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Angela Raykowski-2007-11 Community Services Department (AIIF0RHIA CITY OF GRAND TERRACE i RECREATION SERVICES AGREEMENT i This Agreement is made between the City of Grand Terrace(herein referred to as the"City") and Angela Raykowski (herein referred to as"INSTRUCTOR")for personal services rendered to the City as a skilled sports instructor. f 1. The INSTRUCTOR is working as an independent contractor and is responsible! s a self- employed person to remit any federal or state taxes, and to provide for his/her own Workers' Compensation, Unemployment Insurance coverage, Social Security, Liability, and other such coverage. Evidence of liability insurance shall be filed with the Community Services Department prior to use of City Facilities. 2. INSTRUCTOR agrees to instruct classes in: see_ attachment according to the following schedule: see attachment. 3. All registration forms and class fees are to be collected by the INSTRUCTOR u 1 less otherwise arranged for off-site classes. INSTRUCTOR shall maintain accurate attendance records at all times. INSTRUCTOR'S total compensation for services rendered under this agreement shall be the e4uivalent of seventy-percent(70%) total fees received. The remaining thirty-percent(30%)shall be paid to the City of Grand Terrace to offset administrative costs, secretarial services, and facilities maintenance. 4. INSTRUCTOR is responsible for all expenses of instruction including substitute'teachers and assistance, instructional supplies and materials, publicity, and transportation. Student's supplies shall be the responsibility of each student. In the event INSTRUCTOR is unable to teach class due to illness, or any emergency, the following procedure shall be adhered to: A. INSTRUCTOR shall procure a substitute teacher, equally or better qualified to -instruct class at the prescribed time and place. B. INSTRUCTOR shall then notify the City of the person's name, qualifications, address, and phone number prior to the start of class. Any payment for the substitute shall be arranged between he/she and the INSTRUCTOR_ and it shall be INSTRUCTOR'S.responsibility to issue payment. C. If a substitute cannot be procured on short notice, class will be cancelled and an additional class will be added or student-will be given a credit or refund' INSTRUCTOR shall be responsible for notifying the students and the Community Services Department of the cancellation. JI 5. INSTRUCTOR hereby agrees to hold the City of Grand Terrace and their officers, employees, and agents free, clear, and harmless from any and all claims, damages, or litigation arising out of INSTRUCTOR'S performance of this Agreement. { 22795 Barton Road• Grand Terrace, California 92313-5295 • (909) 430-2201 fax(909) 783-2600 www.cityofgrandterrace.org - i 6. This Agreement is subject to cancellation at any time by either party submitting a 30-day written notification of such cancellation. I hereby certify that I have read, understand, and agree to the above provisions, and to the"Rules and Regulations for the Use of City Facilities", which are printed on the reverse side of this agreement and which are incorporated herein by reference as though fully set forth herein. i INSTRUCTOR'S NAME ' �Y�OVJ5�� PHONE#_ r � ADDRESS o`�a$D$ `/i^ e►CITY� —,efface ZIP INSTRUCTOR'S SIGNATURE DATE APPROVED BY DATE JP SISTAflT TY MANAGER i INSURANCE POLICE# POLICY EXPIRATION DATE O �© —0[ NAME OF INSURANCE COMPANY tllyneS Q.j WdntSS &fyiC V Anj PHONE#���J Jq 5 90 -?s pkl k�Je_'[��lf i Mail complete form to: Community Services City of Grand Terrace O' � 22795 Barton Rd aff Verificati n of Insurance Grand Terrace, CA 92313 Certificate I I I RULES AND REGULATIONS FOR USE OF CITY FACILITIES 1. INSTRUCTOR agrees to use the City of Grand Terrace facilities on an"as-is"basis and INSTRUCTOR shall indemnify and hold harmless the City of Grand Terrace, and their