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HomeMy WebLinkAboutA6414 - STEVE BECK, SHOTOKAN KARATE City of Palm Springs Parks & Recreation Department gi Recreational Instructor Agreement NAME: Steve Beck ADDRESS: 2801 E. Avery Drive, #D31 Palm Springs, CA 92264 PHONE: (760)449-7223 INSTRUCTION TYPE: Shotokan Karate This Recreational Instructor Agreement ("Agreement") is made and entered into this day of , 20 by and between the CITY of Palm Springs, a California charter city and municipal corporation, ("CITY") and Steve Beck, Shotokan Karate, an individual or entity and his/her employees, agents, or officers (collectively referred to as "INSTRUCTOR"). I. SCOPE OF WORK A. CITY seeks to provide Shotokan Karate instruction. INSTRUCTOR shall perform all necessary and appropriate services consistent with that purpose ("Services"). These Services shall be non-exclusive. Services are detailed in Exhibit "A," attached hereto and incorporated herein by.reference. B. Services shall be performed at Demuth Community Center("Facilities"). C. INSTRUCTOR warrants that he/she is qualified to provide CITY with Services, and holds all necessary certifications and licenses. D. INSTRUCTOR warrants that he/she will provide all necessary supplies, equipment, personnel, and other such necessities that enable him/her to perform all services in a safe, competent, and professional manner. . E. INSTRUCTOR shall perform Services in a manner consistent with industry standards and the expectations of a reasonable person. II. DURATION A. Services shall begin on November 1, 2018 and end on October 31, 2019. B. This Agreement may be extended by written agreement between CITY and INSTRUCTOR. C. CITY may terminate this Agreement at any time, with or without cause, by giving written notice to INSTRUCTOR. Upon receipt of notice of termination, INSTRUCTOR shall cease performance of all Services on the date set forth on the notice of termination, or immediately if no date is provided. INSTRUCTOR shall be entitled only to compensation for services rendered prior to the termination date. 1 1159537.1 III. COMPENSATION A. CITY agrees to pay INSTRUCTOR for the performance of Services on the following terms: 1. Flat fee $ 2. Hourly fee $ 3. Contingent fee $ per 4. Other 70% of total class receipts received by the City. B. City shall provide payment to INSTRUCTOR on a monthly basis following the final class/es of the month in. accordance with the City's accounts payable- schedule. C. INSTRUCTOR shall not be entitled to any additional compensation of any kind, including but not limited to, payment to INSTRUCTOR'S own employees, reimbursement of expenses, and benefits. IV. USE OF FACILITIES A. INSTRUCTOR shall only use the Facilities for the Services described in this Agreement. B. INSTRUCTOR shall be responsible for any damage caused to the Facilities arising out of his/her rendering of the Services. C. INSTRUCTOR shall ensure that the Facilities are clean following each use. D. INSTRUCTOR shall ensure that the Facilities are secured following each use. V. INSURANCE INSTRUCTOR shall procure and maintain, at its sole cost and expense, policies of insurance as set forth in Exhibit "B," attached-hereto and incorporated herein by reference. VI. INDEMNITY To the fullest extent permitted by law, INSTRUCTOR shall defend (at INSTRUCTOR'S sole cost and expense), indemnify, protect, and hold harmless CITY, its officials, officers, employees, agents and volunteers (collectively the "Indemnified Parties"), from and against any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, penalties, and expenses including legal costs and attorney fees (collectively "Claims"), including but not limited to, Claims arising from injuries to or death of persons (INSTRUCTOR'S employees included), for damage to property, including property owned by CITY, or from any violation of any federal, state, or local law or ordinance, which Claims arise out of, pertain to, or are related to INSTRUCTOR'S performance under this Agreement. This indemnification clause excludes Claims arising from the sole negligence or willful misconduct of the CITY, its elected officials, officers, employees, agents, and volunteers. Under no. circumstances shall the insurance requirements and limits set forth in this Agreement be construed to limit INSTRUCTOR'S indemnification obligation or other liability hereunder. INSTRUCTOR'S indemnification obligation shall survive the expiration or earlier termination of this Agreement until all actions against the Indemnified Parties for such matters indemnified are fully and finally barred by the applicable statute of limitations or, if an action is timely filed, until such action is final. This provision is intended for the benefit of third party Indemnified Parties not otherwise a party to this Agreement. 