RETENTION$ 10000 $

WORKERS COMPENSATION x I STATUTE I I ~Rn-AND EMPI.OYERS' UABIUTY YI N B AAY PROPRIETOR/PARTNER/EXECUTIVE ~

KWC1073679 01/01/2017 01/01/2018 E.L EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? NIA (M&ndltofy In NH) E.L DISEASE • EA EMPLOYEE $ 100,00 ~l~~IO~ ~ ERATIONS bel<M E.L DISEASE • POLICY LIMIT $ 500,00

c NY Disability 0227172 01/01/2017 01/01/2018 Statutory

D D&O Liability ND02551486C 09/1512016 09/1512017 EaClalm: 1,000,00

DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addition&! Rematb Sctledule, ffllY be MUClled If more apace la required)

CERTIFICATE HOLDER

County of Erle and Erle Community College 121 Ellicott Street Buffalo, NY 14203

I

ACORD 25 (2014101)

ERIEC-3

CANCELLATION

SHOULD A.NY OF THE ABOVE DESCRIBED POLICIES BE CANCEUED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

l&Mw1!.µ ·t, © 1988-2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ERIE COMMUNITY COLLEGE AND

People Inc.

INTERNSHIP AGREEMENT

THIS INTERNSHIP AGREEMENT is made this Wednesday June 28th, 2017 by and between Erie Community College ("ECC") having its principal offices and place of business at 121 Ellicott St., City of Buffalo, County of Erie and State of New York and People Inc., 692 Millersport Highway - Town of Amherst, County of Erie and State of New York ("Sponsor").

The principle objective of this Internship program is to combine the knowledge acquired in the classroom with the practical experience gained from on- the- job training and mentoring. By associating local ECC students who are fully matriculated in the Human Services Certificate program with WNY businesses or organizations interested in securing a talented future workforce, ECC hopes to create an opportunity to fill the ever-increasing demands for professional employees in the Western New York community.

In consideration of the mutual promises and obligations set forth herein, the Parties hereby agree as follows :

TERMS AND CONDITIONS

1. Definitions The follow ing definitions apply a. " Internship" means a program of study as part of ECC's course or degree

requ irements, conducted in cooperation with the Sponsor, at its place of employment, whereby Interns rece ive supervised experience and instruction in a professional setting.

b. "Sponsor" means an in dividual or Company/Organization. c. "Supervisor" means that person employed or retained by the Sponsor

responsible for the development and administration of the Internship affiliat ion with the College.

d. " Intern" means a student enrolled in an ECC course or degree program who is to perform the Internship.

e. "Coordinator of Internships" means the person employed or retained by the College who is responsible for the development and administration of th is Internship affi liation with the Sponsor.

f . Learning Agreement is the agreement between the Sponsor's Supervisor, the student intern and the ECC faculty supervisor stipulating the obligations of each party relative to an Internship.

2. Purpose As part of ECC's course or degree educational requirements or as required for the award of a cert ificate in particular areas of study, students must complete supervised field experience, such as th is Internship.

3. Term The term of the Agreement shall be from 6/28/17 to 6/28/20 and may be extended by mutual written agreement of the Parties. In the event of expiration or · termination of this Agreement, Interns shal l be permitted to complete all Internships that began prior to the termination date, and with respect to such internships, all

terms

and conditions of the Agreement shall apply until the last Internship is completed.

4. The Sponsor's Obligations

a. The Sponsor agrees to provide training to each Intern for a minimum of one hundred and thirty-five (135} hours, or as required by the ECC curriculum, during t he internship period.

b. The Sponsor agrees to provide.the student with practical experience in his/her area of academic interest during the internship period . The Sponsor's personnel will also provide mentoring and instruction that are directly related to the academic criteria of the ECC department.

c. The Sponsor agrees to mod ify planned tasks during the internship period, as may be required, given changes in the Sponsor's circumstances; however, the Sponsor will make every reasonable effort to ensure that the Intern is working in a position which exposes him/her to curriculum-related tasks.

d. The Sponsor agrees to provide adequate supervision and evaluation of the Intern during the internship program. To accomplish this task, the Sponsor agrees to review and sign off on the intern' s weekly summary of activities. In addition, the Sponsor agrees to complete an evaluation at the end of the internship in the form and manner attached hereto as Exhibit "A" .

e. The Sponsor agrees to provide a safe work environment for each intern.

