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HomeMy WebLinkAbout06020 - SHOTOKAN KARATE-DO ASSOCIATION OF SO CAL FACILITY USE AT 3601 E MESQUITE AVE AMENDMENT NO. 1 TO FACILITY USE AGREEMENT (SHOTOKAN KARATE-DO ASSOCIATION OF SOUTHERN CALIFORNIA) This Amendment No. 1 to Facility Use Agreement ("Amendment') is made and entered into this day of to 2012, by and between the City of Palm Springs ("City") and Shotokan Kat to-do Association of Southern California ("SKA"), a sole- proprietorship concerning the use of the Demuth Community Center("Facility"). RECITALS WHEREAS, the City and SKA previously entered into an agreement for use of the Demuth Community Center on August 2, 2011 ("Facility Use Agreement'); and WHEREAS, the Facility Use Agreement was for an initial period of one year, beginning July 1, 2011 and ending June 30, 2012, with the option of two additional one-year terms; and WHEREAS, the City and SKA desire to renew the Facility Use Agreement for the first one-year term. NOW, THEREFORE, the City and Bloom do hereby mutually agree as follows: AGREEMENT 1. The term of the Facility Use Agreement shall be extended for a one-year period from July 1, 2012 to June 30, 2013. 2. All other terms and conditions of the Facility Use Agreement shall remain in full force and effect. [SIGNATURES ON FOLLOWING PAGE] 866560.1 ORIGINAL BIU AND/OR AGREEMENT IN WITNESS THEREFORE, these parties have executed this Amendment on the day and year first set forth above. CITY OF PALM SPRINGS Date: David H. Ready, City Ni ATTEST: es Thompson, City Clerk APPROVED BY CITY MANAGER APP OVER AS TO FORM:jw&kg�� Douglas C. Holland, City ttomey SHOTOKAN KARATE-DO ASSOCIATION OF SOUTHERN CALIFORNIA ,:f Date: `7- /F — a2©1 Z Steve Beck, Chief Instructor 866560.1 FACILITY USE AGREEMENT (SHOTOKAN KARATE-DO ASSOCIATION OF SOUTHERN CALIFORNIA) This Facility Use Agreement ("Agreement") is made and entered into this 4= day of A 201A ,by and between the City of Palm Springs("City")and Shotokan Karate-do Assoc ation of Southern California("SKA"),a sole proprietorship,concerning the use of the Demuth Community Center("Facility"). RECITALS WHEREAS, the City and SKA are mutually interested in providing needed amenities and community services to all residents of Pahn Springs; and WHEREAS, through this agreement, SKA will be afforded the opportunity, on the same basis as other lawful users,to provide services,including sports and recreation classes desired by the community; and WHEREAS,SKA has previously entered into an agreement for the use of the Facility,which is located at 3601 East Mesquite Avenue in Palm Springs,California,for the purpose of conducting martial arts-related classes; and WHEREAS, SKA now desires to enter into this Agreement to obtain access and use of the Facility, according to the terms and conditions stated herein. NOW,THEREFORE, the City and SKA do hereby mutually agree as follows: AGREEMENT 1. TERM. 1.1. Term. This Agreement shall be in full force and effect for a period of one(1)year, beginning July 1,2011 and ending June 30,2012. City and SKA may renew this Agreement for two (2)additional one(1)year terms,under the same terms and conditions stated herein,except for any changes such as fees and charges for the use of certain facilities as specified in Section 2. 1.2. Termination. City and SKA may terminate this Agreement at any time, with or without cause,upon sixty(60) days' written notice to SKA. Nothing shall prohibit termination at less than sixty(60) days'written notice upon any material breach of this Agreement. 2. FACILPTY USE. 2.1. Facility Use. City grants SKA the use of the Martial Arts Room,the Office and the Kitchen at the Facility,as identified in Exhibit"B",and subject to the rules and regulations outlined in Exhibit"A". The Facility,and the areas to be used by SKA,are more specifically described in the attached Exhibit "B" and incorporated herein by reference. 2.2. Scheduling of Use. SKA may use the Facility in accordance with Section 1.1 onlyduring the times specified in the Schedule,attached as Exhibit"C" and incorporated herein by ORIGINAL BID 772566.1 1 AND/OR AGREEMENT reference. The City may, in its sole discretion, alter the Schedule in order to maximize use of the Facility for all users_ 2.3. Fees and Charges for Facilijy Use. SKA agrees to pay City Six Hundred Forty Dollars ($640.00) monthly, on or before the fifth of every month, for use of the Facility. An additional late charge of$35 shall be due on all payments received after the fifth of every month. 2.4. Personal Proms. SKA may deposit karate equipment inside the martial arts room. Such karate equipment shall remain the personal property of SKA. City shall not be responsible for the security of such equipment and any losses of such equipment shall be the sole responsibility of SKA. 2.5. Mailbox. City permits SKA's use of a designated mail slotlinbox at the front reception counter area of the Facility. 2.6. Utilities. SKA is responsible for establishing telephone lines, in separate accounts from the City, and is responsible for payment of monthly accounts related to these services. All other utilities shall be provided by the City. SKA expressly waives any and all claims to the City for compensation for any and all losses or damages sustained for any reason or any defect,deficiency or impairment of any utility system,water supply system,drainage system,electrical apparatus or wires serving the Facility with respect to the loss of the facility for SKA functions. 2.7 Improvements. Should SKA desire any improvements at the facilities referenced above, SKA shall provide City advanced written notice of such improvements, including the proposed scope of work, and obtain City's written approval prior to any commencement of work. SKA shall be solely responsible for any tenant improvements at the facilities, and represents and warrants that all improvements by SKA or SKA's contractors shall comply with all applicable local, state, and federal law, including zoning and building codes and any applicable business licenses. Proof of insurance covering the proposed work in favor of the City,to the satisfaction of the City, must be presented to City prior to the commencement of any work. SKA is personally responsible for the cost of any proposed improvements. If SKA commences improvements without complying with the procedures outlined herein,the City may declare a material breach of this Agreement and terminate the Agreement immediately without any penalty. In addition, upon expiration or termination of this Agreement for any reason, SKA releases all claims to any improvements at the facilities and permits the City to retain or remove any improvements and recover any such costs from SKA. 3. SECURITY AND BACKGROUND CHECKS. 3.1. Background Checks. Any person having supervisory or disciplinary authority over any minor is required to obtain a criminal background screening in accordance with the procedures outlined in California Public Resources Code Section 5164. Such persons shall be disclosed in the attached Exhibit"D". Copies of all criminal background checks shall be made available to the City upon request. 3.1.1. Supplemental Questions. Each employee or volunteer having supervisory or disciplinary authority over any minor must complete the supplemental questions attached as Exhibit "E" and incorporated herein by reference. 772565.1 2 3.1.2. Submission and Fingerprints. SKA must submit a completed copy of Exhibit "E" to the City and arrange for the fingerprinting of each employee and volunteer before this Agreement maybe executed by the City. During the first year that the City requires the background screening for a particular individual,the screening shall include screening by the federal government. All subsequent years that the City requires a background check on that same individual, the screening need only be performed by the state government. 4. INSURANCE. 4.1. Minimum Insurance. SKA shall procure and maintain,at its sole cost and expense,in a form and content satisfactory to City, during the entire term of this Agreement, including any extension thereof, the following policies of insurance: 4.1.1. Comprehensive General Liability Insurance. A policy of comprehensive general liability insurance in an amount not less than One Million Dollars ($1,000,000.00) per occurrence and in an amount not less than Two Million Dollars ($2,000,000.00) in aggregate. Insurance companies shall have an AM Best's Guide Rating of A-, Class VII or better. 