Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
25-001 Elena Valentina Pavel for Fitness Instruction
CITY OF CUPERTINO RECREATION SERVICES AGREEMENT No. FY2026 - 2028 1. Parties. This contract is made by and between the City of Cupertino, a municipal corporation ("City"), and Elena Valentina Pavel ("Contractor"), a Sole Proprietorship/Individual for Fitness Instruction and is effective on the last date signed below ("Effective Date"). 2. Services. Contractor agrees to provide the Services included in the Scope of Work and in accordance with the Schedule of Performance attached in Exhibit A. 3. Term. This contract begins on the Effective Date and ends on 06/30/2028 ("Contract Time"), unless extended or terminated as provided herein. Time is of the essence and Contractor must have sufficient time, resources, and qualified staff to deliver the Services as required. Contractor must promptly notify City of any actual or potential delays to afford the Parties adequate opportunity to address or mitigate such delays. The City's appropriate department head or the City Manager may extend the Contract Time through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City's purchasing policy. 4. 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 $9,000.00 ("Contract Price"), based upon the Scope of Services, 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. 5. Independent Contractor. 5.1 Contractor is an independent Contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement. No civil service status or other right of employment will be acquired by virtue of Contractor's performance of the Services. Contractor is not entitled to City's health benefits, worker's compensation or any other benefit. Contractor must have the skills and qualifications to perform the Services in a competent and professional manner. Recreation Services Agreement/ Rev. April 2025 Page 1 of 7 Contractor will supply all tools, materials, and equipment required to perform the Services under this Contract. Contractor is responsible for obtaining permits and licenses required by law and must obtain a City business license, if required by the Cupertino Municipal Code. 5.2 Contractor is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. Contractor and any of its employees, agents, and subcontractors shall not have any claim under this Agreement or otherwise against City for seniority, vacation time, vacation pay, sick leave, personal time off, overtime, health insurance, medical care, hospital care, insurance benefits, social security, disability, unemployment, workers compensation or employee benefits of any kind. Contractor shall be solely liable for and obligated to pay directly all applicable taxes, fees, contributions, or charges applicable to Contractor's business including, but not limited to, federal and state income taxes. City shall have no obligation whatsoever to pay or withhold any taxes or benefits on behalf of Contractor. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement is determined by a court of competent jurisdiction, arbitrator, or administrative authority, including but not limited to the California Public Employees Retirement System (PERs) to be eligible for enrollment in PERS as an employee of City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City, and actual attorney's fees incurred by City in connection with the above. 6. Proprietary/Confidential Information. To the extent Contractor may have access to private or confidential information owned or controlled by the City, Contractor agrees to treat it as confidential and use it solely to perform this Agreement. Contractor must exercise the same standard of care to protect City information as a reasonably prudent Contractor would use to protect its own proprietary data. 7. Ownership of Materials. To the extent Contractor prepares written material, drawings, or data in connection with this contract, City will have the property rights to those materials and all copyrights, if any, to such work product will, to the extent requested by City, constitute City property upon completion of the work to be performed hereunder or upon termination of this Agreement. 8. Records. Contractor must maintain complete, accurate, and detailed accounting records relating to its performance in accordance with generally accepted accounting principles and procedures. The records must include detailed information about Contractor's services, benchmarks, deliverables, and costs/fees, and must be made reasonably available to City. The records and supporting documents must be kept separate from other files and maintained for four (4) years from the date of City's final payment. Recreation Services Agreement/ Rev. April 2025 Page 2 of 7 9. Assignment. This Contract is not assignable. Contractor may not substitute another or transfer any rights or obligations under this Contract without prior written approval of City. Only those persons whose names are included in Exhibit A may perform the Services. 10. Publicity and Signs. Any publicity generated by Contractor related to this contract or the Services during the Contract Time and for one (1) year thereafter must reference City contributions. The words "City of Cupertino" shall be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews, and newspaper articles. No signs may be posted, exhibited, or displayed on or about City property, except signage required by law or under this Agreement, without prior written approval from City. 11. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole and active 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 this contract or the 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 Contract. This Section 11 shall survive termination of the Agreement. 12. Insurance. Contractor shall comply with the insurance requirements in Exhibit B. City will not execute the Agreement until it has received and approved satisfactory certificates of insurance and endorsements evidencing the type, amount, and dates of coverage. Alternatively, City in its sole discretion, may purchase insurance and deduct the costs from payments to Contractor, or terminate the Agreement. 13. Compliance with Laws and Other City Requirements. Requirements for all Contracts. This contract is subject to local, state and federal laws and regulations prohibiting discrimination, including Title VII of the Civil Rights Act of 1964, the California Fair Employment Practices Act, the Americans with Disabilities Act of 1990, and other laws that pertain to fair employment and anti -discrimination practices. Contractor agrees to provide records and documentation to the City on request necessary to monitor compliance with this provision. Contractor must comply with labor laws pertaining to prevailing wages, working hours, overtime, payroll records, and other requirements imposed by the Department of Industrial Relations. If Contractor does not have employees, it must sign the Affidavit of No Employees, attached as Exhibit C. Contractor is responsible for verifying employment eligibility of employees pursuant to the Immigration Reform and Control Act of 1986. Contractor must comply with conflict of interest laws and regulations applicable to this Agreement and avoid conflicts of interest. Contractor may be required to file a conflict of interest form for engaging in governmental decisions or serving in a staff Recreation Services Agreement/ Rev. April 2025 Page 3 of 7 capacity, and is hereby advised to review the requirements of California Political Reform Act and the California Code of Regulations. Services may only be performed by persons who are not employed by City and who do not have a contractual relationship with City other than this contract. Contractor agrees to abide by City policies and administrative rules prohibiting gifts to City officials and employees. Additional Requirements for Services Provided to Minors. Contractor and its employees who provide services under this Agreement must comply with these additional requirements: A. Undergo fingerprints and a criminal background and verify all employees providing services under this contract have met this requirement. B. Complete a Tuberculosis screening test as required by law and as set forth in Exhibit D. C. Comply with the Mandatory Reporting under California Penal Code 11164-11174.3 and with the protocols, reporting, and training required under California Health and Safety Code Section 124235, AB 2007, and other laws pertaining to concussion evaluation, removal from play, and return to play protocols. (Refer to Center for Disease Control & Prevention, httl2s://www.cdc.gov/headsul2/index.html). D. Submit required forms and acknowledgments included in Exhibit D, and ensure its each participant is provided with a concussion information sheet, signs and returns the forms to the City as required by Health and Safety Code Section 124235. Require coaches and administrators to successfully complete the concussion and head injury education at least once either online or in person, before supervising a participant. Contractor shall offer training, educational materials, or both to each Contractor administrator on a yearly basis. (Training resources are available at the Center for Disease Control & Prevention (link cited above). E. If providing instruction, Contractor must acknowledge and comply with all requirements set forth in the Parks & Recreation Services Instructor Manual. This contract currently does not require services for children. If in the future, services for children are required, the contract will require a 'written amendment' to include the appropriate insurance coverages as required in 'Exhibit B - Insurance Requirements for Recreation Contracts', proof of fingerprinting and additional requirements under Paragraph 13. The contract will also require the approval of the Director of Parks and Recreation and City Attorney. 