22-001 Amendment #2 dated 1-6-25 Grace Duval for Fitness Instruction1
SECOND AMENDMENT TO AGREEMENT 22-001
BETWEEN THE CITY OF CUPERTINO AND GRACE
DUVAL FOR FITNESS INSTRUCTION
This Second Amendment to Agreement 22-001 is by and between the City of Cupertino, a
municipal corporation (hereinafter "City") and GRACE DUVAL, a Sole Proprietorship/Individual
(“Contractor”) whose address is and is made
with reference to the following:
RECITALS:
A. On July 06, 2022, Agreement 22-001 (“Agreement”) was entered into by and between
City and Contractor for Fitness Instruction.
B. On June 18, 2024, City and Contractor agreed to the First Amendment for Fitness
Instruction.
C. The Agreement and First Amendment are collectively referred to as the “Agreement”
unless otherwise indicated.
D. City and Contractor desire to modify the Agreement on the terms and conditions set
forth herein.
NOW, THEREFORE, it is mutually agreed by and between the undersigned parties as
follows:
1. Paragraph 4 of the Agreement is modified to read as follows:
Compensation. City will pay Contractor for satisfactory performance of the Services an
amount that will be based upon actual costs but that will be capped so as not to exceed
$45,000.00 (“Contract Price”), based upon the Scope of Services, budget, performance
schedule, and rates included in Exhibit A. The maximum compensation includes all costs,
expenses, and reimbursements and will remain in place even if Contractor’s actual costs
exceed the capped amount. Contractor must submit invoices and the information required
in Exhibit A in order to receive payment. City will compensate Contractor within thirty (30)
days after approval of written invoices.
Invoices are subject to review and audit by City during regular business hours upon 24
hours’ notice. Contractor must maintain complete and accurate records of payrolls,
expenditures, disbursements and other cost items charged to City or establishing the basis
for an invoice, for a minimum of four (4) years from the date of the final payment.
2. Exhibit A of the Agreement is modified as follows, under the following section(s):
Compensation for CONTRACTOR Services
Contractor shall be compensated for services performed pursuant to this Agreement.
For the Sports Center and Quinlan Community Center, $44/hour.
For the Senior Center: seventy percent (70%) of revenue generated from the member rate per
participant, plus seventy percent (70%) of the revenue from drop-in passes.
City and Contractor may mutually agree for Contractor to teach a class online rather than in
person, provided the City and Contractor reach agreement for compensation for that online
2
class. Compensation for that online class shall be specified in writing in a separate side
agreement before online instruction for a class begins.
The total compensation to the Contractor shall not exceed $45,000.00.
3. Except as expressly modified herein, all other terms and covenants set forth in the
Agreement shall remain the same and shall be in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused this modification of Agreement
to be executed.
CITY OF CUPERTINO
By
Title
Date
APPROVED AS TO FORM
City Attorney
ATTEST:
City Clerk
Date
GRACE DUVAL
By
Title
Date
EXPENDITURE DISTRIBUTION
Item PO Number Amount
Base Amount 2023-51, 2023-50, 2023-52,
2024-52, 2024-53, 2024-54 29,000.00
Amendment 1 2025-84, 2025-85, 2025-86 8,000.00
Amendment 2 8,000.00
- - 45,000.00
Fitness Instructor
Dec 23, 2024
Christopher D. Jensen
Director of Parks and Recreation
Jan 2, 2025
Jan 6, 2025
CLAIMS MADE SEXUAL MISCONDUCT AND MOLESTATION INSURANCE
Form: Tysers SafeGuard 2021 - primary
Policy Number:
Unique Market Reference: B0572MR244153
Renewal of:
Named Insured: Name: City of Cupertino – Parks and Recreation Department,
Public Works Department
Address: 10300 Torre Avenue, Cupertino, CA 95014
Policy Period: From: 1st July 2024 To: 1st July 2025
Both days at 12:01 a.m. Local Time at the Address specified above
Limit of Liability:
a) USD 5,000,000 in the aggregate during the policy period for all claims brought
by or on behalf of each victim, and
b) USD 5,000,000 in the aggregate during the policy period for all claims brought by or
on behalf of all victims
and separately:
c) USD 75,000 in the aggregate during the policy period for all safeguard costs
resulting from all circumstances
Such Limit of Liability shall be in addition to the overall Limit of Liability stated in a) and b) above.
Retention:
USD 35,000 each Victim
Optional Extension Period: 12 months Additional premium of 100% of the annual premium plus
applicable taxes, provided no claims and/or
circumstances have been reported to the insurance
company.
