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HomeMy WebLinkAbout26-158 Jeff Clark Bike Fest 2026 - Sound Engineer SHORT FORM ENTERTAINMENT AGREEMENT CITY OF CUPERTINO Parks & Recreation 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: Jeff Clark Contractor Authorized Representative: Jeff Clark 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: Provide amplified sound system for Bike Fest 2026 - sound tower and fill speaker. Location: Civic Center Plaza Time: 9:00 AM - 1:00 PM. Set-up starts at 7:30 AM. B. TERM. The services and/or materials furnished under this Agreement shall be provided from 9/26/2026 to 9/26/2026. C. COMPENSATION. For the full performance of this Agreement, the City of Cupertino shall pay Contractor a total of $450.00 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 Exhibit "D" - Contractor's Mandated Reporter Declaration if Contractor provides services to children 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. General Liability Insurance. The undersigned shall maintain general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury, and property damage. Undersigned’s general liability policies shall be endorsed to provide that City and its officers, officials, employees, and agents shall be additional insureds under such policies. 3. 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, Contractor Declaration shall be attached. 4. Assignment. Contractor may not assign, transfer, or subcontract this Agreement or any portions thereof, without prior written consent of City. 5. 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. 6. 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. 7. 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: Birgit Werner. May 5, 2020 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 Tax I.D. No.: APPROVED AS TO FORM: MICHAEL K. WOO Senior Assistant City Attorney ATTEST: LAUREN SAPUDAR City Clerk Date Jeff Clark Sound Engineer Aug 30, 2061 Michael K Woo Chad Mosley Director of Public Works Sept 17, 2026 Lauren Sapudar Sept 17, 2026 Revised 2.06.23 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 ____________, 2026, at , California. ______________________________ PRINT NAME ______________________________ SIGNATURE Exhibit C EventSound 17 September Santa Cruz Jeff Clark CERTIFICATE NO.: - CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. P O Box 744963 Los Angeles, CA 90074-4963 License No: OC 36861 City of Cupertino, Its City Council, Officers, Officials, Employees, Agents, Servants and Volunteers Amended certificate replaces all prior certificates NAMED INSURED (EVENT HOLDER): City of Cupertino, its City Council, Officers, Officials, Employees, Agents, Servants and Volunteers 10300 Torre Ave Cupertino, CA 95014 EVENT INFORMATION: TYPE: 2026 Cupertino Fall Bike Fest DATE(S): September 26, 2026 LOCATION: Cupertino Civic Center, 10350 Torre Ave, Cupertino, CA 95014 *Liquor Liability Yes No **Liquor Liability after 12 am ends before 2 am This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2026 EXPIRATION: JANUARY 1, 2027 COMMERCIAL GENERAL LIABILITY General Aggregate Limit Products & Completed Operations Personal & Advertising Injury Each Occurrence Limit Damage To Premises Rented To You (Any One Premises) Medical Payments (Any One Person) Liquor Liability (If purchased) Optional Limits Purchased $1,000,000/$3,000,000 $2,000,000/$2,000,000 Damage To Property (If purchased) Waiver of Subrogation (If Purchased) X Yes No $ 2,000,000 1,000,000 1,000,000 1,000,000 100,000 5,000 1,000,000 OCCURRENCE FORM DEDUCTIBLE: NONE SPECIAL CONDITIONS: The following endorsements attached to the Master Policy do not apply to this Certificate Of Insurance: The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. OTHER ADDITIONAL INSUREDS Civic Park Master Association Black Mountain Composite Mountain Bike Team Tim Oey Bruce Hildenbrand Jeff Clark Climate Carnival CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: 7/27/26 Page 1 of 2MDIL 1001 08 11 EVANSTON INSURANCE COMPANY FORMS SCHEDULE POLICY NUMBER: FORM NUMBER FORM NAME MJIL 1000 08 10 MPIL 1007 01 20 MPIL 1039-CA 01 20 MPIL 1041 02 20 MPIL 1083 04 15 MDIL 1001 08 11 IL 00 21 09 08 MEIL 1231 10 13 MDGL 1008 08 11 BC CG 00 01 04 13 CG 02 24 10 93 CG 20 01 04 13 CG 20 11 04 13 CG 20 26 04 13 CG 21 33 11 85 CG 21 47 12 07 CG 21 58 04 13 CG 21 70 01 15 CG 21 76 01 15 CG 21 96 03 05 IL 00 17 11 98 MEGL 0241 05 16 MEGL 1639 08 14 MEGL 2300 11 19 MEGL 2322 05 21 MEGL 5300 05 16 MEGL 5302 05 16 MEGL 5303 05 16 MEIL 1200-CA 02 23 MEIL 1225 10 11 MEIL 1251 10 21 MGL 1319 01 16 MGL 1356 10 20 MIL 1214 09 17 IL 12 01 11 85 MDIL 1000-CA 08 11 Common Policy Declarations Policy Changes - for CA Trade or Economic Sanctions Exclusion - Cyber Incident, Data Compromise, And