4.1.2. Workers' Compensation Insurance. To the extent required by Labor Code § 3700, SKA shall procure and maintain workers' compensation insurance in the amount and to the extent required by law. 4.2. Proof of Insurance.Proof of the insurance required under Section 4 shall be provided to City prior to the execution of this Agreement. 4.3. Primary Insurance. SKA's insurance coverage shall be primary with respect to the City and its respective elected officials,officers,employees,agents,and volunteers. Any insurance or self-insurance maintained by City and its respective elected officials,officers,employees,agents, and volunteers shall be in excess of SKA's insurance and shall not contribute with it. For Workers' Compensation and Employer's Liability Insurance only, the insurer shall waive all rights of subrogation and contribution it may have against City, its elected officials, officers, employees, agents, and volunteers. 4.4. Endorsements. SKA shall obtain an Additional Insured Endorsement designating the City, its officers, officials, employees, agents, and volunteers as additional insureds for liability arising out of this Agreement. All endorsements shall reference that SKA's insurance shall be primary and non-contributory, as outlined in Section 4.3. 4.5. Deductible. Any deductibles or self-insured retentions must be declared to and approved by the City prior to the commencement of this Agreement. At the option of the City,either (1)the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City, its elected officials, officers, employees, agents, and volunteers; or(2) SKA shall procure a bond guaranteeing payment of losses and related investigations, claim administration,and defense expenses. Certificates of Insurance must include evidence of the amount of any deductible or self- insured retention under the policy. SKA guarantees payment of all deductibles and self-insured retentions. 4.6. Amendment of Insurance Policy. SKA shall not amend,or allow to be amended,any insurance policy under this Agreement if such amendment is not consistent with the minimum 772565.1 3 insurance requirements contained herein. Such amendment without the consent of the City shall be considered a material breach of this Agreement and City may immediately terminate this Agreement upon such occurrence. 4.7. No Cancellation of Insurance Policy. SKA shall not cancel,or allow to be cancelled, any insurance policy required under this Agreement. If said policies of insurance are cancelled,SKA shall, prior to the cancellation date, immediately obtain new insurance consistent with the requirements of this Agreement and immediately submit evidence of such insurance to the City. 4.8. Failure to Obtain Valid Insurance During Use of the Facility. If SKA is not minimally insured,as required under Section 4,SKA shall be considered in material breach of this Agreement and City may immediately terminate this Agreement. 4.9. No Limitation. The provisions of this Section 4 shall not be construed as limiting in any way the extent to which SKA may be held responsible for the payment of damages to any persons or property resulting from SKA's activities or the activities of any person or persons for which SKA is otherwise responsible. 5. INDEMNIFICATION AND DEFENSE. 5.1. Indemnification. SKA agrees to indemnify the City, its officers, agents and employees against, and shall hold and save each of them harmless from, any and all actions, suits, claims, damages to persons or property, including injury or death to any person, losses, costs, penalties, obligations, errors, omissions or liabilities (herein "Claims") that may be asserted or claimed by any persons,firm or entity arising out of or related to this Agreement or SKA activities at the Facility,except to the extent that the Claim arises from the sole negligence or willful misconduct of the City, its officers, agents or employees. 5.2. Defense. SKA agrees to defend,with counsel acceptable to City,the City,its officers, agents and employees against any Claims that may be asserted or claimed by any persons, firm or entity arising out of or related to this Agreement or SKA activities at the Facility,except to the extent that the Claim arises from the sole negligence or willful misconduct of the City,its officers,agents or employees. 5.3. Costs Associated with Indemnification and Defense. SKA shall be responsible for all costs incurred by the City that are associated with the indemnification or defense of City by SKA, including any costs associated with the use of City resources, including lost time by employees, expended in furtherance of the indemnification or defense. 6. GENERAL PROVISIONS. 6.1. Notice. All notices,demands and requests which maybe given or which are required to be given by any party to this Agreement, and any exercise of a right of termination provided by this Agreement, shall be in writing and shall be deemed effective either: (1) on the date personally delivered to the address below, as evidenced by written receipt therefore, whether or not actually received by the person to whom addressed; (2) on the third (3rd)business day after being sent,by certified or registered mail, return receipt requested, addressed to the intended recipient at the address specified below;(3)on the first(1 st)business day after being deposited into the custody of a nationally recognized overnight delivery service(i.e.,FedEx Corporation,UPS,or DHL)addressed 772565.1 4 to such party at the address specified below; or (4) on the business day sent via facsimile transmission to the facsimile numbers below, as evidenced by a printed confirmation of the successful electronic transmission of the message prior to 2:00 p.m. (Pacific Standard Time), or otherwise delivery shall be considered to be on the following business day. For purposes of this section, the addresses of the parties for all notices are as follows: 6.1.1. C City Manager City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 (760) 323-8299 6.1.2. SKA. Steve Beck 2015 N. San Gorgonio Road Palm Springs, CA 92262 (760)449-7223 SKA shall be responsible for notifying the City, in writing, of any changes in SKA's address. 6.2. California Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute,claim or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Riverside, State of California, or any other appropriate court in such county, and SKA covenants and agrees to submit to the personal jurisdiction of such court in the event of such action. 6.3. Waiver. No delay or omission in the exercise of any right or remedy by a non- defaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any subsequent act.Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement. 6.4. Rights and Remedies are Cumulative. Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party. 6.5. 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. 6.6. Attorney's Fees. If either party to this Agreement is required to initiate or defend or 772565.1 5 made a party to any action or proceeding in any way connected with this Agreement,the prevailing party in such action or proceeding,in addition to any other relief that maybe granted,whether legal or equitable, shall be entitled to reasonable attorneys' fees. Attorneys' fees shall include attorneys' fees on any appeal, and, in addition, a party entitled to attorneys' fees shall be entitled to all other reasonable costs for investigating such action, taking depositions and discovery, and all other necessary costs the court allows that are incurred in such litigation.All such fees shall be deemed to have accrued on commencement of such action and shall be enforceable whether or not such action is prosecuted to judgment. 6.7. Non-Liability of City Officers and Employees. No officer or employee of the City shall be personally liable to SKA,or any successor-in-interest,in the event of any default or breach by the City or for any amount that may become due to SKA or to its successor,or for breach of any obligation of the terms of this Agreement. 6.8. Conflict of Interest. No officer or employee of the City shall have any financial interest,direct or indirect,in this Agreement nor shall any such officer or employee participate in any decision relating to the Agreement that affects his financial interest or the financial interest of any corporation,partnership or association in which he is directly or indirectly interested,in violation of any state statute or regulation. SKA warrants that it has not paid or given and shall not pay or give any third party any money or other consideration for obtaining this Agreement. 