Insurance Requirements:

a. In connection with Vendor’s provision of food and services pursuant at this
event, Vendor shall procure and maintain in full force and effect at Vendor shall sole expense, an
insurance policy or policies naming “Association of Poinciana Villages, Inc.” as additional insured
and protecting APV, its managers, employees, personnel, agents, contractors, members, officers,
directors and employees of APV’s management company against any loss, liability or expense
whatsoever from (without limitation) fire, personal injury, theft, death, property damage or
otherwise arising or occurring upon or in connection with Vendor’s provision of food and
services. Such policy or policies shall include comprehensive general liability insurance in the
amount of TWO MILLION DOLLARS ($2,000,000.00) general aggregate and ONE MILLION
DOLLARS ($1,000,000.00) per occurrence to cover any and all claims and costs arising in
connection with any accident or occurrence related or pertaining to Vendor’s provision of food
and services at this event.

b. Insurance Certificate must also waive insurer’s right to subrogation in favor of
APV. The language in the certificate shall be substantially similar to, “The Association of
Poinciana Villages (APV) is granted additional insured status by the General Liability policy on a
primary and non-contributory basis. Waivers of subrogation are provided in favor of APV for
General Liability and Workers Compensation.”
c. Insurance must be non-cancelable without 30 days written notice to APV.
d. Vendor must also provide proof of Workers Compensation insurance if Vendor
has any employees on site or a written waiver from the State of Florida.
e. Vendor must provide proof of such insurance coverage in a form satisfactory to
APV within fifteen (15) days of signing this agreement but no later than the date of the event. If
Vendor fails to provide proof of insurance to APV at least fifteen (15) days prior to the date of
first use or any anniversary of this agreement, APV may cancel the Vendor’s participation in the
event without further notice to Vendor and deny Vendor entry into the event.

Certificate Holder: Association of Poinciana Villages, 401 Walnut Street, Poinciana FL 34759

Food Vendors:
Must have licenses to prepare and sell food on site at the event.

PAYMENT AND CERTIFICATE OF INSURANCE REQUIRED UPON COMPLETED APPLICATION
---Payments will be accepted by cash or credit card in person at 445 Marigold Ave, Poinciana FL 34759 or over the phone with authorization. 
---Email completed COI to giselle.padilla@fsresidential.com for verification

ASSOCIATION OF POINCIANA VILLAGES, INC.