officers, employees, and agents, from and against any and all claims, demandsi, losses, legal and investigation expenses, or liability of any kind of nature which the City or their officers, employees, and agents may sustain or incur, or which may be alleged as to them, or imposed upon them for any alleged injury to, or death of persons, or damage to property as the result of, or arising out of, or in any manner connected with this Agreement, the providing of instruction pursuant to the Agreement, or with the occupancy and use of the premises and facilities by INSTRUCTOR, his/her officers, employees, agents, concessionaires, patrons, or visitors, except liability arising out of the sole negligence of the City. 2. INSTRUCTOR shall maintain comprehensive general liability insurance, if required, naming the City of Grand Terrace and their officers, employees, and agents as i additionally insured, covering all activities associated with the use of City facilities in the amount of$1,000,000. *ALL INSTRUCTOR'S shall obtain a City business license. 3. INSTRUCTOR shall provide City, as part of this agreement, an original Certific Ition of insurance evidencing coverage required by this agreement. The Certificate of Insurance must be received in the City office two(2)weeks prior to the first day of class. Insurance coverage must cover all assistants or substitutes. The procuring of such required policy or policies of insurance shall not be construed to limit INSTRUCTOR'S liability not to fulfill indemnification provisions and requirements of this agreement. The liability insurance policy required by this agreement shall contain the following clause: I A. All rights of subrogation are hereby waived against the City of Grand Terrace, City Council, and elective or appointed officers or employees when acting within the scope of their employment or appointment." B. "It is agreed that any insurance maintained by the City of Grand Terrace will apply in excess of, and not contribute with, insurance provided by this policy." C. "The above described policies will not be cancelled, limited or non-renewed until after(30)days written notice has been given to the Assistant City Manger of Grand Terrace." 4. It is the responsibility of the INSTRUCTOR to provide evidence of this insurance before new classes begin or current ones continue. A copy of the insurance must be submitted with the original contract prior to approval. Classes will be cancelled if the contractor fails to,show an up-to-date certificate of insurance. 5. Classes shall not be held on City recognized holidays without prior permission. Make-up classes are to be added to the end of the session when regular classes are not held due to a holiday or other interruption if scheduling does not interfere with existing programs. Alternative is to refund fees for the class or credit to next session. The city has priority for all facilities for special programs. Notification will be given prior to contracted quarter. 6. INSTRUCTOR shall pay a$50.00 key deposit for the use of the City Facilities if requested by City staff. E 7. In the event INSTRUCTOR will be late to a class due to emergency, INSTRUCTOR shall notify the Community Services Office. 8. INSTRUCTOR must begin and end classes promptly according to the time agreed upon in the contract. A fifteen minute shared transition period is allowed before and after classes. Failure to abide by agreement may result in cancellation or non-renewal of Agreement. i 9. INSTRUCTOR must submit any promotions, publicity, or written material for classes to park administrative staff for approval at least ten (10) days prior to use of such. I 10. Classes may be cancelled if they consistently fall below the minimum agreed number of students. I i 11. INSTRUCTOR is responsible for setting up and taking down equipment necessary for classes, including but not limited to, tables, chairs, exercise mat, or exercise platform. Room must be cleared and returned to the original condition it was found in. 1 12. Distribution and/or sales of personal or professional items is NOT permitted without permit or written permission. 