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2019-20 Capri, Maria (Instructor) - Zumba Classesta Qa�fra - GEJ1 Jthr DESERT - MEMORANDUM TO: Christina T. Calderon, Community Resources Manager FROM: Luis Magallanez, Community Resources Coordinator DATE: February 7, 2020 RE: Maria Capri, Fitness #AGR424202-2020, Instructor Attached for your signature is an agreement with independent contracted instructor Mari Capri for (Zumba and Dance Fusion) classes. Please sign the attached agreement(s) and return to the City Clerk for processing and distribution. Reguesting department shall check and attach h ilms below as aawrODriate X Contract payments will be charged to account number: 101-0000-42214 X Amount of Agreement, Amendment, Change Order, etc.: 70% of fees 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 Manager's authority provided under Resolution No. 2019-021 for budgeted expenditures of $5,000 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 c iFicates as required by the agreement (approved by Risk Manager on dart") N/A Performance bonds as required by the agreement (originals) X City of La Quinta Business License number: LIC-768571 EXPIRES 1/31/2021 N/A A requisition for a Purchase Order has been prepared (amounts over $5,000) X A copy of this Cover Memo has been emaiied to Finance tevQaiAreu City La Q of uinta --GERM J'rheDLSL'RT— Community Services Department Contract # 424202-19 INSTRUCTOR AGREEMENT This INSTRUCTOR AGREEMENT is hereby formed on JULY 1, 2019 through JUNE 30, 2020 between the CITY OF LA QUINTA, COMMUNITY RESOURCES DEPARTMENT ("CITY") and INSTRUCTOR NAME, 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: Zumba & Dance Fusion/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 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 approve3d annual payroll calendar. 3. INDEPENDENT rONTRACTOR. 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 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 prggram 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. M(�_ (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) certificdte(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, or agents. 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") APPR ED: 1 = By: ` RISTINA CALDERON Community Resources Manager Required for over $S,000: By: CHRIS ESCOBEDO Community Resources Director Rev May 2015 Maria Capri (-CONTRACTOR") APPROVED: o By: 79050 Shadow Trail La Quinta, CA 92253 760.777.0472 CERTIFICATE OF LIABILITY INSURANCE DATE02/05/2020/2020IYYYY) 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 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 Next First Insurance Agency, Inc PHONE (855) 222-5919 F.ix PO Box 60787 IAX. Ne, Exl}; Palo Alto, CA 94306 E-MAIL ADOMS! suGm ort re next -in pP tNSURER(SkAFFORl11NA'3-CGYEt6pGE NAIC q INSURER A: State National Insurance Company, Inc 12831 INSURED Maria Capri Maria Capri INSURERS: INSURER C : INSURER D : 79050 Shadow Trl La Quints, CA 92253 INSURER E: COVERAGES CFRTIFICATF NIIMRFR- 5965209 RFVICI(1NI MI IMRPR- 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 RODL 5u9H POL:GY EFF I POLICY Elt1+ LTR TYPE OF INSURANCE POLICYNUMBER 1,1Nlt1DfYYYY MM," LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 51,000,000.00 CLAIMS -MADE X OCCUR _ AME-70PSWED PREMISES_{Fa qpc& enca $100.000.00 _ MED EXP (Any oneperson) E10,000.00 A X NXT2W7THPS-OD-GL 02/06/2020 02/06/2021 PERSONAL 8 ADV INJURY $1,000.000 00 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000.00 X POLICY JEC _ LOC PRODUCTS -COMP/OPAGG $1.000,000.00 S OTHER AUTOMOBILE AUTOMOBILE LIABILITY COM84NW INOLE LIMIT . {El ipGdarl) 5 $ ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED I NON -OWNED ONLY 1 AUTOS ONLY Y QA11Y1M1G PROPERTE [PeraCbdent) _ $ S f UMBRELLALIAB OCCUR EACHOCCURRENCE S AGGREGATE S EXCESS LU1B CLAIMS -MADE DED f RETENTION S S COMPENSATION PER +IWORKERS AND EMPLOYERS' LIABILITY Y f N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? ❑ NIA TAT T ER E L EACH ACCIDENT S E L DISEASE - EA EMPLOYEE $ (Mandataryto NH) If yes, descnbe under . DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of La Quints is an Additional Insured on the General Liability policy, on a primary and non-contributory basis if required by written agreement with the insured, CERTIFICATE HOLDER CANCELLATION City of La Quints 78495 Celle Tampico Le Quints, 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. A. Such person or organization is an additional insured 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 with respect to: a. Premises you own, rent, lease, or occupy; or b. Your ongoing operations performed for that insured. B. The insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. C. The Limits of Insurance applicable to the additional insured are the lesser of those specified in: 1. The written contractor agreement; or 2. The Declarations for this policy, whichever is less. Such are included in, and not in addition to, the Limits of Insurance shown in the Declarations. D. Any coverage provided to an additional insured under this endorsement shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a written contract or agreement specifically requires that this insurance be primary in which case any other insurance available to the additional insured shall be considered excess and non-contributory. All other terms and conditions of the policy remain unchanged. NXT-0308 BM GL 0218 Includes material copyrighted by Insurance Services Office, Inc. used with its Page 1 of 1 permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 01 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE NXT2W7THPS-00-GL 02/06/2020 State National Insurance Company, Inc. NAMED INSURED AUTHORIZED REPRESENTATIVE Maria Capri 79050 Shadow Trl Ann Ryan La Quinta, CA 92253 COVERAGE PARTS AFFECTED Commercial General Liability Coverage Part CHANGES SEE ATTACHED SCHEDULE Additional Total $0.00 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 2 ❑ Copyright, ISO Commercial Risk Services, Inc., 1983 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ADDITIONAL INSURED - PRIMARY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person or Organization: City of La Quinta 78495 Calle Tampico La Quinta, CA 92253 SECTION II - WHO IS AN INSURED is amended to include the person or organization 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. 11. 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. III. Coverage provided to the additional insured shown in the SCHEDULE is afforded on i) a primary basis, ii) a noncontributory basis, or iii) a primary and noncontributory basis in accordance with the applicable written contract between you and the additional insured. All other terms and conditions of the policy remain unchanged NXT-0084 BM GL 0218 Includes material copyrighted by Insurance Services Office, Inc. used with its Page 1 of 1 permission