HomeMy WebLinkAbout2004-04-12 City CouncilTO:
City of Palo Alto
City Mana r’s Report
HONORABLE CITY COUNCIL
FROM: CITY MANAGER DEPARTMENT: COMMUNITY SERVICES
DATE:APRIL 12, 2004 CMR: 185:04
SUBJECT:APPROVAL OF A CONTRACT WITH SKYHAWKS SPORTS
ACADEMY FOR RECREATION YOUTH SPORTS CONTRACT
CAMPS
RECOMMENDATION
Staff reconv-nends that Council approve and authorize the Mayor to execute the attached
a~eement with Sk3,hawks Sports Academy, Inc. in the amount of $100,000 for FY ’04-’05,
toprovide revenue-producing youth sports camps on a contract basis, and to authorize the
City, Manager to renew the contract for up to two additional one-year terms in the mnount of
$ I00,000 per year.
BACKGROUND
The Recreation Division utilizes many contractors who provide a variety, of services and
programs for the community,. Fees for these programs are reviewed and approved by the
City, Council during each year’s budget process. Should registration for any of these
activities fall short of the minimum required enrollment, the activity, is canceled. Any fee
collected for a cancelled activity, is returned to registrants, with no payment to the
contractor. A processing fee is collected for cancelled registrations.
SkD’hawks Sports Academy provides and colnpensates instructors for a variety, of sports
camps conducted prilnarily during the surmner months of June, July and August. SkThawks
has provided sports camps on behalf of the City, for approximately 10 3;ears. Customer
evaluations have consistently rated Slcyhawks instructors and service from good to
excellent. Program participants in the Sl~hawks Sports Camps have exceeded !,000 per
year.
To ensure quali~ service and competitive pricing for the sulrnner of 2004, staff initiated a
request for proposals in November of 2003. Finns were given 21 days to respond to the
request. Staff also directly, contacted other vendors and encouraged them to respond.
S~hawks was the only vendor to respond. No other vendor was able to offer as wide a
variety; of camps with as much frequency as SkThawks.
CMR 185:04 Page 1 of 2
A vendor selection coirunittee consisting of staff from the Comlnunity Services and
Administrative Services Departments reviewed the proposal and determined it was
appropriate to award the contract to Skyhawks.
AI,TERNATIVES TO STAFF RECOMMENDATION
The only viable alternative is to conduct the pro~am with City staff. This would require an
undetermined amount of salaw and supply dollars to be added to the budget. This option
would not be as cost effective as a contractual an’angement for services such as those from
Skyhawks.
FISCAl. IMPACT
The contract will be in an amount not to exceed $100,000 per year. Funding for this
contract is included in the FY ’04-’05 Budget. Funding for the second and third years of the
contract would be included in the proposed budgets. Staff estimates that Skyhawks annually
generates $140,000 in revenue. Cost recover), is approximately 130 percent.
POI,ICY IMPI,ICATIONS
This report does not represent an?, change to existing City policies.
TIMEI,INE
If approved, the contract would be implemented July 1, 2004 and continue in effect through
June 30, 2007 should the City manager approve the contract for t-wo additional one-year
tenns.
ENVIRONMENTAl, REVIEW
Approval of the attached contract is not subject to the California Envirorunental Quality Act
(CEQA) under Section 15061 (b)(3) of the CEQA Guidelines.
ATTACHMENTS
Attacl-unent A:
PREPARED BY:
Contr,act with Skyhawks SpA~ts Academy
ERIC CHRISTENSEN
Supervisor
DEPARTMENT HEAD:
CITY MANAGER APPROVAL:
HARRISON
Assistant City Manager
CMR 185:04 Page 2 of 2
AGREEMENT
BY A!qD BETWEEN THE CITY OF PALO ALTO AND
SKYHAWKS SPORTS ACADMEY, INC.
