MHUSD - Funding for SCYTF (2019)(2)40
MOR.GA.N HILL UNIFIED SCHOOL DISTRICT
SERVICES AGREEMENT
2019-20
THIS AGREEMENT {"Agreement") is made between Morgan Hill Unified School. District, 15600
Concord Circle, Morgan Hill, CA 95037, hereinafter referred to as the DISTRICT, and the following
named service provider hereinafter referred to as VENDOR:
VENDOR NAME: City of Gilroy
DBA: South County Mouth Task Force
ADDRESS: 7301 Hanna Street
MAILING ADDRESS: (if different than above)
CITY: Gilroy STATE: CA ZIP: 95020
PHONE: (408) 846-0362 FAX: (408) 846-0387
EMAIL ADDRESS: Albert.Balagso@ci.gilroy.ca.us
FEDERAL TAX I.D. OR SOCIAL SECURITY NUMBER 94-6000340
Vendor is resdonsible for uadatim? contact information in a timely manner.
iVOTL•: Federal Regulations (Code Sections 6041 and 6209) require non -corporate recipients of $600.00 or
more to fttrnish their taepayer identification number to the payer. The regulations also provide that a penalty
may be imposed or failure to fumish the ttaxpayer identification number. The DISTRICT requires your
federal tax identification number or Social Security Number, whichever is applicable, in order to comply with
these regulations.
Check appropriate box for federal tax classification:
Flindividual/sole proprietor �C Corporation S Corporation
�Parincrship �Trust/estate F]CtherCity Government
4_._JLimited Liability Company Type:a(C) ❑(S) 1-1P)
Submittal of Documents: The VENDOR shall not commence the work under this Agreement until the
VENDOR has submitted and the DISTRICT has approved the certificate(s) and affidavit(s), and the
endorsement(s) of the insurance required as indicated below:
Signed Agreement
jInsurance Certificates and Endorsements
fl '-9 Form
Workers' Compensation Certificate (if applicable)
/Tuberculosis Clearance (if applicable)
t7l Fingerprinting/Criminal Background Investigation (if applicable)
DIR 9 (if applicable)
Addendum for Technology Service Agreement (if applicable)
Pg. 1 of 6
15600 Concord Circle - Morgan Hill, CA 95037 - 408.201.6000 - Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
1. JERryl
This Agreement is effective on July 1, 2019 and terminates on June 30, 2020 or upon completion
of services, whichever occurs first.
VENDOR shall not undertake any work under this Agreement until this Agreement is reviewed and
approved by the DISTRICT's Board of Education, and VENDOR is in receipt of a signed Agreement.
2. TF.P-MINATION
2.1 Without cause by DISTRICT. DISTRICT may, at any time, with or without reason, terminate this
Agreement and compensate VENDOR only for services satisfactorily rendered to the date of termination.
Written notice by DISTRICT shall be sufficient to stop further performance of services by VENDOR.
Notice shall be deemed given when received by the VENDOR no later than three (3) days after the day of
mailing, whichever is sooner.
2.2 Without cause by VENDOR. VENDOR may, upon thirty (30) day notice, with or without reason,
terminate this A.a eement. Upon this termination, DISTRICT shall only be obligated to compensate
VENDOR for services satisfactorily rendered to the date of termination. Written notice by VENDOR
shall be sufficient to stop further performance of services to DISTRICT. VENDOR acknowledges that
this thirty (30) day notice period is acceptable so that the DISTRICT can attempt to procure the services
from another source.
2.3 With cause by DISTRICT. DISTRICT may terminate this Agreement upon giving of written notice
of intention to tenninate for cause. Cause shall include:
2.3.1. Material violation of this Agreement by the VENDOR; or
2.3.2. Any act by VENDOR exposing the DISTRICT to liability to others for personal injury or
property damage; or
2.3.3. VENDOR is adjudged bankrupt, VENDOR makes a general assignment for the benefit of
creditors or a receiver is appointed on account of VENDOR'S insolvency.
Written notice by DISTRICT shall contain the reasons for such intention to terminate and unless within
three (3) calendar days after that notice the condition or violation shall cease, or satisfactory arrangements
for the correction thereof be made, this Agreement shall upon the expiration of the three (3) calendar days
cease and terminate. In the event of this termination, the DISTRICT may secure the required services
from another VENDOR. If the expense, fees, and/or costs to the DISTRICT exceed the cost of providing
the services pursuant to this Agreement, the VENDOR shall immediately pay the excess expense, fees,
and/or costs to the DISTRICT upon the receipt of the DISTRICT'S notice of these expenses, fees, and/or
costs. The foregoing provisions are in addition to and not a limitation of any other rights or remedies
available.
3. SUBCQNTRACT OR ASSIGNMENT
Neither party shall assign, delegate or subcontract any part of this Agreement without the written consent
of the other parry.
4. jLVTFRPRETATTON
In the event of any conflict or 'inconsistency between VENDOR'S agreement or documents and this
MORGAN HILL UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT, the MORGAN HILL
UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT shall prevail and supersede all other
agreements or contract language.
pg. 2 of 6
15500 Concord Circle • Morgan Hill, CA 95037. 408.201.6000 • Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. t`+OW) BER: 94-6000340
5. RjMFPF,NDI1 NT CONTRA STATUS
In the performance of the services to be provided, VENDOR is an independent contractor with the authority to
control and direct the performance of the details of the work, and this Agreement shall not be construed to
create the relationship of agent, employee, partnership, joint venture, or association. VENDOR understands
and agrees that it and all of its employees are not employees of the DISTRICT and are not entitled to benefits
to which DISTRICT employees are normally entitled, including, but not limited to, State Unemployment
Compensation, Workers' Compensation, vacation or sick pay.
6. TAX REPORT_iNC I PAYMENT
VENDOR shall assume full responsibility for payment of all federal, state, and local taxes or contributions,
including, but not limited to, Unemployment Insurance, Social Security and Income Taxes with respect to
VENDOR'S employees. Pursuant to IRS regulations, the DISTRICT shall provide VENDOR in IRS
identified tax classification with an annual statement of compensation on the appropriate federal forms
(currently IRS Form 1099 Misc.).
7. REGUL TA IONS
VENDOR shalt comply with all federal, state, and local laws, ordinances, regulations, permit requirements,
and Board of Education's policies and regulations in performance of this Agreement, including as set forth
herein at Paragraph 8.
8, YJNGRRPR12LT1NG ANY) CRIMINAL RF,CORDS CHG .K
The Fingerprinting(Criminal Background Investigation Certification must be completed and attached to this
Agreement prior to the VENDOR performing any of the services as listed in Item 12 of this Agreement.
DISTRICT retains authority to remove any VENDOR employee from DISTRICT site upon the
determination that he/she has not complied with this fingerprinting and background check requirement, or
has been convicted of a violent or serious felony, as defined in Education Code §45122.1. VENDOR
must notify the DISTRICT and remove any employee immediately should the VENDOR learn that an
employee working on a DISTRICT site has been convicted of a serious or violent felony, or sex offense.
Failure to provide notice as required above may result in cancellation of this Agreement by DISTRICT and
further legal action by the DISTRICT where applicable.
9. GQVERNING LAW
This Agreement shall be governed under the laws of the State of California. VENDOR hereby consents to the
jurisdiction of the state or federal courts of Santa Clara County, CaIifomia.
10.$C.EI,i,ANFC)iJfi
This Agreement contains the entire agreement between DISTRICT and VENDOR and supersedes any
and all prior discussions, understandings, and negotiations, whether oral or in writing. This Agreement
may not be modified or amended unless in writing and signed by both parties.
11. INSURANCE AND INDEMNIFICATION
VENDOR agrees to defend, indemnify, and hold harmless the DISTRICT, its Board of Education, officers,
employees and agents, individually and collectively, tiom. and against all costs, losses, claims, demands,
suits, actions, payments, liabilities and judgments, including attorneys fees, arising from personal or bodily
injuries, property damage or otherwise, regardless of and however caused that may arise for any reason from
VENDOR'S performance of this Agreement.
