HomeMy WebLinkAboutWEI, QUINGCity of Santa Ana
-- 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amendments (if any) are no longer in effect.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.
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 L',i V►
N-2022-254
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(List all amendments. Use space below if needed.)
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JAN 11 2024
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N-2022-254
iNSURANCE ON FILE
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UNTIL INSURANCE EXPIRES
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cl- Qing Wei ("Speaker/Performer")
N 15911 Rochester Street
Westminster, C�2683
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Re: Speaker/Performer Engagement Agreement
This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the
engagement described below:
1. Event Description: As further detailed in Exbibit A, the Qing Wei Lion & Dragon Dance Cultural Troupe will
provide a live dance performance for The Moon Festival.
2. Date(s): Saturday, September 17, 2022
3. Event Time(s): 2:00 p.m. — 4:00 p.m.
4. Location ("Property"): Santa Ana Public Library, Newhope Branch, 122 N Newhope Street, Santa Ana, CA 92703
5. Compensation: $888.00 (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS
form W-9 before payment can be made
6. Provided by City: advertising the program, space for the patrons attending, and staff to setup the space for patrons.
7. Provided by Speaker/Performer: All other equipment and materials necessary.
8. City Contact Person (for coordinating purposes only): Maria Miranda Castro
9. Independent Contractor: Speaker/Performer shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed
to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion
or control over the professional manner in which Speaker/Performer performs the services that are the subject matter
of this Agreement; however, the services to he provided by Speaker/Performer shall be provided in a manner
consistent with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages,
employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be
responsible for all applicable withholding taxes.
10. Indemnification: Speaker/Performer, his or her agents, or employees (if applicable) agrees to and shall indemnify,
defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives
from and against all loss, expenses, or liability (including costs and attorney's fees) arising from the negligence or
willful misconduct of Speaker/Performer, his or her agents, or employees.
II. Release: Speaker/Performer accepts the Property and any City -provided equipment used in connection with the
performance in their "as -is" condition, with all faults. Speaker/Performer fully releases, waives and discharges
forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not
to sue, City, its elected officials, officers, employees, agents and volunteers, and all persons icting on behalf of, by,
through or under each of them, under any present or future laws, statutes, or regulations for any claim or event
relating to the condition of the Property or City -provided equipment or Speaker/Performer's use thereof.
Letter Agreement — Qing Wei
Page 2
12. Commercial General Liability Insurance (CGL). 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, not be limited to protection against claim 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: Insurance Services Office Form CG 00 01 covering CGL
on an "occurrence" basis, including property damage, bodily injury and personal and 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
require occurrence limit.
13. Workers' Compensation. If Speaker/Performer has employees, workers' compensation insurance is required by the
State of California, with Statutory Limits, and Employer's Liability Insurance with a limit of no less than $1,000,000
per accident for bodily injury or disease.
14. Broader Coverage. If Speaker/Performer 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 Speaker/Perfonner. Any available insurance proceeds in excess of the specified minimum limits of insurance
and coverage shall be available to the City.
15. Certificates of Insurance. Speaker/Performer shall furnish the City with original Certificates of Insurance including
all required amendatory endorsements (or copies of the applicable policy language effecting coverage required) and
a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before
work begins. The City reserves the right to require complete, certified copies of all required insurance policies,
including endorsements affecting the coverage required by these specifications, at any time.
16. Primary Coverage. For any claims related to this contract, the Speaker/Performer's coverage shall be primary
insurance coverage at least as broad as ISO CG 20 0104 13 as respects to the City, its officers, officials, employees,
agents and volunteers.
17. Waiver of Subrogation. The Insurance Company agrees to waive all rights of subrogation against the City, its
elected or appoints officers, officials, agents, and employees for losses paid under the terms of any policy which
arise from work performed by the Speaker/Performer for the City. This provision also applies to the
Speaker/Performer's Workers' Compensation policy.
18. Cancelation of Insurance Policy. Each insurance policy required shall not be canceled, except with thirty (30) days
written notice to the City.
19. Self -Insured Retentions. Self -insured retentions must be declared to and approved by the City. The City may
require the Speaker/Perfo Tier 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.
20. 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 ANII, unless otherwise acceptable to the City.
21. Claims Made Policies. If any of the required policies provide claims -made coverage: (1) the retroactive date must
be shown, and must be before the date of the contract or the beginning of contract work; (2) insurance must be
maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract
of work; (3) if coverage is canceled or non -renewed, and not replaced with another claims-inade policy form with
Letter Agreement — Qing Wei
Page 3
N-2022-254
a retroactive date prior to the contract effective date, the Speaker/Performer must purchase "extended reporting"
coverage for a minimum of five (5) years after completion of work.
22 Verification of Coverage. Speaker/Performer shall famish the City with original certificates of insurance including
all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by
this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsement
to City before work begins. However, failure to obtain the required documents prior to the work beginning shall
not waive the Speaker/Performer'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.
23. 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.
24. 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.
25. Speaker/Performer 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. Speaker/Performer affirms that they are an equal opportunity
employer and shall comply with all applicable federal, state and local laws and regulations.
26. 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.
27. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding
the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This
Agreement may not be modified except by written instrument signed by the City and by an authorized representative
of Speaker/Performer.
