12-001 Shin-Ok Kim and Joosik ShinCUPERTINO
February 10, 2014
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
TELEPHONE: (408) 777 -3223 • FAX: (408) 777 -3366
WEBSITE: www.cupe- rtino.org
Re: Second Amendment to Agreement for Contract Services
Enclosed is a fully executed copy of the above stated 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 -3120.
Sincerely,
Andrea Sanders
Senior Office Assistant
City Clerk's Office
Enclosure
cc: Parks & Recreation
No 32970
FY 13 -14
SECOND AMENDMENT TO AGREEMENT BETWEEN THE CITY OF CUPERTINO AND
JOOSIK SHIN FOR CONTRACT SERVICES
This Second Amendment to the Agreement between the City of Cupertino and JOOSIK SHIN, for
reference dated December 2, 2013, is by and between the CITY OF CUPERTINO, a municipal
corporation (hereinafter "City ") and JOOSIK SHIN, a sole proprietor, whose address is
(hereinafter "referred to as Contractor' ), and is made with reference to the
following:
RECITALS:
A. On July 1, 2012, the City and Contractor entered into an Agreement; and
B. On June 20, 2013, the City and Contractor entered into a First Amendment to the Agreement
between the City and Contractor (collectively, the Agreement and First Amendment are hereafter referred
to as "Agreement "); and
C. 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 and undersigned parties as follows:
I The term of the Agreement as set forl:h in Paragraph 1 shall be extended six months,
from January 1; 2014 until June 30, 2014, unless terminated earlier as set forth in the
Agreement; and
2. Contractor shall receive no additional compensation under the Agreement, nor shall
Contractor receive any compensation from the participants; and
3. On or before the term of this Second Amendment, Contractor shall provide the City with
a certificate of insurance and additional insured endorsement demonstrating
Contractor's ongoing compliance with. the Agreement's insurance obligations and
naming the City as an additional named insured; and
4. Contractor represents, warrants, and declares that the Agreement Exhibit "C" the "City
of Cupertino Consultant Declaration" remains accurate and current.
5. Except as expressly modified herein, all other terms, covenants and conditions 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.
JOOSIK SHIN CITY OF CUPERTINO
A Municipal Corporation
By By Lauren Neff
Title: Korean Consulate Director Title: Recreation Coordinator
Date:.,.
,C dMENAPPRO VAL:
reation Supervisor
A1 3P VE O F RM:
�� City Attorney
Date: I (o —t LJ
ATTEST:
n r /JET Cit y Clerk
Date: II —
CUPERTINO
July 9, 2013
Joosik Shin
Re: Agreement
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
TELEPHONE: (408) 777 -3223 • FAX: (408) 777 -3366
WEBSITE: www.cupertino.org
Enclosed is an original copy of your 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 -3120.
Sincerely,
E41 01��
Brittany Carey
Senior Office Assistant
City Clerk's Office
Enclosure
cc: Parks & Recreation
No: 32970
FY 13 -14
1St AMENDMENT TO AGREEMENT BETWEEN THE CITY OF CUPERTINO
AND JOOSIK SHIN FOR Contract Services
This 0 Amendment to the Agreement between the City of Cupertino and JOOSIK SHIN for reference
dated May , 2013, is by and between the CITY OF CUPERTINO, a municipal corporation (hereinafter "City ")
and JOOSIK SHIN a sole proprietor whose address is
(hereinafter "referred to as Consultant "), and is made with reference to the following:
RECITALS:
A. On July 1, 2012(original Contract date), an agreement was entered into by and between City and
JOOSIK SHIN (hereinafter "Agreement ").
B. City and Consultant desire to modify the Agreement on the terms and conditions set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as follows:
1. Paragraph 1 of the Agreement is modified to read as follows:
"The term of this Agreement shall commence on July 1, 2012, and shall terminate on December
31, 2013, unless terminated earlier as set forth here-in."
2. Paragraph 3 of the Agreement is modified to read as follows:
"Consultant shall be compensated for services performed pursuant to this Agreement in the
amount set forth below.
