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SOCAL DRUM PARTY, LLC
INSURANCE ON FILE WORK MAY PROCEED N-2024-170 UNTIL INSURANCE EXPIRES ill 51 �r CITY CLERK DATE: 0"PWRCI) JUN i a 209 AGREEMENT WITH SOCAL DRUM PARTY, LLC, Cs, gp rd)^W TO PROVIDE SPECIAL ENTERTAINMENT FOR CITY EVENTS THIS AGREEMENT is made and entered into this 19th day of April 2024, by and between SoCal Drum Parry, LLC, a California limited liability company ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"), each a "Party" or collectively "Parties." RECITALS A. The City desires to retain a contractor to provide special entertainment for various City events, including the City's Summer Splash Day Camp, Kids Night Out, Afterschool Programs, and other events ("Events") as directed by the City. B. Contractor represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in its field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. 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. Contractor shall, during the term of this Agreement, provide the equipment and personnel to provide the services as further described and set forth in Exhibit A, attached hereto and incorporated in full, at dates, times, and locations as mutually agreed upon by the Parties in a signed writing. b. City grants Contractor the right to enter its property for the purpose of delivery, set- up, operation, and pick-up on the days of the scheduled Events. C. The equipment shall be disassembled and removed by Contractor at the conclusion of each Event. d. City shall have the sole discretion as to engagement of Contractor for services/events not detailed in Exhibit A. The City reserves the right to administratively change event locations, dates, or services for any mutually agreed upon services/Events. C. In the event of an inconsistency among the provisions of this Agreement and any of its exhibits, the inconsistency shall be resolved by giving precedence in the following order: Page 1 of 10 (1) This Agreement; (2) The scope of services attached as Exhibit A; (3) Contractor's price list attached as Exhibit B. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A and Exhibit B, attached hereto and incorporated in full. The total amount to be expended under this Agreement shall not exceed Twenty -Five Thousand Dollars and 00/100 ($25,000) b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. City and Contractor agree that all payments due and owing under this Agreement shall be made through Automated Clearing House (ACH) transfers. Contractor agrees to execute the City's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, the City will be authorized to deposit payments directly into Contractor's account(s) with financial institutions. C. 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 May 1, 2024, and terminate on April 30, 2025, unless terminated earlier in accordance with Section 17, below. 4. PREVAILING WAGES Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an Page 2 of 10 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor 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. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Contractor under this Agreement ("Documents & Data"). Contractor shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data that were provided to Contractor by the City. City shall not be limited in any way in its use of the Documents & Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 7. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance, as described below, for the entire Term of this Agreement, against claims for injuries to persons or damage to property which may arise from or in connection with services, products and materials supplied to City. Total cost of such insurance shall be borne by Contractor. a. Minimum Scope and Limit of Insurance (1) Commercial General Liability (CGL). Insurance Services Office ("ISO") 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 and $2,000,000 aggregate. Required policy limits can be met with primary and umbrella/excess insurance policies. (2) Automobile Liability. ISO Form CA 00 01 covering Code 1 (any auto), with limits no less than $1,000,000 per accident for bodily injury and property damage. In the event Contractor does not maintain commercial automobile Page 3 of 10 liability insurance, City will accept evidence of personal automobile insurance as compliance with this requirement. (3) Workers' Compensation. As required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. Coverage is not required if Contractor has no employees and signs request to waive.\ (4) Sexual Abuse or Molestation Liability (SAML). If the work will include contact with minors, and the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, Contractor shall obtain and maintain a policy covering Sexual Abuse and Molestation with a limit of no less than $1,000,000 per occurrence or claim. (5) Broader Coverage. If the Contractor 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 Contractor. 