6.9. Covenant Against Discrimination. SKA covenants that,by and for itself, its heirs, executors,assigns and all persons claiming under or through it,that,to the extent permitted by law, there shall be no discrimination against or segregation of any person or group of persons on account of race,color,creed,religion,gender,marital status,sexual preference,domestic partnership status, national origin or ancestry in the performance of this Agreement. 6.10. Compliance with Governing Law. SKA shall comply with all applicable laws,codes, ordinances and regulations of the federal, state, and local government. 6.11. Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction that might otherwise apply. 6.12. Modification. This Agreement maybe amended at anytime by the mutual consent of the parties by an instrument in writing. 6.13. Severabilitv. In the event that any one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that this invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless. 6.14. Successors. The terms and conditions contained herein shall be binding on and inure to the parties to this Agreement,their administrators,representatives,successors and assigns,except as otherwise provided in this Agreement. 772565.1 6 6.15. Assignment. SKA may not assign or transfer its interest under this Agreement without City's prior written consent, which consent may be withheld, conditioned or delayed in City's sole and absolute discretion. Any attempted assignment,sublet or transfer made in violation of this provision shall be void. 6.16. Venue. Any action at law or in equity brought by either party to this Agreement regarding the subject matter of this Agreement shall be filed in the Superior Court of the State of California for the County of Riverside, Indio Branch. 6.17. Headings. The headings used in this Agreement are employed solely for convenience of the parties and are not to be used as an aid in interpretation. 6.18. Relationship. Nothing contained in this Lease shall be construed as creating the relationship of principal and agent or of partnership or joint venture between City and SKA. 6.19. Authority to Enter into Agreement.The persons executing this Agreement on behalf of SKA warrants that they are duly authorized to execute and deliver this Agreement on behalf of said party,and by so executing this Agreement,such party is formally bound to the provisions of this Agreement. 6.20. Counterparts and Facsimiles. This Agreement may be executed in any number of counterparts,each of which shall be deemed an original and all of which shall constitute one and the same instrument. Any facsimile of the original shall be treated as an original. The party submitting any facsimile must submit a copy of the original to the other Party within a reasonable time after the transmission of the facsimile. 6.21. Entire Agreement. This Agreement constitutes the entire Agreement between City and SKA. There are no oral agreements between the parties hereto affecting this Agreement. This Agreement supersedes and cancels any and all previous negotiations,arrangements,agreements and understandings, if any,between the parties, and none shall be used to interpret this Agreement. [SIGNATURES TO FOLLOW] 772665.1 7 IN WITNESS THEREOF, these parties have executed this Agreement on the day and year shown below: CITY OF PALM SPRINGS Date: a aUl David H. Ready,City lv�a . ger ATTESTED: Date: O8 fOzIzal 1 �esThom�psoCity Clerk APPR AS TO FORM: Date: b�'r� d-011 Dougl C.Holland,City Attorney APPROVED BY CITY MANAGER SHOTOKAN KARATE-DO ASSOCIATION OF SOUTHERN CALIFORNIA Date: / — S eve Ifeck, C •e or Tax ID No. If SKA is a corporation, a Corporate Resolution and/or Corporate Seal is required. If a partnership, Statement of Partnership must be submitted to City. 772565.1 8 EXHIBIT "A" (RULES AND REGULATIONS) l. SKA shall require users of the kitchen to clean up after themselves and maintain the kitchen in a clean condition. The City reserves the right to revoke access to the kitchen at its sole discretion 2. SKA is responsible for maintaining the security of attendees and parked vehicles at the Facility through its own efforts,within the scope of SKA's use of the Facility or any portion thereof. 3. All of SKA's refuse and rubbish shall be removed on a regular basis at SKA's sole cost and expense. SKA shall not place any rubbish or other matter outside any building within the Facility, except in such containers as are authorized from time to time by the City. 4. No radio or television or other similar device audible outside the facility shall be installed without obtaining in each instance the written consent of the City. No aerial shall be erected on the roof,exterior walls or grounds of the Facility without first obtaining in each instance the written consent of the City which consent shall not be unreasonably withheld or delayed. Any aerial so installed without such written consent shall be subject to removal without notice at any time. 5. No loudspeakers,televisions,phonographs,radios or other devices shall be used in a manner so as to be heard or seen outside of the Facility without complying with the provisions of the City's Noise Ordinance. 6. No sirens, outside paging or any type of signalization will be permitted, except approved alarm systems. 7. SKA will not allow animals, except seeing-eye dogs,in, about or upon the Facility. 772565.1 Vern{ �:ov�nnnV�i�e�. a LL 2 £ BaeketbRH Gpros+i Mar"Axb }•: 06L waeoam H P P P,S.G(mnaS4 {S � Rom �Sct..dkAa� s,�al acts oma ®ed. Sl-L.�e Acc4. SKA Ull]aM .n �i+e Q.'$fr .. SeGaLS Sl^edU.�) (Ver scO cA ke,e s re cure-, eoyse woa� kmvioblw <t SJ tc llG� We Lobby w mm-pulvow Use au Cw..ts i w� •smuoff EXHIBIT"C" (SCHEDULE) SCHEDULETRAININCI MON DAY Beginner Idds * 5:30 - 6:30 p.m. Beginner adults * 6:30 - 7:30 p.m. TUESDAY Women's Self Defense: 12-1 p.m. Advanced kids 9 5:30 - 6:30 p.m. Black/Brown Belts • 6:30 - 7:30 p.m. WEDNESDAY Beginner kids * 5:30 - 6:30 p.m. Beginner adults • -6:30 - 7:30 p.m. TH U RSDAY Women Self Defense: 12 - 1 p.m. Beginner kids • 5:30 - 6:30 p.m. Beginner adults * 6:30 - 7:30 p.m. FRI DAY Competition/Advanced * 5:30 - 7:00 p.m. SATU RDAY Beginners/Advanced • 10:00 - 11 :00 a.m. 772565.1 EXHIBIT "D" (SUPERVISORY EMPLOYEES) Steve Beck Noel Pajonar Elizabeth Owsley Claudia McVeigh Jennifer Kovalenko 772565.1 EXHIBIT "E" (SUPPLEMENTAL QUESTIONS) STEVE BECK SUPPLEMENTAL QUESTIONNAIRE Pursuant to California Public Resources Code§5164, this form must be completed by all applicants for positlow involvftrgsupervisoiy or&smffivary authority over any minor. YES NO 1. Have you ever been convicted of sexual assault or assault with intent to commit maybam? ❑ ��/ 2. Have you ever been convicted or unlawful sexual intacowse with a parson under age 192 ❑ U+� 3. Have you am been convictedofrape? ❑ 4. Have you ever bees convicted of We rape of spouse? ❑ S. Have you ewer been convicted of wtlifutharm or injury to a child? 0 6. Han you ever been convicted of childendaogermam? ❑ 7. Have you am been convicted of corporal punishment or injury to a child? ❑ S. Hare you ever been convicted or willful infliction of corporal injury to a spouse,former ❑ spouse,cohabitant,or mother or father ofyour child? 9. Rave you ever been convicted of any sexual crime or offense? ❑ �/ 10. Haver you ever been convicted of any of the following mimes or of an attempt to commit any of the following crimes? 10.1. Kidmnplimg? ❑ If yes,were you convicted of hidmappiog or attempted kidnapping with the intent to ❑ commit rape,sodomy,lewd or lascivious acts,oral copulation,or forcible acts of seals! Bev 10.2. KidoWingfbrransom? - ❑ Ifyes,were you convicted oficidnapping forransoai or attempted kidnapping for ravaom ❑ / with the intent to commit rape,sodomy,lewd or lascivious acts,oral opulstion,or _ finable ads of samal penetration? 103. Sternal.battery? ❑ /' I OA. Afd'mg,abetting or soliciting the rape,rape of a spouse,or forcible am of sexual. . ❑ 4/ pmemadon? 10.5. Enticement of an unmarried minor ferrate for purposes of prostitimion? ❑ 10.6. Aiding and abetting the anucmnmt of an entrained minor female for purposes 0f O . . . prostitution? 10.7. homing sexual intercourse with another when the other's consent is Fwnvd by false ❑ praenses with the intent in create fear? . 