Violation Of Statutes Related To Personal Data Exclusion - Unmanned Aircraft Two Or More Coverage Forms or Policies Changes - Civil Union Service Of Suit - California Exclusion - Lead Exclusion - Asbestos Exclusion-Organic Pathogen And Legionellae Exclusion - Communicable Disease Exclusion - Marijuana Excl - Aircraft and Hot Air Balloon Rides, Demos & Waiver Of Transfer of Rights Against Others to Us Common Policy Conditions ESX Silica Or Silica-Related Dust Exclusion Exclusion Of Punitive Damages Related To A Certified Act Of Terrorism Cap on Losses From Certified Acts of Terrorism Exclusion - Professional Veterinarian Services Employment Related Practices Exclusion Exclusion - Designated Products Additional Insured - Desg Person or Organization Additional Insured-Managers or Lessors of Premises Primary & Noncontributory - Other Ins Condition Earlier Notices of Cancellation Provided By Us Commercial General Liability Coverage Form Commercial General Liability Coverage Part Declarations Minimum Earned Premium And Minimum Retained Premium Nuclear Energy Liability Exclusion Endorsement GD Forms Schedule U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders How To Report A Claim California Surplus Lines Notice (D-2) Privacy Notice Policy Jacket/Signature Page Page 2 of 2MDIL 1001 08 11 Abuse, Molestation, Or Exploitation Coverage-Defense Costs Within Limits Concert or Performance Exclusions and Limitations Exclusion - Aircraft and Watercraft Liability Assumed Under An Insured Contract Exclusion - Amusement Devices and Rides Exclusion - Boxing, Wrestling and Contact Martial Arts Exclusion - Entertainers, Participants and Equipment Exclusion - Fireworks, Pyrotechnics and Flashboxes Exclusion - Motorized Sporting Events Exclusion - Professional Sporting Events Exclusion - Rodeos and Roping Events Exclusion - Obstacle Course Races and Mud Runs Additional Insured - Concessionaires, Exhibitors and vendors Aggregate Limit of Insurance Broadened Insurance Damage to Property Coverage Liquor Liability Coverage Premium Reporting Primary and Noncontributing Insurance Exclusion-Abuse, Molestation, Or ExploitationMEGL 2632 01 24 MEGL 1857 11 17 MEGL 1856 10 14 MEGL 1855 08 14 MEGL 1854 08 14 MEGL 1853 10 14 MEGL 1852 08 14 MEGL 1851 08 14 MEGL 1664 08 15 MEGL 1647 08 14 MEGL 1646 08 14 MEGL 1645 08 14 MEGL 1644 08 14 MEGL 1643 08 14 MEGL 1642 10 14 MEGL 1641 05 16 MEGL 1640 08 14 MEGL 1638 11 19 MEGL 0205 01 24 © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 26 04 13 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 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. COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 POLICY NUMBER: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Name Of Additional Insured Person(s) Or Organization(s): City of Cupertino, Its City Council, Boards and Commissions, Officers, Officials, Employees, Agents, Servants, and Volunteers Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1MEGL 0241 5 16 EVANSTON INSURANCE COMPANY 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 FORM The following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us under Section IV – Commercial General Liability Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule of this endorsement with respect to written contracts that exist between you and such person or organization, provided you have agreed in writing to furnish this waiver. This waiver applies only to the person or organization shown in the Schedule of this endorsement. All other terms and conditions remain unchanged. SCHEDULE COMMERCIAL GENERAL LIABILITY POLICY NUMBER: Name Of Person Or Organization: Additional Premium:$150 per Tenant/User or Instructor/Recreation Event Waiver is provided to a state or municipal public entity when required for an individual "Tenant/User Event" or "Instructor/Recreation Event", and when this waver has been elected and purchased for that individual event. A “Tenant/User Event” is an event that is held or sponsored by companies, organizations, or individuals that have been permitted to use your premises. An “Instructor/Recreation Event” is an event that is instructional to its participants. Instructors are not employees of the public entity, but provide instructional services for a fee. © Insurance Services Office, Inc., 2012 Page 1 of 1 CG 20 01 04 13 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition 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 an additional insured under your policy provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)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. Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 CG 02 24 10 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 90 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. COMMERCIAL GENERAL LIABILITY CG 02 24 10 93 POLICY NUMBER: Form_SCTNID_CTGRY.CA05216489_DECPAGE 973898350 R FB86020 INS DECPAGE U POLWHITEFONT 5LQW7HJEJYLJUMGCLA2UPSYI4D0001 RPUID TRACWHITEFONT BDF_PCA Policy number: Underwritten by: Progressive Express Ins Page of Policy Period: Apr 4, 2026 1 2 - April 6, 2026 Oct 4, 2026 Online Service Make payments, check billing activity, print policy documents, update your policy or check the status of a claim. progressivecommercial.com For customer service and claims service, 24 hours a day, 7 days a week. 1-800-895-2886 Cleveland, OH 44101 P.O. Box 94739 Progressive Named insured Commercial Auto Insurance Coverage Summary This is your revised Renewal Declarations Page Your policy period has changed Your coverage began on April 4, 2026 at the later of 12:01 a.m. or at the time that payment was made. This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits. The policy contract is form 6912 (02/19) . The contract is modified by forms 2852CA (03/24), 4852CA (02/19), 4881CA (02/19) and Z228 (01/11). The named insured organization type is a sole proprietorship. Outline of coverage Description Limits Deductible Premium……………………………………………………………………………………………………………………………………………………….. Bodily Injury Liability $30,000 each person/$60,000 each accident Liability To Others $168 Property Damage Liability $15,000 each accident………………………………………………………………………………………………………………………………………………………..Uninsured/Underinsured Motorist $30,000 each person/$60,000 each accident 57……………………………………………………………………………………………………………………………………………………….. Rejected --Uninsured Motorist Property Damage……………………………………………………………………………………………………………………………………………………….. Rejected --Medical Payments……………………………………………………………………………………………………………………………………………………….. See Auto Coverage Schedule Limit of liability less deductible 26Comprehensive Subtotal policy premium ……………………………………………………………………………………………………………………………………………………….. $251.00……………………………………………………………………………………………………………………………………………………….. California Vehicle Assessment Fee 0.88 ……………………………………………………………………………………………………………………………………………………….. Total 6 month policy premium and fees $251.88 Important information about fees The following additional fees may apply: Late payment fee $10.00 Fee for returned checks or refused payments $20.00 Rated drivers ………………………………………………………………………………………………………………………………………………….. Jeffrey Clark1.W 4 Continued Form 6489 CA (05/21) 973898350 R FB86020 INS DECPAGE U POLWHITEFONT 5LQW7HJEJYLJUMGCLA2UPSYI4D0001 RPUID TRACWHITEFONT BDF_PCA Policy number: Jeffrey W Clark Page of 2 2 Auto coverage schedule 1998 ISUZU NPR Stated Amount: * $5,000 (including Permanently Attached Equip) VIN: JALB4B1K3W7000999 Garaging Zip Code: 95062 Radius: 300 miles Personal use: N Body type: Box Truck 1. Liability Premium ……………………………………………………………………………………………………………………………………………… Liability Premium $168 UM/UIM Premium $57 Physical Damage ………………………………………………………………………………………………………………………………………………Premium $251 Auto TotalComp Deductible $2,500 Comp Premium $26 *A vehicle's stated amount should indicate its current retail value, including any special or permanently attached equipment. In the event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value, less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Important Notice 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. Company officers President Secretary Form 6489 CA (05/21) 70 Fenchurch Street London EC3M 4BR Telephone: +44 (0)20 3037 8000 Fax: +44 (0)20 3037 8010 www.tysers.com CLAIMS MADE SEXUAL MISCONDUCT AND MOLESTATION INSURANCE Form:Tysers SafeGuard 2021-Primary Policy Number: Unique Market Reference: B0572TBA Renewal of: MR254153 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 2026 To: 1st July 2027 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 45,000 (annual) plus applicable taxes Notification pursuant to Clause IX. Shall be given to: Beazley Group Attn: Claims Group 65 Memorial Road, Suite 320, West Hartford Connecticut 06107, United States of America. 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: East Tower, 25th Floor New York, NY 10017 Governing Law: New York Conditions: Application Dated: 26th May 2026 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, Inc Rolling Meadows, IL 60008 License Number: 0C66724 State of Filing: CA Subject to: 1. Confirmation of the Surplus Lines Broker. Including name of individual, company name, address and license number. All subjectivities to be received prior to binding otherwise Underwriters reserve the right to amend terms or cancel ab initio. Information:Employees 210 Volunteers 0 Independent Contractors 110 Total FTE count - 320 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: Information About Lloyd's) Validity Period: Expires 1st July 2026