HomeMy WebLinkAboutCalifornia Highway Patrol Rainbow Commercial Vehicle Enforcement Facility; 2018-04-13; GS1678SCOPE OF WORK
EXHIBIT A
(Standard Agreement)
California Highway Patrol and
City of Carlsbad
Agreement # 17C686005
Exhibit A Page 1 of 1
1. Contractor agrees to provide to the Department of California Highway Patrol (CHP) Rainbow Commercial
Vehicle Enforcement Facility (CVEF) the services described herein:
See Attachment 1 -Agreement for Use Carlsbad Safety Training Center (STC).
2. The services shall be performed at:
Carlsbad Safety Training Center
5750 Orion St.
Carlsbad, CA 92010
3. The services shall be provided during:
Such times that is mutually agreeable to both parties.
4. The project representatives during the term of this agreement will be:
STATE AGENCY
Department of California Hi
NAME
Officer Carl Barres
Rainbow CVEF
TELEPHONE NUMBER
951-506-2020
Direct all inquiries to :
STATE AGENCY
FAX NUMBER
Department of California Highway Patrol
SECTION/UNIT
Business Services Section, Contract
Services Unit
ATTENTION
CONTRACTOR
Cit of Carlsbad
NAME
760-931-2236
CONTRACTOR
City of Carlsbad
SECTION/UNIT
ATTENTION
Jason.kenned carlsbadca. ov
MaDonna Young, Contract Analyst Jason Kennedy, Facility Mgr., Safety Training Center
ADDRESS
P.O. Box 942898
Sacramento, CA 94298-0001
TELEPHONE NUMBER
(916) 843-3623 I
FAX NUMBER
(916) 322-3166
ADDRESS
1635 Faraday Ave.
Carlsbad, CA 92008
TELEPHONE NUMBER
760-931-2236 I
EMAIL
Jason.kennedv@carlsbadca.aov
STATE OF CALIFORNIA
. STANDARD AGREEMENT
STD 213 (Rev 06/03) AGREEMENT NUMBER
17C686005
1. This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCY'S NAME
Department of California Highway Patrol
CONTRACTOR'S NAME
City of Carlsbad
2. The term of this
Agreement is:
06/01/2018 or upon approval (whichever is later) through 05/31/2020
$49,999.00 3. The maximum amount
of this Agreement is: Forty Nine Thousand Nine Hundred Ninety Nine Dollars and Zero Cents
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A -Scope of Work
Exhibit B -Budget Detail and Payment Provisions
Exhibit C* -General Terms and Conditions
Attachment 1 -Agreement for Use of The Carlsbad Safety Training Center (STC)
Exhibit A -Safety Training Center Facility Description, Capabilities and Location
Exhibit B -Participant Release Form
Exhibit C -Facility Fees
1 page
1 page
GTC 04/2017
11 pages
Signatures appear on page 6 of 6 Attachment 1 of this Agreement
Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at www.dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CITY OF CARLSBAD
CONTRACTOR'S NAME (if other than an individual, state whether a corporation, partnership, et
BY (Authorized Signature)
ADDRESS
STATE OF CALIFORNIA
AGENCY NAME
BY (Authorized Signature)
California Department of General
Services Use Only
~ Exempt per: SCM 4.04
EXHIBIT B
(Standard Agreement)
BUDGET DETAIL AND PAYMENT PROVISIONS
1. Invoicing and Payment
Department of California Highway Patrol
City of Carlsbad
Agreement #17C686005
Exhibit B Page 1 of 1
A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to
compensate the Contractor for actual expenditures incurred in accordance with the rates specified
herein, which is attached hereto and made a part of this Agreement.
B. Invoices shall include the Agreement Number and shall be submitted in duplicate not more frequently
than monthly in arrears to:
Officer Carl Barres
CHP Rainbow CVEF
1796 Rainbow Valley Blvd. West
Fallbrook, CA 92028
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered
under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of
no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to
Contractor or to furnish any other considerations under this Agreement and Contractor shall not be
obligated to perform any provisions of this Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the
State shall have the option to either cancel this Agreement with no liability occurring to the State, or
offer an agreement amendment to Contractor to reflect the reduced amount.
3. Prompt Payment Clause
Payment will be made in accordance with, and within the time specified in, Government Code Chapter
4.5, commencing with Section 927.