FOR RECREATION YOUTH SPORTS CAMPS
THIS AGREEMENT is made and entered into this day of
, 2004, by and between the CITY OF PALO ALTO, a
municipal corporation of California, hereinafter referred to as
"CITY," and SKYHAWKS SPORTS ACADEMY, INC., a Washington
corporation, 12020 N. Mil! Road, Spokane, WA 99128 (Taxpayer
Identification Number 91-1549581), hereinafter referred to as
"CONTRACTOR"
W I T N E S S E T E:
WHEREAS, CITY desires to provide sports camps and
programs for children 4 to 14 years of age through CITY’S
Recreation Division; and
WHEREAS, CITY desires to engage CONTRACTOR to provide
these services by reason of its qualifications and experience for
performing such servicesl and CONTRACTOR has offered to provide the
required services on the terms and in the manner set forth herein;
NOW, THEREFORE, in consideration of their mutual
covenants, the parties hereto agree as follows:
SECTION 1 - PROJECT COORDINATION
l.l City
The City Manager shall be representative of CITY for all
purposes under this Agreement. ERIC CHRISTENSEN is designated as
the PROJECT MANAGER for the City Manager, and she shall supervise
the progress and execution of this Agreement.
1.2 Contractor
CONTRACTOR shall assign a single PROJECT DIRECTOR to have
overall responsibility for the progress and execution of this
Agreement for CONTRACTOR. PHIL CHAMPLIN, Business Manager is
hereby designated as the PROJECT DIRECTOR for CONTRACTOR. Should
circumstances or conditions subsequent to the execution of this
Agreement require a s~_bstitute PROJECT DIRECTOR for any reason, the
PROJECT DIRECTOR designee shall be subject to the prior written
approval of the PROJECT MANAGER.
//
040405 c17060784
SECTION 2 - DUTIES OF CONTRACTOR
2.1 Services to be Furnished
CONTRACTOR shall provide sports programs and camps for
children 4 through 14 years of age as requested by CITY and in
accordance with and on the terms and conditions set forth in
Exhibit "A", a copy of which is attached hereto and incorporated
herein.
2.2 Laws to be Observed
CONTRACTOR shal!:
2.2.1 Procure all permits and licenses, pay all
charges and fees, and give all notices which may be necessary and
incident to the due and lawful prosecution of the services to be
performed by CONTRACTOR under this Agreement.
2.2.2 Keep itself fully informed of all
existing and future federal, state, and local laws, ordinances,
regulations, orders, and decrees which may affect those engaged or
emp!oyed under this Agreement, any materials used in CONTRACTOR’s
performance under this Agreement, or the conduct of the services
under this Agreement.
2.2.3 At all times observe and comply with, and
cause all of its subcontractors and employees, if any, to observe
and comply with, all of said laws, ordinances, regulations, orders
and decrees mentioned above.
2.2.4 Immediately report to the PROJECT MANAGER
in writing any discrepancy or inconsistency it discovers in said
laws, ordinances, regulations, orders, and decrees mentioned above
in relation to any provisions of this Agreement.
SECTION 3 - COMPENSATION
For the full performance of the services described herein
by CONTRACTOR, CITY shall pay CONTRACTOR as follows:
3.1 For furnishing sports programs and camps to children
4 through 14 years of age, CONTRACTOR shall be paid in accordance
with the rate schedule attached as Exhibit "B" for each class or
camp registrant, not including refunds. Total compensation payable
under the terms of this agreement shall not exceed One Hundred
Thousand Dollars ($i00,000) per contract year.
3.2 CONT~hCTOR shall be paid no less often than monthly.
The amount payable to CONTRACTOR shall be computed by the number of
people who register for a particular program or camp, less the
040405 ct 7060784
number of people who cancel their registration within the class
cancellation period times the per registrant fee. Should
registration for any of the activities fall short of the minimum
required enrollment, the program or camp will be canceled. Any
fee collected for a cancelled program or camp will be returned to
registrant with no payment to CONTRACTOR.
3.3 All compensation payable hereundershall be subject
to the appropriation of funds by CITy’s Council for the applicable
fiscal year during which such services are to be or are rendered.
In the event funds are not appropriated for services to be rendered
in any fiscal year during the term of this Agreement, this
Agreement shall be deemed terminated at the end of the fiscal year
for which funds are appropriated. No penalty shal! accrue to CITY
in the event this Agreement is terminated pursuant to the
provisions of this Section 3.3, and CITY shal! not be liable for
any future payments due or for any damages as a result of the
termination of this Agreement pursuant hereto.
SECTION 4 - TERM
This Agreement shall be retroactive to July i, 2004 and
shall continue in ful! force and effect through June 30, 2005,
unless the Agreement is extended. City has the option but not the
obligation to extend this Agreement for two (2) additional one (i)
year terms.
SECTION 5 - SUSPENSION; TERMINATION
5.1 Temporary Suspension. The City Manager shall have
the authority to suspend this Agreement, wholly or in part, for
such period as he deems necessary due to unfavorable conditions or
due to the failure on the part of the CONTRACTOR to perform any
provision of this Agreement.-
5.2 Right to Suspend or Terminate
The City Manager may suspend or terminate this Agreement
for any reason by giving seven (7) days’ written notice to
CONTRACTOR. Upon receipt of such notice, CONTRACTOR shall
immediately discontinue his performance under this Agreement.
5.3 Payment
Upon such suspension or termination, CONTRACTOR shall be
paid for all services actually rendered to CITY to the date of such
suspension or termination; provided, however, if this Agreement is
suspended or terminated for fault of CONTRACTOR, CITY shal! be
obligated to compensate CONTRACTOR only for that portion of
CONTRACTOR’s services which are of benefit to CITY.
040405 c17060784
SECTION 6 - ASSIGNMENT; SUBCONTRACTORS; EMPLOYEES.
6.1 Assignment
This agreement shal! not be assigned or transferred
without the written consent of the CITY. No amendments, changes or
variations of any kind are authorized without the written consent
of the City Manager.
6.2 Subcontractors; E~oloyees
CONTRACTOR shall be responsible for employing or engaging
all persons necessary to perform the services of CONTRACTOR
hereunder. Prior to providing services under this Agreement,
CONTRACTOR will provide CITY with a written list of individuals it
intends to use to provide these services. CITY shall approve in
advance the use of any persons to provide service under this
Agreement. CONTRACTOR shall be responsible for the performance and
payment of any and all subcontractors utilized by CONTRACTOR in the
performance of this Agreement. CONTRACTOR shall give its persona!
attention to the fulfillment of the provisions of this Agreement by
all of its employees and subcontractors, if any, and shall keep the
work under its contro!. If any employee or subcontractor of
CONTRACTOR fails or refuses to carry out the provisions of this
Agreement or appears to be incompetent or to act in a disorderly or
improper manner, he or she shal! be dischar, ged immediately from the
work under this Agreement on demand of the PROJECT MANAGER.
SECTION 7 - NOTICES
All notices hereunder shall be given in writing and
mailed, postage prepaid, by certified mai!, addressed as follows:
To CITY:Office of the City Clerk
P.O. Box 10250
Palo Alto, CA 94303
To CONTRACTOR: Attention of the PROJECT DIRECTOR
at the address of CONTRACTOR recited
above
SECTION 8 -INTEREST OF CONTRACTOR
In accepting this Agreement, CONTRACTOR covenants that it
presently has no interest, and shall not acquire any interest,
direct or indirect, financial or otherwise, which would conflict in
any manner or degree with the performance of the services
hereunder. CONTRACTOR further covenants that, in the performance
of this Agreement, no subcontractor or person having such an
interest shall be employed. CONTRACTOR certifies that no one who
has or wil! have any financia! interest under this Agreement is an
040405 cl 7060784
4
officer or employee of CITY. It is expressly agreed that in the
performance of the professiona! services required under this
Agreement CONTRACTOR, and any of its subcontractors or employees,
shal! at al! times be considered independent contractors and not
agents or emp!oyees of CITY.
SECTION 9 - AUDITS
CONTRACTOR agrees to permit CITY to audit, at any
reasonable time, CONTRACTOR’s records pertaining to matters covered
by this agreement.