Compensation: $0 per participant. Compensation shall not exceed a total amount of zero dollars
to be paid during the periods of July 1, 2012 -June 30, 2013 ($0) and July 1 -Dec. 31, 2013 ($0).
Payment by the City to the Consultant for services: Consultant will be paid on final roster data."
3. 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.
Joosik Shin CITY OF CUPERTINO
A Municipal Corporation
By: By
LEturen Neff, Recreation Coordinator
Title: Korean Consulate Director
Date: ,J ��j 1 RECOMMENDED FOR APPROVAL:
By�' Lecreation Supervisor
APP��VED A TO F RM:
`'�"'"'�- ity Attorney
AT FST:
V ,City Clerk
CUPERTINO
June 27, 2012
Shin -Ok Kim
Re: Agreement
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE • CJPERTINO, CA 95014 -3255
TELEPHONE: (408) 777 -3213 • FAX: (408) 777 -3366
WEBSITE: www.cupertino.org
Enclosed is a copy of your agreement with the City of Cupertino. If you have any questions or need
additional information, please contact our office at 408- 777 -3223.
Sincerely,
Brittany Morales
Acting Senior Office Assistant
City Clerk's Office
Enclosure
cc: Parks & Recreation
CITY OF
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
Cupertino, CA 95014
CUPERTINO 408- 777 -3200
Z6Y
THIS AGREEMENT, made and entered into this 1St day of
CUPERTINO (Hereinafter "CITY ") and Shin -Ok Kim
of their mutual covenants, the parties
CONSULTANT shall provide or furnish the fallowing specified services and /or materials:
Check box if services are further described in an Exhibit.
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: Exhibit A, B,
AND C.
TERM: The services and /or materials furnished under this Agreement shall commence on
July 1, 2012 and shall be completed no later than June 30, 2013.
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONSULTANT:
$0 per participant. Instructor will collect a material in class.
California Labor Code, Section 1771 requires the payment of prevailing wages to all workers
employed on a Public Works contract in excess of $1,000.00.
GENERAL TERMS AND CONDITIONS
Hold Harmless. Consultant shall, to the fullest extent allowed by law, indemnify, defend, and hold
harmless the City and its officers, officials, agents, employees and volunteers against any and all
liability, claims, stop notices, actions, causes of action or demands whatsoever from and against
any of them, including any injury to or death of any person or damage to property or other liability
of any nature, arising out of, pertaining to, or related to the performance of this Agreement by
Consultant or Consultant's employees, officers, officials, agents or independent Consultants.
Consultant shall not be obligated under this Agreement to indemnify City to the extent that the
damage is caused by the sole or active negligence or willful misconduct of City, its agents or
employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's
choice, expert fees and all other costs and fees of litigation.
Subcontracting. Consultant has been retained due to their unique skills and Consultant may not
substitute another, assign or transfer any rights or obligations under this Agreement. Unless prior
written consent from City is obtained, only those people whose names are listed this Agreement
shall be used in the performance of this Agreement.
Assignment. Consultant may not assign or transfer this Agreement, without prior written consent
of CITY.
Page 1 of 3
Short Form Agreement
Insurance. Consultant shall file with City a Certificate of Insurance consistent with the following
requirements
Coverage:
Consultant shall maintain the following insurance coverage:
(1) Workers' Compensation:
Statutory coverage as required by the State of California.
(2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $500,000 each occurrence
$1,000,000 aggregate
If submitted, combined single limit policy with aggregate limits in the amounts of $2,000,000 will be
considered equivalent to the required minimum limits shown above.
(3) Automotive:
Comprehensive automobile liability coverage in the following minimum limits:
Bodily injury: $500,000 each occurrence
Property Damage: $500,000 each occurrence
or
Combined Single Limit: $1,000,000 each occurrence
Subrogation Waiver. Consultant agrees that in the event of loss due to any of the perils for which
it has agreed to provide comprehensive general and automotive liability insurance, Consultant
shall look solely to its insurance for recovery. Consultant hereby grants to City, on behalf of any
insurer providing comprehensive general and automotive liability insurance to either Consultant or
City with respect to the services of Consultant herein, a waiver of any right to subrogation which
any such insurer of said Consultant may acquire against City by virtue of the payment of any loss
under such insurance.
