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10-001 Kidz Love Soccer CITY OF / AGREEMENT CITY OF CUPERTINO 10300 Torre Avenue 4 ,1.' 9 6. 3 Cupertino, CA 95014 `s / (408) 777 -3200 NO. CUPERTINO ' Fiscal Year 2010 -2011 BY THIS AGREEMENT made and entered into on the 12th day of February, 2010 by and between the CITY OF CUPERTINO (Hereinafter referred to as CITY) and (1) Kidz Love Soccer Address: Hereinafter referred to as CONTRACTOR), in consideration of their mutual covenants, the parties hereto agree as follows: CONTRACTOR shall provide or furnish the following specified services and /or materials: Soccer Instruction EXHIBITS: The following attached exhibits hereby are made part of this Agreement: Exhibit A TERMS: The services and /or materials furnished under this Agreement shall commence on July 1, 2010 and shall be completed by June 30, 2011. COMPENSATION: For the full performance of this Agreement, CITY shall pay CONTRACTOR: 70% of the Resident Fee (Minus a $10.00 Administration Fee per Participant) GENERAL TERMS AND CONDITIONS: Hold Harmless. CONTRACTOR agrees to save and hold harmless the CITY, its officers, agents, and employees from any and all damage and liability of every nature, including all costs of defending any claim, caused by or arising out of the performance of this Agreement. CITY shall not be liable for acts of CONTRACTOR in performing services described herein. Insurance. Should the CITY require evidence of insurability, CONTRACTOR shall file with CITY a Certificate of Insurance before commencing any services under this Agreement. Said Certificate shall be subject to the approval of CITY'S Director of Administrative Services. Non - Discrimination. It is understood and agreed that this Agreement is not a contract of employment in the sense that the relation of master and servant exists between CITY and undersigned. At all times, CONTRACTOR shall be deemed to be an independent contractor and CONTRACTOR is not authorized to bind the CITY to any contracts or other obligations in executing this Agreement. CONTRACTOR certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of CITY. Changes. This Agreement shall not be assigned or transferred without the written consent of the CITY. No changes or variations of any kind are authorized without the written consent of the CITY. CONTRACT COORDINATOR and representative for CITY shall be: ENTERED NAME: Jeff Ordway DEPARTMENT: Parks & Recreation This Agreement shall become effective upon its execution by CITY. In witness thereof, the parties have exe ed this Agreement By: - By: . ) - 1// 6 7 IC Title: S . Title: Recreation Coordinator APPROVALS EXPENDITURE DISTRIBUTION DEPART TE ACCOUNT NUMBER AMOUNT 3 "( /4?‘ 580 - 6449 -7014 $36,000 CITY CL RK DAT 41,10 11 �c'T,lp CUPERTINO City of Cupertino Contractor Affidavit The undersigned does hereby certify that: 1. I am a representative of kt „e _cc e or company name); that I am familiar with the fact herein certified and am authorized and qualified to execute this certificate. 2. I verify that Lo-,,.r r-- (contract or company name) has complied with fingerprinting and criminal background investigation requirements with respect to all Contractor's employees who may have contact with minors in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in California Penal Code Section 11105.3 3. That a complete and accurate list of Contractor's employees who may come in contract with minors during the course and scope of the contract is included below 4. All of the below mentioned employees have tested negative for TB, or X -ray results for TB, and have current documentation on file with Contractor. A List of all Contractor Employees Working for the City of Cupertino: / r In a. (self V 1. 12, - , Li e MM e; 1"w\ Ne Ev C,v/ 2 I?onr, fv 1 ell A t ,Vorncr5 . 1\\2y (maces le` b ce • 5. The City of Cupertino will be notified by Contractor of any new employees and will be added to the above list prior to beginning work for the City of Cupertino. Contractor Si /� Signature: � Date: 2/4 � /G' Staff Title: ' f i. t . _ „ 1 141 l EXHIBIT A 1. The City reserves the right to terminate this Agreement with a 30 -day notice. The contractor may terminate this Agreement with a 30 -day written notice. 2. In the event that the Contractor has employees who will assist in the performance of this Agreement, Contractor shall file with City a Certificate of Worker's Compensation Insurance and for those instructing persons 18 years and younger, provide fingerprint clearance and current TB test. 3. In the event that less than the required minimum number of participant shall request and pay for services prior to the agreed upon time for the commencement of services to be preformed by Contractor, City may cancel and withdraw from this Agreement. 4. City shall have no right of control as to they 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. 5. The 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. The Contractor shall not promote his /her business to participants /egistere,d in the City's programs. // Revised 9/23/07 DATE (MMIDDIYYYY) coR °® CERTIFICATE OF LIABILITY INSURANCE K1DZLs2 12/02/09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER SBC Insurance Services , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . 150 E1 Camino Real Bldg B #31 - ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ,s Altos CA 94022 NAtC # Phone: 650-469-0400 Fax: 650 - 469•-0420 INSURERS AFFORDING COVERAGE INSURED INSURER A: Markel Insurance Company North American Youth INSURER B: Activities, LLC dba Kidz Love INSURER C: Soccer - P.O. Box 95 ' NSURER D: Cupertino CA 95015 NsuRERE: 1 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 10 ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POI.ICY EFFECTIVE POLICY EXPIRATION INSR ADD1 POLICY NUMBER OATS (MMFDOCYYYY) DATE (MMIDDRYYYY) LIMITS LTR INSRC TYPE OF INSURANCE EACH OCCURRENCE $1,000,000 GENERAL LIABILITY DAMA(it rOReNttO $LOO OOO A X COMMERCIAL GENERAL LIABILITY 8502AH02? 045 12/01/09 12/01/10 PREMISES {Eaoccurence) r CLAIMS MADE 1 I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS- COMP /OPAGG $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER - I POLICY FI PRO- JECT n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ . I OCCUR 1 1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WC STAI U- Ol H- WORKERS COMPENSATION 1 WC LIMITS 1 r ER AND EMPLOYERS' LIABILITY EL EACH ACCIDENT $ ANY PROPRIETORIPARTNERJEXECUTIV OFFICERIMEMBER EXCLUDED? I , E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) II ye, describe under EL DISEASE - POLICY LIMIT $ SP PROVISIONS below OTHER A Accident Insurance 4102AH021044 12/01/09 12/01/10 Med. Max: 100,000 Full Access Ded: DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI CITCUPE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEF City of Cupertino NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAT Parks and Recreation Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attn; Jeff Ordway REPRESENTATIVES. 10185 N. 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