13-001 Karen GottliebOFFICE 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
CUPERTINO
January 14, 2015
Karen Gottlieb
Re: First Amendment to Agreement
Enclosed is an original copy of the first amendment to 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,
"Dorothynfott
Senior Office Assistant
Enclosure
cc: Parks & Recreation
No: 58218
FY 14-15
FIRSTAMENDMENT TO AGREEMENT BETWEEN THE CITY OF
CUPERTINO AND KAREN GOTTLIEB
This First Amendment to the Agreement between the City of Cupertino and Karen
Gottlieb, for reference dated January 5, 2015, is by and between the CITY OF CUPERTINO, a
municipal corporation (hereinafter "City") and Karen Gottlieb a sole proprietor, whose address
is (hereinafter referred to as "Contractor"), and is made
with reference to the following:
RECITALS:
A. On September 4, 2013, the City and Contractor entered into an Agreement; and
B. 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:
1. The Agreement's paragraph entitled "TERM" is amended to read as follows:
The services and/or materials under this Agreement shall commence on
September 7, 2013 and shall be completed no later than June 30, 2015, unless
terminated earlier as set forth in the Agreement.
2. The Agreement's paragraph entitled "COMPENSATION" is amended to read as
follows:
For the full performance of this Agreement, CITY shall pay CONTRACTOR
70% of resident fees minus $5 administrative fee per participant. The total
compensation under the Agreement is not to exceed the following: $8,000 (total),
$5,000 for the term of September 7, 2013 to December 31, 2014; $3,000 for the
term of January 5, 2015 to June 30, 2015.
3. On or before the term of this First 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.
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.
KAREN GOTTLIEB,
A sole proprietor Q
By
Karen Gottlieb,
Date: ).5 i S
APPROVALS
CITY OF CUPERTINO
A Municipal Corporation
By: Karen Levy, -V-kl
Recreation Coordinator
Date: 1151 Ig,
EXPENDITURE DISTRIBUTION
DEP6FqMENT HEAD DATE
AMOUNT
580-6449-7014
$8,000.00
1 6
CITYATCTNEY PP VEDA TO FORM DTE
-
Q-1 r
CITY CLERK: ATTEST DATE
CITY
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
TELEPHONE: (408) 777-3223 • FAX: (408) 777-3366
WEBSITE: www.cuperfino.org
CUPERTINO
September 17, 2013
Karen Gottlieb
Re: Agreement
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,
Dorothy Stee fott
Senior Office Assistant
Enclosure
cc: Parks & Recreation
CITY OF
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
12 Cupertino, CA 95014 /1
CUPERTINO 408-777-3200 NO.
THIS AGREEMENT, made and entered into this 4th day of Se tem between the
CITY OF CUPERTINO (Hereinafter "CITY") and Karen Gottlieb_ci�
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 Dance Instruction.
Check box if services are further described in an Exhibit. 0
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: A, B, C.
TERM: The services and/or materials furnished under this A eemen hall commence on
September 7, 2013 and shall be completed no later than D ember 31./2014.
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR:
70% of resident fees -$5 administration fee per K)articipant
GENERAL TERMS AND CONDITIONS
Hold Harmless. Contractor shall, to the fullest extE)nt 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.
Page 1 of 3
Short Form Agreement
Insurance. Contractor shall file with City a Certificate of Insurance consistent with the following
requirements
Coverage:
Contractor 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: $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:
Comprehensive automotive liability coverage in the following minimum limits:
Bodily Injury: $500,000 each occurrence
Property Damage: $100,000 each occurrence
or
Combined Single Limit: $500,000 each occurrence
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.
Page 2 of 3
Short Form Agreement
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.
CONTRACT CO-ORDINATOR and representative for CITY shall be:
NAME: Karen Levy _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:
By:
Title: Da t Instructor
APPROVALS
CITY OF CUPERTINO:
By: Karen Levy oO
Title: Recreation Coordinator
EXPENDITURE DISTRIBUTION
DE HEAD DAT
1
NUMBER
AMOUNT
-A'--(,'DLJNT
560-6449-7014
$5,000.00
CITY EY APPROVED AS TO FORM
- 6�J >
CITY CLERK: ATTEgrT DATE
Page 3 of 3
Short Form Agreement
EXHIBIT A
CONSULTANT SERVICES TO BE PERFORMED
The CONSULTANT will provide instruction in, but not limited to, the following
programs:
Acrobatics and Jazz, Pre -Ballet
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:5 Maximum: 15
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.
Children are not allowed in adult classes and adults are not allowed in children only
classes. The only exception would be a special needs child whose parent might need to
attend class with them.
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 MANDATEI) 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. (California Penal Code 11165.7).
If your job duties as an employee or an independent contractor of the City of Cupertino
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 the City of
Cupertino, 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 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.
00,
N e (Signature)
LA. G04 -we -10 -
Name
04-Kt'e-10Name (Print)
T&� /3
Date
EXHIBIT C
City of Cupertino Consultant Declaration
The undersigned does hereby certify that:
1. I am a representative of Karen Gottlieb (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 Karen Gottlieb (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 Consultam:'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.
List of Consultant's employees assigned to perform. services under this agreement:
N/A
6. Consultant agrees to complete background check, TB testing and mandated reporter training and
notify City in writing in advance of assigning any new employees to perform services under this
agreement.
I declare under penalty of perjury that theforegoing is true and correct:
Date Place Consultant Signature