VENDOR must keep in full force and affect a policy or policies of Workers' Compensation insurance in
the amount or amounts required by applicable law.
Pg. 3of6
15600 Concord Circle -Morgan Hill, CA 95037.40A.201.6000 • Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
During the term of this Agreement, VENDOR shall procure and maintain general liability, automobile
liability, and professional liability (errors and omissions) from a California licensed insurer acceptable
to DISTRICT with per -occurrence limits of $1 Million unless otherwise specified by the DISTRICT.
VENDOR shall provide DISTRICT with a Certificates) of Insurance evidencing such coverage. High
risk activities may require additional coverage as determined by the DISTRICT. Certificate Holder is
Morgan Hill Unified School District. VENDOR shall also provide an Additional Insured Endorsement,
naming Morgan Hill Unified School District as Additional Insured. Such insurance coverage shall be
primary insurance and any insurance or self-insurance maintained by the DISTRICT shall be non-
contributory. These certificates shall contain a provision that coverage afforded under the policy
will not be cancelled or allowed to expire .until at least thirty (30) days prior written notice has been
delivered to the DISTRICT.
12. D .S RIETION QESE, RViCF (S OP OF WORIQ
VENDOR shall supply all required payment and performance bonds and shall pay employees applicable
prevailing wages in accordance with state and federal law where required. VENDOR shall furnish, at its own
expense, all labor,. materials, equipment and other items necessary to carry out the terms of this
Agreement. VENDOR shall provide the following services to DISTRICT:
The Amount of within this agreement wil(provide funding to support the work of the South County Youth
Task Force ( SCYTF) . The SCYTF is a collaboration that seeks to reduce juvenile delinquent behaviors,
recruitment of youth into gangs, and youth vllgjlence in South Santa Clara County. This agreement will
provide matching funds to compliment funding from the County of Santa Clara, the City of Gilroy and the
Gilroy Unified Schooi District.
SCYTF will provide the followiing services to MHUSD; Youth Outreach, Youth Groups, Case Management,
& School -Based Team Crisis Response. These services will be available to the Middle and High Schools.
The City of Gilroy will invoice MHUSD for a lump sum payment in the amount of $45,000 within 30 days
prior to the end of the 2019-20 School year. `
TAdd tionai pages may be added and shall be inarked Exhibit "A" and are incorporated herein by this reference).
13. _ COMP E.NS TI N ALJD EXPENSES
DISTRICT agrees to pay the VENDOR for services satisfactorily rendered pursuant to this Agreement at the
rate of S 45,000.00 perflal rate Qfor a total fee not to exceed $ 45,000.00. District
shall pay VENDOR according to the following terms and conditions:
13.1. Payment shall be made for all undisputed amounts in installment payments within thirty (30) days
after the VENDOR submits an invoice to the DISTRICT. VENDOR will only be paid after the MHUSD
Board of Education has approved/ratified this Agreement.
13.2. VENDOR invoices will be subject to verification that services have been rendered and subject to
written approval by Glen Webb, Director of Curriculum, instruction, & Assessment
13.3. DISTRICT shall not be liable to VENDOR for any costs or expenses paid or incurred by VENDOR
in performing services for DISTRICT including but not limited to travel, professional development related
expenses, duplication, etc.
13.4. VENDOR shall not increase prices during the term of this Agreement.
13.5. All invoices must be submitted within 30 days of rendering services. DISTRICT reserves the right
to reiect invoices submitted for uavment more than 30 days after services are performed,
14, OWNERS H)_P QF WORK PRODUC-C
VENDOR agrees all work prepared or produced during the course of this Agreement and arising from the
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15600 Concard Circle • Morgan Hill, CA 95037 - 408.201.6000 - Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
services rendered (see Paragraph 12) shall be owned by and assigned to DISTRICT as its sole and exclusive
property.
15. AIM
VENDOR shall establish and maintain books, records, and systems of account, in accordance with generally
accepted accounting principles, reflecting all business operations of VENDOR transacted under this
Agreement_ V1rNDOR shall retain these books, records, and systems of account during the Term of this
Agreement and for five (5) years thereafter. VENDOR shalt permit the DISTRICT, its agent, other
representatives, or an independent auditor to audit, examine, and make excerpts, copies, and transcripts from
all books and records, and to make audit(s) of all billing statements, invoices, records, and other data related
to the services covered by this Agreement. Audit(s) may be performed at any time, provided that the
DISTRICT shall give reasonable prior notice to VENDOR and shall conduct audit(s) during VENDOR'S
normal business hours, unless VENDOR otherwise consents.
16, CFRTIFjCATFS / PERMITS / LICENSES
VENDOR and all VENDOR'S employees or agents shall secure and maintain in force such certificates,
permits and licenses as are required by law in connection with the furnishing of services pursuant to this
agreement.
17. CONFIDENTIA=
VENDOR and all VENDOR'S agents, personnel, employee(s), and/or subcontractors) shall maintain the
confidentiality of all information received in the course of performing the services. This requirement to
maintain confidentiality shall extend beyond the termination of this Agreement.
18.
Any notice required or permitted to be given under this Agreement shall be deemed to have been given,
served, and received if given in writing and either personally delivered or deposited in the United States mail,
registered or certified mail, postage prepaid, return receipt required, or sent by overnight delivery service, or
facsirnile transmission, addressed as follows:
DISTRICT
VENDOR
Morgan Hill Unified School District
City of Gilroy
15600 Concord Circle
7301 Hanna Street
Morgan Hill, CA 95037
Gilroy. CA 95020
ATTN: Glen Webb ATTN: Albert Balagso
19. ATTORNEY t{ FRS / COSIS
Should litigation be necessary to enforce any terms or provisions of this Agreement, then each party shall
bear its own litigation and collection expenses, witness fees, court costs and attorney's fees.
20. COhR , .TI N
The work completed herein must meet the approval of the DISTRICT and shall be subject to the
DISTRICT'S general right of inspection and supervision, in a manner consistent with VENDOR'S status as
an independent contractor, to secure the satisfactory completion thereof. Work must be completed in good
workmanship like manner and in accordance with the generally accepted standard of care in the industry.
21. SEVERABILIT
If any provision of this Agreement shall be held to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining portions hereof shall not in any way be affected or
Pg. 5 of 6
15500 Concord Clrcle • Morgan Hill, CA 95037.408.201,6000 - Fax 408.201.6006
VENDOR: City of Gilroy
TAX T.D. NUMBER: 94-6000340
impaired thereby, except where enforcement is inconsistent with the parties' intent.
22. RELEASE. DTSCNAR =E OR WAMR
No release, discharge or waiver of any provision hereof shall be enforceable against or binding upon either
party hereto unless in writing and executed by both parties hereto. Neither the failure to insist upon strict
performance of any of the agreements, terns, covenants or conditions hereof, nor the acceptance of
monies due hereunder with knowledge of a breach of this Agreement, shall be deemed a waiver of any
rights or remedies that either party hereto may have or a waiver of any subsequent breach or default in any of
such agreements, terms, covenants or conditions,
23. EXFr'TITTON IN COUNTERPARTS
This Agreement may be executed in several counterparts each of which shall be an original and all of which
shall constitute but one and the same agreement.
Any party signing this Agreement on behalf of the VENDOR hereby represents that he/she is
duly authorized by the VENDOR to execute this Agreement and that the VENDOR has agreed
to be bound by the provisions hereof.
City of Gifroy
("VENDOR")
Signature: C _ Date
Title: C��-� VIZAVW
r
MORGAN HILL UNIFIED SCHOOL DISTRICT ("DISTRICT') f
Signature Date:
Name: Kirsten Pere
Title: Assistant SuDerintendent. Business Services
Date of Board Approval
Notwithstanding the effective date of this Agreement set forth in Paragraph 1, this Agreement shall not be
considered accepted, approved or otherwise effective until 1) Board approval and 2) the required approvals and
certifications have been implemented, provided by, or submitted to the DISTRICT, as appropriate.
