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HomeMy WebLinkAboutMASCORRO, JOSE ALEJANDRO (MARIACHI LOS SANTANEROS)INSURANCE ON FILE Nl"RK MAY PROCEED UNTIL INSDRANCE EXPIRES 41 Z41 1 7,02U CITY 111466 2 6 2024 DATE: rHtUWl1 August 19, 2024 Jose Alejandro Mascorro f/s/o Mariachi Los Santaneros ("Speaker/Performer") Alexmascorro22@gmail.com 503-380-2669 Re: Speaker/Performer Engagement Agreement N-2024-288 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, Speaker/Performer shall provide a one (1) performance by the Mariachi Los Samaneros at the Library's final summer reading celebration. 2. Date(s): Wednesday, August 28, 2024 3. Event Time(s): 6:30 p.m. — 7:30 p.m. 4. Location ("Property"): Santa Ana Senior Center, 424 W. 3rd Street, Santa Ana, CA 92701 5. Compensation: An amount not to exceed $664.00 (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: space for the event(s), microphone, tables and chairs. 7. Provided by Speaker/Performer: Insurance as further detailed in Exhibit B and all other equipment and materials necessary. 8. City Contact Person (for coordinating purposes only): Maria 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. 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. H. 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. Speaker Agreement — Jose Alejandro Mascorro f/s/o Mariachi Los Santaneros Page 2 12. 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. 13. 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. 14. 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. 15. 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. 16. 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 TA AN CITY Nunez J City Manager ATTEST: i Jennifer L. Ha FOR APPROVAL ��Brian St2t g20, 202408:10 PDT) Brian Sternberg Library Services Director Library Services SPEAKER/PERFORMER Jo ISe�A ejandro MPa'rro0, 202414:05 PDT) Jose Alejandro Mascorro Director, Mariachi Los Santaneros APPROVED AS TO FORM: By: Bra on Salvatierra Deputy City Attorney EXHIBIT A Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Name: Jose Alejandro Mascorro Address: NA Phone Number: 503-380-2669 Email Address: alexmascorro22@gmail.com EVENT: End of Summer Reading Program Celebration LOCATION: 424 W 3'' St. Santa Ana CA, 92701 TERM: Wednesday, August 281, 2024 COMPENSATION: $664.00 The Library will host a final summer celebration for the participants of the summer reading program. Jose Alejandro Mascorro and the group Mariachi Los Santaneros, will perform an hour-long mariachi presentation on Wednesday, August 28, 2024, at the Santa Ana Senior Center at 424 W 3rd St., Santa Ana, CA 92701. The time will be 6:30-7:30 pm. Senior Librarian Olga Morphew, will host the event and will be present for the entire event. Jose Alejandro Mascorro will be compensated $664.00 for their participation. This event is free and open to the public. EXHIBIT B EXHIBIT B Speaker/Performer shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damages 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 Speaker/Performer. 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. (2) 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 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 policies required above, 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. (2) Certificate Holder. The Certificate Holder on each evidence of insurance certificate shall be: City of Santa Ana, Attn: (name of department staff responsible for Agreement), 20 Civic Center Plaza M-XX (responsible staffs department mailbox), Santa Ana, CA 92701. The name and location of event should be included in the description of operations section of each certificate. C. 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 allpolicy 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. d. Special Events Coverage. Special events coverage is available and can by purchased by Speaker/Performer. Use this link to learn more: www.2snarta.com e. 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. Speaker -Performer Agreement —Jose Alejandro Mascorro (Summer Reading Celebration 2024) unsigned Final Audit Report 2024-08-20 Created: 2024-08-20 By: Dylan Dario (ddario@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAAQZDOD44JvbD4PeKOYg4ZpddiYOBObGtp "Speaker -Performer Agreement —Jose Alejandro Mascorro (Sum mer Reading Celebration 2024) unsigned" History Document created by Dylan Dario (ddario@santa-ana.org) 2024-08-20 - 2:48:16 PM GMT 124 Document emailed to Brian Sternberg (bsternberg@santa-ana.org) for signature 2024-08-20 - 2:48:24 PM GMT Email viewed by Brian Sternberg (bsternberg@santa-ana.org) 2024-08-20 - 2:57:48 PM GMT b© Document e-signed by Brian Sternberg (bsternberg@santa-ana.org) Signature Date: 2024-08-20 - 3:10:16 PM GMT - Time Source: server 124 Document emailed to Jose Alejandro Mascorro (alexmascorro22@gmail.com) for signature 2024-08-20 - 3:10:18 PM GMT Email viewed by Jose Alejandro Mascorro (alexmascorro22@gmail.com) 2024-08-20 - 9:04:19 PM GMT do Document e-signed by Jose Alejandro Mascorro (alexmascorro22@gmail.com) Signature Date: 2024-08-20 - 9:05:13 PM GMT - Time Source: server Agreement completed. 2024-08-20 - 9:05:13 PM GMT Q Adobe Acrobat Sign CERTIFICATE OF LIABILITY INSURANCE 08/19/2024 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(! s) must have ADDITONAL INSURED provisions or be endorsed. If SUBRQQP�ATION IS WAIVED, subjecito the terms and conditions f the RdaMeyocertaingplicies y require an endorsement. A statement on this /tificate does not confer rights to the certificate holder in 'et of UA !neaslzrifDl�\ / [` 1 /Y Ilir% r Hub Internation 3000 Executive San Ramon State: CA 94583 License Number: 0757776 Jose Alejandro Ma o DBA Mariachi�anta See Full Named I r ScC 1625 W McFad Ave nC rn' 92 COVERAGES E-MAIL ilci ub r IN. U ( AF INSU' _:RA: 'olony Insurance F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 97o INSURED MEMEBER ENDORSEMENT LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE 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 INSURED MEMBER ENDT COVERAGE EFFECTIVE/ LIMITS NUMBER EXPIRATION DATE A ❑J COMMERCIAL GENERAL LIABILITY 24011694 08/28/2024/ EACH OCCURENCE $1,000,000 ❑ ❑CLAIMS -MADE ❑J OCCUR 08/29/2024 DAMAGE TO RENTED PREMISES (Ea occurrence) $1.000,000 ❑ MED EXP (Anyone person) $5,000 ❑ PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE APPLIES O SEPERATELY TO THE NAMED INSURED AS PER ATTACHED ENDORSEMENT GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP $2,000,000 T1523-0111 AGG LIQUOR LIABILITY PER N/A OCCURENCE (AGGREGATE INCLUDED IN GENERAL LIABILITY AGGREGATE) MASTER POLICY NUMBER: 103 CL 0212472 01 EFFECTIVE DATE: 2024-01-01 EXPIRATION DATE: 2025-01- 12:01 A.M. standard Time at your Mailing 01 Addreee DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is included as Additional Insured as per endorsement T5409-0118. This insurance is Primary and Non -Contributing as per endorsement CG 2001 1219. The insurance company waives rights of recovery as per endorsement CG 2404 1219. The Insured Member Endorsement cannot be cancelled by the insurance company as per endorsement T1523-0111. Named Insureds as per Full Named Insured Schedule. Event Type: Vendor/Caterer/Exhibitor Event Locations: 424 W 3rd St. Santa Ana California 92701 See Full Location Schedule CERTIFICATE HOLDER CANCELLATION City of Santa Ana, its City Council, its officers, officials, employees, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE agents, and volunteers CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY 20 Civic Center Plaza PROVISIONS. Santa Ana California 92701 9 ��s."1 q F I, � RhkMuuganattD[viainn f?FnEWED6APa8av®Bv: Aqu "44 R6k Management Speciaint THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IF CAREFULLY SEPARATION OF INSUREDS - INSURED MEMBERS AND REPORTING ENDORSEMENT This endorsement modifies insurance provided under the following: Master Policy Number: 103 GL 0212472 01 COMMERCIAL GENERAL LIABILITY COVERAGE PART Master Endorsement Number: LIQUOR LIABILITY COVERAGE PART 24011694 A. SECTION I — COVERAGE, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, and COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, and SECTION I — LIQUOR LIABILITY COVERAGE, 2. Exclusions of the LIQUOR LIABILITY COVERAGE FORM are amended and the following added: This insurance does not apply to: Unreported Events "Bodily injury", "property damage", "personal and advertising injury" or "injury" arising out of any "Insured Member(s)" that you have not reported in the Policyholder's Bordereaux, subject to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Reporting Provisions ADDED IN ITEM E. below. However, this provision does not apply in the event of an unintentional error or omission in not reporting an "Insured Member" in the Policyholder's Bordereaux if such "Insured Member" received a Certificate of Insurance and paid the premium prior to the "bodily injury", "property damage" or "personal and advertising injury" or "injury" that resulted in a claim or "suit". B. SECTION II — WHO IS AN INSURED, 1. a. of the COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY COVERAGE FORMS, is deleted and replaced with the following: a• An individual, you and your spouse are a named insured, but only with respect to your conduct as an "Insured Member" named