14. Coordination of Services. The Parties designate the following persons as Services Coordinators with the responsibility to oversee the delivery of Services in accordance with the terms of this Agreement. Contractor's designation and any substitution are subject to City approval. For City: For Contractor: Name: Colleen Ferris 15. Abandonment. City may abandon or postpone the Activity or Program and will notify Contractor as soon as possible. Contractor will be paid for satisfactory Services rendered through the date of abandonment upon submission of final invoices approved by City. Recreation Services Agreement/ Rev. April 2025 Page 4 of 7 16. Termination. City may terminate this contract for cause or without cause at any time and will notify Contractor as soon as possible. Contractor will be paid for satisfactory services rendered through the date of termination upon submission of final invoices approved by City. 17. Governing Law, Venue, and Dispute Resolution. This contract is governed by the laws of the State of California. Any legal actions or proceedings filed against City in connection with this contract must comply with the government claims filing requirements and must be filed with the Superior Court for the County of Santa Clara, State of California. At City's request, Contractor is required to continue to provide Services pending resolution of any dispute. If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of law and fact. 18. Attorney Fees. If City is required to pursue litigation, arbitration or other administrative or regulatory proceeding to enforce its rights or the terms of this Agreement, the prevailing party will be entitled to reasonable attorney fees and costs. This Section 18 survives this Agreement. 19. Third Party Beneficiaries. There are no third party beneficiaries under this Contract. 20. Waiver. Neither acceptance of Services nor payment thereof constitutes a waiver of any contract provision. City waiver of a breach shall not constitute waiver of another term, provision, covenant, or condition, or a subsequent breach, whether the same or a different character. 21. Entire Agreement. This Agreement and all referenced Exhibits are hereby attached and incorporated into the Agreement by this reference and represent the full and complete understanding as to those matters contained herein, and supersede any other contract or understanding, either oral or written, between the Parties. This Agreement may not be modified or amended except in writing signed by both Parties. If there is any inconsistency between any term, clause, or provision of the main contract and any term, clause, or provision of the attachments or exhibits thereto, the terms of the main contract shall prevail and be controlling. 22. Inserted Provisions. Each provision or clause required by law or this contract is deemed to be included and will be inferred herein. Either party may request an amendment to cure any mistaken insertion or omission of a required provision. 23. Headings. The headings are for convenience only and are not a part of the contract or intended to affect, limit, or amplify the terms or provisions of this Agreement. 24. Severability/Partial Invalidity. If any contract term or provision, or their application to a particular situation, is found by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling. All other contract terms and provisions and their application to specific situations will remain in full force and effect. 25. Survival. All provisions which by their nature must continue after the Agreement ends, including without limitation Indemnification, Insurance, Ownership of Materials, Records, Governing Law, and Attorney Fees, will survive the expiration or termination of this Agreement. Recreation Services Agreement/ Rev. April 2025 Page 5 of 7 26. Notices. All notices and instruments pertaining to material provisions of this contract or significant disputes which are required by law or under this contract to be in writing must be sent to the persons listed below. The notices will be deemed effective on the date of personal delivery or the date confirmed by a reputable overnight delivery service, on the fifth (5th) calendar day after deposit in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission. To City of Cupertino: Office of the City Manager 10300 Torre Ave., Cupertino, CA 95014 Cc: Representative/Coordinator: Colleen Ferris Email: colleenf@cupertino.gov 27. Execution. The person executing this contract on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to execute this contract and to carry out all actions and services required. This contract constitutes a legally binding obligation of Contractor, and may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instrument. SIGNATURES CONTINUE ON THE FOLLOWING PAGE Recreation Services Agreement/ Rev. April 2025 Page 6 of 7 IN WITNESS WHEREOF, the parties have caused this contract to be executed. CITY OF CUPERTINO A Municipal Corporation B Y Name Rachelle Sander Title Director of Parks and Recreation Jul 22, 2025 APPROVED AS TO FORM: 7e C16Zd uJaa MICHAEL K. WOO Senior Assistant City Attorney ATTEST: KIRSTEN SQUARCIA City Clerk DateJul 22, 2025 CONTRACTOR By, Name Valentina Pavel Title Zumba Instructor Date Jul 22, 2025 Tax I.D. No.: Refer to W9 Recreation Services Agreement/ Rev. April 2025 Page 7 of 7 I*A:611.10 .11 SCOPE OF WORK, PERFORMANCE AND PAYMENT SCHEDULES The CONTRACTOR will provide Fitness Instruction in, but not limited to, the following: Zumba, Subbing Services Location and Time of CONTRACTOR Services: Refer to the City's Publications for agreed upon dates, times, and locations of a class, camp, activity, program, or service ("class"). The City, at its sole discretion, may change the agreed dates, times and locations of a class, or may cancel a class. Compensation for CONTRACTOR Services: Contractor shall be compensated for services performed pursuant to this Agreement. For a class taught in person, $38/hour. City and Contractor may mutually agree for Contractor to teach a class online rather than in person, provided that City and Contractor reach agreement for compensation for that online class. Compensation for that online class shall be specified in writing in a separate side agreement before online instruction for a class begins. Eligible Participant Minimum and Maximums for CONTRACTOR Services: Minimum: 20 Maximum: 45 If less than the required minimum number of participants enroll in and pay for a particular class as identified in the schedule before the class is scheduled to start, the City may cancel the particular class and/or terminate this Agreement without additional notice or payment to Contractor. Performance of CONTRACTOR Services: Class Cancellation Contractor will only receive compensation for a class that is performed. If performance of a class is cancelled by the City or Contractor before instruction begins, Contactor will not receive compensation for the class. If the City or Contractor cancels performance of certain meetings of a class, Contractor will only receive compensation for those meetings of the class that are performed. In the case Contractor unilaterally cancels performance of a class without City approval, City reserves the right to immediately and without notice cancel the remainder of classes offered and or performed by Contractor. Updated 04129125 Registration, Enrollment, and Supervision The Contractor shall follow all guidelines pertaining to registration procedures as listed in the quarterly recreation schedule. Participants may not take part in the program unless they are listed on the class roster or can show proof of enrollment. All participants and volunteers need to complete the City's Waiver of Liability form prior to taking part in the program. If applicable, contractors who are responsible for supervising minors must remain with the class until a parent or legal guardian has arrived and all minors are released to them. Injury of a Class Participant In the event of an injury occurring to a participant, the Contractor will notify the City within 1 hour and complete an Incident Report in the form approved by the City. The Incident Report must be submitted to the City within 24 hours of the injury occurring. Updated 04129125 Exhibit B Insurance Requirements for Recreation Contracts As required by the Agreement, Contractor shall procure prior to commencement of Services and maintain the following insurance for the duration of the Agreement, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City. Minimum Scope and Limit of Insurance. Coverage shall be at least as broad as: Commercial General Liability (CGL): Coverage at least as broad as Insurance Services Office ("ISO") Form CG 00 01 with limits no less than $1,000,000 per occurrence and $2,000,000 general aggregate. The policy shall include a per project or per location general aggregate endorsement as broad as CG 25 03 or CG 24 04. If a per project/location endorsement is not available, the limit of the general aggregate shall be doubled. a. It shall be a requirement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (H) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Contractor's policy shall allow and be endorsed "primary and non-contributory," will not seek contribution from City's insurance/self-insurance, and shall be at least as broad as the most recent edition of ISO Form CG 20 01. c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess liability insurance, provided each policy follows form of the underlying policy and complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary basis for the benefit of City. The City's own insurance or self-insurance shall not be called upon. 2. Automobile Liability: Coverage shall be provided using ISO CA 00 01 covering Code 1 (any auto), or if Contractor has no owned autos, Code 8 (hired) and 9 (non -owned), with limits no less than $1,000,000 per accident for bodily injury and property damage. (Required if automobile is used to perform work under this contract.) LJ Not required. Contractor shall be fully remote and not use automobiles to provide the service. In the event Contractor uses an automobile or automobiles in the operation of its business to provide services under this Agreement, the Contractor shall, prior to such use, provide the City with evidence of Business Automobile Liability insurance coverage in the amount required under this Section 2 for owned, non -owned and hired autos (any auto -Symbol 1), or if Contractor does not own autos (hired autos -Symbol 8 and non -owned autos -Symbol 9). Evidence shall be provided with a Certificate of Insurance, along with an additional insured endorsement in favor of the City, primary and non-contributory coverage and endorsement, and waiver of subrogation coverage and endorsement under the policy prior to the use of any automobile. F Contractor has provided written confirmation that it does not own any autos. Contractor shall provide coverage for hired autos -Symbol 8 and non -owned autos -Symbol 9. Primary and Non - Contributory coverage and Waiver of Subrogation coverage is waived under the Automobile Liability hired and non -owned only coverage. In the event Contractor uses an owned automobile or automobiles in the operation of its