Termination of Agreement. The City reserves the right to terminate this Agreement with or
without cause with a 30 -day notice. The Consultant may terminate this Agreement with or without
cause with a 30 -day written notice.
Non - Discrimination. No discrimination shall be made in the employment of persons under this
Agreement because of the race, color, national origin, ancestry, religion, gender or sexual
orientation of such person
Interest of Consultant. It is understood and agreed that this Agreement is not a contract of
employment in the sense that the relationship of master and servant exists between City and
undersigned. At all times, Consultant shall be deemed to be an independent Consultant and
Consultant is not authorized to bind the City to any contracts or other obligations in executing this
Agreement. Consultant certifies that no one who has or will have any financial interest under this
Page 2 of 3
Short Form Agreement
Agreement is an officer or employee of City. City shall have no right of control as to the manner
Consultant performs the services to be performed. Nevertheless, City may, at any time, observe
the manner in which such services are being performed by the Consultant.
The Consultant shall comply with all applicable FedE!ral, State, and local laws and ordinances
including, but not limited to, unemployment insurance benefits, FICA laws, and the City business
license ordinance.
Changes. 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: Lauren Neff DEPARTMENT: Parks and Recreation
This Agreement shall become effective upon its exE:cution by CITY, in witness thereof, the parties
have executed this Agreement the day and year first written above.
CONSULTANT: CITY OF CUPERTINO:
By � By L. GI CA r C-y
)e 1 r�{'_�1Gt
Title L n/�"1
dfy Title: _ _ l ��YC�
APPROVALS
EXPENDITURE DISTRIBUTION
rE rTMENT HEAP
DATE
Z_
A COUNT NUMBER
AMOUNT
5EIO- 6349 -7014
$0
—CIT"(AQRN EY P
VEDA TO FORM
DATE
CITY LERK: ATTEST
DATE
2—.
Page Page 3 of 3
Short Form Agreement
EXHIBIT A
CONSULTANT SERVICES TO BE PERFORMED
The CONSULTANT will provide Teen and Adult classes in, but not limited to, the
following programs:
Korean Language and Culture
Location and Time of CONSULTANT Services:
Refer to current Recreation Schedule for agreed upon dates, times, and class locations.
By Mutual agreement of both parties, class schedule may change.
Eligible Participant Minimum and Maximums for CONSULTANT Services:
Minimum: 2
Maximum: 20
In the event that less than the required minimum number of participants shall request and
pay for services prior to the agreed upon time for the commencement of services to be
performed by Consultant, City may cancel and withdraw from this Agreement.
Performance of CONSULTANT Services:
City shall have no right of control as to the manner Consultant performs the services to be
performed. Nevertheless, City may, at any time, observe the manner in which such
services are being performed by the consultant.
The Consultant shall follow all guidelines pertaining to registration procedures as listed
in the quarterly recreation schedule. Participants may not take part in the program unless
they are listed on the class roster or can show proof of enrollment. All participants and
volunteers need to complete the City's Waiver of Liability form prior to taking part in the
program. Contractors are responsible for supervising minors after class until a parent of
legal guardian has arrived.
In the event of an injury occurring to a participant, the Consultant will notify the City
within 1 hour and complete an ABAG Incident Report. The ABAG Incident Report must
be submitted to the City within 24 hours of the injury occurring.
EXHIBIT B
ACKNOWLEDGEMENT OF MANDATED REPORTING REQUIREMENTS,
RECEIPT OF TRAINING, AND RECEIPT OF PENAL CODES STATUTES
A mandated reporter is an individual who is obligated by law to report suspected cases of
child abuse and neglect. In general, any individual who, in the ordinary course of their
employment, has contact with children is a mandated reporter. Mandated reporters include
child care workers, teachers and coaches. (Califarnia Penal Code 11165.7).
If your job duties as an employee or an independent contractor of Shin -Ok Kim include
contact with children, you are a Mandated Reporter. Prior to commencing employment and
as a prerequisite of that employment, California law requires that you sign a statement to the
effect that you have knowledge of the provisions of the Mandated Reporter Law, and will
comply with those provisions. (California Penal Code 11166.5).
