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08-001 Kidz Love SoccerCITY OF CUPERTINO AGREEMENT CITY OF CUPERTINO 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3200 032739 NO. Fiscal Year 2008-2009 BY THIS AGREEMENT made and entered into on the 5"' day of February, 2008 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 part of this Agreement: Exhibit A TERMS: The services and/or materials furnished under this Agreement shall commence on Julv 1, 2008 and shall be completed by June 30, 2009. COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: 70% of the Resident Fee (Minus a $10.00 Administration Fee ger 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 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 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: NAME: Jeff Ordway DEPARTMENT: Parks ~ Recreation This Agreement shall become effective upon its execution by CITY. In witness thereof, the parties have executed this Agreement the day and year first written above. CONTRACTOR: ~ CITY O PERTINO: By: ~.~L.~ ~--- By: Title: ~ o.~~u I M An.) R G-~-r' Title: Recreation Coordinator Social Security/Tax ID #: ~ ~ - "~ APPROVALS „ EXPENDITURE DISTRIBUTION DEPAR- MFMT-Ff ATE ACCOUNT NUMBER AMOUNT i Z Z~ 580-6449-7014 $100,000 ~ CITY CLE K DATE ~ ~ ~ O J 0 ~¢~~ aq'/ ~ Z U •~_, ~ ~ oa ~'ARtcs ta'O4w CUPERTtNO City of Cupertino Contractor Affidavit The undersigned does hereby certify that: I am a representative of -1 i~Z ~o uc SotLvl .~n c (contract or company name); that I am familiar with the fact herein certified and am authorized and qualified to execute this certificate. 2. I verifythat kaL -ou~ S~~C¢r~^ycontract 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: 1 ~U~• ^ I~~ l~i!~ C,I~-2 ~5 ~~n~~ 2w~d: (11e5P~~ . 1~~~c~S DGS~~ti~. (~ u y ~ ~ r 1 ~7Yi~. L\ 1(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. ~_T r Contractor Signature: ~/~ ~ ~' ____--~ Date: ~ 2~ C/ Staff Title: y"~~-~~ u~ ~c;,f EXHIBIT A 1. The City reserves the right to terminate 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, Contractor shall file with City a Certificate of Worker's Compensation Insurance and 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. Nevertheless, 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 applicable Federal, State, and local laws and ordinances including, but not limited 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 ~.,~.~. .,,, ,. ........... ,,.. .... ~. .. ...... ~. ..._.~~. ....~~ ...,...r. ._. , OP ID DATE (MM/DD/YYYY) ACt7RJD CERTIFICATE OF LIABILITY INSURANCE ~IDZI~_1 12/12/07 PRODUCER THIS CERTIFICATE IS ISSUED A5 A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABC Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 150 El Camino Real Bldg B #31 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. .,os Altos CA 94022 Phone:650-463-0400 Fax:650-469-0420 Kidz Love Soccer, Inc. Peter Boguski P.O. Box 95 Cupertino CA 95015 INSURERS AFFORDING COVERAGE NA1C # INSURERA _Markel Insurance Company INSURER B' $afeCO Insurance Company 24740 INSURER C: __ INSI IRER D' INSURER E COVERAGES THE POLICIES OF INSUP,ANCE LISTED 6ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERh1 OR CONDITION OF ANY CUNTFWCT OR OTHER DOCUMEIJT WITH RESPECT TU WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TG ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR SR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDMY) DATE (MMfDDM!) UMN'S GENERAL LIABILITY EACH OCCURRENCE $ 1, U O 0, U U O A X COMMERCIAL GENERAL LIABILITY 8503AH0268682 12/07/77 12/07/08 PREMISES (E,occurence) $ 100,000 CLAIMS MADE a OCCUR MED EXP (Any one person} $ 5 , O U O PERSONAL & ADV INJURY $ 1 ,DUO , aaa GENERAL AGGREGATE $ ~ , OOO , 0O0 GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS -COMP/OP AGG $ 1 , OOO , OOO PRO- }{ POLICY JECT LOC AUT OMOBILE LIABILITY COMBINED. SIrJC;LE LIMIT $ 1 , DDO , 000 $ X ANY AUTO O1CH4525672 12/07/07 12/07/08 (Ea acrident} ALL owNED Auros BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY ~ IJOf•~OWNED ALrf05 (Per accidonl) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO GTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURREWCE $ OCCUR ~ CLAJMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ / $ / / / WORNER9 COMPENSATION A1lD TORY LIMITS ER -- EMPLOYERS' LWBILTTY ANY PROPRIETOR/PARTP1Ek'/EXECUTI'JE E.L EACH ACCIDENT $ OFFICERMIEMBER EXCLUDED9 E.L. DISEASE - EA EMPLOYEE - $ ~~ - If yes, descriGo under - SPECIAL PROVISIONS Gelow E L DISEASE - POIICy LIMIT $ OTHER ~ A Ciroup Accident 4103AH2331314 12/07/07 12/07/08 Med Max: $1,000,000 Ded. $500.00 DESCRIPTION OF OPERATIONS ! LOCATtON9 !VEHICLES / EXCLUSIONS A