business to provide services under this Agreement, the Contractor shall, prior to such use, provide the City with evidence of Business Automobile Liability insurance coverage in the amount required under this Section 2 for owned, non -owned and hired autos (any auto -Symbol 1). Exh. Y Insurance f tr Recreation Contracts Updated May 2025 XIn lieu of Business Automobile Liability, Contractor shall maintain throughout the term of this Agreement and provide the City with evidence (including the policy Declarations Page) of personal automobile insurance coverage in accordance with the laws of the State of California. As available under the policy, evidence shall be provided with the Certificate of Insurance, along with an additional insured endorsement in favor of the City, primary and non-contributory coverage and endorsement, and waiver of subrogation coverage and endorsement. City approval of coverage is required prior to commencement of services. 3. Workers' Compensation: As required by the State of California, with Statutory and Employer's Liability Insurance limits of no less than $1,000,000 per accident/disease. XIf no employees, Contractor must sign Affidavit of No Employees. 4. Sexual Abuse/Molestation. Insurance is required for activities/services involving minors, (i.e., after school activities, recreational programs, athletics, study/training events and transportation of minors) or vulnerable populations. Coverage shall include bodily injury sexual abuse and molestation coverage, personal injury, and property damage, including without limitation, blanket contractual liability. Sexual Abuse/Molestation coverage must be included under General Liability or obtained in separate policies with a limit of no less than $2,000,000 per occurrence and $4,000,000 aggregate. If a general aggregate limit applies, it must apply separately to this contract or be twice the required occurrence limit. XNot Required. Contract does not involve services to minors or vulnerable populations Insurance coverage required may be satisfied by a combination of Primary and Excess/Umbrella insurance. OTHER INSURANCE PROVISIONS The aforementioned insurance shall be endorsed and have all the following conditions and provisions: Additional Insured Status The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers ("Additional Insureds") are to be covered as additional insureds on Contractor's CGL and automobile liability policies. Endorsement of General Liability coverage shall be at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 2010 and CG 20 37 forms, if later editions are used. Primary and Non -Contributory Coverage Except Workers' Compensation coverage, Contractor's insurance coverage shall allow and be endorsed primary coverage at least as broad as the most recent edition of ISO CG 20 01. Any insurance or self- insurance maintained by City, its officers, officials, employees, agents, or volunteers shall be excess of Contractor's insurance and shall not contribute to it. Notice of Cancellation Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums. If a carrier will not provide the required notice of cancellation or policy modification, the Contractor shall provide written notice to the City of a cancellation or policy modification no later than 30 business days in advance or 10 days in advance if due to non-payment of premiums. Waiver of Subrogation Contractor waives any right to subrogation against City/Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the General Liability, Automobile Liability and Workers' Compensation policies shall allow and be endorsed with a waiver of Exh. B Insurancefir it Recreation Contracts updated May 2025 2 subrogation in favor of City for all work performed by Contractor, its employees, agents, volunteers and subcontractors. This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. Deductibles and Self -Insured Retentions Any deductible or self -insured retention must be declared to and approved by the City (Insert on the Certificate of Insurance, if .zero, insert "$0"). At City's option, either: the insurer must reduce or eliminate the deductible or self -insured retentions as respects the City/Additional Insureds; or Contractor must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the insured or the City. Acceptability of Insurers Insurance shall be placed with insurers admitted in the State of California and with an AM Best rating of A- VII or higher. Verification of Coverage Contractor must furnish acceptable insurance certificates and amendatory endorsements (or copies of the policies effecting the coverage required by this Contract), including a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right to demand verification of compliance at any time during the Contract term. Subcontractors Contractor shall require and verify that all subcontractors maintain insurance that meet the requirements of this Contract, including indemnification, defense, and naming the City as an additional insured on subcontractor's insurance policies. Higher Insurance Limits If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Contractor. Adequacy of Coverage City reserves the right to modify these insurance requirements/coverages based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice. Exh. R Insurance f tr Recreation Contracts Updated May 2025 3 DATE (MMMD1YYYY) A`� o` CERTIFICATE OF LIABILITY INSURANCE 07/02/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.lf SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement onthis certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mass Merchandising K&K Insurance Group, Inc. Box 2338 PHONE PAXP.O. (AIC, No, Ext): 1-800-506 4855 (AIC. No): 1-260-459-5596 E-MAIL ADDRESS: info fiitnessinsurance-kk.00m Fort Wayne, IN 46801-2338 PRODUCER CUSTOMER ID: INSURERS) AFFORDING COVERAGE NAIC 0 INSURED: 2001874180 CP# 891 INSURER A: Markel Insurance Company 38970 Valentina Elena PAVEL INSURER B: 1190 Buttercup COVERAGES CERTIFICATE NUMBER. 