4. Rate Schedule
CHP agrees to pay Contractor in arrears for actual services rendered at the facility fees identified in
Attachment 1, Exhibit C.
GS1674
ATTACHMENT 1
AGREEMENT FOR USE OF THE CARLSBAD SAFETY TRAINING CENTER (STC)
BETWEEN
THE CITY OF CARLSBAD AND THE CALIFORNIA HIGHWAY PATROL (CHP)
1. PARTIES AND DATE
This Agreement for use of the Carlsbad Safety Training Center (STC) ("Agreement") is
entered into this ) .. 3-/i; day of ~ ~· Q , ,.;lo!)? , by and between the
City of Carlsbad, a municipal corporatio~ ganized under the laws of the State of California with
its principal place of business at 5750 Orion Street, Carlsbad, California 92010 ("City"), and the
California Highway Patrol (CHP), a law enforcement division under the State of California with
its principal place of business at 1796 Rainbow Valley Boulevard West, Fallbrook, California
92028 ("Agency"). City and Agency are sometimes individually referred to as "Party" and
collectively as "Parties" in this Agreement.
2. RECITALS
2.1 Agency desires to use certain City facilities located at 5750 Orion Street in the
City of Carlsbad, California, known as the Carlsbad Safety Training Center ("STC Facilities");
and
2.2 Agency desires to use the STC Facilities for the purposes of Firearms Training
and other Law Enforcement Training Activities on or about June 1, 2018 ('Training Events").
2.3 City is willing to allow the Agency to use the STC Facilities pursuant to the terms
and conditions set forth below.
3. TERMS AND CONDITIONS
3.1 STC Facilities. City agrees to allow Agency to use the STC Facilities pursuant to
this Agreement including the conditions, requirements and fees as described in Exhibit "A",
Exhibit "8'', Exhibit "C" and the STC Standard Operating Procedures (SOP), as may be
amended from time to time by the City at its sole and absolute discretion, all as incorporated
herein by this reference. The STC Facilities are subject to the needs of the City and as such the
Agency's use of STC Facilities may be cancelled by the City at any time. In the event City
determines, in its sole and absolute discretion, that the STC Facilities are needed for any City
purposes, the Agency shall immediately vacate the STC Facilities upon notice by the City. It will
also be understood that the STC Facilities will be made available on an "as is" basis.
3.2 Training Events. Agency represents and warrants that all attendees,
participants, students, observers, instructors and any other persons brought to the STC
Facilities by the Agency ("Agency Invitees") are qualified to participate in the Training Events,
and use of the STC Facilities. The City retains the discretion to terminate this Agreement and
requires all Agency Invitees to immediately vacate the STC Facilities if the Training Events or
anyone's participation in the Training Events poses any kind of threat or liability to the City, the
public, Agency Invitees or anyone else. Agency Invitees shall not be considered an employee
or agent of City for any purpose related to the Training Events.
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3.3 Release of Liability / Assumption of Risk. In consideration of the City's
Agreement to allow the Agency to use the STC Facilities, the Agency, on behalf of itself and its
elected officials, officers, employees, contractors, agents, volunteers, students, and all Agency
Invitees hereby releases and forever discharges the City and each of its elected officials,
officers, employees, contractors, agents, and volunteers from any and all known and unknown,
certain or contingent, past, present or future obligations, liabilities, demands, claims, costs,
expenses, debts, controversies, damages, actions, and causes of action of every nature,
character, or description which they may have against the City, arising from or in any way
related to the Training Events, use of STC Facilities or this Agreement. Furthermore, Agency
assumes all risks associated with using the STC Facilities for the Agency's purposes, including
but not limited to inspections of the facility prior to and after use, determination that the facilities
"as is" status is appropriate for the Agency's Training Events, supervision and control of all
Agency Invitees involved in the Agency's use of the STC Facilities including Agency Invitees,
members of the general public and anyone else exposed during the period of time the Agency is
using the STC Facilities.
AGENCY HEREBY ACKNOWLEDGES THAT IT HAS READ AND IS FAMILIAR
WITH THE PROVISIONS OF CALIFORNIA CIVIL CODE SECTION 1542
("SECTION 1542"), WHICH IS SET FORTH BELOW:
"A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE
CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER
FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN
BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER
SETTLEMENT WITH THE DEBTOR."