2 1159537.1 VII. INDEPENDENT INSTRUCTOR The legal relationship between the Parties is that of an independent contractor, and nothing herein shall be deemed to snake INSTRUCTOR a CITY employee. During the performance of this Agreement, INSTRUCTOR and its officers, employees, and agents shall act in an independent capacity and shall not act as CITY officers or employees. INSTRUCTOR will determine the means, methods and details of performing the Services subject to the requirements of this Agreement. The personnel performing the Services under this Agreement on behalf of INSTRUCTOR shall at all times be under INSTRUCTOR'S exclusive direction and control. Neither CITY nor any of its officials, officers, employees, agents or volunteers shall have control over the conduct of INSTRUCTOR or any of its officers, employees, or agents, except as set forth in this Agreement. INSTRUCTOR, its officers, employees or agents, shall not maintain a permanent office or fixed business location at CITY'S offices. CITY shall have no voice in the selection, discharge, supervision, or control of INSTRUCTOR'S officers, employees, representatives or agents or in fixing their number, compensation, or hours of service. INSTRUCTOR shall pay all wages, salaries, and other atnounts due its employees in connection with the perfonnance of Services under this Agreement and shall be responsible for all reports and obligations respecting them, including but not limited to social security income tax withholding, unemployment compensation, workers' compensation, and other similar matters. CITY shall not in any way or for any purpose be deemed to be a partner of INSTRUCTOR in its business or otherwise a joint venture or a member of any joint enterprise with INSTRUCTOR. VIII. SUBCONTRACTING OR ASSIGNMENT PROHIBITED INSTRUCTOR'S expertise, capability, and reputation were a substantial inducement for CITY to enter into this Agreement. A. Only those authorized in writing by the CITY may render Services or perform any term of this Agreement. B. INSTRUCTOR shall not agree with any other party to perform the Services without the CITY'S express prior written approval. C. This Agreement shall not be assigned in whole or in part to another party without CITY'S express prior written approval. IX. INTEGRATED AGREEMENT This Agreement contains all terms and conditions between INSTRUCTOR and CITY and cannot be supplemented or modified without mutual written agreement. X. COMPLIANCE WITH THE LAW A. INSTRUCTOR shall perform all Services in accordance with all applicable federal, state, and local laws. B. INSTRUCTOR shall obtain and keep current any necessary licenses or permits necessary for the lawful performance of Services. C. In the performance of Services, INSTRUCTOR shall not discriminate against any person or group of persons on account of race, color, creed, religion, sex, marital status, disability, sexual orientation, national origin, or ancestry. XI. CRIMINAL BACKGROUND CHECK CITY may require INSTRUCTOR to submit to, and pass, a criminal background investigation prior to the conunencement of Services. 3 1159537.1 XII. LEGAL ACTION In addition to any other rights or remedies, either Party may take legal action, in law or in equity, to cure, correct or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement. XIII. ATTORNEY FEES In the event any dispute between the Parties with respect to this Agreement results in litigation or any non judicial proceeding, the prevailing Party shall be entitled, in addition to such other relief as may be granted, to recover from the non-prevailing Party all reasonable costs and expenses, including but not limited to, reasonable attorneys' fees, expert INSTRUCTOR fees, court costs and all fees, costs, and expenses incurred in any appeal or in collection of any judgment entered in such proceeding. To the extent authorized by law, in the event of a dismissal by the plaintiff or petitioner of the litigation or non judicial proceeding within thirty (30) days of the date set for trial or hearing, the other Party shall be deemed to be.the prevailing Party in such litigation or proceeding. INSTRUCTOR hereby warrants that he/she has fully read this Agreement, understands and agrees to each and every term, and is authorized to sign on behalf of any authorized persons performing the Services. Instructor Signature Date Sl-eve Beck O'b l e.F xnSTruC►v�` Printed Name/Title avid H. Ready, City Manager.