CITY OF SANTA ANA SPEAKER/PERFORMER
Affdel,? wt,- d
Austin Quach (Sep 2, 2022 09:26 PDT)
KRISTINE RIDGE Austin Quach
City Manager CEO
[signatures continued on next page]
Letter Agreement — Austin Quach
Page 4
ATTEST:
A i
Clerk of the Council
FOR APPROVAL
Bnan Sternberg
Executive Director
Library Services Agency
APPROVED AS TO FORM:
By:
B&ffd on Salvatierra
Deputy City Attorney
Exhibit A
SCOPE OF SERVICES
VENDOR INFORMATION:
Name: Qing Wei / Austin Quach
Address: 15911 Rochester St, Westminster, CA 92683
Phone Number: 714-766-2943
Email Address: gingweibooking@gmail.com
EVENT: Harvest Moon Celebration
LOCATION: Santa Ana Public Library, Newhope Branch, 122 N Newhope St, Santa Ana, CA 92703
TERM: One-time event: Saturday, September 17, 2022 — 2-4 p.m.
COMPENSATION: $ 888.00
DESCRIPTION: Qing Wei Lion & Dragon Dance Cultural Troupe will provide a dance presentation,
which includes:
• Signature Pair Lions
• Happy Buddha
• Seven -piece percussion ensemble
• Traditional, yet modernized choreography, with acrobatic stunts and lifts
• Gift set & scroll from our group's behalf
• Photo cps when lions open large scrolls with blessings in Vietnamese
• Lion interaction with guests from table to table
• Photo ops with our lions & Buddha with all guests!
• 1045 minute performance.
The Moon Festival is free to the public, and it will take place at the Newhope Library. The performance
will be in person and attendees will have a chance to enjoy the presentation and meet the lions and
dancers. The event will be hosted by Tony Lam, Technology Librarian. This celebration will take place
on September 17a', 2022 from 2-4:00 p.m. Qing Wei Lion and Dragon Dance Cultural Troupe will be
compensated $888 for their presentation.
Samantha Digitally signed by
Samantha M
Ae"R& CERTIFICATE OF LIABILITY INSUR 7VC t Latebert , .07DATE(MM12022m
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 'IFIFICA E HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 Will Maddux
NAME:
PHGNE , (530) 477-6521 A No
East Main Street Insurance Services, Inc.
E-MAIL info lheeventhel er.com
ADDRESS: @ P
Will Maddux
INSURERS AFFORDING COVERAGE
NNC #
PO BOX 1298
INSURER A: Evanston Insurance Company
35378
Grass Valley CA 95945
INSURED
INSURER a :
INSURER C:
Qing Wei
INSURER D :
Austin Quach
INSURER E:
15911 ROCHESTER ST
1 INSURER F:
Westminster CA 92683
CUVERAGE5 CEH IIFICATE 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.
x COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FKOCCUR
Host Liquor Liability
A I I Retail Liquor Liability
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY PRO-
JECT LOC
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBBELLALIAB OCCUR
EXCESS LIAR r,eiue
EMPLOYERS' LIABILITY Y/N
jROPRIETORIPARTNERIEXECUTIVE ❑
,ERIMEMBEREXCLUDED9
Y I N 13DS5473-M2748331 09210/ 02 10 /18/ AM
02
2:01
Deductible $ 1
COMBINEDSINGLE LIMIT $
Ea amident
BODILY INJURY (Perperson) $
BODILY INJURY(Peraoddent) $
PROPERTYDAMAGE $
Per accident
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule,may be attached if more space is required)
;ertificate holder listed below is named as additional insured per attached MEGL 2217 01 19.
attendance: 40, Event Type: Event Vendor.
-vent Location: Santa Ana Public Library, Newhope Branch, 122 N Newhope St, Santa Ana, CA 92703
City of Santa Ana is listed as additional insured and will be mailed written notice of cancellation
SHOULD ANY OF THE ABOVE DESCF
THE EXPIRATION DATE THEREO
ACCORDANCE WITH THE POLICY PR
City of Santa Ana
Risk Management Division AUTHORIZED REPRESENTATIVE
20 Civic Center Plaza
Santa Ana CA 92701
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® Risk Management Supervisor
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@ 1988-2015 ACI
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
All rights reserved.
COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: 3DS5473-M2748331
MARKEL" EVANSTON INSURANCE COMPANY
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 FORM
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
City of Santa Ana
Risk Management Division
20 Civic Center Plaza
Santa Ana, CA 92701
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 of this endorsement, but only with respect to liability for
"bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part,
by the acts or omissions of any insured listed under Paragraph 1. or 2. of Section II — Who Is An
Insured:
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 permittel
2. If coverage provided to the additional insured is required by a contract or agreemE
such additional insured will not be broader than that which you are required by
provide for such additional insured.
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MEGL 2217 0119 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2
with its permission.
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.
All other terms and conditions remain unchanged.
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® Ruk Manzgemenc Supervisor
MEGL 2217 0119 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2
with its permission.
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CITY OF SANTA ANA
RISK MANAGEMENT dwaat 4HUMAN RESOURCES
Managing Risk owwgh PosttJve Change
WORKERS' COMPENSATION DECLARATION
Austin Quach
(Name/Title)
following declaration:
I certify on behalf of Qing Wei
hereby affirm under penalty of perjury, the
that during the term
(Consultant/Company Name)
of my contract for Lion Dance 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: 9/2/2022
Print Name: Austin Quach
Print Title: CEO
Signature: Am4ti+v(Z"d-tl
Telephone: 714-766-2943
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 ATTnRn v,c GGGc
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