BY SIGNNING BELOW, AGENCY HEREBY WAIVES THE PROVISIONS OF
SECTION 1542 IN CONNECTION WITH THE RELEASED MATJERS.
Printed Name of Agency Representative
3.4 Indemnification / Hold Harmless. Agency shall indemnify, defend and hold
harmless City, its elected officials, officers, employees, contractors, agents, and volunteers
("Indemnified Parties") from and against any and all claims, damages, demands, liability, costs,
losses and expenses, including, without limitation, court costs and reasonable attorneys' fees
and costs, arising out of, in connection with or in any way related to Agency's actions or
inactions related to this Agreement, including without limitation any actions or inactions related
to use of STC Facilities or the Training Events, to the fullest extent permitted by law.
3.5 Assumption of Risk Agreement and Participant Release. Agency shall ensure
that all Agency Invitees observing or participating in the Training Events sign and execute a
release, substantially in the same form as set forth in the attached Exhibit "B'', incorporated by
this reference ("Participant Release"). No one shall attend or participate in the Event or use the
STC Facilities without signing and executing a Participant Release also commonly known as a
Hold Harmless Agreement.
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3.6 Insurance. Agency shall, at its sole expense, procure and maintain for the
duration of its obligations under this Agreement insurance against claims for injuries to persons
or damages to property which may arise from or be in connection with the STC Facilities and
the Training Events or activities conducted by the Agency, its elected officials, officers,
employees, contractors, agents, volunteers, students, and Agency Invitees. The insurance shall
take the form of a commercial general liability policy or approved self-funding agreement, to
include bodily injury, personal injury, and property damage coverage, written on an occurrence
basis with a company reasonably acceptable to the City, in an amount not less than Two Million
Dollars ($2,000,000) to cover any activities performed by any person under the permission
granted herein and any damage or loss suffered or incurred by the City, its elected officials,
officers, employees, contractors, agents, and volunteers resulting from such activity. The
insurance will be obtained from an insurance carrier admitted and authorized to do business in
the State of California. The insurance carrier is required to have a current Best's Key Rating of
not less than "A-:VII" OR with a surplus line insurer on the State of California's List of Eligible
Surplus Line Insurers (LESLI) with a rating in the latest Best's Key Rating Guide of at least
"A:X". Agency shall maintain Workers Compensation coverage in the statutorily required
amounts, if applicable. Agency shall require its insurer to waive all rights of subrogation against
City, its elected officials, officers, employees, contractors, agents, and volunteers, except for
any liability resulting from the willful misconduct or grossly negligent acts of City. The Agency
will provide evidence of such insurance coverage to City's satisfaction prior to initiating the
Training Events. The Agency shall cause all such policies to be endorsed to add the City, its
elected officials, officers, employees, contractors, agents, and volunteers as Additional
lnsured's. Agency's self-funded programs will be required to provide evidence that meets City's
requirements as determined at the sole and absolute discretion of the City.
3. 7 Governmental Approvals. Agency shall or has obtained all necessary and
applicable federal, state and local approvals, certifications, and permits to conduct the Training
Events prior to use of STC Facilities. City reserves the right to require Agency to provide proof
regarding these approvals, certifications, and permits, if applicable.
3.8 Scheduling of Facility/ Cancellations. Agency may schedule use of the City's
Facilities on an "as available", "first come first served" basis by contacting the City's Facility
Manager. In the event Agency is unable to use its allotted time(s), it shall, contact the City's
Facility Manager within ten (10) business days. Agency will be invoiced for hours scheduled not
actual hours used if sufficient notice for cancellation is not provided.
3.9 Term of Agreement. The term of this Agreement shall commence from June 1,
2018 through May 30, 2019. It is also understood that the City may terminate this Agreement at
any time for any or no reason.
3.10 Payments for Use of STC Facilities. City shall invoice Agency on an hourly fee
based upon Agency scheduling and use of STC Facilities. All STC Facility use fees shall be in
accordance with the STC Facility fee table which may be amended by the City from time to time.
