HomeMy WebLinkAboutCC AG PKT 2010-10-11 #I AGENDA STAFF REPORT
DATE: October 11, 2010
TO: Honorable Mayor and City Council
THRU: David N. Carmany, City Manager
FROM: Jill R. Ingram, Assistant to the City Manager
SUBJECT: COMMUNITY SERVICES CONTRACT INSTRUCTOR
PACKET
SUMMARY OF REQUEST:
It is recommended that the City Council authorize the City Manager to implement
the proposed Community Services Contract Instructor Packet, including the
Contract Instructor Information Letter, Contract Instructor Application, Contract
Instructor Guidelines and Policies, Master Program Instructor Agreement, and
Quarterly Addendum Letter.
BACKGROUND:
The Community Services Department utilizes independent contract instructors to
provide recreational services to our community. The proposed Contract
Instructor Packet was drafted to assist the Community Services Department in
establishing guidelines and policies with contractors that represent the City, as
well as staff oversight in management of contract instructors. The draft Contract
Instructor Packet attached to this staff report as Attachment A includes the
following:
D Contract Instructor Informational Letter — Defines the application
process and the relationship between the City and proposed contract
instructor.
D Contract Instructor Application — Specifically for instructors to propose
and outline classes to the Community Services Department, and how
potential students may benefit from the program.
D Contract Instructor Guidelines and Policies — Establishes the rules and
regulations for contract instructors, including class cancellations and
subcontractors, compensation, records, facilities, keys, equipment,
supervision, incident reports, publishing the quarterly Shoreline recreation
Agenda Item
Page 2
brochure, marketing of classes, enrollment, minimum and maximum
participants, refunds, fingerprinting and background checks, and right to
refuse service.
> Master Program Instructor Agreement — The master agreement covers
the specifics of the contract. The Master Program Instructor Agreement
will be required to be signed by all new, current, and returning instructors
when they initially begin teaching with the City.
> Quarterly Addendum Letter — The Quarterly Addendum Letter will be
provided to each instructor on a quarterly basis as a verification of what
each instructor is going to be teaching in that given quarter. The Quarterly
Addendum Letter also features an "Instructor's Certification Statement"
that certifies each instructor reviewed the terms of the Master Program
Instructor Agreement, Quarterly Addendum Letter, and current Contract
Instructor Guidelines and Policies issued by the City of Seal Beach.
On September 22, 2010, staff presented the proposed Community Services
Contract Instructor Packet, including the Contract Instructor Information Letter,
Contract Instructor Application, Contract Instructor Guidelines and Policies,
Master Program Instructor Agreement, and Quarterly Addendum Letter to the
Recreation & Parks Commission. Following discussion the Commission
unanimously directed staff to present a recommendation to the City Council that
the City Council authorize the City Manager to implement the proposed
Community Services Contract Instructor Packet.
Approval and implementation of the Community Services Contract Instructor
Packet at the October 11, 2010 City Council meeting will be a timely action which
would allow the Community Services Department staff to immediately implement
for the Winter Quarter 2011 Shoreline recreation classes which begin in
November.
FINANCIAL IMPACT:
There are no fiscal impacts associated with this item.
RECOMMENDATION:
It is recommended that the City Council authorize the City Manager to implement
the proposed Community Services Contract Instructor Packet, including the
Contract Instructor Information Letter, Contract Instructor Application, Contract
Instructor Guidelines and Policies, Master Program Instructor Agreement, and
Quarterly Addendum Letter.
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SUBMITTED BY: NOTED AND APPROVED:
J' I Ingram, • David N. Carm ny, City Manager
Assistant to the City Manager
Prepared by: Tim Kelsey, Community Services Supervisor
Attachments:
A. Proposed Contract Instructor Information Packet
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Community Services Department
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, , e, Contract Instructor Application
room
Name: Date:
Address:
Work Phone: Home Phone:
Cell: Fax:
Which of the above numbers will you allow us to release to the public?
E -Mail:
1. Proposed class name:
2. Description of class (please write a 25- 40 word description of your class):
3. List reasons why we should offer this program (how your students will benefit):
4. Proposed start date:
5. Facility location preferred:
6. How many weeks will the class be taught?
7. Days and times you would like to teach:
1 choice:
2 "d choice:
3 choice:
8. Age range of participants:
9. Number of participants you can accommodate: (Minimum) (Maximum)
10. Student class fee:
11. Materials fee (if any):
12. When should we offer this class? Spring Summer _Fall Winter
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Please enclose a brief bio and class outline along with your resume.
