HomeMy WebLinkAboutGET CPR CERTIFIEDINSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
I- I2.ZS
CLERK OF COUNCIL
DATE:
N-2022-197
RECREATION SERVICES AGREEMENT WITH GET CPR CERTIFIED
THIS AGREEMENT is made and entered into on this 1-7 day of May, 2022 by and between
Ana Guillen, an individual doing business as Get CPR Certified ("Provider"), and the City
aof Santa Ana, a charter city and municipal corporation organized and existing under the
C'4 Constitution and laws of the State of California ("City"). City and Provider may be
'n collectively referred to as the "Parties" or individually as a "Party."
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RECITALS
A. The City desires to retain a recreation service provider having special skills, resources and
knowledge to provide adult and pediatric CPR/AED classes in its recreation class program.
B. Provider represents that it is able and willing to provide such services to the City
C. In undertaking the performance of this Agreement, Provider represents that it is
knowledgeable in their field and that any services performed by Provider under this
Agreement will be performed in compliance with such standards as may reasonably be
expected.
D. The Parties acknowledge that the City intends to provide recreational activities to the public
but must balance the need to comply with all COVID-19 guidance and restrictions.
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:
1. SCOPE OF SERVICES
A. Provider shall perform those services as set forth in Exhibit A to this Agreement.
B. All classes operated pursuant to this Agreement for conducting recreation classes
at City facilities, including parks, will comply with all applicable guidance and
public health orders, including those from the Centers for Disease Control
("CDC"), California Department of Public Health ("CDPH"), the Orange County
Health Care Agency ("OCHCA") and the City itself for as long as those orders and
guidance remain in place. Provider will remind participants of these guidelines.
To the extent that Provider needs assistance with enforcing any rules or
requirements, Provider will contact a City Parks' employee or City security for
assistance.
C. Provider shall not attend a class or teach any class if Provider is sick or has any
symptom(s) associated with COVID-19 including but not limited to, fever above
100.4, chills, cough, shortness of breath, loss of taste or smell, nausea, muscle or
body aches, vomiting, headache, sore throat or diarrhea.
D. Provider will not attend class or teach a class if Provider or any member of
Provider's household has been asked to quarantine or self -isolate due to symptoms
of COVID-19 or a positive test result for COVID-19.
E. Provider acknowledges that, to the extent that City is able to and chooses to conduct
classes indoors, this Agreement will also cover classes conducted at one of City's
recreational centers during the term of this Agreement.
F. City reserves the right to change the location(s) at which the services contemplated
by this Agreement are provided.
G. Provider shall comply with the City's recreation class policy manual and any other
City rules and regulations regarding the operation of recreation classes.
2. COMPENSATION
a. In consideration for the provision of the programs set forth in Exhibit A, City agrees
to pay, and Provider agrees to accept as total payment for their services for the City,
seventy percent (70%) of all gross revenue received from program participants. Total
revenue to Provider shall not exceed Twenty -Five Thousand Dollars and Zero Cents
($25,000).
a. 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 twenty percent (20%) of all gross revenue received
from program participants as an administrative fee.
3. TERM
This Agreement shall commence on July 8, 2022 and end on June 30, 2023 unless
terminated earlier in accordance with Section 14 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, 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 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
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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. Minimum Scope and Limit of Insurance:
Commercial General Liability Insurance, Provider shall maintain commercial
general liability insurance which sball 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. Insurance Services Office Form CG 00 01
covering CGL on an "occurrence" basis, including products and completed
operations, property damage, bodily injury and personal & advertising injury with
limits no less than $1,000,000 per occurrence. If a general aggregate limit applies,
either the general aggregate limit shall apply separately to this project/location (ISO
CG 25 03 or 25 04) or the general aggregate limit shall be twice the required
occurrence limit. 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.
2. 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.
3. Broader Coverage. If the Provider maintains broader coverage and/or higher
limits than the minimums shown above, the City requires and shall be entitled to
the broader coverage and/or the higher limits maintained by the Provider. Any
available insurance proceeds in excess of the specified minimum limits of insurance
and coverage shall be available to the City.
b. Other Insurance Provisions
1. Additional Insured Status: The City, its officers, officials, employees,
and volunteers are to be covered as additional insureds on the CGL
policy with respect to liability arising out of work or operations
performed by or on behalf of the Provider including materials, parts, or
equipment furnished in connection with such work or operations.
