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09-001 Kidz Love Soccer CITY t>F AGREE~IIENT CITY OF CUPERTINO 10300 Torrey Avenue _ ~ Cupertino, C:A 95014 ~l /-y" CUPERTIN / ~~j ~ (408) 77i'-3200 NO. Fiscal Year 2009-2010 BY THIS AGREEMENT made and entered into on the 27t1h day of February, 2009 by and between the CITY OF CUPERTINO (Hereinafter referred to as CITY) and (1) Kidz Love Soccer Address: P.O. BOX 95. Cupertino. CA, 95014 Phone: (408) 252-1894 Hereinafter referred to as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as follows: CONTRACTOR shall provide or furnish the following specified services and/or materials: Soccer Instruction EXHIBITS: The following attached exhibits hereby are made Fart of this Agreement: Exhibit A TERMS: The services and/or materials furnished under this Agreement shall commence on July 1, 2009 and shall be completed by June 30. 2010. COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: 70% of the Resident Fee (Minus a $10.00 Administration Fee per Participant) GENERAL TERMS AND CONDITIONS: Hold Harmless. CONTRACTOR agrees to save and hold h~lrmless the CITY, its officers, agents, and employees from any and all damage and liability of every nature, including all costs of defending any claim, caused by or arising out of the performance of this Agreement. CITY shall not be liable for acts of CONTRACTOR in performing services described herein. Insurance. Should the CITY require evidence of insurability, CONTRACTOR shall file with CITY a Certificate of Insurance before commencing any services under this Agreement. Said Certificate shall be subject to the approval of CITY'S Director of Administrative Services. Non-Discrimination. It is understood and agreed that this Agreement is not a contract of employment in the sense that the relation of master and servant exists between CITY and undersigned. At all times, CONTRACTOR shall be deemed to be an independent contractor and CONTRACTOR is not authorized to bind the CITY to any contracts or other obligations in executing this Agreement. CONTRACTOR certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of CITY. Changes. This Agreement shall not be assigned or transferrE~d without the written consent of the CITY. No changes or variations of any kind are authorized without the written consent of the CITY. CONTRACT COORDINATOR and representative for CITY shall be: ~ NAME: Jeff Ordway DEPARTMENT: Parks ~ Recreation j~ This Agreement shall become effective upon its execution by CITY. In witness thereof, the parties ve executed this Agreement the day and year first written above. CONTRACTOR: CITY ~DF CUPERTINO: j _ . , By: ( ~l~-~..~ ~ .s~;,~...~,~-Wit--,. By: r - Title: ~ d ~ ~ ~ ~ Title: Recreation oordinator Social Security/Tax ID - D~f~ (o~~~: APPROVALS E)CPENDITURE DISTRIBUTION DEPART E D TE P.000UNT NUMBER AMOUNT ` 3 /d Ei80-6449-7014 $90,000 CITY CLERK D/ATE i /lv ~O ~ ~e CUPERTINO City of Cupertino Contractor Affidavit The undersigned does hereby certify that: 1. I am a representative of ~ SoCC~'" r . (contract or company name); that I am familiar with the fact herein certified and am authorized and qualified to execute this certificate. 2. I verify that Ik~~~2 ~D ~ L Sal ~n (contract oir company name) has complied with fingerprinting and criminal background investigation requirE~ments with respect to all Contractor's employees who may have contact with minors in the course of providing services pursuant to the Contract, and the California Department of Justice has ~Jetermined that none of those employees has been convicted of a felony, as that term is dei~ined in California Penal Code Section 11105.3 3. That a complete and accurate list of Contract~~r's employees who may come in contract with minors during the course and scope of the contract is included below 4. All of the below mentioned employees have tested negative for TB, or X-ray results for TB, and have current documentation on file with Coni:ractor. A List of all Contractor Employees Working for the City of Cupertino: S ENV' G-CcI~IrQ.in ~~7tyc.~ilnc~~/, ?e.+~,~ ~rr+en ~ ~ _ V// j~ G~ ~G~ L..~Par~ LJodIC~~~'iVI ~T ~J ' c y s ~G~M Q~Gt ~Yvt.~N _ u Y~ _ 5. The City of Cupertino will be notified by Contractor of any new employees and will be added to the above list prior to beginning work for the City of Cupertino. Contractor Signature: C~ ° ~ Date: Staff Title: ~~Ps'G(~ ~1/I /'rlti'G~ ACORD CERTIFICATE OF LIABILITY INSURANCE OPID As DATE (MM/DDnYYY) KIDZL-1 12 OB OB PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO C)NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 0 El Camino Real Bldg B #31 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Los Altos CA 94022 Phone: 650-469-0400 Fax: 650-469-0920 IN:iURERS AFFORDING COVERAGE NAIL # INSURED INSLIRERA: Markel Insurance Co any INSURER B: Kidz Love Soccer, Inc. INSURER C: Peter Boguski P.O. BOX 95 INSL~RERD: Cupertino CA 95015 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NJUNED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE CtIMlDD/YY DATE MM/DD/YY LIMITS GENERAL LU161LITY EACH OCCURRENCE $ 1 , OOO , OOO A X X COMMERCIAL GENERAL LIABILITY 8502AH0268684 112/07/08 12/07/09 PREMISES (Eaoccurence) 5100,000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 , O O O PERSONAL 8 ADV INJURY $ 1 , OOO , OOO GENERAL AGGREGATE $ 3, 000 ~.OOQ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM WOP AGG $ 1 , O O O , O OO X POLICY - JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ~ (Ea accident) ALL OWNED AUTOS BODILY INJURY $ . SCHEDULED AUTOS - ~ (Per perm) - HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ . - - PROPERTY DAMAGE $ (Per accident) GARAGE LUIBILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ / $ / / / WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFK:ER/MEMBER EXCLUDED? E.L. DISEASE- EA EMPLOYE $ R es, describe under SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ OTHER A Group Accident 4102AH2331316 12/~~7/08 12/07/09 Med Max: $1,000,000 Ded. $500.00 DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS City of Cupertino Parks and Recreation Department a.re added as Additional Insured. per attached CG20261185. CERTIFICATE HOLDER CA111CELLATION CITCUPE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Cupertino DATE: THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN Parks and Recreation Dept . Nort~E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn ; Michael BOOkSpuri IMPCSE NO OBLIGATION OR LL461LITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 10185 N. Stelling Road Cupertino CA 95014 REPRESENTATIVES. . _ AUTyi ~ REPRES ATI ~ A _ . ACORD 25 (2001/08} / s++~~Cl.~jf +L`y7/•. ©ACORD CORPORATION 1988 Policy Number: 8502AH0268684 CONIlVIERCIAL GENERAL LIABILITY .THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZ;ATION This endorsement modifies insurance prodded under the f=ollowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Cupertino Parks and Recreation Department 10185 N. Stelling Road Cupertino, CA 95014 Added as Additional Insured (If no entry appears above, information required to completed this endorsement.will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include; as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. CG 20 26 11 85 OFFICE OF THE CITY CLERK CITY HALL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 TELEPHONE: (408; 777-3223 • FAX: (408) 777-3366 W EBSITE: www.cul~ertino.org CUPERTINO March 24, 2009 Kidz Love Soccer PO Box 95 Cupertino, CA 95014 To Whom It May Concern: Enclosed for your records is a fully executed copy of the agreement with the City of Cupertino. If you have any questions or need additional information, please contact the Parks and Recreation department at (408) 777-3110. Sincerely, CITY CLERK'S OFFICE Enclosure