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17-001 Shelley Giacalone NO. aol � — a-+� FY 17-18 AGREEMENT BETWEEN THE CITY OF CUPERTINO AND SHELLEY GIACALONE FOR COMMUNICATION TRAINING THIS AGREEMENT,is by and between CITY OF CUPERTINO,a municipal corporation (hereinafter referred to as"City"), and SHELLEY GIACALONE, a CALIFORNIA SOLE PROPRIETORSHIP,whose address is (hereinafter referred to as"Consultant"),and is made with reference to the following: A. SCOPE OF SERVICES. Contractor shall provide or furnish the following specified services and/or materials:COMMUNICATION TRAINING.Services are further described in Exhibit"A". B. TERM. The term of this Agreement shall commence on 9/28/2017,and shall end on 9/28/2017,unless terminated earlier as set forth herein. C. COMPENSATION. Consultant shall be compensated for services performed pursuant to this Agreement in the amount set forth below and as described in Exhibit"A"which is attached hereto and incorporated herein by this reference. Compensation shall consist of the following:$90/hour for the preparation and facilitation of a Block Leader training workshop on September 28,2017(4 hours preparation and 3 hours facilitation).The total compensation to the Consultant shall not exceed$630. D. EXHIBITS. The following attached exhibits hereby are made part of this Agreement: ® EXHIBIT A-Scope of Services GENERAL TERMS AND CONDITIONS 1. HOLD HARMLESS: Consultant shall,to the fullest extent allowed by law,with respect to all services performed in connection with the Agreement,indemnify,defend,and hold harmless the City and its officers,officials, agents,employees and volunteers from and against any and all liability,claims,actions,causes of action or demands whatsoever against any of them,including any injury to or death of any person or damage to property or other liability of any nature,whether physical,emotional,consequential or otherwise,arising out,pertaining to,or related to the performance of this Agreement by Consultant or Consultant's employees,officers,officials,agents or independent contractors. 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. In addition to the obligations set forth above,Consultant shall indemnify,defend,and hold the City,its elected and appointed officers,employees,and volunteers,harmless from and against any Claim in which a violation of intellectual property rights,including but not limited to copyright or patent rights, is alleged that arises out of,pertains to,or relates to Consultant's negligence,recklessness or willful misconduct under this Agreement. 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. 2. 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 in this Agreement shall be used in the performance of this Agreement. i 3. ASSIGNMENT: i Consultant may not assign,transfer,or subcontract this Agreement or any portions thereof, without prior written consent of City. I FY 2017/2018 Short Form Agreement less than$5,000 1 i 4. INSURANCE: j On or before the commencement of the term of this Agreement,Consultant shall furnish City with certificates showing the type,amount,class of operations covered,effective dates and dates of expiration of insurance coverage in compliance with the paragraphs below. Such certificates,which do not limit Consultant's indemnification,shall also contain substantially the following statement: "Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof,the insurer affording coverage shall provide thirty(30)days'advance written notice to the City of Cupertino by certified mail,Attention:City Manager." It is agreed that Consultant shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company that is acceptable to City and licensed to do insurance business in the State of California. Endorsements naming the City as additional insured shall be submitted with the insurance certificates. A. COVERAGE: Consultant shall maintain the following insurance coverage: i. Workers'Compensation:Statutory coverage as required by the State of California. ii. Liabili :Commercial general liability coverage,including sexual abuse and molestation coverage,in the following minimum limits: 1. Bodily Injury: $500,000 each occurrence $1,000,000 aggregate-all other 2. 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. iii. Automotive:Proof of automobile insurance required at the California statutory minimums. 5. SUBROGATION WAIVER: Consultant agrees that in the event of loss due to any of the perils for which he/she has agreed to provide comprehensive general and automotive liability insurance,Consultant shall look solely to his/her 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. 6. TERMINATION OF AGREEMENT: In the event Consultant fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder,Consultant shall be deemed in default in the performance of this Agreement. If Consultant fails to cure the default within the time specified and according to the requirements set forth in City's written notice of default,and in addition to any other remedy available to the City by law,the City Manager may terminate the Agreement by giving Consultant written notice thereof,which shall be effective immediately.The City Manager shall also have the option,at its sole discretion and without cause,of terminating this Agreement by giving three(3)calendar days'prior written notice to Consultant as provided herein. Upon receipt of any notice of termination, Consultant shall immediately discontinue performance. I FY 2017/2018 Short Form Agreement less than$5,000 2 7. NON-DISCRIMINATION: Contractor shall not discriminate against a job applicant,employee,City employee,or a citizen on the basis of race,color,national origin,ancestry,religion,gender,sexual orientation or other protected class of such person. 