2023-24 Bilhartz Desert Insurance - Medicare Presentations Volunteer OrgMEMORANDUM,
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DATE: March 31,2023--------
TO: Christina Calderon, Community Resources Manager
FROM: Caroline Doran, Community Resources Specialist
RE: Brian Bilhartz Desert Insurance Agency - Volunteer Agreement for Free Medicare Insurance
Information and Medicare Insurance Presentations at the La Quinta Wellness Center.
Please list the Contracting Party / Vendor Name, type of agreement to be executed, including any change orders or
amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name.
Authority to execute this agreement is based upon:
Approved by City Council on
QCity Manager's signing authority provided under the City's Purchasing Policy
[Resolution No. 2019-021] for budget expenditures of $50,000 or less.
�✓ Department Director's or Manager's signing authority provided under the City's
Purchasing Policy [Resolution No. 2019-021] for budget expenditures of $15,000 and
$5,000, respectively, or less.
Procurement Method (one must apply):
E2 Bid R RFP F-1 RFQ F-1 3 written informal bids
P1Sole Source F-1 Select Source 1-1 Cooperative Procurement
Reauestina department shall check and attach the items below as auurouriate:
QAgreement payment will be charged to Account No.: -0-
✓Q Agreement term: Start Date 3-20-2023 End Date 3-20-2024
Amount of Agreement, Amendment, Change Order, etc.: $ -0-
REMINDER. Signing authorities listed above are applicable on the aggregate Agreement amount,
not individual Amendments or Change Orders!
L Insurance certificates as required by the Agreement for Risk Manager approval
NOTE:
a
Approved by:
Date:
Bonds (originals) as required by the Agreement (Performance, Payment, etc.)
Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s)
Review the "Form 700 Disclosure for Consultants" guidance to determine if a Form
required pursuant FPPC regulation 18701(2)
Business License No. 770941 Expires: 3/31 /2024
Requisition for a Purchase Order has been prepared (Agreements over $5,000)
700 is
VOLUNTEER ORGANIZATION
SERVICE AGREEMENT
Our organization, Bilhartz Desert Insurance Agency, will provide volunteers to perform
only the services as outlined in the attached scope of work for the City of La Quinta
("City"). We understand that we will not be compensated for our work and we will
complete our organization volunteer duties in a responsible manner. If we decide to
discontinue our organization volunteer services, our contact person
Adam Leb will notify Caroline Doran, City designee.
We understand and agree that:
• No one in the group is to appear for volunteer service under the influence
of any drugs or alcohol.
• Our organization will provide the City with a roster of individual participants
including the names and hours worked.
• Our organization will report any injuries sustained by participants during
their volunteer activities to Caroline Doran, City designee immediately upon
occurrence.
• Our organization is responsible for directly supervising the activities of all the
individuals in our group who will be doing volunteer work, and therefore, in
consideration of our organization and members being permitted to perform
services on City property, our organization agrees to defend, indemnify, and
hold harmless the City and its officials, employees, and agents from any
damage claim or lawsuit for injury, illness, (including exposure to
communicable diseases, illnesses, or viruses), damage or other loss of any
kind to anyone including members of our organization that might arise out of
our activities or the actions of any individuals of our group, except for injuries
or damages caused by the sole negligence of the City.
• Our organization has commercial general liability insurance of at least $1M
per occurrence / $2M general aggregate to cover our activities. A copy of the
certificate of insurance, the additional insured endorsement, naming the City
as an "additional insured" is attached.
• The City may terminate this agreement at any time without cause, and we
agree that we are volunteering our services at will and may be asked to
discontinue such without prior notice or reason.
This agreement will be in effect for the duration of our volunteer services or one year,
whichever is less, beginning on this date.
Dated this 20 day of March , 20 23 .
Paqe 1 of 2
CITY OF LA QUINTA,
a California Municipal Corporation
CHRISTINA CALDE N,
Community Resources Manager
City of La Quinta, California
Dated:
ATTEST:
f
MONIKA RADEV , Ci Jerk
La Quinta, California
APPROVED AS TO FORM:
/j,
WILLIAM IHRKE, City Attorney
City of La Quinta, California
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CALIFORNIA
Bilhartz Desert Insurance Agen
Name of Organization
Authorized Signature on behalf of
Organization
Brian Bilhartz
Printed Name
Owner
Title
41865 Boardwalk Ste 108
Palm Desert. 92211
Address
Brian@BilhartzInsurance.com
Email Address
760-459-9617
Phone Number
Paqe 2 of 2
SCOPE OF WORK
Bilhartz Desert Insurance Agency will be offering information (Look Who's in the Lobby
information table) and Medicare presentations.
Date/Times:
Dates and times to be agreed to by the agent/s representing Bilhartz Desert
Insurance agency and a Wellness Center staff member.
Location
The Wellness Center lobby
Wellness Center Art & Leisure Room
(Wellness Center Staff will set up tables and tear down tables)