Independent Provider Surf Instructor Permit Page 1 of 6 Permit # XX-XX INDEPENDENT PROVIDER PERMIT Surf Instructor Permit Department of Community & Cultural Services Community Recreation Division 415 Pacific Coast Highway, Santa Monica, CA 90402 Phone: 310-458-2201, ext. 5186 Fax: 310-393-7827 NOTE: You are required to check-in with the lifeguard upon your arrival at the beach each day. Keep this permit with you at all times. Permits are not transferrable. PERMITTEE: CONTACT PERSON: ADDRESS: CITY: ZIP: PHONE: ( ) CELL: ( ) FAX: ( ) EMAIL ADDRESS: DATES OF PERMIT: AUTHORIZED LOCATION: AUTHORIZED ACTIVITY: DAYS AND TIMES OF USE: MAX # OF PARTICIPANTS: MAX PARTICIPANT/INSTRUCTOR RATIO: OTHER RESTRICTIONS/NOTE: PERMIT REQUIREMENTS All activities shall occur only in the area designed for use under this permit unless otherwise directed by the lifeguards to address safety concerns. Permittees may not set-up any operations outside of the assigned area including, but not limited to, Ocean Front Walk, beach parks, and beach parking lots. All instructors in the water must be at least eighteen (18) years of age.
Independent Provider Surf Instructor Permit Page 2 of 6 Permit # XX-XX All group surfing instructors and students shall wear color-specific rash guards printed with the name of the Permittee at all times while in the water. Except for Single Instructors, when conducting activities as provided herein, Permittees must display at all times a City-provided sign with the name of the Permittee. No other advertising or signage, including inflatable signs and balloons, may be placed on the beach or in the beach parking lots. FINANCIAL REQUIREMENTS Permittees shall pay a $150 permit fee. Permittees shall pay rent monthly as described in Attachment 1, Rental Terms. Failure to pay rent in accordance with the Rental Terms may result in forfeiture of this permit. INSTRUCTOR INSURANCE REQUIREMENTS Instructor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property that may arise from or in connection with the performance of the work hereunder and the results of that work by the Instructor, its agents, representatives, employees or subcontractors. Minimum Scope/Limits of Insurance 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering GCL on an occurrence basis, including products-completed operations and personal & advertising injury, with limits of no less than $1,000,000 per occurrence. Workers Compensation and Employer s Liability Insurance: Workers Compensation insurance as required by the State of California and Employer s Liability Insurance with limits of no less than $1,000,000 per accident for bodily injury or disease. Workers Compensation insurance is not required if the Instructor does not have employees. The Instructor must, however, execute the City s Workers Compensation Coverage Exemption Form. If the Instructor maintains higher limits than the minimums shown above, the City of Santa Monica requires and shall be entitled to coverage for the higher limits maintained by the Instructor. Other Insurance Provisions 1. The insurance policies are to contain, or be endorsed to contain, the following provisions: a. Additional Insured Status (CGL policy): The City of Santa Monica, its officers, officials, employees and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of Instructor including materials, parts or equipment furnished in connection with such work or operations. b. Primary Coverage (all policies): For any claims related to this contract, the Instructor s insurance shall be primary as respects the City of Santa Monica, its officers, officials, employees and volunteers. Any insurance or self-insurance maintained by the City of Santa Monica, its officers, officials, employees or volunteers shall be in excess of the Instructor s insurance and shall not contribute with it.
Independent Provider Surf Instructor Permit Page 3 of 6 Permit # XX-XX c. Notice of Cancellation (all policies): Each insurance policy required herein shall state that coverage shall not be cancelled except after notice has been given to the City of Santa Monica. d. Waiver of Subrogation (all policies): Instructor hereby grants to the City of Santa Monica a waiver of any right of subrogation which any insurer of said Instructor may acquire against the City of Santa Monica by virtue of payment of any loss. Instructor agrees to obtain any endorsement that may be necessary to effect this waiver of subrogation, but this provision applies regardless of whether or not the City of Santa Monica has received the a waiver of subrogation endorsement from the insurer. Acceptability of Insurers Insurance is to be placed with insurers with a current a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to the City of Santa Monica. Verification of Coverage Instructor shall furnish the City of Santa Monica with original certificates and amendatory endorsements or copies of the applicable policy language providing the insurance coverage required herein. All certificates and endorsements are to be received and approved by the City of Santa Monica before work commences. However, failure to obtain required documents prior to the work beginning shall not waive the Instructor s obligation to provide them. The City of Santa Monica reserves the right to require complete, certified copies of all required insurance policies, including the endorsements required herein, at any time. PARKING INFORMATION All Independent Provider groups and individuals must pay applicable parking fees. There are no designated drop-off and pick-up sites in any beach parking lot. GENERAL RULES/GUIDELINES Permittee has complied with applicable law, including but not limited to, holding a valid business license and paying appropriate taxes. Permittees shall have and maintain for a period of three years a liability waiver signed by each student or legal guardian if the student is less than 18 years of age. Permittees that supply equipment to students must provide a soft foam surfboard and/or boogie board with a leash. No equipment may be sold or rented separately on the beach or in beach parking lots. Permittee shall maintain the area clean of trash and shall place group-generated trash in City-provided trash receptacles before leaving the area. Alcohol is not permitted on the beach or in beach parking lots. Glass containers are not permitted on the beach. Smoking, fire, fireworks or cooking are not allowed on the beach. Dogs are not permitted on the beach or beach parking lots.