5. The College' s Obligations

a. The College agrees to recommend for placement in the internship program only those students who have earned a satisfactory record and have met the minimum requirements established by ECC and its Internship committee

b. Upon request by the Sponsor, the College agrees to provide the Sponsor with copies of current course outl ines, course objectives, curriculum philosophy, and a list of faculty and their respective qualifications.

c. Upon request by the Sponsor, the College agrees to provide opportunity to the Sponsor to visit with the course faculty/ students of ECC for consultation or other purposes.

d. The College agrees to assist the Sponsor in selection of students for Internships with the student's knowledge and consent.

e. The College agrees to advise students of their responsibilities regarding participation in Internship, including, but not limited to, expected professional

2

conduct, the requ irement to follow ru les and standards set by the Sponsor and ECC, and their requ irement to sign the Learning Agreement. Also the College will inform the Interns of their responsibility to provide any transportation, meals, and lodging related to the Internship.

f. The College agrees to dismiss an Intern during the internship period, from the internship, if, in the opinion of ECC and the Sponsor, the Intern is not making satisfactory progress or is not meeting the expectations set forth by the parties. Prior to ECC dismissing an Intern, the College Professor and the Supervisor will have conferred regarding the lntern's performance and will have exhausted any possible solutions that would have avoided dismissal. When dismissal is required, the ECC Coordinator of Internships and Co-ops, in collaboration with the ECC Faculty Instructor, will dismiss the Intern from the Internship. Any dismissed Intern who does not satisfactori ly complete the Internship, or any portjon thereof, may repeat the Internship with the same Sponsor only with the written approval of both the Sponsor and ECC.

6. Joint Obligations

a. Both the Sponsor and ECC agree that in compliance with federal and New York State laws, including, but not limited to, the provisions of Title IX of the Education Amendment of 1972, Sections 503 and 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, the parties hereto will not discrim inate on the basis of race, sex, religion, age, disability, sexual orientation or military service, or any other category protected by federal or New York State Law in its admissions and/ or employment policies or the administration of its other policies, programs, or activities.

b. The parties agree to open ly communicate and, when necessary, schedule meetings between the parties to this agreement to ensure understanding of the expectations and roles of both parties in providing the internship experience for students and to coordinate and improve internships. ECC and Sponsor mutually agree to waive all claims for consequential damages arising out of or related to th is agreement, including damages associated with losses of income, profit, and reputation, whether based on contract, tort, negligence, strict liability, otherwise.

7. Insurance and Defense and Indemnification

ECC, through the County of Erie is largely self-insured with regard to automobile liability, general liability, medical malpractice liability, and workers' compensation matters. In the event that the Sponsor receives notice of any claim arising out of or related to internship and train ing provided under this Agreement, the Sponsor will immediately give notice thereof to ECC, by sending

3

notice to the Senior Vice President of Operations at ECC-City Campus at 121 Ellicott Street in Buffalo, New York 14203.

During all time periods when ECC students are assigned to the Sponsor's

facilities, the Sponsor will maintain in force and effect policies of general liability,

automobile liability, professional liability and workers' compensation insurance.

The Sponsor will also provide ECC with evidence of such insurance coverage, on ACORD or equivalent insurance certificate forms, and copies of said insurance

certificates will be attached to this Agreement.

The Sponsor agrees to defend, indemnify, and hold harmless ECC, to include the

County of Erie, and its agents and employees from and against all claims, damages, losses or causes of action arising out of or resulting from actions or

omissions, materials provided, services rendered or other performance of or by

the Sponsor, its agents, employees or volunteers, pursuant to this Agreement.

ECC, to include the County of Erie, agrees to defend, indemnify and hold

harmless the Sponsor and its agents and employees from and against all claims,

damages, losses and causes of action arising out of or resulting from actions or

omissions, materials provided, services rendered, or other performance of or by

ECC, its agents, employees or volunteers, pursuant to this Agreement.

8. Notices Other than as outlined in paragraph 7, any notice necessary relative to thisInternship program shall be provided as follows:

Richard C. Washousky

Provost and Executive Vice President

Erie Community College - North Campus

6205 Main Street

Williamsville, New York 14221

Michael Pietkiewicz

Executive VP of Operations

Erie Community College - City Campus

121 Ellicott Street

Buffalo, New York 14203

Dr. Jamie Smith

Dean of Liberal Arts and Science

Erie Community College - North Campus

6205 Main Street

Williamsville, New York 14221

4

To the SPONSOR People Inc. Nicole Galley 692 Millersport Highway, Amherst NY, 14226 ngalley@people-inc.org

INTERNSHIP AGREEMENT SPONSOR CONTACT INFORMATION:

Company: People Inc.