Approved as to Form:
Gilroy City Attorney's Office
By:
City Attorney
Pg. 6 of 6
15600 Concord Circle • Morgan Hill, CA 95037.408.201.6000 • Fax 408.201.6006
MORGAN HILL UNIFIED SCHOOL DISTRICT
AMENDMENT TO SERVICE AGREEMENT
This Amendment to the Service Agreement is hereby entered into on July 1. 2019, -,by Morgan Hill
Unified School District, (hereinafter referred to as "DISTRICT'), and Citv of 01rov
(hereinafter referred to as VENDOR) for the following services: Youth Our , ch. Youth Groups. Case
Management. & School —Based Team Crisis Response for Middle and Hio 'chools
The following changes and)or revisions will be reflected as follows to the original Service Agreement. All
prior agreements remain in force; Amendment only reflects a change in the following: (PLEASE ONLY
CHECK CHANGES THAT APPLY)
ORIGINAL PURCHASE ORDER NUMBER:
❑ TERM(S) OF CONTRACT: -
El DESCRIPTION OF SERVICE(S):
❑ AMOUNT: ** Original:
Change:
New Total: $
❑ BUDGET CODE:
:1
Old:
New: (re-enter if same as above)
Total encumbered prior to this Amendment
Additional amount to be encumbered
0.00 Total of two lines above
Amount
OTHER (PLEASE SPECIFY): item,,. The CITY shall indemnifv, defend, and hold harmless the
DISTRICT, its officers. aaents, and emolovees from anv claim. liability, loss, iniury or
damage arlsina out of or in connection with, performance of this Aareement by the
CITY and/or its aaents. emolovees or sub -contractors, excentina only loss, iniury or
damage caused by the sole nepllaence or willful misconduct of oersonnel emoloved by
the DISTRICT. It is the intent of the parties to this Aareement to provide the broadest
possible coveraae for the DISTRICT. The CiTY shall reimburse the DISTRICT for all
costs. attornevs' fees. expenses and liabilities incurred with respect to anv litigation in
which the CITY contests its obliaation to indemnify, defend and/or hold harmless the
DISTRICT under this Aareement and does not ,prevail in that contest.
The DISTRICT shall indemnifv, defend and hold harmless the CiTY, its ofcers, aaents
and emplovees from anv claim, liability, loss, iniury or damaae arisina out of, or in
connection with, oerformance of this Aareement by the DISTRICT and/or its aaents.
emolovees or sub -contractors, exceotinq only loss, iniury or damage caused by the sole
nealiaence or willful misconduct of personnel emoloved by the CITY. It is the intent of
the parties to this Aareement to orovide the broadest possible coveraae for the Citv.
The DISTRICT shall reimburse the CITY for all costs, attornevs' fees, expenses and
liabilities incurred with respect to anv litigation in which the DISTRICT contests its
obliaation to indemnifv. defend and/or hold harmless the CITY under this Agreement
and does not prevail in that contest.
" The Service Agreement Amendment is required to change: terms, description of services(s) or contractual amount
and may require approval by the Board of Education.
ORIGINAL BOARD APPROVALDATE:
VEND R Signature `
Site / Departip9gnt Administrator gnature�
Kirsten Perez, jsSup rin ndent Business Services
BOARD AMENDED DATE (if required):
Date:
Date:
Date:
15600 Concord Circle, Morgan Hill, CA 408.201.6000 Fax: 408.201.6006
n 1f1
Z MAIN FINGERPRINTING / CRIMINAL BACKGROUND
' INVESTIGATION CERTIFICATION
One of the three boxes below must be checked, with the corresponding certification provided, and this form attached to the
Services Agreement ("Agreement"):
❑ (To be completed by authorized DISTRICT employee only) VENDOR'S employees will have only limited contact,
if any, with DISTRICT pupils and the DISTRICT will take appropriate steps to protect the safety of any pupils that
may come in contact with VENDOR'S employees so that the fingerprinting and criminal background investigation
requirements of Education Code § 45125.1 shall not apply to VENDOR for the services under this agreement. As an
authorized DISTRICT official, I am familiar with the facts herein certified, and am authorized to execute this
certificate on behalf of the DISTRICT (Education Code § 45125.1 (c))
Date:
District Representative Name and Title
Signature
-The fingerprinting and criminal background investigation requirements of Education Code § 45125.1 apply to
VENDOR'S services under this Agreement and VENDOR certifies its compliance with these provisions as follows:
VENDOR certifies that the VENDOR has complied with the fingerprinting and criminal background investigation
requirements of Education Code § 45125.1 with respect to all VENDOR'S employees, subcontractors, agents, and
subcontractors' employees or agents regardless of whether those employees are paid or unpaid, concurrently employed by
the DISTRICT, or acting as independent contractors of the VENDOR, who may have contact with DISTRICT pupils in the
course of providing services pursuant to the Agreement, and the California Department of Justice has determined that none
of those employees has been convicted of a felony, as that term is defined in Education Code § 45122.1. A complete and
accurate list of all employees who may come in contact with DISTRICT pupils during the course and scope of the
Agreement is attached hereto, or shall be provided to the DISTRICT prior to any employee having any contact with
DISTRICT pupils, and an updated list of all employees who may come in contact with DISTRICT pupils during the course
and scope of the agreement shall be provided to the DISTRICT within ten (10) days of DISTRICT's request.
VENDOR'S services under this Agreement shall be limited to the construction, reconstruction, rehabilitation, or repair
of a school facility and although all Employees will have contact, other than limited contact, with DISTRICT pupils,
pursuant to Education Code § 45125.2 DISTRICT shall ensure the safety of the pupils by at least one of the following
as marked:
The installation of a physical barrier at the worksite to limit contact with pupils.
Continual supervision and monitoring of all VENDOR'S on -site employees of VENDOR by an employee of
VENDOR, , whom the Department of Justice has ascertained has not been
convicted of a violent or serious felony.
❑Surveillance of employees by DISTRICT personnel. (To be completed by authorized DISTRICT
employee only)
Date:
District Representative Name and Title
Signature
I am a representative of the VENDOR entering into this Agreement with the DISTRICT and I am familiar with the
facts herein certified, and am authorized and qualified to execute this certificate on behalf of the VENDOR.
Name of VENDOR or Company: a-� C rt7� nDate:
Representative's Name�,and Title: SY11�le_ ! (' il�lle� 0�_
Signature:`r:
15600 Concord Circle Morgan Hill, CA 95037 • 408,201.6000 • Fax 408,201.6006 Page 1 of i
GryrFrEO SCHOOL D15YP�Gi
TUBERCULOSIS, CLEARANCE
The undersigned does hereby certify to the governing board of the DISTRICT as follows:
1 am a representative of the VENDOR currently entering into this Agreement with the DISTRICT and I am familiar
with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of the
VENDOR. VENDOR'S responsibility for tuberculosis clearance extends to all of its employees, subcontractors,
and employees of subcontractors coming into contact with DISTRICT pupils regardless of whether they are
designated as employees or acting as independent contractors of the VENDOR.
VENDOR certifies that at least one of the following items applies to the Scope of Work that is the subject of this
Agreement:
® The VENDOR ensures that any person providing any portion of the services has completed the
Tuberculosis Risk Assessment Questionnaire (in accordance with California Education Code Section 49406
and Health and Safety Code Sections 121525-121555) and found that VENDOR does not have risk factors,
or if tuberculosis risk factors were identified, the patient has been examined and determined to be free of
infectious tuberculosis, by a physician or surgeon, within 60 days of Board approval of the Agreement, or
if previous contractor to the DISTRICT, within the last four (4) years. If there is however a positive
result, chest x-ray verification is required.
Upon the DISTRICT'S request, a complete and accurate list of VENDOR'S employees and of all of its
subcontractors', employees, who may come in contact with DISTRICT pupils during the course and scope
of the Agreement, will be required to furnished — indicating the date of each person's completion of the
questionnaire and if necessary physical examination.
VENDOR'S Scope of Work under this Agreement is to be provided at an unoccupied school site only or
will not be done on any DISTRICT property where any employee and / or subcontractor or supplier of any
tier of Agreement shall come in contact with DISTRICT pupils.