Please mail this Application to: City of Seal Beach
Attention: Community Services Coordinator
Recreation & Community Services Department
211 Eighth Street
Seal Beach, CA 90740
The Community Services Coordinator will review this application and determine its
potential to meet the Department's vision, goals, and community needs, before contacting
you for a more detailed discussion.
Together, the Program Coordinator /Supervisor will work with you to determine the
specific course /activity design in regards to the facility suitability, facility availability, fee
structure, course time frames, participant minimums and maximums, age range, course
description, etc. This does not guarantee that your course /activity will be accepted.
Please note, the City will not accept proposals for the following:
• Programs that are similar to programs we currently offer. Please review the
most recent issue of Shoreline, the Seal Beach Community Services quarterly
brochure.
• Programs we have offered in the past that have been cancelled (unless you can
show that you have the necessary number of participants who are interested).
• Inappropriate programs for the recreation setting or similar programs offered
by local community colleges or business /commercial /professional agencies.
If the City accepts the proposal, the Instructor will have to sign a contract with the City
and follow the guidelines and policies set forth in the attached Guidelines, Policies &
Procedures document.
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The City's purpose in contracting with independent Instructors is to provide its residents
with recreational activities in a manner that will foster a sense of community, security, fun,
and fair play through programs that City staff cannot provide directly. The terms and
conditions of the Instructor's work for the City will be set forth in a Master Program
Instructor Agreement, Quarterly Addenda to the Agreement that must be completed for
each quarter that the Instructor teaches a class for the City, and the guidelines and
policies contained in this document.
Contracts
Instructors are required to sign a Master Agreement with the City. The Master
Agreement specifies the general terms and conditions under which Instructors provide
services; including such matters as compensation, indemnification, and insurance
requirements. Instructors must review and agree to all terms and conditions of the Master
Agreement. Instructors must also sign a Quarterly Addendum to the Master Agreement
for each class taught each calendar quarter. The Quarterly Addenda will specify the class
size, program requirements, and other details for the classes Instructors will teach that
quarter. Classes will be cancelled if the required forms have not been submitted and
approved.
Independent Status
Under the Master Agreement, Instructors act as independent contractors, and not agents
or employees of the City of Seal Beach. Accordingly, Instructors obtain no rights to the
retirement benefits or other benefits that accrue to City employees. Although not
employees of the city of Seal Beach, Instructors do represent the City and must therefore
conduct themselves accordingly. Instructors must conduct themselves in a professional
manner including dressing and speaking professionally, and supporting City policies and
decisions; including those set forth in this document as it may be amended from time to
time.
Class Cancellations & Subcontractors
The City contracts with an Instructor based on his or her special expertise and experience.
The City therefore requires the Instructor to personally perform or directly oversee the
performance of the services. In the event the Instructor is not able to teach a class due to
illness or some other cause beyond Instructor's control, Instructor must follow the
following procedures:
A. Instructor must procure at its sole expense a substitute instructor at least as qualified
as the Principal Instructor to teach the class at its regular time and place. Substitute
instructors must comply with the City's fingerprinting requirements.
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B. Instructor must notify the City of the substitute instructor's name, qualifications,
address, and phone number.
C. If Instructor cannot procure an adequate substitute, then the class will be cancelled
and a make -up must be added to the end of the session. Instructor must notify
students as soon as possible of the cancellation and the make -up class.
Compensation
Instructors are compensated based on a percentage of the registration fees collected by
the City. Typically, Instructors are paid 65% of registration fees paid by class
participants, less an administrative fee. Instructors are not allowed to impose additional
fees or material costs on participants registered through the City unless such fees or costs
have been approved in advance by the Community Services Coordinator and published in
the quarterly brochure. Students will pay material fees directly to Instructor at first class
meeting.
Instructors are paid by warrant check at the conclusion of your class. A 1099 statement
will be issued to you at the end of the year documenting your earnings, if $600 or more.
Instructors are personally liable for any federal, state, or local taxes incurred and the City
will not withhold any deductions from these earnings.
Records and Inspections
Instructors are required to maintain full and accurate records with respect to all services
provided to the City and will be required to make such records available for inspection on
24 -hours notice.
Coordination of Work
Instructors are required to coordinate with the City to avoid conflicts of use. Resolution of
any conflict is at the sole discretion of the City's Community Services Director or that
person's designee.
Set -up & Tear -down
Instructors are responsible for setting -up and being prepared to greet class participants 10
minutes prior to class time. Classes must begin at the agreed upon start time.
