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23-001 Amendment #1 dated 12-19-23 Linda Hsu for Line Dance Instruction1 FIRST AMENDMENT TO AGREEMENT 23-001 BETWEEN THE CITY OF CUPERTINO AND LINDA HSU FOR LINE DANCE INSTRUCTION This First Amendment to Agreement 23-001 between the City of Cupertino and Linda Hsu is by and between the City of Cupertino, a municipal corporation (hereinafter "City") and Linda Hsu, a Sole Proprietorship/Individual (“Contractor”) whose address is 94086, and is made with reference to the following: RECITALS: A. On January 18, 2023, Agreement 23-001 (“Agreement”) was entered into by and between City and Contractor for Line Dance Instruction. B. City and Contractor desire to modify the Agreement on the terms and conditions set forth herein. NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as follows: 1. Paragraph 3 of the Agreement is modified to read as follows: Term. This contract begins on the Effective Date and ends on 12/31/2025 (“Contract Time”), unless extended or terminated as provided herein. Time is of the essence and Contractor must have sufficient time, resources, and qualified staff to deliver the Services as required. Contractor must promptly notify City of any actual or potential delays to afford the Parties adequate opportunity to address or mitigate such delays. The City’s appropriate department head or the City Manager may extend the Contract Time through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City’s purchasing policy. 2. Paragraph 4 of the Agreement is modified to read as follows: Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will be based upon actual costs but that will be capped so as not to exceed $27,000.00 (“Contract Price”), based upon the Scope of Services, budget, performance schedule, and rates included in Exhibit A. The maximum compensation includes all costs, expenses, and reimbursements and will remain in place even if Contractor’s actual costs exceed the capped amount. Contractor must submit invoices and the information required in Exhibit A in order to receive payment. City will compensate Contractor within thirty (30) days after approval of written invoices. Invoices are subject to review and audit by City during regular business hours upon 24 hours’ notice. Contractor must maintain complete and accurate records of payrolls, expenditures, disbursements and other cost items charged to City or establishing the basis for an invoice, for a minimum of four (4) years from the date of the final payment. 3. Exhibit A of the Agreement is modified as follows: The CONTRACTOR will provide Line Dance Instruction in, but not limited to, the following: 2 Line Dance – Beginner, Line Dance Basics Under Compensation for CONTRACTOR Services: Contractor shall be compensated for services performed pursuant to this Agreement. For a class taught in person, seventy percent (70%) of revenue generated at the member rate per participant based on final enrollment plus seventy percent (70%) of the revenue for drop-in students, as space allows. City and Contractor may mutually agree for Contractor to teach a class online rather than in person, provided that City and Contractor reach agreement for compensation for that online class. Compensation for that online class shall be specified in writing in a separate side agreement before online instruction for a class begins. The total compensation to the Contractor shall not exceed $27,000.00. 4. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect. IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement to be executed. CITY OF CUPERTINO By Title Date APPROVED AS TO FORM City Attorney ATTEST: City Clerk Date LINDA HSU By Title Date Line Dance Instructor Dec 20, 2023 Christopher D. Jensen Director of Parks and Recreation Dec 19, 2023 Dec 19, 2023 3 EXPENDITURE DISTRIBUTION Item PO Number Amount Base Amount 2023-345 9,000.00 Amendment 1 18,000.00 - - 27,000.00 1429656.1 AP C J A P G O D L H O B J D M C J C J E J A L A K AP H G H L P J A N M B N L P O P M I P J F M O J K AC O O I O O I E K E O C C O K M K A E A K M A M K American Family Connect Property and Casualty Insurance Company 3500 Packerland Drive De Pere, WI 54115-9070 POLICY NUMBER: POLICY PERIOD: 12:01 AM Standard Time LAPSE IN COVERAGE: 09/03/2023 - 03/03/2024 FOR CLAIMS SERVICE CALL: FOR CLIENT SERVICE CALL: RENEWAL DECLARATION CALIFORNIA NONE 1-888-404-5365 1-888-404-5365 BODILY INJURY LIABILITY PROPERTY DAMAGE LIABILITY UNINSURED MOTORIST BODILY INJURY MEDICAL EXPENSE - EXCESS COVERAGE UNINSURED MOTORIST PROPERTY DAMAGE COLLISION COMPREHENSIVE TOWING AND LABOR COSTS RENTAL EXPENSE TOTAL SEMIANNUAL PREMIUM PER VEHICLE TOTAL SEMIANNUAL PREMIUM ALL VEHICLES - CONSOLIDATED VEHICLE ASSESSMENT FEE COVERAGE/LIMIT $100,000 EACH PERSON $300,000 EACH ACCIDENT $5,000 EACH PERSON $100,000 EACH ACCIDENT $100,000 EACH PERSON $300,000 EACH ACCIDENT CAR 1-WAIVER OF COLLISION DEDUCTIBLE DEDUCTIBLES CAR 1-$100 DEDUCTIBLES CAR 1-$0 2021 AUDI1 Q3 QUATTRO $455.00 INCL INCL $193.00 $1.00 $490.00 $131.00 INCL NONELECT $1,270.87 $1,270.87 $0.87 $75 PER DISABLEMENT Coverage is provided only when both a premium and limit are shown. adca01a (001)07/21/2023 DRIVER INFORMATION LIENHOLDER INFORMATION YOUR POLICY HAS THE FOLLOWING ENDORSEMENTS: YOUR POLICY HAS THE FOLLOWING DISCOUNTS: CAR INFORMATION CARS KEPT AT LOCATION OTHER THAN RESIDENCE 1. Brian Hsu 2. Linda Hsu 3. 4. 5. 6. PREMIER SAFETY, FULL PAYMENT PLAN, TENURE, COSTCO 2021 AUDI - GOOD DRIVER, ANTI-THEFT DEVICE, DUAL AND SIDE AIRBAGS 2021 AUDI WA1DECF3XM1142825 AMENDATORY ENDORSEMENT SPECIAL EQUIPMENT/CUSTOMIZATION: NONE cdec09 - CA Line Dance Instruction Final Audit Report 2023-12-20 Created:2023-12-18 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAA608uuEWKDUoC4P3joP7UQqG21cJOUwGX "Line Dance Instruction" History Document created by City of Cupertino (webmaster@cupertino.org) 2023-12-18 - 11:54:50 PM GMT- IP address: 35.229.54.2 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2023-12-18 - 11:56:37 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2023-12-19 - 0:08:48 AM GMT - Time Source: server- IP address: 71.204.144.228 Document emailed to Yeh linda ( for signature 2023-12-19 - 0:08:50 AM GMT Email viewed by Yeh linda ( 2023-12-19 - 0:08:56 AM GMT- IP address: 74.125.209.34 Signer Yeh linda ( entered name at signing as Linda Hsu 2023-12-19 - 11:17:08 PM GMT- IP address: 118.240.217.79 Document e-signed by Linda Hsu ( Signature Date: 2023-12-19 - 11:17:10 PM GMT - Time Source: server- IP address: 118.240.217.79 Document emailed to christopherj@cupertino.org for signature 2023-12-19 - 11:17:11 PM GMT Email viewed by christopherj@cupertino.org 2023-12-19 - 11:32:32 PM GMT- IP address: 136.24.22.194 Signer christopherj@cupertino.org entered name at signing as Christopher D. Jensen 2023-12-19 - 11:34:36 PM GMT- IP address: 136.24.22.194 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2023-12-19 - 11:34:38 PM GMT - Time Source: server- IP address: 136.24.22.194 Document emailed to Rachelle Sander (rachelles@cupertino.org) for signature 2023-12-19 - 11:34:41 PM GMT Email viewed by Rachelle Sander (rachelles@cupertino.org) 2023-12-19 - 11:36:03 PM GMT- IP address: 104.47.74.126 Document e-signed by Rachelle Sander (rachelles@cupertino.org) Signature Date: 2023-12-19 - 11:36:26 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2023-12-19 - 11:36:27 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2023-12-20 - 0:08:04 AM GMT- IP address: 104.47.74.126 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2023-12-20 - 0:08:14 AM GMT - Time Source: server- IP address: 64.165.34.3 Agreement completed. 2023-12-20 - 0:08:14 AM GMT