Agency shall remit payment in full to the attention of City of Carlsbad, 1635 Faraday Avenue,
Carlsbad, CA 92008, within thirty days (30) days of receipt of such invoice. A late charge
equivalent to 5% of the unpaid balance shall be assessed on all accounts ten (10) or more days
past due. Agency shall be liable for the payment at the full cost of the use of the STC Facilities
for the hours scheduled for Training Events whether Agency subsequently uses the STC
Facilities or not.
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3.11 Accidents/ Damage Investigations. The Agency Safety Officer, as such person
is described in the STC Facilities Standard Operating Procedures (SOP), shall immediately
report any injury or non-injury accidents, equipment damage and/or negligent firearm
discharges immediately to the City Facility Manager. The parties agree to fully and promptly
cooperate in the investigations of injury or non-injury accidents, equipment damage and/or
negligent firearm discharges arising from Agency's use of the STC Facilities. The City's Facility
Manager will coordinate such investigations for determining cause, responsibility and any
physical or operational modifications or improvements deemed necessary to improve facility
safety. In the event damage to the STC Facility requires repair and/or replacement, City shall
affect such repair and present to the Agency an invoice for the cost of the repairs/replacement
plus 5% (five percent) for City administrative costs. Agency shall remit payment in full to the
attention of City of Carlsbad, 1635 Faraday Avenue, Carlsbad, CA 92008, within thirty days (30)
days of receipt of such invoice. A late charge equivalent to 5% of the unpaid balance shall be
assessed on all accounts ten (10) or more days past due.
3.12 Facility Inspections/ Cleanup. The parties will conduct a joint inspection of STC
Facilities before and after use. All damages will be annotated on inspection sheets provided by
the City's Facility Manager to Agency. Agency shall be responsible for general cleanup of the
STC Facilities following its use of the same. For purposes of this Agreement, "cleanup" for STC
Facilities will be described in further detail in the STC Facilities SOP.
3.13 Notices. Except as otherwise expressly provided by law, any and all notices or
other communications required or permitted by this Agreement to be served on or given to
either party to this Agreement shall be in writing and shall be deemed duly served or given when
personally delivered to the party to whom it is directed or to any managing or executive officer or
director of that party in lieu of personal service when deposited in the United States mail, first
class postage prepaid, addressed as follows:
If to Agency:
California Highway Patrol
Business Services Section/Contract Services Unit
601 North 7th Street, Bldg. B
Sacramento, California 95811
If to City:
City of Carlsbad
1635 Faraday Avenue
Carlsbad, CA 92008
Attn: Janean Hawney
Contract Administration
3.14 Survival. Agency's obligations to release, indemnify, defend, and hold harmless
the City as set forth in this Agreement, shall survive expiration or termination of the term of this
Agreement and shall remain in effect until there is no risk to the City of any liability for any
claims or losses due to the use of the STC Facilities for the Training Events.
3.15 Interpretation. The provisions of this Agreement are intended by the parties to be
interpreted and construed to provide the fullest protection possible under the law to the City.
3.16 Selection of Counsel. Agency's obligation to indemnify the City under this
Agreement shall include the obligation of the Agency to defend City with legal counsel of City's
own choosing. In the event City elects not to select such counsel, the designation of such
counsel shall be made by the Agency but shall be subject to prior approval by City.
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3.17 Entire Agreement. This written document contains the entire agreement of the
parties and supersedes any prior oral or written statements or agreements between the parties.
No supplement, modification, or amendment of this Agreement shall be binding unless executed
in writing by the parties.
3.18 Waiver and Severability. No waiver of any default shall constitute a waiver of any
other breach or default, whether of the same or of any other covenant or condition. No waiver,
benefit, privilege or service voluntarily given or performed by either party shall give the other
party any contractual right by custom, estoppel or otherwise. If any provision of this Agreement
is invalid or unenforceable with respect to any party, the remainder of this Agreement or the
application of such provision to persons other than those as to whom it is held invalid or
unenforceable, shall not be affected and each provision of this Agreement shall be valid and
enforceable to the fullest extent permitted by law.
3.19 Counterparts. This Agreement may be signed in counterparts, each of which
shall constitute an original and which collectively shall constitute one instrument.
3.20 Authority: Binding on Successors and Assigns. Each party warrants that the
individuals who have signed this Agreement have the legal power, right, and authority to enter
into this Agreement and bind each respective party. This Agreement shall be binding on and
inure to the benefit of the successors and permitted assignees of the respective parties.
