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HomeMy WebLinkAboutVANDRUFF PRODUCTIONS, INC.;,,z-JRANCE ON FILE NlORK MAY PROCEED UNTIL INSURANC EXPIRES N-2019-164 fl CLERK OF OLIN IL DATE. S P 0 9 2019AGREEMENT WITH VANDRUFF PRODUCTIONS, LLC TO PROVIDE VIDEO PRODUCTION SERVICES Gc> A C HIS AGREEMENT is made and entered into on this 28TH day of August, 2019 by and between Td car^ VanDruff Productions, Inc., a California corporation, ("Consultant'), 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 consultant having special skill and knowledge in the field of producing promotional videos to upload for multiple video formats and platforms. B. Consultant represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. 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: iI 161119 DKII-W":uf ["y Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in the description of projects attached hereto as Exhibit A, and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total amount to be expended during the term of this Agreement shall not exceed $2,000. b. City shall provide a payment of $1,000 upon full execution of this Agreement. The remaining $1,000 shall be paid upon satisfactory completion of all projects. Work to be completed no later than the time provided in Section 3b, below. c. Payment for the remaining funds, defined above in Section 2.b., by City shal I be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. Page 1 of 7 3. TERM a. This Agreement shall commence on the date first written above and continue through December 31, 2019, unless terminated earlier in accordance with Section 15, below. b. Consultant shall provide all deliverables to the City by October 27, 2019. The parties agree that the date provided in Section 3.a., above, will provide for consolidation of any costs or invoices. The Consultant shall be allowed additional time past October 27 to complete the project upon the written consent of the Executive Director of the Community Development Agency, or his/her designee. 4. INDEPENDENT CONTRACTOR Consultant 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 Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant 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. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data'). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant 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 Page 2 of 7 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 Consultant'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 (a) name the City, its officers, employees, agents, 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 insureds provisions. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability fbr worker's compensation or to undertake self- insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. C. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. d. The following requirements apply to the insurance to be provided by Consultant 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 of insurance shall be incorporated by reference into the Agreement. V. Consultant shall supply City with a fully executed additional insured endorsement. e. If Consultant 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 Consultant's right to be paid fbr its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. Page 3 of 7 INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, special counsel, and representatives from liability: (1) 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 Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 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. 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. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises 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. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such Page 4 of 7 information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant 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. 12. NON-DISCRIMINATION Consultant 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, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, 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 Consultant. 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 Consultant 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. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant 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 Page 5 of 7 the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. 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. 18. PROFESSIONAL LICENSES Consultant 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. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. Page 6 of 7 19. 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 City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director, Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-25) P.O. Box 1988 Santa Ana, California 92702 Fax:714-647-6549 To Consultant: VanDruff Productions, Inc. 18841 Deep Well Road Santa Ana, CA 92705-2239 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. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority Page 7 of 7 or power is not, in fact, held by the signatory or is withdrawn. All Exhibits referenced herein and attached hereto shall be incorporated as if frilly set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: 'Daisy Gomez Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City AttoW By: ! d, Ryan O. RECOMMENDED FOR APPROVAL: — —A �- Steven Mendoza Executive Director, Community Development Agency CITY OF SANTA ANA Kristine Ridge City Manager CONSULTANT: 0 By: Title: Page 8 of 7 EXHIBIT A SCOPE OF SERVICES and COSTS Exhibit A Description of Projects There will be six ninety-second videos and one three -minute promotional video for a total of seven "Projects." 