SECTION i0 - iNDEMnITY
CONTRACTOR agrees to indemnify, defend and hold harmless
CITY, its officers, agents and emp!oyees from any and al! demands,
claims, or liability of any nature, caused by or arising out of
CONTRACTOR’s, its officers’, agents’, subcontractors’ or employees’
nggligent acts, errors, or omissions, or willful misconduct, or
conduct for which the law imposes strict liability on CONTRACTOR in
the performance or failure to perform this Agreement.
SECTION ii - WORKERS’ COMPENSATION
CONTRACTOR, by executing this Agreement, certifies that
it is aware of the provisions Df the Labor Code of the State of
California which require every emp!oyer to be insured against
liability for workers’ compensation or to undertake self-insurance
in accordance with the provisions of that Code, and certifies that
it will comply with such provisions before commencing the
performance of the work of this Agreement.
SECTION 12 -INSURANCE
CONTRACTOR, at its sole cost and expense, shall obtain
and maintain in full force and effect throughout th~ entire term of
this Agreement the insurance coverage described in Exhibit "B",
insuring not only CONTRACTOR, but also (with the exception of
workers’ compensation and employer’s liability insurance), CITY,
its officers, agents, and employees, and each of them with respect
to activities and services performed by CONTRACTOR for or on behalf
of CITY under the provisions of this Agreement.
Certificates of such insurance, preferably on the forms
provided by CITY, shall be filed with CITY concurrently with the
execution of this Agreement or, with CITY’s approval, within ten
(i0) working days thereafter. Said certificates shal! be subject
to the approval of the City Attorney and shall contain an
endorsement stating that said insurance is primary coverage and
will not be canceled or altered by the insurer except after filing
with the City Clerk thirty (30) days’ written notice of such
040405 c17060784
cancellation or alteration, and that the City of Palo Alto is named
as an additional insured (except on policies of professional
liability insurance.) Current certificates of such insurance shall
be kept on file at all times during the term of this Agreement with
the City Clerk.
SECTION 13 -AGREEMENT BINDING
The terms,covenants, and conditions of this Agreement
shal! apply to, and shal! bind, the heirs, successors, executors,
administrators, assigns, and subcontractors of both parties.
SECTION 14 - WAIVERS
The waiver by either party of any breach or violation of
any term, covenant, or condition of this Agreement or of any
provision, ordinance, or law shall not be deemed to be a waiver of
any other term, covenant, condition, ordinance, or law or of any
subsequent breach or violation of the same or of any other term,
covenant, condition, ordinance, or law. The subsequent acceptance
by either party of any fee or other money which may become due
hereunder by the other party of any term, covenant, or condition of
this Agreement or of any applicable law or ordinance.
SECTION 15 - COSTS AND ATTORNEYS’ FEES
The prevailing party in any action brought to enforce the
terms of this Agreement or arising out of" this Agreement may
recover its reasonable costs and attorney fees expended in
connection with such an action from the other party.
SECTION 16 - NO IMPLIED WAIVER
No payment, partial payment, acceptance, or partial
acceptance by CITY shall operate as a waiver on the part of CITY of
any of its rights under this Agreement.
SECTION 17 -NONDISCRIMINATION; PENALTY
17.1 Duty of Contractor
As set forth in the Palo Alto Municipal Code, no
discrimination will be made in the performance of this Contract
because of the age, race, color, national origin, ancestry,
religion, disability, sexual preference or gender of that person.
If the value of this Contract is, or may be, five thousand dollars
($5,000) or more, CONTRACTOR agrees to meet all requirements of the
Palo Alto Municipal Code pertaining to nondiscrimination, including
completing the requisite form furnished by CITY and set forth in
Exhibit "C"
040405 cl 7060784
17.2 Penalty for Discrimination
If CONTRACTOR is found in violation of the
nondiscrimination provisions of the State of California Fair
Employment Practices Act or similar provisions of Federa! law or
executive order in the performance of this Contract, it will be in
default of this Contract. Thereupon, CITY will have the power to
cancel or suspend this Contract, in whole or in part, or to deduct
the sum of twenty-five dollars ($25) for each person for each
calendar day during which such person was subjected to acts of
discrimination, as damages for breach of contract, or both. Only
a finding of the State of California Fair Employment Practices
Commission or the equivalent federa! agency or officer will
constitute evidence of a breach of this Contract.