Notwithstanding the foregoing, this Agreement may not be assigned by Agency unless City
consents in writing to such assignment.
3.21 Governing Law and Venue. This Agreement shall be governed by the laws of the
State of California. Any action to interpret or enforce this Agreement shall be brought and
maintained exclusively in the courts of and for San Diego County, California.
[SIGNATURES ON NEXT PAGE]
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4. AUTHORITY
The individuals executing this Agreement and the instruments referenced in it, on behalf of
Agency, each represent and warrant that they have the legal power, right and actual authority to
bind Agency to the terms and conditions of this Agreement.
CITY OF CARLSBAD (.· .. · 7rl;L
By: ), ~-if>,
fif Kevin aord
'/" City Manager
Atte~LJm~bn
Barbara Engleson tJ .... -
City Clerk
Proper notarial acknowledgment of execution by Agency must be attached. If a corporation,
Agreement must be signed by one corporate officer from each of the following two groups:
Group A
Chairman,
President, or
Vice-President
AGENCY •• !
By: ~.£Z~
Signature J.
f lfn21c 14 b/.1-MOI\J, ~
Name (Print)
,sm:iL
Title (Print)
APPROVED AS TO FORM:
::LIA ;r;}l,~ Attorney
9eptHy City Attorney
M'i1'..
Group B
Secretary,
Assistant Secretary,
CFO, or Assistant Treasurer
By:
Signature
Name (Print)
Title (Print
City Attorney Approved Version 2/11 /14
6
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Fil~~o.: 70.011731.015S52
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"A Notary Public or other officer completing this certificate verifies only the identity of the individual
who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or
validity of that document"
State of California
County of Sacramento
On March 23, 2018, before me, Jackie Vaughn, Notary Public, personally appeared Patricia Gamoning
who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to
the within instrument and acknowledged to me that she executed the same in her authorized capacity,
and that by her signature on the instrument the person, or the entity upon behalf of which the person
acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
my hand and official seal
EXHIBIT "A"
SAFETY TRAINING CENTER FACILITY DESCRIPTION,
CAPABILITIES AND LOCATION
GS1674
1. The Carlsbad Safety Training Center (STC) is a four-acre facility that provides training
resources which can replicate emergency scenarios and high-risk training events that
Joint First Responders may encounter when conducting public safety operations. The
STC Facilities are predominantly used by firefighting and law enforcement agencies to
maintain and enhance their First Responder capabilities and to increase the readiness of
internal public safety networks. The training conducted at this facility is crucial to
building a rapid and capable First Responder Agency that can respond to emergencies
within the City of Carlsbad and outlying cities.
2. The STC Facilities consists of a primary training building which houses two indoor
shooting ranges (25 yards and 100 yards), multiple storage areas, and three classrooms
with audio visual systems, and a training room for computer generated training
scenarios. The outside areas of the facility consist of a residential live fire burn prop,
four story commercial tower with multiple live fire burn props, confined space training
area, trench extrication area, vehicle extrication area, city streetscape, emergency
vehicle training area (grinder), parking, and various equipment storage areas that house
City of Carlsbad Police and Fire related equipment.
3. General Location Information:
a. The STC is located at 5750 Orion Street, Carlsbad, CA 92010.
b. U.S. Geological Survey (USGS) Information:
-Map Sheet: San Luis Rey Quadrangle, California-San Diego (7.5 Minute Series}
-Latitude and Longitude: N 33° 8' 16.106" W 117° 16' 0.397"
-Grid Reference System (1 0-digit/WGS-84 Datum): 11 S MS 75118 66596
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EXHIBIT "B"
PARTICIPANT RELEASE
(HOLD HARMLESS CERTIFICATION)
GS1674
I, _________________ (print name), have voluntarily
requested that the City of Carlsbad ("City") allow me to use or observe the use of the facilities at
the Carlsbad Safety Training Center and/or the various safety training apparatus located at
5750 Orion Street, Carlsbad, California, 92010, known as the Carlsbad Safety Training Center
("STC Facilities"}, for the purposes of conducting Firearms Training and other Law Enforcement
Training Activities on or about ___________ ("Training Events"). I hereby
acknowledge, understand and agree that the City is allowing the use of said STC Facilities for
my sole benefit. I also acknowledge, understand and agree that by using STC Facilities I may
be exposed to risks of damage to my person or property, including, but not limited to, personal
property damage, personal bodily injury, mental or psychological effects, gunshot wounds, small
explosions, strikes from bullet fragments and shell casings, falls from high structures, trip and
snag hazards, falls on wet surfaces, lead contamination, falling debris, motor vehicle accidents,
and/or other known and unknown hazards that may result in serious bodily injury or death. I
understand, acknowledge and agree that such serious bodily injury or death may be caused,
either directly or indirectly, in whole or in part, by the fact that I am present upon the STC
Facilities site whether or not I may be participating in or observing a Training Event.