--"'— anage Date ity of Palm Springs 3200 E. Tahquitz Canyon Way APPROVED Fy r,M!MANAGER ATfE Palm Springs, CA 92262 ',1 760.323.8201 _ __r W14 City APPROVED AS TO FORM: Date City Attorney J 4 1159537.1 EXHIBIT A 1. Describe activity/instruction and services to be rendered: Shotokan Karate. voo�n2n 0,,Y16 e-n V-o.Y-C- -e \Vas i cs, a\ck Ck. OL h Coard' YICAL�i��o � 2. Frequency of meetings: Mondays, 6:00 p.m. —7:00 p.m.; Tuesdays &Thursdays, 12:00 p.m. — 1:00 p.m. & 5:30 p.m. — 8:00 p.m.; Wednesdays, 5:30 p.m. —8:00 p.m.; and Fridays, see instructor of details. 3. List all instructors, employees, assistants, helpers, volunteers: NAME ROLE 4. List materials and supplies to be used: C,k v1G� SOn�6)6 S CkY 6 3rbcus 5. Estimated class size: e'en Vo +W vu,c t 6. Fee schedule: ,$80/month—Family discount available. Z50 l�er�nnon��n 2 nd gdc4i }-i orl c-'\ Vcd\^''\\�) YN evvkbeY-70 5 1159537.1 EXHIBIT B INSURANCE 1. Types of Insurance. INSTRUCTOR shall procure and maintain, at its sole cost and expense, the insurance described below. The insurance shall be for the duration of this Agreement and includes any extensions, unless otherwise specified in this Agreement. The insurance shall be procured in a forin and content satisfactory to CITY. The insurance shall apply against claims which may arise from the INSTRUCTOR'S performance of Services under this Agreement, including INSTRUCTOR'S agents, representatives, or employees. In the event the City Manager determines that the Services to be-performed under this Agreement creates an increased or decreased risk of loss to the CITY, the INSTRUCTOR agrees that the minimum limits of the insurance policies may be changed accordingly upon receipt of written notice from the City Manager or his designee. INSTRUCTOR shall immediately substitute any insurer whose A.M. Best rating drops below the levels specified in this Agreement. All insurance provided under this Agreement shall be on an occurrence basis. The minimum amount of insurance required shall be as follows: A. Workers' Compensation Insurance. INSTRUCTOR shall obtain and maintain, in full force and effect throughout the term of this Agreement, workers' compensation insurance in at least the minimum statutory amounts, and in compliance with all other statutory requirements, as required by the State of California. INSTRUCTOR agrees to waive and obtain endorsements from its workers' compensation insurer waiving subrogation rights under its workers' compensation insurance policy against the CITY and to require each of its subcontractors, if any, to do likewise under their workers' compensation insurance policies. If INSTRUCTOR has no employees, INSTRUCTOR shall complete the CITY'S Request for Waiver of Workers' Compensation Insurance Requirement form. B. Commercial General Liability Insurance. INSTRUCTOR shall obtain and maintain, in full force and effect throughout the term of this Agreement, a policy of commercial general liability insurance written on a per occurrence basis with a combined single limit of at least one million dollars ($1,000,000.00) and two million dollars ($2,000,000.00) general aggregate for bodily injury and property damage including coverages for contractual liability, personal injury, independent contractors, broad form property damage, products and completed operations. 2. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City Manager or his/her designee prior to commencing any Services under this Agreement. INSTRUCTOR guarantees payment of all deductibles and self-insured retentions. CITY reserves the right to reject deductibles or self-insured retentions in excess of$10,000, and the City Manager or his/her designee may require evidence of pending claims and claims history as well as evidence of INSTRUCTOR'S ability to pay claims for all deductible amounts and self-insured retentions proposed in excess of$10,000. 