DATE: { 41 o f7p '\
Name of VENDORr Company: C k�
Re resent ive's NEC Ind T'JP: &v\•rt
Cr v p 3
15600 Concord Circle • Morgan Hill, CA 95037 •408.201.6000 • Fax 408.201.6006 Page 1 of 1
n l#1
_ WORKERS' COMPENSATION
", ;� CERTIFICATION
California law requires all employers to carry workers' compensation insurance, even if they have only one
employee. If you are the sole owner and you have no employees, or if your business is an out of state corporation
with no employees worki ig in California, you may not be required to carry workers' compensation insurance. It is
your responsibility to comply with the law. If you do not know whether you are required to carry workers'
compensation insurance, find out by contacting the California Department of Industrial Relations (`°DIR").
Information is also available on the DIR's website at http://dir.ca.gov.
Labor Code § 3700 in relevant part provides that every employer except the State shall secure the payment of
compensation in one or more of the following ways:
By being insured against liability to pay compensation by one or more insurers duly authorized to write
compensation insurance in this State.
Fvi By securing from the Director of Industrial Relations a certificate of consent to self -insure, which may be
given upon furnishing proof satisfactory to the Director of Industrial Relations of the ability to self -insure
and to pay any compensation that may become due to its employees.
I understand that California Labor Code § 3700 et seq requires employers to provide workers'
compensation insurance coverage for any employees of my business. I hereby warrant that this business is
exempt from the California Labor Code provisions regarding workers' compensation insurance because it
has no employees working in California or is a sole -owner with no employees.
I am aware of the provisions of Labor Code § 3700 which requires every employer to be insured against liability for
workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will
comply with such rovisions before commencing the performance of the Scope of Work of this Agreement.
DATE: t I t`i I
Name of VEND R or Company:
Representative s Name and Title: Lee I�-A1 x
Signature:(i V��-�
t - v
, vt 6zu t`r-p--,
15600 Concord Circfe • Morgan Hill, CA 95037 •408.201.6000 1 Fax 408.201.6006 Page i of 1
CERTIFICATE OF COVERAGE
NAME AND ADDRESS OF AGENCY:
Municipal Pooling Authority of Northern California
P.O. Box 67
Walnut Creek, CA 94596
(925) 943-1100 * FAX (925) 946-4183
NAME AND ADDRESS OF COVERED ENTITY:
City of Gilroy
LeeAnn McPhillips
HR/Risk Mgmt Dept.
7351 Rosanna Street
Gilroy, CA 95020
ORGANIZATION AFFORDING COVERAGE:
Municipal Pooling Authority of Northern
California
This is to certify that coverage agreements listed below have been issued to the covered parties named above and are in force at this time. 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 coverage afforded by the
coverage agreements described herein Is subject to all the terms, exclusions, and conditions of such coverage agreements.
TYPE OF COVERAGE COVERAGE AGREEMENT I COVERAGE AGREEMENT LIMITS OF LIABILITY
NUMBER EXPIRATION per occurrence
General Liability
Auto Liability
Auto
Collision and Comprehensive
Workers' Compensation and
Employers Liability
"1PA19-20
6/30/2020 Bodily Injury, Property
Damage, Personal Injury
Combined $0
Bodily Injury, Property
Damage, Personal Injury
Combined $0
$3,000 Deductible Police Vehicles
$2,000 All Other Vehicles
Limit of Liability = $250,000
SIR $500,000
Workers' Comp = Statutory
Employers' Liability =$4,5 million
Description of Operations/Locations/Vehicles/Event/Restrictions/Special Items:
It is hereby agreed that the Morgan Hill Unified School District (MHUSD), its Board, officers, employees, and volunteers are
named additional covered parties in respect to the Agreement between MHUSD and the City of Gilroy to support the work of the
South County Youth Task Force in an effort to reduce juvenile delinquent behaviors, gang recruitment, and youth violence, but
only to the extent assumed by the City of Gilroy under the Agreement, subject to MPA's Memorandum of Coverage terms,
conditions, and exclusions. This coverage shall be primary.
Cancellation: Should any of the above described coverage agreements be canceled before the expiration date thereof, the Issuing company will endeavor to mail 30
days written notice to the below named certificate holder, but failure to mail such notice shall Impose no obligation or liability of any kind upon the Authority, It's
agents or representatives.
CERTIFICATE HOLDER (name and address):
Morgan Hill Unified School District
15600 Concord Circle
Morgan Hill, CA 95037
certificate ID: 2551 : 2015-16 FY
Prepared By: mp
Date Issued June 25, 2019
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LOCAL AGENCY WORKERS' COMPENSATION EXCESS
JOINT POWERS AUTHORITY
(LAWCX)
2019/2020 MEMORANDUM OF COVERAGE
Policy Number: LAWCX 19.20
DECLARATION
ITEM #I COVERED MEMBER: City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
Expanded Covered Members
Identified in SchecluleA ofMOC
ITEM 42 COVERAGE PERIOD: FROM 7/1/2019 TO 7/1/2020
12:01 a.m. Pacific Standard Time
ITEM 43 LIMIT OF LIABILITY:
a. COVERED MEMBER'S RETAINED LIMIT:
Workers' Compensation Coverage $500,000
Employer's Liability Coverage $500,000
b. LAWCX SELF -INSURED RETENTION:
Workers' Compensation Coverage $5 Million Less
Member's Retained
Limit
Employer's Liability Coverage $5 Million Less
Member*s Retained
Limit
ON BEHALF OF THE LOCAL AGENCY WORKERS'
COMPENSATION EXCESS JOINT POWERS AUTHORITY
jZ-1 - cee- 5 P I
Authorized Signature
Schedule A - LAWCX Members
As of July 1, 2019
CERTIFICATE OF COVERAGE
NAME AND ADDRESS OF AGENCY:
Municipal Pooling Authority of Northern California
P.O, Box 67
Walnut Creek, CA 94596
(925) 943-1100 * FAX (925) 946-4183
NAME AND ADDRESS OF COVERED ENTITY:
City of Gilroy
LeeAnn McPhillips
HR/Risk Mgmt Dept.
7351 Rosanna Street
Gilroy, CA 95020
ORGANIZATION AFFORDING COVERAGE:
Municipal Pooling Authority of Northern
California
This Is to certify that coverage agreements listed below have been issued to the covered parties named above and are In force at this time, 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 coverage afforded by the
coverage agreements described herein is subject to all the terms, exclusions, and conditions of such coverage agreements.
TYPE OF COVERAGE COVERAGE AGREEMENT I COVERAGE AGREEMENT LIMITS OF LIABILITY
NUMBER EXPIRATION per occurrence
General Liability MPA19-20
Auto Liability
Auto
Collision and Comprehensive
Workers' Compensation and
Employers Liability
6/30/2020 Bodily Injury, Property
Damage, Personal Injury
Combined $0
Bodily Injury, Property
Damage, Personal Injury
Combined $0
$3,000 Deductible Police Vehicles
$2,000 All Other Vehicles
Limit of Uablllty = $250,000
SIR $500,000 —
Workers' Comp = Statutory
Employers' Liability =$4.5 million
---- ------
Description of Operations/Locations/Vehicles/Event/Restrictions/Special Items: —
It is hereby agreed that the Morgan Hiil Unified School District (MHUSD), its Board, officers, employees, and volunteers are
named additional covered parties in respect to the Agreement between MHUSD and the City of Gilroy to support the work of the
South County Youth Task Force In an effort to reduce juvenile delinquent behaviors, gang recruitment, and youth violence, but
only to the extent assumed by the City of Gilroy under the Agreement, subject to MPA's Memorandum of Coverage terms,
conditions, and exclusions. This coverage shall be primary.
Cancellation: Should any of the above described coverage agreements be canceled before the expiration date thereof, the Issuing company will endeavor to mail 30
days written notice to the below named certificate holder, but failure to mall such notice shall Impose no obligation or liability of any kind upon the Authority, It's
agents or representatives.
