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2016-17 Instructor AgreementsRl _iyE Y City of La Quinta eC6J QW�&6 Community Services Department -- C;Lm _a, dr, m s�< r — Contract # 422701-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and GAYLE COCHRANE, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: PERSONAL TRAINING classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. %- (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 80% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 20% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of- pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of Rev May 2015 1 its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this fNSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change Rev May 2015 original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. Q (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. B. Vendor shall procure and maintain Sexual Abuse/Molestation Liability coverage with limits of not less than $100,000 per occurrence and $300,000 general aggregate. Coverage may be provided as part of Commercial General Liability coverage, Professional Liability coverage, or as a separate policy. 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT, 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. Rev May 2015 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. G� (initials) Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: Rev May 2015 CONTRACTOR: Gayle Cochrane 50275 Doral La Quinta, CA 92253 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Gayle Cochrane COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: By Ch' cdo, Community Resources Director COU ER IGNRII: By. Ali Chr� i deroli, Com u 'ty ices Supervisor APPROVFD- Rev May 2015 Hello Gayle, Below is your class information for May — September 2016. Please review and verify by typing your name and date on the lines below as soon as possible. Personal Trainer Instructor: Gayle Cochrane, CPT ACE Cost Da s Time Location TOTH 12-8pm Wellness Center Fitness Room 472701 $45 (1 day) 472702 $160 (4 Sessions) 4727003 $280(8 Sessions) Sessions: 5/3 — 5/31, 6/2 — 6/30, 7/5 — 7/28, 8/2 — 8/30, 9/1 — 9/29 Web Trac Brochure Info: Please place a description here. Instructor Signature: Date T� —/4e Signing this docu t only verifie that you have read and understand the material within this document. is document shall not act as a contractual agreement between you and the City of La Quinta. The personal training and packages rates I'd like to offer at an 80/20 split with La Quinta Wellness Center are as follows: Single session (1hour): $45.00 5 sessions: $160 ($40.00/session) 10 sessions: $280 ($35.00/session) Gayle Cochrane 50275 Doral Street, La Quinta, 92253 1-858-735-7704 gacfitness@gmail.com VV-Q- P e+u ua K CERTIFICATE OF LIABILITY INSURANCE GATE 06/0(M2/016/2016 Y) PRODUCER Maguire Insurance Agency, Inc. 27101 Puerta Real Suite 200 Mission Viejo, CA 92691- 877.438 7459 INSURED Gayle Cochrane 50275 Doral St La Quinta, CA 92253- COVERAGES THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL t4 INSURER A: Philadelphia Indemnity Insurance Company _ 1gD5R INSURER B: _ INSURER C: _ INSURER D: !NSURER E - 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 CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'! POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY) DATE MM/OD/YYYYI UNITES A X GENERAL LIABILITY PHPK1474099- 04/04/2016 04/04/2017 EACH OCCURENCE _ $],D00,000 PREM $ E omrrr ne $100.000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 000 MED EXP (Any one person) $2,500 PERSONAL&ADV INJURY S10W,D00 X PROFESSIONALLIARIUTY GENERAL AGGREGATE $3,000,000 - PRODUCTS — COMP/OP AGG S3,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PROIECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUT05 (Per person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE UARI LOY AUTO ONLY — EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONLY: AGG EXCESS / UMBRELLA UABIUTY OCCUR CLAIMS MADE EACH OCCURENCE AGGREGATE DEDUCTIBLE RETENTION EiyIPLOYERS' IIABIlff7 Y/N ANv PROPRiETORAIA'RTNER/EXECUTIVE O DFTiCERIMEMRER EXCLUDE U7 70AY UM175 ER E L EACH ACCIDENT - (Mandatory in NH) Yf w, dewnhn. under SPECIA7 PROVISIONS below E. L. DISEASE — EA AMPLOYEE _ .— - E.L, DISEASE —POLICY LIMIT - OTHER Sexual Abuse/Molestation 04/04/2016 04/04/2017 EACH OCCURENCE $1,0013,000 GENERAL AGGREGATE $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS it is understood and agreed that the following entity: The City of La Quinta is added as an additional insured but only with respect(s) to the operations of the named insured except that Ilability resulting from the additional insured's sole negligence CERTIFICATE HOLDER CANCELLATION The City of La Quinta 79495 Catle Tampico La Quinta, CA 92253-2839 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE eo--4��(D ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY CHANGE DOCUMENT POLICY NO: CHANGE # 3 CHANGE EFFECTIVE: 04/04/2016 PHPK1474099-000 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: Gayle Cochrane MAILING ADDRESS 50275 Doral St La Quinta, CA 92253- POLICY PERIOD: FROM 04/04/2016 TO 04/04/2017 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Amending Additional Insured: The City of La Quinta Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 Page 1 of 1 POLICY NUMBER: PHPK1474099-000 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) The City of La Quinta 78495 Calle Tampico La Quinta CA 92253-2839 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 PI-FW-006 (01/07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SEXUAL ABUSE ENDORSEMENT This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Part SCHEDULE Sexual Abuse Limits of Insurance Sexual Abuse Each Occurrence Limit: Sexual Abuse Aggregate Limit $100,000 $300,000 A. Except as otherwise provided by this endorsement, this policy does not apply to "bodily injury," "property damage" or "personal and advertising injury" caused by, based upon or arising, in whole or in part, out of any: 1. Actual, threatened or alleged "sexual abuse" or "sexual harassment'; or 2. "Negligent employment' of any person who caused or commits or is alleged to have caused or committed "sexual abuse" or "sexual harassment." As respects coverage afforded by this endorsement, the following changes apply to the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: B. Paragraph 1. of Section I — Coverages — Coverage A — Bodily Injury And Property Damage Liability is deleted and replaced by the following: 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit' seeking those damages, including any "suit' alleging that the "bodily injury" arose out of "sexual abuse" caused or committed by the insured. However, we will have no duty to defend or continue to defend any insured against: (1) any "suit' seeking damages for "bodily injury" to which this insurance does not apply; (2) any "suit' for which the insured is found to have in fact caused or committed an act of "sexual abuse"; or (3) any "suit' for which the insured has admitted to have in fact caused or committed an act of "sexual abuse." We may, at our discretion, investigate any 'occurrence" and settle any claim or "suit' that may result. But: Page 1 of 4 PI-FW-006 (01/07) (a) The amount we will pay for damages is limited as described in Section F — Limits Of Insurance of this endorsement; and (b) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or "defense expenses" under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided under Section D of this endorsement — Supplementary Payments — Coverage A and B. b. This insurance applies to "bodily injury" only if: (1) the "bodily injury" is caused by an "occurrence" that first commences in the "coverage territory" at a specific date and time on or after the effective date of this endorsement and during the policy period; (2) the "bodily injury" arises out of "sexual abuse" caused or committed by your "employee"; and (3) the "sexual abuse" arises out of your "negligent employment" of that "employee." C. The insurance provided by this endorsement is subject to the following additional exclusions: 2. Exclusions This insurance does not apply to: a. Any person who: (1) Has admitted to or been found guilty of, or pled guilty or nolo contendere to any act involving "sexual abuse"; (2) Participated in, directed or knowingly allowed "sexual abuse"; or (3) Has failed to comply with any applicable law, ordinance or regulation which requires the reporting of "sexual abuse" after having knowledge of the "sexual abuse." b. Any expense associated with a criminal trial, proceeding or investigation, or to any expense for appeals for any "suit" against you or any person insured. c. Any claim for damages arising out of "sexual abuse" which is part of a series of related acts of "sexual abuse" if the first of such series of acts took place before the effective date of this endorsement. d. Any claim for damages arising out of "sexual abuse" alleged to have been caused or committed by any "employee" who had previously committed such an act of which any insured had knowledge. e. Any liability of others assumed by you under any contract or agreement, either oral or written. f. Any claim made against an insured by another insured. g. Any "sexual abuse" caused or committed by or which is alleged to have been caused or committed by any independent contractor or employee or agent of such independent contractor. h. "Sexual harassment." i. "Bodily injury" arising from any violation or alleged violation of the civil rights of any person. Page 2 of 4 PI-FW-006 (01/07) D. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B With respect to the insurance provided by this endorsement, Paragraph 1.a. and Paragraph 2. of Section I — Supplementary Payments — Coverages A and B are deleted. E. WHO IS AN INSURED With respect to the insurance provided by this endorsement, Paragraph 2. of Section II — Who Is An Insured is deleted. F. LIMITS OF INSURANCE For purposes of the coverage provided by this endorsement, the following is added to Section III — Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM and applies solely to this coverage: 1. The Sexual Abuse Limits of Insurance shown in the SCHEDULE of this endorsement and the rules below fix the most we will pay for damages and "defense expenses", regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits." 2. The Sexual Abuse Aggregate Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury" arising out of "sexual abuse." 3. Subject to 2. above, the Sexual Abuse Each Occurrence Limit shown in the SCHEDULE of this endorsement is the most we will pay for the sum of all damages and "defense expenses" because of all "bodily injury" arising out of "sexual abuse" from any one "occurrence." 4. Subject to 1., 2., and 3. above, covered damages for which insurance is afforded by this endorsement will apply against and reduce the General Aggregate Limit of this policy, as described in Paragraph 2. of Section III — Limits Of Insurance of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM. The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed to be part of the last preceding period for purposes of determining the Limits of Insurance. G. For purposes of the coverage provided by this endorsement, the following definitions are added to Section V — Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM: 1. "Defense expenses" means: a. Fees, costs and expenses charged by attorneys retained by us; and b. Reasonable and necessary fees, costs and expenses resulting from the investigation, adjustment, defense or appeal of a claim. "Defense expenses" do not include: a. Salaries, loss of earnings, reimbursement for the insured's time or attendance required at any investigation, defense or appearance; or b. Other remuneration by or to any insured. Page 3 of 4 PI-FW-006 (01/07) 2. "Negligent employment' means negligent selection, investigation, supervision, training or retention of an "employee." 3. "Sexual abuse" means actual or alleged physical abuse arising out of a single, continuous or repeated exposure of one or more persons to acts of a sexual nature involving inappropriate physical contact caused by or committed by: a. One person; or b. Two or more persons acting together or in related acts or series of acts. All related, interrelated, repeated or continuous episodes of "sexual abuse" involving the same claimant or perpetrator shall be deemed to be a single 'occurrence." 4. "Sexual harassment' means inappropriate non-physical actions or verbal comments or suggestions of a sexual nature. H. For purposes of the coverage provided by this endorsement, Paragraph 13. of Section V — Definitions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include: 13. "Occurrence" means any act of "sexual abuse." Page 4 of 4 This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and TERESA SHIRY, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. 1. SCOPE OF WORK. The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once ap ved by CITY will be attached as exhibits to this INSTRUCTOR AGREEME (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shalt be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shalt pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shalt be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for th performance of the services of CONTRACTOR as an independent contractor and nc as an employee of CITY. Neither CITY nor any of its employees shall have an control over the manner, mode, or means by which CONTRACTOR or its agent! perform the services required herein, except as otherwise set forth hereir CONTRACTOR shall perform all services required herein as an indepencler contractor of CITY and shall remain at all times as to CITY a Wholly independer. contractor with only such obligations as are consistent With that rote. CONTRACTO shall have no power to incur any debt, obligation, or liability on behalf of CID CONTRACTOR shall not at any time or in any manner represent that it or any of it agents or employees are agents or employees of CITY. CONTRACTOR and any of it agent, and subcontractors providing services under this INSTRUCTOR AGREEMEN shall not qualify for or become entitled to any compensation, benefit, or an incident of employment�by CITY, including but not limited to eligibility to enrott ii the California Public Employees Retirement System ("PERS") as an employee of CIT' and entitlement to any contribution to be paid by CITY for employer contribution and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay a required taxes on amounts paid to CONTRACTOR under this INSTRUCTOI AGREEMENT, and to indemnify and hold CITY harmless from any and all taxe! assessments, penalties, and interest asserted against CITY by reason of th, independent contractor relationship created by this INSTRUCTOR AGREEMENT. CIT' shall have the right to offset against the amount of any compensation due b CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY fron CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY an, reimbursement or indemnification arising under this paragraph. 4. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings ' administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right (but not t e•uty to monitor the handling of any such claim or claims if they are likely to involve CITY. Ilk I I IS rZol fis 1 0 1 kk to schedule a map daic (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify Of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CIT (initials) 6. INSURANCE. it s to be understood that CONTRACTOR is Working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. Rev May 2015 A. Commercial General Liability Insurance using Insurance Services Offic "Commercial General Liability" policy form CG 00 01, with an edition do prior to 2004, or the exact equivalent. Coverage for an additional insure shall not be limited to its vicarious liability. Defense costs must be paid i addition to limits. Limits shall be no less than $1,000 ' 000 per occurrence f all covered losses and no less than $2,000,000 general aggregate. 6.1 CONTRACTOR agrees to provide evidence of the insurance require herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencin all of the coverages required and, (b) an additional insured endorsement t CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with a t edition date prior to 1988, which form shall include coverage for completeW operations. The additional insured endorsement shall expressly name CITY, i officers, and employees as additional insureds on the policy (ies) as to commerd general liability coverages, and completed operations coverages, with respect ts s' liabilities arising out of CONTRACTOR's performance of the services under thi INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shalt, prior to the cancellation at submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the some shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE". CONTRACTOR will be required to Obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinto Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW All services rendered hereunder shall be provide1 E --- in accordance with all ordinances, resolutions, statutes, rules, regulations, and la of •m w, of CITY and any Federal, State, or local government agency copeten jurisdiction. 1 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants tha by and for itself, its heirs, executors, assigns, and all persons claiming under o 11 through them, that there shall be no discrimination against or segregation of, an person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTO AGREEMENT. Rev May 2015 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assig this INSTRUCTOR AGREEMENT or its rights or duties without prior writte authorization from CITY. Should such authorization be granted, CONTRACTO agrees to inf•r •ny subcontractor of all the stipulations of this INSTRUCTO AGREEMJ �NL! �' (initials) I Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. 1ERMINATION. It is understood that CONTRACTOR wiH per orm a services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR ,,GREEMENT. 12. NOTICE. Notice shalt be deemed given When CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, Via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Teresa Shiry 52391 k**0jkqWL_0 La Quinta, CA 92253 Community Services Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 C.-, �_Zl(initials) 13. OOCUMENM Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition o t is INSTRU T• R AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Teresa Shiry COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ( tiCITYPI APPROVED: t By. Qedo. Communitv Resources Director APPROVED - Signature 52390 Avenida Velasco La Quinta, CA 92253 310.529.4932 COUNTERSIGNED: BY6 a M a Chi ik6Cold�ron,torni'tO;ogram� Wellness Supervisor Rev May 2015 6 Hello Teresa, Below is your class information for May through Sept 2016. Please review and verify by typing your name and date on the lines below as soon as possible. Cost Da s Time Location $ T 7-8pm Wellness Center Multipurpose room —Stage side Session: 5/3-5/31, 8/2-8/30 =$ 40 (5 classes) drop -in fee $10 Session: 6/7-6/28, 7/,5,_-26, 9/6-9/27=$32 (4 classes) drop -in fee $10 Web Trac Brochure Info: Fundamentals are taught and include how to lead and follow, connect with musical beat, and acquire a natural dance style. Students will learn two dances. Your instructor Teresa Shiry is open for suggestions on what dances you would like to learn. Cost Da Time Location $32/10 T 6-7pm Wellness Center Multipurpose Room Session: 5/3-5/31; 8/2-8/30 = $40 (5 classes) drop -in fee $10 Session: 6/7-6/28, 7/5-7/26, 9/6-9/27=$32 (4 classes) drop -in fee $10 Web Trac Brochure Info: If you are currently comfortable with the basics of a variety of Ballroom dances you will enjoy learning the finer details of dancing. Focus will be on learning one dance to help achieve confidence and encourage you to add your personal style. "y D Instructor Signature: 3 e Signing this document only verifies that you h;ead and understand the material within this document. This document shall not act as a;c ntractual agreement between you and the City of La Quinta, Minimum 5 students and the Maximum 25 students DATE (M/DD ) CERTIFICATE LIABILITY INSURANCE06/28/2014 PRODUCER - THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Maguire Insurance Agency, Inc.' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 27101 Puerto Real suite zoo HOLDER. THIS CERTIFICATE DOES NOT REND, EXTEND OR Mission Viejo, CA 92691- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 877,438.7459 _ - -- INSURERS AFFORDING_ COVERAGE NAIC # INSURED - INSURER A: Philadef hia Indemni insurance Com an 18058 Teresa Shlry :INSURER B: 52390 Avenida Velasco. INSURER C: La Quinta, CA 92253- INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE.. POLICY NUMBER DAT€ M DD... DATE JMMJ22-- LIMITS A X GENERAL LLABIUTY PHPK1343296- 06/01/2016 06/01/2017 EACH OCCURENCE S1,000,000 TXCOMMERCIAL GENERAL LIABILITY001 PREMJSES Ta oiCnrped6C.e S10O,000 CLAIMSMADE r:OCCUR MED EXP (Any one person).$2,500 FESSIONAL LIABILITY PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG.. S3.,000.000 X POLICY '.. PROJECT LOC - - AUTOMOBILELIABILITY" _ COMBINED SINGLE LIMIT ANY AUTO (EA accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNEDAUT05 (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS/ UMBRELLA LIABILITY EACH OCCURENCE OCCUR CLAIMS MADE AGGREGATE RDEDUCTIBLE _ RETENTION £MfrLOYERS` LIABILITY Y N TOR, UAAITS ER ANY PROPRICTORIPARTNER/EXECUTIVE OFFICER/MEMBER XCLIIDED7 E.L::EACHACCIDENT ' . (Mandatory In NH) E.L. D15EASE — EA AMPLOYEE Mes describe under &L l RAOVISIONS below E.L. DISEASE —POLICY LIMIT -.. OTHER - -- -- DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is understood and agreed that the following entity: The City of La Quinta is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence. This insurance is primary, with any insurance or self-insurance program maintained by the name of person or organization listed being non-contributing excepting loss resultingi:'..- from the sole negligence of the name of person or organization listed. CERTIFICATE HOLDER CANCELLATION --- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED. BEFORE THE EXPIRATION DATE The City of La Quinta THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE'. 78495 Calle Tampico CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR. La Quinta, CA 92253-2839 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved,. The ACORD name and logo are registered marks of ACORD 11 IMPORTANT � If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement ~nthis certificate does not confer rights to the certificate holder in lieu of such enclorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights tothe certificate holder in lieu of � suchendooement(s). . DISCLAIMER ' This Certificate of Insurance does not constitute a contract between the issuing insuner(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, 'N extend oralter the coverage afforded bythe policies listed thereon. This `endorsement modifies insurance provided under the : The City of La Quinta La Quinta CA 92253-2839 ;T4NERM _ this Schedule, if not shown above, will be shown in the D Section U1—~--~~-Insured ' amended boin- clude aaanadditional insured the pe (e) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" oouoed. inwhole or in part by your acts or omissions or the acts oromis- sions ofthose acting onyour behalf: A. |nthe performance ofyour ongoing operations; or B. In connection with your premises owned by or rented toyou. ~�~ CG 2026 07 04 @|8O Properties, Inc., 2004 Page 1 of E3 This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and RICK MOLLINDO, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. L" a we-, I z 1 OX4111 z I I IT-1 T144 t 4111111111 1. SCOPE OF WORK. The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, o ved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. 7r (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services- pe rfo rmed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shalt submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated base on t e o owing: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR., This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent Rev May 2015 1 PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right ( ut not t e uty to monitor the handling of any such claim or claims if they are likely to involve CITY. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. ��ials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CO must be made up in a timely manner as approved by CITY. 7= nitials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial Genera Lia ility insurance using nsurance services Office "Commercial Genera[ Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shalt be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required - herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using !SO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6 * 2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if- (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEME11T. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to in ractor of all the stipulations of this INSTRUCTOR AGIRENENT. ; Rev May 2015 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform aR services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, foxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Rick Mollindo 495 E. Twin Palms Apt. 50 Palm Springs, CA 92264 CITY: Community Services Department City of La Quinta La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14 * MISCELLANEOUS- This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year is first stated above. COMMUNITYCITY OF LA QUINTA, Rick Mollindo APPPO D: APPROVED: L By: By: Tusti Larson, Cam nity Resources Manager Sigh Lure 495 E. Twin Palms Apt. 50 Palm Springs, CA 92264 909.816.1014 COUNTERSIGNED: a By:a. Chris ina Calderon, Cbrfimuniy Programs & Wellness Supervisor Rev May 2015 6 Hello Rick, Below is your class information for July through Sept 2016. Please review and verify by typing your name and dating the lines below: 411201 Beginning Guitar Instructor: Rick Mollindo Learn the basics, chords, rhythms, tablature, finger picking, tuning. Class materials and practice website provided. Cost Da Times- Location $55 T 6-7pm Wellness Center- Leisure Room Sessions: 6/7-6/28;7/5-7/26; 8/2-8/23; 9/6-9/27 411202 Second Level Guitar Instructor: Rick Mollindo Introduction to reading standard notation for simple guitar solos. Instructor: Rick Mollindo Cost Day/sTi,me/s---,-- - Location $50 T 7-8pm Wellness Center -Leisure Room Sessions: 7/5-7/26; 8/2-8/23; 9/6-9/27 Materials; f6 B''EIM: Class materials provided. Students are required to bring an acoustic or electric guitar, a pick, and an optional music stand. If you need advice purchasing a guitar, call instructor 760-565-8396. Instructor Signature: Richard Mollindo--Date 3/22/16_ Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. DATE (MMIDDIYYYYj ACOPREP CERTIFICATE OF LIABILITY INSURANCE i 6/14/2016 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. $MPORTANT- It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s CONTACT PRODUCER MA,ME I3e nrr. Inc PAX License #QE67789 PHONE, k1t,_,81.3$ fI199 _._e_Ng17 1 Bene-Marc Athletic Insurance Agency E#1AIL Af ESS 6301 Southwest Blvd, Suite 101 INSUDZFN AFFi:1RDlNO coVERAGE rIA1C d Fort Worth TX 76132 IN w.N .._ u. . INSURED INSURER B: AXI�. CiI012N1 E'IC&ldent,�-..H:.a,ltll,,.�,. .. Southern California Municipal Athletic Federation INSURERC:,m__,�„�„___.-:.____....,�,,.n.;a. PO Box 3605, INSURERE: _u South El Monte, CA 91733 INSURERF: . COVERAGES CERTIFICATE NU1418EFi: _ 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 f ._.....�,.�,.� .,--.._..w ...-. ,...w...��.,.0 _ _.- �_ iG.7r .., A R � PpLIOYE.FF P YEYY) LIMITS TYPE OF INSURANCE POLICY NUMBERWD GENERAL LIABILITY EACH OCCURRENCE dA� r TNtLD` .. u A COMMERCIAL GENERAL LIABILITY ,PREMISE,S;Ea apc: I .$. 100,000.00 CLAIMS -MADE OCCUR MEDBXI'(Asey®nePerscxtl „ $. ®�.5r000W0II IIW W F3ES I atlici a111 - µ- X CP03256-04 12(31/2015 12/31/201 PERSONALSADYIAIJURY 11000 000,00 1a11i ... afn GENERAL AGGREGATE $. 2,000„000,00 12:01 am 12:01 ...OEN'L AGGREGATE. LIMIT APPLIES PER: PftOG?U 'S COMPI P AGG $..: 1,000,000 00.. POLICY r wR " L Mod`Ex a fc r cctators I in1 ..:AUTOMOBILE LIABILITY eOMgg 0$O CAE LIMIT .$.� ANY AUTO BODILY INJURY (Per person) $ ._ a..... , _,�....-.,�..,..,, 6ANED" w, SCHEDULED BODILY INJURY (PeracGdenl) $. �1.17;00 000 AUTOSNON-OWNED PERT% t ^"�I+sPa °+ _... $uros Auros 12l31l201SiACP03256-04 $ LA LIAB OCCUR EACHOCCURRENCE,._,_ .LIAB CLAIMS MADE fiaCREGATETENTi $ _. $ WORKERS COMPENSATION STA P[P.• ti3 AND EMPLOYERS' LIABILITY YIN _ ANY PROPRIETOR/PARTNER/EXECUTIVE N I A E.L. EACH ACCIDENT $ OFFICEMMIEMUE.R: EXCLUDED? (Mandatory In NN) E L ASE DISEEA FMPLOYE II t s, describe t ndw . t ._.._ t7ESCRIPTtON OF OPERATIONS t5ORN E.t, nlSEA.'S.E • Pi3il%Y LIMIT �. SRPO-50256-243 12/31/2015 12/31/2016 Medical Limit $5,000.00 B Participants Excess Accident 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AttachACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'] Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence - and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approver! Recreational Classes', 12/31 /2015 - 12/31/2016. CERTIFICATE HOLDER CANCELLATION Cert #: 9066-30899-215380-0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta, CA 92253 Attn: Risk anagenient ©1988-2010 ACORD COR RATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILIT'3 CG 24 04 05 Oa MNI WAIVER OF TRANSFER OF RIGHTS OF RECOVER I AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: •P I 1:1 1.101 Bill" &*fflolyj kyll w 4:0 1 :1 WC W6 C1.141-111 I IJ10N 1612 4 F.111.1 I I I WKISK�ft"TAR" SCHEDULE Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 The following is added to Paragraph 8i Trans er g s Of Recovery Against Others T Us of Section IV - Conditions: I I Iml CG 24 04 05 09 @ Insurance Services Office, Inc., 2008 Page 1 of 1 0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to com lete this Schedule, if not shown above, will be shown in the Declarations. __J A, SemtionU—Who Is An Insured is amended to include onmnadditional insured the (o) or nrgnniodion(u)shown inthe Schedule, but only with respect to liability arising out of the ownership, maintenance oruse ofthat part ofthe premises leased to you and shown in the Schedule and subject 0mthe following additional exclusions: This insurance does not apply to: 1. Any "uoounanco^which takes place after you cease boboatenant inthat premises. 2.Structunm| a|Umnmtiuno, now construction or demolition operations performed by or on behalf of the person(s) o, organization(s) shown inthe Schedule. However: 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded tuauohadditionm| insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect tothe insurance afforded to \h000 additional insureds, the following is added to SenUun|U—Limits Of Insurance: If coverage provided to the additional insured is required byacontract oragreement, the most we will pay on behalf ofthe additional insured is the amount ufinsurance: 1. Required bythe contract uragreement; or 2.Avai|ab|o under the applicable Limits ,f Insurance shown inthe Declarations; t The insurance afforded to such additional whichever isless. insured only applies to the extent permitted This endorsement shall not increase the bylaw; and applicable Limits of |noumnoo shown in the Declarations. CG20 1104f3 0Insurance Services Office, Inc., 2012 Page 1of1 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 11, 2016 RE: Stacy Misell, Fitness Classes, AGR2016-0067, Instructor Attached for your signature is an agreement for Fitness (Zumba) classes with independent contracted instructor Stacy Misell. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number:101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 60% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute thiSagreement_is based upon: N/A Approved by the City Council on X Community Resources Manger's signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents Qre attached to the agreement: * I X Insurance certificates as required by the agreement (approved by Risk Manager on I date) N/A Performance bonds as required by the agreement (originals) PA/W � , X City of La Quinta Business License number LIC-763820 expires 4/30/2017 N/A Purchase Order number City of La Quinta ta Community Services Department - GEXI of 1h, DESLR - - Contract # 422901-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and STACY MISELL, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re- locate said program to another suitable facility if one is available. If there are no available facilities, CITY will can said program and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or ch ed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. S. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to subcontractor of all the stipulations of this INSTRUCTOR M-C-- AGREEMEN(initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. ame Address ,Phon Number 3`l-1c� Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Stacy Misell 72759 Hedgehog Street Palm Desert, CA 92260 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 1`4� (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Stacy Misell COMMUNITY SERVICES DEPARTMENT -("CONTRACTOR") ("CITY") APPRO ED: APPROVE By: By: Tust n Larson, CorKrnunity Resources Manager Signature 72759 Hedgehog"Street Palm Desert, CA 92260 760.902.7771 COUNTERSIGNED: �/h/a By Chriit4& Calderon, Com unity Programs and Wellness Supervisor Rev May 2015 Hello Stacy, Below is your class information, for May — September 2016. Please review and verify by typing your name and date on the lines below as soon as possible. 422901 Zumba Morning Instructors: Stacy Missel Cost Dayls Time Location $ T/TH 8:45-9:45am Wellness Center Aerobics Room Sessions: 5/3-5/31, 6/2 — 6/30, 8/2 — 8/30; 9/1— 9/29 = $33.50/drop in $6 (9 classes) Sessions: 7/5 — 7/28, = $28 +2 = 30/drop in $6 (8 classes) (Aerobics Room 5/12, 6/9, 7/14, 8/11, 9/8) Web Trac Brochure Info: The most awesome workout ever; dance to great music, with great people, and burn calories without even realizing it. 422902 Zumba Morning Saturday Instructors: Stacy Missel Sessions: 7/4 — 7/30= ] 9:s0 (15, Isses) Sessions: 8/6 — 8/27; 9/ T 24=$16.00 (4 classes) Instructor Signature: _ . Date + Signing this document on ver f1 s t at you have read and und'ertand the material w�ththis 9 9 Y document. This document sh I not act as a contractual agreement between you and the City of La Quinta. Drop in 492901 — Tuesday/Thursday July $6 DATE (MMIDD/YYYY) ACC'RV CERTIFICATE OF LIABILITY INSURANCE 6/ 14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License 4OE67789 PHONE FAX Bene-Marc Athletic Insurance Agency EMAIL id}• (8�7]�38-6899 SAT Alc.N°t--�fR17 6301 Southwest Blvd, Suite 101 Fort Worth, TX 76132 INSURED Southern California Municipal Athletic Federation PO Box 3605, South El Monte, CA 91733 rn%irzDA f9FC L`FATIFICATF MI IMRFI7- INSURER e ; _ AXIS_Global Accident,&Health_ INSURER C : INSURER D : INSURER E . INSURER F : RFvi.ginN NIIMRFR• NAIC p THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R L RMM TYPE OF INSURANCE A L' POLicY NUMBER MWDA yM MffFF POLICY YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 PREMISES tEooccwencel $ 100,000'00 A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 10 OCCUR v MEDEXP A onepersgn) S 5,000.00 X �NC-6UElE9-Partiei> X ;/ CP03256-04 12/31/2015 12/31/2016 PERSONAL & ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 1_cUl f-"PLlty - 12:01 am 12:01 am GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $ 1,000,000.00 Med Ex f r$S ectators Only POLICY PRv' ElLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a auodenl BODILY INJURY (Per person)ALL ANYAUTO BODILYINJURY(Peraccident) $ OWNED SCHEDULED AUTOS AUTOS NON-OWNED��- J 12/31/2015 12/31/201 (ParaPROP i DAMAGE $ AHIREDAUTOS CP03256-04 01 UMBRELLA LIAB OCCUR nit, EACH OCCURRENCE _ $ $ EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION_ $ $ WORKERS COMPENSATION _ WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN - - - —' ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ DISEASE -POLICY LIMIT S If yes, desulbe under • DESCRIPTION OF OPERATIONS below 0E.L. 12/31/2015 12/31/2016 Medical Limit $5,000.00 B Participants Excess Accident SRPO-50256-243 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. CERTIFICATE HOLDER CANCELLATION Cert #:9066-30899-215380-0 City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Attn: Risk Manaeemei SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01M M ©1988-2010 ACORD CORF6bRATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 11 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 1104 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 P MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 18, 2016 RE: Kristoffer Kepler, Personal Trainer, AGR2O16-0078, Instructor Attached for your signature is an agreement with independent contracted Personal Trainer Kristoffer Kepler. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as -appropriate: X Contract payments will be charged to account number:101-0000-42214 & 101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 80% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on X Community Resources Director signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) X Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-7639902 Expires 7/31/2017 N/A Purchase Order number J City of La Quinta Community Services Department Contract # 421903-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and KRISTOFFER KEPLER, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: PERSONAL TRAINING classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. r z initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 80% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 20% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2016 1 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right (but not the duty) to Rev May 2016 2 monitor the handling of any such claim or claims if they are likely to involve CITY. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pro ram and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. ��initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. B. Vendor shall procure and maintain Sexual Abuse/Molestation Liability coverage with limits of not less than $100,000 per occurrence and $300,000 general aggregate. Coverage may be provided as part of Commercial General Liability coverage, Professional Liability coverage, or as a separate policy. Rev May 2016 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. ,CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) r? Rev May 2016 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Kristoffer Kepler 77777 Country Club Dr. Apt.11 Palm Desert, CA 92260 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2016 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Kristoffer Kepler COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY') APPROVED: By r �= Chn obedo, Community Resources Director APPROVED: By: �_ _._ Sig at — 7' 77777 Country Club Drive Dr. Apt. 11 Palm Desert, CA 92260 760.984.7669 COUNTERSIG ED: By:1y11,W�,.f,/y.0 Chri ti Cald ron, om u r rams a�rr e s Supervisor Rev May 2016 PRODUCER Maguire Insurance Agency, Inc 27101 Puerta Real Suite 200 Mission Viejo, CA 92691- 877.438.7459 INSURED Kristoffer Kepler 77777 Country Club Dr Apt 11 Palm Desert, CA 92211- COVERAGES CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/Y 07/12/2016 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURER A: Philadelphia Indemnity Insurance Companv 19059 INSURER B: INSURER C: INSURER D: INSI,IRER F' 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 CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MWDDAYYY) DATE (MMIDDIMYI LIMITS A X GENERAL LIABILITY PHPK14U1177- 10/01/2015 10/01/2016 EACH OCCURENCE 51,000,000 PREMISES Ea nrrprftlnCg $100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE F OCCUR 000 VIED EXP (Any one person) S2,500 PERSONAL & ADV INJURY $1,000,000 . PROFESSIONAL LIABILITY GENERAL AGGREGATE $3,000,000 PRODUCTS — COMP/OP AGG $3,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY11 PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY —EA ACCIDENT _ OTHER THAN EA ACC ANY AUTO AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURENCE AGGREGATE OCCUR E] CLAIMS MADE DEDUCTIBLE RETENTION WORKER!, CDMP`ENnTR5ITM7I= EMPLOYERS' UAMUTY V N S - TORY LIMITS ER ANY PROPRIETOR PARTNER/EXECUTIVE OFFICERJNAEMBER �XCLUDED? u E L EACH ACCIDENT E L. DISEASE— EA AMPLOYEE (Mandatory in NH) IY yyes, describe under Ss'ECJAL PROVISIONS below E-L DISEASE —POLICY LIMIT OTHER Abuse and Molestation as part of PHPK1401177 10/01/2015 10/01 /2016 $100.000 / $300,000 the General Liability -000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence. This insurance is primary, with any insurance or self-insurance program maintained by the name of person or organization listed being non-contributing excepting loss resulting from the sole negligence of the name of person or organization listed CERTIFICATE HOLDER CANCELLATION The City of La Quinta 79495 Cattle Tampico La Quinta, CA 92253- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1401177-000 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) The City of La Quinta 78496 Calle Tampico La Quinta CA 92253- Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 E3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) POLICY NO: P H P K1401177-000 POLICY CHANGE DOCUMENT CHANGE # 3 CHANGE EFFECTIVE: 06/10/2016 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: Kristoffer Kepler MAILING ADDRESS 77777 Country Club Dr Apt 11 Palm Desert, CA 92211- POLICY PERIOD: FROM 10/01/2015 TO 10/01/2016 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Amended Additional Insured, City of La Quinta, 78495 Calle Tampico, La Quinta, Ca 92253. Added Form CG2404 — Waiver of Transfer of Rights of Recovery Against Others To Us. Added 30 Day Notice of Cancellation. Include Primary and Non Contributory wording on Certificate of Insurance. Total Annual Total Prorate Additional/Return Premium $100.00 Additional/Return Premium $31.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 Page 1 of 1 Additional Insured Schedule Policy Number:PHPK1401177-000 The City of La Quinta Page 1 of 1 Additional Insured Schedule POLICY NUMBER: PHPK1401177-000 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: The City of La Quinta 78495 Calle Tampico La Quinta CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. ISO Properties, Inc. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 IMPORTANT If the certificate hoideris an ADDITIONAL INSURED, the policy(ies) must -be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) WPA It MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 11, 2016 RE: Fara Bauer, Leisure classes, AGR#2016-0068, Instructor Attached for your signature is an agreement with independent contracted instructor Fara Bauer teaching (cooking classes). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 70% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to exeeute this Agreement is based upon: N/A Approved by the City Council on X Community Resources Manager's signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required doements nre_attached to the agreement; r X Insurance certificates as required by the agreement (approved by Risk Manager on 7 r a 1kte) X Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-763418 expires 12/31/2016 1 N/A Purchase Order number City of La Quinta ta Community Services Department — GF.M o/ die DESERT — Contract # 413701-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and FARA BAUER a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once roved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2016 1 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2016 2 PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. . (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT[3 C,TOR must be made up in a timely manner as approved by CITY �'r (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in' this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2016 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the some shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to info ny subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2016 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Fara Bauer 51270 Charlbury St. Indio, CA 92201 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2016 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Fara Bauer COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPRO . By: IZ4 Tull us Larson C unity Services Manger CO By: Chi E D: APPROVED: By: T Signature 51270 Charlbury St. Indio, CA 92201 949.572.8225 Wellness Supervisor Rev May 2016 Hello Fara, Below is your class information for May through September 2016. Please review and verify by typing your name and date on the lines below as soon as possible. Fara's Food Mainly Vegetarian Instructor: Fara Bauer, Author & Teacher Cost Dayls Time Location $25 W 11am-12:30pm Wellness Center MPA (Kitchen side) Sessions: Sept 14, Sept 28, Oct 5, Oct 12, Oct 19, Oct 26, Nov 2, Nov. 9, Nov. 16, Nov 30 = $25 (1 day class) Sessions: Dec 7, Dec 14 (no Dec 21 & Dec 28) = $25 (1 day class) Sessions: July 20, August 10 = $25(1 day class) Web Trac Brochure Info: Are you looking for creative inspiration for your healthy lifestyle? You will prepare a wholesome satisfying meal, containing healthy essential nutrients from Mediterranean and Middle Eastern vegetarian recipes created by your instructor. Students are invited to stay and eat their prepared meal. Instructor: Fara Bauer author of Fara's Food Mainly Vegetarian. Instructor Signature: _ Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. Minimum 5 students Maximum 10 July 20: Spinach, Herbs & Berries Kookoo; As salad: Mixed green salad with unique mandarin dressing. August 10: Basmati Rice with Lentils, Saffron, Nuts and Barberries; As salad: Tomatoes, Onion & Herbs Salad with Raspberry Dressing. CERTIFICATE OF LIABILITY INSURANCE R 02 6/1601166 THIS CERTIFICATEIS 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(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsements . PR40UCER AUTO CLUB INSURANCE AGENCY LLC/PHS 253682 P: (866) 467-8730 F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAMg ONE ((AAM,NNo,ExQ: (866) 467-8730 FAX (888) 443-6112 pR"ESS: INSURER(S) AFFORDING COVERAGE NAICN INSURERA: Sentinel Ins co LTD 11000 INSURED FARA BAUER 51270 CHARLBURY ST INDIO CA 92201 INSURER B: INSURER C INSURER D INSURER E' INSURER F. COVERAGES CERTIFICATE NUMBER: 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. ZTPEOFLNSURANCE ADUL .SUER POL/CYAVMRM POLWYEFF M/DIA FOLICYEKP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1, 000, 000 DAMAGE TO RENTED PREMISES Ea oaxlnaelca 1000,000 / CLAIMS -MADE QOCC{SR A X General Liab X X 72 SBM AR5642 11/01/2015 11/01/2016 MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $1, 000, 000 GEML AGGREGATE LIMIT APPLIES PER: POLICY I I PRO a LOC I.�J JECT GENERALAGGREGATEs2,000,000 PRODUCTS - COMP/OP AGGs2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (En ancidenl] BODILY INJURY (Per person) g ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per occident) PROPERTY DAMAGE (Per -cadent) UMBRELLA U AB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DEO RETENTION S WORKERS COMPENSATION AND EMPLOYERS'LLIRUJTY -. .. PER OT11, STATUTE JER E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandalory in NH) NIA E.L. DISEASE- EA EMPLOYEE ff yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE- POLICY LIMIT DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES (ACORD 101, AddMonal Remarks Schedule, maybe attadwd If more apace is requlred) Those usual to the Insured's Operations. The City of La Quinta, its agents, officers, servants and employees are an Additional Insured, a Waiver of Subrogation applies in favor of the Certificate Holder and coverage is primary and non-contributory per the Business Liability Coverage Form SS0008 attached to this policy. (_CRT1F1(1ATC Nn1 r1FR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESENrATTVE CITY OF LA QUINTA 78495 CALLE TAMPICO LA QUINTA, CA 92253 U 1985-2016 AGVKIJ GVKP'UKA I IUN. All ngnm reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD FRI n,o M R i_ _ Select Customer Insurance Center 3600 WISEMAN BLVD. SAN ANTONIO TX 78251 Policyholder, please callus at: (866) 467-8730 Agent, please callus at: (866) 467-8730 SERVICE.TX@THEHARTFORD.COM INSURANCE ENDORSEMENT ATTACHED *** PLEASE REVIEW THE CHANGE *** Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes: Policyholder, please callus at: (866) 467-8730 Agent, please callus at: (866) 467-8730 between 7 A.M. and 7 P.M. CST . The premium billing will be mailed to you separately. You can expect to receive it soon. Thank you for allowing us to service your business needs. AUTO CLUB INSURANCE AGENCY LLC/PHS THE HARTFORD SELECT CUSTOMER INSURANCE CENTER The Hartford Hartford Fire Insurance Company and its Affiliates One Hartford Plaza, Hartford, Connecticut 06155 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below: Policy Number: 72 SBM AR5642 DX Named Insured and Mailing Address; FARA BAUER 51270 CHARLBURY ST INDIO CA 92201 Policy Change Effective Date: 06 / 15 / 16 Effective hour is the same as stated in the Declarations Page of the Policy. Policy Change Number: 001 Agent Name: AUTO CLUB INSURANCE AGENCY LLC/PHS Code: 253682 POLICY CHANGES: SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE LOCATION 001 BUILDING 001 IS REVISED PRO RATA FACTOR: 0.381 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 1211 04 05 T Page 001 (CONTINUED ON NEXT PAGE) Process Date: 0 6 / 2 9 / 16 Policy Effective Date: 11 / 01 / 15 Policy Expiration Date: 11 / 01 / 16 POLICY CHANGE (Continued) Policy Number: 72 SBM AR5642 Policy Change Number: 001 BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED ADDITIONAL INSUREDS) ARE ADDED THE FOLLOWING ARE ADDITIONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 PERSON/ORGANIZATION: SEE FORM IH 12 00 FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE: IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION Form SS 12 1104 05 T Page 002 Process Date: 0 6 / 2 9 / 16 Policy Effective Date: 11 / 01 / 15 Policy Expiration Date: 11 / 01 / 16 POLICY NUMBER: 72 SBM AR5642 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION THE CITY OF LA QUINTA, ITS AGENTS, OFFICERS, SERVANTS AND EMPLOYEES 78495 CALLE TAMPICO LA QUINTA, CA 92253 Form IH 12 00 1185 T SEQ. NO. 001 Printed in U.S.A. Page 001 Process Date: 0 6 / 2 9 / 16 Expiration Date: 11 / 01 / 16 T4t�t 4 seP MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 13, 2016 RE: Miguel Angel Rojas, Sports classes, AGR2O16-0077, Instructor Attached for your signature is an agreement for Sports (Taekwondo classes) with independent contracted instructor Angel Rojas. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate. X Contract payments will be charged to account number:101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 70% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is bused upon: N/A Approved by the City Council on X Community Resources Director signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-0107598 expires 6/30/2017 N/A Purchase Order number i City of La Quinta ta Qwkra Community Services Department Contract # 430101-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and MIGUEL ANGEL ROJAS, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: SPORTS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. - (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: CITY: Miguel Angel Rojas Community Services Department 41098 Manchester City of La Quinta Indio, CA 92203 La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and arketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Miguel Angel Rojas COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: APPROVED: By: I By, Christ r Escobedo Signatur Community Resources Director 41098 Manchester Indio, CA 92203 760.673.6760 COUNTERSIGNED: + yl� By: Chrt i a Calderon, Co Tnunity Programs & Wellness Supervisor Rev May 2015 ATE AC40RI> CERTIFICATE OF LIABILITY INSURANCE D6/29/2016 ) 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Sanae Martin NAME: Desert Cornerstone Insurance Service, Inc. FAX {AfaNWE4 E&1`(760)347-7723 (AIC, No): (760)347-7725 CA License #OF15709 E-MAIL ADDRESS' sanae@desertcornerstoneins.com 81557 Dr. Carreon Blvd. Ste B8 INSURER(S) AFFORDING COVERAGE NAIC # Indio CA 92201 INSURERA:Nationwide Mutual Insurance Co INSURED INSURER B Angel Rojas, Jr., DBA: Rojas TKD INSURER C: 41098 Manchester St. INSURERD: INSURER E: Indio CA 92203 INSURER F: CnVFRAGFS CFRTIFICATF NIIMRFR•2016GL RFVIRION NIIMRFR- 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. MSR - POLICY CIF POLICY EXP - - - — - -- LTR TYPE OF INSURANCE POLICY NUMBER MIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001 A CLAIMS -MADE X I OCCUR TftM $ES (aao aarrerloe) $ 500,000 MED EXP (Any one person) $ 5,000 X 6BMAS000005853700 5/2/2016 5/2/2017 $ 1,000,000 PERSONAL 8 ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: $ 5,000,000 GENERAL AGGREGATE POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 1,.000,000 Professional Liability $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A QMll $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS _..__ AUTOS 6BMAS000005853700 5/2/2016 5/2/2017 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE _ DED RETENTIONS _$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? +-. N/A PER OTH- STATUTE ER _ $ EL EACH ACCIDENT EL DISEASE - EA EMPLOYEE . (Mandatory in NH) $ If yes, describe under DESCRIPTION OF OPERATIONS below -_-- E L. DISEASE - POLICY LIMIT $ A Medical Payments/Particp 6BMAS000005853700 5/2/2016 5/2/2017 Excess Medical $150,000 Legal Liab to Participants 6BMAS000005853700 5/2/2016 5/2/2017 Limits $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Location: 78495 Calls Tampico, La Quinta, CA 92253 - Martial Arts Style: Taekwondo -The City of La Quinta, its agents, officers, and servants and employees are additional insured, but only for liability caused, in whole or in part, by the acts of omissinos of the named insured. Additional Insured Endorsement to follow. CERTIFICATE HOLDER CANCELLATION La Quinta Senior Center La Quinta Wellness Center City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Matt List/SAN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) 7/6/2016 1:03:27 PM Faxserver Faxserver003 Page 2 POLICY NUMBER: 6BMAS0000005853700 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of La Quinta Insured: Angel Rojas, Jr. DBA: Rojas TKD CP#508 I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 OF BUSINESS LOCATION 78450 AVENIDA LA FONDA BUSINESS NAME: ROJAS, ANGEL 78-495 Calle Tampico La Quinta, California 92253 (760) 777-7000 ERTIFICATE,� wF�- 4,-TRANSFERNa P, ow Dear Susine5-Ovvmor; BUSINESS ADDRESS: 52855 AVENIDA NAVARRO -OW LA QUINTA, CA 012253I III 11'.111,1 _Z_ Please be aware that issuance of a business license by the City does not authorize you to conduct business in a building or tenant space that has not been approved for occupancy by the Design pno,pevel-9pT - If you have an 'eq? Department y _qywons ryprd n -_- . i & fts issue, or ify6tiare ,:not:mir.e ifa,iCertificme of Occupancy hallZm is� -_W qeqr youLpJac of business, piease Contact Design and Development at ( VP = q The Licensee named herein having paid to the City of La C-akiw9l f6hi re�qMQ Mense is hereby granted said licensee to transact the business herein set forth, for the period stated, In conformity with the Provisions of Ordinance No. 2 of this City. This Licensee is issued without verfication that the licensee is subject to or exempt from licensing by the State of California.- & ff BUSINESS LIC INC.,-: LI&0107598 CLASSIFICATION: OTHER BUSINESS DESIGN AND DEVELOPMENT DIRECTOR EXPIRATION DATE: 6/30/2017 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: July 1, 2016 RE: Sam Klein, Leisure Classes #AGR2016-0069, Instructor Shinning Stars Acadmeny of Performing Arts -Business name Attached for your signature is an agreement with independent contracted instructor Sandra Klein for (Leisure) classes. Compensations may exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: x Contract payments will be charged to account number: 101-0000-42200 Leisure Enrichment x Amount of Agreement, Amendment, Change Order, etc.: 60 % of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on x City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: x Insurance certificates as required by the agreement (approved by Risk Manager on iN1 date) N/A Performance bonds as required by the agreement (originals) x City of La Quinta Business License number LIC-0112069 expires 11/31/2017 N/A Purchase Order number.— City of La Quints tev �(�, Community Services Department - GEM fNm UESER7 - Contract # 413101-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and SAM KLEIN, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. , Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. 'WIL (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have-no-power--to-incur-any--debt; obligation, or liability -on -behalf-of-CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negl percentage o' entire portion CITY. gent and where CITY's active negligence accounts for only a the liability involved, the obligation of CONTRACTOR will be for that or percentage of liability not attributable to the active negligence of PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. 3Aj L (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this ----INSTRUCTOR AGREEMENT. - 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT.' (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided -in Section 1. Additional subcontractors -will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Sandra Klein 78735 Via Sonata La Quinta, CA 92253 CITY: Community Services Department City of La Quinta La Quinta, CA 92253 1-1 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Sandra Klein COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: By: Christap er ffscobedo Community Resourcesp-irtc+or- COUNT RSi NED: By. a Chn na Calderon, C r & Wellness Supervisor Programs APPROVED: ,� By: �' 78735 Via Sonata La Quinta, CA 92253 760.799.5894 Rev May 2015 Hello Sam, Below is your class information for May through Sept 2016. Please review and verify by typing your name and date on the lines below as soon as possible. 413103 La Quinta Glee Instructor: Sam Klein Cost Day/s Time Location $ TH 6-7pm WC — MPB (5-14yrs) Sessions: 5/12- 5/26 = $15 t (3 weeks) Session: 7/7-7/28, 8/4-8/25 =$20 to $25 (4 weeks) Sessions: 6/2-6/30 , 9/1-9/29= $25 to $30 (5 weeks) Web Trac Brochure Info: Your child has a unique opportunity to sing and perform Pop and Broadway music in a high energy and exciting atmosphere with Performing Arts Instructor Sam Klein. Your child will learn choreography, voice and microphone technique, musical expression, and gain self-confidence. Performance participation will include City of La Quinta events, Riverside County Fair, Sun City Rockettes Show, Fountains at Carlotta, The Gardens of El paseo, and the American Cancer Relay for Life and more! Materials to Brink: Music folder & performance t-shirt (with City Logo) $15 fee paid to instructor Instructor Signature: Date: Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. DATE (MM/DD/YYYY) AC<:>Rrs CERTIFICATE OF LIABILITY INSURANCE 6/ 14/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Aq E. _ License #OE67789 PHONE FAX Bene-Marc Athletic Insurance Agency EMAIL (8 )'7 8-6' � 6301 Southwest Blvd, Suite 101 INSURE S AFFORDING COVERAGE NAICp Fort Worth, TX 76132 _- INSURER A : Atlantic Specialty INSURED INSURER B : AXIS Global AcctdcnL.&.Health Southern California Municipal Athletic Federation INSURERC: PO Box 3605, INSURER E: South El Monte, CA 91733 INSURER F : Cr1VFRAr;FR CFRTIFICATF NI IMRFR• RI-VIRInN NI)MRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A -._ _ _. - -POLICY ,EFF- __.._ ...._--.--._.,.._- LTR TYPE OF INSURANCE POLICY NUMBER IIM.PAIDDrYYYYI fMMIDDfYYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A COMMERCIAL GENERALVABILJTY CLAIMS -MADE 1XI OCCUR $ 100,000.00 $ 5,000.00 PREMISES(E occumanee) MED EXP (Any one person) PERSONAL&ADVINJURY $ 1,000,000.00 _ —7 X ANC-WDE,,"rtieipant— —_ IMR ili:y X CP03256-04 12/31/2015 12:01 am 12/31/2016 12:01 am GENERALAGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1,000,000.00 Med Ex f Irk e_ ctators Only POLICY PRO' LOC AUTOMOBILE LIABILITY _ji - COMO NED SINGLE LIMI Ea a ent BODILY INJURY (Per person) $ ANY AUTO �i ALL OWNED SCHEDULED AUTOS AUTOSNON-OWNED HIRED AUTOS AUTOS CP03256-04 12/31/2015 12/31/201 BODILY INJURY (Per accident) $ FROF'E'RTY M A'-' GE -er c $ _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ I $ WORKERS COMPENSATION VVCSTATU- 1 OTH- EB AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE � -- - - - E.L EACH ACCIDENT -- $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A E L. DISEASE - EA EMPLOYE $ E L. DISEASE - POLICY LIMIT $ If yyes, describe under DESCRIPTION OF OPERATIONS below B Participants Excess Accident SRPO-50256-243 12/31/2015 12:01 am 12/31/2016 12:01 am Medical Limit $5,000.00 Deductible $0.00 —- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'] Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. ULK I WIL;A It HULUtK Cert #: 9066-30899-215380-0 City of La Quinta 78495 Calle'ranlpico La Quinta, CA 92253 Attn: Risk Manaaemei SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0& ©1988-2010 ACORD I ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD /m TION. All risahts reserved. POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 11 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section If — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable Limits of Insurance shown in the Declarations. CG 20 1104 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 f'r? '22 e ► MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 13, 2016 RE: Art True, Fitness classes, AGR2016-0075, Instructor Attached for your signature is an agreement for fitness classes with independent contracted instructor Art True. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 70% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on X Community Resources Manager's signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The folio . ing required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-0112073 expires 7/31/2017 N/A Purchase Order number I " City of La Qu i nta taQal�trcv Community Services Department GE NI of th, UEURI — Contract # 421801-17 INSTRUCTOR AGREEMENT This --INSTRUCTOR AGREEMENT is -hereby--formed on J_ULY 1,_2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and ART TRUE, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested b letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once oved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRAC OR hall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. -CONTRACTOR-shall-not-at-any-time--or in any -manner -represent -that -it or any -of its - agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a Rev May 2015 2 percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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-CIT-Y-. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pr and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT OR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to -liabilities -arising --out- of CONTRACTOR's -performance--of-the -services-under-this-- INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inforrR a subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Art True 80870 Hwy 111, #125 Indio, CA 92201 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Quinto" CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY approval prior to distribution. by for 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Art True COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: By: Chris cobedo Community Resources Director COUNTERSI ED: By: 2 Chri i Calderon, om unity Programs Wellness Supervisor APPROVED: 80870 H`wy 111, #125 In5io, CA 92201 760.702.4633 Rev May 2015 Hello Art, Below is your class information for May 2016 — September 2016. Please review and verify by typing your name and date on the lines below as soon as possible. 421801 Sunset Yoga Instructor: Art True Cost Day/s Time _ Location $56/*63/**49/$10 M/W 6-7pm Wellness Center Aerobics Room Sessions: 7/6- 7/27; 9/7-9/28 = $49 (7 classes) (9/5 Labor Day) Sessions: 5/2-5/28= $56 (8 classes) (5/30 Memorial Day) Sessions: 6/1— 6/29 = $63 (9 classes) Sessions: 8/1— 8/31= $70(10 classes) Web Trac Brochure Info: Harmonize your breath with movement, and quiet your mind for inner peace. Strengthen your body and increase your range of motion. A fitness practice for any age. Your Instructor Art True offers pose modifications for many yoga levels. Materials to Brink: Wear comfortable clothes; bring a mat and a water bottle Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. 491701 Sunset Yoga / Drop in $10 Memorial Day Monday, May 30 Labor Day, Monday, September 5 PRODUCER Maguire Insurance Agency, Inc. 27101 Puerta Real Suite 200 Mission Viejo, CA 92691- 877.438.7459 INSURED Art True 80870 US Hwy 111N125 Indio, CA 92201- COVERAGES DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/12/2016 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC If INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURER B: INSURER C: INSURER D: .... _ INSURER E: THE P011CIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTMTH'STANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY) POLICY EXPIRATION DATE (MWDD/YYYV) LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X PROFESSIONAL LIABILITY GENT AGGREGATE LIMIT APPLIES PER: X POLICYEl PROJECT LOC PHPK1397322- 000 09/24/2015 09/24/2016 EACH OCCURENCE $1,000,000 PRE MISE5 Eaoccnnonce $100,000 IVIED EXP (Any one person) $2,500 PERSONAL &ADV INJURY $1,0D0,000 GENERAL AGGREGATE $3,000,000 PRODUCTS—COMP/OPAGG $3,000,000 AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (EA accident) BODILY INJURY (Per person) '. BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE UABILM ANY AUTO AUTO ONLY — EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY OCCUR El CLAIMS MADE DEDUCTIBLE RETENTION EACH OCCURENCE AGGREGATE EMPLOYERV LIABILITY Y N ANY PRO PRI£TOR PARTNER//EXECUTIVE j OFFICERJMEMBERXCLUDED7 (Mandatory in NH) "yyes descnbeunder SPEC(AI PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE — EA AMPLOYEE E.L DISEASE — POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is understood and agreed that the fallowing entity is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence. City of La Quinta, 78495 Calle Tampico, La Quinta, CA 92253. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of La Quinta THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 78495 Calle Tampico CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR La Quinta, CA 92253-2839 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE G ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the -certificate -holder is -an ADDITIONAL INSURED, the policy(ies)-must be-endorsed.A -statement on -this --- certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) POLICY CHANGE DOCUMENT POLICY NO: CHANGE # 1 CHANGE EFFECTIVE: 09/24/2015 PH PK1397322-000 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: Art True MAILING ADDRESS 80870 US Hwy 111#125 Indio, CA 92201- POLICY PERIOD: FROM 09/24/2015 TO 09/24/2016 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Adding Additional insured City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 Page 1 of 1 POLICY NUMBER: PHPK1397322-000 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) City of La Quinta 78495 Calle Tampico La Quinta CA 92253-2839 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ -- 78-495 Calle Tampico La Quinta, California 92253 60) 777-7000 i I�lligl' I I'� I�ilii� 'I' ail, III�I TIFICAT 'l I' IIll�llli�iilll Idl��III i�li NOWTRANSFERA$L !liiil ' BUSINESS LOCATION Dear Business Owner: 78450 AVENIDA LA FONDA A ilk BUSINESS NAME: TRUE, ARTHUR BUSINESS ADDRESS: 80870 HIGHWAY 111 #125 AFF119DIO, CA 92201 _ By y r DESIGN AND DEVELOPMENT DIRECTOR Please be aware that issuance of a business license by the City does not authorize you to conduct business in a bulldatg,or tenant space that has not been approved for occupancy byn and Develap�nent Department. If you have any questions regardingthrs E5sk ' f�ou are notsure if a Certificate of Occupancy has been issued for your plar f Euslness, lease contact Design and Development at (760)777-7000, The Licensee named herein having paid to the Clty of La Quinta all fees required, license is hereby granted said licensee to transact the business herein set forth, for the period stated, in conformity with the Provisions of Ordinance No. 2 of this City. This Licensee is Issued without verfication that the licensee is subject to or exempt.Crorn licensing by the State of California. BUSINESS LIC NO: LIC-01120731IIh! CLASSIFICATION: YOGA EXPIRATION DATE: 7/31/2017 T4ht 4 QUM A MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 14, 2016 RE: Donna Sacks, Leisure Classes, AGR#2016-0079, Instructor Attached for your signature is an agreement with independent contracted instructor Donna Sacks. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number:101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 600/6 of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based uq: N/A Approved by the City Council on X Community Resources Manager signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The foiloyuirlg required documents gre attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) X Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-763884 Expires 1118/17 N/A Purchase Order number a City of La Quinta ta Qw�fra Community Services Department Contract # 414301-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUtNTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and DONNA SACKS, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: MEDITATION classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once 9pproved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said progf m and coordinate with CONTRACTOR to schedule a make-up date. '� . (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY:..x` ? r (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to infor any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. , (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number v . �% a\ 'iZ2- Su - bcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION, It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Donna Sacks 78451 Crestview Terrace La Quinta, CA 92253 CITY: Community Services Department City of La Quinta La Quinta, CA 92253 J' (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") APPROVED: By: Tustih Larso , Community Resources Manager COUNTERSIGNED: By: Chrl,5iyd UdlderonvC6nimunity Programs & Wellness Supervisor Rev May 2015 E Donna Sacks ("CONTRACTOR") APPROVED: y� Signature 78451 Crestview Terrace La Quinta, CA 92253 760.534.8828 Hello Donna, Below is your class information for May — September 2016. Please review and verify by typing your name and date on the lines below as soon as possible. 414301 Meditation Instructor: Donna Sacks Cost Day/s Time Location Thursday 6-7pm La Quinta Wellness Center Leisure Room Sessions: 6/2 — 6/30; Sessions: 9/1— 9/29= $30+2=$32 (5-weeks) Sessions: 7/7 — 7/28; 8/4 — 8/25= $24 +2 =$26 (4-weeks) Web Trac Brochure Info: A guided meditation with Donna Sacks whom has 25 years of teaching meditation will help you experience a higher level of consciousness. Theta healing meditation and mindful meditation are two modalities that will be practiced. Tibetan Bells will bring you back from your meditative state. Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. Donna Sacks (donna sacks@yahoo.com) William Sacks WBSacks@gmail.com assistant Drop -ins 493001 $8 Drop -in increase DATE (MM/DD/YYYY) _F CERTIFICATE OF LIABILITY INSURANCE 6114/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 r AME• lhne-Marq, Inc License 40E67789 PH QNE FAX Bane -Marc Athletic insurance Agency E-MAILoeA)'� c Q ACOR S: 6301 Southwest Blvd, Suite 101 INSURE S AFFORDINGCOVERARE NAICq Fort Worth, TX 76132 INSURERA: Atlantic Snecialtv Insurance Comoanv_- INSURED INSURER B.: (?L)�j,�fp��CGlLlenL.BG.HEa�II� Southern California Municipal Athletic Federation INSURERC: INSURER D : PO Box 3605, INSURERE: South El Monte. CA 91733 INSURER F : nn%1=A!]CQ nCDTICII"ATr- RII IAAM17G• RFL/IRI(1N1 N11MI FR' - 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.SU _ tLTR NSR TYPE OF INSURANCE A POLICY NUMBER h i]Cl Yrimr fdNllbbdYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A COMMERCIALGENERALLIAE111.ITY CLAIMS -MADE 10 OCCUR PREMISES I ggLoa;qrrencel $ 100,000.00 MEDEXP An one person) $ 5,000.00 ANC-LUl3ad5-I'11s1ieipanf- ---LzgaWabiliLp 7C CP03256-04 12/31/2015 12:01 am 12/31/2016 12:01 am PERSONAL&ADVINJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000.00 Med Ex f r$S ectators Only POLICY PRO` 17 LOC AUTOMOBILE LIABILITY COMBI k E L --00T 160 acoid0 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ A ALL OWNED SCHEDULED HIRT DSAUTOS AONO WNED CP03256-04 12/31/2015 12/31 /201 PROPERTY EIAMAGE $ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS-MAOE DED RETENTION $ $ WORKERS COMPENSATION _ WC 10TH- AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA TORYSTAN-q1 FR- - E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Participants Excess Accident SRPO-50256-243 11/31/2011 12:01 em 12/31/2016 12:01 am Medical Limit $5,000.00 Deductible $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'1 Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City, of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. L:tK I IFIL:A I t= YlULUtK I+AIVIrCLLA I IU14 Cert N;9066-30899-215380-0 City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Attn: Risk Iylanagemel SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0 ---- M 01AAR-2o10 ACORD COR RATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 1104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 1104 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any fight of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organlzation and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 4 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Tustin Larson, Community Resources Manager DATE: July 6, 2016 RE: Sheri Hein, Leisure Classes, AGR2016-0080, Instructor Attached for your signature is an independent contracted instructor agreement with Sheri Hein for Reiki (healing) classes. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate. N/A Contract payments will be charged to account number: X Amount of Agreement, Amendment, Change Order, etc.: receives 60 % of student fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is bayed upon: N/A Approved by the City Council on X Community Resources Manger's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreemen# X Insurance certificates as required by the agreement (approved by Risk Manager on _ _ date) N/A Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-763704 expires 3/31/2017 N/A Purchase Order number 9 City of La Quinta ,Ca QaLtra Community Services Department —U; MnJrhrDLA.R[— Contract # 414101-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and SHERI HEIN, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. 5 �- (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2015 1 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2015 2 PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date._ (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE.It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name I Address _ l Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Sheri Hein 81929 Sun Cactus Lane La Quinta, CA 92253 CITY: Community Services Department City of La Quinta La Quinta, CA 92253 � (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Sheri Hein COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPR ED: APPROVED: By: _ By: C7 - Tusti Larson, C munity Resources Manager Signature 81929 Sun Cactus Lane Lo Quinta, CA 92253 310.367.3433 COUNTERSIGNED: By ---� Ch ' a Calderon, Community Programs & Wellness Supervisor Rev May 2015 DATE (MMIDD/YYYY) A,C"Rb CERTIFICATE OF LIABILITY INSURANCE i��' 6/ 14/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 ME: GT I�Cn1;-tUi9 rC- Etjj,' License #OE67789 PHONE FAx Bene-Marc Athletic Insurance Agency !�^M No.fKt) ($17j �3$-68�rL tuc.N®s 817 AD BFS 6301 Southwest Blvd, Suite 101 INSURE $ AFFORDING COVERAGE N_AIC0_ Fort Worth, TX 76132 _ INSURER A : 6 �tv r INSURED INSURER B : AXIS. Woba1 Accident & Hea11h Southern California Municipal Athletic Federation [INSURERC. PO Box 3605, [INSURER E: South El Monte, CA 91733 NSURER F : rnvcDArrCc roDTIClf ATc AHtaAC1F@• RFVIAIAN NIIMRFR• 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. INSW AD- L IXIPOLICY EFF POLICY F.XP LTRTYPE OF INSURANCE POLICY NUMBER MWDD/YYYY) IMWDDNYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A COMMERCIAL GENERAL LIABILITY PREMISES (Ea 0rtrr9nca) $ 100,000.00 CLAIMS -MADE ® OCCUR MED EXP (Anyone person) $ 5,000.00 X ---ANC 14 I'aeftetPa^t- _ I egall.iability. GEN'LAGGREGATE LIMIT APPLIES PER: X CP03256-04 1211112111 12:01 am 12/31/2016 12:01 am PERSONAL &ADVINJURY $ 1,000,000.00 GENERALAGGREGATE $ 2,000,000.00 PRODUCTS -COMP/OPAGG $ 1,000,000.00 Med Ex f Poucv PRO' 01.00 Ir$S cctators Only AUTOMOBILE LIABILITY M INEDSIN [ Lt iT Ee crJderrl BODILY INJURY (Per person) $ ANYAUTO BODILY INJURY (Per accident) $ X0 00- I A ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS CP03256-04 12/31/2015 12/31/201 ROP RTY DAMAG = n $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE ..$ $ - - EXCESS LIAR CLAIMS -MADE -. DED I I RETENTIONS WORKERS COMPENSATION WCSTATU- I OTH- -_-- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YINN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) / A E.L. EACH ACCIDENT s E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ _^ If yS describe under DESCRIPTION OF OPERATIONS below B Participants Excess Accident SRPO-50256-243 12/31/2015 12:01 am 12/31/2016 12:01 am Medical Lilnit $5,000.00 Deductible $0.00 - — DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits, Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. r:FRTIFIr'ATF Mr)l r1FP CANCFI I ATInN Celt #: 9066-30899-215380-0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico La Quinta CA 92253 AUTHORIZED REPRESENTATIVE f Attu: Risk anagement © 1988-2010 ACORD CORWHATION. All rlgnts reserves. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 1104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 1104 13 C Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 11 I MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Caroline Doran, Community Resources Coordinator DATE: July 14, 2016 RE: Clare Dune, Chair Massage Therapist, AGR2016-0082, Instructor Attached for your signature is an agreement with independent contracted Certified Massage Therapist. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as a ro riate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 70% of students' fees N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to -execute this agreement is based u on: N/A Approved by the City Council on X Community Resources Manager's signing authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less X Initial to certify that 3 written informal bids or proposals were received and considered in selection The following re_ aired documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) X Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-762441 Expires 11/30/2016 N/A Purchase Order number City of La Quinta ca �, Community Services Department GE%l w on DESER f — Contract # 421701-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and CLARE DUNE, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: CHAIR MASSAGE for adult clients over 18 years of age held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, once approv,p4,by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent Rev May 2015 1 contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2015 2 PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pr7r m and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT1Vy AOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE.It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quints Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to Warr- ny subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to"perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will ,perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Clare Dune P.O. Box 118 La Quinta, CA 92253 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 r U (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") APPRO D: By: Tusti Larson, CVnWunity Resources Manager Clare Dune ("CONTRACTOR") APPROVED: By: SigncrCure P.O. Box 118 La Quinta, CA 92253 805.272.5695 COUNTKCalderon, ED: By Ch ' ina Co n y Program - & Wellness Supervisor Rev May 2015 Cbm �_-�__` Certificate of Insurance OCCURRENCE COVERAGE ABMP In -Dues Liability Program ABMP MAILING ADDRESS: MASTER POLICY HOLDER Associated Bodywork & Massage Professionals Allied Professionals Insurance RPG 25188 Genesee Trail Road Suite 200 AGENT/BROKER Golden, CO 80401 Allied Professionals Insurance Services ISSUED BY: POLICY #: API-ABMP-16 Allied Professionals Insurance Company, A Risk Retention Group, Inc. LIABILITY LIMITS (per member) ANNUAL AGGREGATE ............................................... $6,000,000 COMMERCIAL GENERAL LIABILITY PER OCCURRENCE LIMIT ........................................... $2,000,000 PRODUCTS-COMP/OP.................................................. Included PROFESSIONAL LIABILITY ........................................ Included GENERAL LIABILITY .............................................- Included FIRE LIABILITY LIMIT ............................................. $100,000 To verify information, contact ABMP. Tel: 303-674-8478 Fax: 303-674-0859 This Policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group. Coverage is afforded to person(s) named herein as Named Insureds according to the terms and conditions of the Policy to which this Certificate refers. No other rights or conditions, except as specifically stated herein, are granted or inferred. COVERAGES THIS IS TO CERTIFY THAT THE POLICY OF INSURANCE LISTED ABOVE HAS BEEN ISSUED TO THE INSURED NAMED BELOW. THE INSURED ACTIVE DATE LISTED BELOW APPLIES ONLY TO ELEMENTS OF COVERAGE CONTINUOUSLY IN PLACE SINCE THE INCEPTION OF THE NAMED INSURED'S POLICY. CHANGES TO COVERAGE ARE EFFECTIVE RETROACTIVELY ONLY TO THE DATE THE CHANGE WAS MADE. REPORT IN WRITING WITHIN 48 HOURS ANY & ALL CLAIMS, OR INCIDENTS THAT YOU BELIEVE MAY RESULT IN A CLAIM, EVEN IF GROUNDLESS. This Certificate, along with the Policy to which it refers, is valid evidence of coverage extended to the Certificate Holder listed below. CERTIFICATE HOLDER (Active Registered Members are on file with the ABMP Membership Director.) Member/Named Insured: Claire Dune Membership I.D. #: 886766 Member/Policy Term Active: Jul-07-2016 Member/Policy Term Expires: Jul-06-2017 Total Member Cost: $ 199 (ADMPMembership,including Member Liability Coverage) P�A n Authorized Representative CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 10 days written notice for non-payment or 90 days written notice for any other reason to the certificate holder named above, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. ITIONAL INSURED: (with inception dale) City of La Quinta, CA Jul 07, 2016 78495 Calle Tampico La Quinta, CA 92253 Coverage is extended subject to all terms and conditions of the Policy. �ry rr7 -^_ u b 111 r Associated Bodywork & Massage Professionals 1 / Massage Professional & General Liability Insurance Policy Notice: This policy (the "Policy") is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group. In consideration of the payment of the premium, in reliance upon the statements made in the application for insurance provided under this Policy, and subject to the limits of liability, exclusions, conditions, and other terms of this Policy, the Company and the Named Insured (as hereinafter defined) enter into the following contract for insurance: I. DEFINITIONS When used in this Policy: A. ABMP - means Associated Bodywork and Massage Professionals, with offices at 25188 Genesee Trail Road, Suite 200, Golden, CO 80401, which is not the Master Policyholder. B. Bodily Injury - means physical injury, sickness, disease or death of a person, except for persons injured while taking part in athletics. C. Claim Reported - means a written notice filed by the Named Insured and received by the Company, or a written notice of a Suit filed by a claimant or other person acting for the claimant and received by the Named Insured and by the Company that alleges Damages to an injured party from acts or omissions by the Named Insured that are covered by this Policy. D. Client - means a person to whom the Named Insured has provided Professional Services for a fee or in connection with an educational, charitable or promotional activity. E. Company - means Allied Professionals Insurance Company, a Risk Retention Group, Inc., with offices at 1100 West Town & Country Rd., Suite 1400, Orange, CA 92868. F. Damages - means sums the Named Insured is legally obligated to pay for liability covered under this Policy. The term "Damages" does not include either any sums demanded or awarded as punitive or exemplary damages or defending the Named Insured from any claims. G. Incident - means any act or omission which results in alleged or actual Damages. H. Named Insured - means the person or organization named In the Declarations of this Policy (the "Declarations"). I. Policy - means this policy, the Declarations to this policy, all applications for membership and / or coverage or endorsements to coverage provided by or on behalf of the Named Insured (including any supplemental documentation provided therewith) and all coverage endorsements issued to the Named Insured. J. Professional Corporation - means a professional corporation as defined in the Declarations. K. Professional Services -means Professional Services as defined in Article VI, Section A.1, of the Policy. L. Property Damage - means physical damage to tangible property. Electronic data is not tangible property. M. Suit - includes 1) a cross claim; and 2) an arbitration to which the Named Insured is required to submit or to which the Named Insured has submitted with the Company's consent. II. POLICY PERIOD; PREMIUMS; AUDITS A. Policy Period. The initial policy period of this Policy is stated in the Declarations forming a part of this Policy. Subject to the right of the Company to cancel this Policy in accordance with the provisions of the Cancellation Condition, the Policy Period may be extended for successive periods by payment of the required renewal premium, and any other amounts required as a condition of such renewal, to the Company on or before the effective date of each successive period. The expiration date of such period shall be the end of the policy period. B. Premium. All premiums and other charges for this Policy shall be computed in accordance with the Company's rules, rates, rating plans, premiums, and minimum premiums applicable to the insurance afforded herein and in effect with respect to the period for which premiums are due. All premiums and other charges for this Policy are payable in advance to the Company or its authorized representative. The first payment is due at inception of the Policy. Each renewal payment is due on or before the expiration of the period for which the preceding payment was paid. Any payment not paid on or before its due date will be in default. C. Inspection and Audit. The Company may examine, audit, and inspect the Named Insured's property, business operations, books, and records at any time during the policy period and renewals thereof within three (3) years after the final termination of this Policy, as far as they relate to the subject matter of this insurance. The Company is not required to make such inspections and audits and does not guarantee that the Named insured's operations are safe or that they conform to any laws, rules, or regulations. III. CANCELLATION & NON -RENEWAL The Named Insured may cancel this Policy by surrender thereof to the Company or any of its authorized agents by mailing to the Company written notice stating when thereafter the cancellation shall be effective. The Company may cancel or