HomeMy WebLinkAboutMERRITT STUDIO, LLC (2) 0.9vcsrj(CR) INSURA^ICE ON FILE
Of1w1i iftiez(oz) A-2023-0
49-01
MAYOR CITY`:L'_ a CITY MANAGER
Valerie Amezcua Dr;T=- VAY 0 7 2026 ,�,� � Alvaro Nunez
MAYOR PRO TEM ,;,.,y CITY ATTORNEY
David Penaloza Sonia R.Carvalho
COUNCILMEMBERS CITY CLERK
Phil Bacerra , , Jennifer L.Hall
Johnathan Ryan Hernandez s'`
Jessie Lopez
Thai Viet Phan
Benjamin Vazquez CITY OF SANTA ANA
PARKS, RECREATION AND
COMMUNITY SERVICES AGENCY
20 Civic Center Plaza I PO Box 1988
Santa Ana,California 92702
www-santa-ana.orq
March 24, 2026
Merritt Studio, LLC.
Attn. Devin Daily
1140 Cerritos Dr.
Fullerton, CA 92835
Re: Extension of Agreement No.A-2023-049 to„provide Desisn Services
Pursuant to Section 3 ("Term")of the above-referenced Agreement,entered into by Merritt Studio, LLC,
and the City of Santa Ana,which commenced on April 4,2023,the parties hereby exercise their option to
extend the term of the Agreement for an additional one (1) year through April 3, 2027. Any insurance
certificates are required to be extended and/or renewed to cover this extension. All other terms and
conditions of the Agreement remain unchanged and in full force and effect.
Sincerely,
Hawk Scott(Apr 17,2026 14:27:26 PDT)
Hawk Scott
Executive Director of Parks,
Recreation&Community Services Agency
CITY OF SANTA ATTEST
Alvaro Nunez enrufer a
City Manager City Cler
APPROVED AS TO FORM CONSULTANT
r
7s2T e��TJ�o�y
Jonathan T. Martinez By. Merritt D Dailey
Assistant City Attorney Title:President, Creative Director
SANTA ANA CITY COUNCIL
Valene Amezcua ❑av�tl Penalom Thai vvt Phan Be^jami vazq;,ez J"Sm mz Pill Bacerra Johnathan Ryan t*M-21dez
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CERTIFICATE OF LIABILITY INSURANCE 10/01/225 MM, 025YYY)
0/
THIS CERTIFICATE 15 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 C0VERAGEAFFORDED BY THE POtICIFS BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S),AUTH ORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IM PORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL IN SHRED provisions or he endorsed_If SUBROGATION IS W AIVED.subject to the terms and
conditions of the policy,certain policies may require an endorsement.A statement on this Certificate does not confer rights to the certificate holder in lieu ofsuch endorsement(s)
PRODUCER CONTACT
VIRABYAN INSURANCE INSURANCE NAME: NAZELI VIRABYAN
PHONE FAX
800 S Victory BIvd100 (A/C,NO,FXT) (707)722-2200 (A/C.N0): 000-000-0000
Burbank, CA 91502
E-MAIL
ADDREss:nvirabyan@farmersagent.com
INSURER(S)AFFORDING COVERAGE NAIC9
INSURED INSURER A: Truck Insurance Exchange 21709
MERRITT STUDIO, LLC INSURERB: Farmers Insurance Exchange 21652
MERRITSTUDIO INSURERC Mid Century fnsurance Company 21687
1 140 CERRITOS DR INSURER D
FULLERTON,CA 92835-4020 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER_ REVISION NUMBER:
TH IS IS TO CERTIFY THATTH E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUFDTO TH E INSURED NAME ABOVE FOR THE POLICY PERIOD IN01CATER.NOTW ITHSTAN DING ANY
REQUIREMENT,TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY
THEPOLICIES DESCRIBED HEREIN 15 SUBJECTTO ALtTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS.