CERTIFICATE HOLDER (name and address):
Morgan Hill Unified School District
15600 Concord Circle
Morgan Hill, CA 95037
Certificate ID: 2551 : 2015-16 FY
Prepared By: mp
Date Issued June 25, 2019
N7inchanU, Af-Nl - Liability Claims
.,
Request for Taxpayer Give Form to the
Form
(Rev. November2017)
Identification Number and Certification requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
I► Go to wwitvJmgcv/Form W9 for instructions and the latest information.
1 Name (as shown on your Income tax return). Name Is required on this line; do not leave this line blank.
CITY OF GILROY
2 Business name/disregarded entity name, if different from above
M
3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
mfollowing
seven boxes.
certain entities, not individuals; see
a
p
Elindividual sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ElTrust/estate
Instructions on page 3):
ai
[1 o
single -member LLC
Exempt payee code (f any)
�` U
Limited liability company. Enter the tax classification C=C corporation, S-S corporation, P=Partnershi ►
❑ Y P Y• f P rP P)
`o
Note; Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
+ Fri
LLC If the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
LLC that Is disregarded from the for federal tax
code (if any)
.r n
la.Is
another not owner U.S. purposes. Otherwise, a single -member LLC that
disregarded from the owner should check the appropriate box for the tax classification of its owner,
a
v
❑✓ Other (see Instructions) ► GOVERNMENT AGENCY
fwar•�ro�co r=�rra aW urus.i
N
5 Address (number, street, and apt. or suite no.) See Instructions. Requester's name and address (optional)
7351 ROSANNA STREET
I
6 City state, and 2fP code
GILROY, CA 95020
7 Ust account number(s) here (optional)
M1LM Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number
backup withholding. For Individuals, this Is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later_ For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
71N, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M94 — 6 1 0 1 0 1 1I3 4 OI
FUTTMAI Certification
Under penalties of perjury, i certify that:
1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the internal Revenue
Service (IRS) that i am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the iRS that you are currently subject to backup withholding because
you have failed to report all Interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividend ou are not required to sign the certification, but you must provide your correct TIN. See the Instructions for Part 11, later,
Sign Signature of 11.05_2019
Here I U.S. person ► Date ►
General Instructions • Form 1099-DIV (dividends, including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/F`ormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), Individual taxpayer Identification number (ITIN), adoption
taxpayer identification number (ATiN), or employer Identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information retum. Examples of Information
returns Include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TiN.
It you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X - Form w-9 (Rev. 11.2017)
roan hr
WMORGAN HILL UNIFIED SCHOOL DISTRICT
SERVICES AGREEMENT
2019-20 F
THIS AGREEMENT ("Agreement") is made between Morgan Hill Unified School. District, 15600
Concord Circle, Morgan Hill, CA 95037, hereinafter referred to as the DISTRICT, and the following
named service provider hereinafter referred to as VENDOR:
VENDOR NAME: City of Gilroy
DBA: South County Youth Task Force
ADDRESS: 7301 Hanna Street
MAILING ADDRESS: (if different than above)
CITY: Gilroy STATE: CA ZIP: 95020
PHONE: (408) 846-0362 FAX: (408) 846-0387
EMAIL ADDRESS: Albert.Balagso@ci.gilroy.ca.us
FEDERAL TAX I.D. OR SOCIAL SECURITY NUMBER: 94-6000340
Vendor is responsible for updating contact information in a timely manner.
NOTE: Federal Regulations (Code Sections 6041 and 6209) require non -corporate recipients of $600.00 or
more to furnish their taxpayer identification number to the payer. The regulations also provide that a penalty
may be imposed or failure to fumish the taxpayer identification number. The DISTRICT requires your
federal tax identification number or Social Security Number, whichever is applicable, in order to comply with
these regulations.
Check appropriate box for federal tax classification:
Individual/sole proprietor C Corporation S Corporation
PartnershipTrust/estate F ]Other City Government
❑Limited Liability Company Type:1(C) ❑(S) 11(p)
Submittal of Documents: The VENDOR shall not commence the work under this Agreement until the
VENDOR has submitted and the DISTRICT has approved the certificate(s) and affidavit(s), and the
endorsement(s) of the insurance required as indicated below:
Signed Agreement
Insurance Certificates and Endorsements
W-9 Form
Workers' Compensation Certificate (if applicable)
Tuberculosis Clearance (if applicable)
Fingerprinting/Criminal Background Investigation (if applicable)
DIR # (if applicable)
Addendum for Technology Service Agreement (if applicable)
Pg. 1 of 6
15600 Concord Circle • Morgan Hill, CA 95037 - 408.201.6000 • Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
1. JERM
This Agreement is effective on July 1, 2019 and tenninates on June 30, 2020 or upon completion
of services, whichever occurs first.
VENDOR shall not undertake any work under this Agreement until this Agreement is reviewed and
approved by the DISTRICT's Board of Education, and VENDOR is in receipt of a signed Agreement.
2. TERMINATION_
2.1 Without cause by DISTRICT. DISTRICT may, at any time, with or without reason, terminate this
Agreement and compensate VENDOR only for services satisfactorily rendered to the date of termination.
Written notice by DISTRICT shall be sufficient to stop further performance of services by VENDOR.
Notice shall be deemed given when received by the VENDOR no later than three (3) days after the day of
mailing, whichever is sooner.
2.2 Without cause by VENDOR. VENDOR may, upon thirty (30) day notice, with or without reason,
terminate this Agreement. Upon this termination, DISTRICT shall only be obligated to compensate
VENDOR for services satisfactorily rendered to the date of tennination. Written notice by VENDOR
shall be sufficient to stop further performance of services to DISTRICT. VENDOR acknowledges that
this thirty (30) day notice period is acceptable so that the DISTRICT can attempt to procure the services
from another source.
2.3 With cause by DISTRICT. DISTRICT may terminate this Agreement upon giving of written notice
of intention to terminate for cause. Cause shall include:
2.3.1. Material violation of this Agreement by the VENDOR; or
2.3.2. Any act by VENDOR exposing the DISTRICT to liability to others for personal injury or
property damage; or
2.3.3. VENDOR is adjudged bankrupt, VENDOR makes a general assignment for the benefit of
creditors or a receiver is appointed on account of VENDOR'S insolvency.
Written notice by DISTRICT shall contain the reasons for such intention to terminate and unless within
three (3) calendar days after that notice the condition or violation shall cease, or satisfactory arrangements
for the correction thereof be made, this Agreement shall upon the expiration of the three (3) calendar days
cease and terminate. In the event of this termination, the DISTRICT may secure the required services
from another VENDOR. If the expense, fees, and/or costs to the DISTRICT exceed the cost of providing
the services pursuant to this Agreement, the VENDOR shalt immediately pay the excess expense, fees,
and/or costs to the DISTRICT upon the receipt of the DISTRICT'S notice of these expenses, fees, and/or
costs. The foregoing provisions are in addition to and not a limitation of any other rights or remedies
available.
3. SUBCONTRACT OR ASSIGNMENT
Neither party shall assign, delegate or subcontract any part of this Agreement without the written consent
of the other party.
4. JNTERPRFTATIO
In the event of any conflict or inconsistency between VENDOR'S agreement or documents and this
MORGAN HILL UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT, the MORGAN HILL
UNIFIED SCHOOL DISTRICT SERVICES AGREEMENT shall prevail and supersede all other
agreements or contract language.
Pg. 2 o4 6
15600 Concord Circle • Morgan Hill, CA 95037 - 408.201.600() ° Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
5. MEPENDENT CONTRACTOR STATUS
In the performance of the services to be provided, VENDOR is an independent contractor with the authority to
control and direct the performance of the details of the work, and this Agreement shall not be construed to
create the relationship of agent, employee, partnership, joint venture, or association. VENDOR understands
and agrees that it and all of its employees are not employees of the DISTRICT and are not entitled to benefits
to which DISTRICT employees are normally entitled, including, but not limited to, State Unemployment
Compensation, Workers' Compensation, vacation or sick pay.