non -renew this Policy by mailing to the Named Insured at his or her latest address shown on the Company records, written notice stating when, not less than ninety (90) days thereafter, such cancellation or non -renewal shall be effective, unless cancellation is for nonpayment of premium, in which case such notice will be not less than ten (10) days prior to the effective date of cancellation or non -renewal. The mailing of notice as aforesaid shall be sufficient proof of notice. The time of surrender or the effective date and hour of cancellation or non -renewal stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Named Insured or by the Company shall be equivalent to mailing. If this Policy is cancelled, the Company will send the Named Insured a refund of any unearned premium, computed on a pro-rata basis, as soon as practicable thereafter. Payment or tender of unearned premium is not a condition of cancellation. IV. CLAIMS A. Incident Report. Upon the happening of any incident reasonably likely to involve this insurance, written notice containing information sufficient to identify the Named Insured, time, place, and circumstances of the event, and the names and addresses of the injured and of available witnesses must be given by or for the Named Insured to the Company within three (3) business days of the happening of any such event or as soon as practicable. B. Notice of Claim or Suit. If a claim or suit is reported against the Named Insured based on an Incident covered by this Policy, the Named Insured shall, within three (3) business days, by certified mail return receipt requested forward to the Company every demand, notice, summons, or other process received by him or her or by his or her representative. Failure to give such notice will result in a total loss of coverage and constitute a material breach of the Policy only when a) such failure actually prejudices in any way the ability of the Company to adjust, settle or defend any claim or action, or b) the Named Insured has failed to give notice until after the Named Insured has submitted to the jurisdiction of a court or until after judgment, which the Named Insured and the Company agree shall constitute substantial and actual prejudice which adversely affects the rights ®Allied Professionals Insurance Company, RRG, Inc. All Rights Reserved, Rev.10/21/15 1 ABMP2002 of the Company, which bases its Policy and premiums on cost -containment methods of dispute resolution, mandatory arbitration, and settlement. C. Cooperation. The Named Insured shall cooperate with the Company and, upon the Company's request, assist in making settlements in the conduct of suits and other proceedings; and the Named Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The Named Insured shall not, except at his or her own cost, voluntarily make any payment or assume any obligation without the consent of the Company. The Named Insured shall not destroy, discard, alter, or fabricate any evidence related to a claim, whether in the form of documentation or physical, tangible objects or equipment, including, but not limited to, records, therapy tables, heat lamps, and tens units. This does not apply to signed, dated bona fide corrections to records. V. GENERAL CONDITIONS A. Abide by Terms. The Named Insured specifically agrees to abide by the terms and conditions of this Policy and by all rules and regulations of the Company relating to the conduct of the Named Insured's professional practice. B. Action Against the Company. No action shall lie against the Company, its Agents, Employees, Brokers, or the Master Policy Holder unless the action is commenced within one (1) year from the date that the Company sends a letter denying coverage on a claim, or in the case of actions not relating to a denial of coverage by the Company, one (1) year from the date of loss or damage to the Named Insured. Additionally, as conditions precedent to any such actions, 1) there shall have been full compliance with all of the provisions of this Policy, and 2) the amount of the Named Insured's obligation to pay shall have been finally determined either by judgment against the Named Insured after actual arbitration or trial or by written agreement of the Named Insured, the claimant, and the Company. C. Arbitration. All disputes or claims involving the Company shall be resolved by binding arbitration, whether such dispute or claim arises between the parties to this Policy, or between the Company and any person or entity who is not a party to the Policy but is claiming rights either under the Policy or against the Company. This provision is intended to, and shall, encompass the widest possible scope of disputes or claims, including any issues a) with respect to any of the terms or provisions of this Policy, or b) with respect to the performance of any of the parties to the Policy, or c) with respect to any other issue or matter, whether in contract or tort, or in law or equity. Any person or entity asserting such dispute or claim (the "Claimant") must submit the matter to binding arbitration with the American Arbitration Association, under the Commercial Arbitration Rules of the American Arbitration Association then in effect, by a single arbitrator in good standing. If the Claimant refuses to arbitrate, then any other party may, by notice as herein provided, require that the dispute be submitted to arbitration within fifteen (15) days. Neither the Claimant nor any other party shall have the right to participate as a member of any class of claimants, and there shall be no authority for any dispute to be decided on a class action basis. In addition, an arbitration can only decide a dispute between the Claimant and the Company, and may not consolidate or join the claims of other persons who have similar claims. All procedures, methods, and rights with respect to the right to compel arbitration pursuant to this Article shall be governed by the Federal Arbitration Act. The arbitration shall occur in Orange County, California. The laws of the State of California shall apply to any substantive, evidentiary or discovery issues. Any questions as to arbitrability of any dispute or claim shall be decided by the arbitrator. If any party seeks a court order compelling arbitration under this provision, the prevailing party in such motion, petition or other proceeding to compel arbitration shall recover all reasonable legal fees and costs incurred thereby and in any subsequent appeal, and in any action to collect the fees and costs. A judgment shall be entered upon the arbitration award in the U.S. District Court, Central District of California, or if that court lacks jurisdiction, then in the Superior Court of California, County of Orange. D. Application Warranty. The Named Insured warrants that he or she has made true, correct, and full answers to all questions propounded to him or her upon the application for insurance coverage (the "Application") and agrees to provide the Company with full and correct answers to any other questions related to his or her competence or financial ability as shall be reasonably propounded to him or her by the Company. The Named Insured acknowledges and agrees that if the Named Insured does not sign the Application, this Policy is void and no insurance coverage is conveyed thereby. E. Breach of Policy. Breach by the Named Insured or any person covered by this Policy of any of the conditions of this Policy shall subject the Named Insured to termination at the instance of the Company and upon thirty (30) days written notice. F. Change of Address. The Named Insured will keep ABMP apprised of his or her current addresses, both business and residential, and will report in writing any change of address within ten (10) days. G. Changes. Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or a change in any part of this Policy or bar the Company from asserting any right under the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by endorsement issued to form a part this Policy by an authorized representative of the Company. H. Assignment. Assignment by the Named Insured of his or her interest under this Policy shall not bind the Company, until its consent is endorsed hereon; if however, the Named Insured shall die, such insurance as is afforded by this Policy shall apply to the Named Insured's legal representative, as the Named Insured, but only while acting within the scope of his or her duties as such. I. Other Insurance. If the Named Insured andlor Additional Insured has other valid and collectible insurance available, the insurance afforded by this Policy shall be secondary and shall not apply unless and until the limits of liability of such other insurance have been exhausted. J. Subrogation. In the event of any payment under this Policy, the Company shall be subrogated to all the Named Insured's rights of recovery against any person or organization, and the Named Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Named Insured shall do nothing after loss to prejudice such rights.. The Company reserves the right to make counter -claims and to bring suit against persons making frivolous claims against the Named Insured. The Named Insured hereby grants that right to the Company and acknowledges that any award resulting from such counter -claim or suit shall be the property of the Company. K. Non-Assessability. This Policy is non -assessable. L. Territory. This Policy only affords coverage for Professional Services rendered in U.S. States or Territories where the Named Insured is specifically legally authorized to practice. M. Captions. Captions or headings in this Policy are inserted only as a matter of convenience and for reference and shall not be deemed to define, limit, enlarge, or describe the scope of this policy or the relationship of the parties and shall not affect the Policy or the construction of any provisions herein. N. Endorsements. Any endorsements to this Policy are part of this Policy, and all the conditions and terms of this Policy shall apply to such endorsements: O. Settlements. The Company may settle any claim without the Named Insured's consent, unless the Named Insured: 1) Objects to the proposed settlement; 2) Requests that the amount of the proposed settlement be paid directly to the Named Insured by the Company; and 3) Agrees to take over the defense of the claim at the Named Insured's sole expense. If the Named Insured makes such an election, then upon payment by the Company to the Named Insured of the proposed settlement amount, the Company shall have no further obligation of any kind to further defend or indemnify the Named Insured with regard to such claim. P. Choice of Law. Except as provided in Article V, Section C, this Policy and the rights of the parties hereunder shall be governed by and construed in accordance with the laws of the State of California, including all matters of construction, validity, performance, and enforcement without giving effect to the principles of conflict of laws. Q. No Intended Third Party Beneficiaries. The parties to this Policy agree that there are no intended third party beneficiaries by or under this Policy, unless such person or entity is specifically identified by name in this Policy. R. Additional Profession Coverage. If the Named Insured practices a profession other than the profession listed in the Declarations of this Policy ("Additional Profession"), coverage is automatically extended to the Named Insured for such Additional Profession ("Additional Profession Coverage"), subject to the terms and conditions specified below, and provided that: (a) The Named Insured has applied for and been approved by the Company for the Additional Profession; (b) The Company has not denied the Named Insured for the Additional Profession; and (c) the Named Insured has been provided with a sample of the policy and certificate of insurance which would have been issued had the Named Insured applied separately for coverage for the Additional Profession ("Additional Policy Form"). Additional Profession Coverage is extended on the following basis: (a) Whenever the Named Insured is practicing the Additional Profession, Articles VI and X of the Named Insured's Policy are deleted and replaced by the language contained within Articles VI and X of the Additional Policy Form, which shall be the basis for determining coverage in connection with the rendering or failure to render Professional Services; and (b) Additional Profession Coverage does not increase the limits of liability under this Policy. The Named Insured has paid for and received only one Policy with one set of limits. The fact that Additional Profession Coverage has been extended to the Named Insured does not increase, stack or cumulate these limits beyond the single set of limits set forth in the Declarations. VI. INSURING AGREEMENTS A. Liability Coverage. The Company shall pay on behalf of the Named Insured all sums that the Named Insured shall become legally obligated to pay for loss because of Professional Liability, Personal and Advertising Injury Liability, Premises Liability and Products Liability, ("Liability Coverage") solely arising out of Incidents, during the Policy Period as set forth in the Declarations (the "Policy Period"). 1 . Professional Liability - is defined as Damages the Named Insured shall legally be obligated to pay for Bodily Injury to a Client arising out of the rendering or failure to render Professional Services during the Policy Period. Professional Services is defined as the following techniques: a) Massage, defined as stroking, kneading, tapping, pressing, vibrating, rocking, rubbing, pushing, squeezing, moving, or stretching the muscular structure or soft tissues of the human body, with the hand, arm, elbow, foot, and to the extent permitted by law, with the aid of implements, tools, hot and cold packs, or mechanical and electromechanical devices (that do not require the use of transcutaneous electrodes), which are commercially marketed as massage implements, tools, and devices and which mimic or enhance the actions made by the hands. Stretching and movement is limited to non -forceful, non -sudden, active or passive stretches and movement. Soft Tissue does not include any organ of the body other than the skin. b) Movement Therapy, defined as teaching or guiding Clients through a system of movements, hold positions, breathing, and meditation to support the Client in achieving spiritual balance, self-awareness, and enhanced general wellbeing. c) Energy Therapy, defined as the use of gentle hand placement, soothing sounds, aromas, soft lighting, breathing instruction, or verbal cues to assist the Client in achieving a state of relaxation and to positively affect the general energetic system of the body; and /or d) Spa Therapy, defined as the use of body wraps; body scrubs; and the use of oils, creams, gels, herbal pastes, rubbing alcohol, lotions and powders as lubricants. 2. Personal and Advertising Injury Liability - is defined as Damages arising out of the Named Insured's rendering of Professional Services to a Client, which the Named Insured shall legally be obligated to pay for, other than Bodily Injury, to a Client or Clients, which a) occurs during the Policy Period and b) arises out of one or more of the following: (i) false arrest, detention or imprisonment; (ii) the wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or Premises that a Client occupies, by or on behalf of its owner, landlord or lessor; (iii) oral or written publication of material that slanders or libels a Client; or (iv) oral or written publication of material that violates a Client's right of privacy. 3. Premises Liability - a) Premises Liability is defined as Damages resulting from Bodily Injury or Property Damage arising out of (i) the rendering of Professional Services to a Client or Clients which occurred in the office, clinic, residence or such other location where the Named Insured is providing Professional Services (Premises), or (ii) an Incident which occurs in the common areas of the Premises if the Named Insured has specifically assumed liability of such common areas by way of a written agreement, and such claim alleges negligent acts by the Named Insured are the cause of the claimant's Damages: (1) by the Named Insured, or (2) by any person for whose acts or omissions the Named Insured is legally responsible (as described in Article Vill. Persons Insured hereof). b) In circumstances where the Named Insured has rented a Premises, separate from their residence (the "Rented Premises"), Property Damage to a third party, other than the Named Insured's Landlord, shall be considered to have arisen "out of the rendering of Professional Services to a Client or Clients", if such Property Damage is i) caused solely by Professional Service Equipment (as defined below), and such Professional Service Equipment is located on the Rented Premises; or ii) such Property Damage is caused by the negligent failure to turn on or off electricity or water resulting in water Property Damage or fire Property Damage. c) Professional Service Equipment means an appliance or other equipment: (i) owned by the Named Insured, and (ii) used by the Named Insured to practice Professional Services; and shall include, but not be limited to, fans, candles, clothes washers, clothes dryers, information technology equipment, music sound systems, lamps, water coolers and diffusers. 4. Products Liability - is defined as Damages the Named Insured shall legally be obligated to pay to a Client or Clients, subject to a $10,000 Products Liability Sublimit, for Bodily Injury arising from massage products bought from the Named Insured relating to external -use only preparations or essential oils. The Products Liability Sublimit does not apply to the Named Insured's liability for the application of a massage product during the rendering of Professional Services. B. Defend Claim. The Company shall have the right and duty to defend each covered claim reported against a Named Insured during the Policy Period, even if any of the allegations of the claim or suit are groundless, false, or fraudulent (except as excluded by this Policy) and the Company may make such investigation and make settlement of any claim reported as it deems expedient. In the event that a covered claim results in a Suit where at least one of the causes of action are covered for indemnity under the Policy (the "Covered Cause of Action"), the Company shall have the obligation to defend all of the causes of action that are contained in the Suit, so long as there is a Covered Cause of Action pending. The Company's costs of providing such a defense shall not be included in the computation of the Named Insured's limits of liability. C. Defense Limitations. The Company shall not be liable for the cost of professional services, including, but not limited to, legal and accounting services by any attorney, accountant, or any other professional selected by the Named Insured without the written consent of the Company. The Company will not pay for any costs or legal fees incurred in defense of any criminal investigation or prosecution. D. Supplementary Payments. The Company will pay, in addition to the applicable limit of liability: 1. Expenses. All costs assessed against the Named Insured in any suit defended by the Company and, with respect to any judgment, all interest on the entire amount of such judgment that accrues before the Company has paid or tendered or deposited in court that part of the judgment that does not exceed the limit of the Company's liability thereof. 2. Bonds. Premiums on appeal bonds required in any suit to which this Policy applies, and to furnish such appeal bonds necessary to appeal such suit up to the Company's limit of liability, but without any obligation to apply for or furnish a bond in excess of such limit of liability; and premiums on bonds to release attachments in any such suit for an amount not in excess of the applicable limit of liability of the Company. 3. Loss of Earnings. The Company will pay up to $500 per day for loss of earnings, up to a maximum of $10,000 per suit, if the Named Insured is away from their practice at the Company's request to help defend a suit. 4. Medical Expenses Coverage. The Company will pay all medical expenses incurred by anyone other than the Named Insured, a person working for the Named Insured, or a person who usually occupies the Named Insured's Premises, except for those incurred for services rendered by the Named Insured, due to an accident, regardless of fault, for which the Named Insured becomes liable, other than as a consequence of rendering or failing to render Professional Services, up to a maximum of $2,500 per accident, and $5,000 per Policy Period, irrespective of how many such claims are asserted in a Policy Period. VII. PERIOD OF COVERAGE The Company shall not have any obligations under the above Insuring Agreements if a claim reported against a Named Insured during the Policy Period is based on an incident prior to the Policy Period stated in the Declarations of this Policy or in the Declarations of an earlier dated policy issued by the Company of which this Policy is a renewal or replacement. This insurance applies only to Incidents and to Professional Services rendered or which should have been rendered during the Policy Period as stated in the Declarations or in the Declarations of an earlier dated policy issued by the Company of which this Policy is a renewal or replacement. VIII. PERSONS INSURED A. This Policy does not afford coverage for any act or omission of any other health care provider, including, but not limited to, any physician, surgeon, podiatrist, nurse, anesthetist, chiropractor, acupuncturist, physical therapist, physical therapy assistant, massage therapist, skin care professional, nail professional, hair care professional or any person licensed, certified or registered under any health professions statute, or who recommends any type of service, treatment, or procedure to maintain, diagnose, or treat any person's physical or mental condition ("Other Health Provider"), unless such person is specifically listed in the Declarations of this Policy as a Named Insured. B. This Policy does afford coverage within the applicable limits to the following persons for whose acts or omissions the Named Insured is legally responsible, but only to the extent of the Named Insured's liability for the acts of these persons in connection with the rendering or failing to render Professional Services and to Incidents, subject to all the same terms, conditions, and exclusions that apply to the Named Insured: 1. The Named Insured; 2. If the Named Insured practices his or her profession as a professional corporation which employs no Other Health Provider, and as long as all other shareholders, officers, and directors of said corporation (and all present and future massage therapists employed by the Named Insured or said corporation) are also insured by the Company, and if coverage for a professional corporation is indicated in the Declarations, the professional corporation and any other officer or director thereof with respect to covered incidents by the Named Insured or such employed massage therapists listed in the Declarations; C. This Policy does afford coverage within the applicable limits and subject to all the same terms, conditions, and exclusions that apply to the Named Insured to any additional insured listed in the Declarations for the period therein indicated, but In no event later than the termination of the Named Insureds. Policy, but only for a covered in -cadent by the Named Insured at the office(s). clinic(s), or such other location where the Named Insured is providing Professional Services to a Client, which acre owned lay or shared by the additional insured. D. Student. If the Named Insured is identified in the Declarations as a 'Student", then the Named Insured is only covered by this Policy for Liability Coverage if a) the Named Insured is actively enrolled in the educational institution reflected on the Named Insured's ABMP membership application ("Educational Institution") and has not graduated therefrom as of the date of incident; and b) the claim arises directly from acts or omissions of the Named Insured that were sponsored by, supervised by, or expressly approved by the Educational Institution. IX. LIMITS OF LIABILITY A. The limit of liability stated in the Declarations as applicable to "Each Claim" is the limit of the Company's liability for loss resulting from any one claim or suit or all claims or suits because of any injury or Damages to any one person or entity for all acts arising out of the rendering of, or failure to render, Professional Services and for any other Incidents upon which the claims or suits are based. Two or more claims arising out of a single act, error, or omission or a series of related acts, errors, or omissions shall be treated as a single claim; and B. The limit of liability stated in the Declarations as "Aggregate" is, subject to the provisions of Article IX, Section A, respecting "Each Claim," the total limit of the Company's liability for all claims reported during the Policy Period. C. Such limits of liability shall apply separately to each Named Insured only when so indicated in the Declarations, except the inclusion of more than one (1) Named Insured or the inclusion of shareholders, officers, directors, employees, or agents of the Named Insured in any one (1) claim shall not increase the Company's liability applicable to "Each Claim" as set forth in Article IX, Section A. Where limits of liability at the time of any incident or injury are not identical to limits of liability at the time the claim is made or reported, the limits of liability at the time of such incident or injury shall apply. D. Fire Liability Sublimit. In the event that there is a covered claim for a covered loss attributable in whole or in part to a fire, the maximum the Company will pay for Each Claim and Aggregate per Policy Period is $100,000 ("Fire Liability Sublimit"). This Sublimit does not increase the limit of liability stated in the Declarations for this Policy. E. Products Liability Sublimit. In the event that there is a covered claim for a covered loss attributable in whole or in part to Products Liability, the maximum the Company will pay for Each Claim and Aggregate per Policy Period is $10,000 ("Products Liability Sublimit"). This Sublimit does not increase the limit of liability stated in the Declarations for this Policy. This Sublimit does not apply to the Insured's liability for the application of a product during the rendering of Professional Services. X. EXCLUSIONS A. No Defense or Payment of Damages. This Policy does not apply to the defense or payment of Damages for any claim arising out of the following: 1. Excluded Professional Services. Any claim arising out of any of the following Professional Services: (a) treatment or reduction of any fracture; (b) practice of medicine; (c) the failure of the Named Insured to diagnose or treat any condition; (d) the failure of the Named Insured to refer a Client to any healthcare provider for treatment of any condition; (e) practice of obstetrics or gynecology, including the delivery of babies, or care of newborn infants until they are fourteen (14) days old; (0 colonic irrigations, dehydration of hemorrhoids; (g) the failure of the Named Insured to exercise professional standards of care while utilizing any modality of treatment other than Professional Services, as defined in Article VI, Section A; (h) treatment of cancer, epilepsy, or acquired immune deficiency syndrome; (i) magnetic therapy; (j) gemstone therapy; (k) meridian therapy when being utilized for the treatment of cancer or any other disease; (1) stressology or internal coccyx adjustment; (m) the use of the Toftness device, x-ray, or radium; (n) microwave or fever therapy; (o) moxibustion; (p) ear candling; (q) hypnosis; (r) nutritional or dietary counseling or advice; (s) detoxification services or advice; (t) any procedure which penetrates body cavities either manually or with any other method of intrusion except soft tissue manipulation of the oral or nasal cavities; (u) exercise and or personal training services, counseling, or advice; (v) psychiatry, psychology, or counseling services; (w) practice of acupuncture; or (x) practice of chiropractic, including but not limited to manipulation or adjustments of bones and hard tissues of the human body. 2. Activities Outside the Legal Scope of Practice. Any claim arising out of a procedure performed that is outside the legal scope of massage practice in the U.S. State or Territory in which the service is rendered. 3. Drugs or Surgery. Any injury arising out of the use, administration, or prescription of any drug or pharmaceutical for the treatment of human beings or arising out of the performance of any procedure involving the cutting or penetration of human tissue. 4. Breach of Application Warranty. Any claim where the Named Insured violated General Condition Article V, Section D, of the Policy by failing to disclose the possibility of such claim. This exclusion applies only to such undisclosed potential claim. 5. Failure to Sign Application. Any claim of any type if the Named Insured did not sign the Application for this Policy. 6. Collection Suits. Any claim arising as a counter-laim by a person who was sued for professional fees. Collection suits triggering this exclusion include, but are not limited to, those collections suits filed by a collection agency. Any claim made subsequent to a collection suit shall be presumed to be in response to the collection suit and to be in the nature of a counter -claim and, therefore, shall be within this exclusion. 7. Failure to Obtain Certificate of Insurance. Any claim against the Named Insured that involves, among others, any health care practitioner with whom the Named Insured currently or in the future (a) is a partner, (b) an employee, (c) an independent contractor, or (d) shares office space, where the Named Insured has failed to procure for the Company, automatically and without request, a current certificate of insurance from the professional liability insurer of such health care provider, which provides that the Master Policy Holder named in the Declarations of this Policy receive ongoing notification of the status and any cancellation of such health care provider's professional liability insurance. 8. No Active License. Any act or omission, if at the time of such act or omission, the Named Insured did not hold a current, active license, as required by the U.S. State or Territory in which the act or omission occurred, to practice the profession listed in the Declarations. 9. Intoxicants/Narcotics or Drugs. Any claim arising from a service rendered, or which should have been rendered and was not, while the Named Insured or its employee or agent is under the influence of intoxicants, narcotics, or drugs. 10. Sex Act. Any claim arising out of or related in any way to any sexual act, or acts, performed or alleged to have been performed by the Named Insured or an employee or agent of the Named Insured. 11 . Criminal Act. Any claim arising from an alleged criminal act, or any act allegedly committed while in violation of any law or ordinance. 12. Workers' Compensation. Any injury arising out of any obligation for which a Named Insured or an insurer has been or may be held liable under Workers' Compensation, Unemployment Compensation, Disability Benefits, or any similar law. 13. Guaranteed Results. Any claim arising from guaranteeing the results of services of the Named Insured or its employees or agent. 14. Peer Review Activities. Any claim arising from participation on a peer review committee, including, but not limited to, peer review committees of a hospital, trade association, or professional standards review organization. 15.Officers' and Directors' Liability. Any injury arising out of the rendering of or failure to render Professional Services by any other person for whose acts or omissions the Named Insured may be held liable as a member, partner, officer, director, or shareholder of any professional partnership, association, or corporation that is not listed in the Declarations as being insured by this Policy. 16. Proprietors. Any liability of the Named Insured as a proprietor, medical director, superintendent, administrator, or executive officer of any hospital, sanitarium, surgicenter, clinic with bed and board facilities, skilled nursing facility, convalescent hospital, laboratory, or business enterprise. 17.Assumed Liability. Any liability assumed by the Named Insured, including liability due to breach of contract or assumed by a Named Insured under oral or written contract or agreement or liability resulting from factual admissions by the Named Insured, except as provided for in Article VI, Section A.3, "Premises Liability", above. 18.Government Employment. Any injury from the acts or omissions of Named Insured or its employees or agents while employed by the United States Government or any other governmental or public entity. 19.Other Activities. Any claim arising from statements, acts or omissions by the Named Insured or by any other person alleged to be in connection with or related to any of the following: interference with contract; violations of state and/or federal antitrust or deceptive advertising laws; interference with a person's right to occupy his or her property undisturbed; malicious prosecution; any injury or loss caused directly or indirectly by nuclear reaction, radiation, or radioactive contamination, whether controlled, uncontrolled, or accidental in nature or however caused, or any consequence of any of these; any injury or loss relating directly or indirectly to the Named Insured's actions as the employer of any claimant; discrimination; conversion; interference with prospective advantage; unfair competition; unfair trade and/or business practices; misappropriation of trade secrets; conspiracy to do any unlawful or tortious act; abuse of process; intentional or negligent infliction of emotional distress; negligent misrepresentation; fraud; any other intentional tort (even if such activities are related to a Named Insured's rendering of or failure to render Professional Services); or any injury from any act or any omission to the extent that such injury is not attributable to the rendering or failure to render Professional Services or attributable to an Incident. 20. Research Subject. Any claim by any person who has ever been a research subject of the Named Insured or who was ever solicited to be a research subject of the Named Insured. 21.Excluded Personal and Advertising Injury. Any claim arising from Personal or Advertising Injury; (a) resulting in Bodily Injury; (b) caused by or at the direction of the Named Insured with the knowledge that the act would violate the rights of another; (c) caused by oral or written publication of material, if done by, or at the direction of, the Named Insured with knowledge of its falsity; (d) caused by oral or written publication of material whose first publication took place before the beginning of the Policy Period; (e) caused by the failure of goods, products, or services to conform with any statement of price quality or performance made in any advertisement by the Named Insured; (f) caused by the infringement of copyright, patent, trademark, trade secret, or other intellectual property rights; (g) caused by an electronic chatroom, blog, or bulletin board the Named Insured hosts, has an ownership interest in, or exercises control; (h) caused by the unauthorized use of another's name or products; (i) caused by misappropriation of advertising ideas or style of doing business; (j) to any person who is not a Client; (k) resulting in any injury arising out of an article or paper for any publication; libel; slander; trade libel; trade slander; harming a person's regulation; or harming a person's right to privacy. 22.Liquor Liability. Any claim arising from the Named Insured causing or contributing to the intoxication of any person; the furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or any law or regulation relating to the sale, gift, distribution, or use of alcohol. 23.PolIution. Any claim arising out of the actual, alleged, or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: (a) at or from any premises, site, or location that is or was at any time owned or occupied by, or rented or loaned to, any Named Insured; (b) at or from any premises, site, or location that is or was at any time used by or for any Named Insured or others for the handling, storage, disposal, processing, or treatment of waste; (c) which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for any Named Insured or any person or organization for whom the Named Insured may be legally responsible; (d) at or from any premises, site, or location on which any Named Insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if: (i) the pollutants are brought on or to the premises, site, or location in connection with such operations by such insured, contractor, or sub -contractor; or (ii) the operations are to test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to, or assess the effects of pollutants; (e) which results in any loss, cost, or expense arising out of any request, demand, or order that any Named Insured or others test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to, or assess the effects of pollutants; or f) which result in any claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, or in any way responding to or assessing the effects of pollutants. Pollutants are defined as any solid, liquid, gaseous, or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, and waste. Waste includes materials to be recycled, reconditioned, or reclaimed. 24.Aircraft, Auto or Watercraft. Any claim arising out of the ownership, maintenance, use, or entrustment to others of any aircraft, auto, or watercraft. 25. War. Any claim arising from war, whether or not declared, or any action or condition incident to war. War includes civil war, insurrection, rebellion or revolution. 26.Excluded Property Damage. Any claim arising out of property damage to: (a) property owned, rented or occupied by the Named Insured; (b) property sold, given away, or abandoned by the Named Insured; (c) property loaned to the Named Insured; (d) personal property loaned to the Named Insured. 27.RecalI of Products, Work, or Impaired Property. Damage claimed for any loss, cost, or expense incurred by the Named Insured or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (a) the Named Insured's product or work; or (b) impaired property; if such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy, or dangerous condition in it. 28.AffiIiated Parties. Any claim (a) for Bodily Injury to the Named Insured; (b) arising from any business relationship other than the Named Insured providing Professional Services to any Client; (c) brought by an employee of the Named Insured, including the spouse, child, parent, or sibling of any such employee, or brought by any member of the Named Insured's family or household; (d) for Damages of any kind to a person hired to work for or on behalf of any Named Insured; or (e) for Damages of any kind to a person on the part of the Premises that the person normally occupies. 29.Intentional Acts. Any claim arising from acts expected or intended from the standpoint of the Named Insured to result in any injury to another. 30.Electronic Data. Any claim arising from loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. 31.I1legal Distribution of Material. Any claims arising directly or indirectly out of any action or omission that violates the Telephone Consumer Protection Act, the (CAN-SPAM ACT) or any similar laws, including any amendments or additions to such law. 32. Steam, Sauna, Showers, Pools, or Jacuzzis. Any claim arising from use, operation, maintenance, or ownership of steam rooms, steam booths, steam showers, steam tents, saunas of any kind, showers, pools of any kind, including but not limited to soaking pools, whirlpools and swimming pools, and Jacuzzis. This exclusion does not apply to Bodily Injury solely attributable to Professional Services provided by the Named Insured that do not involve the use of mechanical or electromechanical devices. 33.Tanning. Any claim arising from use, operation, maintenance, or ownership of tanning beds or booths, or tanning lamps. This exclusion does not apply to spray tanning or spray tanning booths, where the state in which the spray tanning is provided specifically authorizes a massage therapist by law to perform spray tanning. 34. Earth movement. Any claim arising from movement of land or earth regardless of whether emanating from, aggravated by, or attributable to the Named Insured. 35. Dishonesty. Any claim arising from any dishonest, fraudulent, or malicious act, error, or omission. 36. Sale of Goods. Any claim arising from goods or products manufactured, bottled, or packaged by the Named Insured, except as provided for in Article VI, Section A.4, "Products Liability", above. 37.Excluded Substances. Any claim arising from or related to asbestos, lead, silica dust, dust and/or toxic dust, fungus, bacteria or organic pathogens. 38. Laser / IPL. Any claim arising from or caused by a laser device or intense pulsed light device ("IPL"). 39.Transmission or Fear of Disease. Any claim arising from or related to the transmission of Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus, or exposure to another having same, or to substances or materials contaminated with same, or fear of contracting Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus or any other disease or illness; or any sexually transmitted disease; or any form of communicable disease. 40. Non -Disclosed Massage Modalities. Any claim relating to a massage modality or any other modality that is not included within the definition of Professional Services, unless such modality is disclosed and approved in writing by the Company. 41.Animal Massage. Any claim arising from the Massage of an animal ("Animal Massage") unless a) the Named Insured can document proof of training in Animal Massage; b) the animal's owner has given written consent; and c) the Named Insured is not legally prohibited from rendering Animal Massage in the state in which the Animal Massage was rendered. 