8. INTEREST OF CONSULTANT: It is understood and agreed that this Agreement is not a contract of employment and,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. 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 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.Consultant 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. 9. PERMITS AND LICENSES: Consultant,at his/her sole expense,shall obtain and maintain during the term of this Agreement, all appropriate permits,certificates,and licenses including,but not limited to,a City Business License, that may be required in connection with the performance of services hereunder. 10. REPORTS AND RECORDS: Each and every report,draft,work product,map,record and other document,hereinafter collectively referred to as"Report",reproduced,prepared or caused to be prepared by Contractor pursuant to or in connection with this Agreement,shall be the exclusive property of City. Contractor shall not copyright any Report required by this Agreement and shall execute appropriate documents to assign to City the copyright to Reports created pursuant to this Agreement. Any Report,information and data acquired or required by this Agreement shall become the property of City,and all publication rights are reserved to City. Contractor may retain a copy of any report furnished to the City pursuant to this Agreement. Contractor shall maintain complete and accurate records with respect to sales,costs,expenses, receipts and other such information required by City that relate to the performance of services under this Agreement,in sufficient detail to permit an evaluation of services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Contractor shall provide free access to such books and records to the representatives of City or its designees at all proper times,and gives City the right to examine and audit same,and to make transcripts therefrom as necessary,and to allow inspection of all work,data,documents,proceedings and activities related to this Agreement. Such records,together with supporting documents,shall be kept separate from other documents and records and shall be maintained for a period of three(3)years after Contractor receives final payment from City for all services required under this agreement. 11. CHANGES: No changes or variations of any kind are authorized without the written consent of the City. 12. COMPLIANCES: Consultant shall comply with all state or federal laws and all ordinances,rules and regulations enacted or issued by City. Contractor shall obtain a Cupertino Business License and further comply with the City's Minimum Wage Ordinance as set forth in Cupertino Municipal Code Chapter 3.37. FY 2017/2018 Short Form Agreement less than$5,000 3 13. AGREEMENT COORDINATOR: The Agreement Coordinator and representative for CITY shall be:LAURA DOMONDON LEE, COMMUNITY RELATIONS COORDINATOR,Recreation&Community Service Department. // // FY 2017/2018 Short Form Agreement less than$5,000 4 INWUh! HERVDF, partieshavir-c:iwd fie AV=enLtobee.%Ku+4Nj. AAo Ia: 7zffc $y HELL C.TACAT.G E By: LAURA.tXWONI IOI LTA Title: PR R T e- f,C),NIM_) i'r-YR 4LT NS CCx?1DTN.,.T' It T)arc: ` Tame- HFC hdib ENDED FOR APPROVAL By: JEFFREY S.NULKESm TltlC, DIRUCMF,RDEREATION&COON AUNrr-y �FRVI ATI=POP Fp AS T4)t'CRM; ............ GRACE SC H--,M I OT n� 2-S5--�f �ttT'STE)x9 *.jam$ 5hurt R=Aw-"mmmtko L�san 25nat l EXHIBIT A CONSULTANT SERVICES TO BE PERFORMED The CONSULTANT will provide COMMUNICATION TRAINING in,but not limited to,the following programs: BLOCK LEADER WORKSHOP FACILITATION: A.CONSULTANT WILL PREPARE CURRICULUM AND ALL MATERIALS IN PREPARATION FOR TRAINING B.CONSULTANT WILL ADMINISTER PARTICIPANT QUESTIONNAIRES ON CONFLICT STYLES C.BASED ON CONFLICT MANAGEMENT STYLES,CONSULTANT WILL DIVIDE PARTICIPANTS INTO GROUPS AND CONSULTANT WILL OUTLINE STRENGTHS/WEAKNESSES OF CONFLICT STYLES AND FACILITATE REPORTING OUT TO LARGE GROUP D.CONSULTANT WILL LEAD A LECTURE ON CONFLICT STYLES AND DYNAMICS TO IMPROVE THE BLOCK LEADERS'WORK IN THE NEIGHBORHOODS Location and Time of CONSULTANT Services: Consultant shall provide services at the Quinlan Community Center,10185 North Stelling Road, Cupertino,CA 95014 on September 28,2017. Performance of CONSULTANT Services: hi the case Consultant unilaterally cancels performance of the class without City approval,City reserves the right to immediately and without notice cancel the remainder of programs offered by Consultant. In the event of an injury occurring to a participant,the Consultant will notify the City within 1 hour and complete an Incident Report in the form approved by the City. The Incident Report must be submitted to the City within 24 hours of the injury occurring. FY 2017/2018 Short Form Agreement less than$5,000 g I I EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 6364-13285306871814 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM I PRODUCER PUBLIC ENTITY(ADDITIONAL INSURED) Alliant Insurance Services,Inc.in conjunction with City of Cupertino Apex Insurance Services P.O.Box 6450 Newport Beach,CA 92658 License No:OC 36861 NAMED INSURED(EVENT HOLDER): EVENT INFORMATION: Shelley Giacalone TYPE: Academic LOCATION: Quinlan Community Center,10185 N Stelling Road,CuperBno,CA 95014 *Liquor Liability Yes0 No "Liquor