6. :LAX REPORTTNG / EAYMF.NT_
VENDOR shall assume full responsibility for payment of all federal, state, and local taxes or contributions,
including, but not limited to, Unemployment Insurance, Social Security and Income Taxes with respect to
VENDOR'S employees. Pursuant to IRS regulations, the DISTRICT shall provide VENDOR in IRS
identified tax classification with an annual statement of compensation on the appropriate federal forms
(currently IRS Form 1099 Misc.).
7. REGULATIONS
VENDOR shall comply with all federal, state, and local laws, ordinances, regulations, permit requirements,
and Board of Education's policies and regulations in performance of this Agreement, including as set forth
herein at Paragraph 8,
8. FIN Y ,RPRINTiNG AND CRTMTI[AI, RFCORDS CHECK
The Fingerprinting/Criminal Background Investigation Certification must be completed and attached to this
Agreement prior to the VENDOR performing any of the services as listed in Item 12 of this Agreement.
DISTRICT retains authority to remove any VENDOR employee from DISTRICT site upon the
determination that he/she has not complied with this fingerprinting and background check requirement, or
has been convicted of a violent or serious felony, as defined in Education Code §45122.1. VENDOR
must notify the DISTRICT and remove any employee immediately should the VENDOR learn that an
employee working on a DISTRICT site has been convicted of a serious or violent felony, or sex offense.
Failure to provide notice as required above may result in cancellation of this Agreement by DISTRICT and
further legal action by the DISTRICT where applicable.
9. GOVERNING LAW
This Agreement shall be governed under the laws of the State of California. VENDOR hereby consents to the
jurisdiction of the state or federal courts of Santa Clara County, California.
10. MISCELLANF,OIN
This Agreement contains the entire agreement between DISTRICT and VENDOR and supersedes any
and all prior discussions, understandings, and negotiations, whether oral or in writing. This Agreement
may not be modified or amended rmless in writing and signed by both parties.
11. INSTJRANCE_AND [NDEMNTFIC.ATION
VENDOR agrees to defend, indemnify, and hold harmless the DISTRICT, its Board of Education, officers,
employees and agents, individually and collectively, from and against all costs, losses, claims, demands,
suits, actions, payments, liabilities and judgments, including attorneys fees, arising from personal or bodily
injuries, property damage or otherwise, regardless of and however caused that may arise for any reason from
VENDOR'S performance of this Agreement.
VENDOR must keep in full force and affect a policy or policies of Workers' Compensation Insurance in
the amount or amounts required by applicable law.
Pg. 3 of 6
15600 Concord Circle • Morgan Hill, CA 95037 - 408.201.6000 • Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
During the term of this Agreement, VENDOR shall procure and maintain general liability, automobile
liability, and professional liability (errors and omissions) from a California licensed insurer acceptable
to DISTRICT with per -occurrence limits of $1 Million unless otherwise specified by the DISTRICT.
VENDOR shall provide DISTRICT with a Certificate(s) of Insurance evidencing such coverage. High
risk activities may require additional coverage as determined by the DISTRICT. Certificate Holder is
Morgan Hill Unified School District. VENDOR shall also provide an Additional Insured Endorsement,
naming Morgan Hill Unified School District as Additional Insured. Such insurance coverage shall be
primary insurance and any insurance or self-insurance maintained by the DISTRICT shall be non-
contributory. These certificates shall contain a provision that coverage afforded under the policy
will not be cancelled or allowed to expire .until at least thirty (30) days prior written notice has been
delivered to the DISTRICT. r
12. DESCRIPTION OF S RVT SCOPE OF WOW,
VENDOR shall supply all required payment and performance bonds and shall pay employees applicable
prevailing wages in accordance with state and federal law where required. VENDOR shall fumish, at its own
expense, all labor,. materials, equipment and other items necessary to carry out the terms of this
Agreement. VENDOR shall provide the following services to DISTRICT:
The Amount of within this agreement will provide funding to support the work of the South County Youth
Task Force ( SCYTF) . The SCYTF is a colla4oration that seeks to reduce juvenile delinquent behaviors,
recruitment of youth into gangs, and youth vilolence in South Santa Clara County. This agreement will
provide matching funds to compliment funding from the County of Santa Clara, the City of Gilroy and the
Gilroy Unified School District -
SCYTF will provide the followiing services to MHUSD: Youth Outreach, Youth Groups, Case Management,
& School -Based Team Crisis Response. These services will be available to the Middle and High Schools.
The City of Gilroy will invoice MHUSD for a lump sum payment in the amount of $45,000 within 30 days
prior to the end of the 2019-20 School year.
(Additional pages may be added and shall be marked Exhibit "A" and are incorporated herein by this reference).
13.LQ21UNSATiON, AND EXPENSES
DISTRICT agrees to pay the VENDOR for services satisfactorily rendered pursuant to this Agreement at the
rate of $ 45,000.00 perflat rate []for a total fee not to exceed $ 45,000.00. District
shall pay VENDOR according to the following terms and conditions.
13.1. Payment shall be made for all undisputed amounts in installment payments within thirty (30) days
after the VENDOR submits an invoice to the DISTRICT. VENDOR will only be paid after the MHUSD
Board of Education has approved/ratified this Agreement.
13.2. VENDOR invoices will be subject to verification that services have been rendered and subject to
written approval by Glen Webb, Director of Curriculum, Instruction, & Assessment
13.3. DISTRICT shall not be liable to VENDOR for any costs or expenses paid or incurred by VENDOR
in performing services for DISTRICT including but not limited to travel, professional development related
expenses, duplication, etc.
13.4. VENDOR shall not increase prices during the term of this Agreement.
13.5. All invoices must be submitted within 30 days of rendering services. DISTRICT reserves the rieht
to reiect invoices submitted for oavment more than 30 days after services are performed.
14. O FH0LP QE WORK PRODUC
VENDOR agrees all work prepared or produced during the course of this Agreement and arising from the
Pg. 4 of 6
15600 Concord Circle • Morgan Hill, CA 95037 - 408.201.6000 • Fax 408,201.6006
VENDOR: City of Gilroy TAX I.A. NUMBER: 94-6000340
services rendered (see Paragraph 12) shall be owned by and assigned to DISTRICT as its sole and exclusive
property,
15. AUDIT
VENDOR shall establish and maintain books, records, and systems of account, in accordance with generally
accepted accounting principles, reflecting all business operations of VENDOR transacted under this
Agreement. VENDOR shall retain these books, records, and systems of account during the Term of this
Agreement and for five (5) years thereafter. VENDOR shall permit the DISTRICT, its agent, other
representatives, or an independent auditor to audit, examine, and make excerpts, copies, and transcripts from
all books and records, and to make audit(s) of all billing statements, invoices, records, and other data related
to the services covered by this Agreement. Audit(s) may be performed at any time, provided that the
DISTRICT shall give reasonable prior notice to VENDOR and shall conduct audit(s) during VENDOR'S
normal business hours, unless VENDOR otherwise consents.
16. CERTIFTCATES / PERMITS / LICF,NSFS
VENDOR and all VENDOR'S employees or agents shall secure and maintain in force such certificates,
permits and licenses as are required by law in connection with the furnishing of services pursuant to this
agreement.
17. CQNFIDENTIALITY
VENDOR and all VENDOR'S agents, personnel, employee(s), and/or subcontractor(s) shall maintain the
confidentiality of all information received in the course of performing the services. This requirement to
maintain confidentiality shall extend beyond the termination of this Agreement.
18. NOTICE
Any notice required or permitted to be given under this Agreement shall be deemed to have been given,
served, and received if given in writing and either personally delivered or deposited in the United States mail,
registered or certified mail, postage prepaid, return receipt required, or sent by overnight delivery service, or
facsimile transmission, addressed as follows:
DISTRICT
VENDOR
Morgan Hill Unified School District
City of Gilroy
15600 Concord Circle
7301 Hanna Street
Morgan Hill, CA 95037
Gilroy, CA 95020
ATTN: Glen Webb ATTN: Albert Balagso
19. ATTORNEY FEES / COSTS
Should litigation be necessary to enforce any terms or provisions of this Agreement, then each party shall
bear its own litigation and collection expenses, witness fees, court costs and attorney's fees.
20. MMPLETION
The work completed herein must meet the approval of the DISTRICT and shall be subject to the
DISTRICT'S general right of inspection and supervision, in a manner consistent with VENDOR'S status as
an independent contractor, to secure the satisfactory completion thereof. Work must be completed in good
workmanship like manner and in accordance with the generally accepted standard of care in the industry,
21. SEVERABILITY
If any provision of this Agreement shall be held to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining portions hereof shall not in any way be affected or
Pg. 5 of 6
15600 Concord Circle • Morgan Hill, CA 95037 •408.201.6000 • Fax 408.201.6006
VENDOR: City of Gilroy TAX I.D. NUMBER: 94-6000340
impaired thereby, except where enforcement is inconsistent with the parties' intent.
22. RELEASE. DISCHARGE OR WAIVER
No, release, discharge or waiver of any provision hereof shall be enforceable against or binding upon either
party hereto unless in writing and executed by both parties hereto. Neither the failure to insist upon strict
performance of any of the agreements, terns, covenants or conditions hereof, nor the acceptance of
monies due hereunder with knowledge of a breach of this Agreement, shall be deemed a waiver of any
rights or remedies that either party hereto may have or a waiver of any subsequent breach or default in any of
such agreements, terms, covenants or conditions.
23. FXECTJT10N TN COUNTERPARTS
This Agreement may be executed in several counterparts each of which shall be an original and all of which
shall constitute but one and the same agreement.
Any party signing this Agreement on behalf of the VENDOR hereby represents that he/she is
duly authorized by the VENDOR to execute this Agreement and that the VENDOR has agreed
to be bound by the provisions hereof.
City of Gilroy ("VENDOR")
of
Signature: -- -- Date
Name:
Title:
MORGAN HILL UNIFIED SCHOOL DISTRICT ("DISTRICT")
Signature: Date:
Name: Kirsten Perez
Title: Assistant Superintendent, Business Services
Date of Board Approval
vaA2Y�9
r �
Notwithstanding the effective date of this Agreement set forth in Paragraph 1, this Agreement shall not be
considered accepted, approved or otherwise effective until 1) Board approval and 2) the required approvals and
certifications have been implemented, provided by, or submitted to the DISTRICT, as appropriate.
Approved as to Form:
Gilroy City Attorney's Office
.....��
By:
City Attorney
Pg. 6 of 6
15600 Concord Circle • Morgan Hill, CA 95037,408,201.6000 • Fax 408,201,6006
Gy���fo s�a`t"
MORGAN HILL UNIFIED SCHOOL DISTRICT
AMENDMENT TO SERVICE AGREEMENT
This Amendment to the Service Agreement is hereby entered into on Julv 1. 2019,by Morgan Hill
Unified School District, (hereinafter referred to as "DISTRICT"), and Citv of Gilrov
(hereinafter referred to as VENDOR) for the following services: Youth Outreach Youth Groups. Case
Management. & School —Based Team Crisis Resoonse for Middle and High Schools
The following changes and/or revisions will be reflected as follows to the original Service Agreement. All
prior agreements remain in force; Amendment only reflects a change in the following: (PLEASE ONLY
CHECK CHANGES THAT APPLY)
ORIGINAL PURCHASE ORDER NUMBER:
❑ TERM(S) OF CONTRACT: --
DESCRIPTION OF SERVICE(S): **
❑ AMOUNT: ** Original:
Change:
New Total: $
❑ BUDGET CODE:
Old:
New: (re-enter if same as above)
Total encumbered prior to this Amendment
Additional amount to be encumbered
0.00 Total of two lines above
Amount
OTHER (PLEASE SPECIFY): item 11. The CITY shall indemnify, defend, and hold harmless the
DISTRICT, its officers, agents, and emplovees from anv claim, liability, loss, iniury or
damaqe arising out of, or in connection with, performance of this Aqreement by the
CITY and/or its agents, emplovees or sub -contractors, exceptina only loss, iniury or
damage caused by the sole negligence or willful misconduct of personnel employed by
the DISTRICT. It is the intent of the parties to this Aqreement to provide the broadest
possible coverage for the DISTRICT. The CITY shall reimburse the DISTRICT for all
costs, attorneys' fees. expenses and liabilities incurred with respect to anv litigation in
which the CITY contests its obligation to indemnify, defend and/or hold harmless the
DISTRICT under this Aareement and does not prevail in that contest.
The DISTRICT shall indemnifv, defend and hold harmless the CITY, its officers, agents
and emplovees from anv claim, liability, loss, iniury or damage arising out of, or in
connection with, performance of this Aareement by the DISTRICT and/or its agents,
emplovees or sub -contractors, excepting only loss, iniury or damaqe caused by the sole
nealiaence or willful misconduct of personnel employed by the CITY. It is the intent of
the parties to this Aqreement to provide the broadest possible coverage for the Citv.
The DISTRICT shall reimburse the CITY for all costs, attorneys' fees, expenses and
liabilities incurred with respect to anv litigation in which the DISTRICT contests its
obligation to indemnify, defend and/or hold harmless the CITY under this Aqreement
and does not prevail in that contest.
** The Service Agreement Amendment is required to change: terms, description of services(s) or contractual amount
and may require approval by the Board of Education.
ORIGINAL BOARD APPROVALDATE:
VEND R Signature
Site / Department Administrator —Signature
Kirsten Perez, Asst. Superintendent Business Services
BOARD AMENDED DATE (if required):
Date:
Date: /.'4- Y/ 9
Date:
15600 Concord Circle, Morgan Hill, CA 408.201.6000 Fax: 408.201.6006
an
_ FINGERPRINTING / CRIMINAL BACKGROUND
INVESTIGATION CERTIFICATION
One of the three boxes below must be checked, with the corresponding certification provided, and this form attached to the
Services Agreement ("Agreement"):
❑ (To be completed by authorized DISTRICT employee only) VENDOR'S employees will have only limited contact,
if any, with DISTRICT pupils and the DISTRICT will take appropriate steps to protect the safety of any pupils that
may come in contact with VENDOR'S employees so that the fingerprinting and criminal background investigation
requirements of Education Code § 45125.1 shall not apply to VENDOR for the services under this agreement. As an
authorized DISTRICT official, I am familiar with the facts herein certified, and am authorized to execute this
certificate on behalf of the DISTRICT (Education Code § 45125.1 (c))
Date:
District Representative Name and Title
Signature
The fingerprinting and criminal background investigation requirements of Education Code § 45125.1 apply to
VENDOR'S services under this Agreement and VENDOR certifies its compliance with these provisions as follows:
VENDOR certifies that the VENDOR has complied with the fingerprinting and criminal background investigation
requirements of Education Code § 45125.1 with respect to all VENDOR'S employees, subcontractors, agents, and
subcontractors' employees or agents regardless of whether those employees are paid or unpaid, concurrently employed by
the DISTRICT, or acting as independent contractors of the VENDOR, who may have contact with DISTRICT pupils in the
course of providing services pursuant to the Agreement, and the California Department of Justice has determined that none
of those employees has been convicted of a felony, as that term is defined in Education Code § 45122.1. A complete and
accurate list of all employees who may come in contact with DISTRICT pupils during the course and scope of the
Agreement is attached hereto, or shall be provided to the DISTRICT prior to any employee having any contact with
DISTRICT pupils, and an updated list of all employees who may come in contact with DISTRICT pupils during the course
and scope of the agreement shall be provided to the DISTRICT within ten (10) days of DISTRICT's request.
VENDOR'S services under this Agreement shall be limited to the construction, reconstruction, rehabilitation, or repair
of a school facility and although all Employees will have contact, other than limited contact, with DISTRICT pupils,
pursuant to Education Code § 45125.2 DISTRICT shall ensure the safety of the pupils by at least one of the following
as marked:
The installation of a physical barrier at the worksite to limit contact with pupils.