42. Hot Stones. Any claim arising from the use of heated stones unless the Named Insured has completed ABMP's Hot Stones Acknowledgement and viewed ABMP's Hot Stones Video. B. No payment of Punitive Damages (Defense Only). This Policy will provide a defense only, but does not provide any payment of punitive or exemplary damages. XI. EXTENDED COVERAGE If coverage terminates under this Policy, the Named Insured (and the Named Insured's professional corporation and/or additional insured, but only if named in the Declarations of this Policy) shall automatically have Extended Coverage providing an unlimited additional reporting period in which claims otherwise covered by this Policy may be reported. By: Authorized Representative Allied Professionals Insurance Company, A Risk Retention Group, Inc. How to File a Claim If any incident occurs that you believe may be covered by your liability insurance, immediately contact ABMP by phone (800- 458-2267), fax (800-667-8260), email (expectmore@abmp.com), or mail (address below) to make your initial report of the incident/claim. You are required to report any incident immediately, even if your client has not made a demand, or indicated that they want to file a claim against you. Failure to report an incident in a timely manner may void your insurance coverage. When something goes wrong during or following a service: • Assess the extent of injuries or damage. Obtain medical help or call the police if warranted or required by law. Do not be overly defensive or hostile to the claimant. Do what you can to soothe the situation. Many times, minor claims are dropped once the claimant's emotional anger diminishes. Report the incident to ABMP. • Take photographs immediately, if possible, and/or when circumstances warrant. It is a good idea to implement the regular practice of taking photographs at the beginning of every client session ("before" photos) and at the end of every client session ("after" photos) to track your client's progress and for your protection. • Do not admit fault. It is not advisable to offer complimentary treatments or refund service fees in an attempt to correct the alleged problem, as this may be construed as an admission of guilt. If the claimant is aware they may incur expenses (i.e., attorney's fees), they may not file an unsubstantiated claim. Discuss the facts or give statements only to the police, your ABMP Risk Management Coordinator or your insurance company representatives. Write down the facts. Detailed notes regarding the incident should be completed as soon as possible to take advantage of short-term memory. This information should include conversations, recollections, types of services or techniques/equipment used, length of session, whether the procedure was creating discomfort for the client, and any documentation outlining appointment history, preexisting conditions, procedures, client notes, releases, client consultation forms, post treat ment/homecare forms, client intake forms and any consent forms, etc. In addition, record any extraneous circumstances you may be aware of, such as previous treatments, work environment, hobbies and sports activities of the client, etc. Finally, record in writing any correspondence, telephone calls, or verbal communication received by you from the claimant or claimant's legal counsel. Reporting the incident or claim: Complete the claim form. Once you have compiled the facts and documents to be forwarded to ABMP (see above), complete and submit a claim form, which is available online at www.abmp.com. It is essential ABMP receives information regarding all communication between you and the possible claimant as soon as possible. You must include the client's name, address, area code, and telephone number; date and time of the alleged incident; date the complaint (verbal or written) was filed with you; a copy of any written correspondence and/or transcript of verbal correspondence, etc., so the insurance company has as much information as possible to pursue a complete investigation. Write down the date, time, and place of the incident. Get names, addresses, and phone numbers of all involved parties and witnesses. Forward this claim form and the corresponding documentation to ABMP within three (3) business days of an incident, or notice of claim or suit. Notice of a Claim from the Client or the Client's Attorney. Sometimes you won't even know about a potential claim until you are contacted later. If, as an ABMP member, you have received written or verbal contact from a client (or client's legal counsel) regarding a possible claim being filed against you, don't panic. Do not immediately inform your client you carry liability insurance. Do not provide any information regarding your (ABMP's) liability insurance policy until you contact ABMP. Do not communicate with the client's legal counsel. Follow the above procedure for gathering facts and completing the claim form. Report the potential claim along with supporting documentation immediately to ABMP. In the event a request for records pursuant to a subpoena, a deposition on written questions, or a request from an attorney or a client occurs, notify ABMP immediately. Please do not release the records until you contact ABMP and are advised to do so. The "Report of Claim or Incident Form" is not required for records request. Please do not send the "Report of Claim or Incident Form" to anyone other than your ABMP Risk Management. Coordinator. ABMP members are to communicate directly with an ABMP Risk Management Coordinator regarding any possible claims within three (3) business days. Send information as outlined to: ABMP Risk Management Coordinator, 25188 Genesee Trail Rd., Suite 200, Golden, Colorado 80401, or fax to 800-667-8260. For claims inquiries, call 800-458-2267. 1 Contract # 422601-17 This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUITA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and JOY MEDEIROS a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. • �� •I qp _ • • 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested b letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, one Quad by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CON ACT R shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2016 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT -shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted__ against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description,_ damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and `consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR_ will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2016 z a PROMPT NOTICE. CONTRACTOR 'agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum -student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if o is vailable. If there are noavailable facilities, CITY will cancel said and coordinate with CONTRACTOR to schedule a make-up date (initials)_ CONTRACTOR RESPONSIBILITY. Y. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved_ schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTORwillbe solely responsible to contact any and all porticipa of the program. Programs that are cancelled or changed by C TOR _must _be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be unde too that CONTRACTOR is working under a contractual obligation as specifie in this INSTRUCTOR AGREEMENT _ and is responsible as a_self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability policy form CG 00 01, with an edition date prior to 2004,_or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2016 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form -shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the requiredinsurance policies is terminated; (2)the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents: 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE IT . All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT I STDISCRIMINATIQN, CONTRACTOR covenants that, by andforitself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization f CITY. Should- such authorization be granted, CONTRACTOR agrees to info' ny subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT;' ` (initials) Rev May2016 4 j Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail _ postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Joy Medeiros 60240 Desert Shadow Drive La Quinta, CA- 92253 13. DOCUMENTS. Any documen CONTRACTOR under this INSTRUCTOR approval prior to distribution. CITY: Community Resources Department City of La Quinta e Tampico CA 92253 nitials) g materials created by be submitted to CITY for 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2016 0 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Joy Medeiros COMMUNITY RESOURCESDEPARTMENT ("CONTRACTOR") («CITY») m Digitally signed by Christopher ' lames Escobedo APPROVED: - DN AP D, 7 �� ,se aIN tuber=2nOx5tn3j7vx3<1 g, -US, st Californ a, I la Quinta, o— i Chistopher lames Escobedo, w . .„ , ,„ ,,, ,„ ,—, c Christopher lames Escobedo ' By: ; Date 201608.15082p2, 0700' F3 r Chris Escobedo, Community Resources Director S' no re 6� 20 Desert Shadows Drive La Quinta, CA 92253 (760)771-5187 s COUNTERSIGNED: By: Chrj ' ' C I eron, Co mu sty gams & Wellness Supervisor ;t I Rev May 2016 6 i 07/11/2016 12:15PM 7607718058 PAGE 02/03 POLICY CHANGE DOCUMENT POLICY NO: CHANGE#1 CHANGE EFFECTIVE: 11/0312015 M -4 nr-lxl 1jU-UUU Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: Joy Medeiros MAILING ADDRESS 60240 Desert Shadows Dr La Quints, CA 92253- POLICY PERIOD: FROM 11103J2015 TO 11/03/2016 at 12:01 A.M. Standard Time at your mailing address shown above: DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Adding Additional Insured: City of La Quints 78495 Calls Tampico La Quints, CA 92253 filtr-1- III - x Total Annual Addl6onal/Retum Twd$urcharge/Fee Total Prorate $0-00 Addonal/Retum Prernium Total Prorm Additional/Retum $0.00 TaWSurchargWFee Page I Of 1 I 07/11/2016 12:15PM 7607718058 PAGE 03/03 +C`CERTIFICATE OF UABILITY INSURANCE 07/08/2 PROWrElt THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Nt4ulrb Insursnm Agency, In a. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE %7191 Nam t. z: HOLDER. THIS CERTIFICATE. IMF A�M END OR r M&a4s9 vlga, ca a;sea- W7ai ALTER THE COVERAGE AFFORDED RY THC LICIT E s3 AFFOIWING EWE=NAIC# INSUWED - --INSUWERA PhSatlePeAre lntlmm� Iraknlfl.a Cann Jay Medefrol INSURER 9e- 69M Deeert 5ftv4p ro Dr La Quhft. CA 92252- PNSGRCR C: INSURER 0: - INSURER E.- COVERAGES THE POUCIES OF IWS—URMCE 9MULOW HAVE BEEN ISSUED TO THE INSURED NAMED AsOVE FOR THE POUCYPERI INDICATED. NOTWITHSTANDING Y REQUIREMENT, TERM ON CONDITIONOF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIRcAinoN MAY BE ISSUED OR MAY PERTAIN, THE 94SURANCE AFFORDED BY THE PouuEs McRmw HEREIN IS SUBIECT TO ALL THE TERMS, EXCLUSIONS AND CONDMOM OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID MS. _ ISPoPIMCTE)MRA-RONN- DATE lA A x LLWUTY PHPR1A1591S 11/09I2015 11/08/2018 EACH OCCURENCE S2 000 x 1.IABIII'IY '': ttt��t ,.L.., SaPxa„aty DE x =LIA rrne S2<5 x PROFES9IONALUABILLTy PEASQNALRADVIWURY ' ,� TdTfit Ab0 TE Sd.aoo, OEN'LAGOREBATELIMITAPPUESPER: PRODUCTS-mMP/OI'AGG Se,000,000' x PROTECT lt]C AUTOMMiElURAWY COMO NEO 9NOU UMrr ANYAUTO (EAaardent) ALL OMED AUTOG -__- -- - bbILY twURv SCHEDULED AU'r aS (Par P...) HIRMAUT05 --. BaOILY 1NIURY NON AUTOS S (PummWent) PROPERTY DAMAGE (Peraegdent} 0 AUTO ONLY —EA AMDENT ` ANVAUTO amCRTHAN EAACC _ AUTO ONLY: AGG EACH OCCURFNCE -. - CLYRCXAMOMAD9 AGGREGATE DEDUCTIBLE REM"ON MR %,MomE E.L EMM ACCIDENT ya�, E.L,DW9A%-EAAMPL0YEE - P Ai,P SI T LLDISEASE-POLICYUBMT OMEN PnGN 1>F nON / wcAnoNi/ VEH 1 >rw / avlaAL' It Is understood and armed that the folloWnS eftoty is added as an addRiarml Insured but olty earl* ,wl,.rl{e} m th. .pgr#6_ ®F kha qR M4 Insured erle:ept that llabft msuRhe® from the addllronal rnseuvd's sole nealkena. CERYIFICATE HOLDER CMCELLATION - -.- - SHOUE13 ANTOFTHE`MOVE DESMMM'POUM 9E...CUCUM ... ,RE THE EMRATIOMM DATE : ®LyorLacliata MWOF. THE IMWAG WURER wtll VI* To MAIL AD ®An wRrrvM NDTIDE TO THE 19M Cage TamProo CWFICA79 ID TO Tm LEFT, ®uT FM1uRE To IW SO PlA L IMPOeSE NO owcATiom an -'. L QUM, CA 92253-2839 aI 00'.:.AW MW—W"Alk MMMMA!_0�9RftPRE9ffUATPA& AUMCMIZEDA134tOSSWAIM ACORD 25 (2009/01) ® 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 07/11/2016 12:04PM 7607718058 PAGE 02/02 I L- If the certificate holder is an ADnITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISC ER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon, ACORD 25 (2009/01) 1MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: AUGUST 4, 2016 RE:JOY MEDEIROS, FITNESS,#AGR2016-0090 Instructor Attached for your signature is an agreement with independent contracted instructor JOY MEDEIROS for (TAI CHI CHURN) class(s). Compensations will not exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. 0 ;•u F MEMORANDUM Frank J. Spevacek, City Manager Christopher Escobedo, Community Resources Director August 16, 2016 RE: Doris Lynch, Social Bridge, #AGR2016-0099, Volunteer Coordinator Attached for your signature is an agreement with volunteer -coordinator DORIS LYNCH for (SOCIAL BRIDGE) open group play. There is no compensation for volunteers. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Kequestin a artrr�ent all h k on at h the ite s bel�war as a �r�r +eater /A Contract payments will be charged to account number: /A Amount of Agreement, Amendment, Change Order, etc.: 1A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests G4 A Conflict of Interest Form 70 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation'171(2). r tho VA e eo t this r e i __bMo Mpg /A Approved by the City Council on Community Resources Directors' signature authority provided under Resolution No. 21-05 for budgeted expenditures of $50,000 or less /A Initial to certify that 3 written informal bids or proposals were received and considered in selection The l I bLed to th red B JA Insurance certificates as required by the agreement (approved by Risk`Manager on date) /A Performance bonds as required by the agreement (originals) /A City of La QuintaBusiness License number /A N/A Purchase Order number Contract # 470201-17 This CONTRACT SERVICE AGREEMENT is hereby formed on JULY 1 ' 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and DORIS LYNCH, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. 1. SCOPE OF WORK. The scope of work is described as: VOLUNTEER COORDINATOR OF SOCIAL BRIDGE PLAY held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from on a bi-annual basis. Work proposals, once approved by CITY w tached as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. (initials) 2. COMPENSATION. VOLUNTEER shall hot be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of man drnpensation from CITY or any participant of the program. (initials)� PAYMENT TERMS. VOLUNTEER shall pay CITY a flat rate of $2.50 per person based on total amount of program participants 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER as an independent contractor and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any • or a against arising out of • performed •- •LUNTEER COORDINATOR AGREEMENT. assumes no obligation or •r by • i but •right (but not the duty) to monitor the handling of any such claim or claims if they are • involve CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program I dinate with VOLUNTEER to schedule a make-up date. (initials) VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the pmg m. Progmms that dre cancelled or changed by VOLUNTEER m I f e made up in a tiendy manner as approved by CITY. �► • 6.- COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. . NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontractor f a the stipulations of this VOLUNTER COORDINATOR AGREEMENT. (initials) t Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name Address Phone Number Mona Russell 47875 Via Trieste, La Quinta CA 92253 760.772.0205 MarilynTaschek 82325 Chochran Drive, Indio 92201 760.625.31285 Subcontractors listed above have been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shallnotbe liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE._ Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & RESOURCES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: Doris Lynch 78945 Via Florence La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La gi CA 92253 (initials) 11. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. Digitally signed by Chd—pher James Escobedo APPROVED: _ - °N CJn ' IN be A 2 0 St 3J73ct Q t o Ch"t ph 1 E b do, Cn Chrst.pher James Escobedo By: Date 2016.081 ] 1614:26-07'00' Chris Escobedo Commu ity Resources Di r for Cou S1 By. Ch i 'a Calderon, Community Programs & Wellness Supervisor r�. APPROVED: P Signature 78945 Via Florence La Quinta, Ca 92253 760.564.2878 TO Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: August 16, 2016 RE: Bob Lewis, Woodcarvers, #AGR 2016-0097 Volunteer/Coordinator Attached for your signature is an agreement with independent contracted instructor Bob Lewis for (Woodcarving Open Group). There is no compensation for volunteer/coordinator. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. City of La Quinta Community Resources Department Contract # WOODCARVERS17 This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and BOB LEIS, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. 1. SCOPE .OF_WORK. The scope of work is described as: VOLUNTEER COORDINATOR OF THE WOODCARVERS GROUP held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY l` a attached as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. (initials) 2. COMPENSATION. VOLUNTEER shall not be paid for services performed under _ this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of etary compensation from CITY or any participant of the program. _ (initials) 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER as an independent contractor and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, _suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert -witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program a39V rdinate with VOLUNTEER to schedule a male -update.. (initials) VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in - advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the program, Programs that are cancelled or changed by VOLUNTEER m be made up in a timely manner as approved by CITY. (initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, 'rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take °affirmative action to insure that applicants are employed and that employees are treated during employmentwithout regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontract f all' the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name A Address Phone Number Naomi Lewis 8721 Crest Ave, Indio, CA 92201 760.347.1751 Subcontractors listed above have been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage -prepaid, return receipt requested, addressed as follows: VOLUNTEER: CITY: Bob Lewis Community Resources Department 82731 Crest Avenue City of La Quinta Indio, CA 92201 78495 Calle Tampico La Quinta, 92253 (initials) 11. DOCUMENTS.: Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. writing12. MWSCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in • •i agreed upon by both parties. • _; of any or • • • of thereof.this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. COMMUNITYCITY OF LA QUINTA, Bob Lewis • r • APPROVED: _ iiUlly dbYCh tphrJames APPROV �— J(�',.- C� O INu 6 2 0 5 h1S, ct9, /VV�I US Cal-f L Q' a o Ch[itophe Ja e. E ,,bedo, ,,—C'flstophe. James Es<obedo L By: Dz 2016,0917132820-0T00 By: Chris Escobedo Signature Community Resources Director COi L lEl�:; 82731 Crest Avenue Indio, CA 92201 By; 760.347.1751 Chris ina Calderon, Cd 1t "Programs & Wellness Supervisor Hello Bob Lewis, Below is your class information for October 2 16— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. Woodcarvers Instructor: Bob Lewis (Naomi Lewis) Cost: 0a s Time Location Friday 5-8pm Art Room (18yrs and older) Sessions: . 10/7-10/28; 11/4 11/18; 12/2-12/16; Sessions: 1/6-1/27; 2/3-2/24; 3/10-3/31; 4/7-4/28 (NO CLASS DATES 11/11 Veterans Day & 1/25,12/23, 12/30, Arts Festival 3/3) Web Trac Brochure Info: INFORMATION BENEFITS OF TAKING CLASS Materials: Woodcarving Kit is $15.00 paid to the coordinators Bob & Naomi Lewis. Instructor Signature'. Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: August 16, 2016 RE: Donna Smith, Mah Jongg Group, #AGR2016-0096, Volunteer/Coordinator Attached for your signature is an agreement with independent contracted instructor Donna Smith for (Mah Jongg open group play. There is no compensation to volunteer/coordinator. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. ReqLAgsting department sholl check and attach the items below as =DroDriate: N/A Contract payments will be charged to account number N/A Amount of Agreement, Amendment, Change Order, etc.: N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with — no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required use this Consultant does not meet the definition in FPPC regulation 18701(2). N/A Approved by the City Council on N/A Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less NIA Initial to certify that 3 written informal bids or proposals were received and considered in selection N/A Insurance certificates as required by the agreement (approved by Risk onager on dote) N/A Performance bonds as required by the agreement (originals) NIA City of Lo Quinta Business License number no business license required no fees paid N/A Purchase Order number • a 1',1 This CONTRACT SERVICE A' ry formed on 1 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES r ' and DONNA• personor business engaged offering ' for Provision of Services to the City. 1. SCOPE OF WORK. The scope of work is described as: VOLUNTEER COORDINATOR • • OPEN PLAY held at a City of • Quinta facility. scopeThe of • all goods • a actions a o complete task VOLUNTEERhas been -• to perform,•- • included in the scope of work or not. Specific dates and times for contracted work will be requested • • VOLUNTEER from CITY on a bi-annual basis.►r proposals, once approved by 'ached as exhibitsto this VOLUNTEER COORDINATOR AGREEMENT. (initials) 2. COMPENSATION. • • not be paid for services performed under this INSTRUCTORAGREEMENT. VOLUNTEER shall perform Si', OF •' • � i " and shall not request or • any formof M a - • • •- •tion fromor any participant of - program. •' PAYMENTTERMS. VOLUNTEER•' pay CITY a flat rateof iE per person based on a • amount of programparticipants. VOLUNTEER3. ••'1 • Agreement callsa performance of of • as an independent contractora • not as an • • - of 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTEER COORDINATOR 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. CITY RESPONSIBILITY. CITY will contact VOLUNTEE' and all program participants if CITY cancels or changes a progra from original approved schedule based on zero enrollments minimum student requirement not met, anif use of facilit becomes unavailable. CITY reserves the right to change origina t s approved schedule of program if the facility becd omes unavailablie CITY will attempt to re -locate said program to another suitabi facility if one is available. If there are no available facilities, CIT will cancel said program dinate with VOLUNTEER t schedule a make-up date. nitials) VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the program-. Programs that are cancelled or changed by VOLUNTEER mue made up in a timely manner as approved by CITY. (initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenant that, by and for itself, its heirs, executors, assigns, and all persons claimin under or through them, that there shall be no discrimination against a segregation of, any person or group of persons on account of race, color, cree 1•I t 0 religion, sex, marital status, national origin, disability, or ancestry in th performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER sha 1 take affirmative action to insure that applicants are employed and tha employees are treated during employment without regard to their race, Coto creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. ShoulZsu authorization be granted, VOLUNTEER agrees to inform any subcontrf all the stipulations of this VOLUNTEER COORDINATOR AGREEMENT.initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name I Address Lucy Perricone 148810 Vista_ Estrella, La Quinta Subcontractors listedabovehave been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER AGREEMENT. 10.- NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS AND WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: CITY: Donna Smith Community Resources Department 48554 Via Amistad- City of La Quinta La Quinta, CA 92253 78495 Calle Tampico La Quinta, CA 92 m 3 (initials) 11. DOCUMENTS. Any documents and marketing materials created by VOLUNTEER under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. MISCELLANEOUS.• "COORDINATOR AGREEMENT Is the only agreement between VOLUNTEER and CITY a • may be amended in writing • • agreed upon by both parties.• waiver of any term or condition o VOLUNTEERthis OR •R AGREEMENT shall• - r continuing waiver thereof. WHEREOF,IN WITNESS - parties- a have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day a • year as • • a I• • CITY OF COMMUNITY• " DEPARTMENT APPROVED: w 9 deyC P e 9 Ci E P U ` o,soa,> s, s By: °a Chris Escobedo Community Resources Director Donna Smith • •, . APPROVED: d/11/4 /. BY Signature �k COU E GNED: 48554 Via Amistad La Quinta, CA 92253 By: �� 760.972.4243 Christ a`Calderon, Community Programs & Wellness Supervisor Hello Donna, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. Mah Jongg Open Play Instructor: Donna Smith, Volunteer Coordinator Cost DayZs Time Location $ T 1-3:30pm Wellness Center MPR Sessions: October 4 2016 through April 25 (no class on 11/8 Voting Day, 2/28 Arts Festival Web Trac Brochure Info: Open group play for all levels. if you have Mah Jongg tiles please bring your set with you. The volunteer/coordinator collects $2.50 from each player. Materials: Mah Jongg tiles, and a card Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. 4 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE. August 18,-2016 RE: Kathleen Salcedo, Fitness, #AGR2016-0100, Instructor Attached for your signature is an agreement with independent contracted instructor Kathleen Salcedo for (Zomba) class(s). Compensations will not exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing` and distribution. City of La A Communitv Contract # 422901-17 1. SCOPE OF WORK. The scope of work is described as: LEISURE 'ZUM B g a ooI classes held at a City of La Quinta facility. The scope of work includes all ds n• actions necessary to complete the task CONTRACTOR has been hired to perfor whether specifically included in the scope of work or not. Specific dates and time for contracted work will be requested rletter to CONTRACTOR from CITY on a bi annual basis. Work proposals, once o ed by CITY will be attached as exhibit to this INSTRUCTOR AGREEME (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed unde this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to b charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintai written records of gross receipts and shall submit such records to CONTRACTO upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments wit[ be made to CONTRACTOR after each session of work is completed,as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. I Rev May 2015 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt,_ obligation, or liability on behalf of CITY. CONTRACTOR shall not at any or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR_ agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses_ of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances_ where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice 'to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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 hivolve CITY. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within fen (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to thecancellationdate, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. . COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights_ or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to info ubcontractor of all the stipulations of this INSTRUCTOR AGREEMEN (initials) Rev May 2015 4 Please list all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name --Address Phone Number 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this IUST,2UCTOR AGREEMENT. 12. NOTICE. Notice shall bea-- rf given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: CITY: Kathleen Salcedo Community Resources Department P.O. Box 413 City of La Quinta La Quinta, CA 92247 La Quinta, CA 92253 '��(initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreemen between CONTRACTOR and CITY and may be amended in writing and agreed upo by both parties. No waiver of any term or condition of this INSTRUCTO AGREEMENT shall be a continuing waiver thereof. I Rev May 2015 WHEREOF,IN WITNESS parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day • i yearstated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitallysigned by Christopher James i_b.edAPPROVEDoN ria .lN b .2nOx5tn3j7vx3c1 g, California,1Ea Quinta,C\ Chi'toph lorries Escobedo, cn=Christopher James Escobedo Date: By: 2016.08,19 10:21:31-07'00' Chris Escobedo Community Resources Director COUN RS NED: By: Chrikirlb Calderon,Co unity Programs & Wellness Supervisor • �.lzapa••, P.O. Box 413 La Quinta, CA 92247 909.560.5283 Rev May 2015 6 Hello Kathleen, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 422302 Zumba Instructor: Kathleen Salcedo, Zumba Instructor Cost Day/s, Time Location $ M/W 9:30-10:30am Wellness Center Multipurpose Room Sessions: 10/3-10/31= $31.50 (9 classes) Sessions: 11/9-11/30; 1/9-1/30; 3/8-3/29=$24.50 (7classes) Sessions: 2/1-2/27; 4/3-4/26=$28 (8 classes) Sessions: 12/5-12/21= $21(6 weeks) Minimum of 5 students' maximum of 12 Web Trac Brochure Info: The most awesome workout ever; dance to great music, with great people, and burn calories without even realizing it. _� Instruct nature: Date '^—�2 ®/ Signing this do ment ly rifies that have read and understand the material within this document. T . docu" ent shall not a t as a contractual agreement between you and the ty of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. ACCOR& DATE(MMloormv) CERTIFICATE LIABILITY IL INSURANCE08/18/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Alternative Balance -The Alternative Ther y Association — _ Fw Veracity Insurance SolutionsLLC.PHONE s (0 fc.Ngk (Sq -6e}8 EMAIL 260 South 2500 West, Suite303r?—C�AOetrteU�.O� INSURERISI,AFFORDING COVERAGE NAIC 1/� Pleasant Grove UT 84062 �� `� "! iNSURERA:Great American Alliance Insurance CoTpay� 26832 Kathleen Kennedy Salcedo INSURER C 53743 Avenida Bermudas P.O. Box 413 INsuRERo: INSU RER Y, La Quinta CA 92247 N 'INSURER F . COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED., NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _INSR ._.�.....�.._.._____- - ---- - --- _ .._.�.�..., "Y�o"L s`t71..� .............._ �..�._ QL.t1S* OFF.:- f�t�i.l�i'��XP ........r...,...�,.,,,,.mm...� LTR TYPE OF INSURANCE POLICYIV.UMBER MMaODdY MMIDLIMITS GENERAL LIABILITY EACH OCCURRENCE $.�OOQO.� x COMMERCIAL GENERAL LIABILITY PREMISEO(E Ogacq x CLAIMS MADE OCCUR - �.d.u�... � MED EXP (Any one person) $ _ A 'v � LL_ PL-3842263-AO30874 11/23/2015 11/23/2016.PERSONAL &ADVINJURY $ .,. ,�...InplUded GENERAL AGGREGATE $ 31000.1:100. GATE LIMIT APPLIES PER GEN'LAGGREmm _ PRODUCTS-COMP/OP AGG K POLICY PRO- LOC $ AUTOMOBILE LIABILITY k I` L L I [Ea aoctden4j ANY AUTO BODILY INJURY (Per person) $ ALL OWNED -SCHEDULED :AUTOS AUTOS , 1, BODILY INJURY (Per accident) $ NON -OWNED IHIREDAUTOS 1 w..l ' PW60 RTY DA#A_5fu-_ $ - AUTOS _(Per accident).... $ UMBRELLA LIAR OCCUR Id EACH OCCURRENCE $ ,._ .. EXCESSLIAB GLAIMSMADE AGGREGATE $ u ,. _.. ' DED ''.. RETENTIONS$. $ WORKERS COMPENSATION - -- WCSTATO- OTH- _- AND EMPLOYERS' LIABILITY Y I N .ANY PROPRIETOR(PARTNERIEXEOUTIVE OFFICEIMEMBER EXCLUDED? N / A - E L: EACH ACCIDENT $ —.m._.............. (Mandatory in NH) - E L: DISEASE - EAEMPLOYE:.. $ If yes, describe under -' EL DISEASE - POLICY LIMIT $ Professional Liability (Claims Made) PL-3842263-AO30874 11/23/2015-11/23/2016 Included DESCRIPTION OF OPERATIONS? LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) It is understood and agreed that the Certificate Holder is named as Additional Insured per attached CG 20 26 - Additional Insured - Designated Person or Organization CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of LaQuinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico La Quinta CA 92253 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CG 20 26 (Ed. 04 13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Organization(s): Per individual Certificate of Coverage. City of LaQuinta 78495 Calle Tampico La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II -WHO IS AN INSURED is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to: liability for "bodily injury,""property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. in the performance of your ongoing operations; or 2. in connection with your premises owned by or rented to you. However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insuranceafforded to these Additional Insureds, the following is added to SECTION III LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contract or agreement; or 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.: Copyright, ISO Properties, Inc., 2012 CG 20 26 (Ed. 04/13) PRO I Page 1 of 1 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: August 18, 2016 RE: Mimi David, Leisure, #AGR2016-0098, Instructor Attached for your signature is an agreement with independent contracted instructor Mimi David for (Bridge) class(s). Compensations will not exceed $S,OOO per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Reggesting department s gall check and attach the items below as aa' ro iote. Contract payments will be charged to account number: > 101-0000-42200 'Amount of Agreement, Amendment, Change Order, etc.: % of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with o reportable interests in LQ or reportable interests /A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 1871(2). hrt we i . N/A Approved by the City Council on Community Resources Directors'; signature authority provided under Resolution No. 215-05ifor budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection �iia '. aired a e s are ed e Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) City of La Quinta Business License number LIC-10422 Expires 2/2/2017 N/A Purchase Order number MOW Kai UUUTTT I I III• 1. SCQPEDFjfQR& The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. � (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall as 60% of gross receipts collected to CONTRACTOR as compensation ase upon t e recor s an shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments wilt be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR ghall have no power to incur any debt, obligation, or liability on behalf of CITY. 'Aev May 2115 1 CONTRACTOR shall not at any time or in any manner represent that it or any o its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any dent of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments ' penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without [imitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2015 PROMPT NOTICE. CONTRACTOR agrees to provide immediate noti to CITY of any claim or loss against CONTRACTOR arising out of the wo performed under this INSTRUCTOR AGREEMENT. CITY assumes tbligation or liabty by such notice, but has the right (but not the duty) moitor the handling of any such claim or claims if they are likely 0 involve CITY. n 5. CANCELLATIONS/CHAAGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and a program participants if CITY cancels or changes a program from origina approved schedule based on zero enrollments, minimum studen requirement not met, or if use of facility becomes unavailable. CIT a] reserves the right to change original approved schedule of program if th facty becomes unavailable. CITY will attempt to re -locate said progra to another suitable facility if one is available. If there are no availabl facilities, CITY will cancel said pr ram and coordinate with CONTRACTO to schedule a make-up date. V (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY a defined in the NOTICE section in advance to notify of any cancellations a changes from original approved schedule if said program is cancelled oI changed by CONTRACTOR. CONTRACTOR will be solely responsible t contact any and all participants of the program. Programs that ar cancelled or changed by CONTRACTOR must be made up in a time[ manner as appro�)ved by CITY. jy(initials) 11 — 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as speced in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Offi "Commercial General Liability" policy form CG 00 it with an edition da prior to 2004, or the exact equivalent. Coverage for an additional insure shalt not be limited to its vicarious liability. Defense costs must be paid i addition to limits. Limits shalt be no less than $1,000,000 per occurrence• all covered tosses and no less than $2,000,0.00 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required. herein ' satisfactory to CITY, consisting of- (a) certificate(s) of insurance evidencing at[ of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shalt include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages ' and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shalt provide written notice to CITY within ten (10) workin days if. (1) any of the required insurance policies is terminated; (2) the limits of an of the required polices are reduced; or (3) the deductible or self -insured retention i increased. In the event any of said policies of insurance are cancelle i CONTRACTOR shall, prior to the cancellation date, submit new evidence o insurance in conformance with this Section 6 to CITY. The procuring of suc insurance or the delivery of policies or certificates evidencing the some shall not b construed as a [imitation of CONTRACTOR's obligation to indemnify CITY, its officerls employees, contractors, subcontractors, or agents. �Wlfl ON I OR W' 1• 114@161114`11W. m HIMP I 0 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. No ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR Rev May 2015 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION -! It is understood that CONTRACTOR will perform at[ services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to insufficient number of participants or unavailability of facties. In such circumst'•nces, CITY shot[ not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, foxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: David Palm Desert, CA 92211 CITY: Community Resources Department City of La Quinta 13. DOWMENTS. Any documents and marketing materials create y CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed as by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA,Mimi David COMMUNITY ("CONTRACTOR") ("CITY") APPRO ED: APPROVED: Chris pher s e o Community Resources Director Signature Tustin Larson 37417 Mojave Sage Street Acting Community Resources Director Palm Desert, CA 92211 760.636.9816 COUNT RS N D: Chr "no Ca eron, i `rnunity Programs& Wellness Supervisor Rev May 2015 6 Hello Mimi, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 410501 Beginning Bridge Instructor: Mimi David Cost DayZs Time Location W 10am-12pm Leisure Room Sessions: 1/11-2/8 = $80 (5 classes) Sessions: 3/8-4/5= $80 (5 classes) Web Trac Brochure Info: The Beginner "I Love Bridge" course is taught in an easy to learn format geared for beginners, and for those who have played in the past and want to refresh their game with the latest bridge systems. Material fee: $20.00 textbook, paid to the instructor. 4105,04 Beginning Bridge 2 Instructors: Mimi David Cost DU/s, Time Location W I Oam- I 2pm Leisure Room Sessions: 2/15-3/22= $80 (5-weeks) (no class 3/1) I• Trac Brochure Info, Description needed This "I Love Bridge" course is taught in an easy to learn format; geared towards advanced beginners and for those who have played in the past and want to refresh their skills.Course subject includes:' takeout doubles, overcalls, and slam bidding as well as, other topics. Material fee: $20 textbook fee paid the first day of class to the instructor. Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. � S Hello Mimi, Below is your class information for October 2016— April 2017 Please review and verify by typing your name and date on the lines below as soon as possible.= 410502 Intermediate Bridge Instructor: Mimi David Cost ay/s Time Location W 1-3pm Leisure Room Sessions: 1/11-2/8 $80 (5-weeks) Web Trac Brochure Info:, The Intermediate "I Love Bridge" course subjects include: The framework of bidding review, notrump Jacoby transfers and super accept, the finesse, and slam bidding and slam controls among other topics: Material fee $20.00 textbook paid to instructor. 10503 Intermediate Bridge 2 Instructor: Mimi David Cost Da /s Time Location W 1-3pm Leisure Room Sessions: 3/8-4/5 = $80 (5-weeks) Web Trac Brochure Info: Description needed "I Love Bridge" course subject includes: Preempts, Overcalls, Takeout Doubles, Balancing Seat, Negative Doubles, Penalty Doubles, the Reverse, Declarer Play and Defense as well as other topics. Your instructor is MimilDavid. Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this Document. This document shall not act as a contractual agreement between you and the City of La Quinta.- The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday,_arch 6, 2017. �t6. I ICERTI I I I DATE IMMIDDIYYYY) 6/ 1412016a 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 License #OE67789 PHOON PAX Bene-Marc Athletic Insurance AgencyAL3 6 �` 'fps` 11311 6301 Southwest Blvd, Suite 101 INSURER(S)AFFORDINGCOVERAGE NAIC# �.� _. _. Fort Worth TX 76132 INsuRERq,p lr _ "_mm� . INSURED INSURER B :.... A.?BLS..Global .Accident,& Hcaltla .:. Southern California Municipal Athletic Federation INSURERCa >INSURER D:.. PO Box 3605 � - INSURER E : South El Monte, CA 91733 INSURER F : COVERAGES CERTIFICATE NUMBER: - 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, AM soR POLICY EPO POL LIMITS L TYPE OF INSURANCE POLICY NUMBER MMI.DDIYYYY MM GENERAL LIABILITY EACH OCCURRENCE S-.1,000,000.00 - A COMMERCIAL GENERAL LIABILITY PREMISES (Ea orcugence) $ 100,000.00 'ALAIMS•MADE FXIOCCUR MEDEXP Any one person) $ 5,000.00 ®� .. _ X CP03256-04 Yz 12/31/2015 12/31/2016 PERSONAL& ADV INJURY $ 1,000,000.00 11 iabt41L�7_ 12:01 am 12:01 am GENERAL AGGREGATE $ 2,000,000.00 4"12N'L 'RE'.GATE'LIMIT APPLIES PER: PRODUCTS-CoMPrOPAGG $-: ...1,000,000.00 POLICY PRo•; LOC Mod x f r$S eCtat oTs Ot11 AUTOMOBILE LIABILITY - aDINEOSINGLE UMIT ANYAUTO BODILY INJURY (Per person) $ '.ALL OWNED SCHEDULED BODILY INJURY (Per accldent) $ AUTOS AUTOS 00,0 NON -OWNED PR7501ERI'Y C7AtAG' __ A HIRED AUTOS AUTOS 12/31/2015 1213 I/201(j?Ar CP03256-04 $ Q-01 sin UMBRELLA UAB I OCCUR EACH OCCURRENCE $ "EXCESS LIAR CLAIMS MADE 1 ...AGGREGATE S t)EO 17RETENTIONS " $ WORKERS COMPENSATION VVCSTATU- OTH -- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE N / A - EL, EACH ACCIDENT OFFICERIMEMBER EXCLUDED? '" ""`" (Mandatory In NH) E L. DISEASE - EAEMPLOYEE $ Bfyyes,do:under _.�_.".„_,..,W,....w_.__...,....,. 'I DESCRIPTIi3N'::OF OPERATIONS. below EL. DISEASE • POLICY LIMIT $ B Participants Excess Accident SRPO-50256-243 12/31/2015 12/31/2016 Medical Limit $5,000.00 p 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. CERTIFICATE HOLDERCANCELLATION Cert #: 9066-30899-215380-0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta, CA 92253 Attn: Risk anagemenl O 1988-2010 ACORD COR4bRATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD PP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 1104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Designa:tio:n Of Premises (Part Leased To You)- 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): C4 of La Quinta Additional Premium: $ Included This Insurance does not apply to: I - Any "occurrence" Which takes place after you cease to be premises. 2. Structural alterations, new construction or demolition operations perfbnmed by or on behalf of the pemon(s) or organization(s) sfipwri- in the Schb�dule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted b V and 2. if coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insuredsi the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required or agra6ment, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 1104 13 @ Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: GP03256-04 WAIVER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Cagle Tampico, La Quinta, CA 92253 The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 11 [, x It I; M4 City of La Quints ta Qwkra Community Services Department - GEM DES'Elz, Contract # 410401-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY SERVICES DEPARTMENT ("CITY") and LIORA CASSEL, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. ' (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2015 1 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. Rev May 2015 2 PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date: _ , .' (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT �CTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inforrrytq,ny subcontractor of all the stipulations of this INSTRUCTOR AGREEME T. � (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name I Address I Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Llora Cassel 52135 Avenida Carranza La Quinta, CA 92253 CITY: Community Services Department City of La Quinta 78495 Calle Tampico La Q�u�inta, CA 92253 lam' (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Llora Cassel COMMUNITY SERVICES DEPARTMENT ("CONTRACTOR") ("CITY") APPRO ED: APPROVED: ,I By. sy: t Tust' Larson Signa ure Community Resources Manager 52135 Avenida Carranza La Quinta, CA 92253 760.580.7696 COUN RSIGNED: B 'I r Ch ° tina Caider6n,"ChWUnity Programs & Wellness Supervisor Rev May 2015 4c� Hello Llora, Below is your class information for May — September 2016. Please review and verify by typing your name and dating the lines below: 410401 Dance, Play, & Pretend 2 1/2-5 yrs. Cost Da s Times Location M 4-4:45pm La Quinta Wellness Center Art & Leisure Room Sessions: 5�12 /23; 6/6 — 6 7—`$32 Session 1 1/25 $24 (no class S 30 ermorial da o August, eptember) 410402 Dance, Play, & Pretend 21/2-5 yrs. Cost Da s Times Location F , :4Sa B & G Community Room Sessions: 5/6 — 5/27, 6/3 — 6/24, 7 1— 7/$32 (no July 15, no August & September) ---- 410403 Beginning Ballet 5-10 yrs. Cost Dav/s Time/s Location TH 6:30-7:15pm La Quinta High School Room 1006 Sessions: 5/5 — 5/26; 6/2 — 6/30• /7 — 8 32 (no August & September)/ 1 /; Web Trac Brochure Info: , 1 Dance, Play, & Pretend - Young children will learn basic movements and coordination with an emphasis on large motor skills. Classical music interpretation and appreciation will be taught along with imagination, fantasy, and dance. Beginning Ballet - Children will learn the basics of ballet and dance through beginning ballet positions and steps. This class will provide children with coordination exercise and poise along with music appreciation and interpretation. Materials to Bring: Dancewear required (leotaad� 4ad ballet shoes) Instructor Signa#ure: � C Date Signing this docurrien( only erifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. ,A� EY CERTIFICATE OF LIABILITY INSURANCE DAT6114/20 6 ) 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 CONTA, FLAME License #OE67789 PHONE - FAX Bene-Marc Athletic Insurance Agency E-MA�iLa,.EhS):.