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Home My WebLink AboutHERNANDEZ PRODUCTIONSCity of Santa Ana Clerk of the Council coic 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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. n 2 F;29 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 No. N-2019-247 was completed on and final payment has been made. (List off amendments. Use space below if needed.) Department: Phone/Ext.: �3Z Signature: Date: Ala%I Revised: 10-18-16 N-2019-247 Letter Agreement — Hernandez Productions, Inc. Page 2 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: (I) 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. 15. 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 as a result of violation by Speaker/Performer of copyright laws. 16. 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. 17. 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. 18. This Agreement representsthe 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 Cif and by an authorized representative of Speaker/Performer. ( l CITY OF SANTA ANA i TINE RIDGE City Manager MOUUMAMISM Title: APPROVED AS TO FORM: ny By: �1 aa�u, % - t �G�X131 L LAURA A. ROSSINI er o t e ounce Assistant City Attorney a RECOMMENDED FOR APPROVAL-,�-' Py Lis udlo , Executive irector, P A THIS CERTIFICATE IS ISSUED AS CERTIFICATE DOES NOT AFFIRM BELOW. THIS CERTIFICATE OF REPRESENTATIVE OR PRODUCER, IMPORTANT: If the certificate hold If SUBROGATION IS WAIVED, suby this certificate does not confer right PRODUCER Pacific Commerce Ins Alley CA Lie 0727575 22600 Savi Ranch Pkwy, Ste A-14 Yorba Linda INSUREO A Hernandez Productions, 10926 Rush St, Ste C THIS IS TO CERTIFY THAT THE POLIC INDICATED. NOTWITHSTANDING ANY CERTIFICATE MAY BE ISSUED OR MA EXCLUSIONS AND rnNnrrinMs nc c„r COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 191 OCCUR GENL AGGREGATE LIMIT APPLIES PER: X POLICY ❑ jEGi LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO OYJNED AWOS ONLY SCHEDULED AUTO$ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LAB OCCUR EXCESS UAS -KI IFICATE OF LIABILITY INSURANCE DATE IMM/OMMj VEL VE R OF INFORMATION ONLY AND CONFERS RIGHTS UPON TH OR NEGATIVELY AMEND, 11106/2 CERTIFICATE HOLDER. THIS URA EXTEND OR ALTER THE COVERAGE E CE DOES NOT CONSTITUTE A CONTRACT BETWEEN FFFRDED BY THE POLICIES 'D TH THE ISSUI CERTIFICATE HOLDER. G INSURER(S), AUTHORIZED s an to tho DDITIONAL INSURED, the poltcy(Ies) must have ADDITIONAL INSURED terms and conditions of the provisions Or be endorsed. the c policy, certain policies may require an ertificate holder in lieu of such enHmm�mo„u�1 endorsement. A statement on CA UNITED ct u51 EO BELOW HAVE BEEN ISSUED TO THE INSUr TERM OR CONDITION OF ANY CONTRACT OR OTHER INSURANCE AFFORDED BY THE POLICIES DESCRIBI TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Y I I I CL1779790C B "(MICE R In In E%CLUDEO? mm rve NIA (Manaarory In rvHl EIG266828000 08/07/2019 08/07/20?0 E, L. EACH ACC it yye , tleTmlre °ntler E.L. DISEASE - 0 SCRIPTION OF OPERATIONS bebw E.L. DISEASE - Employment Practices Liability Each Clair C EPL2659245 08109/2019 08/09/2020 Aggregate DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICL S (AC 0101,Addltlanal RemaN,s ScheEulv,ma be a,hchatl if mores ace is Retention City of Santa Ana, officers, agents, employe s, and volunteers; are named as additional) insured on thispolicyrpursuant memorandum of understanding. Such insur nce as s afforded by this policy shall be primary, and any insurace carried by C t1 noncontributory. 30 day notice of cancellati n in eff, ct. VIE ED APPROVED Y RISi< ANA EMEM !::a CANCELLATION 2019 BHOULD ANY OF THE ABOVE DESCRIBED PO THE EXPIRATION DATE THEREOF, N0711 Ana S MAN MLAMBERTACCORDANCE WITH THE POLICY PROVISION£ ement Divisionnter Plaza AUTHORIZED REPRESENTATIVE CA 92702 ACORD 26 (2076/03) 01988.2015 ACORD CORPOI The A ORD name and logo are registered marks of ACORD 10346 'ECT TO WHICH THIS TO ALL THE TERMS, S $250,000 $260,000 contract, agreement, or all be excess and ?S BE CANCELLED BEFORE WILL BE DELIVERED IN TION. All rights reserved. CITY OFSANTA Am RISK MANAGEMENT. dLilarut 4HUMAN RESOURCES fRt y#ftg Rls'k tunurh Posftive 0- ange ADDITIONAL INSURED ENDORSEMENT Insurance Company: Unite States Liability Insurance ny ''tiff This endorsement modifie such insurance as is afforded by the provisions of Policy#CL177979DC relating to the following 7th Annual Plaza Navidena 1. The City of Santa Ana, 0 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents and volunteers are iamed as additional insureds ("additional insureds") with re and to liability and defense of suits arising f om'tie operations and uses performed by or on behalf of he named insured. 