Liability after 12 am ends before 2 am ❑ This is to certify that the insurance policy listed below has been issued to the above insured named(event holder)for the policy period indicated. The insurance described herein is subject to all the terms,exclusions and conditions of such policy(ies)unless amended as described in Special Conditions. INSURANCE CARRIER:Evanston Insurance Company MASTER POLICY NUMBER: SEP41023 MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2017 EXPIRATION:JANUARY 1,2018 COMMERCIAL GENERAL LIABILITY General OCCURRENCE FORM DEDUCTIBLE: NONE Aggregate Limit $2,000,000 Products&Completed Operations 1,000,000 SPECIAL CONDITIONS: Personal&Advertising Injury 1,000,000 The following endorsements attached to Each Occurrence Limit 1,000,000 the Master Policy do not apply to this Damage To Premises Rented To You(Any One Premises) 100,000 Certificate Of Insurance: Medical Payments(Any One Person) 5,000 MEGL1643 Liquor Liability (If purchased) 1,000,000 Optional Limits Purchased ❑ $1,000,00053,000,000 ❑ $2,000,00052,000,000 Property Damage(If purchased) No Property Damage Coverage The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. OTHER ADDITIONAL INSUREDS City of Cupertino, It's City Council, Boards and Commissions, Officers, Employees, & Volunteers CANCELLATION: Should the above described policy be cancelled before the expiration date thereof,notice will be delivered in accordance with the policy provisions. zZ AUTHORIZED REPRESENTATIVE: I DATE ISSUED: 09/18/2017 POLICY NUMBER: SEP41023 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATE PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): Per each Certificate Of Insurance,as applicable City of Cupertino, It's City Council, Boards and Commissions Officers, Officials,Agents, Employees, Consultants and Volunteers For Certificate No.: 636413285306871814 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for"bodily injury", "property If coverage provided to the additional insured is damage" or "personal and advertising injury" required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. In the performance of your ongoing operations; 1. Required by the contract or agreement; or or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the insured only applies to the extent permitted by Declarations. law;and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 ©Insurance Services Office, Inc.,2012 page 1 of 1 State Farm Mutual Automobile Insurance Company 900 Old River Road Sird t e Fa � Bakersfield,CA 93311 AT2 A-2897 A GIACALONE, SHELLEY PREMIUM PAID: $691.83 DO NOT PAY. Your premium is billed through the State Farm Payment Plan State Farm Payment Plan Number: 1081949602 Your State Farm Agent FIORENTINO INS AGCY INC Policy Number: 286 4300-D19-05 Office:408-927-7526 Policy Period:April 19,2017 to October 19,2017 Address: 1155 REDMOND AVE STE A Vehicle: SAN JOSE, CA 95120-2780 If you have a new ord#ferentcar,have added any drivers,orhave moved, Principal Driver: please contact your agent. NICHOLAS GIACALONE When you provide a check as payment, you authorize us transfer,funds may be withdrawn from your account as soon either to use information from your check to make a as the same day we receive your payment, and you will not one-time electronic fund transfer from your account or to receive your check back from your financial institution. process the payment as a check transaction. When we use information from your check to make an electronic fund Policy Number:286 4300-D19-05 Page number 1 of 4 Prepared March 14,2017 1004583 143562 201 11-12-2014 rt 1. It's What You Know, k 'lr Your auto insurance premium is $691.83. Did you know you may qualify for a discount? Call State Farm° Agent FIORENTINO INS AGCY INC at 408-927-7526 -Not 211 discounts arc available in every state,and discount __ amoutrts mai vary by :state. PZ? tate Farm VEHICLE INFORMATION Review your policy information carefully.If anything is incorrect,or if there are any changes, please let us know right away. How is this vehicle normally used? Vehicle Identification National average:12,000 miles driven Vehicle Description Number(VIN) Who principally drives this vehicle? annually per vehicle Premium Adjustment annually to determine which makes and models have Each year, we review our medical payments and personal earned decreases or increases from State Farm's standard injury protection coverages claim experience to determine rates. If any changes result from our reviews, adjustments the vehicle safety discount that is applied to each make and are reflected in the rates shown on this renewal notice. model. In addition, we review the comprehensive, collision, bodily injury and property damage claim experience DRIVER INFORMATION Assigned Driver(s) The following driver(s)are assigned to the vehicle(s)on this policy. Driving Experience as of Marital Name April 19,2017 Gender Status SHELLEY GIACALONE 20 years Female Married Principal Driver&Assigned Drivers Your premium may be influenced by the information shown For each automobile, the Principal Driver is the individual for these drivers. who most frequently drives it. Each driver is designated as an Assigned Driver on the household automobile that he or she most frequently drives. COVERAGE AND LIMITS See yourpolicy for an explanation of these coverages. A Liability Bodily Injury 100,000/300,000 Property Damage 50,000 $304.11 C Medical Payments 25,000 $37.62 D 100 Deductible Comprehensive $55.50 G 500 Deductible Collision $245.47 H Emergency Road