Continual supervision and monitoring of all VENDOR'S on -site employees of VENDOR by an employee of
VENDOR, , whom the Department of Justice has ascertained has not been
convicted of a violent or serious felony.
❑Surveillance of employees by DISTRICT personnel. (To be completed by authorized DISTRICT
employee only)
Date:
District Representative Name and Title
Signature
I am a representative of the VENDOR entering into this Agreement with the DISTRICT and I am familiar with the
facts herein certified, and am authorized and qualified to execute this certificate on behalf of the VENDOR.
Name of VENDOR or Company: C.A-�j ok �-�� V p U ppDate:
Representative's Nam and Title: 5rlOv. S11�
Signature:
15600 Concord Circle • Morgan Hill, CA 95037 • 408.201.6000 • Fax 408.201.6006 Page 1 of 1
GN�F�fU w`_—S�G1
SCH CH
�RCH
TUBERCULOSIS CLEARANCE
The undersigned does hereby certify to the governing board of the DISTRICT as follows:
I am a representative of the VENDOR currently entering into this Agreement with the DISTRICT and I am familiar
with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of the
VENDOR. VENDOR'S responsibility for tuberculosis clearance extends to all of its employees, subcontractors,
and employees of subcontractors coming into contact with DISTRICT pupils regardless of whether they are
designated as employees or acting as independent contractors of the VENDOR.
VENDOR certifies that at least one of the following items applies to the Scope of Work that is the subject of this
Agreement:
® The VENDOR ensures that any person providing any portion of the services has completed the
Tuberculosis Risk Assessment Questionnaire (in accordance with California Education Code Section 49406
and Health and Safety Code Sections 121525-121555) and found that VENDOR does not have risk factors,
or if tuberculosis risk factors were identified, the patient has been examined and determined to be free of
infectious tuberculosis, by a physician or surgeon, within 60 days of Board approval of the Agreement, or
if previous contractor to the DISTRICT, within the last four (4) years. If there is however a positive
result, chest x-ray verification is required.
Upon the DISTRICT'S request, a complete and accurate list of VENDOR'S employees and of all of its
subcontractors' employees, who may come in contact with DISTRICT pupils during the course and scope
of the Agreement, will be required to furnished — indicating the date of each person's completion of the
questionnaire and if necessary physical examination.
VENDOR'S Scope of Work under this Agreement is to be provided at an unoccupied school site only or
will not be done on any DISTRICT property where any employee and / or subcontractor or supplier of any
tier of Agreement shall come in contact with DISTRICT pupils.
DATE: ��� 4,1 �\
Name of VENDOR �ompany: C k C>�C
GA
15600 Concord Circle • Morgan Hill, CA 95037 • 408.201.6000 • Fax 408.201.6006 Page 1 of 1
SCHOOL ;]1Z
WORKERS' COMPENSATION
CERTIFICATION
California law requires all employers to carry workers' compensation insurance, even if they have only one
employee. If you are the sole owner and you have no employees, or if your business is an out of state corporation
with no employees working in California, you may not be required to carry workers' compensation insurance. It is
your responsibility to comply with the law. If you do not know whether you are required to carry workers'
compensation insurance, find out by contacting the California Department of Industrial Relations ("DIR").
Information is also available on the DIR's website at http://dir.ca.gov.
Labor Code § 3700 in relevant part provides that every employer except the State shall secure the payment of
compensation in one or more of the following ways:
By being insured against liability to pay compensation by one or more insurers duly authorized to write
compensation insurance in this State.
By securing from the Director of Industrial Relations a certificate of consent to self -insure, which may be
given upon furnishing proof satisfactory to the Director of Industrial Relations of the ability to self -insure
and to pay any compensation that may become due to its employees.
I understand that California Labor Code § 3700 et seq requires employers to provide workers'
compensation insurance coverage for any employees of my business. I hereby warrant that this business is
exempt from the California Labor Code provisions regarding workers' compensation insurance because it
has no employees working in California or is a sole -owner with no employees.
I am aware of the provisions of Labor Code § 3700 which requires every employer to be insured against liability for
workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and I will
comply with such �rorvisions before commencing the performance of the Scope of Work of this Agreement.
DATE: I t ( l � C.1% I
Name of VEND or Company: CA-1, 0-�_ CAvu�
Representatives ame and Title: �ehcvvA erDV ,A`,nc .
11 r
Signatur }.,� If
15600 Concord Circle • Morgan Hill, CA 95037 • 408.201.6000 • Fax 408.201.6006
Page 1 of 1
CERTIFICATE OF COVERAGE
NAME AND ADDRESS OF AGENCY:
Municipal Pooling Authority of Northern California
P.O. Box 67
Walnut Creek, CA 94596
(925) 943-1100 * FAX (925) 946-4183
NAME AND ADDRESS OF COVERED ENTITY:
City of Gilroy
LeeAnn McPhillips
HR/Risk Mgmt Dept.
7351 Rosanna Street
Gilroy, CA 95020
ORGANIZATION AFFORDING COVERAGE:
Municipal Pooling Authority of Northern
California
This Is to certify that coverage agreements listed below have been issued to the covered parties named above and are in force at this time. 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 coverage afforded by the
coverage agreements described herein is subject to all the terms, exclusions, and conditions of such coverage agreements.
F- ---- -
-- -
TYPE OF COVERAGE COVERAGE AGREEMENT COVERAGE AGREEMENT LIMITS OF LIABILITY
NUMBER EXPIRATION per occurrence
General Liability MPA19-20 6/30/2020 Bodily Injury, Property
Damage, Personal Injury
Combined $1,000.000
Auto Liability
Auto
Collision and Comprehensive
- _........- - - ..._..— .............. - - - -
Workers' Compensation and
Employers Liability
Description of Operations/Locations/Vehicles/Event/Restrictions/Special Items:
Bodily Injury, Property
Damage, Personal Injury
Combined $0
$3,000 Deductible Police Vehicles
$2,000 All Other Vehicles
Limit of Liability = $250,000
SIR $500,000
11 Workers' Comp = Statutory
Employers' Liability =$4.5 million
It is hereby agreed that the Gilroy Unified School District (District) is named an additional covered party for General Liability in
respect to the City of Gilroy's (City) use of District facilities under the Agreement effective July 1, 1971 between the City and the
District, but only to the extent assumed by the city under the agreement, and subject to MPA's Memorandum of Coverage terms,
conditions and exclusions.
Cancellation: Should any of the above described coverage agreements be canceled before the expiration date thereof, the Issuing company will endeavor to mail 30
days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the Authority, It's
agents or representatives.
CERTIFICATE HOLDER (name and address):
Gilroy Unified School District
Attn: Facilities Dept.
7810 Arroyo Circle
Gilroy, CA 95020..__
Certificate ID: 2283 : 2015-16 FY LB
Prepared By: mp
Date Issued June 25, 2019
- Liability Claims
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LOCAL AGENCY WORKERS' COMPENSATION EXCESS
JOINT POWERS AUTHORITY
(LAWCX)
2019/2020 MEMORANDUM OF COVERAGE
Policy Number: LAWCX 19.20
DECLARATION
ITEM #1 COVERED MEMBER: City of Gilroy
7351 Rosanna Street
Gilroy, CA 95020
Expanded Covered Members
Identified in Schedule A of MOC
ITEM #2 COVERAGE PERIOD: FROM 7/1/2019 TO 7/1/2020
12:01 a.m. Pacific Standard Time
ITEM #3 LIMIT OF LIABILITY:
a. COVERED MEMBER' S RETAINED LIMIT:
Workers' Compensation Coverage $500,000
Employer's Liability Coverage $500,000
b. LAWCX SELF -INSURED RETENTION:
Workers' Compensation Coverage $5 Million Less
Member's Retained
Limit
Employer's Liability Coverage $5 Million Less
Member's Retained
Limit
ON BEHALF OF THE LOCAL AGENCY WORKERS'
COMPENSATION EXCESS JOINT POWERS AUTHORITY
1
Authorized Signature
Schedule A - LAWCX Members
As of July 1, 2019