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HomeMy WebLinkAboutSYEN, LLC; DBA:YOUNG REMBRANDTSP City of Santa Ana Clerk of the Council AGREEMENT TERMINATION FORM 51[ P9 Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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 L�-C OF THE CD!lN(TL 3 9 22 P0:29 No. N-2019-097 was completed on (O G (� and final payment has been made (List all amendments. Use space below if needed.) Department: Phone/Ext.: Signature: Date: Revised: 10-18-16 INSURANCE ON FILE N-2019-097 VVORK MAY PROCEED UNTIL INSURAN" E EXPIRES CETE: a CO 'IL OATS` �(LGS�CC.17MAY 2 3 2019 RECREATION SERVICES AGREEMENT pt $ twl a G"O" THIS AGREEMENT is made and entered into on this 1 s` day of May, 2019 by and between Syen, LLC dba Young Rembrandts ("Provider") and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a recreation service provider having special skills, resources and knowledge to provide Young Rembrandts Various Art classes in its recreation class program. B. Provider represents that she is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Provider represents that she is knowledgeable in her field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Provider shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION In consideration for the provision of the programs set forth in Exhibit A, City agrees to pay the Provider seventy percent (70%) of all gross revenue received from program participants. Total revenue to Provider shall not exceed $25,000.00 annually. Payment to Provider shall be made monthly within thirty (30) days following completion of the last class taught by Provider the prior month. City shall be responsible for collecting all fees from program participants. Provider shall not collect fees but will refer all interested participants to City for registration information. Provider agrees that City shall retain thirty percent (30%) of all gross revenue received from program participants as an administrative fee. 3. TERM This Agreement shall commence on .tune 1, 2019 and end on June 30, 2020 unless terminated earlier in accordance with Section 12 below, The term of this Agreement may be extended by a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Provider shall, (luring 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 manner in which Provider performs the services which are the subject matter of this Agreement; however, the services to be provided by Provider shall be provided in a manner consistent with all applicable standards and regulations governing such services. Provider 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. Provider is not an agent, representative or employee of City and Provider shall have no authority to act on behalf of the City. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Provider shall maintain commercial general liability insurance which 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 Provider'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 and $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured(s provisions. b. Worker's Compensation Insurance. In accordance with California State law, Provider, if Provider has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Provider agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. The following requirements apply to the insurance to be provided by Provider pursuant to this section: . i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv. Where the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts provided by the certificates orinsurance shall be incorporated by reference into the Agreement. V. Consultant shall supply City with a fully executed additional insured endorsement. 2 d. If Provider 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 terminate this Agreement. Such termination shall not affect Provider's right to be paid for its time and materials expended prior to notification of termination. Provider waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. G. INDEMNIFICATION Provider agrees to and shall indemnify, defend and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (I ) for personal injury, damages,just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Provider or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement, to the extent that the injury, damages, just compensation, restitution, judicial or equitable relief is caused by the negligence of the Provider. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. In no case will Provider be required to indemnify or hold harmless the City from injury, damages, just compensation, restitution, judicial or equitable relief caused by the negligence of the City. 7. CONFLICT OF INTEREST Provider 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. 8. FINGERPRINTS AND BACKGROUND CHECK Provider, and any employees, subcontractors or substitutes, shall arrange for and submit their fingerprints for a criminal background check through the Department of Justice through the City's Human Resources Department process. Consultant shall be responsible for all charges associated with fingerprinting. Consultant shall not perform any services pursuant to this Agreement until clearance is received and the Consultant is notified by the City's Parks, Recreation and Community Services Department. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 With copy to: Santa Ana, CA 92702-1988 Fax (714) 647-6956 Executive Director of Parks, Recreation and Community Services City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax (714) 571-4211 To Provider: Syen, LLC. dba Young Rembrandts P.O. BOX 92781 Tustin, CA 92781 Phone: (714) 694-3912, (530) 383-1510 Email: program.pate vounarembrandts.com A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITI" AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Provider regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Provider. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Provider or the City, Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. IL ASSIGNMENT/SUBSTITUTES a. Assignment. The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. b. Substitutes. In the event Provider is not able to teach a class due to illness or some other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a qualified substitute instructor to teach the class at its regular time and place. Provider shall ensure that substitute instructors are at least twenty-one (21) years of age and comply with the City's insurance and live scan requirements contained herein. Evidence of compliance with City's insurance and live scan requirements shall be provided upon request. Provider must immediately notify the City of the substitute instructor's name, qualifications, address and phone number. If Provider cannot procure a qualified substitute and the City is unable to assist in this regard, then the class shall be canceled and a make-up class must be added to the session. Provider must notify participants as soon as possible of any class cancellation and make-up class. Provider must personally teach at least seventy-five percent (75%) of its offered classes. 12. TERMINATION a. This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Provider shall be entitled to receive, and City shall pay Provider, compensation for all services rendered prior to the effective date of termination. b. Termination or cancellation of classes by the Provider outside of Section 1 Lb. must be given to the City at least thirty (30) days prior to termination/cancellation. Failure to provide adequate cancellation notice to the City may put future contracting of business with the City at risk and will result in the City's retention of ten (10%) percent of the final payment to Provider. 13. RECORDS Provider shall use attendance sheets generated and supplied by the City to record attendance in each class. Provider shall keep these and any other records in connection with the work to be performed under this Agreement and shall permit City, upon request, to review such records for a period of three (3) years from the date of final payment to Provider under this Agreement. 14. NON-DISCRIMINATION Provider shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. E 15. JURISDICTION —VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further 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. 16. LICENSES Provider shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. 17. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by validjudgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. 18. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 19. AUTHORITY The person(s) executing this Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that by so executing this Agreement, the parties hereto are tonnally bound to the provisions of this Agreement. [Signatures on next page] IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: ^+2�ar�?- Norma Mitre Acting Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attiey By: Ryan AL: Director of Parks, i and Community Services Agency CITY OF SANTA ANA Kri tine Ridge�- City Manager PROVIDER: 0�1� (?Dom PPrTVt.) Syen, LLC. dba Young Rembrandts Exhibit A SCOPE OF SERVICES A. Provider shall conduct Young Rembrandts Various Art classes for ages 4 -12 yrs. B. Provider shall teach such or similar classes (1) at the times below at facilities to be designated by the City or (2) on a schedule agreed upon by the parties for each class session or term, including the location, specific days and hours when classes will be held, and holidays to be observed, in accordance with City's needs. Rock Out Workshop Out workshop is five days of artistic, rock and roll imagery where students will draw stylized instruments and illustrate close-up portraits of rock stars. Students will draw an awesome concert scene to close out our last day of class. Sketch and Friends - Underwater Explorers Underwater exploration comes to life in this 5-day cartoon workshop. Students draw the cartoon characters in their underwater sea station, drawjokes about life on the job and illustrate other crazy encounter with Sketch and his animal friends. Cartooning techniques like expression, sequencing and scenic development are just a few of the hilarious lessons learned all workshop long. Cartooning FUNdamentals Learning to draw can be fun, especially when we create silly characters, funny expressions and drawing sequences that tell a joke! This delightful program combines Young Rembrandts' innovative, step-by-step drawing method with light-hearted subject matter that engages children, their sense of humor, and their vivid imaginations. Pastel Drawing Workshop - Colorful Critters Students will learn pastel drawing and texturing techniques to illustrate whimsical bees, a fanciful army of frogs, a striking owl and more artistic critters filled with detail. Challenge your creative kids by introducing them to the world of pastels, a guaranteed favorite summer tradition for every Young Rembrandts artist. If you give a mouse a cookie junior workshop Preschool children will explore the world of Laura Numeroff in this five-day workshop full of art and reading. Each day the class will read