19-001 Jason Fitzpatrick NO.
FY2019-20
CITY OF
SHORT FORM ENTERTAINMENT AGREEMENT
12 CITY OF CUPERTINO
Parks and Recreation Department
CUPERTINO 10185 N. Stelling Road
Cupertino, CA 95014
408-777-3120
Contractor Name:JASON FITZPATRICK
Contractor Authorized Representative: JASON FITZPATRICK
By the signature of its Authorized Representative below,Contractor hereby agrees to the following:
A. SCOPE OF SERVICES. Contractor shall provide or furnish the following specified
services and/or materials:SPECIAL GUEST APPEARANCE,AUDIENCE Q&A,MUSICAL
PERFORMANCE
Location and Time of Contractor Services:
Location: CREEKSIDE PARK
10455 MILLER AVENUE 1
CUPERTINO, CA
Time: JULY 13TH 2O19,5PM—JULY 14TH, 10AM
B. TERM.The services and/or materials furnished under this Agreement shall be provided from
7/13/2019 to 7/14/2019.
C. COMPENSATION. For the full performance of this Agreement, the City of Cupertino shall
pay Contractor a total of$850 in a lump sum to be paid following receipt of Contractor's invoice.
D. EXHIBITS. The following attached exhibits hereby are made part of this Agreement:
N Exhibit"C"-Affidavit of no Employees
❑ Exhibit"D"-Contractor's Mandated Reporter Declaration if Contractor provides services to children
GENERAL TERMS AND CONDITIONS
1. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole
negligence or willful misconduct of City personnel, Contractor agrees to indemnify, defend, and
hold harmless the City, its City Council,boards and commissions, officers, officials, employees,
agents, servants,volunteers and Contractors(collectively, "Indemnitees"),through legal counsel
acceptable to City, from and against any liability for damages, claims, actions, causes of action,
demands, charges, losses, costs and expenses (including attorney fees, legal costs and expenses
related to litigation, arbitrations, administrative and regulatory proceedings), of every nature,
arising out of or in any way related to Contractor's or Contractor's agents performance of the
Scope of Services. This includes but is not limited to liability resulting in personal injury, death,
property damage,or economic losses.Contractor must pay any costs City may incur in enforcing
this provision and must accept a tender of defense upon receiving notice from City.Contractor's
payments may be deducted or offset to cover any money the City lost due to a claim or
counterclaim arising out of this agreement.
2. General Liability Insurance: The undersigned shall maintain general liability insurance in an
amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal
injury, and property damage. Undersigned's general liability policies shall be endorsed to
provide that City and its officers, officials, employees, and agents shall be additional insureds
under such policies.
3. Compliance with Laws. Contractor shall comply with all laws applicable to this Agreement
including, without limitation, laws regarding workers' compensation, antidiscrimination, and
conflict of interest. If Contractor has no employees an affidavit to that effect shall be attached to
this agreement. If the scope of work involves providing services to children, the City of
Cupertino,Consultant Declaration shall be attached
4. Assignment.Contractor may not assign, transfer,or subcontract this Agreement or any portions
thereof,without prior written consent of City.
5. Termination. City may terminate this agreement at any time. In the event of cancellation within
24 hours of the time Contractor is to begin providing services City shall pay contractor one half
of the total agreement amount unless cancellation occurs after Contractor's personnel have
arrived at the location where services are to be performed in which case the total contract amount
shall be paid.
6. Interest of Contractor. It is understood and agreed that this Agreement is not a contract of
employment and, 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. 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.
7. 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: Daniel Mestizo.
IN WITNESS WHEREOF,the parties have executed this Agreement effective the date last signed
below.
CONTRACTOR CITY OF CUPERTINO
JASON FITZPATRICK A Municipal Corporation
BY BY 94
Nam Jason Fitzpatrick Name Ginn"_(
Title Co-Owner Title PeCf'2a'�cl�
Date 06/19/2019 Date ILO-2t , wiq
Tax I.D. No.:
APPROVALS EXPENDITURE DISTRIBUTION
PARKS AND RECREATION DEPARTMENT DATE ACCOUNT NUMBER AMOUNT
ASSISTANT DIRECTOR 100-62-639 700-702 $850.00
o _
CITY ATTORNEY:APPROVED AS TO FORM DATE
CITY CLERK: ATTEST DATE
hdarch 28,?019
EXHIBIT C
AFFIDAVIT OF NO EMPLOYEES
State of California
County of Santa Clara
City of Cupertino
I, the undersigned, declare as follows:
I am an independent contractor and the owner of Jason Fitzpatrick
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 Linder the laws of the State of California that the foregoing
is true and correct.
Executed on this 19 day of June , 2019, at Los Angeles , California.
Jason Fitzpatrick
PRINT NAME
X9?b7t-I�- -
SIGNATUR
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: -
CERTIFICATE OF INSURANCE
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER PUBLIC ENTITY(ADDITIONAL INSURED)
Alliant Insurance Services,Inc.in conjunction with Amended certificate replaces certificate issued to you on
Apex Insurance Services May 21,2019
P. O.Box 6450
Newport Beach,CA 92658
License No:OC 36861
NAMED INSURED(EVENT HOLDER): EVENT INFORMATION:
City of Cupertino,Its City Council,Boards and Commissions. TYPE: 2019 Summer Events
Officers,Officials,Employees,Agents,Volunteers and DATE(S): See attached listing
Consultants LOCATION: See attached listing
10300 Torree Ave *Liquor Liability Yes❑ No
Cupertino,CA 95014 1 "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: SEP41028
MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2019 EXPIRATION:JANUARY 1,2020
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE
General 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 MEGL643
Liquor Liability (If purchased) 1,000,000
Optional Limits Purchased
❑ $1,000,00053,000,000
❑ $2,000,00052,000,000
Damage To Property(If purchased)
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
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: C�
DATE ISSUED:
DATES
July 6,9, 10, 12, 13, 14, 16, 17, 18, 20, 23, 24, 25, 26, 27, 28, 30, 31, 2019
August 1, 3,4,6, 7, 8, 11, 17, 18, 25, 30, 31, 2019
September 6,7, 2019
LOCATIONS
Creekside Park, 10455 Miller Ave,
Main Street Park, 19469 Stevens Creek Blvd, Monta Vista Park,
22601 Voss Ave, Jollyman Park,
1000 S. Stelling Road, Portal Park,
10225 N. Portal Ave,Three Oaks Park,
7535 Shadowhill Ln, Wilson Park,
10200 Parkside Ln, Linda Vista Park,
11097 Linda Vista Dr., City Center Amphitheater,
20350 Stevens Creek Blvd., Civic Center Plaza,
100350 Torre Ave., Library Field, 10400 Torre Ave., Cupertino, CA 95014