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17-001 Celeste Repasky (2) a0 i NO. FY 17-18 AGREEMENT BETWEEN THE CITY OF CUPERTINO AND CELESTE REPASKY FOR ADULT FITNESS INSTRUCTION THIS AGREEMENT is by and between CITY OF CUPERTINO,a municipal corporation (hereinafter referred to as"City"),and CELESTE REPASKY, 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:Adult Fitness Instruction.Services are further described in Exhibit"A". B. TERM. The term of this Agreement shall commence on 10/30/2017,and shall terminate on 6/30/2018,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:$40 per 60 minute class,$49 per 75 minute class. The total compensation to the Consultant shall not exceed$1000.00. 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 this Agreement shall be used in the performance of this Agreement. 3. ASSIGNMENT: Consultant may not assign,transfer, or subcontract this Agreement or any portions thereof, without prior written consent of City. FY 2017/2018 Short Form Agreement less than$5,000 1 4. INSURANCE: 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 I 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. r. A. COVERAGE: Consultant shall maintain the following insurance coverage: i. Workers' Compensation:Statutory coverage as required by the State of California. j ii. Liabili :Commercial general liability coverage,including sexual abuse and k 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. F 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 ,f 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 seven(7)calendar days'prior written notice to Consultant as provided herein. Upon receipt of any notice of termination,Consultant shall immediately discontinue performance. 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 FY 2017/2018 Short Form Agreement less than$5,000 3 6 the City's Minimum Wage Ordinance as set forth in Cupertino Municipal Code Chapter 3.37. 13. AGREEMENT COORDINATOR: The Agreement Coordinator and representative for CITY shall be:Karen Levy,Recreation Coordinator,Recreation&Community Service Department. IN WITNESS,WHEREOF,the parties have caused the Agreement to be executed. CELESTE REPASKY CITY OF CUPERTINO A Municipa Corporation By: CELESTE REPAS Y By: KAREN LEVY Title: FITNESS INSTRUCTOR Title: RECREATION COORDINATOR Date: /�Z /� 7 Date: RECOMMENDED FOR APPROVAL: I By-' JEFFREY S.MILKES Title: DIRECTOR,RECREATION&COMMUNITY SERVICES APPROVED AS TO FORM: _k—'Q pRANDOLPH STEVENSON HOM UU CITY ATTORNEY ATTEST: rd-z6-1? GRACE SCHMIDT CITY CLERK EXPENDITURE DISTRIBUTION: Account No: 580-63-620-700-702 Amount: $1000.00 FY 2017/2018 Short Form Agreement less than$5,000 4 EXHIBIT A CONSULTANT SERVICES TO BE PERFORMED The CONSULTANT will provide ADULT FITNESS INSTRUCTION in,but not limited to,the following programs: ZUMBA Location and Time of CONSULTANT Services: Refer to the Recreation Schedule dated FALL 17-SPRING 18 for agreed upon dates,times, and class locations. By the mutual agreement of both parties,class schedule may change. Eligible Participant Minimum and Maximums for CONSULTANT Services: Minimum: 5 Maximum: 20 If less than the required minimum number of participants enroll in and pay for a particular class as identified in the schedule before the class is scheduled to start,the City may cancel the particular class and/or terminate this Agreement without additional notice or payment to Consultant. Performance of CONSULTANT Services: In the case Consultant unilaterally cancels performance of a class,camp or activity without City approval, City reserves the right to immediately and without notice cancel the remainder of programs offered by 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. . 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. I I FY 2017/2018 Short Form Agreement less than$5,000 5 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 fitness 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 /,2-day of�� �; ! , 2017, at n yy.- e- , California. PRINT NAME T � /I nn 17- l SIGNATURE E E f' P FY 2017/2018 Short Form Agreement less than$5,000 6 i EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 6362-86405270335524 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM 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: Celeste Repasky TYPE: Aerobics LOCATION: Quinlan Community Center-Dance&Activity Room *Liquor Liability Yes 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 DIASTER 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 ❑ $1,000,000/$3,000,000 ❑ $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. AUTHORIZED REPRESENTATIVE: DATE ISSUED: 04/24/2017 POLICY NUMBER: SEP41023 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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, Its City Council, Boards and Commissions, Officers, Officials, Employees, Agents and Volunteers For Certificate No.: 636286405270335524 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — 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. Required by the contract or agreement; or 1. In the performance of your ongoing operations; 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 FARMERS Auto Insurance Declaration Page INSURANCE Policy Number: 16284-27-32 Premiums Effective: 8/30/2017 12:01 AM . . . . . . . . . . . . . . . . . . . .. .. . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . Full-term Premium(excluding fees) $379.00 Expiration: 12/9/201712:01 AM Named/nsured(s): Prorated Premium(8/30/2017-12/9/2017) $4.09 Celeste E Repasky cerepasky@gmail.com This is nota bill. Your bill with the amount due will be mailed separately. Underwritten By: Mid-Century Insurance Company 6301 Owensmouth Ave. Woodland Hills,CA 91367 Household Drivers Name Driver Status Name Driver Status Covered Celeste E Repasky Covered Vehicle Information Veh.# Year/Make/Model/VIN Coverage Deductible Limit 1 Collision: $750 Additional Equipment: $1,000 Coverage Information Limits----- ------------------------------------------------------- Premiums by Vehicle Coverage (applicable to all vehicles) _ _Vehicle 1 _ - BodilylnjuryLiability $500,OOOeach person $161.90 $500,000 each accident --------------- --------------------------------------------- ------------------------------------------------------------ ----------- - -------------- ------------------ Property Damage Liability $100,000 each accident Included -------------------------------------------------------------------------------------------------------------------------------------- ----------- - ........---- ------ -------------- --------- Permissive User Limit of Full(See Permissive User Included Liability" Limit of Liability in your policy) - -------------------------------------------------------------------------------------- ------------------------------------------------ ------------------------ --------- ---- ..-------------- ------- ----------- Medical Coverage $5,000 each person $8.40 $500 deductible ----- - - Uninsured Motorist Bodily - y $500,000 each person $27.60 Injury $500,000 each accident ------------------------------------------- ---------------.-------------------------------------------------------------------------------------------------------- Comprehensive $27.50 --------------------------------_-_---------------------- --------------------------------------------------- Collision -.... -. ----------------- - -- $141.10 ---------------_----------------------------------------------------- ----------------------------------- --- ------ Additional Equipment Included i I farmers.com Policy No. 16284-27-32 Questions? Manageyouraccount: Call your agent Natalie Arola at(408) Go to www.farmers-com to access 371-9500 or email your account any time! narola@farmersagent.com 56-6176 1st Edition 7-16 8/31/2017 Page 1 of 3 ` ' . ^ Declaration Page(continued) ` P/em�msbyVeh�� umm� '----'-------------------------� ----'- -. - Vehicle/ � � Coverage $5�2O UninsunedMoto��P/npeny � | Damage With Collision ________________________________________- '-------'-'----------'---- $7.30| Towing and Road 5em�e | $379�OO � Tot |PemiumPerVehide Fu|#wrmPem�m °~^~`~- Discounts Discount Type Applies to Vehicle(s)Vehicle(s) D�o /\nti'LockBrakes ______________________., Good Driver �_____________________________. -------����������� 1 Passive / Auto/Home � ''- -----------'-----�_--'--- ''-_---------------_--_'_-------- � ' �������� 1 GroupEnginee/ / Multiple Car __________________________ _____ .Alternative _,_________________- --'---�-------- l AltennativeFue / Persistency ������������������������� / 1 Safe Driver Stability Control Rating Information � Vehicle 1 Details | - -�--Garaginyl§p ___�___�__������������������������.���������__^___________----�'������ � -- 94087 ------��� -� ���� -�� -- �--�� O�OO � CuxentAnnua|�Wi�age __________________________________________,______ � ----'--------�--�-��---���� ---- 8'O0O p�v�usAnnua|&4i�age� _____________________________________________ - ---------------------------------------------------------- CommuterUse --------------------- Vehicle Usage ______�___________��_____�_�_____________________�����-- '--------------- ---- �9�� Year�ofDr��gExpehence � PoOrna8d Endorsements This section liststhe policyform number and any applicable endorsements that make up your insurance contract.Any endorsements that you have purchased to extend coverage on your policy are also listed in the coverages section of this declarations document: 50'5h841sted.;H1l532nd ed.;25'853l lO'lZ Other Information ^ "YOUR POLICY INCLUDES THE FULL PERMISSIVE USER LIMITOF LIABILITY.PLEASESEE PERMISSIVE USER LIMITOF LIABILITYIN YOUR POLICY FOR FURTHER INFORMATION. ^ You may be eligible for a different rate but with different coverage from Farmers Specialty Insurance Company.Please contact your Farmers'agent todiscuszyouroptions. ^ GnGreen bylogging onto Farm /cs.comorcontacdngyourFa/memAgent. ^ Farmers Friendly Reviews are a great way to make sure you are receiving all the discounts for which you qualify,and identify any potential gaps in coverage.Contact your agent to learn more about the policy discounts,coverage options,and other product o#ehngsthatmay beavailable toyou. fanners.com Policy No. 16284-27-32 Questions? K8anageyouraocount: Call your agent Natalie Am|nat(408) Gomwww.farmers.cnmm access 37l95O0vremail your account any time! nam|a@fanneoagent.ovm