13. Storage of equipment is NOT allowed unless previous arrangements_have been made with Community Services'staff. ' If INSTRUCTOR is unable to obtain required insurance, City will obtain, with the premium being deducted from INSTRUCTOR'S percentage. SPECIAL PROVISIONS: f I I I Agreement/A. Raykowski CITY OF GRAND TERRACE RECREATION SERVICES AGREEMENT SCHEDULE INSTRUCTOR agrees to instruct a class in l® o, lEfLne-ss according to the following schedule: (N me of class) A. Beginning Date (S1—/ D - Ending Date1'nxt 1V�'CI (;C a _(� Day(s) MYA A 0.w e KCe(�+� (end �r Dr ►`1�(3Yl` Facility rune li°rYr�� ' �nl►1ui�l►-tv>Co�►'VL- i i I a Attachment i i �ee,ceKu CERTIFICATE OF LIABILITY INSURANCE I UHI C(MIVrrUU171711 TM. o5r23r2oo7 PRODUCER Phone: (800)396-8075 Fex: (858)519-0822 THIS CERTIFICATE IS ISSUED AS A MATTER OF FITNESS AND 380 STEVENS AVENUE, INFORMATION SUITE 206 I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ISOLANA BEACH CA 92075 I INaI.IKEKSAFI•UKUIIVGCOVERAGE NAIL;If I Aaency Licti.17377645 INSURED INSURER A: Philadelphia Indemnity Insurance Com oan DRAGONFLY STUDIOS INSURER B: C/O ANGELA RAYKOWSKI I 22808 MIRIAM WAY 1114OURER C. GRAND TERRACE CA 92313 INSURER D: Mold loco o• COVERAGES THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO THE INSURED NAMED AEOVE FOR THE PO-ICY PERIOD INDICATED. NOTWITHSTANDING FLICIES. Y KtUUIHtMtNI, I tHM OH CONDI I ION Ur ANY CON I RAC I OK U I HtK DOCUMt(V i WITH HtSHtC I I U WHICH I H15 CtK I Ih ICAI t MAY Lit ISSUtU OR Y PERTAIN, TIME INSLPAIJCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTI-IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH AS:- EGATE_WITS SHOOIN NIAY HAVE BEEN RECUCED BY PAID CLAIMS. setlSR Iwut I TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECr1YE I POLICY E%PIPATIOR I LIMITS LTP. INSRD DATE(1d=:-D DATE IYR7'D GENERAL LIABILITY PHPK215316 1 08101/07 06/01108 EACH OCCURRENCE 2,000,000 A COMMERCIAL GENERAL LIABILITY FrMISES(Ea o:curence) $ 100,000 I - I ,�CLAIMS MADE a OCCUR. I MED EJ(F(Any one person, Is 2 500 I q I I rrno0—&-w 1. R ,I. $ L UUU UUU GENERALAGGR=GATE Is 4,000,000 ®rPhPl Ar_-r REGA-F I IAAIT ADD]IFC DF7 niY�L V.T• `As.i ie ll ni•i w A POLICY PRO- n [7LOC I •+VVV VVV I Al ITOMORII F LIARn rrV Llfl l I LEa accident) UU'A',VCU OIIJULC ANY ALL O`N�NED AUTOS I I BODILY INJURY $ I I SCHEDULED AUTOS I I(Per person) I$ I HIRED AUTOS annu v Iu a IDy II NON-OVVNEDAUTOS I I (Per accident) I$ ' (Per,acciderd)A GARAGE LIABILITY AUf 0 ONLY-ER ACCIDENT $ I I ANYNJTO I CTHERTRAJN EA ACC �$ AUTO ONLY- AGG is I EXCEUMBRELLALIABILITY LAIM S MALE I AGGREGATE FENCE OCC ❑ $$ m I I Is RFTFFRI N 3 I I WORKERS COMPENSATION AND WC sy AP OT.1En EMPLOYERS'LIABILITY rory LIMm F L �xr_.FI Arr.InFnrT a 1ANY PROPRIETDRIPARTNER'ExE[DTNE -' orrICENtlEPAGER EXCLUDEW E.L.DISEASE-EA EMPLOYEE $ If yes,describe under WHIA1 PRUVI1;IOR4 bPI— E.L.DISEASE-POLICY LIMIT $ OTHER: DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS It is understood and agreed that the following entity is added as an additional insured but only as respects the operations of the named ir>1Sured except that liability resulting from the additional insureds sole negligence. I Arirlitinnel Insrirerl Fneinrsemcnt is Effective:45121/07 I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORETHE I tAPIWU IJV DAIL IH=HtUh, IHt I5'6UlNU :N:,'UH=H WILL tNDtAVUH IU 1W.IL 1U DAYS WRITTEN NOTICE TO THE CERTIFICATE [-OLDER "AED TO THE LEFT,BLF The City of Grand Terrace FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 22795 Barton Road inicr loco m nr_�nr r,r FrooFcFn rnr;rrc IGrand Terrace CA 92313-5295 AUTHORI717D PFPRFSFNTATIVF AC Attention: I Jeffrey E. Frick, CEO I ACORD 25(2001108) Certificate# 67261 U ACORD CORPORATION 1988 I