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 The above required insurance policies are to contain or be endorsed to contain the following 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 Contractor including materials, parts, or equipment furnished in connectionwith such work or operations. (2) Waiver of Subrogation. Contractor's insurance company(ies) agree(s) to waive all rights of subrogation against the City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Contractor under this Agreement. (3) Primary Coverage. For any claims related to this Agreement, Contractor's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. (4) Severability. A severability of interest provision must apply for all the additional insured, ensuring that Contractor's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. Page 4 of 10 (5) Cancellation. Insurance policy(ies) herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non -renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written notice shall be provided to City for policy cancellation or non -renewal due to non-payment. (6) Certificate Holder. The Certificate Holder on each evidence of insurance certificate shall be: City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92701. C. 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. d. Verification of Coverage. Contractor 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 allpolicy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor'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. e. Special Events Coverage. Special events coverage is available and can be purchased by Contractor. Use this link to learn more: www.2snarta.com f. 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. 8. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, contractors, 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 Contractor 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 Page 5 of 10 events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor 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 Contractor'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 Contractor. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor represents and warrants that it has obtained the requisite licenses to show the films contemplated by this Agreement. Contractor further agrees to 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 Contractor to the City pursuant to this Agreement. 10. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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. Contractor 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 Contractor under this Agreement. 11. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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 Page 6 of 10 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Contractor 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: City Cleric City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 Executive Director Parks, Recreation, and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, CA 92702 To Contractor: SoCal Drum Party, LLC Attn: Michael Enriquez, Owner 858 Kinbrae Ave Hacienda Heights, CA 91745 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. Page 7 of 10 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor 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 Contractor. 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 Contractor 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 Contractor, Contractor 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 contractors retained by City. 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 thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product completed as of such date, and in such case, such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. Page 8 of 10 18. NON-DISCRIMINATION Contractor 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. Contractor 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 Contractor 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. Contractor 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. 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. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signature page follows/ Page 9 of 10 SIGNATURE PAGE FOR AGREEMENT WITH SOCAL DRUM PARTY, LLC, TO PROVIDE SPECIAL ENTERTAINMENT FOR CITY EVENTS IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: City APPROVED ASTA FORM SONIA R. CARVALHO City Attorney By. randon Salvatierra Deputy City Attorney FOR APPROVAL )�S-� HaW Mott(Apr 23,202410:31 PDT) Hawk Scott Executive Director Parks, Recreation, and Community Services Agency CITY OF SANTA Alvaro Nunez Acting City Manager CONTRACTOR Mic (P Er�ci2a Michael Enrigvex (Ap(23, 20241030 PDT) Michael Enriquez Owner Page 10 of 10 EXHIBIT A Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: SoCal Drum Party EVENT: Summer Splash Day Camp, Kid's Night Out, & Afterschool Programs SERVICE DATE(S): SoCal Drum Party will provide one -hour special entertainment during dates, times, and locations that will be mutually agreed upon in writing by each party. COMPENSATION DUE TO THE VENDOR: Vendor not to exceed $25,000 for the year. Utilizing Exhibit B: Services Offered, compensation will be mutually agreed upon in writing by each party. DESCRIPTION: SoCal Drum Party will provide one -hour special entertainment in the form of musical performances with group led workshops with drumming elements at Summer Splash Day Camp, Kid's Night Out, and Afterschool Programs at the following centers. El Salvador Community Center Jerome Community Center Salgado Community Center Garfield Community Center Roosevelt Walker Community Center Special entertainment will be held at each site with vendor and city seasonal staff for a period of 1 hour with 30 minutes to 1 hour for set-up and take -down. The Vendor will be paid the full amount of compensation, within 45 days of each event. Established and confirmed events: 1 session on Tuesday 6/11- 130pm, El Salvador Center (30 campers) 2 sessions on Friday 6/14-10:30am Salgado Center (60 campers) -1:30pm Jerome Center (60 campers) Total per session: 30 campers- $330 60 campers- $380 60 campers- $380 Total for 3 events: $1090 EXHIBIT B Exhibit B Services Offered SoCalDrumPady.com 626-715-1371 SOCalDrumPady@Gmail.com Drum Circles A casual and social drumming event for events like fairs, festivals, school assemblies, summer camps, cultural events or any other event. We provide drums for everybody and lead the group through fun warm ups, games and jams. All ages welcome. •45 min and 1 hour sessions *Up to 60 people •Large groups can split and rotate $325 - $450 depending on group size and session length Drum and Percussion Ensembles Weekly drumming classes covering basic drumming techniques, progressive rhythms and patterns, and creative expression in a social environment. A fun way to introduce kids to drumming at after -school programs or community centers. Ensembles can perform at events. •1 hour classes *Ages 6-17 •Beg/Int/Adv levels •Equipment provided $800 per 4 sessions, up to 8 kids $1200 per 4 sessions, up to 16 kids Drumming and Music Circle for Special Needs Adults A casual and social weekly music circle for disabled adults and those with special needs. We jam on the drums, experiment with fun percussion instruments, move and dance to music, sing songs, and have a ball enjoying music and drumming. •1 hour sessions *Up to 16 participants *Ages 18+ *Equipment provided $800 per 4 sessions, up to 8 participants $1200 per 4 sessions, up to 16 participants Group Drum Set Classes A small -group class introducing the basics of playing drum set. Students will learn basic drum stick grip and technique, get to know the parts of the drum set, practice basic drum set patterns, and play along with their favorite songs. •1 hour sessions *Up to 6 kids •Ages 6-17 •Beg/Int/Adv levels *Equipment provided $600 per 4 sessions, up to 6 kids 1-on-1 drum set lessons Individual drum set lessons. Students learn to play drum set at their own pace as we practice drum stick grip, progressive drumming techniques, drum set patterns and rhythms, new musical styles, and creative expression. The student's musical interest guides the lessons. •30 min sessions •Ages 6-17 •Beg/Int/Adv levels •Equipment provided $200 per 4 sessions ***Prices negotiable for multiple classes*** CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONYYY) 04/29/2024 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 PRESENTATIVE R PRODUCER, AND THE CE,tfl TE HO DE 0T: e e to holder is an ADDI fP0 li e u A I ONAL INSURED provisions or be endorsed. U 10 I ,subject to the ter- I , and co itions of t e policy, certain policies ay require an endorsement. A statement on thi On a s o fer rights to the certifl -ate o r' of c r PRODUCER Next First Insurance Agency, Inc. PHONE fR551Jp1_591q FAX ODate:2 1 A -A 1 en INSURED 5oCal Drum Parry LLC 858 Kinbrae Ave Hacienda Heights, CA 91745 Company, Inc. C(1VFRAr ion CPRTIFICATF MI IMRFR- 961 S697RA De1N01na1 re ...Co.r 2831 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. INSR LTR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICY EFF MMIDD/1'YYYI POLICY EXP (MMIDOMOM LIMITS X COMMERCIALGENERALLIABILITY EACH OCCURRENCE $110001000.00 � CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000.00 MED EXP (Any one person) $15,000.00 PERSONAL&AOVINJURY $1,000,000.00 A X X NXTQF49P0-00-GL 04/26/2024 04/26/2025 AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,G00.00 GENL X POLICY JECOT LOG PRODUCTS-COMP/OP AGG $2,000,G00.00 $ OTHER AUTOMOBILELIABILITY COMBINED SINGLE LIMIT Ea accede $ BODILY INJURY (Par person) $ ANY AUTO OWNED F SCHEODULED AUTOS ONLY AUTS i BODILY INJURY Par accident)$ HIRED NON-0WNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETOWPARTNEWEXECUTIVE OFFICERLMEMBEREXCLUDED? N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Each Occurrence: $1,000,000.00 A Professional Liability NXTQF49PC3-00-GL 04/26/2024 D426/2025 Aggregate: $2,000,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. AddiBonel Remarks Schedule, maybe aaached if more apses is required) The Certificate