HomeMy WebLinkAboutWONDERS OF WILDLIFE, INC. 10 City of Santa Ana
1� Clerk of the Council
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and all
amendments (if any) are no longer in effect.
Note: If your agreement is grant related, please ensure that all grant retention requirements
have been satisfied prior to signing the termination form. \ /
Is the agreement(s) a permanent record? Yes _ No v
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
Use Only
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32'21Pm :2e
N-2018-114
No. was completed on �00 and final payment has been made.
(List all amendments. Use space below if needed.)
Department: `PKCSA
Phone/Ext.: lQM
Signature: / a�z
Date: N-
Revised: 10-18-16
INSURANCE ON FILE
WORK MAY PROCEED
NTIL,INSURANCE EXPIRES
Z: 6 11 e
CLERK OF COUNCIL
DATE, i ICI 2 2 2018
O: PRCS (/ )
Silvia Cuevas
June 11, 2018
Wonders of Wildlife,,Inc, ("Speaker/Performer")
P.O. Box 5463
Fullerton, CA 92838
Re: Sneaker/Performer Engagement Agreement
N-2018-114
This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagement
described below:
1. Event Description: Animal Show Reading Program event with live animals used during presentation of summer
reading program to encourage reading and explore some myths and tales about animals in different countries.
Program will also pay a little tribute to children's author Dr. Seuss.
2. Date(s): June 18, 2018
3. Event Time(s): 4:OOPM
4. Location: Newhope Learning Center, 122N. Newhope Street, Santa Ana C'Property")
5. Compensation: $275.00 per Invoice 061818 attached as Exhibit A (payable by check within 30 calendar days of
event); Speaker/Performer must provide IRS form W-9 before payment can be made
6. Equipment provided by City: Close access parking, 2 table and electricity along with advertising for the event.
7. Equipment provided by Speaker/Performer: all equipment, materials, supplies and personnel necessary to perform the
act for example: all equipment necessary, including without limitation sound technicians, speakers, laptop/music,
table, microphone, headphone, and strobe light
S. City Contact Person (for coordinating purposes only): Michelle Loera or Lupita Arroyo (714) 6477-5231
9. Independent Contractor: Speaker/Performer shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to
create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or
control over the professional manner in which Speaker/Performer performs the services that are the subject matter of
this Agreement; however, the services to be provided by Speaker/Performer shall be provided in a manner consistent
with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages, employer's social
security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
10. Indemnification: Speaker/Performer, his or her agents, or employees (if applicable) agrees to and shall indemnify,
defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives
from and against all loss, expenses, or liability (including costs and attorney's fees) arising from the negligence or
willful misconduct of Speaker/Performer, his or her agents, or employees.
it. Release: Speaker/Performer accepts the Property and any City -provided equipment used in connection with the
performance in their "as -is" condition, with all faults. Speaker/Performer fully releases, waives and discharges forever
any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not to sue, City,
its elected officials, officers, employees, agents and volunteers, and all persons acting on behalf of, by, through or
under each of them, under any present or future laws, statutes, or regulations for any claim or event relating to the
condition of the Property or City -provided equipment or Speaker/Performer's use thereof.
Letter Agreement— Wonders of Wildlife, inc.
Page 2
N-2018-114
12. Commercial General Liability Insurance. Speaker/Performer shall maintain commercial general liability insurance
naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall
include, but not be limited to protection against claims arising from bodily ar14 personal injury, including death
resulting therefrom and damage to property, resulting from any act or occurrence arising out of SpeakerlPerformees
operations in the performance of this Agreement, including without limitation, acts involving vehicles. The amounts
of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including
death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in
the aggregate. Such insurance shall: (1) name the City, its officers, employees, agents, volunteers, and representatives
as additional insureds; (2) be primary and not contributory with respect to insurance or self-insurance programs
maintained by the City; and (3) contain standard separation of insured provisions.
13. Worker's Compensation -,Insurance. In accordance with the California Labor Code, Speaker/Perfonner, if
Speaker/Performer has any employees, is required to be insured against liability for worker's compensation or to
undertake self-insurance.
14. The City shall have the right and royalty -free license to simulcast or produce and show a tape -delayed broadcast of
Speaker/Performer's presentation to the City community or generalpublic, through webeast or any otter means. This
license shall be non-exclusive and the copyright shall remain with the Speaker/Performer. Copies of
Speaker/Performer's presentation may be maintained by the City, and Speaker/Performer consents to use of such
recordings.
is. Speaker/Performer is solely responsible for payment of royalty fees, performance fees, or similar fees that may be
required by unions or similar organizations. Speaker/Performer shall indemnify the City against any liability or
damages, including attorney's fees, that may arise as a result of violation by Speaker/Performer of copyright laws.
16. Speaker/Performer shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation,
age, national origin, ancestry, disability, or any other basis protected by applicable law in connection with any activities
related to this Agreement.
17. This Agreement shall in all respects shall be interpreted, enforced, and governed exclusively by and under the laws of
the state of California. Both parties agree that Orange County, California, shall be the venue for any action or
proceeding that may be brought or arise out of, in connection with or by reason of this Agreement.
18. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding
the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This
Agreement may not be modified except by written instrument signed by the City and by an authorized representative of
Speaker/Performer.
CiTY OF SANTA ANA SPEAKER/PERFORMER
RAUL GODTNE411 ✓V Name:�--
City Manager Title:
ATTF T;/% APPROVED AS TO FORM:
tYARi D. HUiZAR LAURA A. ROSSINi
Clerk of the Council Senior Assistant City Attorney
RECOMMENDED FOR APPRO31--_.NN___
JEATE 1URAD0, Actirig`"E ccutive Direetor,'PRCSA
Exhibit A
CONFIRMATION AND INVOICE LETTER
5-20-18
INVOICE 061818
From: Wonders of Wildlife, inc
PO BOX 5463
Fullerton Ca 92838
714 992-4969
Fed Tax ID # 95-3808607
LA County Vendor ID #10614101 (if applicable)
This is a letter of confirmation and invoice for performance
Newhope Library
122 N Newhope st
Santa Ana Ca 92703
Program on: Mon June 18 2018 at 4pm
For the monetary amount of $ 275
Checks should be made payable to WONDERS OF WILDLIFE INC
Contact person:
Michelle Loera
714 647-6992
Library cost code -(if applicable)
Additional Requirements/Needs- close parking spot reserved, 2 tables, access to electricity
Will call as date nears to reconfirm- usually arrive an hour or so ahead for set up.
Thank you for your patronage 11
Cheryl Rendes
Director- Wonders of Wildlife, inc
edzoocatorcheryl@yahoo.com
FROK WONDERSOF WZDLIFE
's BOX 5463
FULLEItTON,
(FED TAX n , , :i:W
DATE:t
THIS IS
ll� 1-be�
572,3
WONDERS OF WMDLIFE
i m 4
FOR THE MONETARY AMOUNTOF
a-JECKS SHOULD BE MADE PAXABLE TO WONDERS OF WRDLtM INC
AT (714)992-4969.
oivdu:fff)W:il�.
THANK YOU F
FORWARD TO
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ACOROr CERTIFICATE OF LIABILITY INSURANCE
TE
OA05/14/2018 Y)
05/14/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Allied
Allied Specialty Insurance, Inc.
CONTACT
Stephanie Moore
NAME: _...__ P
10451 Gulf Blvd
_ —_. _—
PHONE 727.547-3121 'FAX
Treasure Island, FL 33706-4814
allieds ecialt com
-ADDRESS, sm_oo_re@P Y�
ADDR
N-2018_114
_ _ INSURERS) AFFORDINGCOVERAGE _
NAICN
INSURER A: T.H.E. Insurance Company
12866
INSURED o -
Wonders pf WUdlife, Inc.
IN SURER B :
INSURER C
P 0 BOX 5463
FULLERTON CA 92838
-
INSURERD;
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: RFVIRInN NnMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
_
INSR' �AOOCSUaR
LTR TYPE OF INSURANCE POLICY NUMBER
POUCYEF�P--T-_ -
MMIDD/YYYY MMIDDflYYV LIMITS
A X'i COMMERCIAL GENERAL LIABILITY I X CPP0101248-OS
/�
''. EACHOCCURRENCE
05/14/2018 05/14I2019 —
$ 1,000,000
-_ _ -
$ 10Q000
CLAIMS -MADE '.
' OCCUR ', �
DAMAGETORENcurr 1
� `PREMISES (Ea occurrence)
i$
MED EXP(Any one person)
PERSONAL &ADV INJURY
I S
I $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERALAGGREGATE
O-
PRO-
POLICY �. ',
I
PRODUCTS-COMP/OPAGG
lit $ 1,000,000
OTHER:,,
$_.
AUTOMOBILELIABILITV
COMBINED SINGLE LIMIT $
(Ea accitlentl _ _ _
IE ANY AUTO
li BODILY INJURY(Perperson) $
OWNED SCHEDULED""-
AUTOS ONLY AUTOS
"--
BODILY INJURY (Per accident) $
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY ',,
I PROPERTYDAMAGE --. -
1. ''. Per accident $_ _
��il
.''. $
E UMBRELLALIAB lr OCCUR
EACH, OCCURRENCE _$
EXCESS LIAB 'I. CLAIMS -MADE/ !
t.
�,. AGGREGATE $ -
DED is RETENTION$
$
WORKERS COMPENSATION
PER OTH-
ANDEMPLOYERS' LIABILITY YIN
STATUTE ER
r
A
OFFICER/MEMBEREXCLUDED? 'NIA -
E L EACH ACCIDENT $ _.—
(Mandatory In NH)
If ory in NH)
EL DISEASE - EA EMPLOYEE! $
If yes, d under
DESCRIPTION
. DESCRIPTION OF OPERATIONS below
�- --
EL. DISEASE -POLICY LIMIT $
ILES
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHIC (AGGRO 101, Additional Remarks Schedule, maybe attached If mom space Is required)
EVENT DATE: 6SURE
ADDITIONAL INSURED:
'th�1r
The City of Santa Ana; it officers, employees, agents, representatives
gag r'sspecct
and volunteL�,, hst y e ce of the named
insured only. Further this insurance will be deemed to be primary and non-contributory
with respect to the insurance uch ddi' gasLed if you agreed to
such a condition in the written contract with such additional insured.
The City of Santa Ana,
20 Civic Center Plaza,
Santa Ana, California 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
101
CORPORATION. All rinhte
ACORD 25 (2016103)
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: CPP0101248-08
COMMERCIAL GENERAL LIABILITY
CG 20 26 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
EVENT DATE: 6/18/18
ADDITIONAL INSURED: The City of Santa Ana; it officers, employees, agents,
representatives and volunteers as respects to the negligence of the named insured only.
Further this insurance will be deemed to be primary and non-contributory with respect to the
insurance of such additional insured if you agreed to such a condition in the written contract
with such additional insured.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", 'property
damage" or 'personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
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CG 20 26 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1
WORKERS' COMPENSATION DECLARATION
�r)& -, hereby affirm under penalty of perjury, the
following declaration
I certify on behalf ofd p/Fm, r,( (4 ` ` I () ( i ^rhat dtlring the term of my
contract for �jL �CansultawCOMp y Name)
1M Obl/services with the City of Santa Ana. I will
Y'. an9» 1 nG- n&Y-t� - f
not employ any person in any manner so as to become subject to the workers'
compensation laws of California and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions and provide proof of workers' compensation coverage.
DATE:
--_ By:
Name: wer 1 5�
Title: L ttP (L
Telephone:_ -7/
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.