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California Highway Patrol - Oceanside; 2013-11-25; PEM1052
Julyl 2013 STATE OF CALIFORNIA PUBLIC LIABILITY AND WORKERS' COMPENSATION INSURANCE FISCAL YEAR JULY 1, 2013 / JUNE 30, 2014 To Whom It May Concern The State of California has elected to be self-insured for general liability exposures (Gov Code section 990 et seq ) Under this form of insurance the State and its employees (as defmed in Section 810 2 of the Government Code) are insured for any tort liability that may develop through the carrying out of official State activities and operations All general liability tort claims against the State of California should be presented to the Victim Compensation and Government Claims Board PO Box 3035 Sacramento, CA 95812-3035 (Gov Code section 900 et seq ) Internet link vww vcgcb ca gov In addition the State of California has elected to be insured for its motor vehicle liability exposures through a self-insurance program administered by the Office of Risk and Insurance Management Under this program the Office of Risk and Insurance Management administers liability claims ansmg out ofthe operation of motor vehicles This self-insurance program and the protection it affords applies to vehicles owned and leased by the State of California All motor vehicle liability tort claims against the State of California should be presented to the Office of Risk and Insurance Management P O Box 989052 MS-403 West Sacramento CA 95798 9052 (800) 900 3634 The State of California has a Master Agreement with the State Compensation Insurance Fund regarding workers compensation benefits for ail state employees, as required by the Labor Code Sincerely 2)0nna Sctnd&nian Donna Sanderson Associate Risk Analyst (916) 376 1621 donna sanderson@dgs ca gov OFFICE OF RISK AND INSURANCE MANAGEMENT | State of 'oWornln | ffoft Coi»M/moi Soivicas Aqi nc/ 707 Vc: Sk' tr ! ' Hooi | West "iacranis iro CA laO'' | JTC '> iC/ ' 'id 17a "iir '>TATE OF CALIFORNIA DEPARTMENT OF FINANCE ^AYEEDATA RECORD (Required when receiving payment from the Stale of California in lieu of IRS W 9) STD 204 (Rev 6-5003) (CHP AUTOMATED) • INSTRUCTIONS Complete all infomiation on this fonn Sign date and retum to the State agency (department/office) address shown al the bottom of this page Prompt retum of this fully completed form w«l prevent delays when processing payments Infomiation provided in this fomi will be used by State agencies to prepare Infomiation Retums (1099) See reverse side for more infomiation and Pnvacy Statement NOTE Govemmental entities, federal. State, and local (Includinq school districts), are not reauired to submit this forni PAYEE S LEGAL BUSINESS NAME (Typo or PrInO CITY OF CARLSBAD SOLE PROPRIETOR . ENTER NAME AS SHOWN ON SSN (Last, Rret. MI) MAILING ADDRESS 1635 Faraday Avenue CITY, STATE, ZIP CODE Carlsbad, CA 92008-7314 EMAILADDRESS BUSINESS ADDRESS 1635 Faraday Avenue CITY, STATE, ZIP CODE Carlsbad, CA 92008-7314 • PAYEE ENTITY TYPE CHECK ONE BOX ONLY ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) I I PARTNERSHIP 6 0 0 9 3 • ESTATE OR TRUST CORPOFVVTION • MEDICAL (eg dentlslry psychotherapy chiropractic, etc.) [~1 LEGAL (eg attorney services) • EXEMPT (nonprofit) H ALL OTHERS I I INDIVIDUAL OR SOLE PROPRIETOR ENTER SOCIAL SECURITY NUMBER iJ (SSN lequlnad by authority of California Revenue and Tax Code Secllon 78646) NOTE Payment will not be processed without an accompanying taxpayer ID number • PAYEE RESIDENCY STATUS Cx] Cahfomia resident - Qualified to do business in California or maintains a pennanent place of business in California • California nonresident (see reverse side) - Payments to nonresidents for services may be subject to State income tax withholding • No sereices performed in California • Copy of Franchise Tax Board waiver of State withholding attached I hereby certify under penalty of perjury that the Information provided on this document Is true and correct Should my residency status change. I will promptly notlty the State agency below AUTHORIZED PAYEE REPRESENTATIVE S NAME (Type or Pnnt) CqJ^tte Wenge^nroth TITLE DATE inance Manager TELEPHONE 760-602-2468 Please return completed form to Department/Office Department of California Highway Patrol Unit/Section Business Services Section-Contract Services Umt Mailing Address P 0 Box 942898 City/state/Zip Sacramento, CA 94298-0001 Telephone 800-735-2922 Fax 916-322-3166 E mail Address s204_507 ftp 0 t\TE OF CALIFORNIA-DEPARTMENT OF FINANCE f^AYEE DATA RECORD STD 204 (Rev 6-2003) (REVERSE) (CHP AUTOMATED) Requirement to Complete Payee Data Record. STD 204 A completed Payee Data Record STD 204 is required for payments to all non govemmental entitles and will be kept on file at each State agency Since each State agency with which you do business must have a separate STD 204 on file it is possible for a payee to receive this form from vanous State agencies Payees who do not wish to complete the STD 204 may elect to not do business with the