Instructors for all adult crafts, cooking, and children classes are requested to wipe down
tables and retum the room to its original condition in order to accommodate the next
scheduled class. All Instructors must set -up and teardown tables and chairs as needed.
Floors must be swept and/or mopped as needed. Restrooms are to be cleared of soap,
towels, and debris.
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Facilities & Keys
Instructor's primary responsibility is to ensure the safety of program participants. Prior
to class, Instructors must visually inspect the programs and facilities to ensure safety. If
any aspect of the area appears unsafe, it is the Instructor's responsibility to notify the
Community Services Coordinator and to take actions that will ensure participant safety.
All Instructors will be assigned a designated key number. Keys will need to be checked
out from the Community Services Department before each class session. At the end of
every class session keys need to be returned to the Community Services Office no later
then one week following the last class meeting. A $100.00 fee will be assessed for all
lost keys to cover the cost to re -key the facility should a key be lost or stolen. When
leaving the facility, an Instructor must ensure that all doors are locked securely and all
lights are turned off.
Equipment & Labor
Instructors are required to furnish all tools, equipment, apparatus, supplies, and materials
necessary for their classes unless otherwise agreed to by the City. Instructors assume all
risk of loss, damage, or harm to such equipment or materials arising in connection with
their services. Instructors are not allowed to distribute and/or sell personal items or
equipment.
Supervision
Instructors are required to establish appropriate rules for conducting the class and to
assume responsibility for student discipline to ensure adequate protection of students and
facility.
Instructors teaching youth programs must stay with their students at all times. At no time
may an Instructor leave the premises before all children have been picked up by a parent
or guardian. Instructors must not release children to anyone other than the authorized
parent, guardian, or to an individual authorized by the parent. Parents are not permitted
to attend children's classes unless the class is designated a parent participation class. It is
the Instructor's responsibility to inform parents that they may not remain in the
classroom. Children are not permitted to attend adult classes with their parent. Again,
address the situation if it occurs immediately and appropriately.
Incident Reports
Instructors are required to inform the Community Services Coordinator/ Supervisor
immediately of accidents or emergency situations that occur or arise during the class time
and that may require further action. Incident report forms can be picked up in the
Community Services Department and must be completed by the Instructor and submitted
within 24 hours.
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Brochure
The Community Services Department publishes 10,500 copies of Shoreline, Seal Beach's
quarterly brochure and schedule of classes. Shoreline is mailed out to residents one .
month prior to the start of classes. Unless otherwise agreed to by the City, all activities
and course outlines are to be performed at times and dates described in the brochure.
Additional flyers and advertising are the Instructor's responsibility and must be approved
by the Community Services Coordinator prior to distribution.
Additional Marketing and Promotion of Classes
The Department will provide a certain amount of publicity for all classes. This will
include a listing and description in the quarterly brochure, Shoreline, with flyers and
press releases by arrangement. Our department will print flyers (within reason) for
Instructors if arrangements are made in advance. Instructors may and are strongly
encouraged to advertise in addition to the class information printed in the City brochure.
Any publicity that includes "Sponsored by the City of Seal Beach" or similar City
identification or endorsement must be approved by the Department prior to public
distribution.
Enrollment, Registration, and Rosters
Class registration forms are mandatory and must be completed for all students each
session/quarter. In the case of drop -in, pay -as- you -go programs, multiple signature forms
are mandatory. The City encourages mail -in, fax -in, and walk -in registration; on -site
registration is discouraged. Onsite registrations received must be submitted to the
Community Services Department prior to the second class. Participants, who have not
paid a registration fee to the City, may not participate. Instructors should take daily
attendance to ensure proper enrollment and payments. Instructors will not be paid for
students not on the roster.
Instructors must call the Community Services Office at least one week PRIOR to the first
scheduled class to verify enrollment. Instructors may pick up class rosters from the
office or request one via e -mail. All correspondence during the course of the class will
be collected in the office, so Instructors should check for messages often. Those
Instructors teaching classes that are co- sponsored by the Community Services
Department and another city will need two rosters. Instructors should check with the co-
sponsoring city if they have not received a second roster prior to class.
Participant Minimum & Maximum
The minimum and maximum number of participants and student to Instructor ratio will
be established by the Instructor and Community Services Coordinator in the Quarterly
Addendum to the Master Agreement. Consideration of the best number for instructional
purposes, room size, and equipment available will be criteria for class numbers.