Contact Name: Nicole Galley

Address: 692 Miiiersport Highway, Amherst NY, 14226

Phone: (716) 322-7058

ACCEPTED AND AGREED:

People Inc.

t-,.jl lt.Je.... Go\\(\._\ Representative (print name)

\J )ucl ( '-} Signature

,\ ,o\\, Date

STATE OF NEW YORK COUNTY OF ERIE

Erie Community College

Dr Dao Hocoy President

Signature

Date

If ~J )'/ / On the Ir) ., day of __ tJ_i_Y ___ __, _.,_/1/f"'----'I c_~_W,;_'t9_(,..._,JJ..:.../l,;;.;.W,_',(t,;;;._7..__. ·----- before me personally came Nicole Galley, to me known to be the individual described in, and who,

execut;;,d, the foregoing instrument and acknowledge that she executed the same.

id:~/&& Notary Public

EDITH M. BELTER NOTARY PUBLIC-STATE OF NEW YORK

No. 01BE6136718 Qualified In Erle county

My Commission Exi:,lrtt November 14, 20!1· 5

STATE OF NEW YORK COUNTY OF ERIE

personally came Dr. Dan Hocoy, to me known to be the individual described in, and who, executed, the foregoing instrument and acknowledge that he executed the same.

Notary Public

APPROVED AS TO CONTENT:

Signature I ~ /;, ,,.,

I Date

APPROVED AS TO FORM:

Leslie Ortiz Fogg, Assistant County Attorney, Erie County

Signature

Date

ECC Document No.

6

PEOP-01 OP ID: BS

ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE {MM/DD/YYYY)

~ 07/12/2017

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, certa in 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 ~2~I~cT Barb Shevlin Vanner Insurance Agency

ilJ8Nfio Extl: 716-688-8888 I rM Nol: 716-688-9001 11 Pinchot Court, Suite 100 Amherst, NY 14228 E-MAIL b h I' I@ · ADDRESS: s ev in vannennsurance.com Ralph James Vanner, Jr.

INSURER{S) AFFORDING COVERAGE NAIC #

INSURER A : Philadelphia Indemnity Ins Co 18058 INSURED People Inc INSURER B: Safety National Casualty 15105

1219 N Forest Rd INSURERC : Williamsville, NY 14221

INSURER D:

INSURER E:

INSURER F:

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 TYPE OF INSURANCE 1~.?~~l~o1 LTR POLICY NUMBER POLICY EFF POLICY EXP

(MM/00/YYYYl (MM/DD/YYYYl LIMITS A x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00( ,__ O CLAIMS-MADE 0 OCCUR PHPK1595237 01 /01 /2017 01 /01 /2018 PREMISEJ YE~~~~encel $ 100,00( ,__

,__ MED EXP {Any one person) $ 5,00(

,__ PERSONAL & ADV INJURY $ 1 ,000,00(

GEN'L AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE $ 2,000,00( R D PRO- 0Loc I PRODUCTS - COMP/OP AGG $ 2,000,00( POLICY JECT

OTHER· Emp Ben. $ 1/1 AUTOMOBILE LIABILITY f OMBINED SINGLE LIMIT $ 1,000,00( Ea accidentl I---

A x ANY AUTO PHPK1595237 01 /01 /2017 01 /01/2018 BODILY INJURY (Per person) $ ,__ ALL OWNED ~ SCHEDULED AUTOS AUTOS BDDIL Y INJURY (Per accident) $

1--- 1--- NON-OWNED

I I I PROPERTY DAMAGE HIRED AUTOS AUTOS I Per accident\ $ ,__ ,__

$

x UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 15,000,00(

A EXCESS LIAB CLAIMS-MADE PHUB568893 01 /01 /2017 01 /01 /2018 AGGREGATE $ 15,000,00(

OED I x I RETENTION$ 10000 $ WORKERS COMPENSATION I x PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER

B YIN SP4056472 01 /01 /2017 01 /01 /2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE (B:JIN/ A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED?

1,000,000 {Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $

~~;~~rtrii ~ t 1~PERATIONS below I I E.L. DISEASE - POLICY LIMIT $ 1,000,000

A Fidelity Bond ...

I PHSD1211427*** 01 /01 /2017 01 /01 /2018 3rd Party theft $50k

A Medical/Profession LIABILITY-PHPK1595237 01 /01 /2017 01 /01 /2018 lnc/.Agg $1M/$2M

DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {ACORD 101, Addition•! Remarks Schedule, may be attached If more space ls required) RE : Internship Program Erie Community College's Human Services Program

CERTIFICATE HOLDER CANCELLATION

ERIEC31 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

Country of Erie and Erie ACCORDANCE WITH THE POLICY PROVISIONS.

Community College AUTHORIZED REPRESENTATIVE

121 Ellicott Street

~K/ Buffalo, NY 14203 I

© 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD