19-141 Bea Johnson, Short Form Entertainment Agreement NO.
FY2019-20
CITY OF
SHORT FORM ENTERTAINMENT AGREEMENT
CITY OF CUPERTINO
10300 Torre Ave.
Cupertino, CA 95014
CUPERTINO - ----- --
--USE OF THIS FORM IS ONLY VALID FOR AGREEMENTS UP TO $3,500.00--
Contractor Name:BEA JOHNSON
Contractor Authorized Representative:BEA JOHNSON
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: 1.5 HOUR PRESENTATION ABOUT ZERO WASTE LIVING:
OBSTACLES, SOLUTIONS,BENEFITS,RESULTING WORLDWIDE MOVEMENT.
Location and Time of Contractor Services:
Location: CITY OF CUPERTINO COMMUNITY HALL,iosso TORRE AVE 95014
Time: 12 PM-9 PM
B. TERM.The services and/or materials furnished under this Agreement shall be provided from
9/23/2019 to 9/23/2019.
C. COMPENSATION. For the full performance of this Agreement, the City of Cupertino shall
pay Contractor a total of$2000.00 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:
X Exhibit"C"-Affidavit of no Employees q
N/A Exhibit "D"- Contractor's Mandated Reporter Declaration if Contractor provides services to
children
GENERAL TERMS AND CONDITIONS {
1. Compliance with Laws. Contractor shall comply with all laws applicable to this Agreement
including, without limitation,tlawp 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
2. Assignment. Contractor may not assign, transfer, or subcontract this Agreement or any
portions thereof, without prior written consent of City.
3. 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.
4. 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.
5. 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:GILEE CORRAL, Sustainability
Program Coordinator, gileec@cupertino.org,408-777-1364.
IN WITNESS WHEREOF, the parties have executed this Agreement effective the date last signed
below.
CONTRACTOR CITY OF CUPERTINO
BEA JOHNSON A Municip C oratio
BY
�[wk1.1 L N e Katy Nomura
By
Titl Assistant to the City Manager_
Name_Bea Johnson
and
Title
By
Date_7/31/19
Name_Cheri Donnelly
Tax LD. No.:_SEE W9
Title_Environmental Programs Manager_
Date $)t 112"'kgk
APPROVALS EXPENDITURE DISTRIBUTION
ACCOUNT NUMBER AMOUNT
ENVIRONMENTAL PROGRAMS MANAGER DATE
SUSTAINABILITY MANAGER DATE
520-81-801 700-702 $1000.00
100-11-180 600-613 $1000.00
CITY ATTORNEY: APPROVED AS TO FORM DATE
CITY CLERK: ATTEST DATE
AGREEMENT,WAIVER AND RELEASE
Onsite Entertainment
In consideration of the services I am providing the City of Cupertino I hereby waive, release and
discharge any and all claims for damages for personal injury or property damage which I may have,or
which may hereafter accrue to me, as a result of providing said service. This release is intended to
discharge in advance the City of Cupertino (its officers, and/or officials, employees,volunteers and
agents)from any and all liability arising out of or connected in any way with my services, unless caused
by the active negligence of the City. It is further agreed that this waiver, release and assumption of risk
is to be binding on my heirs and assigns. I agree to indemnify and to hold the above persons and entities
free and harmless from any loss, liability, damage,cost, or expense which they may incur as the result of
my injury or property damage that I may sustain while participating in said activity.
I HAVE CAREFULLY READ THIS AGREEMENT,WAIVER AND RELEASE AND FULLY UNDERSTAND ITS
CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF
AND THE CITY OF Cupertino.
';. 7/29/19
Par / rent or Guardian Date
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 Zero Waste Home
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 31 day of july 2019, at Mill Valley , California.
Bea Tohnson
PRINT NAME
SIGNAT RE