Instructors should not set minimums too high, as class will be cancelled if it is not
reached at least three days prior to the start of the class.
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Refunds
Students may request to drop a class due to illness, schedule conflicts, or because it was
not what they had expected. Refunds are processed only if their request has been made
prior to the second class. An administrative fee of $10 may be assessed. If a class is
cancelled due to lack of enrollment, a refund will automatically be processed with no fee.
Fingerprinting & Background Checks
Pursuant to California Public Resource Code 5164 and City Policy, Instructors and all
persons under their supervision for the purposes of teaching classes must submit to
undergo Live Scan fingerprinting for a criminal background check prior to providing any
services for the City of Seal Beach. Instructors will be reimbursed for the cost of
fingerprinting and background checks.
Anti - Discrimination Policy
In providing services to the City, Instructors must not discriminate against any person
because of race, religion, color, national origin, handicap, ancestry, sex, sexual
orientation, or age.
Americans with Disability Act (ADA)
Under the Americans with Disability Act (ADA), 1990, Leisure Service Agencies and
their Instructors are required to accommodate individuals with special needs. Instructors
must be willing to work with the City of Seal Beach, Community Services Department
and accommodate those who request assistance.
Confidentiality
All data, documents, discussion, or other information developed or received by
Instructors while providing services to the City must be kept confidential and not
disclosed without the City's prior authorization unless disclosure is otherwise required by
law.
Information that identifies or relates to our students should be safeguarded as
confidential. Class rosters contain the names and telephone numbers of students enrolled.
Such information is not to be distributed without prior City approval and is for the use of
the Instructor only as it relates to the course.
Instructor Contact Information
Instructors must notify the Community Services Coordinator as soon as possible if there
is a change to the Instructor's address or phone number.
Right to Refuse Service
Contract Instructors can refuse service to participants under the following conditions:
• Participants who are unreasonably rowdy or causing trouble
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• Participants whose presence detracts from the safety, welfare, and well -being
of other participants or the Instructor
• Participants that may overfill capacity if let in the class
• Participants you believe to be intoxicated
Quarterly Sessions
Winter Session is December through March
• Proposals must be submitted by late August
Spring Session is March through June
• Proposals must be submitted by early December
Summer Session is June through August
• Proposals must be submitted by mid- February
Fall Session is August through December
• Proposals must be submitted by Late May
Call the Community Services Coordinator for specific deadlines.
Important Numbers
Emergencies 911
Seal Beach Police Department (562) 799- 4100
Community Services Department (562) 431 -2527
Brochure inquiries Extension 1306
Contracts & Insurance Extension 1306
Instructor Pay Extension 1344
General information Extension 1307
Certification
Instructors must certify that they have read and understood and agree to abide by the
policies and guidelines set forth above by signing and returning this from to the
Community Services Department prior to providing any services to the City. The City
reserves the right to amend these policies and guidelines from time to time. The City will
notify Instructors of any such changes within 30 days and Instructors will complete and
return to the City an additional certification.
I have read the above and fully understand and agree to these policies.
Instructor Name Date
Instructor Signature
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- , Master Program Instructor Agreement
This Master Program Instructor Agreement ( "Agreement ") is made as of:
( "Effective Date ")
By and between the City of Seal Beach ( "City) and:
( "Instructor ")
In consideration of the Parties ' performance of the promises, covenants, and conditions
stated herein, the Parties hereto agree as follows.
1. Scope of Services. Instructor will provide instructional services ( "Services ") set
forth in any Quarterly Addenda executed by the parties, which addenda are
incorporated into this Agreement by this reference, on the terms and conditions set forth
therein and this Agreement. In the event of any discrepancy between this Agreement and
any Quarterly Addendum, this Agreement shall control.
Instructor must perform all Services in accordance with all applicable provisions of
federal, state, and local law, and the standard of care generally exercised by like
professionals under similar circumstances and in a manner reasonably satisfactory to
City. Instructor shall also comply with all Guidelines, Policies and Procedures for
Contract Instructors issued by the City's Community Services Department, as such
Guidelines, Policies, and Procedures may be amended from time to time.
Instructor must establish appropriate rules for conducting classes taught by Instructor
within the scope of the Services.
Instructor must coordinate the schedule for providing the Services with City staff so as to
avoid any conflicts with prior scheduled uses of City facilities. In the event of a conflict,
the City Manager, or his or her designee, shall have the sole discretion to determine
priority of use.
Instructor and any of its employees, volunteers, and agents who provide the Services
shall be subject to a background check and fingerprinting.