10.9. Pimpingofavaiaor't ❑ 10.9. Pandering of a minor? ❑ 10.10.Procurement of a chili under 16 years of age for lewd or lascivious ads? ❑ A 10,11.Abduction(taking away)of a parson under age 18 for purposes ofprostitution? ❑ - . �//' 10.12.Aggravated sexual assault of a child? _ ❑ �//' 10,13.Incest? ❑ �/ 772565.1 STEVE BECK YES NO I0.14.Sodonq? ❑ 10.15.Lewd or lascivious acts or die solicitation of the saute? ❑ / 10.16.Omi copulation? ❑ V 10.17.Continuous swami abuse of a child? ❑ 10.18.parAk acts of soma penamnionordw50ichationoftuesame? ❑ 10.19.Seffbi&dbtnbuft printingor wddbitng of child pornography? ❑ d/' 1020.Smmat avioimton of a dhw ❑ 1�3/ 1021.Employment Or use of a minor m perform prohibited acts? ❑ IVM-Advartiamg dtild pomog aphy? ❑ 10.23.Pou"onofcLildpornography? ❑ 1024.An*o ttg or molesting a child under 18? ❑ 1025.Solicitation ofrwbyforaor violence,sodomyby force orviolna,ororal ❑ Pd/ copulation by force orvioknce? 1026.1ndaent«posme? ❑ 1027.Pmcurjag,coumding,or assisting any pusoa to commit indecan wgMM? ❑ 1028.Contributing to&e delinquency of a minor? - - ❑ 1029.Sead'mgbatmful material to a minor with the lutes to seduce said minor? ❑ 11. Hat ❑ 12. Haw you am been convicted of armad*addoe ❑ / 13. Nave you ever beta convicted ofassault Or attempted mentor ofa public ofiicial? ❑ 14. Have you ever bpeo convicted of false imprisonment? ❑ li3 15. Nava you ever been convicted of assault? _ _ ❑ /' 16.- Have you ever beta convicted of battery? ❑ f�// 17. Have you aver been convicted of murder? ❑ ,_mom///�� M Have you ever been convictedofmayltmm? ❑ �. 19. Have you ever been convicted of a crime trot requires you to register as a sax offender in the ❑ State of cal wain? CFATIFlCATTON OF APPLICANT Thereby certify that all responses beraia am no and cort'eck and I understand and agreethat any nit Or amissioa of. ... ..... . tattxWS�lt�toaycmxforEedmemmy ofau - tbyd,is Da l /•-nor O� f " 772565.1 NOEL PAJONAR SUPPLEMENTAL QUESTIONNAIRE Purmiantto California Public Resowaw Code§SI64, this form must be completed by all applicants for posftfons kwhingsupervisory or disciplinary outhority over any Nicer. YES No 1. Have you ever bear convicted of=ual assault orassault with him to commit mayhem? ❑ Dv 2. Have You ever been comvwW or unlawful sexual hhtaatmse with apenom under age 18? ❑ 3. Have YOU ever,been convicted ofrape? 4. Rave You ever been convicted ofthe rape of a spouse? p 5. Have you ever been convicted of willful harm or injury to a child? p .6. Have you aver been convicted of child mdaagerment? O 7. tlavo You ever been convicted of eoporal Puaishmmt or injury to a child? ❑ P4 . 8. Have you ova bear convicted or wd W infliction of oeuporal injury to a spouse former ❑ Ed •apousq cobabitant,or mother or father ofyomr child? 9. Have you ever hem convicted of my sexual crime or offense? p gl 10. • Have you eve boom convicted of any of the folbwiag oboes or of as mtasa t to commit any of the.following crimes? 10.1. Kidnapping? D lfyes,woe you convicted ofladoapptog or attempted b&OPPEOg with the hunt to 0 l$ commit rape,sodomy,lewd or lascivious eras,oral copulation,or forcible acts of sexual peoehalion7 10.2. Kidnappingfhrreasom? D �d Ifyes,were you convicted ofkidmpping forrmtsom or attempted Iddnappimg for ramsom ❑ C3. wAb the mteat to commit rape,sodomy,lewd or lascivious sots,ail ap dabom,or forcible ads of Santa penetration? 103." Soual battery? ❑ C 10.4. Aiding,abetting or soliciting the tape,tape of a spouse,or forcible acts of sexual ❑ penetration? 10.5. laticement of an unmarried minor female for purposes of prostitution? ❑ 10.6. Aiding and abetting the enticeman of an unmarried minor ProstimrtionT female,for purposes of p . . . 10.7. Imda"ing sexual iR%rc msa with another when the other's consent is procured by Use ❑ iylP pretenses with the lout to acate Fear? 10.8. Pimping of a minor? p It 10.9. Pandering are minor? ❑ R 10.10.Pmarement ofa child under 16 yams of age for lewd or lascivious acts? O to 10.11.Abduction(taking away)of a Pasco ands age 18 for pmPosas ofptogthhttion? O 10.12.A gmvdcd sexual Basalt of a obild? ❑ 10.13. Imoest?. ❑ w 772565.1 NOEL PAJONAR YES NO 10,14.Sodomy? p EA 10.15.Lewd or lascivious acts or the solicilatiou ofthe same? ❑ to.16.Oral copulation? ❑ 10.17.Commis sexual abuse of child? ❑ ffi 10.18.F%9kle acts of sexual pmeuation or the solichenion of the same? ❑ 19 10.19.Sailing,dishsbutW&printing or exhibiting of cbHd potnogaphy? ❑ IM Sexinletploimaw of a child? ❑ *4 1021.F.mploymeat or use of a minor to perform proldhi ed ads? ❑ 10.22.Advertising duld pomography? 13 1023.Possession of child pomo~ p 19 10.24.Annoying or molesting a child under 182 13 p 105.Solution ofrape by force or vioence,sodomy by face or violence,or oral ❑ copulation by force or violence? 1026.WkcmtcgKm e? p 1027.Pmauhg,e0003elm8,or assisting any Person to commit indecent exposme? ❑ 1028. Contributing 10 the delinquency of amines? ❑ 1029. Sendmgharmful matariat to a minor with the intwt to educe said minor? ❑ 13f 11. 8aveyouevcbcenauviddofatmodtobbery7 p 12. Have you ever bow cwdctcd of armed cmjaddng? - ❑ gJ 13. Have you ever been convicted of assault or Attempted murder ofapablic official? ❑ 14. Have you nubpmcoaviadofialaehtprismoneW p 15. Have you ever bow Convicted of Assault? p 16.- Have you ever bun coarvictedofbattary7 p �j 17. HM you everbeen convicted ofamdge p 18. Have you am been convidedofmayhem? 0 19. Have you ever bow convicted of a crime that INWI s you to register as a set off"in due ❑ StamofCali M&? - - . - CERTIFICATION OF APPLECANT I hereby ear*that all respos=a herein are true and toted,and I rmdestand and agrees that any miauaaAmout or omission of nuftriadfeet may cause fodeltme an my part of all right to wsplbyme nt by this City. 1» /4 Sigeatora 772565.1 ELIZABETH OWSLEY SUPPLEMENTAL QUESTIONNAIRE Pwsuatrt to Calffornla Public Rwour=Code§5164,this form must be completed by all applicantsfor positions ur olvingstgrervisory or disciplinmy authority over any mirror. Y&S NO // 1. f1m.you ever been convicted ofsexual assault oraawkwhb intent mcommitmaybem? ❑ B" I flaw you ever ben convicted or unlawful serval intercown with a person under.age 18? ❑ 9"/ 3. Have you ever been convicted of rape? ❑ Id- 4. Hen you ever been convicted of the rape oft spouse? _ ❑ 0/ 5. Have you eve been evicted of willful halm or injury,to a child? ❑ @-� 6. Have you over been convicted of child ndangerment? 0 I Have you eve been convicted of cotporal puufudhment or injury to a child? ❑ l7 & Have YOU aver been convicted or W=d infliction of othWM injury to a spouse,former ❑ •spottsc,cohabitrmt or mother or father of your child? 9. Haw you ever ben convicted of mry sexual crime oroffew? ❑ lr� 10. Have you ever been convicted of any of the following crimes or of as attempt to commit any of the following times? 10.1. Kidnapping? ❑ (� If yes,were you convicted of Udnapping or attempted kidnapping with the intent to ❑ ❑ Commit tape,sodomy,lewd or lascivious sds,oral copulation,or forotble acts ofswmal pnaltion? 102. Kidnapping for ransom? - ❑ 0-� Ifyes,were you convicted of kidnapping for ransom or suampted kidnapping for cans_om ❑ ❑ .. with the intent to commit rape,sodomy,lewd or lascivious acts,oral copulation,or kruible ads of aexw penetrabin? / 103. So a d battery! ❑ t3 10A. AMIng,abating or soliciting the rape,npcofa spouse,or fbrcible ads of swmal ❑ penetration? 10.5. Buticementofantmnguried minor femdefor pmpom ofproafmttion? ❑ l� 10.6. Aiding and abetting the enticement of an unmarried minor famale for purposes of Cl __. prostihrtion7 - -/ 10.7. Inducing saxuml inmrcoursa with another when the other's consent is procured by false ❑ C� pretweas Witt the Want to cremefeat? / 10.8. Pimping of a minor? ❑ ❑/ 109. Pandering of a mfim? 0 of/ .- 10.10. Procurement of a child under 16 years of age for lewd or lascivious ads? ❑ E 10.11.Abduction(taking away)of a pass underage 1g for purposes ofprostinnion? ❑ 10.I2.Aggravated seamal assault of a child? - ❑ 01 10.13.Intxst? . ❑ 772565.1 ELIZABETH OWSLEY YES NO ' I0.I4.Sodomy? ❑ d 10.15.Lewd or lascivious acts or the solicitation of the same? - ❑ 10.16.Oral copalawn? ❑ / lo.17.Continuous Sexual abuse of a cW? ❑ —p/ ]0.18.Fomba acts ofsetuelpeach-won ortbe solicitation Of the seme? ❑ 10.19.Sdffn&di*bftin&FinboBorerbibitingof child porno~ ❑ H 1020.Sexual esploftition of a child? - ❑ 1021.Employmeat or use Of minor to perform prohibited acts? E3. f_�/ 1022,Advertising child pornography? ❑ ff 10.23.Possession of child paaogophy? ❑ Er 1024.Annoying or molesting a child under 18? ❑ Cr 1025.SON0112 ion of MPO by face or violeam sodomy by force or violence,or oral ❑ l7 copulation by form or violeaa? 