2000675408 REVISION NUMBER: THIS IS TO CERTIFY THAT 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- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SURR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDD YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X X M1 RPGOOD0000500800 01/26 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR X 12:01AM 12:01 AM DAMAGE TO RENTED PREMISES (Ea Occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY PROJECT �LOC PRODUCTS--COMPIOPAGG $1,000,000 OTHER: Per RPG Member X PROFESSIONAL LIABILITY $1,000,000 LEGAL LIAB TO PAPTICIPANTS $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident) HIRED AUTOS NON -OWNED ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DIED RETENTION WORKERS COMPENSATION NIA PER STATUTE OTHER AND EMPLOYERS' LIABILITY Y f N E.L. EACH ACCIDENT ANY PROPRIETORfPARTWO EXECUTIVE OFFICERIMEMBER EXCLUDED4 E-L. DISEASE — EA EMPLOYEE IMandetury in NH) If yes, desaihe under E.L. DISEASE — POLICY LIMIT DESCRIPTION OF OPERATIONS helaw MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required) Certified Instructor of: Dance, Exercise, ZUMBAV The certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured. Primary and Noncontributory is added via form MGL 1574, Waiver of Transfer of Rights of Recovery Against others to us is added via form CG2404 Sexual Abuse or Sexual Molestation Liability - $100,000 Each Occurrence (included above)/ $300,000 Aggregate (included above) This Certificate voids and replaces certificate# W03021904 CERTIFICATE HOLDER CANCELLATION City of Cupertino, Its City Counsil, Officers, Officials, Employees, Agents, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Servants, and Volunteers EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH 10300 Torre Ave THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cupertino, CA 95015 Owner/ManagerlLessor of Premises © 1988-2015 ACORD CORPORATION. All rights reserved. Coverage is only extended to U.S. events and activities. "' NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. ACORD 25 t2016103j The ACORD name and logo are registered marks of ACORD POLICY NUMBER: M1 RPGOOOOOOO500800 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) City of Cupertino, Its City Counsii, Officers, Officials, Employees, Agents, Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95015 Named Insured: Valentina Elena PAVEL CP# 891 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 1 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE M1 RPGOOOO000500800 07/01 /25 Markel Insurance Company NAMEDINSURED AUTHORIZE❑ REPRESENTATIVE Valentina Elena PAVEL K&K Insurance Group, Inc. COVERAGE PARTS AFFECTED COMMERCIAL GENERAL LIABILITY COVERAGE CHANGES Form MIL 1215 has been added to the policy #891 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 Copyright, ISO Commercial Risk Services, Inc., 1983 COMMERCIAL GENERAL LIABILITY gig POLICY NUMBER: MIRPGO000000500800 M=Er MARKEL INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTY PERSONS OR ORGANIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL AUTO LIABILITY COVERAGE FORM COMMERCIAL CRIME COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL PROPERTY COVERAGE FORM SCHEDULE Person(s) Or Organization(s) Number Of Days Advance Notice For Nonpayment Premium For AnyOf Other Reason City of Cupertino, Its City Counsil, Officers, Officials, Employees, Agents, 10 30 Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95015 Name Insured: Valentina Elena PAVEL CP# 891 Effective Date: 07/01 /2025 - 07101 /2026 A. If we cancel this policy for any reason, we will notify the Person(s) Or Organization(s) shown in the Schedule of this endorsement according to the applicable Number Of Days Advance Notice shown in the Schedule of this endorsement. However, in no event will the Number Of Days Advance Notice to such persons) or organizations) exceed the number of days advance notice to the first Named Insured. B. Our obligation to notify the Person(s) Or Organization(s) shown in the Schedule of this endorsement will terminate at the earlier of the current policy period expiration or when you no longer have a legal or contractual obligation to such person(s) or organization(s) to maintain insurance coverage under a policy which requires notification to the person(s) or organization(s) in the event of cancellation. C. Failure to provide such notification will not extend the policy cancellation date nor negate a cancellation of the policy. All other terms and conditions remain unchanged. MIL 1215 01 18 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. COMMERCIAL GENERAL