General liability coverage can be provided in the form of an
endorsement to the Provider's insurance (at least as broad as ISO Form
CG 2010 11 85 or if not available, through the addition of both CG 20
10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is
used).
2. Primary Coverage: For any claims related to this contract, the
Provider's insurance coverage shall be primary coverage at least as
broad as ISO CG 20 0104 13 as respects the City, its officers, officials,
employees, and volunteers, Any insurance or self-insurance maintained
by the City, its officers, officials, employees, or volunteers shall be
excess of the Provider's insurance and shall not contribute with it.
3. Notice of Cancellation: Each insurance policy required above shall
provide that coverage shall not be canceled, except with notice to the
City.
4. Waiver of Subrogation: Provider hereby grants to City a waiver of any
right to subrogation that any insurer of said Provider may acquire
against the City by virtue of the payment of any loss under such
insurance. Provider agrees to obtain any endorsement that may be
necessary to affect this waiver of subrogation, but this provision applies
regardless of whether or not the City has received a waiver of
subrogation endorsement from the insurer.
5. Self -Insured Retentions: Self -insured retentions must be declared to
and approved by the City. The City may require the Provider to purchase
coverage with a lower retention or provide proof of ability to pay losses
and related investigations, claim administration, and defense expenses
within the retention. The policy language shall provide, or be endorsed
to provide, that the self -insured retention may be satisfied by either the
named insured or City.
6. Acceptability of Insurers: Insurance is to be placed with insurers
authorized to conduct business in the state with a current A.M. Best's
rating of no less than A:VII, unless otherwise acceptable to the City.
Verification of Coverage: Provider shall famish the City with original
Certificates of Insurance including all required amendatory
endorsements (or copies of the applicable policy language effecting
coverage requiredby this clause) and a copy of the Declarations and
Endorsement Page of the CGL policy listing all policy endorsements to
City before work begins. However, failure to obtain the required
documents prior to the work beginning shall not waive the Provider's
obligation to provide them.
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The City reserves the right to require complete, certified copies of all
required insurance policies,including endorsements required by these
specifications, at any time.
8. Subcontractors: Provider shall require and verify that all
subcontractors maintain insurance meeting all the requirements stated
herein, and Provider shall ensure that City is an additional insured on
insurance required from subcontractors.
9. Special Risks or Circumstances: City reserves the right to modify
these requirements, including limits, based on the nature of the risk,
prior experience, insurer, coverage, or other special circumstances.
6. INDENIlVIFICATION
Provider agrees to and shall indemnify, defend and hold harmless the City, its officers,
agents, employees, consultants, 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 Provider or its contractors, subcontractors, agents, employees, or other
persons acting on their 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,
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.
CONFIDENTIALITY
If Provider receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary, Provider 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, including but not limited to student records. 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 Provider disclosed in a publicly available source; (c) is in
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rightful possession of the Provider without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or (e) is independently developed by the Provider without reference
to information disclosed by the City.
8. COVID-19 ASSUMPTION OF RISK AND WAIVER
Provider acknowledges that Provider could be exposed to persons that may have COVID-
19 providing services pursuant to this Agreement. Provider understands that interacting with any
person currently comes with the inherent risk of exposure to COVID-19 and that COVID-19 is
highly contagious. Provider assumes the risks associated with providing services pursuant to this
Agreement, namely potential exposure to COVID-19. Provider acknowledges that while some
people have no symptoms or mild symptoms from COVID-19, some people have become seriously
ill requiring hospitalization and that some people have died from COVID-19. Provider
acknowledges that persons over the age of 65 and persons with underlying health conditions are
at greater risk of contracting COVID-19 and are potentially risking serious injury or death.
Provider is agreeing to provide classes pursuant to this Agreement and does so of Provider's own
free will.
Provider intends to be legally bound by this assumption of risk, release and waiver and to
bind Provider's heirs, personal representatives, next of kin and anyone who may make a claim on
Provider's behalf. Provider knowingly releases and waives any and all claims that Provider may
have or could have in the future and includes any claims resulting from potential exposure or actual
exposure to COVID-19, this includes claims for personal injury, transmittal of COVID-19 to
others, and/or wrongful death. Provider agrees to hold harmless, defend and indemnify the City,
its public officials, officers, employees, volunteers, and agents from any and all claims for liability
or damages, including those for exposure to or diagnosis with COVID-19 as a result of providing
services pursuant to this Agreement.
