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22-001 Alicia Escott-Entertainment Agreement for Mayor's Cup Challenge SHORT FORM ENTERTAINMENT AGREEMENT CITY OF CUPERTINO Recreation and Community Services Department 10185 N. Stelling Road Cupertino, CA 95014 408-777-3120 --USE OF THIS FORM IS ONLY VALID FOR AGREEMENTS UP TO $3,500.00-- Contractor Name: Contractor Authorized Representative: CITY OF CUPERTINO 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: Artists will showcase and describe their art pieces made from plastic materials collected from the waste arriving at the Recology San Francisco recycling and transfer station Location and Time of Contractor Services: Location: 10800 Torre Ave, Cupertino, CA 95014 Time: May 14TH 2022, 10:00AM- 2:00PM B. TERM. The services and/or materials furnished under this Agreement shall be provided from 5/14/2022 to 5/14/2022. C. COMPENSATION. For the full performance of this Agreement, the City of Cupertino shall pay Contractor a total of $500 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: ☐ Exhibit “C”- Affidavit of no Employees 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. 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 3. Assignment. Contractor may not assign, transfer, or subcontract this Agreement or any portions thereof, without prior written consent of City. 4. 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. 5. 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. 6. 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: Ursula Syrova. Mayor’s Cup Challenge, May 2022 IN WITNESS WHEREOF, the parties have executed this Agreement effective the date last signed below. CITY OF CUPERTINO A Municipal Corporation By ________________________ Name______________________ Title ______________________ Date_______________________ CONTRACTOR By ________________________ Name______________________ Title ______________________ Date_______________________ APPROVED AS TO FORM: CHRISTOPHER D. JENSEN Cupertino City Attorney ATTEST: KIRSTEN SQUARCIA City Clerk Date Alicia escott artist May 10, 2022 Christopher D. Jensen Ursula Syrova (she/her) Environmental Programs Manager May 10, 2022 May 10, 2022 Revised 2.03.22 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 contractor and the owner of . 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 ____day of ____________, 2022, at , California. ______________________________ PRINT NAME ______________________________ SIGNATURE Exhibit C self cupertinomay14 AGREEMENT, WAIVER AND RELEASE Onsite Entertainment In consideration of the services I am providing the City of _____________, 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 __________ (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 __________. __________________________________________ __________________________ Participant/Parent or Guardian Date Cupertino Cupertino Cupertino May 10, 2022 Alicia Escott-Entertainment Agreement for Mayor's Cup Challenge Final Audit Report 2022-05-11 Created:2022-05-10 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAA5kbkPzy9zQe2rkkQ5V6fM8uZ66m_IP5s "Alicia Escott-Entertainment Agreement for Mayor's Cup Challen ge" History Document created by City of Cupertino (webmaster@cupertino.org) 2022-05-10 - 7:24:21 PM GMT- IP address: 216.198.111.214 Document emailed to Julia Kinst (juliak@cupertino.org) for approval 2022-05-10 - 7:26:36 PM GMT Document approved by Julia Kinst (juliak@cupertino.org) Approval Date: 2022-05-10 - 7:26:57 PM GMT - Time Source: server- IP address: 216.198.111.214 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2022-05-10 - 7:26:58 PM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2022-05-10 - 8:13:48 PM GMT - Time Source: server- IP address: 73.170.27.253 Document emailed to Alicia escott ( for signature 2022-05-10 - 8:13:50 PM GMT Email viewed by Alicia escott ( 2022-05-10 - 8:20:54 PM GMT- IP address: 157.131.121.247 Document e-signed by Alicia escott ( Signature Date: 2022-05-10 - 8:25:51 PM GMT - Time Source: server- IP address: 157.131.121.247 Document emailed to Christopher D. Jensen (christopherj@cupertino.org) for signature 2022-05-10 - 8:25:54 PM GMT Email viewed by Christopher D. Jensen (christopherj@cupertino.org) 2022-05-10 - 8:58:22 PM GMT- IP address: 104.28.124.87 Document e-signed by Christopher D. Jensen (christopherj@cupertino.org) Signature Date: 2022-05-10 - 11:18:13 PM GMT - Time Source: server- IP address: 136.24.42.212 Document emailed to Ursula Syrova (she/her) (ursulas@cupertino.org) for signature 2022-05-10 - 11:18:15 PM GMT Email viewed by Ursula Syrova (she/her) (ursulas@cupertino.org) 2022-05-11 - 0:02:15 AM GMT- IP address: 104.47.73.254 Document e-signed by Ursula Syrova (she/her) (ursulas@cupertino.org) Signature Date: 2022-05-11 - 0:03:34 AM GMT - Time Source: server- IP address: 98.45.180.112 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2022-05-11 - 0:03:36 AM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2022-05-11 - 0:15:38 AM GMT- IP address: 172.225.89.145 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2022-05-11 - 0:15:50 AM GMT - Time Source: server- IP address: 172.225.89.144 Agreement completed. 2022-05-11 - 0:15:50 AM GMT