HomeMy WebLinkAboutLATINO CENTER FOR PREVENTION AND ACTION IN HEALTH AND WELFARECity of Santa Ana
City Clerk
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amendments (if any) are no longer in effect.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: It 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 City Clerk's Office (M-30).
Call 647-6520 if you have any questions.
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DATE:
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September 12, 2023
Latino Center for Prevention and Action in Health and Welfare (".Speaker/Performer")
450 W. 4th Street, Ste. 130
Santa Ana, CA 92701
Re: Sneaker/Performer Engagement Agreement
N-2023-245
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 described in Exhibit A, attached hereto, Latino Center for Prevention and Action in
Health and Welfare will provide a speaking presentation on COVID-19 recovery and hold a workshop to mentor
teen/young adult volunteers and library patrons.
2. Date(s): Saturday, October 7, 2023.
3. Event Time(s): 1:30 p.m. — 4:00 p.m.
4. Location: Santa Ana Public Library, 26 Civic Center Plaza, Santa Ana, CA 92701 ("Property")
5. Compensation: $300 (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: microphone, projector, event space, tables and chairs.
7. Provided by Speaker/Performer: all other equipment and materials necessary.
8. City Contact Person (for coordinating purposes only): Ella Sepulveda x5265
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 be 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. Insurance: Insurance shall be procured and maintained by the Speaker/Performer as required by the City and as
further detailed in Exhibit B, attached hereto and incorporated herein.
it. 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.
N-2023-245
Speaker Agreement — Latino Center for Prevention and Action in Health and Welfare
Page 2
12. Release: Speaker/Performer accepts 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 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 Speaker/Performer's use thereof.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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 SSANTTA ANA
Kristine Ridge
City Manager
RECOMMENDED FOR APPROVAL
Brian tl5rtbcrg
Library Services Direc or
Library Services
SPEAKER/PERFORMER
CoYeta �GllL
loreta Ruiz (Sep 13, 202318:34 PDT)
Loreta Ruiz
Director of Compliance
APPROVED AS TO FORM:
By. ,
Bradd-on Salvatierra
Deputy City Attorney
EXHIBIT A
Exhibit A
Scope of Work
Vendor Information:
• Latino Center for Prevention and Action in Health and Welfare, 450 W. 4th St., Ste 130 Santa
Ana, CA 92701
Event: Speaking Presentation and Q&A Session/ Discussion
• Community Sustainability: Covid 19 Recovery Presentation/Workshop by Latino Center for
Prevention and Action in Health and Welfare
Location: Santa Ana Public Library, 26 Civic Center Plaza, Santa Ana, CA 92701
Term: One- time event: Saturday, October 7, 2023 from 1:30-4:OOP
Presentation/Workshop Breakdown:
1:30-3:00 : Presentation with Q and A
3:00-4:00 : Youth Project Mentorship ( Assist youth with brainstorming projects on topic of
Covid-19 Recovery and Community health Sustainability)
Compensation: $300.00
Description:
The youth Know: Community Social Innovation Internship Program seeks to engage Youth
Workforce Interns to mentor and guide teen/young adult volunteers and library patrons of all
ages in the development of the skills required to find out about issues of Climate Change, Food
Insecurity and Community Sustainability, (COVID-19 Recovery). They are then tasked to analyze
that information, develop possible paths to improvement/mitigation, and promote their ideas
to engage the community and support sources. This internship project is funded by the
California for All (CA4ALL) youth workforce grant that is being administered by the Santa Ana
WORK Center.
Latino Health Access (Latino Center for Prevention and Action in Health and Welfare), a
community organization that has been in the forefront of the Covid 19 Recovery efforts in our
community will provide a presentation on the topic of Covid-19 Recovery efforts in Santa Ana
and Community Health sustainability for our CA4ALL grant funded youth workforce program
interns. They will mentor interns in brainstorming potential projects focused on the topic of
alleviating Covid-19 Recovery and community health sustainability, in their community. Staff will
be present for the entire presentation and Q & A session/ discussion.
EXHIBIT B
Exhibit B
Prior to undertaking performance of work under this Agreement, Speaker/Performer shall
procure and maintain for the duration of the contract insurance against claims for injuries to
persons or damages to property that may arise from or in connection with the performance of the
work hereunder and the results of that work by the Speaker/Performer, their agents,
representatives, employees or subcontractors.
a. Minimum Scope and Limit of Insurance
1. Commercial General Liability (CGL): 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
aggregatelimit 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. Workers' Compensation Insurance: As required by the state of California, with
statutory limits and employers' liability insurance with a limit of no less than
$1,000,000 per accident for bodily injury or disease.
3. Sexual Abuse and Molestation (SAM) Liability: If the work will include contact
with minors, and the CGL policy referenced above is not endorsed to include
affirmative coverage for sexual abuse and molestation, Speaker/Performer shall obtain
and maintain a policy covering sexual abuse and molestation with a limit no less than
$100,000 per occurrence or claim and with a limit no less than $1,000,000 per
occurrence or claim for an organization. (Not required if City staff will be present at
all times.)
4. Broader Coverage: if the 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/Performer.
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 Speaker/Performer
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 Speaker/Performer's insurance (at least as broad as ISO Form CG 20 10 1185 or
if notavailable, 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 Speaker/Performer'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 Speaker/Performer's insurance and shall not contribute with it.
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: Speaker/Performer hereby grants to City a waiver of any right
to subrogation that any insurer of said Speaker/Performer may acquire against the City
by virtue of the payment of any loss under such insurance. Speaker/Performer agrees
to obtain any endorsement that maybe necessaryto affect this waiverof 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 Speaker/Performer 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: 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 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 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.
8. Subcontractors: Speaker/Performer shall require and verify that all subcontractors
maintain insurance meeting all the requirements stated herein, and Speaker/Performer
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 therisk, prior experience, insurer, coverage, or
other special circumstances.
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor
Latino Center for Prevention and Action
Name:
Project
N-2023-245
Number:
Project Speaker/Performer Engagement Agreement - Latino Center for
Name: Prevention
The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the
insurance requirements. No further action is required at this time.
The compliant coverage(s) are:
POLICY EXPIRATION
TYPE OF INSURANCE COI DATE FILE NAME
NUMBER DATE
CERT- City of
AUTOMOBILE LIABILITY 202304261NPO 07/05/2024 08/25/2023 Santa Ana 2023
Updated.pdf
CERT- City of
GENERAL LIABILITY 202304261NPO 07/05/2024 09/29/2023 Santa Ana
2023.pdf
CERT- City of
WORKERS COMPENSATION AND
SWC1421440 01/01/2024 08/25/2023 Santa Ana 2023
EMPLOYERS' LIABILITY
Updated.pdf
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
10/5/2023 2:36 PM