09-001 Skywakds Sports Academy CITY OF
A GREEM EN T
CITY OF CUPERTINO
10300 Torrl~ Avenue
Cupertino, CA 95014
(408) 7TT-3200 NO. U " ~ ` ~ /
C O P E RT I N C? Fiscal Year 2009-2010
BY THIS AGREEMENT made and entered into on the 271:h day of February, 2009 by and between the CITY OF
CUPERTINO (Hereinafter referred to as CITY) and (1)Skvha~nrks Sports Academy
Address: 6311 E. Mt. Spokane Park Dr.; Mead, WA 99021U Phone: (800) 804-3509
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: Camps and Classes
EXHIBITS: The following attached exhibits hereby are made Dart of this Agreement: Exhibit A
TERMS: The services and/or materials furnished under this F.greement 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:
All Five Indoor Basketball Summer Camps, 9AM-3PM: $103 per participant
All Five Outdoor Basketball Summer Camps, 9AM-3PM: $105 per participant
All Five Outdoor Summer Camps, 9AM-1 PM: $94 I~er participant
All Five Day Outdoor Summer Camps, 9AM-12PM: $91 I~er participant
5 Week: Basketball Basics (45 min/per class): $35 per participant ,
5 Week: Basketball Basics (1 hr/per class): $40 I~er participant
GENERAL TERMS AND CONDITIONS:
Hold Harmless. CONTRACTOR agrees to save and hold harmless 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 cer~ifies 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 transferred 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: ENTERED
NAME: Jeff Ordway DEPARTMENT: Parks 8~ Recreation JY j
This Agreement shall become effective upon its execution b~y CITY. In witness thereof, the parties have executed this
Agreement the day and year first written above.
CONTRACTOR: CITY OF UPERTINO:
Title: ~K r ~ v ~ Title: Recreation Coo rnator
Social Security/Tax ID ~ 1 - !''S y ~ "s {S ~
APPROVA EXPENDITURE DISTRIBUTION
D AD DATE ACCOUNT NUMBER AMOUNT
~ 3 6 580-6449-7014 $65,000
CITY CLE D E
d
CUPERTINO City of Cupertino Contractor Affidavit
The undersigned does hereby certify that:
1. I am a representative of It `~l-~~i,J k ~ (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 S1~`~ I{il~.J~-~ (contract or 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:
''j1: ~4 5~'c Llt~
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: ~ Date: `
Staff Title: ~ ~ • ~
EXHIBIT A
1. The City reserves the right to terminatF~ this Agreement with a 30-day notice.
The contractor may terminate this Agreement with a 30-day written notice.
2. In the event that the Contractor has employees who will assist in the
performance of this Agreement, Contr<~ctor shall file with City a Certificate of
Worker's Compensation Insurance anti for those instructing persons 18 years
and younger, provide fingerprint clearance and current TB test.
3. In the event that less than the required minimum number of participant shall
request and pay for services prior to the agreed upon time for the
commencement of services to be preformed by Contractor, City may cancel
and withdraw from this Agreement.
4. City shall have no right of control as to the manner Contractor performs the
services to be performed. Nevertheles:~, City may, at any time, observe the
manner in which such services are being performed by the contractor.
5. The Contractor shall comply with all a~~plicable Federal, State, and local laws
and ordinances including, but not limitE;d to, unemployment insurance
benefits, FICA laws, and the City business license ordinance.
6. The Contractor shall not promote his/her business to participants registered in
the City's programs.
Revised 9/23/07
Form W'9 Request for' Taxpayer Give form to the
(Rev. November 2005) Identification NumbErr and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service
N Name (as shown on your income tax return)
m Skyhawks Sports Academy, Inc.
a Business name, if different from above
c
0
d C
D. O Individual/ ~ p ~ , p ~ Other ? ~ Exempt from backup
~ ~ Check appropriate box: ~ Sole proprietor ? Cor oration I artnershi
`o ~ withholding
~ C Address (number, street, and apt. or suite no.) Requester's name and address (optional)
~ ~ 6311 E. Mt. Spokane Park Drive, Suite B
v City, state, and ZIP code
a Mead, WA 99021
~ List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the n-sme given on Line 1 to avoid Social security number
backup withholding. For individuals, this is your social security number (SS N). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter. 9 ~ 1 ~-1 ~ 5 ~ 4 ~ 9 ~ 5 ~ 8 ~ 1
' Certification
Under penalties of perjury, 1 certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) i have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3. f am a U.S. person (including a U.S. resident alien).
Certification instructions. You must cross out item 2 above if you have bt3en notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividernds, you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)
$19n Signature of '
Here U.S. person ? ~ 'T
Date ? ~ - (t;.?
Purpose of Form • An individual who is a citizen or resident of the United
A person who is required to file an information return with the States,
IRS, must obtain your correct taxpayer identification number • A partnership, corporation, company, or association
(TIN) to report, for example, income paid to you, real estate created or organized in the United States or under the laws
transactions, mortgage interest you paid, acquisition or of the United States, or
abandonment of secured property, cancellation of debt, or • Any estate (other than a foreign estate) or trust. See
contributions you made to an IRA. Regulations sections 301.7701-6(a) and 7(a) for additional
U.S. person. Use Form W-9 only if you are a U.S. person information.
(including a resident alien), to provide your correct TIN to the Special rules for partnerships. Partnerships that conduct a
person requesting it (the requester) and, when applicable, to: trade or business in the United States are generally required
1. Certify that the TIN you are giving is correct (or you are to pay a withholding tax on any foreign partners' share of
waiting for a number to be issued), income from such business. Further, in certain cases where a
2. Certify that you are not subject to backup withholding, or Form W-9 has not been received, a partnership is required to
3. Claim exemption from backup withholding if you area Presume that a partner is a foreign person, and pay the
U.S. exempt payee. withholding tax. Therefore, if you are a U.S. person that is a
partner in a partnership conducting a trade or business in the
In 3 above, if applicable, you are also certifying that as a United States, provide Form W-9 to the partnership to
U.S. person, your allocable share of any partnership income establish your U.S. status and avoid withholding on your
from a U.S. trade or business is not subject to the share of partnership income.
withholding tax on foreign partners' share of effectively
connected income. The person who gives Form W-9 to the partnership for
Note. If a requester gives you a form other than Form W-9 to Purposes of establishing its U.S. status and avoiding
request your TIN, you must use the requester's form if it is withholding on its allocable share of net income from the
substantially similar to this Form W-9. partnership conducting a trade or business in the United
States is in the following cases:
For federal tax purposes, you are considered a person if you • The U.S. owner of a disregarded entity and not the entity,
are:
Cat. No. 10:?31X Form W-9 (Rev. 11-2005)
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVE=NUE • CUPERTINO, CA 95014-3255
TELEPHONE: (40E~) 777-3223 • FAX: (408) 777-3366
WEBSITE: www.cupertino.org
CUPERTINO
March 24, 2009
Skyhawks Sports Academy
Attn: Chris Stiles
6311 E. Mt. Spokane Park Drive
Mead, WA 99021
To Whom It May Concern:
Enclosed for your records is a fully executed ~~opy 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