State If the payee does not complete the STD 204 and the required payee data is not othenwise provided payment may be reduced for federal backup withhoWing and nonresident State income tax withholding Amounts reported on Infonnation Retums (1099) are in accordance with the Intemal Revenue Code and the California Revenue and Taxation Code Enter the payee's legal business name Sole proprietorships must also include the owner's full name An Individual must list his/her full name The mailing address should be the address at which the payee chooses to receive correspondence Do not enter payment address or lock box mfonnation here Check the box that corresponds to the payee business type Check only one box Corporations must check the box that Identifies the type of corporation The State of California requires that all parties entering Into business transactions that may lead to payment(s) from the State provide their Taxpayer Identification Number (TIN) The TIN is required by the California Revenue and Taxation Code Section 18646 to facilitate tax compliance enforcement activities and the preparation of Forni 1099 and other Infonnation retums as required by the Intemal Revenue Code Section 6109(a) The TIN for individuals and sole proprietorships Is the Social Secunty Number (SSN) Only partnerships estates trusts and corporations will enter their Federal Employer Identification Number (FEIN) Are vou a California resident or nonresident? A corporation will be defined as a "resldenr if rt has a permanent place of business In Califomia or Is qualified through the Secretary of State to do business In California A partnership is considered a resident partnership if rt has a penmanent place of business In California An estate Is a resident if the decedent was a California resident at time of death A toist is a resident if at least one tmstee is a California resident For individuals and sole propnetors the terni "resident" Includes every individual who is in Califomia for other than a temporary or transitory purpose and any Individual domiciled in California who is absent for a temporary or transitory purpose Generally an Individual who comes to California for a purpose that will extend over a long or Indefinite penod will be considered a resident However an individual who comes to perfonn a particular contract of short duration will be considered a nonresident Payments to all nonresidents may be subject to withholding Nonresident payees perfonning sen/ices in California or receiving rent lease or royalty payments from property (real or personal) located in California will have 7% of their total payments withheld for State income taxes However no withholding is required if total payments to the payee are $1 500 or less for the calendar year I For information on Nonresident Withholding contact the Franchise Tax Board at the numbers listed below Withholding Services and Compliance Section 1-888-792-4900 E mail address wscs gen@flb ca gov For heanng impaired with TDD call 1-800-822-6268 Website www fib ca gov 5 I Provide the name title signature and telephone number ofthe Individual completing this fonn Provide the date the form was completed 6 This section must be completed by the Stale agency requesting the STD 204 Pnvacv Statement I Section 7(b) ofthe Pnvacy Act of 1974 (Public Law 93-579) requires that any federal State or local governmental agency which requests an individual to disclose their social secunty account number shall infonn that individual whether that disclosure is mandatory or voluntary by which statutory or other authonty such number is solicited and what uses will be made of it It IS mandatory to furnish the information requested Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and State law imposes noncompliance penalties of up to $20 000 I You have the nght to access records containing your personal information such as your SSN To exercise that nght, please contact the business services unit or the accounts payable unit of the State agency(ies) with which you transact that business I All questions should be referred to the requesting State agency listed on the bottom front ofthis form s204_507 ftp State of California—Transportation Agency EDMUND G BROWN Jr Governor DEPARTMENT OF CALIFORNIA HIGHWAY PATROL Business Services Section Contract Services Unit PO Box 942898 Sacramento CA 94298 0001 (916) 843 3610 (800) 735 2929 (TT/TDD) (800) 735 2922 (Voice) November? 