1026.Iudxeatexposure? - . ❑ p� 1027.P Wj ft 0000sdm&or assisting any parson to commit indecent exposure? ❑ L'r 1028.Coatrtbutingto the delinquency ofaminor? ❑ C?' 1029.Seodmg harmful malarial to a minor vd&the Intent to seducessid mmot? ❑ Cr 1I. Aave you ever been convicted of armed.robbery? ❑ p/� 12. Have you ever been convicted of armedcmjacking? ❑ [-7/ I3. Have you am beena au avictedofassltorsampledmuderofapablicofficiat? ❑ ❑/ 14. Have you aver been anvicusd of false imprisonment? ❑ O 15. 13ave you eva been coavictedofasseult? ❑ IT, 16. - Have you ever bun convicted ofbattW. ❑ ❑ 17. Have you ever been convicted of murder? ❑ O// 18. Have you aver been convicted ofmayhem? p 19. Have year ever been convicted of a crime dust requires you to register as a sect offender in the ❑ Stme of California? CERTIFICATION OF APPLICANT I hereby clatifythat all responses herein are true and courocy and I uoderstsad and agree that any misstatement or omission of material fax may cam fafei errs an my Of all right ft by this City. .. Date: ?ns6s.1 CLAUDIA MCVEIGH SUPPLEMENTAL QUESTIONNAIRE Purseantto California Public Resources Code,¢5I64, this form must be completed by all applicantsfor posfdons mvolvingsupervisory or disciplinary authority over any minor. VFS IK 1. Have you ever ban convicted of sexual assault or assault with intent to commit mayhem? .. ❑ -2. Have you ever been convicted or unlawful sexual intercourse with a person underage Ix? ❑ 3. Havcyrwecmrbeanconvictedofmpe? ❑ 4. Have you ever been convicted orthe rape of spouse? ❑ 5. Have you ever been convicted of willful harm or Mu Y to a child? ❑ 6. Have You ever been convicted of child endangerment? ❑ 7. Have,you ever been evicted of corporal punishment or iujury to a child? ❑ 8. Have you ever been convicted or willful inHicton of rwtpor8l injury to e spouse,formes ❑ .spouse,txdhabiteat,or mother or father of yoer child? . 9. Have you aver been convicted of my sexual crime or offense? ❑ 10. Have you ever bass convicted of say of the following yes or of an attempt to commit any oftlx following crimes? 10.1. Kidnapping? Uyes,wan you convicted ofbdwffiag or attempted kidnapping with the intent to ❑ r 01111n t tape,sodomy,lewd or lascivious acts,Orel copulation,or f olle acts of sexual - Penetration? 10 2. Kidnapping forrsssom? ❑ ZfYe,were you convicted ofMWpmg�*tavwm or attempted lddaapping fie ransom ❑ wits the intent to commit ram sodomy,lewd or lascivious eras Drat copulation or . f nciNe,ads of sexual penetration? 10.3. Sexual battery? ❑ 10.4. Aiding,abaft or soticking the rape,rape of a u �l ape se err fomrMe cps o€sexual• ❑ Penetration? IOS. Enticement of an manarded minor female for purposes of pro tautioa? ❑ tAt$�e� .10.6. Aiding and abetting the enticement of an wumxTW minor Bale for purposes of ❑ tt�. prostitution? 10.7. ludaciug sexual intereoutse with another when the other's cousew is prnwred by false ❑ �. prowtses with the intent to paste fear? 10.8. Pimping of a minor? ❑ r 10.9. Panderiegofamhw& ❑ 10.10. Propsement of a child under 16 years of age ferlewd or lascivious acts? ❑ 10.1 L Abduction(Wdag away)of a person under Age 18 for purposes of prosttuaon? ❑ 10.12. Aggravated sexual assault of a child? ❑ 10.13. lnast7 ❑ k( 772565.1 CLAUDIA MCVEIGH YES NO 10.14.Sodomy? ❑ p,( 11.11.Loved or lascivions ads w the mUckadco of the same? ❑ �^l 10.16.Ord copulation? ❑ pt 10.17.Continuous wand abase ofa child? _ ❑ 10.18.Forcble acts ofswmdpenenationorl6esoli*.S.ofthasame? ❑ . I0.19.Seiliug,dishlbumtg,pdotingorwduryti ngofcbildpmwgraphy? ❑ 1020.Swcud asploitetim of child? K 0 1021.&Vbymemorvu Ofs mhm to perform prohibited aces? p �( 1022.Advertising adidpomo apl{yt lk 10.23.Possession of child pomagraphy? ❑ 1024.Anow ynlg or mok4 tg a child under is? 13 �l 1025.S01 ofrope by force Or violence,sodomy by f u or vlolanoo,or oral O /(( oupoldian by force or violence? 1026.Tadecmtexpo,=? - ❑ d . 1027.Pmpuin&coansding,orasshft any person to commit i &c W exp.? ❑ 1028.Coant3u bg to the delinquency of ammot! p 1029.Sending harmful malerid to a minor v0p the momt to seduce sdd mi.Ml ❑ K 11. Have you cmbomcmmcWdofarmed obbery7 p pl I2. Have you aver been cmvidad ofarmed cmja*W p 13. Have you ever been canvic0ad ofassadt or allmupW murk of a public olficid? ❑ 14. Have you ever been convicted offalse mipris0msew p Ar 15. Have you ever bean convicted ofasaeuh? ❑ " Ili.- Haw you ever been oonyktod ofbatW ❑ 17. Have you am been conViomdofmordwq ❑ , ui Is. Have You am been cwvicted of mayhem? 13 pIM�I 19. Have you over been convicted of a crime that requires you to reglater as a sac offender in the ❑ P StataofCalitomia? C13 umcAum OF APPLICANT I herobycertdy that aff responses bream and 0orroM and I ondadand and m#uiat� y t forfei(me of agree that sW miastatwnent or omission of . te this City. nate: 20j�>gtat,,,� 772565.1 JENNIFER KOVALENKO SUPPLEMENTAL QUESTIONNAIRE Pursuant to California Public Resoraces Code§Sl64, dhfsform must be completed by oil applicams for positions involiringapervisory or discipliruny audio rity over arty minor. YES NO 1. Aaveyoa ever bow oamictedof sexual assault ofwasohwit5fineco[towousamayhem? ❑ Ilk 2. Have you over been convicted or uulawfid sexual tmecow,se w&.peso,under age I82 ❑ 3. Mft You ever been wnvictbdofrape? ❑ 4. Ha"you ever been convicted of the rnPo of a spouse? ❑ 4Q 5. "a"yon ever been convicted of WWW harm or injury to a child?. ❑ 4 . 6. Have you ever ban convicted of child endangetweaV ❑ 7. Have you ever been convicted of corporal punishment or injury to a child? ❑ ' 8. Have You ever been mmcptd or tvt71fu1 iufliotion of curpotal injury,to a spouse,former ❑ •epatve,cohebieM 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 Ode following ai@ea? 10.1. Kidnapping? ❑ Ifyes,were you convicted ofkidnapping or attempted kWWpbg with the intent to ❑ aommitrape,may,lewd or lascivious acts,eel copulation,orfoctbk acts of sexual penetration? . 10.2. Kida"Ingtorramom? ❑ ¢t • IfYm.was You convicted ofkidnapping for ransom or awmpted mdoappiag fa ransom ❑ widr the inteat to commit ram sodomy,lewd m lascivious acts,aal copulation,or fadbkads ofsatnal lnendralioa? 103." Scum battery? ❑ 10.4. Aiding,abetting Orsoliching the tapq rape of a spouse,or forcible acts ofsexual ❑ Penetration? 10.5_ 1t of an unmarried minor female for purposes ofpmrtindon? ❑ _.10.6. Aiding and abetting 910 mtticdmetrt of an unmarried mina female for purposes of ❑ .. _.. . _ F09ft tlon? 10.7. InducNS sexual iWawruse with amodwr when the other's consent isprocuted by false ❑ pratenses with the boat to ctane hear? 10.8. Pimpingofaminor? . ❑ SL 10.9. Pandering of a minor?? ❑ 10.10.1§ocarameat ofa Child under 16 years of age for lewd or Ins Mog ants? ❑ �( 10.11.Abduction(inking away)of a person wider age 18 for proposes ofpncadlotion? ❑ L 10.12.Aggravated sexual asault of a child? `" ❑ 9L 10.13.Incest? . ❑ 772565.1 JENNIFER KOVALENKO YFS NO 10.14.Sodomy? 10.15.Lewd or lascivious acts or the solicitation of the same? - ❑ 10.16. Oral copulation? _ ❑ I0.17. Continuous sexual abuse of child? ❑ �( 10.18.Foryible ads of sexual penetration or the solicitation of the same? ❑ Rl 10.19.SeM%dishibuting,priming or exhibiting of child pomograW ❑ �( 1020.Sexual exploitation of a child? 10.21.Bmptoyment or use of a minor to perform prohibited acts? ❑ O, 1022.Advatissmgg child pornography? ❑ 10.23.Poweadonofebmpomography7 ❑ 10.24.Annoying or molesting a child under 18? 10.25.Soliaptmn ofralw by face or violence,sodomy by fora or violence,or oral - ❑ Rl copulation by force or violence? 10.26.Indeceetexposvaa? ❑ 1027.Procuring,ootmselmg,or assisting any person to commit indecent exposme? ❑ .. 1028.Contributing to the delinquency of a minor? 