10-001 Silicon Shores Jun,30. 2010 2:01PM SHORELINE AQUATIC CENTER No-0865 P, 2
CITY OF
AGREE=MENT
CITY OF CUPERTINO
10300 Torre Avenue [�
Cupertino, CA 95014 lt7l'��
69i
(408) 777 -3200 CUPERTINO Fiscal Year 2010 -2011
BY THIS AGREEMENT made and entered Into on the 1,*& day of February, 2010 by and between the CITY OF
CUPERTINO (Hereinafter referred to as CITY) and (1) I djaip. Shore®
Address:
Hereinafter referred to as CONTRACTOR), in consideration cuf their mutual covenants, the parties hereto agree as follows:
CONTRACTOR shall provide or furnish the following epecifled services and/or materials; Watercraft Instruction
EXHIBITS: The following attached exhibits hereby are made part of this Agreement; 1551shibit
TERMS: The services and /or materials furnished under this: Agreement shall commence on July 1, 2010 and shall be
completed by June 30, 20 1 .
COMPENSATION: For the full performancw6f this Agreern it, CITY,shall pay CONTRACTOR:
Camp Shoreline: S 285 per Particloent
Wlndeurflnn /Sallln_a Camp Level 1 and ?` $325 per Participant
GENERAL TERMS AND CONDITIONS:
Hold Harmlees. 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
perforrnanoe 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. Sald Certificate shall be subject to the approval of
CITY'S Director of Adminlstrative Services.
Non - Discrimination. It is understood and agreed that this Agereement 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 eeitlfles that no one who has or will have any financial interest
under this Agreement Is an officer or employee of CITY,
Changes. This Agreement shell nut be assigned or transferred without the written consent of the CITY. No changes or
variations of any kind are authorized wlthout the written consent of the CITY.
CONTRACT COORDINATOR and representative for CITY shall be:
NAME, Jeff Ordway DEPARTMENT; Parke & Recreation ��� •LI
This Agreement shall become effective upon its execution by CITY, In witness thereof, the parties have executed this
Title; Recreation Coordik
Social Security/Tax ID #:
APPROVALS EXPENDITURE DI
DLFP E) A CC i M9ER AMOU T
7
p o 690.6449 -7014 $22,000
C C }ER A
tit fc, 4 10
300/3008 ONI183dnO dO AlIO Y,N3 89:9L OL03 /0E /90
CUPERTINO City of Cupertino Contractor Affidavit
The undersigned does hereby certify that:
1. 1 am a representative of l ` ✓� (contract or company name); that I am
familiar with the fact here n certified and am authorized and qualified to execute this
certificate.
2. 1 verify that ntract or company name) has complied with fingerprinting
and criminal background investigation requirements 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 determined that none of those employees has
been convicted of a felony, as that term is defined in California Penal Code Section 11105.3
3. That a complete and accurate list of Contractor'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 Contractor.
A List of all Contractor Employees Working for the City of Cupertino:
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: 1, Date: 'r'� ° ( U
Staff Title:
V.