07-001, Phillip Lenihan
AGREEMENT
CITY OF CUPERTINO
10300 Torre Avenue
Cupertino, CA 95014
(408) 777-3200
0,32533
NO.
Fiscal Year 2007-2008
BY THIS AGREEMENT made and entered into on the 22nd day of January. 2007
by and between the CITY OF CUPERTINO (Hereinafter referred to as CITY) and
(1) Phillip Lenihan (2)
Address: 21841 Almaden Avenue Cupertino CA. 95014 Phone: (408) 996-8302
Hereinafter referred to as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as follows:
CONTRACTOR shall provide or furnish the following specified services and/or materials:
In Line Skatina Instruction
EXHIBITS: The following attached exhibits hereby are made part of this Agreement: Exhibit A
TERMS: The services and/or materials furnished under this Agreement shall commence on Julv 1. 2007 and shall be
completed before June 30. 2008.
COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR:
70% of resident fees
GENERAL TERMS AND CONDITIONS:
Hold Harmless. CONTRACTOR agrees to save and hold harmless the CITY, its officers, agents, and employees from
any and all damage and liability of every nature, including all costs of defending any claim, caused by or arising out of the
performance of this Agreement. CITY shall not be liable for acts of CONTRACTOR in performing services described
herein.
Insurance. Should the CITY require evidence of insurability, CONTRACTOR shall file with CITY a Certificate of
Insurance before commencing any services under this Agreement. Said Certificate shall be subject to the approval of
CITY'S Director of Administrative Services.
Non-Discrimination. It is understood and agreed that this Agreement is not a contract of employment in the sense that
the relation 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.
Changes. This Agreement shall not be assigned or transferred without the written consent of the CITY. No changes or
variations of any kind are authorized without the written consent of the CITY.
CONTRACT COORDINATOR and representative for CITY shall be:
NAME: Rachelle Sander
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.
CON~ ~
By: ~1, '
Title: l U <;l , ?
Social Security #: l \ 0 - -z..cP - .q ll0
,
By:
Title:
EXPENDITURE DISTRIBUTION
ACCOUNT NUMBER
580-6449-7014
AMOUNT
$1,500
CITY OF
CUPERTINO
City of Cupertino Contractor Affidavit
The undersigned does hereby certi that:
1. I am a representative of \: L \ P L G l ~ J (contract or company name); that I am
familiar with the fact herein certified and am authorized and qualified to execute this certificate.
2. I verify that~l-\-\ L\ (J LEU 1{1 .6(~ontract or company name) has complied with fingerprinting
and criminal background investigation requirements with respect to all Contractor's employees
who may have contact with minors in the course of providing services pursuant to the Contract,
and the California Department of Justice has determined that none of those employees has been
convicted ofa felony, as that term is defined in California Penal Code Section 11105.3
3. That a complete and accurate list of Contractor's employees who may come in contract with
minors during the course and scope of the contract is 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 Contractor.
A List of all Contractor Employees Working for the City of Cupertino:
(7\-\\L. \ P LGIJd-tAtJ
5. The City of Cupertino will be notified by Contractor of any new employees and will be added to
the above list prior to beginning work for the City of Cupertino.
Contractor Signa~ Date J /2 S; /67
Staff Title:
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYY)
TM, 01/0212007
PRODUCER Phone: (317) 634-4400 Fax: (317) 972-7142 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CITY SECURITIES CORP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. BOX 44992 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
INDIANAPOLIS IN 46244-0992 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
i !
- -------.- ~, ~ ---.--- ---- '-l'NSURER~A:-- AMERICANAL TERNATIVEINS~ CORP
INSURED ..-.........-.-----------...--... ---.-.--. ~ - I
INSURER B:
UNITED SKATE SCHOOLS GROUP ..---- .-..-.. - -. ..-. ..-.. .- .--.---. ..--- . ---- .. _u_. -I
POBOX 3093 lili~~~:: 6:--__~__ ____~~-u---- --~---- _ i
EL SEGUNDO CA 90245 ------..---- --r - -
! INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE
PHILIP LENIHAN TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.
21841 ALMADEN AVE IT'S AGENTS OR REPRESENTATIVES,
CUPERTINO. CA 95014-2855 AUTHORIZED REPRESENTATIVE
Atlention: ~-
P ck J. 0' Connor
'~i:,~~~a TYPE OF INSURANCE
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY'
CLAIMS MADE X OCCUR
POLICY NUMBER
POLICY EFFECTIVE
DATE MMlDDlYY
01/01/07
EACH OCCURRENCE
1-.-.--......------
DAMAGE TC RHlTEC
CS00218051
MED, EXP (Anyone person)
A
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS.COMP/OP AGG
COMBINED SINGLE LIMIT
(Ea accident)
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
BODILY INJURY
(Per person)
!
I BODILY INJURY
i (Pe, accidenl)
~-----
I PROPERTY DAMAGE 1$
, (Per accident)
: GARAGE LIABILITY
ANY AUTO
I AUJ"Q ONhY : EA ACCIDENT $
OTHER THAN EA ACC '$
AUTO ONLY AGG '$
EACH OCCURRENCE
AGGREGATE
EXCESS / UMBRELLA LIABILITY
i OCCUR r CLAIMS MADE
DEDUCTIBLE
RETENTION $
, I ~~g~T~~~~S I
IE~~C~ ACC~T'
i
I E,L, OISE"SE-EA EMPLOYEE
E.L. DISEASE~POLlCY LIMIT
WORKERS COMPENSATION AND
I EMPLOYERS'~iiABltity
ANY PROPRIETORIPARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED?
II yes. describe under
; SPECIAL PROVISIONS below
,OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
ACORD 25 (2001/08)
Certificate #
23446
@ACORD CORPORATION 1988
LIMITS
i$
1,000,000
300.000
o
1,000,000
2,000,000
1,000,000
1$
, $
:$
$
,
$
I
I
$
'$
'$
$
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$