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE that I am fully aware of the
risks and hazards inherent in using or observing the use of STC Facilities or participating in a
Training Events, and I hereby accept and assume full responsibility for any and all risks of
damage, injury, effects or death resulting to me or my property while using or observing the use
of the STC Facilities, or participating in a Training Event, or resulting from the use or condition
of STC Facilities, whether or not using STC Facilities, and whether or not the risks are known or
unknown to me or to City. ___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE, in consideration for the City
allowing me to use or observe the use of STC Facilities or to participate in the Training Events,
that I, my personal representatives, heirs, next-of-kin and assigns (collectively the "Releasors")
hereby release, waive, discharge, and covenant not to sue or bring any claim or demand,
whether administrative, judicial or otherwise, against the City and its elected officials, officers,
employees, contractors, agents, and volunteers for any and all liability from and for any loss or
damage to me or the other Releasors, and from and for any claims or demands therefor on
account of injury to the person or property of me or the other Releasors, including, but not
limited to, personal property damage, personal bodily injury, mental or psychological effects, or
death, whether caused by the negligence or willful misconduct of me, the City, other participants
in the Training Events, or anyone else while I participate in the Training Events, or the condition
of STC Facilities and whether or not using STC Facilities, and whether or not the risks are
known or unknown to me or the City. ___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE to release on my behalf and
on behalf of the Releasors any and all unknown claims. I understand and agree that the
released claims include not only claims presently known to me and/or the Releasors, but also
include all known and unknown, suspected and unsuspected, claims, rights, demands, actions,
obligations, liabilities, and causes of action of every kind and character that would otherwise
come within the scope of the claims released herein. I understand that I and/or the Releasors
may hereafter discover facts different from what I/they now believe to be true, which if known,
could have materially affected the terms of this release, waiver, indemnity and hold harmless
certification, but we (the Releasors and I) nevertheless waive and relinquish any claims or rights
based on such different or additional facts. With respect to the released claims, I knowingly and
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GS1674
voluntarily waive and relinquish any and all rights or benefits that I and/or the Releasors may
now have, or in the future may have, under the terms of Section 1542 of the California Civil
Code, which provides as follows:
"A general release does not extend to claims which the creditor
does not know or suspect to exist in his or her favor at the time of
executing the release, which if known by him or her must have
materially affected his or her settlement with the debtor."
___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE to defend, indemnify, save
and hold free and harmless the City and its elected officials, officers, employees, contractors,
agents, and volunteers from any and all liability from loss, damage, cost or injury, including
death, to any property or persons, including third parties, in any manner arising out of or incident
to any acts, omissions or willful misconduct of me while I participate in the Training Events,
whether while using STC Facilities, including without limitation the payment of attorneys' fees
and costs (with attorneys of City's choosing, in its sole and absolute discretion). Further, I shall
defend at my own expense, including attorneys' fees and costs (with attorneys of City's
choosing, in its sole and absolute discretion), the City and its elected officials, officers,
employees, contractors, agents, and volunteers in any action or proceeding, legal,
administrative or otherwise, based upon such acts, omissions or willful misconduct.
___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE that this release, waiver,
indemnity and hold harmless certification is intended to be as broad and inclusive as is
permitted by the laws of the State of California, and that if any portion thereof is held invalid, it is
agreed that the balance shall, notwithstanding, continue in full legal force and effect.