3. Other Insurance Requirements. The following provisions shall apply to the insurance 6 1159537.1 policies required of INSTRUCTOR under this Agreement: A. For any claims related to this Agreement, INSTRUCTOR'S coverage shall be primary insurance with respect to the CITY and its officers, council members, officials, employees, agents, and volunteers. Any insurance or self-insurance maintained by the CITY and its officers, council members, officials, employees, agents, and volunteers shall be in excess of INSTRUCTOR'S insurance and shall not contribute with it. B. Any failure to comply with reporting or other provisions of the policies, including breaches of warranties, shall not affect coverage provided to CITY and its officers, council members, officials, employees, agents, and volunteers. C. All insurance coverage and limits provided by INSTRUCTOR and available or applicable to this Agreement are intended to apply to each insured, including additional insureds, against whom a claim is made or suit is brought to the full extent of the policies. Nothing contained in this Agreement or any other agreement relating to the CITY or its operations shall limit the application of such insurance coverage. D. No required insurance coverages may include any limiting endorsement which substantially impairs the coverages set forth in this Agreement (e.g., elimination of contractual liability or reduction of discovery period), unless the endorsement has first been submitted to the City Manager and approved in writing. E. INSTRUCTOR agrees to require its insurer to modify insurance endorsements to delete any exculpatory wording stating that failure of the insurer to mail written notice of cancellation imposes no obligation, or that any party will "endeavor" (as opposed to being required) to comply with the requirements of the endorsements. Certificates of insurance will not be accepted in lieu of required endorsements, and submittal of certificates without required endorsements may delay commencement of the Project. It is INSTRUCTOR'S obligation to ensure timely compliance with all insurance submittal requirements as provided in this Agreement. F. INSTRUCTOR acknowledges and agrees that any actual or alleged failure on the part of the CITY to infonn INSTRUCTOR of non-compliance with any insurance requirement in no way imposes any additional obligations on the CITY nor does it waive any rights in this or any other regard. G. INSTRUCTOR shall provide proof that policies of insurance required in this Agreement, expiring during the term of this Agreement, have been renewed or replaced with other policies providing at least the same coverage. Proof that such coverage has been ordered shall be submitted prior to expiration. Endorsements as required in this Agreement applicable to the renewing or new coverage shall be provided to CITY no later than ten (10) days prior to expiration of the lapsing 7 1159537.1 coverage. H. Requirements of specific insurance coverage features or limits contained in this section are not intended as limitations on coverage, limits, or other requirements, or as a waiver of any coverage normally provided by any given policy. Specific reference to a given coverage feature is for purposes of clarification only as it pertains to a given issue, and is not intended by any party or insured to be limiting or all-inclusive. I. The requirements in this section supersede all other sections and provisions of this Agreement to the extent that any other section or provision conflicts with or impair the provisions of this section. J. INSTRUCTOR agrees to provide immediate notice to CITY of any claim or loss against INSTRUCTOR arising out of the Services performed under this Agreement and for any other claim or loss which may reduce the insurance available to pay claims arising out of this Agreement. CITY assumes no obligation or liability by such notice, but has the right (but not the duty) to monitor the handling of any such claim or claims if they are likely to involve CITY, or to reduce or dilute insurance available for payment of potential claims. K. INSTRUCTOR agrees that the provisions of this section shall not be construed as limiting in any way the extent to which the INSTRUCTOR may be held responsible for the payment of damages resulting from the INSTRUCTOR'S activities or the activities of any person or person for which the INSTRUCTOR is otherwise responsible. 4. Sufficiency of Insurers. Insurance required in this Agreement shall be provided by authorized insurers in good standing with the State of California. Coverage shall be provided by insurers admitted in the State of California with an A.M. Best's Key Rating of B++, Class VII, or better, unless such requirements are waived in writing by the City Manager or his designee due to unique circumstances. 