a different Laura Numeroff book, and afterwards, students will draw a Young Rembrandts lesson which incorporates one feature of the book they've enjoyed reading together. Students will create wonderful drawings and bring their favorite stories to life by combining creativity and imagination! Curious George Junior Workshop Preschool children will explore the world of H.A and Margaret Rey in this five-day workshop full of art and books. Each day a different Curious George book will be read with the students. Afterwards, children will draw a Young Rembrandts lesson which incorporates one aspect of the book just read together. Children's creativity and imagination will play together as students bring their favorite books to life through their detailed drawings! African Safari Workshop Students will explore the exciting land and many animals that inhabit Africa, In five days students will draw a variety of animals in various scenes with different media and will explore the African Safari through the fun technique of cartoon as well. Will also create 2 large scenes - one in a graphic style filled with a variety of animals and another focusing on the twists and turns of an African snake completed with pastel chalks. Our exploration through Africa allows for a bounty of adventure and creativity. INSTRUCTOR: Young Rembrandts LOCATION: Jerome Center, 726 S Center St., Santa Ana, (714) 647-6558 • Rock Out Workshop class will consist of monthly sessions, held 5 days per week, 2 hours per day. • Sketch and Friends class will consist of monthly sessions, held 5 days per week, 2 hours per day. • Cartooning FUNdamentals class will consist of monthly sessions, held 1 day per week, I hour per day. • Pastel Drawing Workshop - Colorful Critters class will consist of monthly sessions, held 5 days per week, 2 hours per day • If you give a mouse a cookie junior workshop class will consist of monthly sessions, held 1 day, per week, I % hour per day • Curious George Junior Workshop class will consist of monthly sessions, held I day, per week, 1'/ hour per day + African Safari Workshop class will consist of monthly sessions, held 1 day, per week, 2 hours per day C. Provider shall provide all materials, supplies, equipment, records and personnel. Provider shall be responsible for clean-up of the facilities and materials and shall ensure the safety and effectiveness of instruction. CLASS SIZE A. Each class must have a minimum of 4 paid student and no more than 25 students. B. No registration will be accepted after the second meeting of classes. C. If the minimum registration has not been reached by the second class, the class shall be canceled. Provider will be under no obligation to provide services for the cancelled classes, and the City will have no further obligations to pay Provider compensation for the remaining classes that were cancelled in that session. CLASSFEES A. Each participant shall pay class registration fees as established by City. B. Provider may not waive class participation/registration fees. C. Only registered participants may participate in class. D. Any refunds to participants will be made in accordance with City policy. E. Any materials fee shall be established by mutual agreement of City and Provider and shall be payable directly to Provider. AOORLf CERTIFICATE OF LIABILITY INSURANCE DATE IMMMDA'YYYI o3rDBnot9 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 714E ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder Is an ADDITIONAL INSURED, the polloy(los) must have ADDITIONAL INSURED provisions or be endorsad. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, contain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsomant B , PRODUCER I PAMELA PAGAN StateFaf7Tl LORI GREEK GARABEDIAN INSURANCE AGENCY INC PHONa 949 858 4400—��P�— -Rn-E.in: we x I. 949.247.7015 STATE FARM INSURANCE Eami . PAMELAGLGGINSURANCE.COM "' 29809 SANTA MARGARITA PKWY STE 101 INSURERISI AFFORDING COVERAGE AIDA RANCHO SANTA MARGARITA CA 92688 INSURER A: State Farm General Insurance Company 25151 INSURED INSURER a I State Farm Fire and Casualty Company 25143 Syen, LLC DSA Young Renthrand(s INB RERC: P.O. Box 1793 INSURERD: Tustin CA 92781-1793 IN UR INSURER : COVERAGES CERTIFICATE NUMBER- Rev!q!0M An Musson. 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, EXCLUSION$ AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. ILTRNSR TYPE OF INSURANCE IA SUER POUC N Me PO POLNCDY P LAMBS A COMMERCIALOENERALLL401UTY CLAW"ADE ® OCCUR 92.GG-8281.8 11/29/2018 11l2912019 EACH OCCURRENCE S 2.000,000 y I MED EXP n one ram p 300,000 �W I t0_,000 �~ PERSONAL S ADV INJURY S 2,000,000� GEN'L AGGREGATE LIMIT APPLES PER: POLICY ElwT LOC OTHER: %NERALAGOREDATE S 4,000,000 PRODuCT3•COMPA)p AGa s 4,000,000 S AUTOMOO LE LWBIUrr ANY AUTO AUTOS ONLY AUTOS WNED AIRED UTOSONLY AUTOS ONLY a MID 90DiLY INJURY (Par palm) 9 BODILY INJURY(PW aWdwt) S •_-- PR S S UMBRELLA LMe EXCESSIUAH OCCUR CLMMS.MADE Jn� Carmen n lJ ggta EACHOCCURRENCE S AOOREOATE f DEC) RET NT S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFPICE"eMEBTER eXCLUDEDT EDLxIVE Y l IMLndstory In NNt B 56FOI M Nmdx DESCRIPTION OF OPERATIONS befW NIA T3 Adgecreaft0r.S iC 92-00-$283.2 11/29I2018 17/2SI2018 E.L BAcx acaDENT s 58D,000 E.L. DSEASE-FA EMPLOYE S 600,000 E.L. DISEASE• POLICY LIMIT S 50,000 DESCRIPTON OF OPERATONS t LOCATIONSI VEMCLES (ACORD SOt.0.ddltlomi Renudu 30heNW.