SECTION 18 - AGREEMENT CONTAINS ALL ~DERSTANDINGS;
AMENDMENT
This document represents the entire and integrated
agreement between CITY and CONTRACTOR and supersedes all prior
negotiations, representations, and agreements, either written or
oral. This document may be amended only by written instrument,
signed by both CITY and CONTRACTOR. Al! provisions of this
Agreement are expressly made conditions.
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040405 cl 7060784
RPR 06 2004 8=51RM HP LRSER3ET 3200 p.2
SECT!OkT 19 - GOVEP~NiNG LAW
This Agreement shall be gove_~ned by the laws of the State
of California.
IN WITNESS WHEREOF, the parties hereto have executed this
Agreement the day ~nd year first above written,
ATTEST:CITY OF PALO ALTO
City Clerk Mayor
APPROVED:
Assistant City Manager
APPROVED AS TO FORM:
Senior Asst. City Attorney
Director, Administrative Services
SKYHAWKS SPORTS ACADEMY, INC.
By
Its:
Its : _
Taxpayer Identification No.
91-1549581
Director of Community Services
Insurance Review
~Com.Dliance with CorD. code § 313 is
re.quired if the entity on whose behalf
this conZract is signed is a corporation.
in the alternative, a certified co.~orate
resolution attesting to the sisnatoz-y.
authority of ~he individuals si~ning in
their respective capacities is
acceptable)
Attachments:
EXHIBIT ~A#:
EXHIBIT ~B":
EXHIBIT ~C":
EXHIBIT ~D":
Scope of Services
Rate Schedule
Certificate of Insurance
Certificate of Non Discriminasion
8
RPR OS 2004 8:51HM HP LRSERJET 3200
CERTIFICATE OF ACKNOWLEDGEMENT
(Civil Code ~ 1189)
me,
~0~ ~ "~< , a Notary Public in and for said County and
State, personally appeared ~k~i~ ~ ,
personally known to me or proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed
the same in his/her/their authorized capacity(ies), and that by
his/her/their signature(s) on the instrument che person(s), or the
entity upon behalf of which the person(s) acted, executed the
instrument.
WI~ESS my h~nd and official seal.
Signature of Notary Public
040405 17060784
RPR 06 2004 8:S1RM HP LRSERJET 3200
CERTIFICATE OF ACENOWLEDGES~2~f
(Civil Code § 1189)
STATE OF
COUNTY OF
On
a Notary Publi~]n
State, personally appeared ,
personally known to me.or proved to me on the b~sls of satisfactory
evidence to be the person(s) whose name(s) is/are subscribed to the
wiLhin instrument and acknowledged ~o me that he/she/they executed
the same in his/her/their authorized capacity(ies), a~d that by
his/her/their signature(s) on the instrument %he person(s), or the
entity upon behalf of which the person(s) ac%ed, executed the
instrument.
WI~ESS my hand and official seal.
Signature of Notary Public
04434135 ¢! 70~07~4
i0
EXHIBIT ’~A"
SCOPE OF SERVICES
CONTRACTOR shall teach classes and/or camps through Palo
Alto Recreation Division according to CONTRACTOR’s schedule, as
approved by the City of Palo Alto. The CITY shal! provide
facilities suitable for the class. CONTRACTOR shall comp!~-with
al! applicable City policies.
CONTRACTOR and City wil! share all promotional efforts.
Each party to bear their own cost of their promotiona! efforts.
The CITY must approve all promotiona! flyers and brochures and
affix the CITY’s Recreation !ogo, prior to distribution.
The CITY will process all registrations and will provide
CONTRACTOR with the number of registrants. CONTRACTOR is
responsible for taking "roll" and confirming registration numbers.