___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE that I have read,
understand, and voluntarily sign this release, waiver, indemnity and hold harmless certification
and have had the opportunity to review this certification with legal counsel, and I agree that no
oral representations, statements or inducements apart from the foregoing written certification
have been made, and I further agree this certification shall be binding on me and my personal
representatives, heirs, assigns and next-of-kin. ___ (Initial)
I HEREBY ACKNOWLEDGE, UNDERSTAND AND AGREE that I am age 18 or older,
and that I will strictly abide by all safety requirements and other instructions given to me by any
and all City personnel and/or agency instructors at all times during my presence on the STC site
and during my participation in any Training Events or use of STC Facilities. ___ (Initial)
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GS1674
I HAVE CAREFULLY READ, UNDERSTAND, ACKNOWLEDGE AND AGREE TO THIS
RELEASE, WAIVER, INDEMNITY AND HOLD HARMLESS CERTIFICATION. I
UNDERSTAND THAT I AM GIVING UP VALUABLE LEGAL RIGHTS BY SIGNING THIS
RELEASE, WAIVER, INDEMNITY AND HOLD HARMLESS CERTIFICATION. I HAVE
AGREED TO SIGN THIS CERTIFICATION OF MY OWN FREE WILL. I UNDERSTAND THAT
I MAY SEEK THE ADVICE OF AN ATTORNEY IN ANY MATTER CONNECTED WITH THIS
RELEASE, WAIVER, INDEMNITY AND HOLD HARMLESS CERTIFICATION BEFORE
SIGNING.
PARTICIPANT SIGNATURE:
By:
Signature
Printed Name
Agency/Company Name
Date
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EXHIBIT "C" GS1674
FACILITY FEES
Safet Center - 1 Shootin $550
Safet Center - 1 Shootin $1,100
Safet Center - 2 Shootin $650
Safet Center - 2 Shootin $1,250
Safet $296
Safet $528
$236
$418
Safet $300
Safet $600
Safet $300
Safet $600
Safet $100
Safet $145
Safet Center -PriSim Trainin Simulator -Half Da $250
Safet Center -PriSim Trainin Simulator -Full Da $500
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iJGS ) -: -,, .. ~
July 01, 2017
STATE OF CALIFORNIA
PUBLIC LIABILITY AND WORKERS' COMPENSATION INSURANCE
FISCAL YEAR JULY 1, 2017 / JUNE 30, 2018
To \Nham It l\lay Concern:
In accordance with Government Code section 11007.4, the State of California has elected to be
self-insured for liability exposures. Under this form of insurance, the State and its employees
acting in the course and scope of their employment are insured for tort liability arising out of
official State business. All claims against the State of California based on tort liability should be
presented as a government claim to the Government Claims Program, P.O. Box 989052 MS
414, West Sacramento, CA 95798-9052. (Gov. Code section 900, et. seq.) Internet link:
http:/ !1tNl'N. dos .ca. cov /o rim/Proara ms/GovernmentClaims .asox.
The State of California has also elected to be insured for its motor vehicle liability ex;:iosures
throL.:gh the State l\1otor Vehicle Liability Self-Insurance Program (VELSIP). This program
provides liability coverage arising out of the operations of motor vehicles used by state
employees for official state business (California Vehicle Code Sections 17000 and 17001 ).
Motor vehicle liability claims against the State of California should be presented to the Office of
Risk and Insurance Management, P.O. Box 989052 l\lS-403, West Sacramento, CA 95798-
9052, (800) 900-3634, claims@dgs.ca.aov. If your motor vehicle liability claim is not resolved
within six mor.ths from the date of loss, California law requires you to file a formal claim with the
Government Claims Program, P.O. Box 989052 MS 414, West Sacramento, CA 95798-9052.
(Gov. Code section 900, et. seq.) Internet link:
htto:/lvwN1.das.ca.ao11/orim/Proarams/GovernmentClaims.asox.
The State of California has a Master Agreement with the State Compensation Insurance Fund
regarding workers' compensation benefits for all state employees, as required by the Labor
Code.
Sincerely,
• ... / .. ~f 2:;;=:,•: ·: .. --
'----,
Christopher Carro!!
Associate Risk Analyst
Insurance Services Unit
Phone: (91 6) 376-5279
---~-----
Fax: (916) 376-5275
christopher.carroll@dgs.ca.gov
Office of Risk and Insurance Management I S!ate of Ca!ifomia I Go·1emr-1ent O,cera'.ions Agency
707 3rd Street, 1st Floer I v'iest Sacramento. CA 956051 t 916.376.53CO f 916.376.5277 R:=V 07/27,15