2 Equipment & Labor. Instructor must furnish and maintain at its sole cost all tools,
equipment, apparatus, supplies, and materials (collectively "Equipment ") required to
provide the Services. Instructor assumes all risk of loss, damage, or harm to the
Equipment arising in connection with this Agreement. Instructor shall not charge
participants any equipment fees unless such fees are disclosed in advance to City and
participants prior to registration.
3. Term. The term of this Agreement shall commence as of the Effective Date and
continue until terminated as provided by this Agreement.
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4. Instructor's Com ensation. City will pay Instructor on a percentage basis.
Instructor will receive % of revenue raised by the class registration, less a $
administration fee per Participant. City shall pay Instructor within 30 days of the last day
of each registration session. Instructor acknowledges that it is an independent contractor
and that City will not withhold any applicable federal or state payroll and other required
taxes or other authorized deductions from payments made to Instructor.
5. Records. Upon 24 hours notice from City, Instructor must allow City or City's
agents or representatives to inspect at Instructor's offices during reasonable business
hours all records, invoices, time cards, cost control sheets and other records maintained
by Instructor in connection with this Agreement. City's rights under this Section shall
survive for two years following the termination of this Agreement.
6. Termination. City may terminate this Agreement without cause upon giving
Instructor written termination notice not less than thirty 30 days prior to the date of
termination. City may also terminate this Agreement upon 10 days' notice to Instructor if
Instructor fails to provide satisfactory evidence of renewal or replacement of
comprehensive general liability insurance as required by this Agreement at least 20 days
before the expiration date of the previous policy.
7. Designated Representatives. This Agreement shall be executed by each Party's
designated representative, who shall thereby warrant that they are duly authorized to
execute this Agreement on behalf of the Parties. The City's representative for all
purposes of this Agreement, including execution, is the City Manager or his or her
designee. Instructor's primary representative for purposes of this Agreement, including
execution, is:
8. Notices. All notices permitted or required under this Agreement shall be deemed
made when personally delivered or when mailed 48 hours after deposit in the U.S. Mail,
first class postage prepaid and addressed to the party at the following addresses:
To City: To Instructor:
City of Seal Beach
211 8th Street
Seal Beach, California 90740
Attn: City Manager Attn:
Actual notice shall be deemed adequate notice on the date actual notice occurred,
regardless of the method of service.
9. Independent contractor. Instructor is an independent contractor and not an
employee of the City. All services provided pursuant to this Agreement shall be
performed by Instructor or under its supervision. Instructor will determine the means,
methods, and details of performing the services. Any additional personnel performing
services under this Agreement on behalf of Instructor shall also not be employees of City
and shall at all times be under Instructor's exclusive direction and control. Instructor
shall pay all wages, salaries, and other amounts due such personnel in connection with
their performance of services under this Agreement and as required by law. Instructor
shall be responsible for all reports and obligations respecting such additional personnel,
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including, but not limited to: social security taxes, income tax withholding,
unemployment insurance, disability insurance, and workers' compensation insurance.
Instructor shall indemnify and hold harmless City and its elected officials, officers and
employees, servants, designated volunteers, and agents serving as independent
contractors in the role of city officials, from any and all liability, damages, claims, costs
and expenses of any nature to the extent arising from Instructor's personnel practices.
City shall have the right to offset against the amount of any fees due to Instructor under
this Agreement any amount due to City from Instructor as a result of Instructor's failure
to promptly pay to City any reimbursement or indemnification arising under this Section.
11. Assignment. Instructor shall not assign or transfer any interest in this Agreement
whether by assignment or novation, without the prior written consent of City. Any
purported assignment without such consent shall be void and without effect.
12. Principal & Substitute Instructors. Instructor designates:
, as its "Principal Instructor" for purposes of this
Agreement. City is retaining Instructor based on and for the Principal Instructor's special
expertise and experience. The Principal Instructor must personally perform or directly
oversee the performance of the Services.
In the event that the Principal Instructor is not able to teach a class due to illness or some
other cause beyond Instructor's reasonable control, Instructor must follow the following
procedures:
• Instructor must procure at its sole expense a substitute instructor at least as
qualified as the Principal Instructor to teach the class at its regular time and place.
Instructor shall ensure that Substitute instructors comply with the City's
fingerprinting requirements.
• Instructor must notify the City of the substitute instructor's name, qualifications,
address, and phone number.
• If Instructor cannot procure an adequate substitute, then the class will be canceled
and a make -up must be added to the end of the session. Instructor must notify
students as soon as is possible of the cancellation and the make -up class.