�l�l.%) 38.fi$29 Ac Nar: f8.12j .� ADDRESS; 6301 Southwest Blvd, Suite 101 INSURER(S) AFFORDING COVERAGE NAIC# Fort Worth, TX 76132 INSURER A: Atlantic Specialty Insurance Comoanv INSURED INSURER B : AXIS Global Accident Southern California Municipal Athletic Federation INSURERC: INSURER D : _ PO Box 3605, INSURER E: South El Monte, CA 91733 INSURER F : rnVFRAC;F:C f'.FRTIFIrATF NI I6AFtFR• RFVICInNU WI HUIRI=R• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS --- --- INSR TYPE OF INSURANCE A L U POLICY NUMBER --- MNV DD lEYYY maunflmYY LIMITS L GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A COMMERCIALGENERALLIABILITY _ DAMA R N D PREMISES_(Eaoccun $ 100ence) 000.00_ __ CLAIMS -MADE 10OCCUR MED EXP (Any one person) $ 5,000•00 X —ANG661DES-PefHai nt- Pa X CP03256-04 12/31/2015 12/31/2016 _ PERSONAL & ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 ---t.l`ul-whllitj -- - --.-- 12:01 am 12:01 am GENt.AGGREGATELIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $ 1,00_0,000.00 POLICY — JgGi PRO. LOC Med Ex . f irk .ectators Only AUTOMOBILE LIABILITY comet S GLE LIMI a enl BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS AUTSNON-OWNED 12/31/2015 12/31/201 PPROPERTYno $ A CP03256-04 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE _ $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN E L EACH ACCIDENT $ -- - ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ A NIA -- — - - E L. DISEASE - EA EMPLOYEE -" $ (Mandatory In NH) If Yes, descabe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ B Participants Excess Accident SRPO-50256-243 12/31/2015 12/31/2016 Medical Limit $5,000.00 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) '- Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. Cert #: 9066-30899-215380-0 City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Attn. Risk Manaeemer GANGtLL.A I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01M %ft ©1988-2010 ACORD COR RATION. All riahts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 11 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 11 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 MEMORANDUMTWT 4 TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: Gepter�nber 12, 2016 RE: Chuck Sullivan, Leisure, #AGR2016-0110, Instructor Attached for your signature is an agreement with independent contracted instructor Chuck Sullivan for (Leisure -Ukulele) class(s). Compensations will not exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shalt check and attach the items below as gvpropdotp.. X Contract payments will be charged to account number: 101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 60% of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Ag rit 9 t h5 agreprne i N/A Approved by the City Council on _........... X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection X Insurance certificates as required by the agreement 0 /12/16: Approved by Pam Nieto N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-0105089 Expires 09/30/2016 N/A Purchase Order number 9 City of La Quinta Community Resources Department Contract # 411601-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and CHUCK SULLIVAN, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE (UKULELE) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, one proved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. _ (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said ro ram and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT TOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of Lo Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to infdr any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. w ..... Name.............................._____�_...��_...Add�ress............................................. ..._. _......._...... ._............aaaaa.— Phone Number Subcontractors listed above have b .enaapppr."—'p'"r....._�wovedw................................................ eby CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Chuck Sullivan 48610 Vista Estrella La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 (initials) 13. 'DQC�UMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") APPROVED: Dgitzllysigned by do, —Gty do � c �� \ DN cn=Chr s Escobedo o Cit f La 1/ r Quint.,-, email=C—bedo@la- Date: 2016.09.21 104929-07'00' By: Chris Escobedo Community Resources Director CO By. Ch & Wellness Supervisor Chuck Sullivan ("CONTRACTOR") APPROVED: By. Signature 48-610 Vista Estrella La Quinta, CA 92253 949.887.9941 Rev May 2015 Hello Chuck, Below is your class information for October 2016 through Sept 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 470701 Desert Oasis Strummers Instructor: Chuck Sullivan Cost Da s Time Location F 1-4pm La Quinta Wellness Center MPR (Kitchen side) Sessions: October 7 through April 21 No class 11/25, 12/23 & 12/30, Arts Festival 3/3) Material fees paid to the instructor: $35 annual fee $45 one-time fee for a music book for new students Web Trac Brochure Info: Experienced players will improve their knowledge of musical notation and enjoy playing popular songs in a friendly uplifting group. "Members must have completed Beginning and Intermediate Ukulele classes or equivalent." Materials to Bring: A Ukulele, Electronic Tuner & Music Stand are needed. Ukulele Strummers Concerts are held the last day of the month from 1:30-3:30 pm Concert Date: October 28, January 27, February 24, March 31, room not available -no concert April 28. Instructor Signature: Date 8/10/2016 Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. Hello Chuck, Below is your class information for October 2016 — April 2017. Please review and verify the information by typing your name and dating the lines below: Beginning Ukulele Instructor: Chuck Sullivan Cost Da s Times Location $40 W 2-3:30pm Wellness Center MPR Sessions: 11/2-11/30; 3/8 -3/29 (no class 11/23) Intermediate Ukulele Instructor: Chuck Sullivan Cost Da s Times Location. $40 TH 3:4:30pm Wellness Center MPR Sessions: 1/12-2/2 Web Trac Brochure Info: Beginning Ukulele This class will introduce the ukulele, its history and the basics of musical notation, emphasizing playing the ukulele as an accompaniment to singing. No previous musical experience required. Web Trac Brochure Info: Intermediate Ukulele This class will continue introduction of the ukulele through supervised practice, as well as, an introduction of new material and techniques. Participants must have completed Beginning Ukulele or have previously mastered basics of the instrument. Materials to Bring: Beginning and Intermediate A Ukulele, Electronic Tuner & Music Stand are needed. $10.00 material fee paid to instructor. M Instructor Signature: Date: August 11, 2016 Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. C CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 1hrr.M ' ' 1 6/ 14/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsements . PRODUCER License#OE67789 mMR! ONE8�Bene Marc Athletic Insurance Agency A"ILoExt1 .. (8I7) 738 68J9.,tD tPN:mm-..�1.7 7 lS3j. 6301 Southwest Blvd, Suite 101 Fort Worth, TX 76132 INSURED Southern California Municipal Athletic Federation PO Box 3605, South El Monte CA 91733 r0VF'RAI;FA r:FRTIJ*1..ATI= NIIMFIFR -INSURER A„.:...,,.(LantW,S,p,,r,,Mjty„3;DSIIran�Ce l..Dm anY INSURER B. AXIS _Global.Accident...&...Health ........-_.... INSURER C ', INSURER D INSURER E: INSURER F : .— .,—,,a 1., .w.. RFVISIAN NIIMRPIP. 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. gpN 5R __... TYPE OF INSURANCE.. ... O !N POLICY NUMBER . DD EFF M DBY EXp:..... LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 COMMERCIAL GENERAL LIABILITY 0 A PR _( t� ggcq) $ CLAIMS-MADE[XI OCCUR MED EXP Any one person) $ 0 .. (e 100 000.00 _. PERSONAL & ADV INJURY $ 1,000,000.00 9ttta1t1171 g I�artlelpant X CP03256-04 12/31/2015 12/31/2016 ._--- ..-__..._....._- -- GENERALAGGREGATE $ 2,000 000.00 ._t�,s;grlt.iaatlilily.__. .............. 12:01 am 12:01 am_..--...._..........--............._-.......,....,..._...__�__ ___. GEN'LAGGREGATE LIMIT APPUESPER: PRODUCTS -COMP/OPAGG $ 1,000,000.00 I of ll r Loc Med EX f rBS eatato C ....w Pao. rs On I AUTOMOBILE LIABILITY 5OMaINE'0 S LE. LIU ANY AUTO BODILY INJURY (Per person) $ A CHEDULED OWNED SAUTOS AUTOS .. BODILY _INJURY(Per accident) $ W 1.,.0110,,000.0 NON -OWNED HIRED AUTOS AUTOS 12/31/2015 12/31 /201 I'a0"EtlTY V7A..MAfrk: a �sl A CP03256-04 $ �� ( UMBRELLA LIAR OCCUR EACH OCCURRENCE ..AGGREGATE ............................: ___..,...............................................,...,.. EXCESS LIAB CLAIMS -MADE $ DED RETENTION $ k WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN mEL m ANY ECU7IVE NIA (Mandatory in NHR EXCLUDED? �f DISEASE CEA EMPLOYEE $ p If yes. describe under DESCRIPTION OF OPERATIONS below .-_......W,.........,_.. .... E.L. DISEASE POLICY LIMIT ._...�......,.�,.......,._... ...... $ 12/31/2015 12/31/2016 Medical Limit $5,000.00 B Participants Excess Accident SRPO-50256-243 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF O _.....�_ PERATIONS /LOCATIONS I VEHICLES (Attach ACORD 101,Addllional Remarks Schedule, If more apace is required) Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured Includes: City of La Quinta; its officers, employees, officials and agents of the City as additional insured. Coverage is Primary and Non -Contributory per Waiver of Transfer CG 24 04 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. CERTIFICATE HOLDER CANCELLATION Cert #: 9066-30899-215380-0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta CA 92253 Alur Risk anagemenl 01988-2010 ACORD COR RATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 20 1104 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Information required to complete this Schedule, if not shown above„ will be shown in the Declarations A. Section II — Who Is An Insured is amended to 2. If coverage provided to the additional insured include as an additional 'insured the person(s) or is required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured with respect to liability arising out of the will not be broader than that which you are ownership, maintenance or use of that part of the required by the contract or agreement to premises leased to you and shown in the provide for such additional insured. Schedule and subject to the following additional B. With respect to the insurance afforded to these exclusions: additional insureds, the following is added to This insurance does not apply to: Section III — Limits Of Insurance: 1. Any "occurrence" which takes place after you If coverage provided to the additional insured is cease to be a tenant in that premises, required by a contract or agreement, the most we 2. Structural alterations, new construction or will pay on behalf of the additional insured is the demolition operations performed by or on amount of insurance: behalf of the person(s) or organization(s) 1. Required by the contract or agreement; or shown in the Schedule, 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable Limits of Insurance shown in the Declarations. CG 20 11 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 06 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 i i� MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: GeptEber 1, 201� RE: Mario Sewell, Leisure, #AGR2O16-0109, Volunteer Coordinator Attached for your signature is an agreement with independent contracted instructor Mario Sewell for (Cinema Discussion) class(s). Compensations may exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. nest r a it rx er t alV ° Ap, a tac6 the.jtg tov� as appropriate: X Contract payments will be charged to account number: 101-0000-42214 N/A Amount of Agreement, Amendment, Change Order, etc.: N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). N/A Approved by the City Council on ....... w_.... N/A Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection f?ll i0 _r it dprrrr� r N/A Insurance certificates as required by the agreement 0/12/1 - P�pprOved by F'OFti IetO N/A Performance bonds as required by the agreement (originals) N/A City of La Quinta Business License number LIC-NUMBER Expires DATE OF EXPIRATION N/A Purchase Order number 9 City of La Quinta taQ"(ra Community Resources Department Contract # 414501-17 VOLUNTEER COORDINATOR AGREEMENT This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and MARIO SEWELL, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. CITY AND VOLUNTEER MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: CINEMA DISCUSSION GROUP held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY will be attached as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. (initials) 2. COMPENSATION. VOLUNTEER shall not be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of monetary compensation from CITY or any participant of the program. (initials) 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with VOLUNTEER to schedule a make-up date. (initials) wl VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the program. (initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be ..............................._- _....................... provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontractor of all the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name ........._..�......._ ..�.._��..�.......... _..-.Address. .��...�.....��._..............�...��...........� .....Ph.one�Numbe.r.......� Subcontractors listed above have been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTI,CE.. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: Mario Sewell 54480 Avenida Rubio La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 11. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Mario Sewell COMMUNITY RESOURCES DEPARTMENT ("VOLUNTEER") ("CITY") D'gitally s gned by Chr s Escobedo DN ChrsEscobedo o �ryo, APPROVED: APPROVED: // > e Qui� nt = o° l �. 'I c bedo@la qu nta org c=US Date: 2016 09.21 10:52:06-07'00' By: By: 62A4=0 Chris Escobedo, Community Resources Directgr Signature B y. Chr tj ron, s 6, liness Supervisor 54480 Avenida Rubio La Quinta, CA 92253 760.771.8068 Hello Mario, Below is your class information for November through April 2016. Please review and verify by typing your name and date on the lines below as soon as possible. C4ifte6mol Discussion Instructor: Mario Sewell Cost Dayls Time Location $4/$3 drop in W 1-3:30pm La Quinta Wellness Center Leisure Room Sessions: 11/2 & 11/16, 1/4 & 1/18, 2/1 & 2/15; 3/8 & 3/22; 4/5 & 4/19 Monthly registration fee: $4 (two classes); $3 drop in fee. Web Trac Brochure Info: The goal of the series is to provide insight into and knowledge of different ways of life in our shrinking world. Each foreign film will be preceded by a presentation about the film director and the historical, social and political context of the film. After each film there will be an open discussion about the major themes and characters in the film as well as an overall evaluation. As new foreign films continue to be released and classic foreign films restored and re -issued, and taking into account recommendations by the participants, the specific films to be shown in the series will be reviewed on an ongoing basis. Registered participants will receive information about the first film prior to November 2. After each subsequent film an email will be sent to participants with information about the next film in the series. Mario Sewell has facilitated local cinema discussion groups over the past three years. c /- Instructor Signature: Bate Signing this document only verifies that you have read and under antd ateria w th�document. This document shall not act as a contractual agreement betu and the City of La Quinta. Minimum 5 students and Maximum 30 students `prop -in 4932-01 R 1 91 - 00,V, TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: Gepter�nber 2, 201 RE: Clare Dune, Fitness, #AGR2016-0117, Instructor Attached for your signature is an agreement with independent contracted instructor CLARE DUNE for (FITNESS) class(s). Compensations will not exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Req qg+ jt -g-0 p rtrn hot[ c k �.d attachITIT !.he items bdo— o r, -p-rj.a + , x Contract payments will be charged to account number: 101-0000-42200 NA Amount of Agreement, Amendment, Change Order, etc.: 70 %of fees are paid to instructor NA A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests NA A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). ytbAr"i , laj1 tbi .qenna+ent Ls NA Approved by the City Council on _ .._.................... x Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less NA Initial to certify that 3 written informal bids or proposals were received and considered in selection X Insurance certificates as required by the agreement 0/2/1: P�pprOved by F'er�n NIetO NA Performance bonds as required by the agreement (originals) x City of La Quinta Business License number LIC-762441 Expires 3/31/2017 NA Purchase Order number._..___._.__ 9 City of La Quinta Community Services Department Contract # 421703-17 IINSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and CLARE DUNE, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once a roved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay - 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said prg r m and coordinate with CONTRACTOR , � to schedule a make-up date. and CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CO,NT 'C R must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. qP (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Clare Dune P.O. Box 118 La Quinta, CA 92247 CITY: Community Resources Department 78495 Calle Tampico City of La Quinta La Quinta, CA 92253 (initials) 13. DO UI ENT. , Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Clare Dune COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") Digital iy signed by Chris Escobedo APPROVED: APPROVED: DIN: _Chrs Escobedo —City of LQ ta, ou 'I ce cobedo@la qu'nta org, c=Us Date: 2016.09.2608:07:06-07'00' Y 1 By: By: Chris Escobedo Community Resources Director Signature P.O. Box 118 La Quinta, CA 92247 805.272.5695 COUNT SIGNED: Chri ii ,Ca deron, C6m .u6 y Programs & Wellness Supervisor Rev May 2015 Hello Clare,- -.- Below is your class information for October 201 April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 421703 Body Mind Breath Instructor: Clare Dune CMT, CHt, MPS Dav/s Time TH 8:30-9:30am Wellness Center Leisure Room Sessions: 3/7-3/30; 4/4-4/27=$60/drop in $10 (8 classes) Sessions: 11/1-11/17; 12/1-12/15= $37.50/drop in $10 (5 classes) (no class 11/8) Sessions: 1/3-1/31= $67.50/$10 drop in (9 classes) Sessions: 2/2-2/23= $52.50/drop in $10(7 classes) Sessions: 10/11-10/27= $45/drop in $10 (6 classes) Web Trac Brochure Info: A gentle stretch class with an emphasis on breathe work and meditation accompanied by upbeat music to begin your day. Your instructor Clare Dune will use guided imagery to help students focus on the moment. All fitness lev Is are welcome. _._ µ Instructor Signature- � y � Date Signing this document nl ies that you have read and understand the m 'erial within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. $ " cr class $10 drop in Minimum number of students 5 Maximum 15 Certqieate of Insurance OCCURRENCE COVERAGE ABMP In -Dues Liability Program ABMP MAILING ADDRESS: MASTER POLICY HOLDER Assoedaled Bodywork & Message Professionals Allied Professionals Insurance RPG 25198 Genesee Tail Road Suito 200 AGENT/BROKER Golden, Cca Hoatlt Allied Professionals Insurance Services ISSUED BY: POLICY #: API-ABMP-16 Allied Professionals Insurance Company, A Risk Retention Group, Inc. LIABILITY LIMITS ANNUAL AGGREGATE .......,.,-, ..- .................a........... $6,000,000 (per member) PER OCCURRENCE LIMIT... - ..........................d........... $2,000,000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP................................................ Included PROFESSIONAL LIABILITY ,....,„... .............................. Included GENERAL LIABILITY... ... Included FIRE LIABILITY LIMIT... ..... ..................................... $100,000 To verify information, contact ABMP. Tel: 303-674-8478 Fax: 303-674-0859 This Policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group. Coverage is afforded to person(s) named herein as Named Insureds according to the terms and conditions of the Policy to which this Certificate refers. No other rights or conditions, except as specifically stated herein, are granted or inferred. THIS IS TO CERTIFY THAT THE POLICY OF INSURANCE LISTED ABOVE HAS BEEN ISSUED TO TIIE INSURED NAWMD BELOW® TIIE IN.g)RFD ACTIVE DATE LISTED BELOW APPLIES ONLY" TO I?LF.M1tEN'I'S OF COVERAGE CONTINUOUSLY IN PLACE SINCE THE INCEPTION OF THE NAME® INSURED'SPOLICY, CFIAN(;rSTOCOVF.'RAGEARF.E,FFE.C'FIVERF.'FPOA(,'TIVE[,YO41,YTOi'IM DATF.'I VI E CHr\NOE \� AS MAailF°.. BiF P6)R'[' ITd SYR77TMG W@'ffV€hl A81%()C!$tS Alv'Y a& 1E.i. i'd,Af:'v9S, Ott INC'iDEN I'S rtiAA'S You BELIEVE NULY RESULT' iN A CLAIM, EVEN IF GR®C 131-ESS.. 'I hFs CerII€icnte, sAiong, arith the Pollee to which it re Sera, is welld ev€dcv€ a of eovcrngc extended to the CL!,(I tcoc Holder HAW Seto - CERTIFICATE HOLDER (Active Regislered Members are on file with the ABMP Membership Director) Member/Named Insured: Claire Dune Membership I.D. #: 886766 Member/Policy Term Active: Jul-07-2016 Member/Policy Term Expires: Jul-06-2017 Total Member Cost: $ 199 (AIMIl° Mmihership, including Mcwjlu"-t bability Coreragc) .,a ALithorized Representative CA R C.ELL.ATIO N: Should any of the above described policies be caneclfed before the exPizinl;�az! a1atcaluaascall', thir osR'Iaiq o ompany will ent+��ivor 0" moil ttt w9wyat �,vtltte wu na)ISEc IPa�I,. non luq^r col ail90 shays wtille n A06ec for Ia�ny who rcaomn to IN, cei titlicale hold'cr oirmm. abovcs but hilure to nlaff sach noiiew, slial'I irx paw no oWigadun or lifibifity rrl" my kind tlhsl�n the company, in, agents Qr reprCsuntatives, ADDITIONAL INSURED: (wash inception date) City of La Quinta, CA Jul 07, 2016 78495 Calle Tampico La Quinta, CA 92253 Coverage is extended subject to all ferns and conditions of fhe Policy himAssociated Bodywork & Massage Professionals Massage Professional & General Liability Insurance Policy Notice: This policy (the "Policy") is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for your risk retention group. In consideration of the payment of the premium, in reliance upon the statements made in the application for insurance provided under this Policy, and subject to the limits of liability, exclusions, conditions, and other terms of this Policy, the Company and the Named Insured (as hereinafter defined) enter into the following contract for insurance: I. DEFINITIONS When used in this Policy: A. ABMP - means Associated Bodywork and Massage Professionals, with offices at 25188 Genesee T rail Road, Suite 200, Golden, CO 80401, which is not the Master Policyholder. B, Bodily Injury - means physical injury, sickness, disease or death of a Iaxttrswi except for [*M sons injured while taking in athh.tir s. C. CN,aim Reported - means a written ounce filed by the Named Insured and received by the Curnpany,or a written novice oT a Suit filedby aa. claimant or other Person acting for that cWmant and received by the Nanied Insured ands by throe Company that allege Darna ges to an injured party from acts or omissi()ns by the Named tnsured that sac covered by this Poll D. Client means a pamarseuaa to whom the Named Insured has provided Professional Services for at fee om° in c:onnectiorr with an educational,, charitable or promotional acclivity. E. Company - means Allied Professionals Insurance Company, a Risk Retention Group, Inc., with offices at 1100 West Town & Country Rd., Suite 1400, Orange, CA 92868. F. Damages - means sums the Named Insured is legally obligated to pay for liability covered under this Policy. The term "Damages" does not include either any sums demanded or awarded as punitive or ail ernp laay darnages ur defending the Named Insured from any claims. G. Incident -means any actor omission who results in alfeged or acrarai Daam tgom W Named J ristaredl,- rnoortrs the pr rs ins or or ;ltrWatirm, named in the De+a laminations lilts Policy jt'ho 'V erllarrulcvtsri. I. Policy - means this Policy,„ the Declarations to this policy, all aaprphcalimlK for memherwhip and N or coverage or endorsements to coverage provided by or on behalf of the Named Insured (including any supplemental documentation (provided therewith) and all coverage endorsements issued to the Named Insured. j. Professional Corporation - means a professional corporation as defined in the Declarations. K. Professional Services -means Professional Services as defined in Article VI, Section A.1, of the Policy. L. Property Damage - means physical damage to tangible property, Electronic data is not tangible proparcny. M. Suit - includes 1) a cross clain% and 2) an arbitration to which the Named Insured is required to submit or to which the Named Insured has submitted with the Company's consent. II. POLICY PERIOD; PREMIUMS; AUDITS A. Policy Perlod. Thar iraftiat policy period of this Policy is stated in the Declarations formtng as part of this Pohcy. Subject to the right of the C"orrifmny to c.anr;el [Yams Policy in accordance with the provisions of the Canceplatlon Condition the Policy Period may be extended for successwe perreadsby payment of the required renewal parempum,, and any other arrtounts required as a condition of ,such renewal, to the Company on or before the e ffectivee date of each scrCC ssrve period. The expiration date of such Period shall bell end of the Iaulfr y I cnrd. B. Premium. All preemiooas arid rrtheer charges for this Policy shall be Computed in accordance with the rules, raters, rating plans, prerniunes, and minimum premiurns app'rlicable to the inswan(m aaffo ded herein and in effect with respect to the period for which premiums are due. All premiums and oiher charges for this Policy are payable in advance, to the Company or its authorized representative. The first payment is due at inception of the Poll Each renewal payment is doe on or before the ,expiration of the period for which the preceding payment was paid. Any payment not paid on or before its due date will be in default. C. Inspection and Audit, the Company may examine, audit, and inspect the Named Insured's property, business operations, books, and rccords aat any urns( during the pulley period and renewals tfterceo'f within three (3) years after Mire final termination of this Policy, as far as they rerhoe to the sul l inatteer of this insurance. The f (inipany is not required to make such inspects and audits and does not guatmaantee that the Named iniuned's rgmrafions are satiric or, that they conform to any laws, napes, or regulations. ill. CANCELLATION & NON -RENEWAL The Naained Insured may cancel this Policy, by suire irder thereof to the Comp>any or any of its authorized ;agents by niarhng to the Cornpany written notice stating when the-reafter the cant.tliation shall he off"ecbvae. The Company may cancel (:Ir non -renew this Policy by mailing to the Named losured at his or her latest address shown on the Company records', writtewrr notice Mailing when, not It sit than ninety (90,) days themaher, such cancellation or nova-rcme wal shall be effective, unless rancethatpnn is for nonpayanent of pnernium, in which case such notice whir be riot less than ten (10) days prior to tlw effective clate of r:«ancellaiion or non -renewal. The mailing of notiaa as aforesaid shall be sufficient proof of notice, The time of surrenad'er or the effective date and hour of cancellation Or non -renewal stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Named Insured or by the Company shall be equivalent to mailing. If this Policy is cancelled, the Company will send the Named Insured a refund of any unearned premium, computed on a pro-rata basis, as soon as practicable thereafter. Payment or tender of unearned premium is not a condition of cancellation. IV. CLAIMS A. I ncident Report. Upon the happening of any inc'itlent reasonably likely to involve this insurance, wewhiitten naatice containing infonnatiorl sufficient to identify the Natned Insured, tame, pface, and circumstances of the event, arid the names and addresses otthe injured and of available witnesses must p �ning of aan�y such event or as soon as panaa:arr1r0ape. be ptavwrn lry or for tine Naaratee�l Irasurc.d taathr Crtrrtpaoy witiair°a tlarcra C3) lrruslaaress (flays of throe Na apt B. Notice of Claim of Suit. It ae Clan" or suit is reported against the Warned Insured based on an incident covered by this Policy, the Narraed Insured shapi, within three (3) business (lays, by certified mail return rec opat requested forward to the Company (,wery de aria 1, notice, summons, or other process received by hirn or her or by his or her representative, Failure to give such notice wilt result in a total loss of coverage and constitute a material breach of the Policy manly wises a) such failure actually prejudirm in any way the ability of the Company to adjust, wattle or defend any claim or action, or b) the Named Insured has failed to give notice until after the Named insured has, submitted in the jurisdicil of a c:crun cur" until after judgment, which the Named Insured and the Company agree shall constitute substantial and actual prejudice which adversely affects the rights 'Allied PrOfesslonat5 insurance Cownparly, RRG, Iric All Rights Reserved, Rev.101205 1 ARMP2002 of the Company, which bases its Policy and premiums on cost -containment methods of dispute resolution, mandatory arbitration, and settlement. C. Cooperation. The Named Insured shall cooperate with the Company and, upon the Company's request, assist in making settlements in the conduct of suits and other proceedings; and the Named Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. the Named insured shall not, except at his or her own cost, voluntarily make any payment or assume any obligation without the consent of the Company. The Named Insured shall not destroy, discard, alter, or fabricate any evidence related to a claim, whether in the form of documentation or physical, tangible objects or equipment, including, but not limited to, records, therapy tables, heat lamps, and tens units. This does not apply to signed, dated bona fide corrections to records. V9Kff4lt'M:#�l�.r 7J7r1C3iF A. Abide by Terms. The Named Insured specifically agrees to abide by the terms and conditions of this Policy and by all rules and regulations of the Company relating to the conduct of the. Named Insured's professional practice. B. Action Against the Company. No action shall lie against the Company, its Agents, Employees, Brokers, or the Master Policy I folder unless the action is commenced within one (1) year from the date that the Company sends a letter denying coverage on a claim, or in the case of actions not relating to a denial of coverage by the Company, one (1) year from the date of loss or damage to the Named Insured. Additionally, as conditions proceedent to any such actions, 1) there shall have been full compliance with all of the provisions of this Policy, and 2) the amount of the Named Insureds obligation to pay shirt] have been finally determined either by judgment against the Named Insured after actual arbitration or trial or by written agreement of the Named Insured, the claimant, and the Company. C. Arbitration. All disputes or claims involving the Company shall be resolved by binding arbitration, whether such dispute or claim arises between the parties to this Policy, or between the Company and any person or entity who is not a party to the. Policy but is claiming rights either under the Policy or against the Company. This provision is intended to, and shall, encompass the widest possible scope of disputes or claims, including any issues a) with respect to any of the terms or provisions of this Policy, or b) with respect to the performance of any of the parties to the Policy, or c) with respect to any other issue or matter, whether in contract or tort, or in law or equity. Any person or entity asserting such dispute or claim (the "Claimant") must submit the matter to binding arbitration with the American Arbitration Association, under the Commercial Arbitration Rules of the American Arbitration Association then in effect, by a single arbitrator in good standing. If the Claimant refuses to arbitrate, then any other party may, by notice as herein provided, require that the dispute be submitted to arbitration within fifteen (15) days. Neither the Claimant nor any other party shall have the right to participate as a member of any class of claimants, and there shall be no authority for any dispute to be decided on a class action basis. In addition, an arbitration can only decide a dispute between the Claimant and the Company, and may not consolidate or join the claims of other persons who have similar claims. All procedures, methods, and rights with respect to the right to compel arbitration pursuant to this Article shall be governed by the Federal Arbitration Act. The arbitration shall occur in Orange County, California. The laws of the State of California shall apply to any substantive, evidentiary or discovery issues. Any questions as to arbitrability of any dispute or claim shall be decided by the arbitrator. If any party seeks a court order compelling arbitration under this provision, the prevailing party in such motion, petition or other proceeding to compel arbitration shall recover all reasonable legal fees and costs incurred thereby and in any subsequent appeal, and in any action to col Iect the fees and costs. A judgment shall be entered upon the arbitration award in the U.S. District Court, Central District of California, or if that court lacks jurisdiction, then in the Superior Court of California, County of Orange. D. Application Warranty. The Named Insured warrants that he or she has made true, correct, and full answers to all questions propounded to him or her upon the application for insurance coverage (the `Application") and agrees, to provide the Company with full and correct answers to any other questions related to his or her competence or financial ability as shall be reasonably propounded to him or her by the Company. The Named Insured acknowledges and agrees that if the Named Insured does not sign the Application, this Policy is void and no insurance coverage is conveyed thereby. E. Breach of Policy. Breach by the Named Insured or any person covered by this Policy of any of the conditions of this Policy shall subject the Named Insured to termination at the instance of the Company and upon thirty (30) days written notice. F. Change of Address. The Named Insured will keep ABMP apprised of his or her current addresses, both business and residential, and will report in writing any change of address within ten (10) days. G_ Changes. Notice to any agent or knowledge possessed by any agent or by any other person shall not effect a waiver or a change in any part of this Policy or bar the Company from asserting any right under the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by endorsement issued to form a part this Policy by an authorized representative of the Company. H. Assignment. Assignment by the Named Insured of his or her interest under this Policy shall not bind the Company, until its consent is endorsed hereon; if however, the Named Insured shall die, such insurance as is afforded by this Policy shall apply to the Named Insured's legal etepresenfxive,r as the Narried Insures,11, but only whole wasting wilhfn the wope of lsrs or her dunes as wer(')w. L OtherInsurance. 41'thte Named Insured and/or Additrettta% Insure hasp anther valid and collectible ins�uranc lva4able, the insurance afforded 1)y this Policy sffall t secondary and,thalV not apply unless,and'ur€til flee limits, of liability of such other Insurana•e have been exhauiteO, J. Subrogation. In the event of any payment under this Policy, the Company shall be subrogated to all the Named Insured's rights of recovery against any person or organization, and the Named Insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The Named Insured shall do nothing after loss to prejudice such rights. The Company reserves the right to make counter -claims and to bring suit against persons making frivolous claims against the Named Insured. The Named Insured hereby grants that right to the Company and acknowledges that any award resulting from such counter -claim or suit shall be the property of the Company. K. Non-Assessability. This Policy is non -assessable. L. Territory. This Policy only affords coverage for Professional Services rendered in U.S. States or Territories where the Named Insured is specifically legally authorized to practice. M. Captions. Captuuns or headings in this Policy are inserted only as a matter of convenience and for reference and shall not be deemed to define, limit, enlarge, or describe the scope of this policy or the relationship of the parties and shall not affect the Policy or the construction of any provisions herein. N.:E.rtdorsements. Any endorsements tq this Policy are part of this Policy, and all the conditions and terms of this Policy shall apply to such endorsements: O. Settlements. The Company may settle any claim without the Named Insured's consent, unless the Named Insured: 1) Objects to the proposed settlement; 2) Requests that the amount of the proposed settlement be paid directly to the Named insured by lhe Company; and 3) Agrees to take over tke defense of the claim at the Named Insured's sole expense, If the Naen'ued Insured makes such an election, then upon payment by the Company to the Named Insured of the proposed settlement amount, the Company shall have no further obligation of any kcitecl to further defend or indemnify the Named Insured with regard to such claim. P. Choice of Law. Except as provided in Article V, Section C, this Policy and the rights of the parties hereunder shall be governed by and construed in accordance with the laws of the State of California, including all matters of construction, validity, performance, and enforcement without giving effect to the principles of conflict of laws. Q. No Intended Third Party Beneficiaries. The parties to this Policy agree that there are no intended third party beneficiaries by or under this Policy, unless such person or entity is specifically identified by name in this Policy. R. Additional Profession Coverage. If the Named Insured practices a profession other than the profession listed in the Declarations of this Policy ("Additional Profession"), coverage is automatically extended to the Named Insured for such Additional Profession ("Additional Profession Coverage"), subject to the terms and conditions specified below, and provided that: (a) The Named Insured has applied for and been approved by the Company for the Additional Profession; (b) The Company has not denied the Named Insured for the Additional P(ofession; and (c) the Named Insured has been provided with a sample of the policy and certificate of insurance which would have been issued had the Named Insured applied separately for coverage for the Additional Profession ("Additional Policy Form"). Additional Profession Coverage is extended on the following basis: (a) Whenever the Named Insured is practicing the Additional Profession, Articles VI and X of the Named Insured's Policy are deleted and replaced by the language contained within Articles Vi and X of the Additional Policy Form, which shall be the basis for determining coverage in connection with the rendering or failure to render Professional Services; and (b) Additional Profession Coverage does not increase the limits of liability under this Policy. The Named Insured has paid for and received only one Policy with one set of limits. The fact that Additional Profession Coverage has been extended to the Named Insured does not increase, stack or cumulate these limits beyond the single set of limits set forth in the Declarations. 1 A. Liability Coverage. The Company shall pay on behalf of the Named Insured all sums that the Narnod Insured shall become legally obligated to pay for loss because of Proferssional Liability, Personal and Advertising Injury Liability, Premises Liability and Pru&im,, Liability, ("Liability Coverage") solely arising out of Incidents, during the Policy Period as set forth in the Declarations (the "Policy Period"). 1 . Professional Liability - is defined as Damages the Named Insured shall legally be obligated to pay for Bodily Injury to a Client arising out of the rendering or failure to render Professional Services during the Policy Period. Professional Services is defined as the following techniques: a) Ma.sagv, defined as stroking, kneading, tapping, pressing, vibrating, rocking, rubbing pushing, squeezing, moving, or stretching the muscular struc.twe or soft tissues of the human body, with the hand, ami, elbow, foot, and to the extent pernraitted by law, with the aid of implements, tools, hot and cold packs, or mechanical and electromechanical devices (that do not require the use of transcutaneous electrodes), which are commercially marketed as massage implements, tools, and devices and which mimic or enhance the actions made by the hands. Stretching and movement is limited to non -forceful, non -sudden, active or passive stretches and movement. Soft Tissue does not include any organ of the body other than the slain. b) mov noc+ni I hvr,ipy, defined as leaching or guiding Clients through a system of movements, hold positions, breathing, and meditation to support tjae Odra att urt spin'ilual balance, selWwareness, and enhanced general wa Ilbeing. c) Energy Therapy, defined as the use of gentle hand placement, soothing sounds, aromas, soft lighting, breathing instruction, or verbal c uatt: to a state of n4ax,ation and to positively affect the general energetic system of the body; and!or d) Sl,z,i Ihtgagpy, defined as the use of body wraps; body scrubs; and the use of oils, creams, gels, herbal pastes, rubbing alcohol, lotions, arid prawc9t rs as 6�aj�ric'an'ats. 2. Personal and Advertising Injury Liability - is defined as Damages arising out of the Named insured's rendering of Professional Services to a Client., which the Named Insured shall legally be obligated to pay for, other than Bodily Injury, to a Client or Clients, which a) occurs during the Policy Period and b) arises out of one or more of the following: (i) false arrest, detention or imprisonment; (ii) the wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or Premises that a Client occupies, by or on behalf of its owner, landlord or lessor; (III) oral or written publication of material that slanders or libels a Client; or (iv) oral or written publication of material that violates a Client's right of privacy. 3. Premises Liability - a) Premises Liability is defined as Damages resulting from Bodily Injury or Property Damage arising out of (i) the rendering of Professional Services to a Client or Clients which occurred in the office, clinic, residence of such other location where the Named Insured is providing Professional Services (Premises), or (ii) an Incident which occurs in the common area, of the Premises if the Named Insured has specifically assumed liability of such common areas by way of a written agreement, and such claim alleges negligent acts by the Named Insured are the cause of the claimant's Damages: (1) by the Named Insured, or (2) by any person for whose acts or omissions the Named Insured is legally responsible (as described in Article VIII. Persons Insured hereot7, b) In circumstances where the Named Insured has rented a Premises, separate from their residence (the "Rented Premises"), Property Damage to a third party, other than the Named Insured's Landlord, shall be considered to have arisen "out of the rendering of Professional Services to a Client or Clients", if such Property Damage is 0 caused solely by Professional Service Equipment (as defined below), and such Professional Service Equipment is located on the Rented Premises; or ii) such Property Damage is caused by the negligent failure to turn on or off electricity or water resulting in water Property Damage or fire Properly Damage. c) Professional Service Equipment means an appliance or other equipment: (i) owned by the Named Insured, and (ii) used by the Named Insured to practice Professional Services; and shall include, but not be limited to, fans, candles, clothes washers, clothes dryers, information technology equipment, music sound systems, lamps, water coolers and diffusers. 4. Products Liability - is defined as Damages the Named Insured shall legally be obligated to pay to a Client or Clients, subject to a $10,000 Products Liability Sublimit, for Bodily Injury arising from massage products bought from the Named Insured relating to external -use only preparations or essential oils. The Products Liability Sublimit does not apply to the Named Insured's liability for the application of a massage product during the rendering of Professional Services, B. Defend Claim. The Company shall have the right and duty to defend each covered claim reported against a Named Insured during the Policy Period, even if any of the allegations of the claim or suit are groundless, false, or fraudulent (except as excluded by this Policy) and the Company may make such investigation and make settlement of any claim reported as it deems expedient. In the event that a covered claim results in a Suit where at least one of the causes of action are covered for indemnity under the Policy (the "Covered Cause of Action"), the Company shall have the obligation to defend all of the causes of action that are contained in the Suit, so long as there is a Covered Cause of Action pending. The Company's costs of providing such a defense shall not be included in the computation of the Named Insured's limits of liability. C. Defense Limitations. The Company shall not be liable for the cost of professional services, including, but not limited to, legal and accounting services by any attorney, accountant, or any other professional selected by the Named Insured without the written consent of the Company. The Company will not pay for awry costs or legal fees incurred in defense of any criminal invc:atigation or prosecution. D. Supplementary Payments. The Carroalaany will pay„ in addition to the applicable limit of liability. 1. Expenses. All costs assessed against the Named Insured in any suit defended by the Company and, with respect to any judgment, all interest on the entire amount of such judgment that accrues before the Company has paid or tendered or deposited in court that part of the judgment that does not exceed the limit of the Company's liability thereof. 2. Bonds. Premiums on appeal bonds required in any suit to which this Policy applies, and to furnish such appeal bonds necessary to appeal such suit up to the Company's limit of liability, but without any obligation to apply for or furnish a bond in excess of such limit of liability; and premiums on bonds to release attachments in any such suit for an amount not in excess of the applicable limit of liability of the Company. 3. Loss of Earnings. The Company will pay up to $500 per day for loss of eamings, up to a maximum of $10,000 per suit, if the Named Insured is away from their practice at the Company's request to help defend a suit. 4. Medical Expenses Coverage. 1he Company will pay all rnedical expenses incurred by anyone other than the Named Insured, a person working (or the Named Insured, or a person who usually accupies t1w Named Insured's Premises, except for those incurred for services rendered by the Named Insured, due to an accident, regardless of fault, for which the Named Insured becomes liable, other than as a consequence of rendering or failing to render Professional Services, up to a maximum of $2,500 per accident, and $5,000 per Policy Period, irrespective of how many such claims are asserted in a Policy Period. VII. PERIOD OF COVERAGE the Company shall not have any obligations under the above Insuring Agreements if a claim reported against a Named Insured during the Policy Period is based on an incident prior to the Policy Period stated in the Declarations of this Policy or in the Declarations of an earlier dated policy issued by the Company of which this Policy is a renewal or replacement. This insurance applies only to Incidents and to Professional Services rendered or which should have been rendered during the Policy Period as stated in the Declarations or In the Declarations of an earlier dated policy issued by the Company of which this Policy is a renewal or replacement. VIII. PERSONS INSURED A. This Policy does not afford coverage for any act or omission of any other health care provider, including, but not limited to, any physician, surgeon, podiatrist, nurse, anesthetist, chiropractor, acupuncturist, physical therapist, physical therapy assistant, massage therapist, skin care professional, nail professional, hair care professional or any person licensed, certified or registered under any health professions statute, or who recommends any type of service, treatment, or procedure to maintain, diagnose, or treat any person's physical or mental condition ("Other Health Provider'), unless such person is specifically listed in the Declarations of this Policy as a Named Insured. B. This Policy does afford coverage within the applicable limits to the following persons for whose acts or omissions the Named Insured is legally responsible, but only to the extent of the Named Insured's liability for the ads of these persons in connection with the rendering or failing to render Professional Services and to Incidents, subject to all the same terms, conditions, and exclusions that apply to the Named Insured: 1. The Named Insured; 2. If the Named Insured practices his or her profession as a professional corporation which employs no Other Health Provider, and as long as all other shareholders, officers, and directors of said corporation (and all present and future massage therapists employed by the Named Insured or said corporation) are also insured by the Company, and if coverage for a professional corporation is indicated in the Declarations, the professional corporation and any other officer or director thereof with respect to covered incidents by the Named Insured or such employed massage therapists listed in the Declarations; Cu I'M15 Policy da safford ' fcaR within the grheaJAe'hmfts and wbjeo to all the 8ame terms, conditions, and exclusions that apply to the Named, 0nsoted to, any�additrt aj ,ifisutW 4fsmed in the fXclaratmns for the Ipeno0berion, indilcatecl, ct 6 no event fatty than the ter fmfttartion or the Narnc U jfasuredl"s Policy', bot only for a t"mNesuJ mOdlent by the Named, fmmsored of the, ufficeVs), (diuicts), of such other, location where the Namamecl Insured is Ijtovldnmg professumml Services, to a Cliefit,„ Which art, rrwml by or shated by Ile additiofnal insuff-A. D. Student If the Named Insured A tdertihed in the De larrtum;rns as, a"Siudcn"at", then the Named Insured is only covered by this Policy for Liability Coverage if a) the Named Insured is actively enrolled in the educational institution reflected on the Named Insured's ABMP membership application ("Educational Institution") and has not graduated therefrom as of the date of incident; and b) the claim arises directly from acts or omissions of the Named Insured that were sponsored by, supervised by, or expressly approved by the Educational Institution. IX. LIMITS OF LIABILITY A. The limit of liability stated in the Declarations as applicable to "Each Claim" is the limit of the Company's liability for loss resulting from any one claim or suit or all claims or suits because of any injury or Damages to any one person or entity for all acts arising out of the rendering of, or failure to render, Professional Services and for any other Incidents upon which the claims or suits are based. Two or more claims arising out of a single act, error, or omission or a series of related acts, errors, or omissions shall be treated as a single claim; and B. The limit of liability stated in the Declarations as "Aggregate" is, subject to the provisions of Article IX, Section A, respecting "Each Claim," the total limit of the Company's liability for all claims reported during the Policy Period. C. Such limits of liability shall apply separately to each Named Insured only when so indicated in the Declarations, except the inclusion of more than one (1) Named Insured or the inclusion of shareholders, officers, directors, employees, or agents of the Named Insured in any one (1) claim shall not increase the Company's liability applicable to "Each Claim" as set forth in Article IX, Section A. Where limits of liability at the time of any incident or injury are not identical to limits of liability at the time the claim is made or reported, the limits of liability at the time of such incident or injury shall apply. D. Fire Liability Sublimit. In the event that then: is a covered claim for a covered loss attributable in whole or in part to a fire, the maximum the Company will pay for Each Claim and Aggregate per Policy Period is $100,000 (`Fire Liability Sublimit"). This Sublimit does not increase the limit of liability stated in the Declarations forthis Policy. E. Products Liability Sublimit. In the event that there is a covered claim for a covered loss attributable in whole or in part to Products Liability, the maximum the Company will pay for Each Claim and Aggregate per Policy Period is $10,000 ("Products Liability Sublimit"). This Sublimit does not increase the limit of liability stated in the Declarations for this Policy. This Sublimit does not apply to the Insured's liability for the application of a product during the rendering of Professional Services, X. EXCLUSIONS A. No Defense or Payment of Damages. This Policy does not apply to the defense or payment of Damages for any claim arising out of the following: 1. Excluded Professional Services. Any claim arising out of any of the following Professional Services: (a) treatment or reduction of any fracture; (b) practice of medicine; (e) the failure of the Named Insured to diagnose or treat any condition; (d) the failure of the Named Insured to refer a Client to any healthcare provider for treatment of any condition; (e) practice of obsieltio or gynecology, including the delivery of babies, or care of newborn infants unfil they are fourteen (14) days old; (I) colonic irngalions,, dehydration of hemorrhoids; (g) the failure of the Named Insured to exercise professional standards of care while utilizing any modality of treatment other than Professional Services, as defined in Article VI, Section A; (h) treatment of cancer, epilepsy, or acquired immune deficiency syndrome; (i) magnetic therapy; (j) gemstone therapy; (k) meridian therapy when being utilized for the treatment of cancer or any other disease; (1) stressology or internal coccyx adjustment; (m) the use of the Toftness device, x-ray, of bsa hurrn; (n) pair°frrwavow Of naewewradtaralay; chit nawovrdausloon, bpi ex candlrnpd, fep"a hyprrra;,a;;, lit rauooeionwal or dfrwlwory ccouowaeawl€ng or ,'advrr`e, (o rdr trwxafia wagieort wawrvice s or, wAalvir aw W arny paraocerdurrw whir it pwe nA qr aotrs datardy c ovrltews torthtar rn,snually or rotor ,Any olho't met k old of ono usioro r xt efor vof€ hwsuaw nt,anrpish"mora of the oral or nasal A avines; Jul vXercise and err' p orsonad traanurapp �.wrvwos, a°aotaarsmwllmopd, or aad'yiFe, avd pyodadaalry, psyr hewlogy, rrr e;aaarosofing snrvta os„ fwd prat two o "wet warupunaluw; ortxd poraetrr at, ref e flirt, oltr ac'fic, a" ludrng but rura Ismael to taraanuptsalaanawea or adjustnatwnts of barn ws and hand lissovw of the hunian dnotly. 2. Activities Outside the Legal Scope of Practice. Any claim wahsing out of a procedure performed that Is outside the legal scope of massage^ pruYice in the US, Stataw of Terrirory in which the service is rende.redd, 3 Drugs of' Sorg t,-ry„ Any injury'rosing oert of Ire ebsae, ,adininiwlral'ion, or prescription of any drug or pharmaceutical for the treatment of human bawarap's axr xtsroag, octf of ahe $a' dornaanr'e of any prtue i dote involva"ng thoe rutting or penetration of human tissue. 4 Breach of Application Warranty. Any e Ltarwt where tit(,- Naarned Insured violated General Condihno Article V, Section D, of the Policy by fading eta ehst low d w proswebihty of suir_it Claim, flaas exe kf,aoon wapopafrets cinly to such undisclosed potential claim' S, hadurr two Sign Application. Anyc1lona orfaanyr typo it lhoe Naniiwtd injured did not iign the Aprp ficaaiioir feu tlai't d'aalrw;yw . C"ollecfartaa Suits, Any wlwaorn w-or konlr a,, i countewa�.rlaoro toy a lavosr;bao +,wrhoo WFS sua~el Imam praaofrwssa<rra,rl renirs. t„aolfle�olAun snots I�aidggaering this atsorar lilt Iwrda „ hnt are Furl lrrrr000 td tea, ihosoe c olltwt laonna Butts ffieed by ;a ColleA fion agten(y. Awry rlatroa irtr;rtdrw snd,y egoeori too r ollerlion, suit shall be loam sufuiwrd two fxw sit response to this o ollvorim anal and tea be on than mate of as I ounter-a'daalna and, thewreirne`r, shall dine within this exclusiorow 7, Failure tea Obtain t'ettrfic.ate of dnsurana,ep. gamy cLsilna aagains't firm, Noored Insured ihat irovoalvaw�s, anuorApp c�heas, aera�yt hellth care praoco 000aar walla w,^whiair lheb N.arnm,l lnsuted currerilly for ill ill" duiure Pad rs aa l Arlraerr, (Lif era ramplaoWv, 10 an iraclaep;arenrdaerxt conttaactor, oe tfdd shaares' erffacaw apa,arew, whoo, the Named pA'isuoresd his faded to praoa,aon* For IN, Cirnapauay„ asdornrastally and wrghour nealuewM, ra r unenl Cellifivaase of insurance, frrtwn the habihly oow,uraea of suede dae,alth aware poroAvtdoer, whicdr poroavoch s lhm 0 ws Masser trrbUcy tfolder° naraood: rrr flio l' eclaialoaons of this loohc y sm ewe ongoing nonha,'aaur rrr of the "emus and aory of suit hea th e won:" Jvxovtdea., p.rreifmwssoa.trrai 14,11' ihly lwalrazrur e, 6, No Active License. Any ae1 or omission, if at the time cif sur`h act war omission, flle Nat rod Insured ceded not heald as ctirfent, active 1pten�eU ;as required by the U.S. Slate awr 1 eiritory in which the art ou omission occurred, ter pr.aa�fto;°e thepeeadtiwwv aaata las�fatd ill tears f"7r=t°droraatiroaas. 9. Intoxicants/Ntarroitics or Drugs. Any claim arising, from a service rendrned, or which should have been rendered and was not, while the Named Insured ear its ernprloyee or agrilt is urade'wr the influence of intoxicants, nwan ow s, or drugs. 10, Sex! Act. Any claim arisrrsg oor of or related For any way to any sexual act, or acts, performed or alleged to have been performed by the Named Insured or an employeee or agent of the Named Insnraead. 1 f Criminal "Act, Aotyclaent aaosrmrg frorno wan addew pFf ArlrnfA4d otl" or ar"t allo geedlya°ommiurid while in violaidors ofaany law or onfor sce. l 2. Workers Compensation, My dojur'y loping out oai4rny aolohgatieon for, wham It as Narrirgl hoswrrtwd or an uawact m has lao,wn or may be held liable aorrthol " ol,k os" f aoraapoetrs,altaara, d bnrararpbdrrytvrrwnt Clornlion"aniwn, l tr+ahehly Re'llefos, Ill any wnnilar Law.. 1 dr uaranteewld Resu$fs Aooy c larrnt arising from piairarrontr awraap; the results of s'e vt(es of fhe Named Insured or its employees or agent. 14, Peeor Review Aartivftdes, Any clauri aostarpg hewn) positot ipatioora on a per Iwr ttnerrww committee, including, but nail limited to, peer review ctontaufteaazs of it hosp ilal, 4 aide+,00me rwallon, or prm'ofrsston ad �stlabrad,trefs re"t-w organization. 1 S. Officers' and Direr; ors LiahiIity. Any inpijryw arising out of the rendering off ear faadlore to rawodwwr itraafr>ssirtrrtU Seiwroce% by any rothewt prrsora for whose act, of orlikArrnas tire Nvned Insureed may he held liable as a rawrwoniiael, fxunoiNr faomwi, dit"elor, (it �stsatwilrilder of any professional p. f loving utisuriwad day fitrw policy, parine'wrshr a�sncrauun, or r nr` ooratwrn that is not lasted at Declarations, as 16, Proprietors, Arty babrhly woo the N;anaeed lrasuned as it pntrptaa�rlor„ m dtr',It director, superairatcwaarfenf, aarNarmituAs�taarieor„ or er'xea utwe oothtewf coo' any licupnal, sanitaaoum„ srAa'ptneraiewrn Chow with, bod and board f rp,tlitrr�„+, skllkr d nutsinpt far llity, conv.air•srorit hrttptgal„ httxtr ogory„ or bw,anem enter'prt, en 1;7.Awsurned Liabdwly, ,Any hwilnlit'y as umeet loy the Naanrawd Insured, trtalurlornpg li:N10 th"'to 61,N011, of etMloar'l oa wrssuAooese,C by a Nanaead Insured under oral crc whiten e,'rraatm, r tot apfretrear'ta,araf oar' hahalaty res Inrtg founi faratuaal by floe t* anted Insured, omepxt was, paraavrdoyd for dri ,Artra,lea Vl, Sewctiort. A,,d, 'dorawnaisews l.eaholify', wtbove, t B. Government Employment. Any injury from the acts or omissions of Named Insured or its employees or agents while employed by the United States Government or any oliter gr.aveeforw ental or pubtic entity. 19. Other Activities, Any eta ftor arising tarowaa siatem tints, ae1; or unrosions by, the tsNaamed dusuree,d or by .any othr+a poa;arsrvi, mile ged to I* Imo connection with or relawd to any of fhe following' intrnfrrence with coniratlw v+iclawmo of statt, aanditu derdrwrall aaniitroo ror e.dec�r:eptive advetthingd Iavwws; t N i p y l' ufaran„ arty artivay For loss caused direr dy or ondn'oer;dly by mte rfm o ira rw� will a paF:rsaan's right rn a.ra a'ar ,ay ha±i or hr^r will aaeit w Aanrtrstsae4aa ed, nraln imauos trm rsa^i. nuclear ra ar�auaaa, radiefaarn or rachaA,aotiwa caarafaamuaatuAaaw wviaswlluerr,artafreallc',, d, a anarorahathea;f, or ,ac credreofal art nataoe° of howwweaveo caused, orally r eansiepaor rrc`ew (if :arty of any Anlur'y of hone, n laung theerfly or ondW4,0y if) Ifie Named Mirsuam mJ`s amlaons aas lsrw eoilrrlrryoo tat airy c lwaonwnl„ ediscrranorratrilo: aonveet'Mon, arstradmwrmartca< wash iardospmewrobve advaMtgee; aaorfaar eaAnrpa^fttiroa''m,° aunfrarr tratde a arac�di'rorbusrnrs prarfacve rr"rs.Ap;paicilardrrsraoa of towade sr e ro,K; eonAllio,:wy to duo ,arAy unl,awftad or tuatoous te.r, „rdawse asl mtewru oraal air ne glo tent rnflao.tion arf rwrraerfiori,ad adrstte'^ss, nep*lip;arriN oaaisnwdarae arnfwuwort, fraud," any otheranfaerauomil tool (oven of sfaa du arfiva les are itwdaat(41 to a Nitrowd! i,aflure to reaodrwr Professional services); or any injury from airy aci or any oraraswill to tilt, estoril "swat twain nrpoay is "of a Mfrs trtahlo to file rvndaertng of faaiduov to wro der 11rofv40onail Sorvio i-S car attributable to an lnr°icdexnl. 20. Research Subject. Any claim by any person who has ever been a research subject of the Named Insured or who was ever solicited to be a research subject of thr Named Insured. �'t.Excluded Personal and Advertisinpg Injury", Any eiafiop warsmnyb tetartt Beer oral to ArdvAws*ony, lnitny, tiao resultipg in dbroefay lnpuiyf (lo) caused by to at dolt dire'cnon of fire Named Insturwd %vrth life knowledge thdiai thew Tact worutod virslatrw flue irpghis of wanoaheet„ ira cataweeed by oval of wtuleen publir°wahorra err'' rrr tee at4 of admire by Of aaf Ifiv dmwrftosr rrr, rhos Naraat;ed' lomooere;,d with ki,ruwvlwwdlpw I)( its dals0y; ddl ciuwawd toy oral fir wvriatera pofaLrlicaasarrr of naaleraad Whose firmla t wok plricv, lorwhne drw, dam+,girerfiaag mar ohe`a pobcy N'enodw trap 4,mo,wid Lay the faailury of go ock, parodt cla , aatladmaanrAan ck ;aewrw+ar.ows to a.tbaafArrora with ratty slaterni rrl of pin'v odoaeltly was prrwadaaonaaaracaw nlaadew in $try aralve aaisrwrararraf limy fht, twN;aolod (nsofewod, dfl ra,Ios d by Iho Fnffwt?,iwrnrearo esl o'arpayrrrp,laf, bate+,rat ttwoadaernark„ traxdr s,(^,Feei, rat rrfl'atwr nanwiloociwd l,nopoerly rrgf'N; Pig c.iaosed by on elvcoranala al�,tfrri,eatna, Lalrrg, (rr luulk,lin Iraotard files Nota wd Insaoored hosts, Bras an owrrear^laipy ttrte^resf m, ira extsrc ises coonlpeol, in) carter-d day the %rnaanhorfe ed oty, arf .oaaaafhri� lilt"art tor paroduafsa lid t,aused fly mrsapparoprad'uinn lot a dvottosorog uedeass tir. MyjrM o,ri (6rip br.tsirie s„ dqd to .gray p�rttr iora :vhea is not ;;b P gra'woof�i p'k,i iwsnl0em}° uat army irapa,rry arising, oto rrl itir ortivhl or pa,apot for aany paulalicalion; label, sl,ondr«; tradv blotto: toade wlarodawf, harming ,a pvosttn's togup,rfiion, str' hanning a person's right to privacy. 22, Liquor Liability, Awmoy rl,aim arising horar the fi^Nmrovd insured causing or contributing to the intoxicaton of any person; the furnishing of alcoholor toove rjgo,w to a luewtscon under the legal dE inkrarg wlp e or under the influence of alcohol; or any law or regulation relating to the sale, gift, distribution„ or ttscw of alcolmrol, 23. Floltution. Arty e l mwro atilusang tarot for fill" ;ar tuatl, allerge d, of flaowaferro d rhsed` oogew, dispels'd, we:^a IM$1,4" o'llpfatre'air, ab le'Isaw Or o"A awlfac^ of pollutaiats, (a,) at or loom any prewrutsrts, ,ror•, or location thaot iw off %vas at any hraat. rownvd or riacupiawd by, rrr reeauteed tit luam'd ter,, ,any Naorned lnstaaaet Pb)at or frorao warty parents -es, site, tar hrcaanon th'll rs war %weals di atoy arnre uaaed by rat (or any Nanwewrd Insured or ofhers her i�lre lawaeredldng, sl4rrogv. ckprosal, prose SM"g„ eor lra,1111wrok of waa.tu.; (c) which aru oo were ,it any thoo fr,aiaspaorta;wd„ da.anaddiaada stored, treated, dvparAt«sd rot, or prow 4 .waved as waste by eo: fair any Nionio d lnwtare.d or any pen'rort or rlrg, lr rzaliors for thong file fiNaaaned In5rtr rd may lie legally ompram dsole; fait at or from any premises, site, or location on which any Named Insured or any contractors or subcontractors working directly or indirectly on any insured's behalf are performing operations if. (i) the pollutants are brought on or to the premises, site, or location in connection with such operations by such insured, contractor, or sub -contractor; or (ii) the operations are to test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to, or assess the effects of pollutants; (e) which results in any loss, cost, or expense arising out of any request, demand, or order that any Named Insured or others test for, monitor, clean up, remove, contain, treat, detoxify, neutralize, or in any way respond to, or assess the effects of pollutants; or f) which result in any claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, neutralizing, or in any way responding to or assessing the effects of pollutants. Pollutants are defined as any solid, liquid, gaseous, or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chermc gals, and waste. Waste includes materials to be recycled, reconditioned, or reclaimed. 24.Alrcraft, Auto or Watercraft. Any clairn arising out of the ownership, maintenance, use, or entru5urtecrct, to others of any aircraft, auto, or watercraft. 25.War. Any claim arising from war, whether or not declared, or any action or condition incident to war. War includes civil war, insurrection, rebellion or revolution. 26.Excluded Property Damage. Any claim arising out of property damage to: (a) property owned, rented or occupied by the Named Insured; (b) property sold, given away, or abandoned by the Named Insured; (c) property loaned to the Named Insured; (d) personal property loaned to the Named Insured. 27.Recall of Products, Work, or Impaired Property. Damage claimed for any loss, cost, or expense incurred by the Named Insured or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of. (a) the Named Insured's product or work; or (b) impaired property; if such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy, or dangerous condition in it. 28.Affiliated Parties. Any claim (a) for Bodily Injury to the Named Insured; (b) arising from any business relationship other than the Named Insured providing Professional Services to any Client; (c) brought by an employee of the Named Insured, including the spouse, child, parent, or sibling of any such employee, or brought by any member of the Named Insured's family or household; (d) for Damages of any kind to a person hired to work for or on behalf of any Named Insured; or (e) for Damages of any kind to a person on the part of the Premises that the person normally occupies. 29.Intentional Acts. Any claim arising from acts expected or intended from the standpoint of the Named Insured to result in any injury to another. 30.Electronic Data. Any claim arising from loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. 31.Illegal Distribution of Material. Any claims arising directly or indirectly out of any action or omission that violates the Telephone Consumer Protection Act, the (CAN-SPAM ACT) or,any similar laws, including any amendments or additions to such law. 32. Steam, Sauna, Showers, Pools, or Jacuzzis. Any claim arising from use, operation, maintenance, or ownership of steam rooms, steam booths, steam showers, steam tents, saunas of any kind, showers, pools of any kind, including but not limited to soaking pools, whirlpools and swimming pools, and Jacuzzis. This exclusion does not apply to Bodily Injury solely attributable to Professional Services provided by the Named Insured that do not involve the use of mechanical or electromechanical devices. 33.Tanning. Any claim arising from use, operation, maintenance, or ownership of tanning beds or booths, or tanning lamps. This exclusion does not apply to spray tanning or spray tanning booths, where the state in which the spiny tanning is provided specifically authorizes a massage therapist by law to perform spray tanning. 34. Earth movement. Any claim arising from movement of land or earth regardless of whether emanating from, aggravated by, or attributable to the Named Insured. 35. Dishonesty. Any claim arising from any dishonest, fraudulent, or malicious act, error, or omission. 36. Sale of Goods. Any claim arising from goods or products manufactured, bottled, or packaged by the Named Insured, except as provided for in Article VI, Section A.4, "Products Liability", above. 37.Excluded Substances. Any claim arising from or related to asbestos, lead, silica dust, dust and/or toxic dust, fungus, bacteria or organic pathogens. 38. Laser / I PL. Any claim arising from or caused by a laser device or intense pulsed light device ("IPL"). 39.Transmission or Fear of Disease. Any claim arising from or related to the transmission of Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus, or exposure to another having same, or to substances or materials contaminated with same, or fear of contracting Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus or any other disease or illness; or any sexually transmitted disease; or any form of communicable disease. 40. Non -Disclosed Massage Modalities. Any claim relating to a massage modality or any other modality that is riot included within the definition of Professional Services, unless such modality is disclosed and approved in writing by the Company. 41.Animal Massage. Any claim arising from the Massage of an animal ("Animal Massage") unless a) the Named Insured can document proof of training in Animal Massage; b) the animal's owner has given written consent; and c) the Named Insured is not legally prohibited from rendering Animal Massage in the state in which the Animal Massage was rendered. 42. Hot Stones. Any claim arising from the use of heated stones unless the Named Insured has completed ABMP's Hot Stones Acknowledgement and viewed ABMP's Hot Stones Video. B. No payment of Punitive Damages (Defense Only). This Policy will provide a defense only, but does not provide any payment of punitive or exemplary damages. XI. EXTENDED COVERAGE If coverage terminates under this Policy, the Named Insured (and the Named Insured's professional corporation and/or additional insured, but only if named in the Declarations of this Policy) shall automatically have Extended Coverage providing an unlimited additional reporting period in which claims otherwise covered by this Policy may be reported. y�__.,..a_w_.w.._._ ,_�i`"ti............................................................. Authorized Representat ive Allied Professionals Insurance Company, A Risk Retention Group, Inc. How to File a Claim If any incident occurs that you believe may be covered by your liability insurance, immediately contact ABMP by phone (800- 458-2267), fax (800-667-8260), email (expectmore@abmp.com), or mail (address below) to make your initial report of the incident/claim. You are required to report any incident immediately, even if your client has not made a demand, or indicated that they want to file a claim against you. Failure to report an incident in a timely manner may void your insurance coverage. When something goes wrong during or following a service: Assess the extent of injuries or damage. Obtain medical help or call the police if warranted or required by law. Do not be overly defensive or hostile to the claimant. Do what you can to soothe the situation. Many times, minor claims are dropped once the claimant's emotional anger diminishes. Report the incident to ABMP. Take photographs immediately, if possible, and/or when circumstances warrant. It is a good idea to implement the regular practice of taking photographs at the beginning of every client session ("before" photos) and at the end of every client session ("after" photos) to track your client's progress and for your protection. Do not admit fault. It is not advisable to offer complimentary treatments or refund service fees in an attempt to correct the alleged problem, as this may be construed as an admission of guilt. If the claimant is aware they may incur expenses (i.e., attorney's fees), they may not file an unsubstantiated claim. Discuss the facts or give statements only to the police, your ABMP Risk Management Coordinator or your insurance company representatives. • Write down the facts. Detailed notes regarding the incident should be completed as soon as possible to take advantage of short-term memory. This information should include conversations, recollections, types of services or techniques/equipment used, length of session, whether the procedure was creating discomfort for the client, and any documentation outlining appointment history, preexisting conditions, procedures, client notes, releases, client consultation forms, post treatment/homecare forms, client intake forms and any consent forms, etc. In addition, record any extraneous circumstances you may be aware of, such as previous treatments, work environment, hobbies and sports activities of the client, etc. Finally, record in writing any correspondence, telephone calls, or verbal communication received by you from the claimant or claimant's legal counsel. Reporting the incident or claim: • Complete the claim form. Once you have compiled the facts and documents to be forwarded to ABMP (see above), complete and submit a claim form, which is available online at www.abmp.com. It is essential ABMP receives information regarding all communication between you and the possible claimant as soon as possible. You must include the client's name, address, area code, and telephone number; date and time of the alleged incident; date the complaint (verbal or written) was filed with you; a copy of any written correspondence and/or transcript of verbal correspondence, etc., so the insurance company has as much information as possible to pursue a complete investigation. Write down the date, time, and place of the incident. Get names, addresses, and phone numbers of all involved parties and witnesses. Forward this claim form and the corresponding documentation to ABMP within three (3) business days of an incident, or notice of claim or suit. • Notice of a Claim from the Client or the Client's Attorney. Sometimes you won't even know about a potential claim until you are contacted later. If, as an ABMP member, you have received written or verbal contact from a client (or client's legal counsel) regarding a possible claim being filed against you, don't panic. Do not immediately inform your client you carry liability insurance. Do not provide any information regarding your (ABMP's) liability insurance policy until you contact ABMP. Do not communicate with the client's legal counsel. Follow the above procedure for gathering facts and completing the claim form. Report the potential claim along with supporting documentation immediately to ABMP. • In the event a request for records pursuant to a subpoena, a deposition on written questions, or a request from an attorney or a client occurs, notify ABMP immediately. Please do not release the records until you contact ABMP and are advised to do so. The "Report of Claim or Incident Form" is not required for records request Please do rrpts(,,-am,+dthe "Report rf C wlrrr,a t lra ixie nt prm" Rp anytrp ther„tern ys7pt,.48MP Risk Mafia ggip ?,11 ( r inaw tor. ABMP members are to communicate directly with an ABMP Risk Management Coordinator regarding any possible claims within three (3) business days. Send information as outlined to: ABMP Risk Management Coordinator, 25188 Genesee Trail Rd., Suite 200, Golden, Colorado 80401, or fax to 800-667-8260. For claims inquiries, call 800-458-2267. T4ht 4 4a 0 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: September 22, 2016 RE: Janice Snyder, Personal Training, #AGR2016-0116, Instructor Attached for your signature is an agreement with independent contracted instructor JANICE SNYDER for (PERSONAL TRAINING) class(s). Compensations may exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. R i g.._cl w rrrr rwt Fwq rid at c he ite � law as aP r�r ►riot . X Contract payments will be charged to account number: 101-3002-60107 X Amount of Agreement, Amendment, Change Order, etc.: 80 %of fees are paid to instructor NA A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests NA A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). utW-P.0it t . u i -g9,r . rqn-t t .la -ulpo: NA Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less NA Initial to certify that 3 written informal bids or proposals were received and considered in selection lh. f l X Insurance certificates as required by the agreement 0/22/1: Approved by F'OrYi ietO NA Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-0111445 Expires 3/31/2017 NA Purchase Order number y City of La Quinta Community Resources Department u I'd➢ n � +� rdx r mu lu: 0 ur II Contract # 471201-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and JANICE SNYDER, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK.The scope of work is described as: PERSONAL TRAINING classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, once appro by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACT R shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 80% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 20% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 2. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2016 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 3. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right (but not Rev May 2016 the duty) to monitor the handling of any such claim or claims if they are likely to involve CITY. 4. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said prografOR d coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRA will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONIT CTOR must be made up in a timely manner as approved by CITY. (initials) vV 5. INSURANCE. It is to be undirstood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. B. Vendor shall procure and maintain Sexual Abuse/Molestation Liability coverage with limits of not less than $100,000 per occurrence and $300,000 general aggregate. Coverage may be provided as part of Commercial General Liability coverage, Professional Liability coverage, or as a separate policy. 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its Rev May 2016 officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 6. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 7. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 8. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 9. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform a subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number e Rev May 2016 4 Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 10. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 11. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Janice Snyder 81881 Rancho Santana Drive La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 ( P (initials) 12. DOCUMENTS. Any documents and 4arketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 13. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Janice Snyder COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") APPROVED: APPROVED: Rev May 2016 Digitally signed by Chris Escobedo DINcn Ch' Escobedo o—City of �LaQ't (__)�,, r � � email cescobedo@la qu'nta org, By: �s z' , ..�� By: Date 2016 09 26 08 14:04 -07 00 Chris Escobedo Signature Community Resources Director 81881 Rancho Santana Drive La Quinta, CA 92253 847.814.3518 COUiTE SIGNED: B Cl ri job Caldr n, 'Co & Wellness Supervisor Rev May 2016 Hello Janice, Below is your class information for October 2016=April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. Personal Fitness Trainer Instructor: Janice Snyder, ACE CFT, Senior Fitness Specialist Cost qa s Tim location $45 (1 day) T/TH 12-6pm Wellness Center Fitness Room $152 (4 Sessions) 1 hour sessions $280(8 Sessions) Web Trac Brochure Info: Certified Fitness Trainer and Senior Fitness Specialist, Janice Snyder, will customize a fitness program just for you. Your trainer can help you understand proper technique, enhance your motivation, and alleviate boredom so you accomplish your fitness goals. The first assessment is up too is hour with the trainer. Instructor Signature: -� � ve read and undertan the material within t 9 Signing this document o verifies that you his document. This documen shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. 80/20 Split Independent instructors/ trainers payments are schedule to be paid at the end of the month Janice allows students to call her for appointments 847.814.3518. Janice returns in October 2016. SNYDJA3 OP IDB5 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOD/YYYY)09/21/2016 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 terms 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 InterWest Insurance Services License #OB01094 P.O. Box 8110 Chico, CA 95927-8110 ACE Program INSURED Janice Snyder 81881 Rancho Santana Dr La Quinta, CA 92253 INSURER A: Phlla INSURER C : INSURER D : Ind. Ins. Co. 530-895-1313 N AIC tt 18058 INSURER F : COVERAGES CERTIFICATE NUMBER: 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, NNE _ AtiDL INSURANCE SUe% MBER POLICY NUMBER PCML6CY EFF' hMV�GI� DVIYYYY X 4LI Y FaC Itd9J fi 9DP'YYYY mm ® LIMITS A N LIABILITY COMMERCIAL GENERAL X COM EACH OCCURRENCE S 1,000,00 p CLAIMS -MADE X occuR X ) PHPK1341999 0212812016 0212812017 AIrIYkDL iO'Ii Nil Li .. pitLCuNl4LA a)a�wzr�atLeM � 100„00 .. X Prof Liability PERFORM PIHF1 11195 02128/2016 02/28/2017 MED ExP (Any one person) ,1, 0 0, . ......... ....... .__ . .. PERSONAL & ADV INJURY $ 1,000,000 LIEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 PRO^ POLICY L� J4 "C � J LOC PRODUCTS - COMP/OP AGG $ 3,000,000 _. $ $ AUTOMOBILE LIABILITY I-, r uld * q) ANY AUTO BODILY INJURY (Per person) $ m..., ALL OWNED SCHEDULED BODILY INJURY (Per accident) ' $ ,,. AUTOS .._ PII$OPC.PtP r UAVAI>I' $ H REDAUTOS AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ LIAR CLAIMS -MADE AGGREGATE JEXCES5 EI} RETENTItS�CN $ _ m... I....�..._._._.�. $ .. ......_.,.,,,,, WORKERS COMPENSATION ._._....,.........,....... d SIPTUTE ER AND EMPLOYERS' LIABILITY Y/ N „PE ° m _ ANY PROPRIETOR/PARTNER/EXECUTIVE NIA! OFFICER/MEMBER EXCLUDED? E: P A0. II R ACCIDEN P T iMa"datory In NH) E.L DISEASE EA EMPLOYEE $ _ a � „ _. If �^ea dpNiPi;rolroo uRdpa t3I 8 RIP-,'I''ION OF OPERATIONS below _ .. .� _ _ _ ITE L DISEASE POLICY LIMIT _�, �.�_W__. 0, A ��b iselMolestation � ]PI _ 1341999 02128l2016 0212812017 ach Occ 100,000 Each Aggregate 300,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certholder is added as add'i Insured but only With respect to the operations of the naned Insured except for liability, resulting from the add'I insured's sole negligence When required by Written contract per forin attached. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of La Quinta 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La Quinta, CA 92253 01988--2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1341999 COMMERCIAL GENERAL LIABILITY CG20260413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name of Additional Insu City of La Quinta 76495 Calle Tampico La Quinta, CA 92253 Information SCHEDULE this Schedule, if not A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. above, will be shown in the Declarations. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: EEber 20, 201 RE: Karen Vielhaber, Fitness, #AGR2016-0114, Instructor Attached for your signature is an agreement with independent contracted instructor Karen Vielhaber for (Yoga) class(s). Compensations may exceed $5,000 per fiscal year. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. fieuestina deparimen—U-bAl—Ic r-dgttg— th iten l� low ram : x Contract payments will be charged to account number: 101-0000-42214 x Amount of Agreement, Amendment, Change Order, etc.: 70% of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultants) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). sri t �lttltI� n: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection .:..,f wwrin r. ire-d _ec r x Insurance certificates as required by the agreement 0/ 1/ I : PepprOi�Od bye l�llet0 N/A Performance bonds as required by the agreement (originals) x City of Lo Quinta Business License number LIC-0100326 Expires 4/30/2017 N/A Purchase Order number a City of La Quinta c4a Qa�tra Community Resources Department Contract # 420605-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and KAREN VIELHABER, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS (YOGA) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, one goved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to .CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pr gr and coordinate with CONTRACTOR to schedule a makeup date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants f the program. Programs that are cancelled or changed by CONTRA TOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any' of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMI,N,ATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR GREEMENT or its rights or duties without prior written authorization from ITY. Should such authorization be granted, CONTRACTOR agrees to info y subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. ��.............._�................��.._Name.......��_........_........�.�......� ��.........................................__...........��Address .......................��................................................��...Phone ...Number ......� Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION., It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Karen Vielhaber 49560 Avila Drive La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. M,ISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitally signed by Chris C Escobedo APPROVED: c DN. cr--Chris Escobedo, o-City of � La Q.inta,ou, /// email=cescobedo@la-quinta.org, r--US By: Date: 2016.09.26 08:16:59-07'00' Chris Escobedo Community Resources Director COUNTERSIGNED: By: ^� w Ch a al ron, Colmml nity Rrograff� & Wellness Supervisor Karen Vielhaber ("CONTRACTOR") APPROVED: By: Signature 49560 Avila Drive La Quinta, CA 92253 760.771.0692 Rev May 2015 POLICY NO: PHPK965745-003 POLICY CHANGE DOCUMENT CHANGE # 2 CHANGE EFFECTIVE: 01/09/2016 Philadelphia Indemnity Insurance Company NAMED INSURED: MAILING ADDRESS Karen Vielhaber 49560 Avila Dr La Quinta, CA 92253- PRODUCER: Maguire Insurance Agency, Inc. POLICY PERIOD: FROM 01/09/2016 TO 01/09/2017 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Amending Additional Insured Address to Read: City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Additional/Return Tax/Surcharge/Fee Total Prorate Additional/Return $0.00 Tax/Surcharge/Fee Page 1 of 1 $0.00 ". UP11tIMM/UU/iYtlYl CERTIFICATE OF LIABILITY INSURANCE 09/16/2016 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Maguire Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 27101 Puerta Real Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR Mission Viejo, CA92691- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 877..438. 7459 INSURERS AFFORDING COVERAGE NAIC R INSURED INSURER A: Philadelphia Indemnity Insurance Company 18058 Karen Vielhaber INSURER 8: 49560 Avila Dr - .............................. ...... INSURER C: La Quinta, CA 92253- INSURER p: INSURER E: ,.........._...........................®....m.....m..... ......... COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD,/YYYYI DATE MM/DO/YYYY LIMITS A X GENERAL LIABILITY PHPK965745-003 01/09/2016 01/09/2017 EACH OCCURENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY 'I'TwT�"dxTTGi"FCI:F31fk PRFMa6F5 Ea waccotnrn�rU„�_ S1001000 CLAIMS MADE OCCUR MED EXP (Any one person) $2,500 X PROFESSIONAL LIABILITY PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG S4,000.000 YX POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY — EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURENCE OCCUR E J CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION 1LOkERS'LJASiotY ANY YN 70RY- R4) PRIETORP$IAKT PdR f CXECUTIVE LIMITS ER OFFICER/M EMBER(: X(,L UD EDN E.L. EACH ACCIDENT (Mandatory in NH) E.L.. DISEASE — EA AMPLOYEE vs, deschbe under CIAL PROVISIONS below E L DISEASE POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE The City of La Quinta THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 78495 Calle Tampico CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR La Quinta, CA 92253- LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR12ED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK965745-003 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURE - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or The City of La Quinta 78495 Calle Tampico La Quinta CA 92253- Information required to complete this Schedule, if not shown above, will be shown in the Declarations. ....... _ Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 E3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACCORD 25 (2009/01) Hello Karen, Below is your class information for October 2016 — April 2017. Please review and verify by typing your name and dating the lines below: 420605 Gentle Flow Instructor: Karen Vielhaber Cost Day/s Times Location $drop -in $10 M 10:45-11:45am La Quinta Library Community Room Sessions: 10/3-10/31; _ $43.75 (5 weeks) Sessions: 11/7-11/28; 1/2-1/30; 4/3-4/24=$35 (4 weeks) Sessions: 2/6-2/13= $17.50 (2 classes) Sessions: 12/5-12/19; 3/13 — 3/27= $26.25 (3 classes) (no class on 1/16 Dr. Martin Luther King, 2/20 — Presidents Day) Web Trac Brochure Info: ........................ — Gentle Flow is a series of poses that will move you through the power of inhaling and exhaling. Sequenced movements are smoothly flowing and almost dance -like, which explains why it is sometimes referred to as Vinyasa Flow or just Flow. Karen Vielhaber, Registered Yoga Teacher 500 (RYT500) Materials to Bring: Bring a yoga mat, and wate Instructor Signature: - � Date O Signing this documen only uri iies that you have read aru understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday Feb 27 through Monday, March 6, 2017. Hello Karen, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 420606 Gentle (Flex) Yoga Instructor: Karen Vielhaber Cost Davis Time/s Location $drop in $10 W 10:15-11:15am La Quinta Library Community Room Sessions: 12/7-12/28; 1/4-1/25; 2/1-2/22; 3/8-3/29; 4/5-4/26=$35 (4weeks) Sessions: 11/2-11/30 = $43.75 (5 weeks) Sessions: 10/5-10/19 = $26.25 (3 weeks) Cnu oc!- up Web Trac Brochure info: Instructor: Karen Vielhaber Gentle Yoga is appropriate for those wanting a softer, nurturing, slow paced, well supported and relaxing practice. It includes carefully sequenced movements, controlled pressure and well measured stretches, including range of motion exercises. This style encourages a highly individualized approach with on -going engagement to make moment to moment adjustments. Karen Vielhaber, Registered Yoga Teacher 500 (RYT500) Instructor Signature: bate Signing this document only verifies that you have read and unders and the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. d�cu N UEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: Ef= RE: Mary French, Senior Free Class, #AGR2016-094, Volunteer Coordinator Attached for your signature is an agreement with volunteer coordinator Mary French for (Quilting for Good Times) Group. There is no compensation to volunteer coordinator. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as a_pPrapriate: N/A Contract payments will be charged to account number: N/A Amount of Agreement, Amendment, Change Order, etc.: N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). A hear gxe ut hd .. gMgpU5� n: N/A Approved by the City Council on . N/A Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The ot,towin." -E Lr,.P ..O-P tLmgmt: gre tt Lt� N/A Insurance certificates as required by the agreement 0/22/1��by F'�et0 N/A Performance bonds as required by the agreement (originals) N/A City of La Quinta Business License number N/A Purchase Order number it City of La Quinta taQ�dgra Community Resources Department Contract # QUILTING17 VOLUNTEER COORDINATOR AGREEMENT This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and MARY FRENCH, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. CITY AND VOLUNTEER MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: VOLUNTEER COORDINATOR FOR QUILTING held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY will be attached as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. ),K�- (initials) 2. COMPENSATION., VOLUNTEER shall not be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of monetary compensation from CITY or any participant of the program. '?'f� (initials) 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER as an independent contractor and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with VOLUNTEER to schedule a make-up date. er'l- (initials) VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by VOLUNTEER must be made up in a timely manner as approved by CITY. "),) - (initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontractor of all the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name Address Phone Number w w..w............... Subcontractors listed above have been approved by b the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: Mary French 44675 Marguerite Ct La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 2? (initials) 11. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") APPROVED: Digitally signed by Chris Escobedo -r=+--�------------- DN: cn=Chris Escobedo,o=City of C' � La Quinta, on, email=cescobedo@la-quinta.org, -Us By: Date: 2016.09.26 08:12:28 -0700' Chris Escobedo Community Resources Director CfUN , SIGNED: � r Chri d Calderon, Community Programs & Wellness Supervisor Mary French ("VOLUNTEER") APPROVED: By: bj cr w, .sry Signature 44675 Marguerite Ct La Quinta, Ca 92253 760.360.0621 T--d4t 4 s(P MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: September 26, 2016 RE: SUCH A VOICE, LLC., LEISURE, #AGR2016-0118, Instructor Attached for your signature is an agreement with independent contracted instructor SUB CONTRACTOR LISA FOSTER for (VOICE OVER) class(s). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shalt check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42200 X Amount of Agreement, Amendment, Change Order, etc.: 70%of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authorit}to execute thi. gareeme j i� based upon: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on dote) N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-763691 Expires 3/31/2017 N/A Purchase Order number City of La Quinta 4 Qatkta Community Resources Department _ ceM VfJw DM1r1' Contract # 413501-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and SUCH A VOICE, LLC. a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITYAND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OP WORK. The scope of work is described as: LEISURE (VOICE OVER) classes held at a City of La- Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, once roved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. cn. alsj 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 10% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be'the total compensation for services, including out-of- pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of- pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is Rev May 2015 1 completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. 3. INDEPIENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein., CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against.CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph, 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not Limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or Rev May 2015 2 by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. S. CANCELLATIONSICWANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel sa4ppgrarn and coordinate with CONTRACTOR to schedule a make-up date, (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR, CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONT TOR must be made up in a timely manner as approved by CITYInitials) 1 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability! Insurance and other such coverage, as applicable, in the arriounts and under the conditions as set forth below. I A. Commercial General Liability Insurance using Insurance Services Office "Commercial General liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 1 i i 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general Liability policy using ISO Form CG 2010 with an edition date prior to 1988, which form shall include overage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services underlthis INSTRUCTOR AGREEMENT, 6.2 CONTRACTOR shall provide written notice to CITY. within ten (10) working days if: (1) any of the required in urance policies is terminated; (2) the limits of any of the required polices are reduce; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the sa 1 e shall not be construed as a Limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents, 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT, A copy of the current La Quinta Business license must be provided to the Community Services Department within five (S) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or Local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executO;rs, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in theperformance of this INSTRUCTOR AGREEMENT. 10. NOASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of aLL the stipulations of this INSTRUCTOR AGREEMEN (initials) Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name _° Address Phone Number j Rev May 2015 4 Lisa Levine c/oSuch a Voice 150 Dorsett St. #245, South Burlington, VT 05403 802.805.5096 �, l50 use S� �U✓G� Mn V7 8'rP�3 Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORbINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the 'United States mail postage prepaid, return receipt requested, addressed as follows: ; CONTRACTOR: CITY: Such A Voice, LLC. Community Resources Department 150 Dorsett St. #245 City of La Quinta South Burlington, VT 05403 78495 Calle Tampico La Quinta, CA 92253 (initials) 13. DOCUMENTS. Any dpcuments and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITYIand may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year asi first stated above. CITY OF LA QUINTA, SUCH A VOICE, LLC.. COMMUNITY RESOURCES DEPARTMENT Lisa Levine, V.P. ("CONTRACTOR") ("CITYl ta APPROVED: Digilly signed by Chris Exobedo DN: cn=Chris Escobedo, o=City of �� Quinta, ou, e mail=cescobedo@la-quinta.org, ms E Date: 2016.09.27 08:11:49 -07'00' By: Chris Escobedo Community Resources Director ED; Chr Calderon, Commuu yy rograms & Wellness Supervisor Rev May 201.5 APPROVED: Signature 150 Dorsett St. #245 South Burlington, VT OS403 802.825.5096 M Hello Lisa, Below is your class information for October 2016 — April 2017. Please review and verify by typing your name and elate on the lines below as soon as possible. Voice Over Instructor: Lisa Foster Cost Day/s _ Time Location $45 S 9-11am La Quinta Wellness Center -Art:$ & Leisure Room Sessions: 10122; 3/11 Web Trac Brochure info: This could be one of the most enlightening 2 hours yoWve ever spent as you learn to use your speaking voice for commercials, films, videos, and more{ Learn a unique outside the box way to cash in on one of the most lucrative full or part-time careers out there. Your instructor Lisa Foster has years of experience in alb aspects of the industry. Instructor Signature., Dat® C Signing this document only verifies that you have read and understand ;the material within this document. This documenf shalt not act as a contractual agreement betw6en you and the City of La Quinta_ The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March' 6, 2017, Minimum 5 Maximum 40 Agreement review and signing W-9 on file — as daotiets�r, e. — payment will go: to 14 160 Dorset St. #245, South Burlington, VT 05403 Lisa Foster instructor 1t 1 1 SUCHA-1 OP ID: LS DATE ACORO" CERTIFICATE OF LIABILITY INSURANCE 09109/20Y6 910912016 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 pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 endorsements . PRODUCER CONTACT Belinda S Iller Kinney Pike - Williston PHONE 62 Knight Lane PiyN°" 6 ). 802-878-1600 FAX No); 802-879-4022 Williston, VT 06496 A -We John McAuliffe I ADORES$ INSURER .A1 Peerless Insurance Company 24198 INSURED Such A Voice, LLC INSURER B : Praetorian Insurance Com2any 37257 Alex Goss 150Dorset St #245 INSURERC: So. Burlington, VT 05407 INSURER D: INSURER E : INSURER F : rnVFRAr;Ffi f FRTIFIf:ATF IUf fNlRI=R- RFVI.glnPJ NH IURFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - - - — ADDL!SUBA POLTCIYfFF —P LTdyf LTR TYPE OF INSURANCE PWVD POLICY NUMBER IMMIOOrYYYY) 1MWDDNYYYI I LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 _ CLAIMS -MADE a OCCUR X CBP8633077 03/06/2016 03/06/2017 PREMf$9$rr e $ 100,00 MED EXP (Any one person) $ 5100 _ PERSONAL & ADV INJURY $ 11000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JEGT F-] LOC PRODUCTS - COMP/OP AGG $ 2,000,00 _ $ OTHER: AUTOMOBILE LIABILITY M I ED SIN LB L If 1E.8.ASsi9D.1 $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ OPERTY DAMAGE$ Per accident $ UMBRELLA LIAR H.-CLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION $ $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTiVE Y r N OFFICERIMEMBER EXCLUDED? ® (Mandatory InNHI N I A IQWC4000817 03/3112016 03/31/2017 XAND STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E,L DISEASE -EAEMPLOYEE $ 1,000,00 If Yes, dascrlha under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) THE CITY OF LAQUINTA ITS OFFICERS AND EMPLOYEES ARE ADDITIONAL INSUREDS WITH REGARD TO GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT. City of La Quinta 78450 Avenda La Fonda La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE John McAuliffe 01988-2014 ACORD CORPORATION. All rights reserved, ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Forming a part of Policy Number: CBP8633077 Coverage Is Provided In EXCELSIOR INSURANCE COMPANY Named Insured: Agent: SUCH A VOICE LLC KINNEY PIKE INSURANCE INC Agent Code: 0710189 Agent Phone: (802)-878-1600 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization(s): CITY OF LA QUINTA 78495 CALLE TAMPICO SCHEDULE Location(s) Of Covered Operations A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ® ISO Properties, Inc., 2004 CG 20 10 07 04 Page 1 of 1 03/06/2016 8633077 NNECOSXF2209 PGDM0600 J24094 PCAFPPN 00004790 Page 15 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: GepteEer 20, 201 RE: Mary Francis, Leisure Class, #AGR2O16-0113, Volunteer Attached for your signature is an agreement with volunteer coordinator Mary Francis for (AARP Safe Driver Course) class(s). There is no compensation to instructor. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. it . d a r r n s�aVl c , r d cat t itgm eI � ar+� ri ante: N/A Contract payments will be charged to account number: N/A Amount of Agreement, Amendment, Change Order, etc.: N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection 1 :...pL(o " 1+ fir _tiIL+ I ... �+ r` vr0 :fl. N/A Insurance certificates as required by the agreement �/ I / I /Pi per hOrYi letc� N/A Performance bonds as required by the agreement (originals) N/A City of La Quinta Business License number N/A Purchase Order number City of La Quinta ta Community Resources Department Contract # 470601-17 VOLUNTEER COORDINATOR AGREEMENT This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and MARY FRANCIS, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. CITY AND VOLUNTEER MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: VOLUNTEER COORDINATOR AARP SAFE DRIVING held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY will *ettached as exhibits to this VOLUNTEER COORDINATOR AGREEMENT.initials) 2. COMPENSATION. VOLUNTEER shall not be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of o etcvy compensation from CITY or any participant of the program. (initials) 3. VOLU,N,TE,E,R,,,,COORDINATOR. This Agare ment calls for the performance of the services of VOLUNTEER as an independent contractor and not as an employee of CITY. 4. IND,EMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program an7(initials) inate with VOLUNTEER to schedule a make-up date. VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by VOLUNTEER must e ,.made up in a timely manner as approved by CITY. w' (initials) 6. COMPLIANC WITH LAVA". All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any sub c rat of all the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. ° (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Subcontractors listed above have been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: CITY: Mary Francis Community Resources Department 18070 Langlois Rd. Space 246 City of La Quinta Desert Hot Springs, CA 92241 78495 Calle Tampico La Quinta, CA 92253 (initials) 11. DOCUMENTS. Any documents and mrrketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Mary Francis COMMUNITY RESOURCES DEPARTMENT ("VOLUNTEER") ("CITY") Digitally signed by Chr Escobedo APPROVED: DN:cn ChrsEscobed'o" —City of APPROVED: \ La Qu nta, ou, ail cescobedo@la qu nta org, By. Date 20160927081315 0700 By: Chris Escobedo Community Resources Director, CT'" IGNE , C t ,ffCdld ron Cb" rrtiun'ity Programs & Wellness Supervisor Signature 1% 18070 Langlois Rd. Space 246 Desert Hot Springs, CA 92241 760.408.6286 Hello Mary, Below is your class information for October 2016 through April 2017. Please review and verify by typing your name and dating the lines below: +"caol AARP Safe Driver Instructor: Mary Francis, Instructor Cost Da Times Location $15/*$20 T 8:30am-4:30pm Wellness Center- AftsRmm Sessions: 10/4; 1/31, 4/4 Web Trac Brochure Info: (description) AARP members pay $15 .00 (show card) and the fee for non-members is $20.00. Please make checks payable to AARP. Payment is taken on the day of class. Materials to Brie : Pen, pencil and paper Instructor Signature: Date Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. Registration is available through our City of La Quinta Web site www..,la.-.quinta..rp.T0 Minimum number of students is 5 Maximum 24 Mary Francis does or does not allow students to call her at 760.408.6286 TO: Frank J. Spevacek, City Manager FROM: Chris Escobedo, Community Resources Director DATE: October 6, 2016 RE: Milissa Meyer, Fitness #AGR2016-0125 Instructor Attached for your signature is an agreement with independent contracted instructor Millissa Meyer for (Fitness) classes. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Re uestina de ar nientsh r� � +� h i°terns below a go o� .t X Contract payments will be charged to account number: 101-0000-42214 x Amount of Agreement, Amendment, Change Order, etc.: 70% of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). N/A Approved by the City Council on X City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection X Insurance certificates as required by the agreement 0/0/1. P�pprO�ed by F'Orvi IetO ) N/A Performance bonds as required by the agreement (originals) X City of Lo Quinto Business License number LIC #0111234 Expires 9/30/2017 N/A Purchase Order number 9 City of La Quinta aca Qul�tra Community Resources Department 1."1" i" DI,l,10 - Contract # 423201-17 INSTRUCTOR AGREEMENT CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. -\`c\ w\ - (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. N EMNIPICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified. Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and coordinate with CONTRACTOR to schedule a make-up date. �'L (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. `W (initials) 6. INSURANCE.., It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. .2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self insured retention is increased. In the event any of .said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the some shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7• BUSINESS LI+C'ENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WTN LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. b• and forisef, its heirs,exle executors, assigns, CONTRACTOR covenants that, -COVENANT NATION. _ Y si ns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. N0 ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT.—M N-yX (initials) Rev May 2015 q Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number ntrctors lis-- ...._,,, - -above -been app....... _ �_.. sted have roved by CITY to perform the scope of work as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Millisa Meyer 45-656 Louis Breault Lane C Indian Wells, CA 92210 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 1 'IN1 (initials) 13. CtOCt1lENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution., 14. MISCE'LL NE'OUS. This INSTRUCTOR AGREEMENT is the between CONTRACTOR and CITY and may be amended in writing by both parties. No waiver of any term or condition of AGREEMENT shall be a continuing waiver thereof. only agreement and agreed upon :his INSTRUCTOR Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") APPROVED: Digitally signed by Chris Escobedo DN: cn-Chris Escobedo, o-City of La Quinta, ou, email-cescobedo@la-quinta.org, c=U5 Date: 2016.10.12 08:15:39-07'00' By: Chris Escobedo Community Resources Director COUNTERSIGNED: By: Christi o Calderon, Community Programs & Wellness Supervisor Milissa Meyer ("CONTRACTOR") APPROVED: .r By:�,- -, Signature 45-656 Louis Breault Lane C Indian Wells, CA 92210 760.200.1391 Rev May 2015 Hello Milissa, Below is your class information for October 2016a April 017. soon lease possiview and verify by typing your name and date on the lines be 423201 Fit & Fun Instructor: Milissa Meyer Da s TimeLocatiotl os T/TH/F 2-3pm Multipurpose Room Stage Side Sessions: 10/4-10/2.8; 11./1-11/29; 3/7-3/30; 4/4-4/27 = $44.96(8 classes) Sessions: 12/1-12/16; 2/2-2/23 = $39.34 (7 classes) Sessions: 1/3-1/31=$50.58 (9 classes) (no classes 11/8 voting day, 11/24 Thanksgiving) Web Trac Brochure Info., ardia, strengthand stretch class for all around fitness class with music you can move to with Instructor Milissa Meyer. Materials: What do students need to bring to class place here '--� Date \ Instructor Signature: yu �hare8d and understand the Signing this document only verifies anotoact as a contractual) agreement b et within i you and the document. This document City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. Drop in fee: $7 POLICY NO: PHPK1465340-000 POLICY CHANGE DOCUMENT CHANGE # 1 CHANGE EFFECTIVE: 03/08/2016 Philadelphia Indemnity Insurance Company IPRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED: Milissa Meyer MAILING ADDRESS 45656 C Louis Breault Lane Indian Wells, CA 92210- POLICY PERIOD: FROM 03/08/2016 TO 03/08/2017 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION: In consideration of the premium reflected, the policy is amended as indicated below: Adding Additional Insureds: City of la Quinta 78495 Calle Tampico La Quinta, Ca 92253 760-777-7182 Mountain View Vilas 78000 Betty Barker Way, Indian Wells, CA 92210 760-772-4688 Indi an Wells Vilas 74800 Village Center Dr., Indian Wells, CA 92210 760.568.9199 Cathedral, senior apartments 31750 LandauBlvd., Cathedral city, CA 92234 760-328-5213 Adding CG 20 26 Forms to all Additional Insureds Total Annual Total Prorate Additional/Return Premium $0.00 Additional/Return Premium $0.00 Total Annual Total Prorate Additional/Return Additional/Return Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 Page 1 of 1 PRODUCER Maguire Insurance Agency, Inc. 27101 Puerta Real Suite 200 Mission Viejo, CA 92691- 877.438,7459 INSURED Milissa Meyer 45656 C Louis Breault Lane Indian Wells, CA 92210- DATE (MM/DD/) CERTIFICATE OF LIABILITY INSURANCE I 09/27/2016 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURER D: 12058 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION ......._... ...........��........ LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYYY) DATE (MM/DD/YYYY) LIMITS A % GENERAL LIABILITY PHPK1465340- 03/08/2015 03/08/2017 EACH OCCURENCE $2,000,000 t11COIMME,RCN, LGENERAL LIABILITY 000 6'RCMI,'xN`S uaoLcurrrrncn+� $100,000 CLAIMMADE OCCUR MED E%P(Any one person) $2,500 IOAL LIABILITY PERSONAL & AD_V INJURY $2,000,000 GENERALAGGREGATE $4,000,000 GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OPAGG $4,000,000 % POLICY 71 PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) ''.. HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY— EA ACCIDENT EA CCm�.. _�.�. ANYAUTO OTHERTHAN _ ............A,.�..�.. AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURENCE OCCUR I CLAIMS MADE AGGREGATE DEDUCTIBLE-ITITITmmmm��m� RETENTION EMPLOYERS LIABILITY Y N TORY LIMIT$ ER ANY f?RCJPRGL'10R/PARTNER/E%ECUTIVE ..... ....._� OIFHI,'}EiR/MEMJILR P.XCLUDED? u E.L. EACH ACCIDENT (Mandatory In NH) E L DISEASE EA AMPLOYEE I pes deseddbe under - SPECAL PROVIISIONS below E.L. DISEASE POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENTI/ SPECIAL PROVISIONS It is understood and agreed that the Following entity is added as an additional insured but only with respect(s) to the operations of the named insured except that liability resulting from the additional insured's sole negligence. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of la Quinta THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE 78495 Calle Tampico CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR La Quints, CA 92253-2839 LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE e� ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) POLICY NUMBER: PHPK1465340-000 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person( s Or Or anizations� City of la Quinta 78495 Calle Tampico La Quinta CA 92253-2839 Information reauired to comDlete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Chris Escobedo, Community Resources Director DATE: October , 201 RE: Wayne Meeds, Senior Leisure Classes #AGR2O16-0122, Instructor Attached for your signature is an agreement with independent contracted instructor Wayne Meeds for (Choir) classes. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. N/A Contract payments will be charged to account number: X Amount of Agreement, Amendment, Change Order, etc.: Flat fee of $40 paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). ,Iwri A+w�1e N/A Approved by the City Council on , X City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection X Insurance certificates as required by the agreement 0/05/1: P`pproi�Od by F'rYi leto N/A Performance bonds as required by the agreement (originals) City of La Quinta Business License number LIC #0109232 Expires 11/30/2016 X Purchase Order number 9 City of La Quinta ta QCommunity Resources Department Contract # 411101-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and WAYNE MEEDS, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LA QUINTA VOICES CHOIR group held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, one pproved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay a $40 flat fee per class to CONTRACTOR as compensation based upon the records. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual 2016/2017 payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its Rev May 2015 1 agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. Rev May 2015 2 5. CANCELLATIONSICHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pr ram and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by COM(initials) C OR must be made up in a timely manner as approved by CITY. 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. Rev May 2015 3 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered here -under shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inf r , a subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. * (initials) Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. M.1 Subcontractors liste Address Phone Number d 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number Rev May 2015 of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Wayne Meeds 47946 Via Trieste La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 , (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitally signed by Chris Escobedo A P P RO \ / E D. DN: cn--Chris Escobedo, o-City of V % tlk V La Quinta, ou, email-cescobedo@la-quinta.org, c-US Date: 2016.10.12 08:14:13-07'00' By: Chris Escobedo Community Resources Director Wayne Meeds ("CONTRACTOR") APPROV By: Signature 47946 Via Trieste La Quinta, CA 92253 760.775.3575 Rev May 2015 5 Hello Wayne, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 411107 La Quinta Voices Instructor: Wayne Meeds Cost i:: s "urne Location $15 10-11am Multipurpose Room Sessions: 10/4-10/25; 11/1-11/29; 12/6-12/27; 1/3-1/31; 2/7-2/28; 3/7-3/28; 4/4-4/25 (no class 11/8) el,Izi) Web Trac Brochure Info: Materials: red song book given to first time students Instructor Signature: Signing this document orO verifies that you ave read and unders and t em"aterial within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. ►�+ ►tea►.. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6/14/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE. COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the policy()es) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such ondorsomont(s). PRODUCER. _.. PP N ( 3 -68 9 ... � g. ene-Marc Jar — License 40E67789 PHONE Bene-Marc Athletic Insurance Agency E IAaS� S17).°7 L2)13 - 6301 Southwest Blvd, Suite 101 .. �GNNSsUu,RaEERRaA:..-A-_t1pUtRcESIneAGtyRDNG COVERAGEpmm _..._.. NA-I_C Fort Worth, TX 132 iT INSURED an ..... _Ai1�1oba1 Accident, &I1C1i Southern California Municipal Athletic Federation '- INSURER C : PO Box 3605, INSURER D_ RER.E: �.-_. .�,. .. ........m .�....,�.........�..... ..._a. South El Mollte INSU CA 1733 INSURERF: COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERT`Ti Y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE 11 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR .... TYPE OF INSURANCE + POLICY NUMBER 'I' ILICY YY _ mIIG'I'D EXiYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,0041,000.06 BILITY 0,000.00 A COMMERCIAL CLAIMS -MADE GENERAL LIAOCCUR MED EXPrsreawlw..IT.. $ ,. w IV HLN I0 5,000 OO �p'�OE:S#�artieipent— X CP03256-04 12/31/2015 12/31/2016 PERSONALaADVINJURY ms _ 1,000,000.00 y m.... - 12:01 am 12:01 am_ m. ' ill GENERAL AGGREGATE S 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000.00 El Med Fx f rsS ectato POLICY P'� (, rS Only AUTOMOBILE LIABILITY ,I .t. 1 LIMIT ANY AUTO BODILY INJURY (Per person)) $ ALL AUTOS OWNED AUTOS SCHEDULED BODILY INJURY (Per aoddent) $ H1®? 00 HIRED AUTOS NON-0OWNED P�"ER Y DAMA A _ Auros 12/31/2015 12/31/201 r dent' s CP03256-04 s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSLIAB ...............�.a.,........._....,.....�,,.....•..__. - Id CLAIMS -MADE AGGREGATE $ m.�...m�,..........._._ H'&-�iDRETENTIGN S .—.__ S WORKERS COMPENSATION WCSTATl1- 4T- AND EMPLOYERS'LIABILITY YIN'�----•— ANY PROPRISTORtRARINER/EXECUTIVE Lj E L. EACH ACCIDENT S OFFICEiRa'MC-„MBER EXCLUDED? N / A .....-__.._....-.-. _.. _.,-......•,�,,.,,�....-.� (Mandatory in NH) E.L. DISEASE • EA EMPLOYEE S My� s deicrltw.eunder DE:St:RBP'7Y d OF OPERATIONS below El. DISEASE - POLICY LIMIT S 12/31/2016 B Participants Excess Accident Medical Limit $5,000.00idenl SRPO-50256-243 12:01 am 12:01 am Deductible $0.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES Attach ACORD 101, Additional u ( 1 Remarks Schedule, H more space is required) i Certificate Holder is named as Add'I Insured as respects to the operations of the named insured. Covered Activities: Approved SCMAF Classroom Activities. Abuse and Molestation Coverage is included with $250,000 Occurrence and $500,000 Aggregate Limits. Additional Insured lncludcs: City of La Quinta its officers, cmnploya s, officials and agents of the City as additional insured. Coverage is Primary and Ion -Contributory per Waiver of'Transfer CG 24 0,4 05 09. SCMAF program coverage includes: SCMAF 2016 Approved Recreational Classes, 12/31/2015 - 12/31/2016. CERTIFICATE HOLDER I Ald'0 II I A'r9AKI Cert q: 9066-30899-215380-0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of La Quints ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calle Tampico AUTHORIZED REPRESENTATIVE La "Quints, CA 92253 Atha: Risk anagement ©1988-2010 ACORD COR RATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDIT��U�~K��K INSURED ��8�� IONAL n��n�x~u�. ou��x��~�� ~— u�n��n�»��~n��.'��u� LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased ToYou): 78495 Calle Tampico La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): City of La Quinta Additional Premium: $ Included Informati I be shown in the Declarations. A- Section U— Who Is An Insured is amended to 2. If additional insured coverage include addd�n��mured �e organization(s) shown In the Schedule, but only insurance afforded to such additional insured with respect to liability arising, out of the will not be broader than that which you are ownership, maintenance oruse ofthat part oYthe required by the contract or agreement to premises |aoned to you and shown in the provide for such additional insured. Schedule and subject bmthe following ' B. With respect to the insurance offbmdwd to these ' exclusions: � additional inounedo, the following is added to This insurance does not apply to: Section III — Limits 0f Insurance: I. Any "occurrence" which takes p|mno after you If coverage provided to the additional insured is cease bobeotenant inthat premises. required byacontract uragreement, the most vvn 2' Structural o|hnneUonn, new construction or will pay on behalf ofthe additional insured is the demolition operations performed by or on amount ofinsurance: behalf of the person(s) or organization(s) f' Required bythe contract oragreement; or shown inthe Schedule. 2. Available under � applicable Limits of However: Insurance shown inthe Declarations; 1' The insurance afforded to such additional whichever iuless. insured only applies to the extent permitted This endorsement mhoU not increase the bylaw; and applicable Limits of |nounynoo shown in the Declarations. CG 20 1104f3 0Insurance Services Office, |nc.2O12 Page 1ofI POLICY NUMBER: CP03256-04 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta 78495 Calle Tampico, La Quinta, CA 92253 Information required to complete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Condttions We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and Included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ ,, City of La Quinta ta Community Resources Department u 4 M ,lr/.u. I FS11 1R 11' - Contract #TENNISI7 VOLUNTEER COORDINATOR AGREEMENT This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and DARLENE BAILEY, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. CITY AND VOLUNTEER MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: SENIOR TENNIS GROUP held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY will be t ,ched as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. t. (initials) 2. COMPENSATION. VOLUNTEER shall not be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form =ry tacompensation from CITY or any participant of the program.(initials) 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program an coordinate with VOLUNTEER to schedule a make-up date. (initials) tl-k ? VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely re n ible to contact any and all participants of the program. (initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontractor f ll the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. �............................ - m _— m ...._ Number Name Address ..___. ..� ....._..... ............ ..........w_ ................................................ Subcontractors....liste.d.....above have ................................. ��........... ..__.............................��_. e been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION., It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: Darlene Bailey 79273 Sign of Spring La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (initials) 11. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Darlene Bailey COMMUNITY RESOURCES DEPARTMENT ("VOLUNTEER") ("CITY") APPROVED By. Chris Escobedo, CommuniW'es Digitally signed by Chris Escohedo DN: cn--Chris Escobedo, o—City of La Qulnta, ou, email-cescobedo@la- quinta.org, -US Date: 2016.10.19 11:07:54 07'00' rces Dir ctor ,. ,r 0 Ch&tWd Calderon,"C dh(ty Programs & Wellness Supervisor APPROVED: o By: 79273 Sign of Spring La Quinta, CA 92253 661.350.5360 Hello Darlene, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 000000 Senior Tennis Group Instructor: Darlene Bailey Cost DayZs Time Location Tuesdays 8:30-10:30am Courts #3, #4, #5, #6 Sessions: 10/11-10/25; 11/1-11/29; 12/6-12/27; 1/3-1/31; 2/7-2/28; 3/7-3/28; 4/4-4/25 Web Trac Brochure Info: Materials: tennis racket, tennis balls, non -marking tennis shoes, water bottle Instructor Signature: Date L v — (_�' /� Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. It Parabas Tennis March 6 through March 19 •March 7 & March 9 March 14 & March 16 City of La Quinta Community Resources Department Contract # 414601-17 r INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and JOAN REVELL RYAN, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE (ART) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION,. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pro ram and coordinate with CONTRACTOR to schedule a make-up dote. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTR CTOR must be made up in a timely manner as approved by CITY. n (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Joan Revell Ryan 73496 Fox Tail Lane Palm Desert, CA 92260 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 (initials) 13. aOCU MENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitally signed by Cur EeCobedo APPROVED • ''� " r "'y DN —Chris Escobedo, o C'ty of La Q 'nta, ou ema I cescobedo@la cul Date 2016.10.19 12:40:12-07'00' By: Chris Escobedo Community Resources Director COUNTERSI•,NED: By: Christina Calderon, tom " & Wellness Supervisor " rogram Joan Revell Ryan ("CONTRACTOR") APPROVED: By: Signatu 73496 Fox Tail Lane Palm Desert, CA 92260 914-563-2189 Rev May 2015 AC CERTIFICATE OF LIABILITY INSURANCE DAT ' M8/2016 ) 09/28/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcyYes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 NAME: Mass Merchandising K&K Insurance Group, Inc. R g E�,I . 1-800-328-2317 p N. 1-260-459-5502 1712 Magnavox Way E-MAIL Fort Wayne IN 46804 A_Cgnus: info@eventinsurance-kk.com PRODUCER CUSTOMER ID: ................................_........_.....-............._._____..-..._............__.....-._._.........._.___.__ �. INSURERS AFFORDING COVERAGE NAIC 4 INSURED 2000829327 CP# 467 IN SURER A: Nationwide Mutual Insurance Company 23787 Joan Ryan INSURER B: 73496 Foxtail Lane INSURER C: Palm Desert, CA 92260 INSURER D: A Member of the Sports, Leisure & Entertainment RPG INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2000272915 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL'.SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR ....... -INSO WVD ... MMIDDNY)M, DDIYYYY ...__._-.._... _........ _....__�._ A X COMMERCIAL GENERAL LIABILITY X 6BRPG0000005894600 10/04/16 10/04/17 EACH OCCURRENCE $1,000,000 CLIMMS-MADE E] OCCUR 12:01 AM 12:01 AM DAMAGE TO RENTED PREMISES Ea Occurrence $300,000 MED EXP (Any one person) $5, 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY 0 PROJECT [—I LOC PRODUCTS -COMP/OP AGG $1,000,000 OTHER: PROFESSIONAL LIABILITY $1,000,000 LEGAL LIAB TO PARTICIPANTS $1,000,000 AUTOMOBILE LIABILITY COMBINED a arcident ANY AUTO BODILY INJURY (Per person) OWNED �`�"� SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident X Not provided while in Hawaii UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR H CLAIMS -MADE AGGREGATE DIED 0 RETENTION WORKERS COMPENSATION N/A PER STATUTE OTHER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ Y / N E.L„ EACH ACCIDENT EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.LDISEASE-EAEMPLOYEE If yes, des cr be under -'- DESCRIIf`rfON OF OPERATIONS below E.L. DISEASE -POLICY LIMIT MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) Instructor of: Artistic painting; Drawing The certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured, CERTIFICATE HOLDER CANCELLATION City Of La Quinta SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 78495 Calle Tampico EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH La Quinta, CA 92253 THE POLICY PROVISIONS. Owner/Manager/Lessor of Premises AUTHORIZED REPRESENTATIVE -X� Q 1988.2015 ACORD CORPORATION, All rlahts reserved. Coverage is only extended to U.S. events and activities. ** NOTICE TO TEXAS INSUREDS: The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 6BRPG0000005894600 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Hello Joan, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 414601 Watercolor Instructor: Joan Revell Ryan Cost Da s Time Location $ T 10:30am-12pm Wellness Center Art Room Sessions: 10/4-10/25; )�/29;; 1/10-1/31; 3/7-3/28; 4/4-4/25 = $48 Sessions: 12/6-12/20; 2 —2/21 (3 weeks) _ $36 (no class 11/22) No (4/0 Web Trac Brochure Info: A beginner to the advanced artist, taught by, Joan Revell Ryan, a classically trained watercolor artist using the Impressionist's palate. The beginner will learn the basics of how to create painting Learn unusual combinations of color and other techniques to create texture and interest. Instructor Signature: ................. ___,,Date _._........... Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. Minimum of 5 Maximum of �students Students may call or email instructor Drop in fee to be determined by instructor Hello Joan, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 414701 Pen & Ink Instructor: Joan Revell Ryan Cost lea s Time Location $ TH - 4-5:30pm Wellness Center Art Room Sessions: 10/6-10/27; 1/5-1/26; 2/2-2/23; 3/9-3/30; 4/6-4/27=$48 (4 weeks) Sessions: 11/3-11/17; 12/1-12/15 (3 weeks) = $36 (3 weeks) Web Trac Brochure Info: for the beginner to the adva nced artist, taught by Joan Revell Ryan a classically trained artist. The class will explore various techniques, from your still life drawing, for the accomplished artist, to photomechanical processes using photographs for beginner to advanced students. This is an unusually fun medium. Instructor Signature: . _................ _ Date _ Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. Minimum of 5 Maximum of 12 students Students may email or call the instructor Drop in fee tbd by instructor T e—t " -,,dT 1 cui MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Chris Escobedo, Community Resources Director DATE: C�ctc�ber 2, 201 RE: Lawrence Montoya, Senior Services Free AGR#2016-0127 Volunteer Coordinator Attached for your signature is an agreement with independent contracted instructor Lawrence Montoya for (Senior Tennis Program) open group play. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. e aest_--,.jn.g &epgrtr ent qll. iC a:- ttach the it4gnj below roDria N/A Contract payments will be charged to account number: N/A Amount of Agreement, Amendment, Change Order, etc.: Senior Services Free N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). bmd l .gn: N/A Approved by the City Council on X City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection N/A Insurance certificates as required by the agreement Folunteer N/A Performance bonds as required by the agreement (originals) N/A City of La Quints Business License number N/A Purchase Order number i City of La Quinta Community Resources Department Contract #TENNISI7 VOLUNTEER COORDINATOR AGREEMENT This VOLUNTEER COORDINATOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and LAWRENCE MONTOYA, a person or business engaged in offering services ("VOLUNTEER") for Provision of Services to the City. CITY AND VOLUNTEER MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: SENIOR TENNIS GROUP held at a City of La Quinta facility. The scope.of work includes all goods and actions necessary to complete the task VOLUNTEER has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to VOLUNTEER from CITY on a bi-annual basis. Work proposals, once approved by CITY will be t a hed as exhibits to this VOLUNTEER COORDINATOR AGREEMENT. (initials) 2. COMPENSATION. VOLUNTEER shall not be paid for services performed under this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEEER shall perform SCOPE OF WORK strictly as a VOLUNTEER and shall not request or require any form of man tary compensation from CITY or any participant of the program. (initials) 3. VOLUNTEER COORDINATOR. This Agreement calls for the performance of the services of VOLUNTEER and not as an employee of CITY. 4. INDEMNIFICATION. To the fullest extent permitted by law, VOLUNTEER shall indemnify, protect, defend and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, expenses or costs of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorney fees incurred by CITY, court costs, interest, defense costs including fees of expert Contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of or arising out of or in any way attributable in whole or in part to the performance of this agreement. All obligations under this provision are to be paid by VOLUNTEER as the CITY incurs them. PROMPT NOTICE. VOLUNTEER agrees to provide immediate notice to CITY of any claim or loss against VOLUNTEER arising out of the work performed under this VOLUNTER COORDINATOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact VOLUNTEER and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, and if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said program and co rdinate with VOLUNTEER to schedule a make-up date.' (initials) VOLUNTEER RESPONSIBILITY. VOLUNTEER will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by VOLUNTEER. VOLUNTEER will be solely r as ble to contact any and all participants of the program.(initials) 6. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in� accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of the CITY and any Federal, State, or local government agency of competent jurisdiction. 7. COVENANT AGAINST DISCRIMINATION. VOLUNTEER covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this VOLUNTEER COORDINATOR AGREEMENT. VOLUNTEER shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, disability, or ancestry. 8. NO ASSIGNMENT. VOLUNTEER shall not, under any circumstances, assign this VOLUNTEER COORDINATOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, VOLUNTEER agrees to inform any subcontract r f a' the stipulations of this VOLUNTEER COORDINATOR AGREEMENT. (initials) Please list any/all subcontractors you will hire for the term of this VOLUNTEER COORDINATOR AGREEMENT. Name_.................�.m.�..........._...................... Address.......... Phone Number _ ......... _.� _............ ........ ��............. Subcontractors Subcontractors listed above have been approved by the CITY to perform the SCOPE OF WORK. Additional subcontractors will require prior written approval from the CITY. 9. TERMINATION. It is understood that VOLUNTEER will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, City shall not be liable for compensation or damages to VOLUNTEER for remainder of this VOLUNTEER COORDINATOR AGREEMENT. 10. NOTICE. Notice shall be deemed given when VOLUNTEER contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: VOLUNTEER: CITY: Lawrence "Larry" Montoya Community Resources Department 50855 Washington St., Ste C 311 City of La Quinta La Quinta, CA 92253 78495 Calle Tampico La Quinta, CA 92253 wrc,)' 04- (initials) 11. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this VOLUNTEER COORDINATOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 12. MISCELLANEOUS. This VOLUNTEER COORDINATOR AGREEMENT is the only agreement between VOLUNTEER and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this VOLUNTEER COORDINATOR AGREEMENT shall be a continuing waiver thereof. IN WITNESS WHEREOF, the parties hereto have caused this VOLUNTEER COORDINATOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Lawerence Montoya COMMUNITY RESOURCES DEPARTMENT ("VOLUNTEER") ("CITY") Digitally signed by Chris Escobedo DN: c—Chris Escobedo, APPROVED: o_Cityof La Quinta, on, -N % email=cescobedoVa- quinta.org, -US Date: 2016.10.26 08:34:18 By. 0700' Chris Escobedo, Community Resources Director Signature q, y C ris " a CdIderon, Coffimdnity Programs & ellness Supervisor 50855 Washington St., Suite C311 La Quinta, CA 92253 626.327.0753 P MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: January 18, 2017 RE: Lucilla Beretto, Fitness, #2017-0005, Instructor Attached for your signature is an agreement with independent contracted instructor name for (Pilates) class(s). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 60 % of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The fallowing required documents are attached to the n_greement: X Insurance certificates as required by the agreement (approved by Risk Manager on dote) N/A Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-764386 Expires 12/31/2017 N/A Purchase Order number I� City of La Quinta ta Community Resources Department Contract # 423301-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and LUCILLA BERETTO, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: FITNESS classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, on pproved by CITY will be attached as exhibits ,to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at ali times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every bind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 Z actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pr and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CO NT TOR must be made up in a timely manner as approved by CITY. (initials} 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered lasses and no less than $2,000,000 general aggregate. Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quints Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH CAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to in ubcontractor of all the stipulations of this INSTRUCTOR AGREEM ENT. (initials) Rev May 2015 q Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name ' Address Phone Number Subcontractors listed above work, as provided in Section approval from CITY. have been approved by CITY to perform the scope of 1. Additional subcontractors will require prior written 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Lucilla Beretto 79538 Dandelion Drive La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta �, uinta, CA 92253 (initials) 13. DOCUMENTS.. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both ,parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitally signed by APPROVED: Chris Escobedo Date: 2017.01.19 By: 12:55:59-08'00' Chris Escobedo Community Resources Director GNED: 4 MEM 'hrNgno Calderon, Colt & Wellness Supervisor Lucilla Beretto ("CONTRACTOR") APPROVED: By: Signature 79538 Dandelion Drive La Quinta, CA 92253 760-925-6106 Rev May 2015 Hello Lucilla, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 423301 Pilates Instructor: Lucilla Beretto 423302 Pilates mid morning Cost Lay/s Time Location W/F 9:30-10:30am Aerobics Room 10:35-11:35am Aerobics Room Sessions: 1/11-1/27 = $36 (6 classes) Sessions: 2/1-2/24; 3/8-3/31; 4/5-4/28=$48 (8 classes) Sessions: 12/14-12/28= $24 (4 classes) Web Trac Brochure Info: Pilates Mat workout will help Increase your body/mind connection using techniques developed by Joseph H. Pilates. Expect to increase your strength, flexibility and stamina as you transition from one flowing movement to another. Your instructor is Lucilla Beretto. Materials: A mat, towel, water, and wear comfortable clothing. Instructor Signature _ Date (� 'h J Signing this document only verifies that you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. 493601 - Drop in $10 Monthly registrations equates to $6 per class. � DATE (MMIDD/YYYY) o1z CERTIFICATE OF LIABILITY INSURANCE 12/30/16 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Bene-Marc Inc. NAME dba Bene-Marc Athletic Insurance Agency CA # OE67789 PHONE N- AN4=.PxU;. t8t}t}} 247-1734 i FAX Nu): ! 817) 738-18] ] 6301 Southwest Blvd., Suite 101 ADDRESS: contact a,bene-marc.com Fort Worth, TX 76132 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Southern California Municipal Athletic Federation PO Box 3605 South El Monte, CA 91733 A: Atlantic Specialty Insurance Company B : AXIS Global Accident & Health INSURER C : INSURER D : ' INSURER E : _ SCMAF Member: Desert Sands Unified School District INSURER F : COVFRAGFS CFRTIFICATF NIIMRFR- Cert #- 9066-32189 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. ILTR TYPE OF INSURANCE 1`,ODL SUBR POLICY NUMBER MMI ]D/YYYY I. M ODYYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Cl OCCUR CP03256-05 12/31/2016 12/31/2017 EACH OCCURRENCE $ 1,000,000.00 ,DAfI iS'9E'NT15 PREMISES Ea orM1hc6 $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 X INCLUDES Participant X Legal Liability Abuse or Molestation Coverage - GENERAL AGGREGATE $ 2,000,000.00 00 Each Incident Lilnit $250,000. Aggregate Limit $500,000,00. GEN'LAGGREGATELIMITAPPLIESPER: p Pqut;y tioe PRODUCTS - COMP/OPAGG $ 1,000,000.00 Med Ex for Spectators i�nl AUTOMOBILE LIABILITY WMSIN LE UI—I I 13 END $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS _ AUTOS(Per BODILY INJURY (Per accident) $ PROPERTY DAMAGE seddBltt $ ,_.._._..__ UMBRELLA LIAB OCCUR { EACH OCCURRENCE $ $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION WC STA'IMTUCRY- OTH- ER AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ D? OFFICER/MEMBER EXCLUDE (Mandatory in NH) NIA E. L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ I E.L. DISEASE -POLICY LIMIT I $ If yes, describe under DESCRIPTION OF OPERATIONS belo B Excess Accident Medical SRPO-50256-243 12/31/2016 12/31/2017 Excess Medical Limit$]0,000.00 Excess Medical Deductible: $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate Holder is Named as Additional Insured with respect to the operations of the Named Insured. Approved SCMAF Instructional Class Activities as reported and paid to the carrier. SCMAF Member: Desert Sands Unified School District L,LK I It -It A I t r1ULL1C.K L•erd 7r: vvoo-JL 1 o7 LF1IV L.CLLA 11UIV Desert Sands Unified School District SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 47-950 Dune Palms Road La Quinta, CA 92253 AUTHORIZED REPRESENTATIVE Alisa Lynn Hall ()IA+GU 4'4�►tN + O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER, CP03256-05 COMMERCIAL GENERAL LIABILITY CG 20 11 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 47-950 Dune Palms Road La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): Desert Sands Unified School District Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable Limits of Insurance shown in the Declarations. CG 20 11 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-05 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 P MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: January 18, 2017 RE: Keith Sparkman, Leisure, #2017-0006, Instructor Attached for your signature is an agreement with independent contracted instructor name for (Computer) class(s). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 60 % of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents ore attached to the ogreemenLt; X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-764412 Expires 12/31/2017 N/A Purchase Order number City of La Quinta Community Resources Department Contract # 414901-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and S. KEITH SPARKMAN, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE (COMPUTER) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 z actively negl percentage o' entire portion CITY. gent and where CITY's active negligence accounts for only a the liability involved, the obligation of CONTRACTOR will be for that or percentage of liability not attributable to the active negligence of PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said pro ram and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate., Rev May 2015 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of. (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. ` ). (initials) _. Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: S. Keith Sparkman 45924 Abronia Trail Palm Desert, CA 92260 CITY: Community Resources Department City of La Qauinta La Quinta,�CA 92253 (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, S. Keith Sparkman COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") Digitally signed by APPROVED: Chris Escobedo APPROVED: Date: 2017.01.19 By: 12:55:15-08'00' Chris Escobedo Community Resources Director COUNTERSIGNED: A. z BY )J&ii y Chris. ha Calderon, ComhrrGnity Programs & Wellness Supervisor By: 4. 4-0, Signature 45924 Abronia Trail Palm Desert, CA 92260 760.333.9104 Rev May 2015 e, DATE (MMIDD/YYYY) '! �''�'� CERTIFICATE OF LIABILITY INSURANCE 12/30/16 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Bene-Marc Inc. NAME. ANE__,_. dba Bene-Marc Athletic Insurance Agency CA # OE67789 E M �Q= EA (800) 247-1734 l Flwc, N6); (8171 738-1811 6301 Southwest Blvd„ Suite 101 ADDRESS: contact a,bene-mare.conl Fort Worth, TX 76132 INSURERIS) AFFORDING COVERAGE NAIC # INSURER A : Atlantic Specialty Insurance Company INSURED INSURER B : AXIS Global Accident & Health Southern California Municipal Athletic Federation - PO Box 3605 INSURER C : South El Monte, CA 91733 INSURER D; _ - INSURER E ; SCMAP Member: Desert Sands Unified School District WSURER F., COVERAGES CERTIFICATE NUMBER: Cert #: 9066-32189 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. ILTR TYPE OF INSURANCE DGL $Ui F POLICY NUMBER POLICY EFF DDIYYYY PQLtCY E71P MM@DfYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE El OCCUR _ _ CP03256-05 _ 12/31/2016 12/31/2017 EACH OCCURRENCE $ 1,000,000.00 A A PREMI E occurrence $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL 8 ADV INJURY $ 1,000,000.00 X INCLUDES Participant X Legal Liability GENERAL AGGREGATE $ 2,000,000.00 Abuse or Molestation Coverage - Each incident Limit $250,000.00 Aggregate Limit $500,000-00. GEN-L AGGREGATE LIMIT APPLIES PER: POLICY1_1 PRO LOC PRODUCTS -COMP/OP AGG $ 1,000,000.00 Med Exp for Spectators (Only AUTOMOBILE LIABILITY COM61NE1511 Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS tl NON -OWNED HIREDAUTOS I' AUTOS — BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident) $ $ p— UMBRELLA LIAB ; OCCUR OCCURRENCE $ $ EXCESS LIAB _ CLAIMS -MADE --EACH AGGREGATE $ DIED I RETENTION. WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE $ E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?- ❑ NIA - (Mandatoryin NH) E.L, DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ B Excess Accident Medical SRPO-50256-243 12/31/2016 12/31/2017 Excess Medical Limit $10,000.00 Excess Medical Deductible: $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is Named as Additional Insured with respect to the operations of the Named Insured. Approved SCMAF Instructional Class Activities as reported and paid to the carrier. SCMAF Member: Desert Sands Unified School District CERTIFICATE H01IL ]ER Uert#: JUIJO-Sl16V C:AN ;t_LLA I IUN Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Alisa Lynn Hall a�illhnl E1IIZi ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-05 COMMERCIAL GENERAL LIABILITY CG 20 11 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 47-950 Dune Palms Road La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured): Desert Sands Unified School District Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 11 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-05 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 P MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: January 18, 2017 RE: Kenneth Shiry, Dance Classes, #2017-0007, Instructor Attached for your signature is an agreement with independent contracted instructor name for (West Coast Swing) Dance class(s). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 70% of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute, this.agreement is based. upon: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number LIC-762606 Expires 3/31/2017 N/A Purchase Order number City of La Quinta ta �C, Community Resources Department Contract # 423401-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and KENNETH SHIRY, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE (DANCE) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. '' (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 70% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 70% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 30% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for, the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said grog am and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. S. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform any subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. (initials) Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number 2= A� 43H l fzY PA votA5co '-31 U '"Z--) •`?--)32 I -A- Ou I I -1-)k &A zzS 3 Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Kenneth Shiry 52390 Avenida Velasco La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (initials) L 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 5 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") Digitally signed by APPROVED: Chris Escobedo Date: 2017.01.19 By: 12:54:22-08'00' Chris Escobedo Community Resources Director & Wellness Supervisor Kenneth Shiry ("CONTRACTOR") APPROVE . By: Signature 52390 Avenida Velasco La Quinta, CA 92253 (310)529.4932 Rev May 2015 Hello Ken, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 423401 West Coast Swing Instructor: Ken Shiry Cost Day/s Time Location Thursday 7-8pm Multipurpose Room Stage Side Sessions: 2/2-2/23; 3/9-3/30; 4/6-4/27= $36 (4 classes)/Drop-in students $10 fee. Web Trac Brochure Info: West Coast Swing is perhaps the most popular social dance in existence today. It involves interesting rhythms, detailed footwork and deep connection between partners. The music for West Coast Swing is truly diverse; from Country Western to Pop, and Rhythm & Blues. Learn basic patterns, lead and follow and footwork variations. Each week, we will present an intermediate combination as well as an advanced version of the same grouping with rhythm options and extended turns for the ladies. This is not a Beginner class. Students should already possess a basic working knowledge of West Coast Swing so we can keep the class moving at an intermediate/advanced level. Materials: Wear soft sole shoes that are easy to slide and dance. Instructor Signature: Date 6>1/7 Signing this document only verifies tha you have read and understand the material within this document. This document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. M,,0 2-o('l-000i DATE(MM/DDn fl!Ac Rlo� CERTIFICATE OF LIABILITY INSURANCE 1 12/30/2016 PRODUCER Maguire Insurance Agency, Inc. 27101 Puerta Real Suite 200 Mission Viejo, CA 92691- 877.438.7459 INSURED Ken Shlry 52390 Avenida Velasco La Quinta, CA 92253-3276 COVERAGES THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: Philadelphia lndemnqy Insurance Company 18058 _ INSURER B: INSURERC: INSURER D: _ INSURER E: 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 CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD I TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD DATE MWDD/YYYY LIMITS A X GENERAL LIABILITY PHPK1343290- 07/27/2016 07/27/2017 EACH OCCURENCE $0001000 PREMISES cur enco $100,000 MERCIAL GENERAL LIABILITY 001 CLAIMS MADE � OCCUR T.l..FME MED EXP (Any one person) $2,500 PERSONAL & ADV INJURY SL000,000 SSIONAL LIABILITY GENERAL AGGREGATE $3,000,000 PRODUCTS—COMP/OP AGG $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1_1X POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (EA accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE _ (Per accident) GARAGE LIABILITY AUTO ONLY — EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONLY: AGG EXCESS / UMBRELLA UABIUIY EACH OCCURENCE OCCUR El CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION ITION AND EMPLOYERS' LIABILITY Y N 70RVUM175 ER E.L. EACH ACCIDENT ANY R/MEMOEft XCLUDED7EXECUTIVE / OFFICE E.L. DISEASE — EA AMPLO_YEE (Mandatory In NH) If yyos describe under SPEC(AL PROVISEONS below E.L. DISEASE —POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS It is understood and agreed that the following entity: The City of La Quinta Is added as an additional insured but only with respect(s) to the operations of the names insured except the liability resulting from the additional insured's sole negligence. This insurance is primary, with any Insurance or self -Insurance program maintained by the name of person or oganizatlon listed being non-contributing excepting loss resulting from the sole negligance of the name of person or organlzatfoo lis{od. CERTIFICATE HOLDER CANCELLATION The City of La Quinta 78495 Calle Tampico La Quinta, CA 92253-2939 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILrrV OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK1343290-001 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City of La Quinta 78495 Calle Tampico La Quinta CA 92253-2839 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 13 T4ht 4*OP a w MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christopher Escobedo, Community Resources Director DATE: February 13, 2017 RE: Johanna "Hani" Angelos, Leisure, #2017-0010, Instructor Attached for your signature is an agreement with independent contracted instructor Johanna Angelos (Leisure) Here & Now Discussion class(s). Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shah check and attach the items below as appropriate: X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 60 % of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execute this agreement is based upon: N/A Approved by the City Council on X Community Resources Directors' signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The follawing required documents are attached to the agreement: X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) City of La Quints Business License number LIC- Expires L-3445888 2-28-2018 N/A Purchase Order number i 1k -Z City of La Quints Community Resources Department Contract # 414001-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and JOHANNA ANGELOS, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: LEISURE (DISCUSSION GROUP) classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi-annual basis. Work proposals, once approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) Iq 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 60% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. DROP -IN SESSIONS. CITY shall pay 60% of gross fees to CONTRACTOR as compensation based upon the records and shall retain the remaining 40% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in the SCOPE OF SERVICES and will follow the approved annual payroll calendar. Rev May 2015 1 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been Rev May 2015 2 actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR 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. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said rogrom and coordinate with CONTRACTOR to schedule a make-up date. 9k (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. Rev May 2015 3 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT. CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inf�Y ray subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT . (initials)U Rev May 2015 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Name Address Phone Number Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY RESOURCES COORDINATOR or COMMUNITY PROGRAMS & WELLNESS SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy- two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Johanna Angelos 53100 Ramirez La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta La Quinta, CA 92253 Q �— (initials) U 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2015 IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Johanna Angelos COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") Digitally signed APPROVED: %� — by Chris Escobedo n Date: 2017.02.23 By: 15:49:35-08'00' Chris Escobedo Community Resources Director COUNTERSIGNED: r. By: Chr 'n lderon, Comm nity Programs & Wellness Supervisor Rev May 2015 6 APPROVED: By: Sig tore - 53100 Ramirez La Quinta, CA 92253 (760)406-2111 Hello Hani, Below is your class information for October 2016— April 2017. Please review and verify by typing your name and date on the lines below as soon as possible. 414001 Here & Now Discussion Group Instructor: Johanna (Hani) Angelos Cost Day/s Time Location $10 TH 6-7pm Wellness Center Art Room Session: 2/2-2/23: The Five Levels of Attachment, Author Don Miguel Ruiz Session: 3/9-3/30: The Mastery of Love; Author Don Miguel Ruiz Session: 4/6-4/27: The Mastery of Self, Author Don Miguel Ruiz Web Trac Brochure Info: Expand your consciousne and emb4ce your peace of mind. Instructor Signature: Date Signing this do6u only verifies that you have read and understand the material within this document. his document shall not act as a contractual agreement between you and the City of La Quinta. The La Quinta Arts Festival will be utilizing the Wellness Center from Monday, February 27 through Monday, March 6, 2017. DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/30/16 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 terms 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 Bene-Marc Inc. NA0k:. _.._.. PHONE F u. Exit): (800) 247-1734 FAX Nor (817) 7 dba Bene-Marc Athletic Insurance Agency CA # OE67789 E-MAIL contact a;bone-marc.com 6301 Southwest Blvd„ Suite 101 ADDRESS- Fort Worth, TX 76132 INSURERS} AFFORDING COVERAGE _ _ NAIC # INSURER A: Atlantic Specialty insurance Company INSURED INSURER 6: AXfS GInbal Accident & Ilea Ith Southern California Municipal Athletic Federation — PO Box 3605 INSURERC: South El Monte. CA 91733 INSURER D : INSURER E. . - - - - - SCMAPMember: Desert Sands Unified School District INSURER F: COVERAGES CERTIFICATE NUMBER: Cert#: 9066-32189 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _ ..... ........ .... _ _...._- .-......- ApOLSUdk1 . _.... .._ _. ___ ..-,-pbL1CY€FF POLICY E%p . —.... ._ _ LTR TYPE OF INSURANCE I POLICY N MBER MMIO 1 I YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000.00 A X GENERAL CP03256-05 l2/31/2016 12/3l/2017 -- 15AAt7555_fitvw_!f_ -- .- $ 100,000.00 _COMMERCIAL LIABILITY _ CLAIMS -MADE 1 -- r OCCUR PR[M4SE,S (Ea,grr�ulrancel MEDEXP(Angoneperson) _, ___ S 5,000.00 X INCLUDES Participant X PERSONAL &ADV INJURY 5 I,000,000,00 GENERAL AGGREGATE Legal Liability Abuse or Molestation Coverage - 5 2.00( 000.00 GEN'LAfi�GREGATE�LIMITAPPLIESPER: 6achIncident Linlit$250,000,00 _....-.__.-.�.,._..m. - COMPIOPAGG _ _ $ 1.000.000.00 r'OIICY JP LOG Aggregate Limit $500,000 00 _PRODUCTS Med Exp for Spectators Only AUTOMOBILE LIABILITY COMBINED SI.. L E LIMIT IEu B�c.KL2111�- 5 ... BODILY INJURY (Per person) ANY AUTO $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON.OWNED fffA PE ATV OAMACJ S HIREDAUTOS AUTOS -tQ s000—i -- UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE _AGGREGATE DIED RETENTIONS $ WORKERS COMPENSATION WC TA U• OTti- TOM lI AND EMPLOYERS' LIABILITY YIN E,L.EACRACOMNT ANY PROPRIETORIPARTNER/EXECUTIVE $ OFFICER/MEMBER EXCLUDED? ❑ NIA - -- -----"-'- (Mandatory In NH) EL. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below -- E L. DISEASE - POLICY LIMIT $ B Excess Accident Medical SRPO-50256-243 12/31/2016 12/31/2017 Excess Medical Limit $10,000.00 Excess Medical Deductible: $0.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is Named as Additional Insured with respect to the operations ofthe Named Insured, Approved SCMAF Instructional Class Activities as reported and paid to the carrier. SCMAF Member: Desert Sands Unified School District CERTIFICATE HOLDER Cert ti: 9066-32189 CANCELLATION Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Alisa Lynn Hall © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP03256-05 COMMERCIAL GENERAL LIABILITY CG 20 11 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): 47-950 Dune Palms Road La Quinta, CA 92253 Name Of Person(s) Or Organization(s) (Additional Insured). Desert Sands Unified School District Additional Premium: $ Included Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises, 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable Limits of Insurance shown in the Declarations. CG 20 11 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: CP03256-05 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided finder the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City of La Quinta Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©insurance Services Office, Inc., 2008 Page 1 of 1 0 ta a ii(rW MEMORANDUM TO: Frank J. Spevacek, City Manager FROM: Christina T. Calderon, Community Programs & Wellness Supervisor DATE: May 31, 2017 RE: Lori Farkas, Fitness, #AGR2017-0033, Instructor Attached for your signature are two agreements with independent contracted instructor Lori Farkas for (Personal Training and Golf Fitness Sessions). Please sign the two attached agreement(s) and return to the City Clerk for processing and distribution. Requesting department shall check and attach the items below as appropriate X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 80% of fees are paid to instructor N/A A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with no reportable interests in LQ or _ reportable interests N/A A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant does not meet the definition in FPPC regulation 18701(2). Authority to execgte this agreement is based upon: N/A Approved by the City Council on Uril 18.2017 X City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures of $50,000 or less. This expenditure is $ and authorized by contract approved by N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection The following required documents are attached to the agreernent: X Insurance certificates as required by the agreement (approved by Risk Manager on date) N/A Performance bonds as required by the agreement (originals) X City of La Quints Business License number LIC-764931 5/31/2018 X Purchase Order (Required over $5,000; PO No. will be issued by Finance after agreement is executed) ta Qw�ra City of La Quinta — (sc,\l q )- Community Resources Department Contract # 423501-17 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2016 through JUNE 30, 2017 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and LORI FARKAS, a person or business engaged in offering services ("CONTRACTOR") for Contractor's Provision of Services to the City. CITY AND CONTRACTOR MUTUALLY AGREE AS FOLLOWS: 1. SCOPE OF WORK. The scope of work is described as: PERSONAL TRAINING classes held at a City of La Quinta facility. The scope of work includes all goods and actions necessary to complete the task CONTRACTOR has been hired to perform, whether specifically included in the scope of work or not. Specific dates and times for contracted work will be requested by letter to CONTRACTOR from CITY on a bi- annual basis. Work proposals, once,approved by CITY will be attached as exhibits to this INSTRUCTOR AGREEMENT. (initials) 2. COMPENSATION. CONTRACTOR shall be paid for services performed under this INSTRUCTOR AGREEMENT as follows: CONTRACTOR shall recommend fees to be charged by CITY. Such fees shall be paid directly to CITY. CITY shall maintain written records of gross receipts and shall submit such records to CONTRACTOR upon request. CONTRACTOR shall be compensated based on the following: STANDARD SESSIONS. CITY shall pay 80% of gross receipts collected to CONTRACTOR as compensation based upon the records and shall retain the remaining 20% for the use of public facilities for such services. This compensation shall be the total compensation for services, including out-of-pocket costs. CITY shall pay no other compensation to CONTRACTOR. Payments will be made to CONTRACTOR after each session of work is completed as defined in Section 1, SCOPE OF WORK and will follow the approved annual payroll calendar. 3. INDEPENDENT CONTRACTOR. This INSTRUCTOR AGREEMENT calls for the performance of the services of CONTRACTOR as an independent contractor and not as an employee of CITY. Neither CITY nor any of its employees shall have any control over the manner, mode, or means by which CONTRACTOR or its agents, perform the services required herein, except as otherwise set forth herein. CONTRACTOR shall perform all services required herein as an independent contractor of CITY and shall remain at all times as to CITY a wholly independent contractor with only such obligations as are consistent with that role. CONTRACTOR Rev May 2016 1 shall have no power to incur any debt, obligation, or liability on behalf of CITY. CONTRACTOR shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of CITY. CONTRACTOR and any of its agent, and subcontractors providing services under this INSTRUCTOR AGREEMENT shall not qualify for or become entitled to any compensation, benefit, or any incident of employment by CITY, including but not limited to eligibility to enroll in the California Public Employees Retirement System ("PERS") as an employee of CITY and entitlement to any contribution to be paid by CITY for employer contributions and/or employee contributions for PERS benefits. CONTRACTOR agrees to pay all required taxes on amounts paid to CONTRACTOR under this INSTRUCTOR AGREEMENT, and to indemnify and hold CITY harmless from any and all taxes, assessments, penalties, and interest asserted against CITY by reason of the independent contractor relationship created by this INSTRUCTOR AGREEMENT. CITY shall have the right to offset against the amount of any compensation due to CONTRACTOR under this INSTRUCTOR AGREEMENT any amount due to CITY from CONTRACTOR as a result of CONTRACTOR's failure to promptly pay to CITY any reimbursement or indemnification arising under this paragraph. 4. INDEMNIFICATION. To the fullest extent permitted by law, CONTRACTOR shall indemnify, protect, defend (with counsel selected by City) and hold harmless CITY and any and all of its officials, employees and agents ("Indemnified Parties") from and against any and all liability, claims, suits, actions arbitration proceedings, administrative proceedings, regulatory proceedings, losses, liabilities of every kind, nature, and description, damages, injury (including, without limitation, injury to or death of CONTRACTOR or of any subcontractor) costs and expenses of any kind, whether actual, alleged or threatened, including, without limitation, incidental and consequential damages, actual attorneys' fees incurred by CITY, court costs, interest, defense costs including fees of expert contractors or expert witnesses incurred in connection therewith and any other costs or expenses of any kind whatsoever incurred in relation to, as a consequence of, or arising out of or in any way attributable in whole or in part to the performance of this INSTRUCTOR AGREEMENT by CONTRACTOR or by any individual or entity for which CONTRACTOR is legally liable, including but not limited to agents or subcontractors of CONTRACTOR.. All obligations under this provision are to be paid by CONTRACTOR as CITY incurs them. Without affecting the rights of CITY under any provision of this INSTRUCTOR AGREEMENT, CONTRACTOR shall not be required to indemnify and hold harmless CITY for liability attributable to the active negligence of CITY, provided such active negligence is determined by contract between the parties or by the findings of a court of competent jurisdiction. In instances where CITY is shown to have been actively negligent and where CITY's active negligence accounts for only a percentage of the liability involved, the obligation of CONTRACTOR will be for that entire portion or percentage of liability not attributable to the active negligence of CITY. PROMPT NOTICE. CONTRACTOR agrees to provide immediate notice to CITY of any claim or loss against CONTRACTOR arising out of the work performed under this INSTRUCTOR AGREEMENT. CITY assumes no obligation or liability by such notice, but has the right (but not the duty) to Rev May 2016 2 monitor the handling of any such claim or claims if they are likely to involve CITY. 5. CANCELLATIONS/CHANGES. CITY RESPONSIBILITY. CITY will contact CONTRACTOR and all program participants if CITY cancels or changes a program from original approved schedule based on zero enrollments, minimum student requirement not met, or if use of facility becomes unavailable. CITY reserves the right to change original approved schedule of program if the facility becomes unavailable. CITY will attempt to re -locate said program to another suitable facility if one is available. If there are no available facilities, CITY will cancel said progrgm and coordinate with CONTRACTOR to schedule a make-up date. (initials) CONTRACTOR RESPONSIBILITY. CONTRACTOR will contact CITY as defined in the NOTICE section in advance to notify of any cancellations or changes from original approved schedule if said program is cancelled or changed by CONTRACTOR. CONTRACTOR will be solely responsible to contact any and all participants of the program. Programs that are cancelled or changed by CONTRACTOR must be made up in a timely manner as approved by CITY. (initials) 6. INSURANCE. It is to be understood that CONTRACTOR is working under a contractual obligation as specified in this INSTRUCTOR AGREEMENT and is responsible as a self-employed person to remit any Federal or State Income Taxes, and to provide for his/her own Worker's Compensation, Disability Insurance, Unemployment Insurance coverage, Social Security, Liability Insurance and other such coverage, as applicable, in the amounts and under the conditions as set forth below. A. Commercial General Liability Insurance using Insurance Services Office "Commercial General Liability" policy form CG 00 01, with an edition date prior to 2004, or the exact equivalent. Coverage for an additional insured shall not be limited to its vicarious liability. Defense costs must be paid in addition to limits. Limits shall be no less than $1,000,000 per occurrence for all covered losses and no less than $2,000,000 general aggregate. B. Vendor shall procure and maintain Sexual Abuse/Molestation Liability coverage with limits of not less than $100,000 per occurrence and $300,000 general aggregate. Coverage may be provided as part of Commercial General Liability coverage, Professional Liability coverage, or as a separate policy. Rev May 2016 6.1 CONTRACTOR agrees to provide evidence of the insurance required herein, satisfactory to CITY, consisting of: (a) certificate(s) of insurance evidencing all of the coverages required and, (b) an additional insured endorsement to CONTRACTOR's Commercial general liability policy using ISO Form CG 20 10 with an edition date prior to 1988, which form shall include coverage for completed operations. The additional insured endorsement shall expressly name CITY, its officers, and employees as additional insureds on the policy (ies) as to commercial general liability coverages, and completed operations coverages, with respect to liabilities arising out of CONTRACTOR's performance of the services under this INSTRUCTOR AGREEMENT. 6.2 CONTRACTOR shall provide written notice to CITY within ten (10) working days if. (1) any of the required insurance policies is terminated; (2) the limits of any of the required polices are reduced; or (3) the deductible or self -insured retention is increased. In the event any of said policies of insurance are cancelled, CONTRACTOR shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 6 to CITY. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of CONTRACTOR's obligation to indemnify CITY, its officers, employees, contractors, subcontractors, or agents. 7. BUSINESS LICENSE. CONTRACTOR will be required to obtain a City of La Quinta Business License within thirty (30) calendar days of this signed INSTRUCTOR AGREEMENT. A copy of the current La Quinta Business License must be provided to the Community Services Department within five (5) business days of receipt. 8. COMPLIANCE WITH LAW. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations, and laws of CITY and any Federal, State, or local government agency of competent jurisdiction. 9. COVENANT AGAINST DISCRIMINATION. CONTRACTOR covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, disability, or ancestry in the performance of this INSTRUCTOR AGREEMENT. 10. NO ASSIGNMENT, CONTRACTOR shall not, under any circumstances, assign this INSTRUCTOR AGREEMENT or its rights or duties without prior written authorization from CITY. Should such authorization be granted, CONTRACTOR agrees to inform qny subcontractor of all the stipulations of this INSTRUCTOR AGREEMENT. Y (initials) Rev May 2016 4 Please list any/all subcontractors you may hire for the term of this INSTRUCTOR AGREEMENT. Subcontractors listed above have been approved by CITY to perform the scope of work, as provided in Section 1. Additional subcontractors will require prior written approval from CITY. 11. TERMINATION. It is understood that CONTRACTOR will perform all services set forth herein in a good and workable manner. CITY reserves the right to terminate services for any reason, including, but not limited to, insufficient number of participants or unavailability of facilities. In such circumstances, CITY shall not be liable for compensation or damages to CONTRACTOR for remainder of this INSTRUCTOR AGREEMENT. 12. NOTICE.. Notice shall be deemed given when CONTRACTOR contacts CITY COMMUNITY SERVICES COORDINATOR or COMMUNITY SERVICES SUPERVISOR in person, via telephone call, email, faxed with a fax return, or seventy-two (72) hours after deposit in the United States mail postage prepaid, return receipt requested, addressed as follows: CONTRACTOR: Lori Farkas 78697 Torino Drive La Quinta, CA 92253 CITY: Community Resources Department City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 (,J (initials) 13. DOCUMENTS. Any documents and marketing materials created by CONTRACTOR under this INSTRUCTOR AGREEMENT shall be submitted to CITY for approval prior to distribution. 14. MISCELLANEOUS. This INSTRUCTOR AGREEMENT is the only agreement between CONTRACTOR and CITY and may be amended in writing and agreed upon by both parties. No waiver of any term or condition of this INSTRUCTOR AGREEMENT shall be a continuing waiver thereof. Rev May 2016 5 r� �6 � �/j I IN WITNESS WHEREOF, the parties hereto have caused this INSTRUCTOR AGREEMENT to be executed the day and year as first stated above. CITY OF LA QUINTA, Lori Farkas COMMUNITY RESOURCES DEPARTMENT ("CONTRACTOR") ("CITY") APPRO ED•" By: Chris edo Community Resources Director COUN By: I I UJJTE�z Chri no Calderon, Community & Wellness Supervisor Rev May 2016 ms APPROVED - By: Signd't6re 78697 Tornio Drive La Quinta, CA 92253 562.277.4648