on the Certificate of Insurance referenced in item C. below. C. SECTION 11— WHO IS AN INSURED of the COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY COVERAGE FORMS is amended and the following added: 4. Any "Insured Member" issued a Certificate of Insurance evidencing coverage under this Master Policy will qualify as a Named Insured. However, for the "Event Information" designated in the Certificate of Insurance: a• COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before the "Event Information" inception date shown in the "Certificate policy period'; and b. COVERAGE B does not apply to "personal and advertising injury" arising out of an offense committed before the "Event Information" inception date shown in the "Certificate policy period'; and C. LIQUOR LIABILITY COVERAGE does not apply to "injury" that occurred before the "Event Information" inception date shown in the "Certificate policy period". D. SECTION IV — COMMERCIAL GENERAL LIABILITY and LIQUOR LIABILITY CONDITIONS, 7. Separation Of Insureds is deleted and replaced with the following: 7• Separation Of Insureds This insurance is provided under a Master Policy and applies: a• as if each "Insured Member" shown on a Certificate of Insuranc Named Insured; and T1523-0111 Rlek Mon mmtDlValan REVIe &APPRa BY: e>�3•`oi•\�\.� Risk Management Speaalist b. separately to each "Insured Member" against whom claim is made or "suit" is brought. The Limits of Insurance shown in the Certificate of Insurance issued to the "Insured Member" will apply separately to each "Insured Member" to which this insurance applies. All terms and conditions of this Master Policy are the terms and conditions applicable to the "Insured Member" during the "Certificate policy period". If the expiration date of the "Certificate policy period" shown on the Certificate of Insurance issued to the "Insured Member" is after to the expiration date of the Master Policy, coverage will cease upon the expiration date of the "Certificate policy period." In no event will coverage for the "Insured Member" extend beyond twelve (12) months after the expiration of the Master Policy. If the expiration date of the "Certificate policy period" shown on the Certificate of Insurance issued to the "Insured Member" is prior to the expiration, termination or cancellation date of the Master Policy, coverage will cease upon the expiration date of the "Certificate policy period." If this Master Policy is terminated or cancelled prior to the expiration date of the "Certificate policy period" shown on the Certificate of Insurance issued to the "Insured Member", coverage for the "Insured Member' will continue under the terms and conditions of the Master Policy until the expiration of the "Certificate policy period." In no event will coverage for the "Insured Member' extend beyond twelve (12) months after the termination or cancellation of the Master Policy. E. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS and SECTION IV —LIQUOR LIABILITY CONDITIONS are amended and the following added: Reporting Provisions a. The premium charged at the inception of each policy year is an advance premium. Upon our receipt of your complete Policyholder's Bordereaux at the end of each "reporting period", an endorsement will be issued by us for any adjustment in premium because of "Insured Member(s)" you added or deleted in the Policyholder's Bordereaux. b. Premium Reporting: (1) You must file a Policyholder's Bordereaux with us each "reporting period" and at Expiration, in accordance with this Reporting Provision, showing separately each "Insured Member" to be covered. In addition to the information required by the Policyholder's Bordereaux, you must include a copy of the Certificate of Insurance issued evidencing the "Insured Members" coverage provided by this Master Policy. (2) You may not correct an inaccurate Policyholder's Bordereaux after a claim or "suit" has occurred. c. Failure to Submit a Policyholder's Bordereaux: Coverage only applies to: (1) "Insured Member(s)" shown in the Policyholder's Bordereaux you filed with us prior to the "bodily injury", "property damage", "personal and advertising injury" or "injury" that resulted in a claim or "suit", or, (2) "Insured Member(s)" shown on reports or Certificates of Insurance that were on file with HUB International Insurance Services, Inc. prior to the "bodily injury', "property damage" or "personal and advertising injury" or "injury" that resulted in a claim or "suit". However, paragraph c. does not apply in the event of an unintentional error or omission in not reporting an "Insured Member' in the Policyholder's Bordereaux except if such "Insured Member" received a Certificate of Insurance and paid the premium prior to the ' damage", "personal and advertising injury" or "injury" that resulted in a clai �� rs Risk =os� w Ruk Management Specialist T1523-0111 F. SECTION IV — COMMERCIAL GENERAL LIABILITY and SECTION IV — LIQUOR LIABILITY CONDITIONS, 5. Premium Audit, are deleted and replaced with the following: 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. If the policy is cancelled, to determine any premium refund or additional premium due, we may elect to use an earned premium computed by an audit or pro rate or less than pro rate calculation of the advanced premium or minimum premium. Paragraph 5. of A. Cancellation of the Common Policy Conditions is amended accordingly. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. G. SECTION V — DEFINITIONS is amended and the following added: 1. "Insured Member' means: a. a member of the First Named Insured shown in the Declarations and named as the Event Holder on a Certificate of Insurance issued evidencing the "Insured Member's" coverage under this Master Policy; and b. evidenced on the Policyholder's Bordereaux filed with the company. Throughout this policy the words "you" and "your' refer to the "Insured Member' as a Named Insured under this Master Policy. 2. "Event Information" means the event and the area or location where the event is being conducted provided the event is designated on the Certificate of Insurance issued to that "Insured Member' and Policyholder's Bordereaux filed with the company. 3. "Certificate policy period" means the period of time coverage under this Master Policy will apply for the "Insured Member" indicated on the Certificate of Insurance issued to that "Insured Member". 4. "Reporting period" means the period of time shown below that you must record and file with us a Policyholder's Bordereaux on all changes to the issued Certificates of Insurance, including copies of the Certificates of Insurance issued evidencing the "Insured Members" coverage under this Master Policy. The "reporting period" is: a. each calendar month starting at policy inception, and then each consequential month, and b. ninety (90) days from the date of non -renewal or the date of cancellation if this policy is cancelled prior to policy expiration. Each monthly Policyholder's Bordereaux shall include Certificates of Insurance issued within the previous three (3) calendar months that were not previously reported to us. All references to LIQUOR LIABILITY in this endorsement only apply if a LIQUOR LIABILITY COVERAGE PART is attached to this policy. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. WdAt�.ganmt.Diw.ton REVIMM&APPRO� SY. 4feA wow, ®' Risk Memlgement Spenalist T1523-0111 Master Policy Number: 103 GL 0212472 01 Master Endorsement Number: 24011694 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, its City Council, its officers, officials, employees, agents, and volunteers 20 Civic Center Plaza Santa Ana California 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you Risk Manrgematt Dhislan REVIEwEO& APPRov®BY: 5 A-1p Auk ® Rlsk Management Speaalist T5409-0118 Includes copyrighted material of Insurance Services Office, with its permission. 103 GL 0212472-01 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 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 LIQUOR 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 This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance, and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Risk R erred» ®mr R6k Management Specialist 01 CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 103 GL 0212472-01 POLICY NUMBER: 103 GL 0212472-01 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): As required by written contract with the Named Insured that is executed by the parties to the contract prior to the commencement of work that is called for in the contract. 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 against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. Risk MsmgemadDh6im RenEwEofi APPRW®6Y: A+,Aa�a. MRIMEW Risk Management sped Misl CG 24 04 12 19 Q Insurance Services Office, Inc., 2018 Page 1 of 1 Master Policy Number Member Endorsement Number Date 103 GL 0212472 01 24011694 08/19/2024 Full Named Insured Schedule First Named Insured: Jose Alejandro Mascorro DBA Mariachi Los Santaneros Rik Mwugcmin�Y Dhbim REVIEWEp&APPRO MBY: ® Ruk Management Specialist Master Policy Number Member Endorsement Number Date 103 GL 0212472 01 24011694 oa/19/2024 Full Location Schedule 424 W 3rd St. Santa Ana California 92701 RhkMvmg°"mtUtviel°" �. flEviewEOSArvaw®Bv: ®' Risk Management Spedalist