2013 City ofCarlsbad 5750 Orion Street Carlsbad CA 92010 Subject Agreement Number 13C650000 0 Complete the following marked item(s) and return to the above address within ten (10) business days ^ STD 213 Standard Agreement with attached exhibits Sign the first page of the STD 213, sign the additional single STD 213, and retum both copies STD 213A Standard Agreement Amendment Sign the first page of the STD 213A, sign the additional single STD 213A and retum both copies STD 210 Short Form Contract Sign and retum both copies Letter of Agreement Sign and retum both copies ^ STD 204, Payee Data Record Complete and retum CCC Contractor Certification Clauses Complete and retum Obtain and forward the liability insurance certificate required by the terms of the Agreement Resolution motion order, or ordinance from the local goveming body authorizmg this Agreement STD 807 Payment Bond Complete and retum one copy CHP 28 Voluntary Statistical Data Complete and retum Other Contract status The enclosed agreement is signed on behalf of the Department of California Highway Patrol Process and when approved retum an original to this office The enclosed approved agreement is for your records You are now authorized to provide services TESSA GOMEZ Contract Analyst Enclosures Safety, Service and Security An Internationally Accredited Agency STD213 0613 xft STATE OF CALIFORNIA STANDARD AGREEMENT ANALYST INITIALS TG STD 213 (Rev 06/03) AGREEMENT NUMBER 13C650000 REGISTRATION NUMBER 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 The term of this Agreement is 12/01/2013 or upon approval ('w/7/c/7ever/s/afer) through 11/30/2014 3 The maximum amount of this Agreement is $ 38 400 00 Thirty-Eight Thousand Four Hundred 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 (GTC 610) With the exception of Paragraph 5 (as shown herein) Attachment 1 - Agreement for Use of The Carlsbad Safety Training Center (STC) Exhibit A - Safety Training Center Facility Descnption Capabilities and Location Exhibit B - Participant Release Form 1 pages 1 page 4 pages 6 pages 1 page 3 pages Signatures appear on page 6 of 6 Attachment 1 of this Agreement Items stiown wtth an Astensl< (*) are fiereby incorporated by reference and made part ofthis agreement as if attached hereto These documents can be viewed at www ols dgs ca gov/Standard+Language IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto CITY OF CARLSBAD ^^^^ California Department of General Services Use Only COHTRACJOR S t'iAME (if otherttian an individual state whetiier a corporation partnersfiip ete^—" California Department of General Services Use Only BY (Authorized Signature) DATE SIGNED^Do nof type) PRINTED NAME AND TITLE OF PERSONSj^jmtf ADDRESS^^^^^^^^^ EXEMPT FROM DEPARTMENT OF GENERAL SERVICES APPROVAL IN ACCORDANCE WITH THE STATE STATE OF CALIFORNIA ^^^^ ADMINISTRATIVE MANUAL AGENCY NAME ^^^^ BY (Authorized Signature) ^^..-^ DATE SIGNEDfDo not type) PRINTED NAME AND TITLE^^FPERSON^IgfcUMCT jgj Exempt per SCM 4 04 AGOR^SS^^^^^^^,.,^-^ California Highway Patrol and City ofCarlsbad Agreements 13C650000 Exhibit A Page 1 of 1 EXHIBIT A (Standard Agreement) SCOPE OF WORK 1 Contractor agrees to provide to the Department of California Highway Patrol (CHP) Oceanside Area office the services descnbed herein See Attachment 1 - Agreement for Use Carlsbad Safety Training Center (STC) 2 The services shall be performed at • If checked see attached for additional service locations See Attachment 1 Exhibit A - Safety Training Center Facility Descnption Capabilities and Location 3 The services shall be provided dunng Such times that is mutually agreeable to both parties 4 The project representatives dunng the term of this agreement will be STATE AGENCY Department of California Highway Patrol CONTRACTOR City of Carlsbad NAME Lt PeteRecatto NAME Jason Kennedy, Facility Manager TELEPHONE NUMBER (760) 757-1675 FAX NUMBER (760) 757-0907 TELEPHONE NUMBER 760-931-2236 FAX NUMBER Direct all mqumes to STATE AGENCY Department of California Highway Patrol CONTRACTOR City of Carlsbad SECTION/UNIT Business Services Section Contract Services Unit SECTION/UNIT ATTENTION Tessa Gomez Contract Analyst ATTENTION Jason Kennedy Facility Manager ADDRESS P 0 Box 942898 Sacramento, CA 94298-0001 ADDRESS 5750 Onon Street Carlsbad CA 92010 TELEPHONE NUMBER (916) 843-3610 FAX NUMBER (916) 322-3166 TELEPHONE NUMBER 760-931-2236 FAX NUMBER Department of California Highway Patrol City ofCarlsbad Agreement #13C650000 Exhibit B Page 1 of 1 EXHIBIT B (Standard Agreement) BUDGET DETAIL AND PAYMENT PROVISIONS 1 Invoicing and Payment A For services satisfactonly 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 Name Lt Pete Recatto Office Oceanside Area office Address 1888 Oceanside Boulevard Oceanside, CA 92054 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 appropnate 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 occurnng 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 below 25 yard range $1 000/full day 25 yard & 100 yard ranges $1,200/full day Department of California Highway Patrol City ofCarlsbad Agreement #13C650000 Exhibit C Page 1 of 4 GTC 610 EXHIBIT C GENERAL TERMS AND CONDITIONS 1 APPROVAL This Agreement is of no force or effect until signed by both parties and approved by the Department of General Services if required Contractor may not commence performance until such approval has been obtained 2 AMENDMENT No amendment or vanation of the terms of this Agreement shall be valid unless made in writing signed by the parties and approved as required No oral