VENDOR ASSOCIATE WAIVER RELEASE AND HOLD HARMLESS AGREEMENT
The undersigned, will be operating or providing service on property owned and/or
operated by the Association of Poinciana Villages, Inc. (hereinafter “APV”). The undersigned is
acting as a contractor, or is providing some service to either a third party or APV. In consideration
for the privilege of using APV’s property, including but not limited to its Community Centers,
Athletic Center, fields and pools (hereinafter “APV Property”) the undersigned hereby agrees for
themselves and their heirs, executors, administrators, successors and assigns as follows:
1. RELEASE, DISCHARGE, ASSUMPTION OF THE RISK, INDEMNIFICATION & HOLD
HARMLESS PROVISION.
A. THE UNDERSIGNED UNDERSTANDS AND AGREES THAT THEY ARE USING APV
PROPERTY AT THEIR SOLE AND ABSOLUTE RISK. THE UNDERSIGNED UNDERSTANDS AND AGREES
THAT THE USE OF APV PROPERTY CARRIES CERTAIN RISKS, INCLUDING THE RISK OF BODILY INJURY,
PERSONAL INJURY, PROPERTY DAMAGE AND DEATH TO ONESELF AND OTHERS. IN CONSIDERATION
FOR THE PRIVILEGE OF USING APV PROPERTY, THE UNDERSIGNED AGREES TO BEAR AND ASSUME
ALL RISKS ASSOCIATED WITH THE USE OF THE FACILITIES, AND ALL (100%) OF THE DAMAGES, COSTS,
LOSS OF SERVICES, EXPENSES, ATTORNEY'S FEES, AND COMPENSATION WHATSOEVER, WHICH THE
UNDERSIGNED OR ANYONE ELSE MAY HEREAFTER ACCRUE ON ACCOUNT OF OR IN ANY WAY
GROWING OUT OF ANY AND ALL KNOWN AND UNKNOWN, FORESEEN AND UNFORESEEN BODILY
AND PERSONAL INJURIES, DEATH AND PROPERTY DAMAGE AND THE CONSEQUENCES THEREOF
RESULTING OR TO RESULT FROM ANY ACCIDENT, CASUALTY, OR EVENT ASSOCIATED OR
CONNECTED IN ANY WAY WITH THE USE OF THE FACILITIES. THE UNDERSIGNED AGREES THAT APV
AND ITS PAST, PRESENT AND FUTURE MANAGERS, PREDECESSORS, SUCCESSORS, SUBSIDIARIES,
AFFILIATES, DIVISIONS, PARTNERS, MEMBERS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS,
SERVANTS, ASSIGNS, HEIRS, EXECUTORS, ADMINISTRATORS, INSURERS, ATTORNEYS, AND
PERSONS, FIRMS OR CORPORATIONS HAVING AN INTEREST THEREIN (HEREINAFTER COLLECTIVELY
REFERRED TO AS THE RELEASEES) SHALL NOT BE LIABLE OR RESPONSIBLE FOR ANY AND ALL CLAIMS,
DEMANDS, DAMAGES, ACTIONS, CAUSES OF ACTION, SUITS IN EQUITY OF WHATEVER KIND OR
NATURE, DAMAGES, COSTS, LOSS OF SERVICES, EXPENSES, ATTORNEYS’ FEES, AND COMPENSATION
WHATSOEVER WHETHER CAUSED BY OR CLAIMED TO BE CAUSED IN WHOLE OR IN PART BY THE
ACTS OR NEGLIGENCE OF THE RELEASEES.
B. THE UNDERSIGNED FURTHER AGREES TO RELEASE, INDEMNIFY, DEFEND
AND HOLD HARMLESS THE RELEASEES NAMED ABOVE FROM, AS WELL AS DISCHARGE, PAY AND
INSURE THE RELEASEES FOR, ANY AND ALL CLAIMS, DEMANDS, DAMAGES, ACTIONS, CAUSES OF
ACTION, SUITS IN EQUITY OF WHATEVER KIND OR NATURE, COSTS, LOSS OF SERVICES, EXPENSES,
ATTORNEYS’ FEES, AND COMPENSATION WHATSOEVER, WHICH THE UNDERSIGNED, THIRD
PARTIES, OR ANYONE ELSE MAY HEREAFTER ACCRUE ON ACCOUNT OF OR IN ANY WAY GROWING
OUT OF ANY AND ALL KNOWN AND UNKNOWN, FORESEEN AND UNFORESEEN BODILY AND
PERSONAL INJURIES, DEATH AND PROPERTY DAMAGE, AND/OR CLAIMS OF MONETARY DAMAGES ASSOCIATION OF POINCIANA VILLAGES, INC.
VENDOR ASSOCIATE WAIVER RELEASE AND HOLD HARMLESS AGREEMENT
 Page 2 of 2
AND THE CONSEQUENCES THEREOF RESULTING OR TO RESULT FROM ANY ACCIDENT, CASUALTY,
OR EVENT ASSOCIATED OR CONNECTED IN ANY WAY WITH THE USE OF APV PROPERTY AND/OR
WRITTEN OR ORAL STATEMENTS MADE ON APV PROPERTY, NOTWITHSTANDING THAT SAID
DAMAGES, COSTS, LOSS OF SERVICES, EXPENSES, ATTORNEYS’ FEES, AND COMPENSATION MAY
HAVE BEEN CAUSED OR CLAIMED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE,
ACTION OR INACTION OF ANY ONE OF THE RELEASEES.
C. The undersigned understands and agrees that the terms of this Waiver
Release and Hold Harmless Agreement, apply to each and every time the undersigned uses the
Association Property.
2. This Agreement and the provisions contained within it shall remain in full force and
effect for so long as the undersigned uses and continues to use APV Property. Furthermore, the
provisions of Section 1 shall survive the termination of this Agreement.
3. In the event APV initiates or is forced to defend an action to enforce any of the
provisions of this Agreement and APV prevails, then APV shall be entitled to recover all costs
reasonably incurred in such action, including, without limitation: attorneys and paralegals fees, prelitigation fees (regardless of whether suit is brought) and court costs.
4. This agreement is governed by the laws of Florida and any legal action to enforce this
agreement will take place in the appropriate court located in Osceola County, Florida.
5. The undersigned has carefully read and reviewed this Waiver, Release and Hold
Harmless Agreement, understands it fully and executes it voluntarily.

Food Vendors must register by October 15th.

Please contact Lifestyles Director Giselle Padilla for any questions.

Stay tuned via email for further event details.

Giselle Padilla 
Lifestyles Director
Association of Poinciana Villages
401 Walnut Street
Kissimmee, Fl 34759
Direct:863.313.3655
Email: giselle.padilla@fsresidential.com