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HomeMy WebLinkAboutWALLMAN, RACHEL, DBA: DOODLEBUGS ANIMAL ADVENTURESCity of Santa Ana -r Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and amendments (if any) are no longer in effect..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 Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. N-2019-107 was completed on (List all amendments. Use space below if needed.) Revised: 10-18-I6 COTC Office Use FE® -6 PH 4: 23 C1T� OF SANTA ANA CLERK OF COUNCrL /j'3jg0j9 and final payment has been made. Department: PRcspt Phone/Ext.: u2 161 Signature: Date: vi�f'aG'1�1 yb�O Ws N-2019-107 INSURANCE Y �P r + l iLAwizCLERK OF COUNCIL i l l i DAM \ 2019 to- 0 Ms. Rachael Wallman dba Doodlebugs Animal Adventures ("SpeakerlPerformer") 3024 E. Chapman Ave. #186 Orange, CA 92869 Re: S12eaker/Performer Engagement Agreement This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagement described below (the "Agreement"): Event Description. Wild About Animal Presentation Program event featuring the California desert tortoise, blue -tongue skink, gopher snake, rabbit, Legless lizard, Chinchilla and a Madagascar hissing cockroach. 2. Event Date. June 18, 2019. 3. Event Time. 6:30PM — 7:30PM. 4. Event Location. Santa Ana Public Library, 26 Civic Center Plaza, Santa Ana ("Properly"), 5, Compensation. Speaker/Performer shall be paid $270.00 (payable by check within 30 calendar days of event) for this event; Speaker/Performer must provide IRS form W-9 before payment can be made. 6. Equipment provided by City. Two (2) tables and promotion of event. Equipment provided by Speaker/Performer. All equipment, animals, materials, supplies, and personnel necessary to perform the act shall be provided by the Speaker./Performer. For example: all equipment necessary, including, without limitation, sound technicians, speakers, laptop/music, table, microphone, headphone, and strobe light shall be the responsibility of the Speaker/Performer to provide insofar as they are necessary to perform the act. 8. City Contact Person (for coordinating purposes only). Michelle Loera or Lupita Arroyo (714) 647-5258. 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 Letter Agreement — Doodlebugs Animal Adventures Page 2 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. 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 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. 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, its employees and subcontractors, shall not perform any services pursuant to this Agreement until clearance is received and Consultant is notified by the City's Parks, Recreation and Community Services Department. 15. Limited License. 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 webeast 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. 16. Fee Responsibility. Speaker/Performer is solely responsible for payment of royalty fees, performance fees, or similar fees that maybe 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. 17. Nondiscrimination. 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. Letter Agreement — Doodlebugs Animal Adventures Page 3 18. Choice of Law and Venue. 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. 19, Merger. 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 KRISTINE RIDGE City Manager ATTEST: NORMA MITRE Acting Clerk of the Council RECOMMENDED FOR APPROVAL: SPEAKER/PERFORMER TWW�0 .L/�" Name: RACHAEL WALLMAN Title: Owner APPROVED AS TO FORM: By: k' LAURA A. ROSSINI Senior Assistant City Attorney DAM~ ANIMAL ADVENTURES 3024 E Chapman Ave #186 Orange, CA 92869 (657)333-8126 INVOICE Confirmation Number 051519rw061819 Description Amount Wild About Animal Presentation Tuesday, June 18, 2019 6:30pm-7:30pm $270.00 Animals: Tortoise, Blue Tongue Skink, Gopher Snake, Legless Lizard, Hissing Cockroach, Rabbit or Chinchilla Travel To: Santa Ana Public Library 26 Civic Center Plaza Santa Ana, CA 92701 Total: $270.00 Amount Paid: $0.00 Amount Due: $270.00 We accept Cash, Check, or Credit (Visa/Mastercard/AMEX). Please make checks Payable to: Doodlebugs Animal Adventures. Thank you for choosing Doodlebugs Animal Adventuresl DoodlebugsAnimalAdventures@gmail.com (657) 333-8126 www.DoodlebugsAnimalAventures.com A� H CERTIFICATE OF LIABILITY INSURANCE DA5/20/2019rY) 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 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 CONTACT NAME: Michael Plouffe Specialty Insurance, LTD. P.O. Box 16901 BOON Ext. 203-931-7095 A"� No): 203-931-0682 EMAIL ADDRESS: s P Y certificates ecialt insuranceltd.com INSURER(S) AFFORDING COVERAGE NAIC# West Haven, CT06516 INSURER A: United States Fire Insurance Co. 21113 INSURED Doodlebugs Animal Adventures c/o Rachael Waltman 3024 E. Chapman Ave. #186 Orange CA 92869 INSURER B ; INSURERC: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF Nuamn YYYY POLICY EXP MM/DDIYYYY LIMITS A x COMMERCIALGENERAL LIABILITY CLAIMS -MADE X OCCUR USP2844256 1/1/19 1/1/20 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP iAny one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L x N AGGREGATE LIMIT APPLIES PER POLICY PRO- JECTLOD GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR ,�'j �, EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE QJ DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH)`\``� If yes, describe under DESCRIPTION OF OPERATIONS below NIA �,/ X)Q °\ � y., PER DER - STATUTE ER E. L. EACH ACCIDENT $ E. L. DISEASE - EA EMPLOYE $ E, L. DISEASE -POLICY LIMIT $ A Accident medical US1025248 1/1/19 111/20 Max. Benefit $10,000 Coverage Deductible $100/Claim DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa an, its officers, agents and employees as additional insured. Coverage is Primary and Noncontributory. CERTIFICATE HOLDER CANCELLATION The City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Michael H. Plouffe © 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION Policy Number: USP284256 Insured: Doodlebugs Animal Adventures This endorsement modifies insurance provided under the following: Insured City of Santa Ana Civic Center Plaza ita Ana, CA 92701 ation COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Section II - WHO IS AN INSURED is amended to include as an 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 of the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. To the extent that any of the additional insureds named herein are liable for occurrences arising out of the named insured's negligent acts or omissions, the insurance afforded to the additional insureds under this endorsement is primary insurance over any other valid or collectible insurance which the additional insureds may have with respect to loss under any of the listed policies. Other insurance of any additional insured applicable to loss is non- contributory and excess over the coverage provided by this endorsement, and the amount of the company's liability under this policy shall not be reduced by the existence of such other insurance. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ WORKERS' COMPENSATION DECLARATION I Rachael Wallman/Owner hereby affirm under penalty of perjury, the (Name/Title) following declaration: I certify on behalf of Doodlebugs Animal Adventures that during the term of my (Consultant/Company Name) contract for Wild About Animals (LARGE) 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: 5/15/19 ,�,a e, f1 Name: Rachael Wallman Title: Own er/Educator Telephone: 657-333-8126 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. CJ