In the event any claims and/or circumstances have been
reported to the insurance company, the additional
premium for the 12 month optional extension period
will be determined by the insurance company at the
time this Policy is not renewed or replaced by the
insurance company
Premium:
USD 34,650 to be paid within 30 days of inception
Notification pursuant to Clause IX. Shall be given to:
Beazley Group
Attn: Claims Group
30 Batterson Park Road
Farmington, CT 06032
claims@beazley.com
or
Other Notices:
To report a circumstance under the Safeguard Additional Coverage,
Call +1 844 285 4700 where a service representative will be available 24 hours a day,
seven days a week
Retroactive Date:
1st July 2018
Pending or Prior Litigation Date:
1st July 2018
Service of Suit:
Service of process in any suit shall be made upon:
Lloyd’s America, Inc. Attention: Legal Department 280 Park Avenue,
East Tower, 25th Floor New York, NY 10017
Governing Law:
New York
Conditions:
Application Dated: 25th June 2024
California Surplus Lines Notice
California Complaints Notice
Nuclear Incident Exclusion Clause-Liability-Direct – NMA 1256
Radioactive Contamination Exclusion Clause-Liability - NMA 1477
War and Terrorism Exclusion – NMA 2918
US Terrorism Risk Insurance Act of 2002 as amended New & Renewal
Business Endorsement – LMA5389
Several Liability Notice – LMA5096
Sanctions Limits Clause - LMA3100A
Tysers SafeGuard 2021 - Risk Management & Response Solutions
Cyber Acts Clarification
U.S Classification:
Surplus Lines Broker and State filed in: Risk Placement Services, 2850 Golf Road,
Rolling Meadows, IL 60008
License Number: 0C66724
State of Filing:
CA
Brokerage: 20% or same net equivalent downwards, plus taxes as applicable
Information: Employees – 235
Contractors – 90
Exposure Units – 70,000
Nature of Business – Municipality
Cancellation by an Insured may result in a short rate calculation to determine
the return premium, subject to 5% minimum earned of the total premium.
Underwriting
Security: 100% Lloyd’s (Information About Lloyd's)
Fitness Instruction
Final Audit Report 2025-01-06
Created:2024-12-23
By:Webmaster Admin (webmaster@cupertino.org)
Status:Signed
Transaction ID:CBJCHBCAABAAObZ-ozZSzFmEKKLTbAarr7QP3Gk-dtXx
"Fitness Instruction" History
Document created by Webmaster Admin (webmaster@cupertino.org)
2024-12-23 - 10:56:27 PM GMT- IP address: 35.229.54.2
Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval
2024-12-23 - 10:58:59 PM GMT
Email viewed by Araceli Alejandre (aracelia@cupertino.org)
2024-12-23 - 10:59:07 PM GMT- IP address: 3.232.50.116
Document approved by Araceli Alejandre (aracelia@cupertino.org)
Approval Date: 2024-12-23 - 11:03:07 PM GMT - Time Source: server- IP address: 71.204.144.228
Document emailed to for signature
2024-12-23 - 11:03:11 PM GMT
Email viewed by
2024-12-24 - 0:43:21 AM GMT- IP address: 104.28.133.21
Signer entered name at signing as Grace Duval
2024-12-24 - 1:07:06 AM GMT- IP address: 209.29.152.127
Document e-signed by Grace Duval (
Signature Date: 2024-12-24 - 1:07:08 AM GMT - Time Source: server- IP address: 209.29.152.127
Document emailed to Christopher Jensen (christopherj@cupertino.org) for signature
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2024-12-24 - 1:07:18 AM GMT- IP address: 52.202.236.132
Signer Christopher Jensen (christopherj@cupertino.org) entered name at signing as Christopher D. Jensen
2024-12-24 - 2:44:01 AM GMT- IP address: 104.1.88.56
Document e-signed by Christopher D. Jensen (christopherj@cupertino.org)
Signature Date: 2024-12-24 - 2:44:03 AM GMT - Time Source: server- IP address: 104.1.88.56
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Signature Date: 2025-01-02 - 3:45:04 PM GMT - Time Source: server- IP address: 64.165.34.3
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Document e-signed by Kirsten Squarcia (kirstens@cupertino.org)
Signature Date: 2025-01-06 - 5:26:42 PM GMT - Time Source: server- IP address: 176.108.138.169
Agreement completed.
2025-01-06 - 5:26:42 PM GMT