understanding or Agreement not incorporated in the Agreement is binding on any ofthe parties 3 ASSIGNMENT This Agreement is not assignable by the Contractor, either in whole or in part without the consent of the State in the form of a formal wntten amendment 4 AUDIT Contractor agrees that the awarding department the Department of General Services the Bureau of State Audits or their designated representative shall have the nght to review and to copy any records and supporting documentation pertaining to the performance of this Agreement Contractor agrees to maintain such records for possible audit for a minimum of three (3) years after final payment unless a longer period of records retention is stipulated Contractor agrees to allow the auditor(s) access to such records dunng normal business hours and to allow interviews of any employees who might reasonably have information related to such records Further Contractor agrees to include a similar right ofthe State to audit records and interview staff in any subcontract related to performance of this Agreement (Gov Code §8546 7 Pub Contract Code §10115 et seq , CCR Title 2 Section 1896) 5 INDEMNIFICATION Contractor aarees to indemnify defend and save harmless the State its officers agents and employees from any and all claims and losses accruing or resulting to any and all contractors subcontractors, suppliers laborers and any other person firm or corporation furnishing or supplying work services matenals or supplies in connection with the performance of this Agreement and from any and all claims and losses accruing or resulting to any person firm or corporation whe^ay be injured or damaged by Contractor in the performance of this Agreement KjJ/>'|ti>[|^INITIAL HERE 6 DISPUTES Contractor shall continue with the responsibilities under this Agreement dunng any dispute 7 TERMINATION FOR CAUSE The State may terminate this Agreement and be relieved of any payments should the Contractor fail to perform the requirements of this Agreement at the time and in the manner herein provided In the event of such termination the State may proceed with the work in any manner deemed proper by the State All costs to the State shall be deducted from any sum due the Contractor under this Agreement and the balance, if any, shall be paid to the Contractor upon demand Department of California Highway Patrol City ofCarlsbad Agreement #13C650000 Exhibit C Page 2 of 4 8 INDEPENDENT CONTRACTOR Contractor and the agents and employees of Contractor in the performance of this Agreement shall act in an independent capacity and not as officers or employees or agents of the State 9 RECYCLING CERTIFICATION The Contractor shall certify in wnting under penalty of perjury, the minimum, if not exact percentage of post consumer matenal as defined in the Public Contract Code Section 12200 in products materials goods or supplies offered or sold to the State regardless of whether the product meets the requirements of Public Contract Code Section 12209 With respect to pnnter or duplication cartndges that comply with the requirements of Section 12156(e) the certification required by this subdivision shall specify that the cartridges so comply (Pub Contract Code §12205) 10 NON-DISCRIMINATION CLAUSE Dunng the performance ofthis Agreement, Contractor and its subcontractors shall not unlawfully discnminate harass, or allow harassment against any employee or applicant for employment because of sex race color ancestry religious creed national origin physical disability (including HIV and AIDS) mental disability medical condition (eg cancer) age (over 40j marital status, and denial of family care leave Contractor and subcontractors shall insure that the evaluation and treatment of their employees and applicants for employment are free from such discnmination and harassment Contractor and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov Code §12990 (a-f) et seq ) and the applicable regulations promulgated thereunder (California Code of Regulations Title 2 Section 7285 et seq ) The applicable reguiabons of the Fair Employment and Housing Commission implementing Government Code Section 12990 (a-f) set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations, are incorporated into this Agreement by reference and made a part hereof as if set forth in full Contractor and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other Agreement Contractor shall include the nondiscnmination and compliance provisions ofthis clause in all subcontracts to perform work under the Agreement 11 CERTIFICATION CLAUSES The CONTRACTOR CERTIFICATION CLAUSES contained m the document CCC 307 are hereby incorporated by reference and made a part ofthis Agreement by this reference as if attached hereto 12 TIMELINESS Time is of the essence in this Agreement 13 COMPENSATION The consideration to be paid Contractor, as provided herein shall be in compensation for all of Contractor's expenses incurred in the performance hereof including travel per diem