Fillable Hank-lacayo-institute-internship-placement-agreement HLI Internship Placement Agreement

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Hank-lacayo-institute-internship-placement-agreement HLI Internship Placement Agreement

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CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 1 of 6
This Agreement entered into this ____ day of, ______________, 20__, between the Trustees of the
California State University on behalf of California State University Channel Islands, hereafter referred
to as “UNIVERSITY,” and _____________________, hereafter referred to as Hank Lacayo Institute
Internship Site or “HLI INTERN SITE” and University compensated student intern thereafter referred
to as “HLI INTERN”.
I. STATEMENT OF PURPOSE –
A. The UNIVERSITY’s mission statement emphasizes a strong commitment to providing
experiential learning opportunities by: “Placing students at the center of the educational
experience, California State University Channel Islands provides undergraduate and graduate
education that facilitates learning within and across disciplines through integrative
approaches, emphasizes experiential and service learning, and graduates students with
multicultural and international perspectives.” The University’s mission for experiential
learning complements this mission by developing funded opportunities that address
community needs through the development of strong community partnerships and tying
student experience back to academic goals and reflection activities, while enhancing the
value of workforce development.
B. The mission of HLI INTERN SITE is
C. HLI INTERN SITE and UNIVERSITY recognize the opportunity for meaningful learning
experiences for the UNIVERSITY, HLI INTERN SITE and HLI INTERN. The UNIVERSITY supports
the goals and objectives of the HLI INTERN SITE in which HLI INTERN will participate.
II. PRIORITIES
A. Program Activities: Activities will be accomplished in accordance with the HLI Intern Learning
Plan, reviewed and agreed upon by the HLI INTERN, UNIVERSITY and HLI INTERN SITE prior to
the start of the experience.
The HLI INTERN will:
1. Participate in all relevant trainings required by the HLI INTERN SITE and stated in
Section III-A Training and Orientation in this document.
Rev’d 11/2013 kh
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 2 of 6
2. Model professional and appropriate behavior when working with co-workers and
when on HLI INTERN SITE.
3. Support HLI INTERN SITE events that are a part of the experiential learning experience
as required by the Director of the Hank Lacayo Institute.
4. Meet the goals of the HLI INTERN SITE and the Hank Lacayo Institute to which the HLI
INTERN is committed.
B. Safe and productive environment –
HLI INTERN SITE will:
1. Give HLI INTERN a complete tour of the site, and ensure that HLI INTERN is aware of all
emergency procedures and is able to act responsibly in the case of an emergency.
2. Ensure that HLI INTERN is aware of the type of work associated with the internship
at______________________________ (INTERNSHIP SITE) and is prepared to perform
the agreed upon duties.
C. UNIVERSITY will ensure that HLI INTERN agrees to the following:
1. Abide by HLI INTERN SITE rules and regulations while on site.
2. Ensure that his/her interactions with clients are safe, positive and productive.
3. Support the organization and its objectives by providing support for HLI INTERN SITE
staff as necessary and agreed upon in Section II-A, Program Activities in this
document.
III. STRUCTURE AND SUPPORT OF HLI INTERN
A. HLI INTERN SITE:
1. Site Supervision – ________________________________ (Site Supervisor: First Name,
Last Name, Title) agrees to meet with the HLI INTERN to update him/her on projects
and to provide support. All program staff will support the HLI INTERN as they interact
with him/her, and provide guidance and advice as necessary and appropriate. A
secondary supervisor, ________________________ (First Name, Last Name, Title) will
be responsible for the HLI INTERN in the absence of primary supervisor.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 3 of 6
2. The HLI INTERN SITE director and HLI Internship Consultant at UNIVERSITY shall meet
as appropriate in order to facilitate the most mutually beneficial experience for all
parties involved, or at the request of any of the parties involved.
3. Training, Orientation & Workspace - ______________________________( First Name
& Last Name) will provide specific training needed by the HLI INTERN prior to his/her
working at the HLI INTERN SITE.
4. Work Space – HLI INTERN will have an appropriate space at the HLI INTERN SITE in
which to conduct his/her assigned work. HLI INTERN SITE will provide access and
training for any and all equipment necessary for HLI INTERN to fulfill his/her required
role.
5. Evaluation – The HLI INTERN SITE supervisor will fill out a mid-semester and end of
semester evaluation provided by the Coordinator for Career Development Services
regarding quality of work that the HLI INTERN provided to the site, and as agreed upon
in the HLI Intern Learning Plan document.
B. UNIVERSITY- UNIVERSITY will assign HLI INTERN to the HLI INTERN SITE
1. Training and Reflection - UNIVERSITY will provide a training session for HLI INTERN
regarding his/her responsibilities as described in Section II. The Coordinator for
Career Development Services will provide opportunities for HLI INTERN to reflect on
his/her experience working at the HLI INTERN SITE.
2. Supervision and Accountability – The Coordinator for Career Development Services
and HLI Internship Consultant will work with the HLI INTERN and HLI INTERN SITE, to
meet the agreed upon expectations as outlined in the position description.
IV. LENGTH OF AGREEMENT TERM
A. Initial Term - The UNIVERSITY and HLI INTERN SITE have reached this initial agreement of