The following are the Mandated Reporter responsibilities under California law. You are also
being provided with a separate informational document which includes the text of the
California Mandated Reporter Law and contact information for Child Abuse and Neglect
Reporting for the County of Santa Clara. Please review this information carefully and
acknowledge your receipt and understanding where indicated. If you have questions or
concerns about this form or your Mandated Reporter responsibilities, please contact the
Recreation Supervisor at 408 - 777 -3120.
I understand that:
• By virtue of my employment or independent contractor status with Shin -Ok Kim
and because my employment requires me to have contact with children, I am a
Mandated Reporter as defined by California Penal Code 11165.7.
• The following situations trigger mandatory reports: a) Physical Abuse (willful
harming of a child); b) Sexual abuse including sexual assault, child exploitation,
pornography, and trafficking; c) Severe or General Neglect; and d) Extreme
Corporal Punishment (resulting in injury). (Cal. Pen. Code 11165 et. seq.) I
further understand that I may, but am not required to, report suspected Emotional
Abuse.
• If I reasonably suspect that a child is being abused, I must immediately make a
telephone report. I must follow up with a written report within 36 hours. This
report may be made to local law enforcement, or County Sheriff's Department,
Probation Department or Child Welfare Agency. (Cal Pen. Code 11166(a)).
• I am not required to, but I may, share; information about suspected abuse with my
supervisor or management or the parents of the alleged victim.
When I make a mandated report, I will be required to give my name. However,
my identity will be kept confidential unless I either consent to disclosure or if the
disclosure is made pursuant to a court order. Further, agencies investigating the
mandated report may disclose my identity to one another. (Cal Pen. Code
11167(d)).
• The following agencies and individuals receiving or investigating mandated
reports may disclose my identity to one another:
• Prosecutors in a criminal prosecuting or in an action initiated under
section 602 of the Welfare and Institutions Code arising from alleged child
abuse;
• Counsel appointed pursuant to subdivision (c) of Section 317 of the
Welfare and Institutions Code;
• A licensing agency when abuse or neglect in out -of -home care is
reasonably suspected. (Cal Pen. Code 11167.5)
I may not be disciplined, dismissed, retaliated against, discriminated against or
harassed for making a mandated report of reasonably suspected child abuse.
• As a Mandated Reporter, I have civil. and criminal immunity when making a
report (Cal Pen. Code 11172).
• As a Mandated Reporter, it is a misdemeanor to fail to comply with
Mandated Reporting laws and I can be held criminally liable for failing to
report suspected abuse. The penally for this is up to six months in County jail, a
fine of not more than $1000, or both, I further understand I could be civilly liable
for failure to report. (Cal. Pen. Code 11166(c)).
I have been provided with a copy of California Penal Code sections 11164- 11174.3
(Mandated Reporter Law).
I understand that I am a legally Mandated Reporter. I am aware of and understand
my responsibilities under the Mandated Reporter laws of this state and am willing and
able to comply. I understand that a copy of this Acknowledgement will be kept in my
personnel file.
Name (Signature)
5wxlok kz7M-
Name (Print)
fl'3I /.;� "/ -L-
Date
EXHIBIT C
City of Cupertino Consultant Declaration
The undersigned does hereby certify that:
1. I am a representative of (consultant or company name); that I
am familiar with the facts herein and am authorized and qualified to execute this declaration.
2. I declare that ( consultant or company name) has complied with
fingerprinting and criminal background investigation requirements with respect to all
Consultant's employees who may have contact with minors in the course of providing services
pursuant to the Agreement, 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 Consultant's employees, who may come in contact with
minors during the course and scope of the Agreement, are 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 Consultant.
5. All of the below mentioned employees have received training and understand their
responsibilities under the Mandated Reporter laws of this state and are willing and able to
comply.
A List of all Consultant Employees Working for the City of Cupertino:
ljrFok ()n
6. The City of Cupertino will be notified by Consultant in writing of any new employees and will
be added to the above list prior to beginning work for the City of Cupertino.
I declare under penalty of perjury that the foregoing is true and correct:
Z
ate Place Consultant Signature
Staff Title: