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HomeMy WebLinkAboutROMO, ALYSSA dba VEL THE WONDERCity of Santa Ana r -�t Clerk of the Council 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect.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 have been satisfied prior to signing the termination form. / tad 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-2022-234 was completed on (List all amendments. Use space below if needed.) V�'aej'r;yw( �1Qviol tAagreementslforms\form- agreement termination form_goldenrod.doe l COTC Office Use Only OF THE COUNCIL i122 Am10• 1.9 and final payment has been made. Department: PpCSPc Phone/Ext.: t5(O j — Signature: '1— Date: `xJl:ao(-22'L T INSURANCE ON FILE ,NORK MAY PROCEcU N-2022-234 UNl IL INSURANCE EXPIRES $•30.12- CLERK OF COUNU DATE: AGREEMENT WITH ALYSSA ROMO DBA VEL THE WONDER TO PROVIDE DJ D h) SERVICES AND LIVE PERFORMANCE AT CITY'S CHICANO HERITAGE FESTIVAL (WillwdoaI)�+ c THIS AGREEMENT is made and entered into this 17th day of August, 2022, by and between `" Alyssa Romo, an individual dba Vel the Wonder ("Artist"), and the City of Santa Ana, a charter "� city and municipal corporation organized and existing under the Constitution and laws of the State N of California ("City"). RECITALS A. The City desires to retain an artist to perform DJ services and a live performance at the City's Chicano Heritage Festival. B. Artist represents that Artist is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Artist represents that it is knowledgeable in its field and that any services performed by Artist under this Agreement will be performed in compliance with such standards as may reasonably be expected. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES a. Artist shall perform, during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and customary work required to provide DJ services and a live performance as further described in Exhibit A, attached hereto and incorporated by reference, for the City's Chicano Heritage Festival. b. Artist shall provide a Forty (40) minute live performance, beginning at Artist's Initials: AR C. Artist must provide song list of family friendly, clean edit songs with lyrics to be approved by the City of Santa Ana prior to performance. 2. COMPENSATION a. City agrees to pay, and Artist agrees to accept as total payment for its services for City, including all travel expenses and performance by Artist, the rates and charges identified in Exhibit A. The total amount to be expended under this Agreement shall not exceed Two Thousand Dollars and Zero Cents ($2,000.00). Page 1 of 10 b. Union fees, manager and/or agent commissions, and insurance obligations are part of the cost of production and City shall not be liable or responsible for any such payments under this Agreement. C. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. d. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. 3. TERM This Agreement shall commence on August 28, 2022 and terminate on December 31, 2022, unless terminated earlier in accordance with Section 17, below. 4. ROYALTY -FREE LICENSE The City shall have the right and royalty -free license to simulcast or produce and show a tape -delayed broadcast of the Artist's performance to the City community or general public, through the internet or any other means. This license shall be non-exclusive and the copyright shall remain with the Artist. Copies of Artist's performance may be maintained by the City, and Artist consents to use of such recordings. 5. INDEPENDENT CONTRACTOR Artist 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 Artist performs the services which are the subject matter of this Agreement; however, the services to be provided by Artist shall be provided in a manner consistent with all applicable standards and regulations governing such services. Artist 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. 6. INSURANCE Artist shall procure and maintain for the duration of the contract insurance against claims forinjuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Artist, his agents, representatives, employees or subcontractors. a. Minimum Scope and Limit of Insurance: 1. Commercial General Liability Insurance. Artist shall maintain commercial Page 2 of 10 general liability insurance, which shall include, but not be limited to, protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Artist's operations in the performance of this Agreement. 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. 2. Worker's Compensation Insurance. In accordance with California State law, Artist, if Artist 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, Artist agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. Broader Coverage. If the Artist 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 Artist. 