Holder is The City of Santa Ana, its officers, officials, employees, and volunteers. A General Liability Waiver of Subrogation applies in favor of this Certificate Holder. This Certificate Holder is an Additional Insured on the General Liability policy with respect to ongoing operations. This Certificate Holder is an Additional Insured on the General Liability policy with respect to completed operations. All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured, and are subject to policy terms and conditions. of Santa Ana Management Division LIVE CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Rids Mai agentad DNidon ReviewED 6 APFRovED BY: ' �1 A4V Adwu(A ® Risk Management Specialist m 1 of 1 ERCURE CALIFORNIA EVIDENCE OF LIABILITY INSURANCE Mercury Insurance Company P.O. BOX 10730, SANTA ANA, CA 92711-0730 AGENCY: PTL INS. BROKERS, INC.R (626) 967-9581 POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CAAP0000678616 YEAR MAKE 2019 NISSAN NAMED INSURED EVELYN HILL ENRIQUEZ ADDITIONAL DRIVERS MICHAEL ENRIQUEZ LUIS M ENRIQUEZ 05/05/2024 11/05/2024 VIN 1N4BZ1CP8KC309364 TO REPORT A CLAIM, please call (800) 503-3724 For access to ROADSIDE ASSISTANCE ONLY, please call (866) 519-6478 This insurance complies with CVC 616056 or 616500.5 NAIC # 27553 ./ POL CA YEA 20C NAN EVI ADC MIC LUI: ,".„aq _➢ y�c R1deMwgement Dhi4vn Rmn & APPROVED BY: `®' Risk Management SpecicAist Of CITY OF SANTA ANA RISK MANAGEMENT a division of HUMAN RESOURCES Managing Risk &mqp r Positive Change Affidavit of Exemption for Workers' Compensation Insurance Michael Enriquez, owner hereby affirm under penalty of perjury, the (Nome/Title) following declaration: I certify on behalf of SoCal Drum Party LLC that during the term (Consultant/Company Name) of my contract for Drum Circle 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: 2/26/24 Print Name: Michael Enriquez Print Title: Owner Signature: 'U Telephone: 626-715-1371 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECTAN 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. I:\Risk Mgmt\Insurance Requirements\ Affidavit of Exemption for Workers' Compensation Insurance % Rlele Mnriagemml DlWlan Re it & APPR ED By., �'® Risk Management Specialist THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 02 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE NXTQF49PC3-00-GL 04/29/2024 State National Insurance Company, Inc. NAMED INSURED AUTHORIZED REPRESENTATIVE Michael Enriquez SoCal Drum Party LLC 858 Kinbrae Ave Hacienda Heights, CA 91745 Ann Ryan COVERAGE PARTS AFFECTED Commercial General Liability Coverage Part CHANGES SEE ATTACHED SCHEDULE Return Total $0.00 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 RAMw19MMt:DMSf0n RFmEwm & APPRovm aV: '� Risk Management Specialist LE OF POLICY CHANGES is understood and agreed that: following forms are added: 20 10 0413 - Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization 20 37 0413 - Additional Insured - Owners, Lessees or Contractors - Completed Operations other terms and conditions remain unchanged. IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 '' to yf `® Malt MeugmentDivision RenerrED & AppRO By. Risk Management SpeaAnt POLICY NUMBER: NXTQF49PC3-00-GL COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Locations Of Covered Operations The City of Santa Ana, its officers, officials, employees, and CA volunteers 20 Civic Center Plz Santa Ana, CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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: 1. Your acts or omissions; or B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 2. 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. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. RiskMeugwn DiWlon .. nENAMM 6 APPROVED SY: Risk Management Specialist OF CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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. Rink Mnuga�sntDlvielan ; REVIE &APPRMED BY n Rak Management SpeaAjsf 01 Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: NXTQF49PC3-00-GL COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations The City of Santa Ana, its officers, officials, employees, and volunteers 20 Civic Center Piz Santa Ana, CA 92701 Musical Instruments and Teachers services in CA Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". 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. s..,q '�� . , MMM R1sk MwWnadDMsWn Rene 6 APPRovm By: A- ju Aowa- ' Risk Management Specialist Of CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 01 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE NXTQF49PC3-00-GL 04/26/2024 State National Insurance Company, Inc. NAMED INSURED AUTHORIZED REPRESENTATIVE Michael Enriquez SoCal Drum Party LLC 858 Kinbrae Ave Hacienda Heights, CA 91745 Ann Ryan COVERAGE PARTS AFFECTED Commercial General Liability Coverage Part CHANGES SEE ATTACHED SCHEDULE Additional Total $19.00 Authorized Representative Signature Risk ManeganetttDiWsien �' REVIEWED & APPRov® BY: A Arm Risk Management Spetlalist IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 I SCHEDULE OF POLICY CHANGES I is understood and agreed that: following forms are added: 24 04 05 09 - Waiver Of Transfer Of Rights Of Recovery Against Others To Us other terms and conditions remain unchanged. IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Copyright, ISO Commercial Risk Services, Inc., 1983 Rhfa Ma*g medDMs1Dn REVIEWED&APPROVED BY: .I+oW�i�t(,'% �. ® A+fi A,� Sisk Management Specialist POLICY NUMBER: NXTQF49PC3-00-GL COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 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: Any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. 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. Riak Mumgemna Dbdelon n REVIEW &APPRW Br. p' Afi A"W44 Risk Management Speaelist 01 CG 24 04 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 0 MERCURY CALIFORNIA EVIDENCE OF LIABILITY INSURANCE INSURANCE. MercuryCompany Insurance Co pa y P.O. BOX 10730, SANTA ANA, CA 92711-0730 AGENCY: PTL INS. BROKERS, INC.##(626) 967-9581 POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CAAP0000678616 11/05/2024 05/05/2025 YEAR MAKE VIN 2019 NISSAN 1N4BZ1CP8KC309364 NAMEDINSURED EVELYN HILL ENRIQUEZ I ADDITIONAL DRIVERS i MICHAEL ENRIQUEZ LUIS M ENRIQUEZ TO REPORT A CLAIM, please call (800) 503-3724 For access to ROADSIDE ASSISTANCE ONLY, please call (866) 519-6478 i This policy complies with §16056 or §16500.5 of the CA Vehicle Code. NAIC # 27553 APPROVED By Tu Tran Nguyen at 5:26 pm, Feb 05, 2025 Tu Tran Digitally signed by Tu Tran Nguyen Nguyen 1727282ogao5 Renewal Auto Policy Declarations MERCURY To report a claim please call (800)503-3724 INSURANCE Policy Period Policy Number From: 11/05/2024 12:01 AM CAAP0000678616 To: 05/05/2025 12:01 AM Standard time at the address of the Named Insured Agent Company PTL INS.BROKERS,INC.#(042984) Mercury Insurance Company P.O.BOX 4155 P.O.BOX 10730 COVINA,CA 91723 SANTA ANA,CA 92711-0730 (626)967-9581 Named Insured EVELYN HILL ENRIQUEZ 858 KINBRAE AVE HACIENDA HEIGHTS,CA 91745-1322 (818)369-4807 EHILLENRIQUEZ@MTSAC.EDU Important Information Date Sent:10/08/2024 We understand the COVID-19 pandemic brought about unprecedented challenges,and we are offering an additional credit to our customers.The credit has automatically been applied to your policy renewal offer and is reflected in your premium below. The enclosed Auto Insurance Renewal Bill and the U-251 IMPORTANT NOTICE are part of this policy. These specify the amount of your premium,your payment options,any applicable fees,and the due date.Your automobile insurance expires and coverage ceases at 12:01 AM on 11/05/2024.Coverage under this policy will become effective provided you pay the premium and any applicable fees as indicated on the Auto Insurance Renewal Bill.If you have any questions,please contact your agent at the phone number provided above. This Declaration provides only a summary of coverage.All coverage is subject to the terms,conditions,and exclusions of the policy contract. Discounts 2015 VOLKSWAGEN PASSAT S#81556-Exceptional Driver,Good Driver,Group Discount,Multi-Car,Multi-Policy 2017 AIRSTREAM TRAILER#37338-Exceptional Driver,Good Driver 2019 NISSAN LEAF S PLUS SL P#09364-Exceptional Driver,Good Driver,Group Discount,Multi-Car,Multi-Policy 2006 CHRYSLER TOWN&COUNTRY#07953-Exceptional Driver,Good Driver,Group Discount,Multi-Car,Multi-Policy 2021 NISSAN ARMADA PLATINUM#70532-Exceptional Driver,Good Driver,Group Discount,Multi-Car,Multi-Policy Listed Drivers EVELYN HILL ENRIQUEZ-Years License Experience:51 LUIS M ENRIQUEZ-Years License Experience:49 MICHAEL ENRIQUEZ-Years License Experience:19 Excluded Drivers None The Designated Excluded Drivers—Coverage Exclusion is applicable to all coverages,including but not limited to,liability and uninsured motorists,provided now or later.It is agreed that the insurance afforded by this policy shall not apply nor accrue to the benefit of any insured or any third-party claimant when any motor vehicle is being used or operated by an Excluded Driver designated above, regardless of where the person resides or whether the person is licensed to drive. Please refer to the terms of your auto policy. Page 1 of 4 U-176 CA 03/2023 Additional Household Members None Vehicles and Coverage Limits 2015 VOLKSWAGEN PASSAT S SED 4DR,VIN:1VWAT7A38FC081556 o Garaging Address: 858 Kinbrae Ave,Hacienda Heights,CA,91745-1322 Primary Use of the Vehicle: Pleasure Current Term Annual Mileage: 11,000 Renewal Term Annual Mileage: 11,000 Current Term Mileage Program: Estimated Renewal Term Mileage Program: Estimated Loss Payee/Additional Interest VW CREDIT,PO BOX 5215,CAROL STREAM,IL,60197 Coverages es Limits Premium ........................................................................................... Bodily Injury Liability $250,000 each Person/$500,000 each Accident $357.00 Property Damage-Liability $100,000 each Accident ........................... ..........................................•----...................................... Uninsured/Underinsured Motorist Bodily $100,000 each Person/$300,000 each Accident $51.00 Injury ..... .........................................................-........................ ..--........................_...........----------------------.....- ----------................_......... Uninsured Motorist Property Collision Deductible Waiver Applies $2.00 Damage/Collision Deductible Waiver -- ............ ... ................. --------...........----..--................................-------------..........................----- ................................_• ............. Medical Payments $5,000 each Person/each Accident $6.00 c ...............-----------•----------------...........------..................--•-----------•--...................................................---.........................---------------------..............'................. Comprehensive Actual Cash Value Less$250Deductible $35.00 ---------............-..................................................................... - Collision Actual Cash Value Less$500 Deductible $212 00 ......----------........... ........ -------- -------- -------... ...................................._.... ... ............... 8 Rental ---------------------------------$40 each Day/Maximum 30 Days......................-............._........----•-$27.00 Non_Factory Equipment.......................-----....-----------$1,000------- ---- ---__.. -- . . ........ .... -- .............. ---.................._Included Total Premium for 2015 VOLKSWAGEN PASSAT S SED 4DR $690.00 2017 AIRSTREAM TRAILER 16,VIN:1STHRACiXHJ537338 Garaging Address: 858 Kinbrae Ave,Hacienda Heights,CA,91745-1322 Primary Use of the Vehicle: Pleasure Current Term Annual Mileage: 9,000 Renewal Term Annual Mileage: 9,000 Current Term Mileage Program: Not Applicable Renewal Term Mileage Program: Not Applicable Coverages Limits •Premium Bodily Injury Liability $250,000 each Person/$500,000 each Accident $0.00 Property Damage Liability.........................................$100,000 each. Ac.ci_.dent .. ............ -----..... . ------------ -------- .------..... Uninsured Motorist Property Collision Deductible Waiver Applies $1.00 Damage/Collision Deductible Waiver ---------------_---- ..........---_.......................__.. .............--ual Comprehensive Actual Cash Value Less$50 Deductible $62.00 Collision -Actual Cash Value Less$100 Deductible $67.00 C --olli.. .... . .....- ..-. ......................................----- ........--.-.....-----.......------------......-- - ....- ---..............................................................._. Total Pr..emium..........for.. .2017 AIRSTREAM..... TRAILER 16 $130.00 2019 NISSAN LEAF S PLUS SL P HCHBK 4DR,VIN:iN48Z1CP8KC309364 Garaging Address: 858 Kinbrae Ave,Hacienda Heights,CA,91745-1322 Primary Use of the Vehicle: Acceptable Business Use Current Term Annual Mileage: 13,000 Renewal Term Annual Mileage: 13,000 Current Term Mileage Program: Estimated Renewal Term Mileage Program: Estimated Loss Payee schools first fcu,PO BOX 11547,SANTA ANA,CA,92711 Coverages ____-•, Limits Premium Bodily Injury Liability $250,000 each Person/$500,000 each Accident $416.00 Page 2 of 4 U-176 CA 03/2023 Property Damage Liability $100,000 each Accident .................. . ..... . ................... ............ ..... . . .................................. Uninsured/Underinsured Motorist Bodily $100,000 each Person/$300,000 each Accident $69.00 Injury ........................................................ ----------.................__........... .................................. ................................ Uninsured Motorist Property Collision Deductible Waiver Applies $2.00 Damage/Collision Deductible Waiver ........................................................................................................................................................................................._.........__._......................... Medical Payments $5,000 each Person/each Accident $9.00 ....................................---- ................................................................---..._............._........I--.._.............._....._............._............_............._... Comprehensive Actual Cash Value Less$250 Deductible $74.00 ---------...................................... .................------ --------------- - - ._..._........_........_......._..........._....................... Collision Actual Cash Value Less$500 Deductible $292.00 ....................................---- - - ----. - --- ------- --...- ............................................................................................................................................._.. -- Rental $40 each Day/Maximum 30 Days $27.00 .................................................... ... ............................................................... . ................................................................. .............. Non-Factory Equipment $1,000 Inc ..... ...... Total Premium for 2019 ISSAN LEA PLUS SL P HCHBK 4DR ,,a/y8�9.00 2006 CHRYSLER TOWN&COUNTRY WAG 4X2 411),VIN:2A4GP44RX6RB07953 Garaging Address: 858 Kinbrae Ave,Hacienda Heights,CA,91745-1322 Primary Use of the Vehicle: Pleasure Current Term Annual Mileage: 12,000 Renewal Term Annual Mileage: 12,000 Current Term Mileage Program: Estimated Renewal Term Mileage Program: Estimated Coverages Limits P...remium - ----------------------................................................................................... -- ...... ........................................................................-- .. - - Bodily Injury Liability $250,000 each Person/$500,000 each Accident $263.00 Property Damage Liability $100,000 each Accident ......... ................. ..-...............................-................................--.........................................------............................... .. - ............................. Uninsured/Underinsured Motorist Bodily $100,000 each Person/$300,000 each Accident $50.00 Injury..................... --•..........-......................................................... .....--------................. ....---........----......------........---- -------------------- Uninsured Motorist Property Collision Deductible Waiver Applies . lies $4.00 Damage/Collision Deductible Waiver Medical Payments _. .. _.............. .... ... _.............•$5,000.each Person/each Accident............................_ .... ._$4.00 .00 Comprehensive Actual Cash Value Less$1,000 Deductible $33.00 ----siv .... - ...... .............-- -•-...-- -- a 1,- --e..............0.0.---------- ---_......................- ... -- ---- -- Collision Actual Cash Value Less$1,000 Deductible 74.00 Non-Factory Equipment..............................................................1000 - ........- 428.00 Total Premium for 2006 CHRYSLER TOWN&COUNTRY WAG 4X2 4D 2021 NISSAN ARMADA PLATINUM UTL 4DR,VIN:JN8AY2DA4M9370532 Garaging Address: 858 Kinbrae Ave,Hacienda Heights,CA,91745-1322 Primary Use of the Vehicle: Pleasure Current Term Annual Mileage: 12,000 Renewal Term Annual Mileage: 12,000 Current Term Mileage Program: Estimated Renewal Term Mileage Program: Estimated Limits Premium Coverages - . ..... .......................- - $250,000 each Person/$500,000 each Accident 418. � Bodily Injury Liability Property -- -g- _ ............ •........ 100,000 each Accident Dama eU bili $ -- . ............................................................................. $100,000 each Person/$300,000 each Accident 56.00 Uninsured/Underinsured Motorist Bodily In1uN...._-.....- - .... - ................................................................................................................ ..... - Uninsured Motorist Property Collision Deductible Waiver Applies 2 Damage/Collision Deductible Waiver....._..-.......... .............--------••---.........-----........--•----.....-............................................................. _..... .....................................-•--....- 00 Medical Payments .--_-___._- $5,000 each Person/each Accident 3 .y. - _..- — .................00---ac - ... on/ ••c A i -•--... ....-..--- ...................................... .... _--..---. 9200 Comprehensive Actual Cash Value Less$250.Deductible •----------------------------------- _--------------------------- --- ------------..-----.--Act -- -----.........a-I-u- . 254.00 Collision Actual Cash Value less$500 Deductible ----------on.....--•................._•-----..............--•--•--.... . . .... ......................._....................................... ....-............... 27 00 Rental $40 each Day/Maximum 30 Ray------_------------------- .................:...... ---- n- - - ........................--........... .-- Included $1,000 Non Factory Equipment... -...-- - - _ _ .......... ..... .............. - .................... - - - Total Premium for 2021 NISSAN ARMADA PLATINUM UTL 4D $852.00 Page 3 of 4 U-176 CA 03/2023 b Subtotal Policy Premium(All Vehicles) $2,989.00 _ ._.... —.....__.................................................................................................. ............................... __.__..............._...........__............._.........._........ Fraud Fee $4.40 ...........................................................................................................................................-............................................................................................................. COVID-19 Credit $14.00cr ............................................................................................................................ ................................................................................................................................. Total 6 Month Policy Premium(All Vehicles) $2,979.40 Policy Contract and Endorsements Your insurance policy and any endorsement(s)contain a full explanation of your coverage.The policy contract is form U-10 MIC California Auto Policy(03/2023).The contract is modified by endorsement(s): U-176 CA 03/2023 Page 4 of 4