1029.Sending hem&[materbi to a minor with the intent to aedtae said mica? ❑ 11. Haw you ever been 00,Muedofarmedrobbery? ❑ 1% 12. Have you ever bow convicted,of armed carjackmg? ❑ A 13. Have you ever been convicted ofassaultoraftempted murder ofapublicofficial? ❑ 34 14. Have you aver bpen convicted of Ww impriwarne t? ❑ 0 15. Have You aver been convicted of assault? ❑ h} 16. - Have you ever been convicted of battery? ❑ 17. Have you am been convictedofmm*z,.) ❑ Ill. Have you over bow convicted of mayhem? ❑ 19. Have you ever been convicted of a crime that requires you to register as a sax off xuler in the ❑ StmeofCalifomia? - - CERTIFICATION OF APPLICANT I hereby certt am all responses herein and cancel and I any misstatement a omission of :...material fact may cone fafeitnre on ofatl rights to amp Dater Slgnamre: v 772565.1 AGREEMENT TO USE FACILITIES This Agreement to Use Facilities("Agreement") is made and entered into this 1A day of 201 1 , by and between the City of Palm Springs ("City") and Shot kan Karate-Do Association of Southern California ("SKA")with reference to that certain facility located at 3601 East Mesquite Avenue in Palm Springs, California ("Facility"). The parties enter into this Agreement on the basis of the following facts and intentions: RECITALS WHEREAS, the City and SKA are mutually interested in providing needed amenities and community services to all residents of Palm Springs; and WHEREAS, it is recognized that, through this agreement, SKA will be afforded the opportunity, on the same basis as other lawful users, to provide services, including sports and recreation classes desired by the Community. NOW, THEREFORE, the City and SKA do hereby mutually agree as follows: 1. INTENT OF AGREEMENT 1.1 It is the intent of this agreement to describe the responsibilities of the City and SKA with reference to SKA's provision of services, including karate classes, desired by the residents of Palm Springs and surrounding communities. 2. AREAS OF RESPONSIBILITY 2.1 Facility Use and Scheduling 2.1.1 The City shall make available to SKA full access to karate room designated for SKA services and full access, with key to facility. Schedule of classes is contained in Exhibit "D". 2.1.2 SKA staff may use the kitchen/food service preparation area located on the first floor of the Facility. Users are required to clean up after themselves. 2.2 Security and Access 2.2.1 Any person having supervisory or disciplinary authority over any minor UJ is subject to a criminal background screening as specified in w California Public Resources Code Section 5164. Each employee or Cx w volunteer having supervisory or disciplinary authority over any minor qo must complete the supplemental questions attached as Exhibit "A" — and must concurrently submit to being fingerprinted. SKA must submit z o a completed copy of Exhibit "A" and arrange for the fingerprinting of 9 ] a � each employee and volunteer before this Agreement may be executed by the City. The first year that the City requires the background screening for a particular individual, the screening shall include screening by the federal government. All subsequent years that the City requires a background check on that same individual,the screening need only be performed by the state government. 2.2.2 SKA representatives are responsible for locking the building and setting the alarm upon departure in those instances that SKA staff are the last occupants in the facility. SKA shall identify to the City, in writing, one or more representatives responsible for securing the building and setting the alarm upon departure. SKA shall complywith Chapter 5.02 of the Palm Springs Municipal Code as an "alarm user" and shall be liable for all false alarm response fees pursuant to Palm Springs Municipal Code § 5.02.075 resulting from SKA's failure to set the alarm under circumstances required by this agreement. 2.3 Fees and Charges for Facility Use SKA agrees to pay the City$640.00 on or before the first of every month to continue using the Facility. An additional late charge of $35 shall be due on all late payments. 2.4 Personal Property. All karate equipment located inside the designated karate room are the property of SKA. 2.5 Mailbox SKA has a designated mail slot/inbox at the front reception counter area of the Facility. 2.6 Utilities SKA is responsible for establishing telephone lines, in separate accounts from the City, and is responsible for payment of monthly accounts related to these services 2 3. INSURANCE AND INDEMNIFICATION 3.1 SKA shall procure and maintain, at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement, including any extension thereof, the following policies of insurance: (a) Comprehensive General Liability Insurance. A policy of comprehensive general liability insurance written on a per-occurrence basis. A combined single limit of$1,000,000.00. (b) Workers' Compensation Insurance. To the extent required by Labor Code§3700, SKA shall procure and maintain workers' compensation insurance. All of the above policies of insurance shall be primary insurance and shall name the City, its officers, employees and agents as additional insureds. The insurer shall waive all rights of subrogation and contribution it may have against City, its officers, employees and agents and their respective insurers. All of said policies of insurance shall provide that said insurance may not be amended or canceled without providing thirty (30) days' prior written notice by registered mail to the City. In the event any of said policies of insurance are canceled, SKA shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 3.1 to the Contract Officer. SKA agrees that the provisions of this Section 3.1 shall not be construed as limiting in any way the extent to which SKA may be held responsible for the payment of damages to any persons or property resulting from SKA's activities or the activities of any person or persons for which SKA is otherwise responsible. 3.2 Indemnification SKA agrees to indemnify and defend the City, its officers, agents and employees against and shall hold and save them and each of them harmless from any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities (herein "claims or liabilities")that may be asserted or claimed by any persons,firm or entity arising out of or in connection with the activities at the Facility of SKA, its agents, employees or invitees, or arising from the negligent acts or omissions of SKA, or arising from SKA's negligent performance of or failure to perform any term, provision, covenant or condition of this Agreement, but excluding such claims or liabilities arising from the sole negligence or willful misconduct of the City, its officers, agents or employees, who are directly responsible to the City, and in connection therewith: 3 4. WAIVER OF UTILITY FAILURE 4.1 SKA expressly waives any and all claims to the City for compensation for any and all losses or damages sustained for any reason or any defect, deficiency or impairment of any utility system, water supply system, drainage system, electrical apparatus or wires serving the Facility with respect to the loss of the facility for SKA functions. 5. ENFORCEMENT OF AGREEMENT 5.1 California Law This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California. Legal actions concerning any dispute, claim or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Riverside, State of California, or any other appropriate court in such county, and SKA covenants and agrees to submit to the personal jurisdiction of such court in the event of such action. 5.2 Disputes In the event of any dispute arising under this Agreement, the injured party shall notify the injuring party in writing of its contentions by submitting a claim therefor. The injured party shall continue performing its obligations hereunder so long as the injuring party commences to cure such default within ten (1 Q) days of service of such notice and completes the cure of such default within forty-five (45) days after service of the notice, or such longer period as may be permitted by the injured party; provided that if the default is an immediate danger to the health, safety and general welfare, such immediate action may be necessary. Compliance with the provisions of the section shall be a condition precedent to termination of this Agreement for cause and to any legal action, and such compliance shall not be a waiver of any party's right to take legal action in the event that the dispute is not cured, provided that nothing herein shall limit City's or SKA's right to terminate this Agreement without cause pursuant to Section 5.8. 5.3 [Reserved] 5.4 Waiver No delay or omission in the exercise of any right or remedy by a non- defaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any subsequent act. Any waiver by either party of any default must be in writing 4 and shall not be a waiver of any other default concerning the same or any other provision of this Agreement. 5.5 Rights and Remedies are Cumulative Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party. 5.6 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. 5.7 Termination Prior to Expiration of Term This section shall govern any termination of this Agreement except as specifically provided in the following section for termination for cause. City reserves the right to terminate this Agreement at any time, with or without cause, upon sixty (60) days' written notice to SKA, except that where termination is due to the fault of SKA, the period of notice may be such shorter time as may be determined by the Contract Officer. In addition, SKA reserves the right to terminate this Agreement at any time, with or without cause, upon sixty (60) days' written notice to City, except that where termination is due to the fault of City, the period of notice may be such shorter time as SKA may determine. 5.8 Attorneys' Fees If either party to this Agreement is required to initiate or defend or made a party to any action or proceeding in any way connected with this Agreement, the prevailing party in such action or proceeding, in addition to any other relief that may be granted, whether legal or equitable, shall be entitled to reasonable attorneys' fees. Attorneys' fees shall include attorneys' fees on any appeal, and, in addition, a party entitled to attorneys' fees shall be entitled to all other reasonable costs for investigating such action, taking depositions and discovery, and all other necessary costs the court allows that are incurred in such litigation. All such fees shall be deemed to have accrued on commencement of such action and shall be enforceable whether or not such action is prosecuted to judgment. 5 6. CITY OFFICERS AND EMPLOYEES: NON-DISCRIMINATION 6.1 Non-Liability of City Officers and Employees No officer or employee of the City shall be personally liable to SKA, or any successor in interest, in the event of any default or breach by the City or for any amount that may become due to SKA or to its successor, or for breach of any obligation of the terms of this Agreement. 6.2 Non-Liability of SKA Officers and Employees No officer or employee of SKA shall be personally liable to the City, or any successor in interest, in the event of any default or breach by SKA or for any amount that may become due to City or to its successor, or for breach of any obligation of the terms of this Agreement. 6.3 Conflict of Interest No officer or employee of the City shall have any financial interest, direct or indirect, in this Agreement nor shall any such officer or employee participate in any decision relating to the Agreement that affects his financial interest or the financial interest of any corporation, partnership or association in which he is directly or indirectly interested, in violation of any state statute or regulation. SKA warrants that it has not paid or given and shall not pay or give any third party any money or other consideration for obtaining this Agreement. 6.4 Covenant Against Discrimination SKA covenants that, by and for itself, its heirs, executors, assigns and all persons claiming under or through it, that, to the extent permitted by law, there shall be no discrimination against or segregation of any person or group of persons on account of race, color, creed, religion, gender, marital status, sexual preference, domestic partnership status, national origin or ancestry in the performance of this Agreement. 7. MISCELLANEOUS PROVISIONS 7.1 Notice Any notice, demand, request, document, consent, approval or communication either party desires or is required to give to the other party or any other person shall be in writing and either served personally or sent by prepaid, first-class mail, in the case of the City, to the City Manager and to the attention of the Contract Officer, CITY OF PALM SPRINGS, P. O. Box 2743, Palm Springs, California 92263-2743, and, in the case of SKA, to the person at the address designated in Section 8.1. Either party may change its address by notifying the other party of the change of address in writing. 6 Notice shall be deemed communicated at the time personally delivered or in seventy-two (72) hours from the time of mailing if mailed as provided in this section. 7.2 Interpretation The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction that might otherwise apply. 7.3 Integration; Amendment It is understood that there are no oral agreements between the parties hereto affecting this Agreement and this Agreement supersedes and cancels any and all previous negotiations, arrangements, agreements and understandings, if any, between the parties, and none shall be used to interpret this Agreement. This Agreement may be amended at any time by the mutual consent of the parties by an instrument in writing. 7.4 Severability In the event that any one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that this invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless. 7.5 Corporate Authority The persons executing this Agreement on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv)the entering into this Agreement does not violate any provision of any other agreement to which said party is bound. 7 8. COORDINATION 8.1 Representative of SKA SKA's representative to coordinate with the City regarding operational matters is: Steve Beck 2015 N. San Gorgonio Rd. Palm Springs, CA 92262 Telephone: 760-449-7223 8.2 City Representative The City's shall assign a representative to coordinate with SKA regarding operational matters. 9. TERM 9.1 Unless earlier terminated in accordance with Section 5.7 of this Agreement, this Agreement shall continue in full force and effect for a period of one (1) year beginning July 1, 2010 and ending June 30, 2011. [Signatures on the Following Page] 8 IN WITNESS WHEREOF,the parties have executed and entered into this Agreement as of the date first written above. ATTEST: CITY OF PALM SPRINGS, a municipal corporation 6�y By. ity Clerk /6-�f Z p 1 1 David H. Read w City Manager SHOTOKAN KARATE-DO ASSOCIATION OF SOUTHERN tpEl � AS TO FORM CALIFORNIA By: City At�arney Steve Beck, Chief Instructor APPROVED BY CITY MANAGER � d pboao 9 "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 mirror. YES NO 1. Have you ever been convicted of sexual assault or assault with intent to commit mayhem? ❑ 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 18? ❑ 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? ❑ 13 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? ❑ 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? ❑ �s 10.11. Abduction(taking away)of a person under age 1.8 for purposes of prostitution? ❑ �/ A 10.12. Aggravated sexual assault of a child? ❑ �/� 10.13. Incest? ❑ YES NO 10.14, Sodomy? ❑ 10.15. Lewd or lascivious acts or the solicitation of the same? ❑ 14.16. Oral copulation? ❑ r 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? ❑ I(�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? I0.26. Indecent exposure? ❑ I0.27. 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'? ❑ ld_d'/� 12. Have you ever been convicted of armed ear acking? ❑ 13. Have you over 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 ❑ 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 may cause forfeiture on my pW of all ent by this ty. Date// -W/fgnature: "EXHIBIT A" Page 2 of 2 .. ............ . .. _ _ . .... .. .. . i "EXHIBIT A" i Page I 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? ❑ g 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 18? ❑ 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? 0 6. Have you ever been convicted of child endangerment? ❑ 7. Have you ever been convicted of corporal punishment or injury to a child? [p [ S. 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? ❑ +gl 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? ❑ lqi 10.4. Aiding,abetting or soliciting the rape,rape of a spouse,or forcible acts of sexual ❑ L 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 © 131 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 nunor7 ❑ 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 1.8 for purposes of prostitution? ❑ C5( 10.12. Aggravated sexual assault of a child? ❑ 19 10.13. Incest? 0 YES NO 10.14. Sodomy? ❑ 10.15. lewd or lascivious acts or the solicitation of the same? ❑ [ 10.16. Oral copulation? 