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 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 Artist including materials, parts, or equipment furnished in connectionwith such work or operations. General liability coverage can be provided in the form of an endorsement to the Artist's insurance (at least as broad as ISO Form CG 20 10 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 Artist's insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 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 Artist'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. Artist hereby grants to City a waiver of any right to subrogation that any insurer of said Artist may acquire against the City by virtue of the payment of any loss under such insurance. Artist agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this Page 3 of 10 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 Artist 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. 7. Claims Made Policies. If any of the required policies provide claims -made coverage: a. The retroactive date must be shown, and must be before the date of the contract or the beginning of contract work. b. Insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work. c. If coverage is canceled or non -renewed, and not placed with another claims -made policy form with a retroactive date prior to the contract effective date, the Artist must purchase "extended reporting" coverage for a minimum of five (5) years after completion of work. 8. Verification of Coverage. Artist shall furnish 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 Artist's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies,including endorsements required by these specifications, at any time. 9. Subcontractors. Artist shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Artist shall ensure that City is an additional insured on insurance required from subcontractors. Page 4 of 10 10. 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. RELEASE Artist, on behalf of Artist, accepts any City -provided equipment used in connection with the performance in their "as -is" condition, with all faults. Artist, on behalf of Artist, 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 City -provided equipment or Artist's use thereof. 8. INDEMNIFICATION Artist agrees to defend, and shall indemnify 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 Artist or its 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. 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 Artist 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 Artist'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 of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Artist. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Artist shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Artist to the City pursuant to this Agreement. Page 5 of 10 10. RECORDS Artist shall keep records and invoices in connection with the work to be performed under this Agreement. Artist 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 Artist under this Agreement. All such records and invoices shall be clearly identifiable. Artist 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. Artist 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 Artist under this Agreement. 11. CONFIDENTIALITY If Artist receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Artist 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 Artist disclosed in a publicly available source; (c) is in rightful possession of the Artist without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Artist without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Artist covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. 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 Page 6 of 10 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With copy to: Executive Director Parks, Recreation, and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 To Artist: Alyssa Rome dba Vol the Wonder PO Box 3294 Fontana, CA 92334 626-235-8703 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 timeframes, weekends, federal, state, County or City holidays shall be excluded. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Artist 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 Artist. 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 Artist 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 are not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Artist, Artist 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. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services that are the subject to this Agreement performed by City personnel or by other consultants retained by City. Page 7 of 10 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. TERMINATION This Agreement may be terminated by the City upon seven (7) days written notice of termination. In such event, Artist shall be entitled to receive and the City shall pay Artist compensation for all services performed by Artist prior to receipt of such notice of termination, except that payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 18. NON-DISCRIMINATION Artist 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. Artist affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 19. 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. 20. PROFESSIONAL LICENSES Artist 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. Artist 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 8 of 10 21. 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 or power is not, in fact, held by the signatory or is withdrawn. b. Artist represents and warrants that it is in compliance and will maintain compliance with all applicable laws including, but not limited to, the California Talent Agency Act. C. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. d. In the event of any conflict or inconsistency between the terms and conditions in this Agreement and any terms or conditions set forth in any Exhibit, purchase order, or other document relating to the transactions contemplated by this Agreement, the terms and conditions set forth in this Agreement shall prevail. C. This Agreement is the final and complete agreement and any prior or contemporaneous agreement(s) for similar services between the parties is superseded by this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: r_ DAISY GOMEZ 4/Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO CITY OF SANTA ANA KRISTINE, RIDGE City Manager ARTIST City Attorney randon Salvatierra Alyssa Romo dba Vel the Wonder Deputy City Attorney Manager [signatures continued on next page] Page 9 of 10 FOR APPROV Hawk Scott" Executive Direc r Parks, Recreation, and Community Services Agency Page 10 of 10 EXHIBIT A Alyssa Romo PO BOX 3294 Fontana, CA 92334 626-235-8703 Description Chicane Heritage Festival -Artist: Vel Nine -Live Performance Includes: DJ with Turn Tables. Live performance of up to 40 minutes in length. Items below to be provided by the event organizer for Artist Performance: Full PA sound system 1 wireless microphone for Artist 1 wired microphone for DJ .. ... . . ... ..... . ... . . . .. . .. ..... .. .. . .. . . . • 1 table for DJ • XLR cables for DJ's turn tables. TOTAL THANK YOU FOR YOUR BUSINESSI Wli July 31, 2022 I WA 1 104 10: City of Santa Ana Parks, Recreation and Community Services 20 Civic Center Plaza Santa Ana, CA 92701 2,000.00 $ 2,000.00 A✓ CERTIFICATE OF LIABILITY INSURANCE Tracy'. Digitally signed 1 by Tracy Jacobs Date: 2022.08.24 Jacob S 12:14:26-07'00' oATE1MWOOIYYYO 08/24/2022 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(his) 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 cergficate does not confer rights to the certificate holder in lieu of such endorsement(s). PRaoucsa NNE Insurance Campy Program Support FHDNE ess.844-520.6993 M; 801-763-1374 Insurance Canopy m ag_ info@insumnmmnopy.com PO Box 34833 North Chesterfield VA 23234 wwRERS APFowwocovePoTGE xacX MMMA: Great American E8S Insurance Company 26832 INSUM wwREne: wNMC: Alyssa Romo IxwREAo: 746 South Nonn ie Avenue 401 Los Angeles CA 90005 INWn E: wBURERF: 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 Cli LTMR TWEGFINSUR M 5 Po11CYNMER w MIR E MMRE GCNcoe, UNENU Y EACHCCCURRENCE 5 1,000.000 x CIXAMERC%ALER OENNL LABILITY cwMSAWOE �OLCUR � r , RTEO_%iEMISEg c¢u—... _.._ __ 5 300,000 MEDW(Myane Person) s 5,000 A PLE786898-CEP90867 0812820U Oa/90/2022 PenggN,M eaw wmav s 1,000,000 ___..-. Genaw-AscRECATE 5 2,000,000 GEM. aGGREWTE WAITAPPL1E8pER: PRODUCTS CGMPIGPAGG 5 2,000,000 x POLICY PPP LGC ANIMAL HAl1EE 5 AUfOMOGILE W& I— I— EU IXBI�HEDISINGLE LIMIT IS1— 5 MiYAl150 BODILY INJURY (Pxp n) ALLOMEO SCHEOUIFO AUM. AUTO. HOOLYINJURY(IvaItken 5 HIREOAUTOS AUTOS DPINAGE PgOjE LNwi1 s _ 4 REL1A WB OCCUR F— F— FACHOCCM�rCE 5 AGGREGa1E S EXCESSUNe.. LWM.MAOE DEO I I RETENnONS S woMrenaeoeawlaAnox ASAE88'LorEN4'LJXNLm gNYpROWUErORRARmQLE%ECUrtJE YIN I� wes�ATIA oTH- EL EACNACC®ENT S OFFlLEMEM.ERIXCWGEm ❑ N)A I EL DISEASE-FAE$&LOYE S IxngebryN Mw xYaAxwlW,vder ELDISEPBE-POUCYLIMIT $ F—F— OESCPocate mwecyper nquche holderdditin line red regarding had been added as additional insured regarding hadb beenaddedbe bovekmentione .hove mentioned policy per attached Additional Insure Additional Insured -Designated Person or Organization (CG 20 2fi Ed. 04 13) E CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana- Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Drive East Santa Ana, CA 92701 AUMORDID REPRESEMATrvE 7 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (20141(1) The ACORD name and logo