The programs and summer camps offered will focus on
programs for children 4 to 14 years of.age, in order to accommodate
al! levels of customers. The ratio for classes and summer camps
will be 8 to 1 for younger children and i0 to 1 for older children.
Classes will be offered according to the Summer 2004
Skyhawks Program Proposal attached hereto. CONTRACTOR will
provide a minimum of three programs per week during the summer
break. Program minimum enrollment will be i0 and maximum will be
determined by site limitations and Palo Alto Coordinator input.
CONTRACTOR will have the same instructors quarter by
quarter to gain stability and comfort with students and to ensure
that the classes and summer camps are consistent with teaching
techniques unless different instructors are approved by City
pursuant to section 6.2 of the Agreement.
CONTRACTOR shall submit the following prior to the start
of work under this contract:
Proof of Negative TB tests for all staff working with
children
Fingerprint background check for all staff working with
children.
Signed copy of the Declaration of Employee Safety AB-14.
Insurance in accordance with City guidelines.
Signed copy of W-9 form.
040405 cl 7060784
11
PRICE & COMPENSATION SCHEDULE FOR SKYHAWKS SUMMER
CAMPS
Full Day HalbDay except Golf Golf
2004 $138 $126 $136
2005 $141 $126 $136
2006 $145 $126 $136
2004 Revenue split for full day camps:
Skyhawks: $88.50
City of Palo Alto: $49.50
2005 Revenue split for full day camps:
Skyhawks: $90
City of Palo Alto: $51
2006 Revenue split for full day camps:
Skyhawks: $92
City of Palo Alto: $53
Revenue split for all half-day camps except golf for the length of this contract:
Skyhawks: $81
City of Palo Alto: $45
Revenue split for all half-day golf camps for the length of this contract:
Skyhawks: $91
City of Palo Alto: $45
EXHIBIT "B"
OF LIABILITY INSUFb NCE , I i2/!5/2003iTHI~ CERTIFICATE i$ ISSUED.AS A MA~ER OF INFORMATION
ThE ~OLICIES OF/k’,~’URAI’I£E LISTED ~ELOW 4AVF. ~EEN ISSUED TO THE INSURED NAMED ABOVE FOR TNE =OL!C’¢" PERIOD :NDICATED. K!C’: ~V1TF~ST..~JJDIN,Ahv REQUIREMENT, TERM O~ COND~ION OF ,~,NV CONT’P.,~,C1’ OR OTP,=-R DOG~JMENFT WITH RE.SPECT TO It~rt~h Trtl$ CERTIFI2~,T~ ~.~;-.’f 9~ ~gS:Jf-O OR
MAY ~=_R’I’AIN+ ",HE !NSURANC~ Ar’~ORDEC’ BY THE ,=OLICtE$ ~E:$CRIBED H~F.~...IN IS SUBJECT I’O ALL TH~ TERMS, EXCLUSIONS AND COND~T+.O*4S OF SUCH
OICG2B¢I7001 02/0~/200~
OZI08/Z00S 02/08/2004
THAN
insurance is provided as noted above ~’~ith r~spects Zo operations of th~ na~ed insured.
I
Z,gOO, 0~I
The City of Pale Alto
PO Box 102~0
e~le Mt~. CA 5~0~
! Jan henton/b~J (./
~CGRD CO~ORA~ON ~BB8
EXHIBIT "C"
IMPORTANT
If the certificate ho!~e, is an ADDITIONAL iNSURE3, bh¢ policy(i~s) musl be enaorsed. A statement
on [~,[s ce~iflcat~, dee¢ no’, conf÷~ righ[s to [~’,e ~-’ertif,cste holder in lieu Of suet, endor~ement(~),
I.~ SbBROGAT~ON !S W~\IVED, subject t~ the terms end conditions oft.he polio], cer~air~ polisies
require an endorsement. ~, statement on this ce~ifieate d~& not csnf~r ~ght~ ’to the
holder In lieu ~ such ~ndarsement(s).