2. With respect to cl ims rising out of the operations and uses performed by or on behalf of the named insured, such ins rant as is afforded by this policy is primary and is liot additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to thE com any s limits of liability. The inclusion of any persoh or organization as an insured shall not affect any r ght which such person or organization would have as a claimant if not so included. 4. With respect to the in coverage or limits exce 20 Civic Center Plaza, Sant; Completion of the Effective 10/06/20 1 9 al insureds, this insurance shall not be canceled, o materially reduced thirty (30) days written notice has been given tot a City of Santa Ana, lifornia 92701. countersignature, is required to make this endolrsement effective. this endorsement form as a part of Policy# CL17797 Q Issued to Hernand z,Productions, Inc (Named Insured) I: iRisk Endorsement by August2019 POLICY NUMBER: CL1779790i THIS ENDORSE EN CHANGES THE POLICY. PLEASE READ IT Cii ADDITIONAL IN UI ED - DESIGNATED PERSON OR OI This endorsement modifies In uranc provided under the following: COMMERCIAL GENERAL LIABIL Y COVERAGE PART SCHEDULE Name of Additional Insured Pars i n(s) Or Organization(s): Effective bate: 10106/2019 12111 AM City of Santa Ana, officers, agar Is, sent loyees, and volunteers are named as additionally insured on this pursuant to written contract, agn ement or memorandum of understanding. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 Information required to complee this Schedule, if not shown above, will be shown n the A. Section II -Who Is An Insured is',amended to include as an additional Insured the p rsohO or organizations) shown In the Schedule, but on y with respect to liability for "bodily Injury", "property da age' or "personal and advertising injury" caused, n whole c ir in pan, by your acts or omissions or the acts onus sions of those acting on your behalf: 1. in the performance of your )ngoir 9 operations; or 2. It connection with your prei nises: wned by or rented to you. However: 1. The Insurance afforded to s ich a ditional insured only applies to the extent parmitte, I by law; and 2 If coverage provided to the dditto al insured Is required by a contract or alleee the insurance afforded to such additional i sure will not be broader than that which you are,r quired IH the contract or agreement to pr vide f r such additional Insured n K With respect to the Insurance additional Insureds, the follow Section III - Limits Of Insure 0 coverage provided to the ac required ty a contract or agre will pay on behalf of the additi amount of insurance: 1. Required by the contract 2 Available tinder the apply Insurance shown In the E whichever is less. This endorsement shall not in Limits of Insurance shown In I CG 20 26 0413 � �' � _®is fence services Office, Inc., 2012 GENERAL LIABILITY CG 20 26 0413 Y. NIZATION rded to these is added to lal insured Is it, the most we insured Is the agreement; or de Limits of 6se the applicable Declarations. Page 1 of 1 City of Sant, Risk Manage 20 Civic Cer Santa Ana, C Re: Auto Ins Dear City of I, Jose Her licensed pr Santa Ana. During the mariachi p, Cuatro in E Sincerely, {. a C Jose Herna Hernandez DEZ PRODUCTIO and E&0 Requirement - Release Ana Risk Management Division: Hernandez Productions, Inc. will not utilize/operate an al during the course and scope of my participation or s 16/19 through 11/16/19, my company will only be exh ;e to the public at the City's Plaza Navidena event loc t Santa Ana. ns, Inc APPROVED QyR IWM A IEMFW i%IVISION 2 19 ....I AA�1t �+ IAM13ERf NENNwlO o vehicle or hire a rvice with the City of at Plaza a 10926 Rush Street *Suite C * South El Monte > California, 91 733 * (�26) 279-1 700