9. 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.
10. BACKGROUND CHECK
Provider shall ensure that all employees, subcontractors, and any volunteers are
fingerprinted and background checked prior to conducting any work pursuant to this Agreement.
Provider shall not assign any employee, agent, subcontractor, volunteer or the Provider personally
to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer,
or the Provider personally are required to register as a sex offender under California Penal Code
Section 290 et seq, have a conviction for any crime of moral turpitude, have a conviction for a
sexual based crime, have a conviction for a violent felony as defined in California Penal Code
Section 667.5(c), or has a conviction for a serious felony as defined in California Penal Code
Section 1192.7(c). Disqualifying convictions include but are not limited to, violations of California
Penal Code Sections 37, 128, 136.1 with Section 186.22, 187, 190-190.4 and 192(a), 205, 206,
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207-209.5, 211, 212, 212.5, 213, 214, 215, 218-219, 220, 236.1(b) or 236.1(c), 243.4, 261, 261.5,
273.5, 262, 264.1, 266, 266c, 266h, 266i, 266j, 267, 269, 272, 273a, 273ab, 273d, 285, 286, 288,
288a, 288.2, 288.3, 288.4, 288.5, 288.7, 289, 290, 311.1, 311.2, 311.3, 311.4, 311.10, 311.11, 314,
347(a), 368, 417(b), 451(a),518 with 186.22, 647.6, 653f(c), 664 and 187, 667.5(c), 18745, 18750,
or 18755, 12022,53, 11418(b)(1) or (b)(2); Business and Professions Code Section 729.
11. NOTICR
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
fast 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.Q. Box 1988
Santa Ana, CA 92702-1988
Fax (714) 647-6956
With copy to:
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: Get CPR Certified
Attn: Ana Guillen
7325 Finevale Drive
Downey, CA 90240
Phone: 562-445-0207
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.
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12. EXCLUSIVITY 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.
13. 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.
14. 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 I 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.
15. 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.
16. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genetic
information, or military and veteran status, 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,
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. 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.
19. 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 valid judgment 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.
20. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in
the body of this Agreement.
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21. 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 formally bound to the provisions 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 Attorney
Brafidon Salvatierra
Deputy City Attorney
AL:
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Execrative Director of Parks,
Recreation and Community Services Agency
CITY OF SANTA ANA
Kristine Ridge
City Manager
PROVIDER:
Ana Guillen
Owner
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Exhibit A
A. Provider shall conduct Adult First AidWCPR/AED Blended Learning & Pediatric First
Aide/CPR/AED Blended Learning
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.
Adult First AidkCPR/AED Blended Learning - The Adult First Aid/CPR/AED blended learning course
equips students to recognize and care for a variety of first aid, breathing, and cardiac emergencies
involving adults. It is designed for students who needs a certification that satisfies OSHA, workplace or
other regulatory requirements. This class is taught in a blended leaning format and the online portion
(accessed via mobile, desktop or tablet) must be completed prior to attending the Instructor -led skills
session. Upon completion, a valid 2-year digital certificate for Adult First Aid/CPR/AED is issued.
C FRT1p1ED
INSTRUCTOR: Get CPR / Ana Guillen
LOCATION: El Salvador Center, 1825 W Civic Center Dr., Santa Ana, (714) 647-6558
• Adult First AidA/CPR/AED Blended Learning class will consist of monthly
sessions, held 1 day per month, 11/2 per month. Age: 15-Adutls. (21 Friday)
• Pediatric First Aidi/CPR/AED Blended Learning classes will consist of monthly
sessions, held 1 day per month, 11/2 per month. Age: 15-Adutls. (41 Friday)
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 5 paid students and no more than 12 students.
B. No registration accepted after the second meeting of class.
C. If the minimum registration has not reached by the second class, class will be canceled. Provider
will be under no obligation to provide services for the canceled classes, and the City will have no
further obligations to pay Provider compensation for the remaining classes that were canceled 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.
COVID-19 REQUIREMENTS
A. Instructor and participants shall wear a mask at all times to participate.
B. Temperature will be taken at the beginning of the class for instructor and participants.
C. Social Distancing should be adhered to at all times.
E. State of California COVID-19 regulations shall apply.
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ACC7$ RL7® CERTIFICATE OF LIABILITY INSURANCE
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DATE (MMIOD YVYY)
07/13/2022
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
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IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must have ADDITIONAL INSURED provisions or be endorsed.