HLI INTERN completing 120 hours during the term beginning _______________, 20___,
and ending _________________, 20___.
This agreement shall become effective upon execution and shall continue until the
placement term date above. PARTIES reserve the right to terminate participation
and shall provide the other party written notice of the intention to terminate and
reason(s) for same.
Renewal Process – This UNIVERSITY may offer renewal of this agreement and is based on
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 4 of 6
HLI INTERN feedback, HLI INTERN SITE evaluations and the Hank Lacayo Institute’s desire
to continue this relationship for the purpose of experiential learning.
V. GENERAL PROVISIONS
A. Indemnification
The University agrees to indemnify, release, discharge and hold the INTERN SITE
harmless and agrees to defend the INTERN SITE from and against any and all liabilities,
losses, damages, claims, lawsuits, causes of action, and expenses associated herewith
(including reasonable attorney’s fees in defending against any such claim or lawsuit)
caused or asserted to have been caused, directly or indirectly, by the negligence or
willful misconduct of the University, its officers, employees, or faculty, in its
performance under this Agreement.
The INTERN SITE agrees to indemnify, release, discharge and hold the UNIVERSITY
harmless and agrees to defend the University from and against any and all liabilities,
losses, damages, claims, lawsuits, causes of action, and expenses associated herewith
(including reasonable attorney’s fees in defending against any such claim or lawsuit)
caused or asserted to have been caused, directly or indirectly, by the negligence or
willful misconduct of the INTERN SITE and its employees in its performance under this
Agreement.
It is the intention of UNIVERSITY and INTERN SITE that the provisions of this paragraph
be interpreted to impose on each party responsibility for the negligence of their
respective officers, agents and employees.
B. Insurance
The HLI INTERN SITE shall procure and maintain General Liability Insurance,
comprehensive or commercial form with $1,000,000 minimum limit for each
Occurrence and minimum limit of $2,000,000 General Aggregate, as further defined
below and as mutually agreed upon for this placement.
The California State University system has elected to be insured for its General Liability
exposure through the self-insured CSU Risk Management Authority.
The State of California has elected to be self-insured for its vehicle liability and
Workers’ Compensation and property exposures. As a State agency, the California
State University, Office of the Chancellor, the Trustees, and the CSU system of
campuses are included in this self-insured program.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 5 of 6
C. Status of Students
An HLI INTERN will be compensated by the UNIVERSITY for a 1 semester, 120 hour
maximum upon which university liability and insurance liability ends following the
completion of this commitment. Any further relationship between the HLI INTERN
and HLI INTERN SITE occurs at the risk of the HLI INTERN SITE.
D. Governing Law
All contracts and purchase orders shall be construed in accordance with, and their
performance governed by, the laws of the State of California. Further, the
community-based organization shall comply with any state or federal law applicable to
community-based organization's performance under this Contract.
E. Assignments
Without written consent of the CSU, this agreement is not assignable by the HLI
INTERN SITE either in whole or in part.
F. Agreement Alterations & Integration
No alteration or variation of the terms of the agreement shall be valid unless made in
writing and signed by the parties hereto, and no oral understanding or agreement not
incorporated herein shall be binding on any of the parties hereto.
G. Endorsement
Nothing contained in this Agreement shall be construed as conferring on any party
hereto any right to use the other party’s name as an endorsement of product/service
or to advertise, promote or otherwise market any product or service without the prior
written consent of the other parties. Furthermore nothing in this Agreement shall be
construed as endorsement of any commercial product or service by the University, its
officers or employees.
H. Survival
Upon termination of this contract for any reason, the terms, provisions,
representations and warranties contained in this agreement shall survive expiration or
earlier termination of this agreement.
I. Severability
If any provision of this agreement is held invalid by any law, rule, order of regulation
of any government or by the final determination of any state or federal court, such
invalidity shall not affect the enforceability of any other provision not held to be
invalid.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
H
ANK LACAYO INSTITUTE
INTERNSHIP PLACEMENT AGREEMENT
Page 6 of 6
J. Entire Agreement
This agreement constitutes the entire agreement and understanding of the parties
with respect to the subject matter hereof and supersedes all prior agreements,
arrangements, and understandings with respect thereto. No representation, promise,
inducement, or statement of intention has been made by any party hereto that is not
embodied herein, and no party shall be bound by or liable for any alleged
representation, promise, inducement, or statement not set forth herein.
This document reflects our understanding of the agreement.
CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS
(Name of INTERN SITE)
By: By:
TITLE: TITLE:
Procurement & Contract Services Authorized Signatory
Printed Name: Printed Name:
Date: Date:
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Completed 14 March 2020

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