LIABILITY gig POLICY NUMBER: MIRPGO000000500800 M=Er MARKEL INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE PROVISION - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Person Or Organization: SCHEDULE City of Cupertino, Its City Counsil, Officers, Officials, Employees, Agents, Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95015 Name Insured: Valentina Elena PAVEL CP# 891 Effective Date: 07/01 /2025 - 07/01 /2026 The following is added and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Person Or Organization shown in the Schedule of this endorsement, provided that: (1) Such Person Or Organization is an additional insured under your policy; (2) The additional insured is a Named Insured under such other insurance; and (3) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions remain unchanged. MGL 1574 DT 21 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. POLICY NUMBER: M1 RPGO000000500800 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of Cupertino, Its City Counsil, Officers, Officials, Employees, Agents, Servants, and Volunteers 10300 Torre Ave Cupertino, CA 95015 Name Insured: Valentina Elena PAVEL Effective Date: 07/01 /2025 - 07/01 /2026 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of arising out of your ongoing operations or "your work" done Rights Of Recovery Against Others To Us of Section under a contract with that person or organization and IV — Conditions: included in the "products -completed operations hazard". We waive any right of recovery we may have against This waiver applies only to the person or organization the person or organization shown in the Schedule above shown in the Schedule above. because of payments we make for injury or damage CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 GEICO Tel: 1-800-841-3000 GEICO General Insurance Company P.O. Box 509090 San Diego, CA 92150-9090 Date Issued: May 24, 2025 Named Insured Traian Pavel Elena Valentina Pavel Vehicles Coverages* Limits and/or Deductibles Vehicle 1 Vehicle 2 Vehicle 3 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Bodily Injury Liability Each Person/Each Occurrence $30,000/$60,000 $43.20 $70.80 $50.30 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Property Damage Liability ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ $50,000 $84.70 $104.40 $96.90 Uninsured & Underinsured Motorists Each Person/Each Occurrence $30,000/$60,000 $14.10 $29.20 $17.10 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Uninsured Motorists Property Damage ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ $3,500 $2.70 - - Comprehensive {Excluding Collision) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ $500 Ded $58.00 $101.60 $76.50 Collision $500 Ded - - $225.90 -------------------------------------------------------------------------------- $1,000 Ded - $731.30------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ - Emergency Road Service Full $11.60 $6.30 $11.60 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Six Month Premium Per Vehicle $214.30 $1,043.60 $478.30 --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Total Six Month Premium $1,736.20 Continued on Back DEC —PAGE (03-14) (Page 1 of 4) Renewal Page 9 of 51 'Coverage applies where a premium or $0.00 is shown for a vehicle. If you elect to pay your premium in installments, you may be subject to an additional fee for each installment. The fee amount will be shown on your billing statements and is subject to change. Dkrnuntc Single/Multi-Car Factor (All Vehicles) California Good Driver (All Vehicles) Anti -Theft Device (All Vehicles) Subclass Factor (All Vehicles) Loyalty Persistency (All Vehicles) New Car (Veh 2) Advanced Safety Features (Veh 2) Group Insurance Plan: Professional Group Insurance Plan Contract Type: A30CA Contract Amendments: ALL VEHICLES - A30CA SIGPGCW Unit Endorsements: UE316C(VEH 2,3) Class: A -N -39MM - P (VEH 1); A -N -08SF - T (VEH 2); A -N -29MF - T (VEH 3) Important Policy Information - You have elected to receive your insurance documents via electronic delivery at the electronic mail address displayed on this Declarations Page. To change the address where you receive your policy documents, visit geico.com or call 1-800-841-3000. - No coverage is provided in Mexico. - Reminder - Physical damage coverage will not cover loss for custom options on an owned automobile, including equipment, furnishings or finishings including paint, if the existence of those options has not been previously reported to us. This reminder does NOT apply in VIRGINIA, however, in Virginia coverage is limited for custom furnishings or equipment on pick-up trucks and vans but you may purchase coverage for this equipment. Please call us at 1-800-841-3000 or visit us at geico.com if you have any questions. - Congratulations! Your policy qualifies for the Professional Group Insurance Plan and includes a savings of $720.20. - Subject to the policy carrying Comprehensive and/or Collision Coverage, if a nor -owned auto, in operation while leased or rented for a fee, has a Manufacturer Suggested Retail Price above $100,000, the limits of liability for loss to the nor -owned auto is the highest of the actual cash value of any owned auto shown on the Declarations page. - GEIC❑ now offers a discount in California for advanced safety features factory -installed on many vehicles. Please be sure to review each of your vehicles on geico.com or call us at 1-800-841-3000 to confirm all applicable safety features are listed. - Coverages and/or limits were changed as you requested or due to state requirements. - For your protection, California law requires the following to appear on this form: "Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison." Continued on Next Page DEC —PAGE (03-14) (Page 2 of 4) Renewal Page 10 of 51 Important Policy Information - The State of California increased minimum coverage limits for Bodily Injury Liability to $30,000/$60,000, Property Damage Liability to $15,000, and Uninsured/Underinsured Motorist Bodily Injury to $30,000/$60,000. Your policy was adjusted to meet these new minimum limit requirements. - Confirmation of coverage has been sent to your lienholder and/or additional insured. - In California, you have the right to designate one person to receive notices from GEICQ if your policy is about to cancel or expire for non-payment. Your designee will not have any rights or benefits under your policy other than the right to receive the notice or make a payment. You can change or remove the designee at any time. If you would like to add, change or remove a designee from your policy, simply log into your account at geico.com or call us at 1-800-841-3000. - Claims incurred while an insured vehicle is being used to carry passengers for hire may not be covered by this contract. Please review the contract for a full list of exclusions and contact us if you plan to use any of your insured vehicles for this purpose. - Please verify that the coverages you requested are accurately reflected on your Declarations Page. Visit geico.com to review additional coverages and/or limits available to you. - In accordance with Section 1872.87 of the California Insurance Code, in addition to your premium, a $0.88 charge per vehicle is assessed to fund auto insurance fraud reduction initiatives. This charge is applied once per policy term per vehicle. - The number of vehicles and drivers on your policy affects the calculation of your premium. - Information about the safety features of your vehicle has impacted how we determined your premium. - The annual mileage figures applicable to the vehicles on your policy for the current and upcoming policy periods are: Vehicle Current Mileage Upcoming Mileage 2011 BMW X5 12,000 7,541 2023 Testa Model 3 11,000 12,000 2017 BMW X3 11,000 12,000 DEC_PAGE (03-14) (Page 3 of 4) Renewal Page 11 of 51 ❑EC_PAGE (03-14) (Page 4 of 4) Renewal Page 12 of 51 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 Elena Valentina Pavel. 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 07 day of 22 , 2025, at Sunnyvale , California. Valentina Pavel PRINT NAME SIGNATURE Updated 06/23/21 Fitness Instruction Final Audit Report 2025-07-22 Created: 2025-07-10 By: Webmaster Admin (webmaster@cupertino.org) Status: Signed Transaction ID: CBJCHBCAABAAMh8BPpKXChOVS12nQAIFx5LdjOnPv8sm "Fitness Instruction" History Document created by Webmaster Admin (webmaster@cupertino.org) 2025-07-10 - 10:35:38 PM GMT- IP address: 35.229.54.2 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2025-07-10 - 10:36:43 PM GMT Email viewed by Araceli Alejandre (aracelia@cupertino.org) 2025-07-10 - 10:36:52 PM GMT- IP address: 54.159.123.137 Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2025-07-10 - 10:59:59 PM GMT - Time Source: server- IP address: 71.202.76.156 Document emailed to for signature 2025-07-10 - 11:00:02 PM GMT Email viewed by 2025-07-11 - 1:51:46 AM GMT- IP address: 69.147.89.136 Webmaster Admin (webmaster@cupertino.org) added alternate signer The original signer can still sign. 2025-07-22 - 2:49:42 PM GMT- IP address: 73.93.62.184 Document emailed to for signature 2025-07-22 - 2:49:43 PM GMT Email viewed by 2025-07-22 - 2:50:22 PM GMT- IP address: 104.47.58.126 Signer entered name at signing as Valentina Pavel 2025-07-22 - 4:50:57 PM GMT- IP address: 136.226.79.85 Document e-signed by Valentina Pavel ( Signature Date: 2025-07-22 - 4:51:00 PM GMT - Time Source: server- IP address: 136.226.79.85 Powered 6y Adobe CVPERTIND Acrobat Sign Document emailed to Michael Woo (michaelw@cupertino.org) for signature 2025-07-22 - 4:51:02 PM GMT Email viewed by Michael Woo (michaelw@cupertino.org) 2025-07-22 - 4:51:13 PM GMT- IP address: 52.87.209.107 Document e-signed by Michael Woo (michaelw@cupertino.org) Signature Date: 2025-07-22 - 5:09:05 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Rachelle Sander (rachelles@cupertino.org) for signature 2025-07-22 - 5:09:07 PM GMT Email viewed by Rachelle Sander (rachelles@cupertino.org) 2025-07-22 - 5:09:15 PM GMT- IP address: 3.216.94.165 Document e-signed by Rachelle Sander (rachelles@cupertino.org) Signature Date: 2025-07-22 - 5:10:00 PM GMT - Time Source: server- IP address: 64.165.34.3 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2025-07-22 - 5:10:02 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2025-07-22 - 5:10:10 PM GMT- IP address: 100.27.194.255 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2025-07-22 - 5:33:34 PM GMT - Time Source: server- IP address: 64.165.34.3 O Agreement completed. 2025-07-22 - 5:33:34 PM GMT Powered by Adobe CVPERTIND Acrobat Sign