-Myth WAclnd a,bon "date nquindt ADDITIONAL INSURED: THE CITY OF SANTA ANA THE CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 SHOULD ANY OF THE ABOVE DESCRI9ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE MTN THE POLICY PROVISIONS. ALVRY AD tAU twua) I no AW VKU name ano toga are regunerea mat9s Of ACORD IOG1486 132&9.12 00-M-2016 SM Policy No, 92GGS2818 1314-FA64 CMP-4860.1 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP-4860.1 ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Policy Number: 92GGS2818 Named Insured: SYEN LLC DBA YOUNG REMERANDTS 1411 MONTGOMERY ST TUSTIN CA 92782-1793 Name And Address Of Additional Insured Person Or Organization: THE CITY OF SANTA ANA 20 CIVIC CENTER PLZ SANTA ANA CA 92701 4058 1. SECTION II — WHO IS AN INSURED of SECTION 11 - LIABILITY is amended to in- clude, as an additional.insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", or "personal and advertis- ing injury" caused, in whole or in part, by: a. Premises And Ongoing Operations Your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations; or b. Products -Completed Operations "Your work" performed for that additional insured and included in the "products - completed operations hazard". However, Paragraph 1, above is subject to the following: a. The insurance afforded to the additional insured only applies to the extent permit- ted bylaw; b. 4� �tiveragSitTe 'to %fttional in- sured is r tt��Irerf#`coiifract or agree- ment, th6'X rance provided to the additional -insured will riot be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional insured; and c. If the contract or agreement between you and the additional insured is governed by California Civil Code Section 2782 or 2782.05, the insurance provided to the additional insured is the lesser of that which: (1) Is allowed for the satisfaction of a de- fense or indemnity obligation by Cali- fornia Civil Code Section 2782 or 2782.05 for your sole liability; or (2) You are required by contract or agreement to provide for such addi- tional insured. We have no duty to defend or indemnify the additional insured under this endorsement un- til a claim or "suit' is tendered to us. ti), Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CONTINUED CMP-4860.1 Page 2 of 2 1 Any insurance provided to the additional in- sured shall only apply with respect to a claim made or a "suit" brought for damages for which you are provided coverage. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations. 3. With respect to the insurance afforded to the additional insured, the following is added to SECTION 11— LIMITS OF INSURANCE: If coverage provided to the additional insured is required by contract or agreement, the most we will pay on behalf of the additional insured will be the lesser of the amount of insurance: g, a. Required by the contract or agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the ap- plicable Limits Of Insurance shown in the Declarations. 4. With respect to the insurance afforded to the additional insured, the following is added to Paragraph 3. Duties In The Event Of Occur- rence, Offense, Claim Or Suit of SECTION It — GENERAL CONDITIONS'. The additional insured must: a. See to it that we are notified as soon as practicable of an "occurrence" or an of - which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occur- rence" or offense took place; (2) The names and addresses of any in- jured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occur- rence" or offense; b. Tender the defense and Indemnity of any claim or "suit" to us and to all other insur- ers who may have insurance potentially available to the additional insured; and c. Agree to make available any other insur- ance the additional insured has for de- fense or damages for which we would provide coverage under SECTION II — LIABILITY. With respect to the insurance afforded the ad- ditional insured, the following replaces SEC- TION 11 — LIABILITY of Paragraph 7. Other Insurance of SECTION 1 AND SECTION 11— COMMON POLICY CONDITIONS: a. This insurance is primary to and will not seek contribution from any other insur- ance available to the additional insured, provided that the additional insured is a named insured under such other insur- ance. b. Regardless of any agreement between you and the additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional in- sured has been added as an additional in- sured on other policies. There will be no refund of premium in the event this endorsement is cancelled. All other policy provisions apply. CMP-4860.1 1007042 148020 08-26.2014 C, Copyright, State Farm Mutual Automobile Insurance Company, 2013 Includes copyrighted material of Insurance Services Office, Inc., with its permission. F,e , �d b NCO Tkkc!—S�- CSP,j?,1aC tic WURKLPS' C0b1PENSATION DECLARATION 1 _Y hereby affirm under penalty of petjury, the ;>w i tfo tollowin6 declaration: I certify on behalf of_--5A- s� o _ 3 that during the term of my �fonmlumr ComN;ut �V'unicl �-� C0I1Iract tot' F'@CC68tI0n CHSS25 service's With till' lty 01'Santa Ana. I will notellpioF tin♦'person ❑1 any manner so as to become subject to the 4V"orkers' compensation laws of California, and agrek that if'[ should become subject to the evorkers` compensation provisions of Section 0700 of the Labor Code, I shall forthwith comPly with those provisions and provide proof of %vorkers' compensation coverage. DATE: '?,I-ZIIel By: Name: VDNM PA S Title: ownw Telephone: I4 WARNING: FAILURE TO SECURE WORIfERS' COVITENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRni,ITNAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND' DOLLARS (StO0,000), IN ADDITION TO THE COST OF CO iPENSATT ON, DAtV[AGES AS PROVIDED FOR IN SECTION 3706 OF TILE LABOR CODE, INTEREST. AND AYFORNIEY`S FEES. e\]a