0 l 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? El 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? ❑ Q 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? p 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 ❑ 1&AL State of California? CERTIFICATION OF APPLICANT 1 hereby certify that all responses herein are true and correct,and I understand and agree that any misstatement or omission of material fact may cause forfeiture on my part of all rights to employment by this City. Date: l .. Signature: "EXHIBIT A" Page 2 of 2 i I i "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 1, Have you ever been convicted of sexual assault or assault with intent to commit mayhem? ❑ Q" 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 18? ❑ 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? ❑ C � 6. Have you ever been convicted of child endangerment? ❑ 7. Have you ever been convicted of corporal punishment or injury to a child? ❑ S. Have you ever been convicted or willful infliction of corporal injury to a spouse,former ❑ E spouse,cohabitant,or mother or father of your child? 9. Have you ever been convicted of any sexual crime or offense? ❑ E - 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? 103, Sexual battery? ❑ Z� 10.4. Aiding,abetting or soliciting the rape,rape of'a spouse,or forcible acts of sexual ❑ i 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? 10.13. Incest? 0 i YES NO 10.14. Sodomy? ❑ p/ 10.15. Lewd or lascivious acts or the solicitation of the same? ❑ C3� 10.16. Oral copulation? ❑ 10.17. Continuous sexual abuse of a child? ❑ [r 10.18. Forcible acts of sexual penetration or the solicitation of the same? ❑ ET-' / 10.19. Selling,distributing,printing or exhibiting of child pornography? ❑ Q 10.20. Sexual exploitation of a child? ❑ 10.21. Employment or use of a minor to perform prohibited acts? ❑ Fr� 10,22. Advertising child pornography? ❑ Er-� 10.23. Possession of child pornography? ❑ 10.24. Annoying or molesting a child under 18? ❑ Er 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? ❑ p� I0.27, Procuring,counseling,or assisting any person to commit indecent exposure? ❑ 11-11 10.28. Contributing to the delinquency of a minor? ❑ f� 10.29. Sending harmful material to a minor with the intent to seduce said minor? ❑ L� 11. Have you ever been convicted of armed robbery? ❑ [� 12. Have you ever been convicted of armed carjaeking? ❑ (J 13. Have you over been convicted of assault or attempted murder of a public official? ❑ c.}' 14. Have you ever been convicted of false imprisonment? ❑ J� 15. Have you ever been convicted of assault? ❑ I� 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 ❑ (� 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 materi1al/fact t may cause forfeiture on my part of all rights to emvlQyrrient by this City. Date:`/J 1 �� Signature: "EXHIBIT A" Page 2 of 2 i i "EXHIBIT A" Page l 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 1K 1. Have you ever been convicted of sexual assault or assault with intent to commit mayhem? ❑ 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 18? ❑ i. 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? p 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? ❑ Kj If yes,were you convicted of kidnapping or attempted kidnapping with the intent to ❑ 1 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 conimit rape,sodomy,lewd or lascivious acts,oral copulation,or forcible acts of sexual penetration? 10.3. Sexual battery? ❑ 10.4. Aiding,abetting or soliciting die rape,rape of a spouse, or forcible acts of sexual ❑ �t penetration? 10.5. Enticement of an unmarried minor female for purposes of prostitution? ❑ C 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 ❑ CK 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? ❑ LIN 10.11. Abduction(taking away)of a person under age 1.8 for purposes of.prostitution? ❑ 10.12. Aggravated sexual assault of a child? ❑ 10.13. Incest? 0 �` i YES NO 10.14, Sodomy? ❑ ►► f 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? p 10.20. Sexual exploitation of a child.? 10.21. Employment or use of a minor to perform prohibited acts? p 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? p 12. Have you ever been convicted of armed catjacking? ❑ V 13. Have you ever been convicted of assault or attempted murder of a public official? ❑ (p; 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 ❑ State of California? CERTIFICATION OF APPLICANT I hereby certify that all responses herein eU3iq and correct,and I understand and agree that any misstatement or omission of material fact Mv cause forfeiture o of Il riZren this City, Date: 29faignature: "EXHIBIT A" Page 2 of 2 i I "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 1. Have you ever been convicted of sexual assault or assault with intent to commit mayhem? ❑ 'Ek 2. Have you ever been convicted or unlawful sexual intercourse with a person under age 18? ❑ 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? ❑ j 6. Have you ever been convicted of child endangerment? ❑ 7. Have you ever been convicted of corporal punishment or injury to a child? ❑ S. 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 becn 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 01 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? ❑ -El. 10.4. Aiding,abetting or soliciting the rape,rape of a spouse,or forcible acts of sexual 11 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? ❑ ,g 10.9. Pandering of a minor? p 1* 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 1.8 for purposes of prostitution? ❑ 1 . 10.12. Aggravated sexual assault of a child? ❑ 52- 10.13. Incest? 0 .... .. .......... .. ... . ............................ 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? p 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? p 10.21. Employment or use of a minor to perform prohibited acts? ❑ 10.22. Advertising child pornography? ❑ 10.23. Possession of child pornography? p 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 0 Z 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? G7 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? El ji� 14. Have you ever been convicted of false imprisonment? ❑ fz 15. Have you ever been convicted of assault? © . 16. Have you ever been convicted of battery? ❑ 17. Have you ever been convicted of murder? p 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 0 State of California? CERTIFICATION OF APPLICANT I hereby certify that all responses herein and correct,and I u9d at any misstatement or omission of material fact may cause forfeiture on in p of all rights to emp y-tlizs Date:_ Signature: "EXHIBIT A" Page 2 of 2 EXHIBIT "B" / LIST OF SKA'S EMPLOYEES AND VOLUNTEERS WHO HAVE SUPERVISORY OR DISCIPLINARY AUTHORITY. �jo PCa VACS 7,"o.0 rn ► o VCA >n C Io,uAi " mC v-ei',) V t clbpT w'SlQ y "EXHIBIT B" Page 1 of 1 EXHIBIT "C" RULES AND REGULATIONS 1. As between the City and the Tenant, the Tenant is responsible for maintaining the security of attendees and parked vehicles at the Facility through its own efforts, within the scope of the Tenant's exclusive use of the Facility or any portion thereof. 2. All of Tenant's refuse and rubbish shall be removed on a regular basis at Tenant's sole cost and expense. Tenant shall not place any rubbish or other matter outside any building within the Facility, except in such containers as are authorized from time to time by the City. 3. No radio or television or other similar device audible outside the facility shall be installed without obtaining in each instance the written consent of the City. No aerial shall be erected on the roof, exterior walls or grounds of the Facility without first obtaining in each instance the written consent of the City which consent shall not be unreasonably withheld or delayed. Any aerial so installed without such written consent shall be subject to removal without notice at any time. 4. No loudspeakers,televisions, phonographs, radios or other devices shall be used in a manner so as to be heard or seen outside of the Facility without complying with the provisions of the City's Noise Ordinance. 5. No sirens, outside paging or any type of signalization will be permitted, except approved alarm systems. 6. Tenant will not allow animals, except seeing-eye dogs, in, about or upon the Premises. EXHIBIT "D'' CLASS SCHEDULE SHOTOKAN El 1760 9 * 7 e ,. SCHEDULE MON DAY Beginner kids • 5:30 - 6:30 p.m. Beginner adults • 6:30 - 8:110 p.m. TUESDAY Women's Self Defense: 12-1 p.m. Advanced kids • 5:30 - 6:30 p.m. / Black/Brown Belts • 6:30 - %00 p.m. WEDNESDAY Beginner kids • 5:30 - 6:30 p.m. Beginner adults • 6:30 - 1:00 p.m. " THURSDAY Q Womens Self Defense: 12 - 1 p.m. Beginner kids • 5:30 - 6:30 p.m. Beginner adults • 6:30 - $:190 p.m. FRIDAY Competition/Advanced • 5:30 -- 7:00 p.m. SATU RDAY Beginners/Advanced • 10:00 - 11:00 a.m. DNT 5 IT Private lessons available. Please see Sensei Beck for details. THE BENC ...... . LOCATED AT THE PALM SPRINGS YMCA • MESQUITE AND EL CIELO