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PD San Quentin State Prison Range Hold Harmless and LiabilityCalifornia Department of Corrections and Rehabilitation San Quentin State Prison San Quentin State Prison Subject: SQSP-Range Hold Harmless Agreement & Limits of Liability Date: California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) agrees to allow the User to use the property described above for training purposes on the following date listed. Agency Name: City of San Rafael - San Rafael Police Department (USER) The undersigned hereby acknowledges, consents and agrees that in no event shall California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) or any of its Warden, managers, shareholders, officers, and/or employees be held responsible or liable for any acts or omissions, or for any indirect, direct, incidental, special or consequential damage, injuries or cost whatsoever, resulting from or related to the use of the Shooting Ranges or Range Facilities by the undersigned. The undersigned also agrees and consents to hold California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) harmless for any acts or omissions on the part of the undersigned as it related to: • The direct or indirect handling of firearms and/or equipment • The use of firearms and/or equipment while participating in live fire events on any of the range. • The transportation of firearms and/or equipment to and from the facility, and certifies that the method used to transport said firearms and/or equipment confirms to the laws of the State of California. The undersigned further acknowledges and admits that California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) had taken every precaution necessary to insure the undersigned's safety during your visit to its facility and the California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) shall not be held liable for any act or omission outside its jurisdiction or control, or directly related to negligence on the part of the undersigned. The undersigned further acknowledges receipt and understanding of the Safety Rules, Range Procedure and protocols of this facility and agrees to abide by them at all times while at the San Quentin State Prison (SQSP) range. The undersigned acknowledges that failure to comply with the rules could result in their expulsion from the range and temporary and/or permanent loss of range privileges. The undersigned affirms, by signature that they have refrained from being under the influence of alcoholic beverages or drugs while in the state property owned and controlled by California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP). The undersigned affirms that they understand that the consumption of drugs or alcoholic beverages is expressly prohibited on California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) property, and that any person(s) who, strictly by our observation, appears to be under the influence of alcohol of illicit drugs or emotionally unstable, shall be denied access to any part of the facility. By your signature you affirm that you have read, understand, and will the requirements as set forth herein, and do herby agree to hold California Department of Corrections and Rehabilitation, San Quentin State Prison (SQSP) or any of its Warden, managers, shareholders, officers, and/or employees harmless for any act or omission for which you are directly responsible or that cause you harm. Agency Represer)ktive: Jim c huAz , C i ty_N na g er Signature: Date: Zr -oZ0.C) CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Police Project Manager: Roy Leon, Lieutenant Extension: 415-485-3392 Contractor Name: San Quentin State Prison Contractor's Contact: David Arvizo Contact's Email: David.arvizo@cdcr.ca.gov ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT Project Manager DATE Click here to Check/Initial ❑ 1 a. Email PINS Introductory Notice to Contractor enter a date. b. Email contract (in Word) & attachments to City 9/24/2020 Atty c/o Laraine.Gittens@cityofsanrafael.org ❑ 2 City Attorney a. Review, revise, and comment on draft agreement Click here to and return to Project Manager enter a elate. ❑ b. Confirm insurance requirements, create Job on Click here to PINS, send PINS insurance notice to contractor enter a date. ❑ 3 Project Manager Forward two (2) originals of final agreement to Click here to ❑ contractor for their signature enter a date. 4 Project Manager When necessary, * contractor -signed agreement ❑ N/A agendized for Council approval *PSA > $75,000; or Purchase > $75,000; or Or ❑ Public Works Contract > $175,000 Date of Council approval Click here to PRINT enter a date CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City Attorney with printed copy of this routing form 6 City Attorney Review and approve hard copy of signed 0�agreement � VZ Review and approve insurance in PINS, and bonds 7 City Attorney (JU (for Public Works Contracts) 8 City Manager/ Mayor Agreement executed by Council authorized official�io l (mss W +_. 9 City Clerk Attest signatures, retains original agreement and �q l a forwards copies to Project Manager fI