2018-19 Barsaleau, Mary (Instructor) - Pickle Ball Tournamentta Qa,�fra
— GP.,1 of;iw DESERT —
MEMORANDUM
TO: Christina T. Calderon, Community Resources Manager
FROM: Caroline Doran, Community Resources Specialist
DATE: October 22, 2018
RE: Mary Barsaleau, Pickle Ball Tournament, #AGR430601-18
Attached for your signature is an agreement with Independent Contracted Instructor Mary
Barsaleau for (Pickleball) tournament. Compensation is based on class attendance with a
70% portion of fees to instructor and 30% portion of fees to City of Lo Quinta.
Please sign the attached agreement(s) and return to the City Clerk for processing and
distribution.
Requesting department shall check and attach the items beloFw as a ro riate:
X Contract payments will be charged to account number: 101-6000-42214
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:
X Approved by the City Council on
X Dept. Manager's signature authority provided under Resolution No. 2018-014 for budgeted expenditures
of $5,000.
N/A Initial to certify that 3 written informal bids or proposals were received and considered in selection
The -following re uired documents are attached to theagreement:
X Insurance certificates as required by the agreement (approved by Risk Manager on.1 4 date)
N/A Performance bonds as required by the agreement (originals) �S
X City of La Quinta Business License Number License - 766739 Expires 9/30/2019
N/A A requisition for a Purchase Order has been prepared (amounts over $5,000)
N/A A copy of this Cover Memo has been emailed to Finance
Revised May 2017
City La Q of uinta
Community Services Department
Contract # 430601-18
INSTRUCTOR AGREEMENT
This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2018 through
TUNE 30, 2019 between the CITY OF LA QUINTA, COMMUNITY RESOURCES
DEPARTMENT (-CITY") and MARY BARSALEAU 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: Pickleball
Tournament 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 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 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
approve3d 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
Rev May 2015 1
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. P" & (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. The insurance policy shall contain a
severability of interest clause providing that the coverage shall be primary for
losses arising out of Contracting Party's performance hereunder and neither
City nor its insurers shall be required to contribute to any such loss. 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. Instructor shall obtain policy endorsement on Commercial General
Liability Insurance that name Additional Insureds as follows: The City of La
Quinta, its officers, officials, employees and agents.
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 and, 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
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
CERTIFICATE OF LIABILITY INSURANCE
DAr10/ 2018""l
,A��R�'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS
Coastal Plains Insurance, LLC
CERTIFICATE DOES NOT AMEND, EXTEND
OR ALTER THE
P.O. Box 6869
COVERAGE AFFORDED BY THE POLICIES BELOW.
Hilton Head Island, SC 29928
INSURERS AFFORDING COVERAGE
NAIC #
Erica James, AINS — (843)785-7733 ext 252 — Erica@Cctat;talplains-gale
INSURED
INSURER A: Philadelphia Indemnity Insurance Co.
18058
1
INSURER B:
Professional Tennis Registry
INSURER C:
Professional Pickleball Registry
P.O. Box 4739
INSURER D:
Hilton Head Island, SC 29938
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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSA
LTR
ADD'L
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
A
®
GENERAL LIABILITY
PHPK1868098
9/1/2018
9/1/2019
EACH OCCURENCE
$1,000,000
DAMAGE TO RENTED
$100,000
COMMERICAL GENERAL LIABILITY
❑❑ CLAIMS MADE ® OCCUR
PREMISES Ea occurrence
MED EXP (Any one person)
$
❑
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$3,000,000
® POLICY ❑ PROJECT ❑ LOC
$
❑
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
❑ ANY AUTO
(Each Occurrence)
❑ ALL OWNED AUTOS
BODILY INJURY
❑ SCHEDULED AUTOS
(Per person)
$
❑ HIRED AUTOS
BODILY INJURY
❑ NON -OWNED AUTOS
(Per acddenl)
$
PROPERTY DAMAGE
$
❑❑
(Per acddenl)
®EXCESS/UMBRELLA
LIABILITY
PHUB643653
9/1/2018 9/1/2019
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
® OCCUR ❑ CLAIMS MADE
❑ DEDUCTIBLE
® RETENTION $10.1101)
$
WORKERS COMPENSATION AND
❑ OT
❑ WC
❑
EMPLOYERS' LIABILITY
ORY LIMITS
E.L EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECU-
TIVE OFFICER/MEMBER EXCLUDED?
E.L DISEASE -EA EMPLOYEE
$
If yes, describe under
SPECIAL PROVISIONS below
E L DISEASE -POLICY LIMIT
—
$
❑
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
73891 - Certificate Holder is listed as Additional Insured # 460 with respects to PTR Member# 73891, Mary Barsaleau 36068 Avenida De
La Montanas Cathedral City, CA 92234
�ya:r�lyly_rr�;I•I�•�a: rlt►ly�1�_t�s.•�.
City of La Quinta
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
78495 Calle Tampico La Quinta, CA 92253
EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO
MAIL _ 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 (2001108) (9) ACORD CORPORATION 1988
POLICY NUMBER: PHPK1688738
COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
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
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 0 Insurance Services Office, Inc., 2012
PI-GL-005 (07/12)
!HIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Effective Date: 09/01/2018
Name of Person or Organization (Additional Insured):
'City of La Quinta
SECTION 11— WHO I5 AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown In the endorsement Schedule, but only with respect to Lability, for "bodily Injury,`
"property damage" er'personal and advertising injury" arising out of or relating to your negligence In the
performance of "your work" for such parsons) or a rga nizatio n (s) that occurs on or after the effective date
shown In the endorsement Schedule.
This Insurance is pdrnary to and non-contributory with,any other insurance maintained by the person or
organization (Additional Insured), except for loss resulting from the sole negligence of that person or
organization.
This condition applies even if other valid and collectible Insurance Is available to the Additional Insured
For a loss or "occurrence' we cover for this Additional Insured.
The Additional Insured's limits of insurance do not increase our limits of Insurance, as described in
SECTION III — LIMITS OF INSURANCE.
All other terms, conditions, and exclusions under the policy are applicable to this endorsement and
remain unchanged.
Page 4 of 4
Includes copyrighted material of Insurance Services Office, Inc., with Its permission.
BUSINESS LICENSE
CERTIFICATE
ICON -TRANSFERABLE
BUSINESS LOCATION
OUTSIDE CITY LIMITS
II ° 1 � s�
IQ�-
aca
. -
-
GEM ofebe DESEU — —
78-495 Calle Tampico La Quinta, California 92253
--.. (760) 777-7000
Dear susioiessOwner.
��jlt�41 H dll�.
BUSINESS NAME: BARSALEAU, II
MAILING ADDRESS: 36068 AVENIDA LOS MONTANAS
CATHEDRAL CITY, CA 92234
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 building or tenant space that has not been approved for occupancy
by the Design and aevelopmentotRartment. If you have any questions regar..ding this
issue, or'sf y-ou j e not sure if_a defftificate of Occupancy has been issued for your:place
of 13usinee5sitiease contact-JDAr and Development at (750)777-7000:
The Licensee namdd herpR having paid to the City of La Qufnta 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 from licensing by the
State of California -
BUSINESS LIC:NO- UC-766739
E
CLASSIFICATION: HOSTING PICKLEBALL EVENTS.
EXPIRATION DATE: 9/30/2019