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PRODUCER
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5 Concourse Parkway
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Get CPR Certified
7325 Flnevale Drive
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Downey CA 90240
INSURER D:
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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.
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
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ACCORDANCE WITH THE POLICY PROVISIONS.
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HISCOX
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
UDC-5202016-CGL-22
Get CPR Certified
18
July 12, 2022
Hiscox Insurance Company Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — MANAGERS OR LESSORS OF
PREMISES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
1. Designation of Premises (Part Leased to You): 7325 Finevale Drive
Downey,CA 90240
2. Name of Person or Organization (Additional Insured): City Of Santa Ana
20 Civic Center Plaza
Santa Ana,CA 92701
(If no entry appears above, the information required to complete this endorsement will be shown in the Declara-
tions as applicable to this endorsement.)
WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization shown in the
Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the pre-
mises leased to you and shown in the Schedule and subject to the following additional exclusions:
This insurance does not apply to:
1. Any "occurrence" which takes place after you cease to be a tenant in that premises.
2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or
organization shown in the Schedule.
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CO 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994
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H ISCOX
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
UDC-5202016-CGL-22
Get CPR Certified
16
July 12, 2022
Hiscox Insurance Company Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ABUSE OR MOLESTATION EXCLUSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following exclusion is added to Paragraph 2.,
Exclusions of Section I — Coverage A — Bodily
Injury And Property Damage Liability and Para-
graph 2., Exclusions of Section I — Coverage B —
Personal And Advertising Injury Liability:
This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of:
1. The actual or threatened abuse or molestation by
anyone of any person while in the care, custody
or control of any insured, or
2. The negligent:
a. Employment;
b. Investigation;
c. Supervision;
d. Reporting to the proper authorities, or failure
to so report; or
e. Retention;
of a person for whom any Insured is or ever was
legally responsible and whose conduct would be
excluded by Paragraph 1. above.
CG 2146 07 98 Copyright, Insurance Services Office, Inc., 1997
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HISCOX
Policy Number: UDC-5202016-CGL-22
Named Insured: Get CPR Certified
Endorsement Number: 21
Endorsement Effective:July 13, 2022
Hiscox Insurance Company Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY - OTHER
INSURANCE CONDITION
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available
to an additional insured under your policy, pro-
vided;
1. you have agreed in a written contract or
agreement to add such additional insured to
a policy providing the type of coverage af-
forded by this policy; and
2. you have agreed in a written contract or
agreement with such additional insured that
this insurance would be primary and would
not seek contribution from any other insur-
ance available to the additional insured.
CGL E5581 CW (03116) Includes copyrighted material of
Insurance Services Office, Inc., with Its permission
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HISCOX
Policy Number:
Named Insured:
Endorsement Number:
Endorsement Effective:
UDC-5202016-CGL-22
Get CPR Certified
15
July 12, 2022
Hiscox Insurance Company Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
MODIFIED WAIVER OF TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV —Conditions:
You may waive your rights against another party so
long as you do so in writing prior to: (i) an offense
arising out of your business that caused a "personal
and advertising injury; or (ii) an "occurrence" that
caused "bodily injury" or "property damage".
CGL E5402 CW (03110) w w.knm.gmanEm"wwon
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Includes copyrighted material of Insurance Services Offlce, Inc., with Its permiss rs..km.,,,a9emn,mntra�aae
CaTroP SANTA ANA
RI51f MANAGFJv6NT,n Aawae" 4 HURAN RESOURCES
WORKERS! COMPENSATION DECLARATION
I, Ana GUlilen hereby affirm under penalty of .perjury, the
(Name/7irle)
following declaration:
I certify on behalf of Get CPR Certified that during the term
x0mvitant%cbmpanyfName)
of my contract for Recreation Class services with the City of Santa Ana,
(Type of service pravlded)
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 the provisions and provide proof of workers' compensation coverage
immediately.
Date_ 4/4/2022
Print Name: Ana GUi'llen
PrIntTltie: Owner, Get CPR Certified
Signature: 'Ana \.7 U.I.II$'n uN'
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Talaphone: 562-445-0207
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 ATTDRNEY'S FEES.
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