are registered marks of ACORD IN5025 rymm1l ;`o�°j 3„sn113IR� RiiMvsverandDh'Mw REVIEwEDfi MPRovEDBY T4 y J.I�G ® Rbk Management AnNha PLE786898-CEP90867 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Organization(s): City of Santa Ana - Risk Management Division Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 26 (Ed. 04 13) A. SECTION II • WHO IS AN INSURED is amended to include as an Additional 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 or the acts or omissions of those acting on your behalf: 1. in the performance of your ongoing operations; or 2. in connection with your premises owned by or rented to you. However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III — LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contract or agreement; or 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Copyright, ISO Properties, Inc., 2012 CG 20 26 (Ed. 04113) PRO (Page 1 of 1) R swEoh 6'APFaovm By _� Ruk Management AnMys GREAGLNERICAN. i"SURMCE GROUP Policy Number: PLE786898-CEP90867 Effective Date of Change: 08/24/2022 BUSINESSPRO POLICY CHANGES NAMED INSURED AND ADDRESS: POLICY PERIOD: Alyssa Romo 12:01 A.M. STANDARD TIME AT THE ADDRESS OF 746 South Normandie Avenue THE NAMED INSURED SHOWN AT LEFT. 401 Los Angeles, CA 90005 FROM: 08/28/2022 TO: 08/30/2022 THIS ENDORSEMENT CHANGES BROKER NAME AND ADDRESS: THE POLICY. Insurance Canopy PO Box 34833 PLEASE READ IT CAREFULLY. North Chesterfield, VA 23234 INSURANCE IS AFFORDED BY THE COMPANY INDICATED BELOW: (EACH A CAPITAL STOCK CORPORATION) ( ) GREAT AMERICAN INSURANCE COMPANY ( ) GREAT AMERICAN ASSURANCE CO. ( ) GREAT AMERICAN ALLIANCE INS. CO. ( ) GREAT AMERICAN INSURANCE CO. OF NY (X) GREAT AMERICAN E & S INSURANCE COMPANY In consideration of the additional premium of $20.00 plus an GRIP Fee of $20.00, for a total of $40.00, it is hereby understood and agreed that the following forms have been added to the policy mentioned above: ❑ Additional Insured — Vendors CG2015 (Ed. 04 13) with primary and noncontributory wording 2 Additional Insured — Designated Person or Organization CG 20 26 (Ed. 04/13) with primary and noncontributory wording O Primary and Noncontributory— Other Insurance Condition CG 20 01 (Ed. 04 13) 0 Waiver of Transfer of Rights of Recovery Against Others to Us CG 24 04 (Ed. 05 09) ❑ Trailer Endorsement —Amendment to Exclusion -Aircraft, Auto or Watercraft CG 88 02 (Ed. 11 85) ❑ Increase Inland Marine Limits to $ (maximum payout for any one article) / $ (annual aggregate) ❑ Increase Aggregate Limits to $2M ❑ General Endorsement— Professional Coverage Extension CG 88 02 (Ed. 11 85) ❑ Loss Payable Provisions — CM 78 70 (Ed. 06 92) All other terms and conditions remain the same. Ri�Mvsgenvd Divlia ry RE\V'h' MPRov®Bv 1 Tvu y JrtiaG: ® Risk Management Mays CG 20 01 (Ed. 04 13) 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance (1) the Additional Insured is a Named Insured under such other insurance; and (2) you have agreed in writing in a contract or This insurance is primary to and will not agreement that this insurance would be seek contribution from any other insurance primary and would not seek contribution from avail- able to an additional insured under any other insurance available to the your policy provided that: Additional Insured. Copyright, ISO Properties, Inc., 2012 CG 20 01 (Ed. 04/13) CG 24 04 (Ed. 05 09) 1liJeAlos�dlraiio THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Itwimm&APPMO BY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Ruk Management Malys This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Schedule Name of Person or Organization: City of Santa Ana - Risk Management Division 20 Civic Center Drive East Santa Ana, CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to paragraph8. Transfer of Rights of Recovery Against Others to Us of SECTION IV - CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard." This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 (Ed. 05/09) Copyright, ISO Properties, Inc., 2008 PRO (Page 1 of 1) xiskMnagened i,a „���?.. R�EwEo6MPRovmav ;� ��acy JacoG; ® RBk Management Marys CITY OF SANTA ANA RISK MANAGEMENT dG<ealaa 4HUMAN RESOURCES 3 Managing Risk mrnugn Positive Change „, : 9 WORKERS' COMPENSATION DECLARATION Alyssa Romo (Nome/Title) following declaration: hereby affirm under penalty of perjury, the I certify on behalf of Alyssa Romo, aka Vel the Wonder that during the term (Consultant/Company Name) of my contract for performance services with the City of Santa Ana, (Type of service provided) 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: 8-1 g-22 Print Name: Alyssa Romo Print Title: Artist Signature: Telephone: 626�-23/5-8703 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. ? 1 RZn4 PROV®BY: I:�Risk Mgmt�lnsurance Requirements�WC Declaration 08152019