5. Verification of Coverage. INSTRUCTOR shall furnish CITY with both certificates of insurance and endorsements, including additional insured endorsements, affecting all of the coverages required by this Agreement. The certificates and endorsements are to be signed by a person authorized by that insurer to bind coverage on its behalf. All proof of insurance is to be received and approved by the CITY before work commences. CITY reserves the right to require INSTRUCTOR'S insurers to provide complete, certified copies of all required insurance policies at any time. Additional insured endorsements are not required for Workers' Compensation policies. Verification of Insurance coverage may be provided by: (1) an approved General and/or Auto Liability Endorsement Form for the City of Palm Springs or(2) an acceptable Certificate of Liability. Insurance Coverage with an approved Additional Insured Endorsement with the following endorsements stated on the certificate: 8 1159537.1 A. "The City of Palm Springs, its officials, employees, and agents are named as an additional insured..." ("as respects City of Palm Springs Contract No. " or 'for any and all workperformed with the City"may be included in this statement). B. "This insurance is primary and non-contributory over any insurance or self- insurance the City may have..." ("as respects City of Palm Springs Contract No. " or 'for any and all work performed with the City" may be included in this statement). C. "Should any of the above described policies be canceled before the expiration date thereof, the issuing company will mail 30 days' written notice to the Certificate Holder named." Language such as, "endeavor to" mail and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representative" is not acceptable and must be crossed out. D. The Workers' Compensation policy shall contain the insurer's waiver of subrogation in favor of CITY, its elected officials, officers, employees, agents, and volunteers. In addition to the endorsements listed above, the City of Palm Springs shall be named the certificate holder on the policies. All certificates of insurance and endorsements are to be received and approved by the CITY before Services commence. All certificates of insurance inust be authorized by a person with authority to bind coverage, whether that is the authorized agent/broker or insurance underwriter. Failure to obtain the required documents prior to the commencement of Services shall not waive the INSTRUCTOR'S obligation to provide them. 9 1159537.1 CERTIFICATE OF LIABILITY INSURANCE DAT512�QD'9' 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 INSURER(S), AUTHORIZED ..REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must.be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights. to the certificate holder In lieu of such-endorsement(s).. PRODUCER 'CONTACT _ FRANCIS L.DEAN&'ASSOCIATES,LLC NAME: 12800 UNIVERSITY DR STE 125 PHONE o Eal: (sQQ)745-2409 FAX,Nu: (630)66577294 FORT MYERS FL 33907-5335 E-MAIL info@fdean.com r ADDRESS: (800)745-2409 INSURERS)AFFORDING COVERAGE NAIC d MSURERA: United States Fire Insurance 21113 INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION(PURCHASING GROUP}AND UISURERB: ITS PARTICIPATING MEMBERS INSURERC;. Steve Anthony Beck INSURERD: 30356 Sterling Road Cathedral City,CA 92234 INSURERS; INSURERF; COVERAGES .CERTIFICATE NUMBER: USP286882 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. INSA TYPE OFINSURANCE ADDL SUBR pDLICY NUMBER M) POLICY EFF POLICY EXP LIMITS LTR INSR NANO MDDIYYYY _MMIDDrYYYY GENERAWABILITY - - GENERAL AGGREGATE S1.000.000-00 X COMOERCtALGEREl7ALUAUUrY - PRODUCTS-COMPIOPAGO S1,000,000,00 CLAMS-MADE Fl occus PERSONAL a ADV 114JURY S1,000,000.00 01J211A X SRPGAPML-101-0718 12;01 AM Q112 1 AM EACH OCCURRENCE $1.000,000.00 12;Ot AM 12 Q1 AM_ FIRE DAMAGE(Any one fire) $300,000 DO GEtTL AGGREGA7E LlfA7 APPLIES PER: MED EXP(Arty One person) SD QO x PE RS - .. .. POUCY !COr LOC ,AUTOMOBILE LIABILITY EOL'Etr�EDSN+GLE unrT $ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCMEDIriEO -BODILY INJURY(Pe(a=denli S - AUTOS AUTOS HMED AUTO NON-OWNED .. PROPERTY DAMAGE AUTOS +P«a<vd-tl S UMBRELLA WA13 OCCUR EACH OCCURRENCE S EXCESS LIAR H.CLAPAS.MADE AGGREGATE S DEC) RETENTION I EACH OCCURRENCE SO 00. GE14ERAL AGGREGATE S0.00 EACH OCCURENC£ S GENERAL AGGREGATE S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ANach ACORD 101,Additional Remarks Schedule,IfmorespaeeIsrequired) Martial Arts Activities The Certificate Holder is added as an additional Insured but only with respect to liability arising out of the named Insured during the policy period. CERTIFICATE HOLDER CANCELLATION City of Palm Springs fSHouCo ANY OF THE ABOVE AESCRIBED POLI6185"BE CANCELLED 3200 E.7ahquintz Canyon Way IBEFORE-THE-EXPIRATION DATE THEREOF;=THE ISSUING_COMPANY,WILL ENDEAVOR TO MAIL 30_13AYS_WRITTEN-NOTICE':TO THE CERTIFICATE— Palm Palm Springs,CA 92262 (HOLDER NAMED TO THE LEFT, BUT.FAILURE TO MAIL SUCH NOTICE; SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY,KIND_UP_O_N)THE COMPANY,ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE Francis L. Dean ACORD 25(2010105)041120.601 ©198&2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACO DATE(MMIDDNYYY) ADDITIONAL INTEREST SCHEDULE 5/22/2019 AGENCY - CARRIER NAIL CODE Francis L.Dean&Associates,LLC United States Fire Insurance Company 21113 POLICY NUMBER - EFFECTIVE DATE NAMED INSURED(S) " SRPGAPML-101-0718JUSP286882 01/21/2019 Steve Anthony Beck 12.01 AM ADDITIONAL INTEREST(Not all fields apply to all scenarios—provide only the necessary.data) . INTEREST NAME AND ADDRESS RANK; EVIDENCE: CERTIFICATE POLICY SENO BILL INTEREST IN ITEM NUMBER X ADDITIONAL INSURED LOSS PAYEE LOCATION. .BUILDING: DDITI BEACH OF MORTGAGEE City Of Palm Springs Demuth Community Center VEHICLE:_ BOAT; WARRANTY CO-OWNER OWNER 3601 E,Mesquite Road AIRPORT: AIRCRAFT: EMPLOYEE REGISTRANT Palm Springs,CA 92264 cuss: AS LESSORREM; LEASEBACK TRUSTEE REM DESCRIPTION OWNER LIENHOLDER R1.1.17 -ILOANS; INTEREST END DATE; LIEN AMOUNT; PHONE(AM.No.E.); FAX WC,N-L REASON FOR OREREST: - - E-MAILADDRE33: INTEREST NAME AND ADDRESS RANK; EVIDENCE: CERTIFICATE POLICY SEND BILL INTEREST IN ITEM NUMBER . X ADDITIONAL LOSS PAYEE - .LOCATION; BNLbIHO; UISUREDBEACH OF .. WARRANTY MORTGAGEE Palm Valley School VEHICLE: BOAT;, CO-OWNER OWNER 35525 Da Vall Road AIRPORT: AIRCRAFT-- EMPLOYEE REGISTRANT Rancho Mirage,CA 92260 ITEM .eEM: ASLESSOR CLASS: LEASEBACK TRUSTEE OWNER REM DESCRIPTION UENHOLDER REFERENCEI LOAN/; INTEREST END DATE: LIEN AMOUNT; AMINE(AM.No,Fa): FAX IAIC,N.11 - REASONFORINTEREST: E-MAIL ADDRESS: INTEREST - NAME AND ADDRESS RANK: EVIDENCE, CERTIFICATE POLICY SEND BILL INTEREST IN ITEM NUMBER ADDITIONAL LOSS PAYEE LOCATION: BUILDING: X INSURED BEACH OF MORTGAGEE City Of Palm Springs VEHICLE: BOAT: WARRANTY CO-OWNER OWNER 3200 E.Tahqu'sntz Canyon Way AIRPORT; AIRCRAFT; EMPLOYEE REGISTRANT Palm Springs,CA 92262 REM ASLES30A .. -' - CLASS: ITEM: LEASEBACK TRUSTEE OWNER REM DESCRIPTION LIENHOLDER REFERENCE P LOAN C INTEREST END DATE: UENAMOUNT! PHONE LAIC,No.I,): FAX(AIC,Noi; REASON FOR UITERESTI E4MAIL ADDRESS: The above are added as additional Insured but only with respect to liability arising out of operations of the named Insured during the policy period. ACORD 45(2009104) ^1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marls of ACORD COMMERCIAL GENERAL LIABILITY CG 20 26 07 Opt THIS ENDORSEMENT CHANGES THE POLICY-. PLEASE READ IT CARE,FULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION Policy Number. SRPGAPML-101-0718/USP286882 Insured:Steve Anthony Beck This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Palm Springs 3200 E.Tahquintz Canyon Way Palm Springs, CA 92262 Information required to complete this Schedule, if not shown above will be shown in the Declarations. To the extent that any of the additional insureds Section Il - WHO 1S AN INSURED is amended to named herein are liable for occurrences arising out include as an insured the person(s) or organiiation(s) of the named insured's negligent acts or omissions, shown in the Schedule, but only with respect to liability the insurance afforded to the additional insureds for"bodily injury", "property damage" or"personal and under this endorsement is primary insurance over advertising injury" caused, in whole or in part, by your any other valid.or collectible insurance which the acts 'or omissions of the acts or omissions of:those additional insureds may have with respect to loss acting on your_behalf: under any of the listed policies. Other insurance of any additional insured applicable to loss is non- A. In.the performance of: our ongoing operations;or contributory and excess over the coverage provided p Y g g p by this endorsement,and the amount of the B. In connection with .your premises owned by"or company's liability under this policy shall not be rented to you. reduced by the existence of such other insurance. CG 20 26 07 04 ©ISO Properties, 1 nc.,-2004 Page 1 of.1 L3. Certificate of • - Compensation TO: City of Palm Springs ATTN. City Clerk and Risk Manager SUBJECT.• Sole Proprietor/Partnership/Closely Held Corporation with No Employees Please let this memorandum notify the City of Palm Springs that I am a sole proprietor partnership ❑ closely held corporation and do not have any employees whose employment requires me to carry workers' compensation insurance. Therefore,. I do not carry workers' compensation insurance coverage. I further warrant that I understand the requirements of Section 3700, et seq., of the California Labor Code with respect to providing Workers' Compensation coverage for any employees. I agree to comply with the code requirements and all other applicable laws and regulations regarding workers' compensation, payroll taxes, FICA and tax withholding and similar employment issues. I further agree to hold the City of Palm Springs harmless from loss or liability which may arise from the failure to comply with any such laws or regulations. �' Risk Management Approval: Contractor Signature Printed Name of Contractor Date Date NW CITY OF PALM SPRINGS AGREEMENT FOR RECREATION SERVICES This Agreement is entered into this 9th day of July, 2013, between the City of Palm Springs, California("City") and Steve Beck, Shotokan Karate ("Instructor"). Services and Compensation. Instructor shall provide services as set forth in the Scope of Services, attached hereto as Exhibit "A" and incorporated herein by reference. City agrees to compensate instructor for such services in accordance with the Schedule of Fees set forth in Exhibit "A". Termination. This Agreement may be terminated at any time for any reason by either party to this Agreement after providing the other party at least five (5) calendar days notice. The City may terminate this Agreement immediately if the City determines, in its sole discretion, that termination is necessary to protect the safety or welfare of the public. Relationship. Instructor acknowledges that Instructor is an independent contractor. Nothing in this Agreement shall be understood or construed to create or imply any relationship between the parties in the nature of any joint venture, employer/employee, principal/agent, or partnership. Instructor shall not become or be deemed an employee of the City by acting under this Agreement, and Instructor shall be solely responsible for the payment of any applicable taxes and social security contributions owing from the above compensation, if any. Authority. Each party certifies that it has all necessary authority to execute and deliver this Agreement and to perform the obligations described in this Agreement. Upon execution by both parties, this Agreement will be a valid and binding obligation of each party and enforceable in accordance with its terns. Governing Law. This Agreement shall be governed by and construed exclusively in accordance with the laws of the State of California. If any term or provision of this Agreement is held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected. Assignment. This Agreement may not be assigned without the written consent of the other party. This Agreement shall be binding upon and inure to the benefit of and shall be enforceable by and against the parties and their successors and assigns. Liability. Instructor shall be solely liable for any and all losses, liabilities, claims, damages, and expenses (including attorneys' fees) caused by Instructor's failure to comply with any federal, 898202.1 state, local, or municipal regulations, ordinances, statutes, rules, or laws applicable to Instructor's performance of Instructor's obligations under this Agreement and/or activities at any City property, any unlawful acts on the part of Instructor, the negligent acts, errors, and/or omissions or the willful misconduct of the Instructor, or the material breach or default of the Instructor of any provision of this Agreement. Modification of Agreement. It is understood and agreed that this Agreement may not be changed, modified, or altered, except by written agreement of both parties. p Instructor: (sign) Date: O 2 13 (print) 3 I,q-)) � (Z4Y Address 740 - 40eq — 7 zZ3 Phone Number City: Date: r David H. ea y, City Manager City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 760.323.8201 898202.1 EXHIBIT "A" Scope of Services Instructor shall provide services to City as follows: Shotokan Karate ("Services"). Days and hours when the Services shall be provided: Monday—Thursday, 5:30 p.m. — 8:00 p.m.; Tuesdays & Thursdays, 1 p.m. —2 p.m.; Fridays & Saturdays—set w/instructor Location where Services are to be provided: Demuth Community Center Start Date: July 1, 2013 End Date: June 30,2014 Minimum Class Size: 1 Maximum Class Size: 20 Fee to be paid by class participants: $80 per month(multiple family discounts) Any and all materials and equipment required for performance of the Services shall be provided by Instructor. At least one week prior to the Start Date, Instructor shall submit a class outline to City. City may, in its sole discretion, cancel or reschedule any or all classes. In the event class enrollment does not meet the minimum class size set forth above by the Start Date, this Agreement shall automatically terminate. Schedule of Fees Instructor shall be compensated as follows: ❑ $ per hour ❑ $ per class X 70 percent of total class receipts received by City, however, until arrears are paid in full the City will retain an additional 20% of class fees. City shall provide payment to Instructor on a monthly basis following the final class of the month in accordance with the City's accounts payable schedule. 898202.1 54ALC- "EXHIBIT A" Page 1 of 2 SUPPLEMENTAL QUESTIONNAIRE Pursuant to California Public Resources Code §5164, this form must be completed by all applicants for positions involving supervisory or disciplinary authority over any minor. YES NO I. Have you ever been convicted of sexual assault or assault with intent to commit mayhem? ❑ X 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 189 ❑ 3. Have you ever been convicted of rape? ❑ 4. Have you ever been convicted of the rape of a spouse? ❑ 5. Have you ever been convicted of willful harm or injury to a child? ❑ 6. Have you ever been convicted of child endangerment? ❑ 7. Have you ever been convicted of corporal punishment or injury to a child? ❑ 8. Have you ever been convicted or willful infliction of corporal injury to a spouse,former ❑ spouse,cohabitant,or mother or father of your child? 9. Have you ever been convicted of any sexual crime or offense? ❑ 10. Have you ever been convicted of any of the following crimes or of an attempt to commit any of the following crimes? 10.1. Kidnapping? ❑ If yes,were you convicted of kidnapping or attempted kidnapping with the intent to ❑ commit rape, sodomy, lewd or lascivious acts,oral copulation,or forcible acts of sexual penetration? 10.2. Kidnapping for ransom? ❑ If yes,were you convicted of kidnapping for ransom or attempted kidnapping for ransom ❑ with the intent to commit rape, sodomy, lewd or lascivious acts,oral copulation, or forcible acts of sexual penetration? 10.3. Sexual battery? ❑ X" 10.4. Aiding,abetting or soliciting the rape,rape of a spouse, or forcible acts of sexual ❑ penetration? 10.5. Enticement of an unmarried minor female for purposes of prostitution? ❑ 10.6. Aiding and abetting the enticement of an unmarried minor female for purposes of ❑ prostitution? 10.7. Inducing sexual intercourse with another when the other's consent is procured by false ❑ pretenses with the intent to create fear? 10.8. Pimping of a minor? ❑ 10.9. Pandering of a minor? ❑ 10.10. Procurement of a child under 16 years of age for lewd or lascivious acts? ❑ 10.11. Abduction(taking away)of a person under age 18 for purposes of prostitution? ❑ 10.12. Aggravated sexual assault of a child? ❑ 1< M 13. Incest? 0 A YES NO 10.14. Sodomy? ❑ 10.15. Lewd or lascivious acts or the solicitation of the same? ❑ 10.16. Oral copulation? ❑ 10.17. Continuous sexual abuse of a child? ❑ 10.18. Forcible acts of sexual penetration or the solicitation of the same? ❑ 10.19. Selling, distributing,printing or exhibiting of child pornography? ❑ 10.20. Sexual exploitation of a child? ❑ 10.21. Employment or use of a minor to perform prohibited acts? ❑ 10.22. Advertising child pornography? ❑ 10.23. Possession of child pornography? ❑ 10.24. Annoying or molesting a child under 18? ❑ 10.25. Solicitation of rape by force or violence, sodomy by force or violence,or oral ❑ copulation by force or violence? 10.26. Indecent exposure? ❑ 10.27. Procuring,counseling,or assisting any person to commit indecent exposure? ❑ 10.28. Contributing to the delinquency of a minor? ❑ 10.29. Sending harmful material to a minor with the intent to seduce said minor? ❑ 11, Have you ever been convicted of armed robbery? ❑ 12. Have you ever been convicted of armed carjacking? ❑ 13. Have you ever been convicted of assault or attempted murder of a public official? ❑ 14. Have you ever been convicted of false imprisonment? ❑ 15. Have you ever been convicted of assault? ❑ 16. Have you ever been convicted of battery? ❑ 17. Have you ever been convicted of murder? ❑ 18. Have you ever been convicted of mayhem? ❑ 19. Have you ever been convicted of a crime that requires you to register as a sex offender in the ❑ X State of California? CERTIFICATION OF APPLICANT I hereby certify that all responses herein are true and correct, and I understand and agree that any misstatement or omission of material fact forfeiture on ri s to� oyment b � his City. Date: / 7�O 3 Signature: "EXHIBIT A" Page 2 of 2