Service $4.23 U Uninsured Motor Vehicle Bodily Injury 100,000/300,000 $41.58 U1 Uninsured Motor Vehicle Property Damage $3.32 Total Premium $691.83 Policy Number:286 4300-D19-05 Page number 2 of 4 Prepared March 14,2017 AW ow State Emm, The claim experience on your make and model of vehicle If any coverage you carry is changed to give broader has resulted in an increase to your vehicle rating group for protection with no additional premium charge,we will give collision coverage. you the broader protection without issuing a new policy, starting on the date we adopt the broader protection. DISCOUNTS These adjustments have already been applied to your premium. Vehicle Safety ✓ Driving Safety Record ✓ California Good Driver ✓ Loyalty ✓ Total Discounts $97031 SURCHARGES AND DISCOUNTS Driving Safety Record Rating Plan more than$1000. For accidents occurring prior to Your driving safety record, along with other rating factors, December 11,2011, an accident shall be chargeable determines what you pay for Liability, Medical Payments, provided it resulted in death or in payment(s) by an insurer Comprehensive, Collision, and Uninsured Motor Vehicle due to damage to any property in the amount of more than Coverages. Policyholders with no accidents and convictions $750. pay less than those with accidents and convictions. For applicants without prior insurance at the time of the The Driving Safety Record Rate Level that is assigned to accident, an accident shall be chargeable provided it your policy moves up, down, or stays the same every policy resulted in damage to any property in the amount of more renewal, depending upon your driving record. For every 12 than $1000(more than$750 if the accident occurred prior to months since the renewal following the occurrence of a December 11,2011). chargeable accident or the conviction of a minor violation, Chargeable accidents for renewal business are those which the initial assigned Driver Record Level for that chargeable resulted in bodily injury or death or State Farm claim accident or conviction shall be lowered by 1 level. For each payments totaling more than$1000 (more than $750 for 12 month period since the conviction of a major violation, accidents occurring prior to December 11,2011)under the initial assigned Driver Record Level for that conviction property damage liability coverage and collision coverage shall be lowered by 2 levels. The Rate Level is increased if combined. there are subsequent chargeable accidents or convictions. For more information about the rating plan, please contact Definition of Chargeable Accidents your State Farm agent. Chargeable accidents for new business are those which Superior Driver Rate Level resulted in bodily injury or death or in payment(s) by an insurer due to damage to any property in the amount of ADDITIONAL INFORMATION If the above information is incomplete or inaccurate,or if you want to confirm the information we have in our records please contact your agent. Save money with our Drive Safe &Save ' Discount! Empowering Your Drive'"' You can receive a discount on your premium by participating in our Drive Safe&Save Program.This program recognizes how much your vehicle is driven. There are several ways you can participate depending on the vehicle you drive. You'll receive an initial participation discount just for enrolling. At each six-month renewal, your discount will be adjusted based on information collected from your car. (continued on next page) Policy Number:286 4300-Dl 9-05 Page number 3 of 4 Prepared March 14.2017 Contact your State Farm agent or visit drivesafeandsave.com for details. Buying a new car? Remember to contact your agent! When you buy an additional car or one that replaces a car already on your policy, you need to report the change to your agent promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company, you, as the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent, you can help: • avoid any complications or lack of coverage in the event of an accident or loss, • avoid insurance verification problems with a lienholder,the police, or the department of motor vehicles, and • ensure that you receive any new discounts you may be entitled to. Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state. If you have any questions about coverage for a newly acquired car, please contact your State Farm agent. Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number:286 4300-D19-05 Page number 4 of 4 Prepared March 14.2017 Contractor/Consultant Affidavit of No Employees State of California County of Santa Clara City of Cupertino I, the undersigned, declare as follows: I am an independent Communication instructor. I wish to enter into a services contract with the City of Cupertino. I am fully aware of the provisions of section 3700 of the California Labor Code,which requires every employer to provide Workers' Compensation coverage for employees in accordance with the provisions of that Code. I am also aware that I must provide proof of workers' compensation insurance to the City of Cupertino for any and all employees I may have, pursuant to Section 12 of the City of Cupertino's contract. I hereby certify that I do not have any employees nor will I have any employees working for me or my business during the term of any service contract with the City of Cupertino. I am not required to have Workers' Compensation insurance. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ` Executed on this t day of 2017, at g a 7e , California. PRINT NA SI TORE