and taxes unless othenrt/ise expressly so provided 14 GOVERNING LAW This contract is governed by and shall be interpreted in accordance with the laws of the State of California Department of California Highway Patrol City ofCarlsbad Agreement #13C650000 Exhibit C Page 3 of 4 15 ANTITRUST CLAIMS The Contractor by signing this agreement hereby certifies that if these services or goods are obtained by means of a competitive bid the Contractor shall comply with the requirements of the Government Codes Sections set out below a The Government Code Chapter on Antitrust claims contains the following definitions 1) "Public purchase" means a purchase by means of competitive bids of goods services or matenals by the State or any of its political subdivisions or public agencies on whose behalf the Attorney General may bnng an action pursuant to subdivision (c) of Section 16750 ofthe Business and Professions Code 2) "Public purchasing body" means the State or the subdivision or agency making a public purchase Government Code Section 4550 b In submitting a bid to a public purchasing body the bidder offers and agrees that if the bid is accepted it will assign to the purchasing body all nghts title and interest in and to all causes of action it may have under Section 4 ofthe Clayton Act (15 U S C Sec 15) or underthe Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 ofthe Business and Professions Code) ansing from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder Government Code Section 4552 c If an awarding body or public purchasing body receives, either through judgment or settlement a monetary recovery for a cause of action assigned under this chapter the assignor shall be entitled to receive reimbursement for actual legal costs incurred and may upon demand recover from the public body any portion of the recovery, including treble damages attnbutable to overcharges that were paid by the assignor but were not paid by the public body as part ofthe bid pnce less the expenses incurred in obtaining that portion ofthe recovery Government Code Section 4553 d Upon demand in writing by the assignor the assignee shall, within one year from such demand reassign the cause of action assigned under this part ifthe assignor has been or may have been injured by the violation of law for which the cause of action arose and (a) the assignee has not been injured thereby or (b) the assignee declines to file a court action for the cause of action See Government Code Section 4554 16 CHILD SUPPORT COMPLIANCE ACT For any Agreement in excess of $100 000 the contractor acknowledges in accordance with Public Contract Code 7110 that a The contractor recognizes the importance of child and family support obligations and shall fully comply with all applicable state and federal laws relating to child and family support enforcement including but not limited to disclosure of information and compliance with earnings assignment orders as provided in Chapter 8 (commencing with section 5200) of Part 5 of Division 9 of the Family Code and b The contractor to the best of its knowledge is fully complying with the earnings assignment orders of all employees and is providing the names of all new employees to the New Hire Registry maintained by the California Employment Development Department Department of California Highway Patrol City ofCarlsbad Agreement #13C650000 Exhibit C Page 4 of 4 17 UNENFORCEABLE PROVISION In the event that any provision of this Agreement is unenforceable or held to be unenforceable then the parties agree that all other provisions of this Agreement have force and effect and shall not be affected thereby 18 PRIORITY HIRING CONSIDERATIONS If this Contract includes services in excess of $200 000 the Contractor shall give pnority consideration m filling vacancies in positions funded by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200 in accordance with Pub Contract Code §10353 19 SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING REQUIREMENTS a If for this Contract Contractor made a commitment to achieve small business participation then Contractor must within 60 days of receiving final payment under this Contract (or within such other time penod as may be specified elsewhere in this Contract) report to the awarding department the actual percentage of small business participation that was achieved (Govt Code § 14841 ) b If for this Contract Contractor made a commitment to achieve disabled veteran business enterpnse (DVBE) participation then Contractor must within 60 days of receiving final payment under this Contract (or within such other time period as may be specified elsewhere in this Contract) certify in a report to the awarding department (1) the total amount the pnme Contractor received underthe Contract (2) the name and address ofthe DVBE(s) that participated in the performance of the Contract (3) the amount each DVBE received from the pnme Contractor (4) that all payments under the Contract have been made to the DVBE and (5) the actual percentage of DVBE participation that was achieved A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation (Mil & Vets Code § 999 5(d) Govt Code § 14841 ) 20 LOSS LEADER If this contract involves the furnishing of equipment matenals or supplies then the following statement is incorporated It is unlawful for any person engaged in business within this state to sell or use any article or product as a loss leader" as defined in Section 17030 of the Business and Professions Code (PCC 10344(e)) S \ADM1N\HOMEPAGE\GTC-610 doc PEM1052 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 Trainmo Center (STC) ( Agreement) is entered into this ^fj^^ day of ^i5^t^V6^t tO^'b by and between the City of Carlsbad a municipal corporation organized under the laws of the State of California with its pnncipal place of business at 5750 Onon Street Carlsbad California 92010 ( City) and the California Highway Patrol (CHP) a law enforcement division under the State of California with Its pnncipal place of business at 1888 Oceanside Boulevard Oceanside California 92054 ( 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 of 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 on or about December 1, 2013 ( 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 condibons requirements and fees as descnbed in Exhibit A Exhibit B , 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 Trainina 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 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 descnption 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 appropnate 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 dunng the penod 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 MAT] Signature orAgeflfcy Representative Pnnted 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 inachons 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 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 anse 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, wntten 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 msurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California The insurance earner is required to have a current Best's Key Rating of not less than "A-Vll" 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 'AX" Agency shall maintain Workers Compensation coverage in the statutonly required amounts, if applicable Agency shall require its insurer to waive all nghts 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 Citys satisfaction pnor 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 Insured'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 ofthe 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 pnor 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 December 1, 2013 through November 30, 2014 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 or not Agency subsequently uses the STC Facilities or not 3 11 Accidents / Damaqe 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 investigahons 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 the purpose of determining cause responsibility and any physical or operational modrfications 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 ofthe same For purposes ofthis Agreement cleanup for STC Facilities will be descnbed in further detail in the STC Facilities SOP 3 13 Notices Except as othenwise 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 If to City California Highway Patrol City of Carlsbad Administrative Services Division 1635 Faraday Avenue 601 North 7th Street Carlsbad CA 92008 Sacramento California 95811 Attn Property and Environmental Management Division 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 obligahon 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 pnor approval by City 3 17 Entire Agreement This wntten document contains the entire agreement of the parties and supersedes any pnor oral or written statements or agreements between the parties No supplement modificahon 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 pnvilege or service voluntanly given or performed by either party shall give the other party any contractual right by custom estoppel or othenwise 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 \t 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 constrfute an original and which collectively shall constrfute 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 mure 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] 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 authonty to bind Agency to the terms and conditions of this Agreement CITY OF CARLSBAD By Javid Hauser Property and Environmental Management Director Attest Proper notanal acknowledgment of execution by Agency must be ^^1^ • If a corporation Agreement must be signed by one corporate officer frcJfn'l^ach ofthe following two groups Group A Chairman President or Vice-President AGENCY By y . . . Signkuf^ (f^_^^ Name (Pnnt) Title (Pnnt) Group B Secretary Assistant Secretary CFO or Assistant Treasurer