1. Pre -Production. Up to seven hours of pre -production planning, roughly one hour per Project. 2. Production. Up to fourteen hours of pre -production planning, roughly two hours per Project. Footage can include: ➢ Static shots and motion car shots of landmarks and buildings ➢ Drone shots of buildings, landmarks, and unique locations of Santa Ana (if permissible according to FAA and city regulations) ➢ Static shots and motion interior/exterior shots of building, events, shows, etc. Licensed stock footage, licensed music enhancement, as needed 3. Post -Production. Post -Production will include between four and five weeks of post - production editing and deliverables preparation for all Projects inclusive: ➢ Two client editorial review and revise passes per Project Subsequent review/edit passes will be at an additional cost, amount dependent on the complexity of changes ➢ Deliverable is a high -definition digital media render of each Project in formats specific to website and social media embedding. Any logos or other artwork will be incorporated into the respective Projects upon request and as provided by the Client. 4. Completed Projects All seven of the Projects will be completed between October 1411, 2019 and Oct. 215t 2019. Engagement Fee Inclusive: $2,000 VIDEO PRODUCTION AGREEMENT Page 4 of 4 ACORD CERTIFICATE OF LIABILITY INSURANCE F DATE ultemoIVYYY) 0W26/2019 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 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 CONTACT Kenneth King Memwelher & Williams Insurance Services PHONE Fall. (415) 217-6571 FAX 9u : (415) 986-4421 License No.: 0001378 'M kkingQimwis.com 550 Montgomery St., Suite 550 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 4 San Francisco CA 94111 INSURER A: ACE Property and Casualty Insurance Company 20699 INSURED INSURER S: VAN DRUFF PRODUCTIONS, INC. INSURER C 18841 DEEP WELL RD INSURER D: NSURERS: SANTA ANA CA 92705 INSURER F: GOVtNAGtS CERTIFICATE NUMBER: ULlVUZZ14MZ REVISION NUMBER: CL1982214842.2 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. INER LTR TYPE OF INSURANCE MOL I SUBN POLICYNUMBER POLICYEFF MMIDONW POLICY E P NrWDD/YYYY LIMITS X COMMERCIAL GENERALUMILITY CLAIMS -MADE ©OCCUR EACH OCCURRENCE $ 2,000,000 PREMISES Ee occDAWGE TO urrence $ 1,000,000 MEDEXP(ny one pmapn) S 5,000 A Y N D94920218 08/15/2019 08/15/2020 PERSONAL A ADV INJURY S 2.000.000 GENI AGGREGATE LIMITAPPLIES PER: POLICY ❑ JET LOC GENERALAGGREGATE $ 4,000,000 PRODUCTS - COMPYOPAGG S 4,000,000 $ OTHER AUTOMOBILE LIABILITY COMUINED 9INOLELIMIT a ascid.1 $ BODILY INJURY (Par person) If ANY AUTO OWNED SCHEOULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H BODILY INJURY (PerauMmO f PROPERTYOAMAGE Per accMenl $ UMBRELLA UAS EXCESS LIMB OCCUR CLAIMS -MADE REVIEWED & AP By RISI( MANA EMENi OVED DIVISION EACH OCCURRENCE S AGGREGATE t DED I I RETENTIONS $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOWPARTNER/EXECUTVE ❑ OFFICEMMEMBER EXCLUDED9 N/A PER OTH- STATUTE ER EL. EACHACCIDENT S E.L. DISEASE-EAEMPLOYEE S (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 10i, Additional Romarke Schedule, may be atlachod If mom space Is mquimd) City of Santa Ana, its officers, agents, employees, and volunteers are Additional Insureds regarding General Liability with respect ID the Named Insured's operations where required by written agreement. All insurance afforded by the General Liability shall be primary, and any insurance Carried by City shall be excess and noncontributory. Thirty days written notice of coverage cancellation or reduction shall be provided to the Certificate Holder according to the provisions of the policy except in the event of non- payment of premium when ten days notice will apply. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RISK MANAGEMENT DIVISION ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA 4TH FLOOR AUTHORIZED REPRESENTATIVE _ SANTA ANA CA 92701 e �� (c1 49RR.9n15 AnnRn Cn ROnRATinM ------Al ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00002280 is LOC #: A ADDITIONAL REMARKS SCHEDULE AGENCY 6 Williams Insurance Services POUCYNUMSER D94920218 CARRIER ACE Property and Casualty Insurance Company NAMED INSURED VAN DRUFF PRODUCTIONS, INC. 8841 DEEP WELL RD SANTA ANA, CA 92705 NAIC CODE 20699 1EFFECTIVEDATE: 0811512019-08/15/2020 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes EXCLUSIONS LISTED BY POLICY FORM: SOP436030814 EXCLUSION -GENETICALLY MODIFIED ORGANISMS BPO517 0106 EXCLUSION - SILICA OR SILICA -RELATED DUST BP14860713 COMMUNICABLE DISEASE EXCLUSION BP1506 0514 EXCLUSION -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION SOP477380416 EXCLUSION -HEALTHCARE INFORMATION TECHNOLOGY PRODUCTS AND SERVICES SOP485730117 LEAD EXCLUSION BOP47843 0316 EMPLOYMENT -RELATED PRACTICES EXCLUSION BOP460681214 PROPERTY COVERAGE PART EXCLUSION BOP48527 0117 ASBESTOS EXCLUSION BOP503970518 MARIJUANA EXCLUSION REVIEWED & APPROVED By RISk MANAGEMENT DIVISION -0PNER. 0 2019 FRANCVILLAREAL Page 01 of 01 the ACORD name and logo are registered marks of ACORD CORPORATION. All Additional Named Insureds Other Named Insureds -- VPro Doing Business As REVIEWED & APPROVEL_ By RISI( MANAGEMENT DIVISION �A 12 30 p g FRANCINE R. VILLAREAL OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC WORKERS' COMPENSATION DECLARATION I Mark Van Druff. CEO hereby affirm under penalty of perjury, the following declaration: I certify on behalf of Van Druff Productions, Inc that during the term of my contract with the Community Development Agency, 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. DATE: &22/2019 By: Name: Mark Van Druff Title: CEO REVIEWED & APPROVED Telephone: 714.532.3253 By Risk MANAGEMENT DIVISION US 3 0 019 FRAN INE 2. VILLAREAL 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.