DISCLAIMER
The Certifiuato of !n~urance on the reverse side of tJqls form do~=~ not consetute a contra~ between
the les~ing t~gutot{~), autho~i2ed represeniative or producer, and ~e oeRffioa~ holder, nor does ff
a~atively or nega~vaiy a~nd, e~end o~ al~r the coveLsge offered by tr~e poiic~es listed therec~.
JExces s Ace ~dent
B, ,~edi
~e City of Polo Alto, CA, i~s council ~mbers, officers, ~ents and employe~s ~re ~ddition~] insured
~s their interests ~y appear. This insurance iG primary pe~ insuring form GLEOOO7
1:O00. 0..~0
~0,00o
excl uded
i
z,ooo,
Z, ODO, 000
E,L. DISEAS£ - FOUCYLiM~J~ ~
S25,000 ~edlca3 Naximum
$10,000
$;,OOD Denta] Maxi~m 5100 Ded
"~"~Revision of certificate issued 2/20/03
Polo Alto, The City of
Purchasing ~ Con%ra;t Administration
~3 Bo~ i02~0
P~lo A]~O, CA B4303
_C _~_~.OE L LATION
E~I~TION D&TE THEREOF, THE 15SUING INEUff~ ~,~L ENDSAYOR TO ~L
IMPORTANT
If the c~.’t;ficste hcl_4~ Is art ,’kDD;TIONAL ,N$UR_D, the pohcy(iesl must ~e endorsed A st~[ement
~P, thi~ cert!fisate doe~ not confer r!Ohts to the ce,’t;ficate hoider in ~ieu of such endorsement(s).
;f SUP, ROGATiON IS WAIVED, subjecl ~ l:h~ [erms and c’anditions oflhe policy’ certa!n paii~,i~, m_P.y
holder ~n liau d such endorsemant(..~}.
DISCLAIMER
the i£suing insurer,s), au~ho,’~ed r~pr~sentative or producer, and lhe c~dificat~ holder, nor dues it
a~rmative y or cega~ely amead e~end or a~tar the coverage afforded by the pOliCies li~ted ~P, ereon.
i
ACORO 25 (200!,;08)
COPY
~ IJ N !~ CE!~.T’~P{CATE OF WORKgRS’ CONPENSATiON
FOLIO’Y NUMBER"i6 e s~v] -2 cobC~R.TI;ICATE ID:25
tn~ur~e ~m~s~oner ~0 the employer nard ~low for the ~il~y pg~od indicted.
~8~11~ which thb ~en~;a~B of ~nsumn~ m~}’ ~ issu~ or ~y ~in r lh~ in~u~n~ afford~ ~y the ~licies
E~ORSE~h~’ #lSO0 - DAVID BERTO, PRESID~ - ~L~D.
CERTIFICATION OF NONDISCRIMINATION SECTION 410
PROJECT: Provision of Summer ..#ports Camps
Certification of Nondiscrimination:
As suppliers of goods or services to the City of Palo Alto, the firm and individuals listed below
certify that they do not discriminate in employment with regards to age, race, color, religion, sex,
national origin, ancestry, disability, or sexual preference; that they are in compliance with all
Federal, State, and local directives and executive orders regarding nondiscrimination in
employment.
THE INFORMATION HEREIN IS CERTIFIED CORRECT BY SIGNATURE(S) BELOW.
Signature:
Name:
Sig
(PRINT OR TYPE NAME)
Name:
(PRINT OR TYPE NAME)
Note:The City, pursuant to Cafifomia Corporations Code Section 313 requires two corporate
officers to execute contracts.
*The signature of First Officer* must be one of the following: Chairman of the
Board; President; or Vice President.
**The signature of the Second Officer** must be one of the following: Secretary;
Assistant Secretary; Chief Financial Officer," or Assistant Treasurer.
(In the alternative, a certified corporate resolution attesting to the signatory
authority of the individuals signing in their respective capacities is acceptable)
CITY OF PALO ALTO 103651 PAGE 1 OF 1
EXHIBIT "D"