12-001 Sports, Fitness, and Karate / OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
yS'I'sr TELEPHONE: (408) 777-3223• FAX: (408) 777-3366
CUPERTINO WEBSITE:www.cupertino.org
November 14, 2012
Sports, Fitness, and Karate
Re: Agreement
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 Carey
Acting Senior 01 e Assistant
City Clerk's Offic-
Enclosure
cc: Parks & Recreation
CITY OF
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
4vSE Cupertino, CA 95014 M �
CUPERTINO NO 408-777-3200 NO. J /
\/...7( FY 12-13
THIS AGREEMENT, made d entered into this _1st_ day of August is by and between the CITY
OF CUPERTINO (Hereinafter "CITY") and Sports, Fitness, and Karate
Hereinafter "CONTRACTOR"), in consideration of their mutual covenants, the parties agree as
follows:
CONTRACTOR shall provide or furnish the following specified services and/or materials: Youth
and Teen sports & Karate classes.
Check box if services are further described in an Exhibit. X
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: A, B, C.
TERM: The services and/or materials furnished under this Agreement shall commence on
October 1St, 2012 and shall be completed no later than June 30, 2013
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR:
I 70%of final roster fees minus a $10.00 administration fee per student.
GENERAL TERMS AND CONDITIONS
Hold Harmless. Contractor 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
Contractor or Contractor's employees, officers, officials, agents or independent contractors.
Contractor 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. Contractor has been retained due to their unique skills and Contractor 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. Contractor may not assign or transfer this Agreement, without prior written consent
of CITY.
Insurance. Contractor shall file with City a Certificate of Insurance consistent with the following
requirements
Coverage:
Page 1 of 3
Short Form Agreement
Consultant shall maintain the following insurance coverage:
(1) Workers' Compensation:
Statutory coverage as required by t:he State of California. Not necessary for Sole
Proprietors.
(2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $500,000 each occurrence
$1,000,000 aggregate - all other
Property Damage: $100,000 each occurrence
$250,000 aggregate
If submitted, combined single limit policy with aggregate limits in the amounts of
$1,000,000 will be considered equivalent to the required minimum limits shown
above.
(3) Automotive:
Proof of automobile insurance required at the California statutory minimums.
Subrogation Waiver. Contractor 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, Contractor shall
look solely to its insurance for recovery. Contractor hereby grants to City, on behalf of any insurer
providing comprehensive general and automotive liability insurance to either Contractor or City with
respect to the services of Contractor herein, a waiver of any right to subrogation which any such
insurer of said Contractor 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 thirty (30)-day notice. The Contractor may terminate this Agreement with or
without cause with a thirty (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 Contractor. 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, 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. 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.
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.
Changes. No changes or variations of any kind are authorized without the written consent of the
City.
Page 2 of 3
Short Form Agreement
CONTRACT COORDINATOR and representative for CITY shall be:
NAME: Rachelle Sander DEPARTMENT: Parks and 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 OF CUPERTINO:
By ✓/�� By Rachelle Sander
Title Al/i/ (�� Title: Recreation Coordinator
APPROVALS EXPENDITURE DISTRIBUTION
• •RT) NT HEAD DATE :COUNT NUMBER AMOUNT
580 6349 7014 $4,000.00
• •- E -G•VEDAS O FORM DATE
1 • Iry ir - 5---iz 9,003/1'V
CT'',CLERK: ATT ,, DATE
Page 3 of 3
Short Form Agreement
EXHIBTT A
CONSULTANT SERVICES TO BE PERFORMED
The CONSULTANT will provide sports, fitness, & Karate classes in, but not limited
to, the following programs:
Karate, basketball, soccer
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: 8
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. (CalifDrnia Penal Code 11165.7).
If your job duties as an employee or an independent contractor of Sports, fitness, and karate
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. (C'alifornia 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 Sports, fitness,
and karate, 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:
o Prosecutors in a criminal prosecuting or in an action initiated under
section 602 of the Welfare and Institutions Code arising from alleged child
abuse;
o Counsel appointed pursuant to subdivision(c) of Section 317 of the
Welfare and Institutions Code;
o 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 penalty 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,via email, 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.
)
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:
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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:
/d/
Date PI e
Consultant Title(