Independent Provider Surf Instructor Permit Page 4 of 6 Permit # XX-XX Surf camps are allowed to erect no more than 200 sq. ft. of canopy. Tents or temporary enclosures are not permitted. Advertising or sponsorship recognition is not allowed. Portable boom boxes with built-in speakers only (no additional speakers) are permitted in the designated area only. Please direct speakers toward the ocean and be courteous to neighbors. Bull horns may be used for emergencies only. Permittees shall have a first aid kit available on-site. All Permittees must check in with the LA County lifeguards at the assigned tower each day of class or camp. Permittees shall maintain on-site a cell phone programmed with the LA County Lifeguard emergency dispatch phone number, (310) 394-3261. Permittees shall provide and maintain a Permittee contact name and cell phone number to the City. By September 30, 2013 Permittee is required to provide City with written report of summer season activities, stating the number of program participants served, gross income and activities offered under permits issued by the City of Santa Monica. PERMIT REVOCATION The City has the ability to terminate this permit based on recommendation of County Lifeguards, violation of permit requirements or lack of registered participants. I, representing the Permittee, have read this permit and the attached rental terms and agree to abide by all the terms and conditions of conducting activities authorized under this permit. Signature Name Date Title APROVED FOR ISSUANCE: Community Recreation Division Date (This permit is not valid without signature by an authorized City representative)
Independent Provider Surf Instructor Permit Page 5 of 6 Permit # XX-XX ATTACHMENT 1, RENTAL TERMS Each Permittee shall pay a percentage of monthly gross receipts in accordance with the following terms and conditions: 1. MONTHLY PERCENTAGE RENT: Throughout the term of this permit, the Permittee agrees to pay the City as monthly rent an amount equal to ( %) of the amount of Monthly Gross Sales ( Monthly Percentage Rent ). Gross Sales and Gross Receipts shall refer to the actual price for all goods, wares, and merchandise sold exclusive of applicable sales tax and the actual charges for all services performed by the Permittee and its authorized agents and/or employees arising out of the activities authorized under this permit, whether for retail, cash, or otherwise, without reserve or deduction for inability or failure to collect. Gross Sales shall include without limitation all sales and services (a) where the orders therefor originate in, at, from, or arising out of the activities authorized under this permit, whether delivery or performance is made from Santa Monica State Beach or from some other place; (b) made or performed by mail, telephone, or computer orders; and (c) all revenues and receipts generated by or arising from the activities authorized under this permit. Any deposit not refunded shall be included in Gross Sales. Each installment or credit sale shall be treated as a sale for the full price in the month during which such sale is made, regardless of whether or when Permittee receives payment therefor. Gross Sales also shall include any revenues and receipts generated from any television, radio, movie, studio, or photograph promoter, or any other such activity dependant on authorization under this permit. 2. ITEMIZED STATEMENT OF GROSS SALES: Permittee shall deliver to the City the following: A. Monthly Report of itemized Gross Sales: Within fifteen (15) days after the close of each calendar month of the term of the permit, a written report signed by the Permittee or by an authorized officer of agent of Permittee, showing the itemized Gross Sales made in the preceding calendar month. Such report shall be submitted on the City s Monthly Report of Operations Form or other Cityapproved instrument. B. Percentage Rent: Within fifteen (15) days after the close of each calendar month throughout the term of the permit, along with the Monthly Report of Gross Sales, a check made payable to the City of Santa Monica in the amount of rent due, as described above. Checks shall be delivered to: City of Santa Monica Community Recreation Division 415 Pacific Coast Highway Santa Monica, CA 90402 Attn: Heath Hamilton 3. PERMITTEE S RECORDS: Permittee shall keep the following: A. Required Records: For the purpose of permitting verification by City of any amounts due as rent, Permittee covenants and agrees that all business
Independent Provider Surf Instructor Permit Page 6 of 6 Permit # XX-XX conducted under this permit shall be performed so that a computerized point of sales records, duplicate sales slip, invoice, or non-resettable cash register receipt, serially numbered, or such other device for recording sales as City approves, shall be issued with each sale or transaction, whether for cash, credit, or exchange. B. Maintenance of Records: Permittee shall keep and preserve for at least two (2) years, and during the term of the permit shall keep in office a general ledger, required receipts and disbursement journals, and such sales records and other supporting documentation together with original or duplicate books and records that shall disclose in detail all information required to permit City to verify Permittee s Gross Sales and that shall conform to and be in accordance with generally accepted accounting principles. 4. AUDITS: At any time or from time to time with twenty-four (24) hours advance notice to Permittee, City or its consultants, representatives, and/or accountants shall have the right during business hours to make any examination or audit of such books and records that the City may desire. If such audit discloses that, in any rental year, rent due is greater than rent paid by Permittee for such period, Permittee shall pay to City within (10) days of notice thereof the amount of such deficiency. In addition, if such audit shall disclose that the Permittee has underpaid by three percent (3%) or more any rent payable by Permittee, the amount of which is based on Gross Sales, then upon thirty (30) days written notice to Permittee, Permittee shall pay the cost of such audit, all monthly Percentage Rent then payable, plus interest at the default rate on such monthly Percentage Rent, calculated from the date such additional monthly Percentage Rent was originally due and payable. The City may declare an Event of Default after issuance of three notices of deficiency to Permittee. 5. FAILURE TO PAY RENT: If Permittee fails to pay any rent within ten (10) days after the same is due, Permittee shall be obligated to pay a late payment charge equal to ten percent (10%) of any rental payment not paid when due ( Late Charge ) to reimburse City for its additional administrative costs. In addition, rent shall bear interest at the Default Rate from the first day due until paid ( Interest on Late Payments ). Late Charges and Interest on Late Payments shall be payable with the next installment of Monthly Rent. Failure to pay rent by the fifteenth (15) of each calendar month may result in revocation of Permit. I have read the above and agree to abide by all its terms and conditions: By: Title: Date: