HomeMy WebLinkAboutHANSEN, ALENCity of Santa Ana
Clerk of the Council I COTCOffice Use Only
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amendments (if any) are no longer in effect.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 ! City of Santa Ana
have been satisfied prior to signing the termination form. j
042 2621
Is the agreement(s) a permanent record? Yes No
Clerk of the Council
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with �At}a�YA
No. N-2018-195 was completed on 1610)18, and final payment has been made.
(List all amendments. Use space below if needed.) ���} Department: 'i-�ntC,A1 ML r'l. '
Phone/Ext.: ��.133-W
Signature: � U L0k_Q A,PNDI J
Date: -113F7 br-\
Revised: 10-18-I6
N-2018-195
INSURANCE ON FILE
WORK MAY PROCEED
NTIL INSURANCE EXPIRES
/0-/J -/8
CLERK OF COUNCIL
DATE: OCT Z 2018 "
0:PRCS(/) _
Silvia Cuevas
October 2, 2018
Alen Hansen ("Speaker/Performer")
410 S. Forest Ave.
Santa Ana, CA 92703
Re: Speaker/Performer Engagement Agreement
Dear Mr. Hansen:
This letter represents your agreement with the City of Santa Ana ("City") as entered into on the
above date for the engagement described below:
Event Description: Entertainment/Music Performance with Moises Vasquez for the
Domestic Violence Awareness Program event, as outlined in the attached Exhibit A.
2. Date(s): Saturday, October 13, 2018
3. Event Time(s): 1:00 p.m. to 3:00 p.m.
4. Location: Santa Ana Public Library located at 26 Civic Center Plaza, Santa Ana
("Property") exterior courtyard.
5. Compensation: $133.00 (payable by check within 30 calendar days of event);
Speaker/Performer must provide IRS form W-9 before payment can be made
Equipment provided by City: Showmobile for use of the speakers.
Equipment provided by Speaker/Performer: Equipment coordinated with Moises Vasquez
including sound system, microphones, musical instruments including a conga drum, guitar,
speakers, wiring, laptop or computer.
8. City Contact Person (for coordinating purposes only): Patty Lopez (714) 647-5325
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
Letter Agreement — Allen Hansen
Page 2
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.
11. 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.
12. 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. If Speaker fails
or refuses to produce or maintain the insurance required by this section or fails or refuses
to furnish the City with required proof that insurance has been procured and is in force and
paid for, the City shall have the right, at the City's election, to forthwith terminate this
Agreement. Such termination shall not affect Speaker's right to be paid for its time and
materials expended prior to notification of termination. Speaker waives the right to receive
compensation and agrees to indemnify the City for any work performed prior to approval
of insurance by the City
13. 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.
14. 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 because of violation by Speaker/Performer of copyright laws.
15. Speaker/Performer shall not discriminate because of race, color, creed, religion, sex,
marital status, sexual orientation, age, national origin, ancestry, disability, or any other
Letter Agreement — Allen Hansen N-2018-195
Page 3
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 can be terminated by the City with forty-eight (48) hours written notice.
Notice shall be provided at the address listed on page 1 of this Agreement for Speaker.
18. Speaker covenants that it presently has no interests and shall not have interests, direct or
indirect, which would conflict in any manner with performance of services specified under
this Agreement.
19. This Agreement is not assignable without the City's written permission.
20. 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.
21. This Agreement may be signed in sub -parts and via fax or electronic e-signature. Such
signatures will have the same force and affect as an original signature.
CITY OF SANTA ANA
RAUL GODINEZ I
City Manager
ATTEST:
MARIA D. HUIZAR
Clerk of the Council
SPEAKER/PERFORMER
A&
Alen Hansen
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Attorney
By: - "I-IA-
LAURA A. ROSSINI
Senior Assistant City Attorney
Exhibit A
SCOPE OF SERVICES
EVENT: Domestic Violence Awareness and Education program for the public.
TERM: Saturday, October 13, 2018 from 1:00 p.m. to 3:00 p.m.
DESCRIPTION:
Moises Vasquez, along with Alen Hansen and Ivan Hurtado, will perform together as "Calle 4
Cuatro" and provide live musical entertainment for the Domestic Violence Awareness program
at the Santa Ana Public Library for the public. They will also perform and play music in Spanish
between presentations.
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.:
CERTIFICATE OF INSURANCE
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER
PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with
Apex Insurance Services
P. O. Box 6450 N-2018-195
Newport Beach, CA 92658
License No: OC 36861
NAMED INSURED (EVENT HOLDER):
EVENT INFORMATION:
City of Santa Ana
TYPE: Concert and Resource Fair
P O Box 1988
DATE(S): October 13, 2018
Santa Ana, CA 92702
LOCATION: 26 Civic Center Plaza, Santa Ana CA
*Liquor Liability Yes ❑ No
"Liquor Liability after 12 am ends before 2 am ❑
This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy
period indicated. The insurance described herein is subject to all the terns, exclusions and conditions of such policy(ies) unless
amended as described in Special Conditions.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: SEP41026
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2018 EXPIRATION: JANUARY 1, 2019
COMMERCIAL GENERAL LIABILITY
OCCURRENCE FORM
DEDUCTIBLE: NONE
General Aggregate Limit $ 2,000,000
Products & Completed Operations 1,000,000
SPECIAL CONDITIONS:
Personal & Advertising Injury 1,000,000
'the following endorsements attached to
Each Occurrence Limit 1,000,000
the Master Policy do not apply to this
Damage To Premises Rented To You (Any One Premises) 100,000
Certificate Of Insurance:
Medical Payments (Any One Person) 5,000
MEGL643
Liquor Liability (If purchased) 1,000,000
Optional Limits Purchased
❑ $1,000,000/$3,000,000
❑ $2,000,000/$2,000,000
Damage To Property (If purchased)
The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event.
OTHER ADDITIONAL INSUREDS
Moises Vasquez
Alen Hansen
Ivan Hurtado
CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy
provisions,
AUTHORIZED REPRESENTATIVE:
DATE ISSUED:
4
lo-q-0
WORKERS' COMPENSATION DECLARATION
I X4 4741 hereby affirm under penalty of perjury, the
(NumerTiUe) j
following declaration: 11
I certify on behalf of � l� 7lX -IV that during the term of my
contract for l i U? 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: 9 -0/IS
0
Name:
IZ-6p 9//7JFi4/
Title: -4M10-W
Telephone: (-'/`f� V 9'1- 9 a 33
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
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