DED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITCLTPE SHOULD AIJY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Cl ty of Cupertino DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRffTEN Parks and Recreation Dept . NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL At to ; Michael Bookspun IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, Try AGENTS OR 10185 N. Stelling Road Cupertina CA 95014 REPRESENTATIVES. A IYED REPRESE T~f„ ,~ +h d 25 !2001/081 ° ~ ©ACORD CORPORATION 1988 OP ID A DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE xIDZL-1 12 12 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SBC Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR X150 E1 Camino Real Bld B #31 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 4 ,s Altos CA 94022 rhone:650-469-0400 Fax:650-469-0420 INSURED Ridz Love Soccer, Inc. Peter Boguski P.O. Box 95 Cupertino CA 95015 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Markel Insurance Company INSURER B: Safeco Insurance Company 24740 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWffHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T HIS 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. INSR ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $]-,000,000 A X COMMERCIAL GENERALLIABILffY 8503AFI0268682 12/07/07 12/07/08 PPEMSes(Eaoccurenca) $ 100,000 CLAIMS MADE }[ OCCUR MED EXP (Any one person) $ 5 , 000 PERSONALBADVINJURY $1,000,000 GENERAL AGGREGATE $ 3, 000, 000 GEN'LAGGREGATELIMffAPPL1ESPER: PRODUCTS-COMP/OPAGG $1,000,000 ~[ POLICY jECOT- LOC AUTOMOBILE LIABILITY COMBINED SINGLELUviR $ 1 000 QQQ B X ANY AUTO O1CH4525672 12/07/07 12/07/08 (Ea accidenq r ~ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-0WNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE ~~ AGGREGATE $ DEDUCTIBLE g RETENTION $ / $ / / / WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? _` E.L. DISEASE - EA EMPLOYEE $ K es, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMB $ OTHER A Group Accident 4103AH2331314 12/07/07 12/07/08 Med Max: $1,000,000 Ded. $500.00 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CtK I IFIGA I E HULDtK CANCELLATION CITCUPE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO City of Cupertino DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN Parks and Recreation Dept . NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn ; Michael Bookspun 10185 N. Stelling Road IMPOSE NO OBLIGATION OR LIABILITY OF ANV KIND UPON THE INSURER, ITS AGENTS OR Cupertino CA 95014 REPRESENTATIVES. AU ~D REPRESFJQTATIy~~. l ~ - h A ` "` "O~' ' ~^S~~ ~ 7 7~ Al,vKU [~ (LUU7/uS1 V AGUKD GUKPUKA I IUN 7 OP ID A DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE KIDZL-1 12 14 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE C Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR _~50 El Camino Real Bldg B #31 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Los Altos CA 94022 Phone:650-469-0400 Fax:650-469-0420 INSURED Kidz Love Soccer, Inc. Peter Boguski P.O. Box 95 Cupertino CA 95015 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Markel Insurance Co an INSURER B: 5afeco Insurance Co an 24740 INSURER C: INSURER D: ________ ___ _ __ INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 MMIDDIYY DATE MM/DDIYY LIMITS GENERAL LIABILITY EAGH OCCURRENCE $ 1 , OOO , OOO A X X COMMERCIAL GENERAL LIABILITY 8503AH0268682 12/07/07 12/07/08 PREMISES (Eaoccurence) $ 100,000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 , ~ 0 0 PERSONAL 8 ADV INJURY $ 1 , OOO , 000 GENERAL AGGREGATE $ 3 , OOO , OOO GEN'L AGGREGATE LIMff APPLIES PER: PRODUCTS -COMP/OP AGG $ 1 , OOO r O00 X POLICY PEGOT- LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT 000 1 000 B X ANY AUTO O1CH4525672 12/07/07 12/07/0$ (Eaaccldent) , $ , ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per parson) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE ' (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE S DEDUCTIBLE $ RETENTION $ / $ / / / WORKERS COMPENSATION AND TORY LIMBS ER EMPLOYERS' LUIBILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ _ OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ H describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ A OTHER Group Accident 4103AH2331314 12/07/07 12/07/08 Med Max: $1,000,000 Ded. $500.00 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECU\L PROVISIONS Certificate holder is added as Additional Insured. All California Operations CERTIFICATE HOLDER Cupertino Unified School District Attn: Kathy Vyfvinkel 10301 Vista Drive Cupertino, CA 95015 CUPETIN CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI( DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 25(2001!08)