13. Insurance. Instructor, at its own expense, shall obtain and maintain in effect at all
times during the term of this Agreement, all insurance coverage related to every aspect of
the Services. Instructor is responsible for securing and maintaining all insurance
coverage to provide the Services pursuant to requirements of federal, state, and local law.
Instructor must provide proof of general liability, workers compensation, vehicle, and
other insurance to City before providing any Services pursuant to this Agreement and
again prior to extension or renewal of this Agreement. Instructor shall obtain and
maintain general liability insurance of $2,000,000. City shall be named as additional
insured.
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14. Indemnification, Hold Harmless, and Duty to Defend. Instructor must indemnify,
and hold the City, its officials, officers, employees, volunteers and agents (collectively
"Indemnities ") free and harmless from any and all claims, demands, causes of action,
costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons,
including wrongful death, in any manner arising out of or incident to any acts or
omissions of Instructor, its employees, or its agents or volunteers, in connection with the
performance of this Agreement, including without limitation the payment of all
consequential damages and attorneys fees and other related costs and expenses. With
respect to any and all such aforesaid suits, actions, or other legal proceedings of every
kind that may be brought or instituted against Indemnitees, Instructor must defend
Indemnitees, at Instructor's own cost, expense, and risk, and must pay and satisfy any
judgment, award, or decree that may be rendered against Indemnitees. Instructor must
reimburse City and its directors, officials, officers, employees, agents, and/or volunteers,
for any and all legal expenses and costs incurred by each of them in connection therewith
or in enforcing the indemnity herein provided. Instructor's obligation to indemnify shall
not be restricted to insurance proceeds, if any, received by the City, its directors, officials,
officers, employees, agents or volunteers. All duties of Instructor under this Section shall
survive termination of this Agreement.
15. Entire Agreement. This Agreement contains the entire agreement of the Parties with
respect to the subject matter hereof, and supersedes all prior negotiations, understandings,
or agreements. This Agreement may only be modified by a writing signed by both
parties.
16. No Third Party Rights. No third party shall be deemed to have any rights hereunder
against either party as a result of this Agreement.
17. Waiver. No waiver of any default shall constitute a waiver of any other default or
breach, whether of the same or other covenant or condition. No waiver, benefit,
privilege, or service voluntarily given or performed by a party shall give the other party
any contractual rights by custom, estoppel, or otherwise.
18. Attorneys' Fees. If either party commences an action against the other party, either
legal, administrative or otherwise, arising out of or in connection with this Agreement,
the prevailing party in such litigation shall be entitled to have and recover from the losing
party all of its attorney's fees and other costs incurred in connection with such action.
IN WITNESS WHEREOF, the Parties hereto, through their respective authorized
•
representatives have executed this Agreement as of the date and year first above written.
CITY OF SEAL BEACH INSTRUCTOR
By: By:
David Carmany, City Manager
(Print Name)
Approved as to Form:
•
Its:
By:
Quinn Barrow, City Attorney
Page 13
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\TamTM. Quarterly Addendum Letter
SAMPLE LETTER
DATE
[INSTRUCTOR NAME]
ADDRESSS
Re: 20 [Winter /Spring/Summer/Fall] Quarterly Addendum
Dear INSTRUCTOR:
The Community Service Department has determined you may provide the following
course as described below for the 20_ [Winter /Spring/Summer/Fall] Quarter.
Course Name
Principal Instructor
Registration Fee
Location
Course Description
Course Number (1) Days Dates Times
Course Number (2) Days Dates Times
Please review this information, complete the certification statement at the end of this
letter, and retum it to the Community Services Departemnt before [DATE].
Pursuant to Section 1 of the Master Program Instructor Agreement between you and the
City, dated , this letter will serve as the Quarterly Addendum for the 20_
[Winter /Spring/Summer /Fall] Quarter.
If you have any questions, please contact the Community Services Department at (562)
431 -2527 ext. 1344.
Sincerely,
NAME
Page 14
INSTRUCTOR'S CERTIFICATION STATEMENT
(To be signed and returned to the Community Services Department)
I, , certify that I have reviewed the terms
and
(Print Name)
conditions of this Quarterly Addendum and agree to provide the program instructional
services
described herein pursuant to such terms, the terms of the Master Program Instructor
Agreement,
the latest version of Contract Instructor Guidelines and Policies issued by the City of Seal
Beach
Community Services Department.
Signed:
Date:
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