By Signature Name (Pnnt) Trtle (Print APPROVED AS TO FORM CELIA A BREWER City Attorney By. Assistant City Attorney ACKNOWLEDGMENT state of California County of ^^^gmgnto before me (insert name and title ofthe officer) personally appeared ^OiCJ^ ii^\\jr\ who proved to me on the balis of satisfactory evi proved to me on the ba§is of s5tisfacton7 evidence to be the person(9)-whose name(s) is/efe- subscribed to the withm instrument and acknowledged to me that he/she/they executed the same in -Iws/her/thetr authonzed capacity(4©s) and that by t*»/her/th€tr signature's^ on the instrument the person<s)r or the entity upon behalf of which the person4s> 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 WITNESS my hand and official seal (Seal) Commission # 2017722 Notary Public California Volo County LCommjxpires AprUijoi 71 EXHIBIT "A" SAFETY TRAINING CENTER FACILITY DESCRIPTION, CAPABILITIES AND LOCATION 1 The Carlsbad Safety Training Center (STC) is a four-acre facility that provides training resources which can replicate emergency scenanos and high nsk training events that Joint First Responders may encounter when conducting public safety operations The STC Facilrties 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 wrthin the City of Carlsbad and outlying cities 2 The STC Facilities consists of a pnmary training building which houses two indoor shoohng ranges (25 yards and 100 yards) murtiple storage areas and three classrooms with audio visual systems and a training room for computer generated training scenarios The outside areas of the facility consists of a residential live fire burn prop four story commercial tower with murtiple live fire burn props confined space training area trench extncation area vehicle extrication area city streetscape emergency vehicle training area (gnnder) 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 Onon Street Carlsbad CA 92010 bus 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 (10-digit/WGS-84 Datum) IIS MS 75118 66596 EXHIBIT "B" PARTICIPANT RELEASE (HOLD HARMLESS CERTIFICATION) I (print name) have voluntanly 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 vanous safety training apparatus located at 5750 Onon Street Carlsbad California 92010 known as the Carlsbad Safety Training Center ( STC Facilities ) for the purposes of Firearms Training on or about December 1. 2013 (Training Events ) I hereby acknowledge understand and agree that the City is allowing the use of said STC Facilities for my sole benefrt 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 stnkes from bullet fragments and shell casings falls from high structures tnp and snag hazards falls on wet surfaces lead contamination falling debris motor vehicle accidents and/or other known and unknown hazards that may resurt in serious bodily injury or death I understand acknowledge and agree that such senous 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 nsks 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 nsks of damage injury effects or death resurting to me or my property while using or observing the use of the STC Facilrties or participating in a Training Event or resurting from the use or condition of STC Facilrties whether or not using STC Facilrties and whether or not the risks are known or unknown to me or to City (Initial) I HEREBY ACKNOWLEDGE UNDERSTAND AND AGREE m 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 bnng any claim or demand whether administrative judicial or othenwise 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 Facilrties and whether or not the nsks 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 othenwise come wrthin 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 rf 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 Wrth respect to the released claims 1 knowingly and 1 voluntanly waive and relinquish any and all nghts 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 rf 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 ansing out of or incident to any acts omissions or willful misconduct of me while I participate in the Training Events whether while using STC Facilrties including without limitation the payment of attorneys fees and costs (wrth attorneys of City s choosing in its sole and absolute discretion) Further I shall defend at my own expense including attorneys fees and costs (wrth attorneys of Citys 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 rf 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 voluntanly sign this release waiver indemnity and hold harmless certification and have had the opportunity to review this certrfication wrth 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 certrfication 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 dunng my presence on the STC site and dunng my participation in any Training Events or use of STC Facilities (Initial) EXHIBIT "B" PARTICIPANT RELEASE (HOLD HARMLESS CERTIFICATION) 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 Pnnted Name Date