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Home My WebLink AboutPECK, JOSEPHCity of Santa Ana *�l Clerk of the Council coic office -- Clerk AGREEMENT TERMINATION FORM ??��ttpp i Please complete this form in its entirety when the attached agreement angry,411 9 PM 3` 11 amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements CITY! OF SANTA ANA have been satisfied prior to signing the termination form. CLERK OF COUNCIL Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with '�Oa �QT b?--e ' No. N-2018-123 was completed on 7Ict ( S/ and final payment has been made. (List all amendments. Use space below if needed.) Department: -1 F—i %4r Revised: 10-16-16 Phone/Ext.: Signature: A QASA a /ctft Date: 25 I t s, INSURANCE ON FILE WORK MAY PROCEED TIL INSURANCE EXPIRES 3-3/-/? a CLERK OF COUNCIL: DATE: I JtL 7 201 0: PRCS (j ) Silvia Cuevas June 25, 2018 Joseph Peek (" Speaker/Perfortner") DBA Panhead Music P.O. BOX 4323 Malibu, CA 90264 Re: Speaker/Performer Engagement Agreement This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagements described below: i. Event Description: Caribbean. Drum Circle --Interactive Music Performance Workshop; free event to the Community to experience and learn about the cultural significance of the steel drum and to participate in playing in a calypso band (see attached Exhibit A) 2. Date(s): Monday; July 9 2018 3. Event Time(s): 4:00 PM — 5:00 PM 4. Location: Newhope Library Learning Center; 1-22 N. Newhope Street, Santa Ana ("Property") 5. Compensation: VOO.00 per Invoice — Exhibit B (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment. 6. Equipment provided by City: None„ however, the City will be responsible for setting up the space for the patrons attending and advertising the program. 7. Equipment provided by Speaker/Performer: all equipment, materials, supplies and personnel necessary for the performance. 8. City Contact Person (for coordinating purposes only): Lupita Arroyo or Michelle Locra (714) 647-5231 9. Independent Contractor: Speaker/Pcrformer 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/Perfonner, its agents, or its employees (if applicable) agrees to and shall indemnify, defend, and hold harmlcss 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, its agents, or its employees, IL Release: Speaker/Performer, its agents, and employees accept the Property and any City -provided equipment used in connection with the performance in "as -is" condition, with all faults. Speaker/Performer, its agents, and employees, fully release, waive and discharge forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenant not to sue, City, its elected officials, officers, employees, agents and volunteers, and all Letter Agreement — Joseph Peck Page 2 N-2018-123 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. 12. 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 and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Speaker/Performer's 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/Performer, 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 general public, through webcast or any other 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. 1.5. 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. 16. 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. 17. 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 SAN�A A SPEAKERIP RFORNIER RAUL GODINEZ EPA PECK City Manager rilr ATTEST:„ APP,,ROVED AS TO jFORM: o „I By. aowa, i 19jS t,Y1l MARIA D. HUIZAR LAURA A. ROSSINI Clerk of the Council Senior Assistant City Attorney RECOMMENDED -FOR APPROVAL: Jeannie Jurado Acting Executive Director of Parks, Recreation, and Community Services Agency N-2018-123 Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Joseph Peck dba Panhead Music P.O. Box 4323 Malibu, CA 90264 (213) 840-6892 EVENT: Interactive Music Performance Workshop SERVICE DATE(S): July 9, 2018 COMPENSATION: Not to exceed $300 DESCRIPTION: This vendor will provide an entertainment performance on July 9, 2018. Amount shall not exceed $300 total per the term of the contract. Joseph Peck will provide a music show. The show will be presented at the Newhope Library Learning Center, 122 N. Newhope Street, Santa Ana CA 92703. The City will be responsible for setting up the space for the patrons attending and advertising the program. Vendor will be responsible for providing all equipment, materials, supplies and personnel necessary to perform the act. City staff will be present at all times during the performance. Exhibit B N-2018-123 INVOICE Joseph Peck Music / Panhead Music & Entertainment PO Box 4323 Malibu, CA 90264 cell: 213-840-6892 1 alt: 424-272-12771 office: 310-728-8277 Joseph,@Jose PeckMusic.com Federal EIN. 27-4167531 BILL TO/LOCATION: Santa Ana Public Library M-75 PROGRAM TITLE: 26 Civic Center Plaza PO Box 1988 Santa Ana, CA 92702 TELEPHONE/EMAIL: -P-R—OGRAM 714-647-5231 DESCRIPTION: rnloeragsanta-Ana.org -66-N-TACr. Michelle Loera iIN_vOICE NUMBER: -----"M--on—da-y,J—uly9,-20-1-8''PONU—MBER:--PERFORMANCE — DATE: PERFORMANCE 4:OOPM SPECIAL TIME: REQUESTS: QUANTITY One (1) Performance Workshop DURATION: One _(1)Hour_ CLIENT COST 1 CODE: AMOUNT. ---- $300.001 Performance Description Quantity Unit Price Cost Joseph Peck's Caribbean Drum Circle - 1 $300.00 $300.00 Interactive Music Performance Workshop . ........... .. $300.00 Total $300.00 Please Make Check Payable to: Panhead Music (EIN: 27-4167531) Sincerely yours, V Joseph Peck . lncpnht& 1nQPnhPPnkMi Sadler Sports: Entertainers / Performers Insurance Plan IDATE (MMI ODI YYYY) '$*CVRO- CERTIFICATE OF LIABILITY INSURANCE 0510312018 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 eartt0ced holder Is an ADDITIONAL INSURED, the pollcydep must be entlmeetl. If SUBROGATION IS WAIVED, subject to the farms and conditions of the policy, certain pDllclas may require an endorsement A statement on this contiguous does not confer rights to the cedigcate holder In Her of such endomementhap PRODUCER SADLER & COMPANY, INC. P.O. BOX 5866 COLUMBIA, SOUTH CAROLINA 29250-5866 CONTACT NAME: Sports Dept PHONE (A/C, No. Exth 600-622-7370 1 FAX (Al C, Not eo3.256-4017 E� MAIL ADDRESS: evenls@sloVerepons.cem PRODUCER CUSTOMER to#: INSURED Joseph Peck IDEA Panhead Music DO BOX 4323 MALIBU, CA 90264 N-2018-12 MA Application ID: 218984 A Memberof the Sports, Leisure & Entertainment RPG INSURER(S) AFFORDING COVERAGE NAIL INS LINES ltle ER A: Nations Mutual Insurance Company INSURER B: INSURER C: INSUREa D: COVERAGES CERTIFICATE NUMBER REVISION NUMBER THIS 19 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICYEXP LIMITS LTR INSR WVD (MMI DOI YYYY) (MMI DW YYYY) A GENERALLIABILITY X - ®COMMERCIAL GENERAL EACH OCCURRENCE $1,E0111000 DAMAGE TO PREMISES RENTED $1.000,000 LIABILITY TO YOU (Fire Legal Llablllly) El CLAIMS MADE 2 MEDICAL EXPENSE (other than g5p0D Participants) OCCUR 12:01AM ET 12:01AM ET PERSONALBADVERTISING PERRY exmadab RPGOOOOOO6071100 03/31/2018 03/31/2019 GENERAL AGGREGATE (other than Products- Completed Operations) $5,000,000 GEN'L AGGREGATE LIMIT PRODUCTCOMPLETED APPLIES PER'. OPERATIONS S $1,000,000 PROFESSIONAL LIABILITY $1,000 Goo POLICY PROJECT LEGAL LIABILITY TO $5000 LOG PARTICIPANTS MEDICAL PAYMENTSTO $5,000 PARTICIPANTS AUTOMOBILE LIABILITY ❑ANY AUTO CCOMbBINED SINGLE LIMIT (Es ALL OWNED AUTOS BODILY INJURY (Per person) SCHEDULED AUTOS BODILY INJURY (Per sceldenQ HIRED AUTOS ❑ NON OWNED AUTOS PROPERTY DAMAGE (Per accident) NOT PROVIDED WHILE IN HAWAII [-]UMBRELLALIASOCCUR EACH OCCURRENCE E]EXCESSLIAB CLAIMS- MADE AGGREGATE DEDUCTIBLE ❑ RETENTION WORKERS COMPENSATION AND WC STATUTORY LIMITS EMPLOYERS' LIABILITY ANY PROPRIETOR ❑OTHER PARTNER/ Y/N EXECUTIVE OFFICER/ N/A E.L.EACH ACCIDENT MEMBER EXCLUDED' E.L. DISEASE - EA EOMPLOYEE (Mandatory in NH) If yes, despdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED 101, AdUutonal Remarks Schedule. if more speed is required) RE: Type of Entertainer I Performer - Musician, Singer or Vocalist, PROFESSIONAL LIABILITY $1,000,000 The certll1cate holder Is added as or add Iflonal Insured, but only wlth respect 10 Pie Ilablllly, arising out of the operations of ma barred above. CERTIFICATE HOLDER CANCELLATION RELATIONSHIP: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPI Property Owner? Lessor DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PjflR NS. �j� City of Santa Ana, its officers, agents, and AUTHORIZED REPRESENTATIVE employees 20 Civic Center Plaza `ram 4 Santa Ana, CA 92701 `✓ '�J _ n rived is �,nr ex,enne„rn �.o. av ® l?l;- "NOTICE TO TEXAS INSUREDS: The Insurer for tire purchasing group may not be subject to all the Insurance laws and reguloltons of the Stale of Texas. ACORD 25 (2014101) O 1988-2114 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Sadler Sports: Entertainers / Performers Insurance Plan ISO I Commercial General Liability Forms 101/01/96 POLICY NUMBER: RPG0000006071100 INSURED: Joseph Peck COMMERCIAL GENERAL LIABILITY CG 20 11 04 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased To You): 2. Name of Person or Organization (Additional Insured): City of Santa Ana, its officers, agents, and employees 20 Civic Center Plaza Santa Ana, CA 92701 3. Additional Premium: none 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 arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises, 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and Date Added: 02/13/2018 02:19:09 PM CG 2011 0413 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. S. 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. Copyright, Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 6BRPG0000006071100 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION This endorsement modifies insurance under the following: COMMON POLICY CONDITIONS, A. Cancellation, 2.b, is deleted and replaced by: 30 days before the effective date of cancellation if we cancel for any other reason. This endorsement applies only to the insureds designated below: Named Insured: Joseph Peck DBA: Panhead Music Additional Insured: City of Santa Ana, its officers, agents and employees 20 Civic Center Plaza Santa Ana CA 92701 Effective 06/04/18 — 03/31 /19 SRPG8016 09/08 WORKERS' COMPENSATION DECLARATION I Joseph Peck / Performer hereby affirm under penalty of perjury, the (Name/Title) following declaration I certify on behalf of Panhead Music that during the term of my (Consultant/Company Name) contract for Library Music Workshop services with the City of Santa Ana, I will 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: 2/13/2018 By:� �1LC Name: Joseph Peck Title: Owner/Performer Telephone: 213-840-6892 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.