fLTR TYPE OFINSURANCE AIN�DL SUHR WVO POLICY NUMBER POLICY EFF POLICY EXP LIMITS
[MM/DD/YYYY} (MM/DD/YYYY)
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
DAMAGE TO RENTED $1,OOa,aOa
CLAIMS-MADE X OCCUR PREMISES(EDOccurrence)
MED EXP(Anyone person) $10,000
0 q 607109835 12/16/2025 12/16/2026 PERSONAL&ADV INJURY $1,000,000
GEN`L AGGREGATE LIMITAPPLIESPER: GENERALAGGREGATE $2,000,000
X POLICY D PROJECT F] LOG PRODUCTS-COMP/OPAGG $1,000,000
OTHER:
COMBINED SINGLE LIMIT $
AUTOMOBfLE LIABILITY (Eaacdclent)
ANYAUTO BODILY INJURY(Per person) $
OWNEDALlfOS SCHEDULED
ONLY
AAUT ❑ ❑ BODILY INJURY(Peraccident$
HIREDAUTOS NON-OWNED PROPERTY DAMAGE
ONLY AUTOSONLY (Peraccident) $
GAR LIAB GAR AGGREGATE $
EldUMBRELLA LIAB OCCUR EACH OCCURRENCE $
HExCE55LIAB CLAIMS-MADE ❑ AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER OTHER $
AND EMPLOYERS'LIABILITY STATUTE
ANY PROPRIETOR/PARTNER/ Y N E.L.EACH ACCIDENT $
RECUTIVE OFFICER/MEMBER N`A
CLUDED?(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under DESCRIPTION OF OPERATIONS beioW EL DISEASE POLICY LIMIT $
DESCRIPTION OFOPERATIONS/LOCATIONS/VFHICLES(ACORO101 Additional Remarks Schedule,way be attached Hmore space isrequired)
1140 CERRITOS OR,FULLERTON,CA,92835
APPROVED
9y Tu Tran Nguyen at 3:07 pm,Apr 20,2026
CERTIFICATE HOLDER CANCELLATION
CITY OF SANTA ANA SHOULD ANY OFTHFABOVF DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATION
DATE THEREOF,NOTICE W ILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
20 CIVIC CENTER PLZ AUTHOR17EDREPRESENTATIVE
SANTA ANA CA 92701
ACORD 25(2016/03) @1988-2015 ACORD CORPORATION,All Rights Reserved
31-1769 11-15
The ACORD rnameand logo are registered marks of ACORD
THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT CAREFULLY.POLICY NUMBER: 607109835 17238
1 st Edition
FARMERS
INSURANCE
ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided underthe following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
BUSINESSOWNERS COVERAGE FORM
APARTMENTOWNERS LIABILITY COVERAGE FORM
CONDOMINIUM LIABILITY COVERAGE FORM
SCHEDULE
Name Of Additional insured Person(s)Or organization(s):
City of Santa Ana, its City
Council, officers,
Information required to complete this Schedule,if not shown above,will be shown in the Declarations.
A. The following is added to Paragraph C.Who Is An Insured of the applicable Coverage Form:
Any person(s) or organization(s) shown in the Schedule is also an additional insured, 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 in the performance of your ongoing
operations or in connection with your premises owned byor rented to you.
However:
a. The insurance afforded to such additional insured only applies to the extent permitted bylaw;and
b. If coverage provided to the additional insured is required by a contractor 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 forsuch additional insured.
B. With respect to the insurance afforded to these additional insureds, the following is added to Paragraph D.Liability
And Medical Expenses Limits Of Insurance of the applicable Coverage Form:
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 contractor 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.
This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all the
terms of the policy.
f 7238-E D 1 02-19 Includes copyrighted material of Insurance services office,Inc.,with its permission. Page 1 of 1
937238 J7238101
CITY OF SANTA ANA
Risk Management a division of Human Resources ^.
Managing Risk through Awareness and Action
AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE
I D e v i n Dailey, President ("Representative"),attest that I am an authorized
(Name and Title of Vendor Representative)
representative of Merritt Studio ("Company"), and
(ConsultantlCompany Name)
possess the authority to legally bind Company.
In my capacity as Representative of Company, i represent and confirm the following, as relates to the
agreement between Company and City of Santa Ana, agreement number
("Agreement")to provide G ra p h i c Design ("Services"):
(Services to be provided under agreemendcontract)
During the course and scope of Company's agreement with the City of Santa Ana,
Company employees, consultants, representatives, and agents will not use and/or drive
any Company owned/rented/leased/borrowed vehicles to perform Services to, for, or on
behalf of City of Santa Ana.
If at any time it is found that Company is not adhering to any and/or all of the statements in this
document and does not maintain the minimum automobile liability insurance coverage as
required in the Agreement, it will be considered a breach of Agreement rendering the Agreement
null and void and Company will be fully liable for any and all damages.
Devi n Da i le Digitally signed by D: 7 Dailey 4-17-2026
Date:2026.04.17 1 Q:17:14-07'00'
Signature Date
Devin Dailey
Print Name
President
Title
949.370.3824
Contact Information,i.e.,Telephone Number and/or Email Address
Affidavit of Exemption for Automobile Liability Insurance 11.12,2024
CITY OF SANTA ANA
Risk Management a division of Human Resources
Managing Risk through Awareness and Action 19
AFFIDAVIT OF EXEMPTION FOR PROFESSIONAL LIABILITY INSURANCE
I Devin Dailey, President ("Representative"), attest that I am an authorized
(Name and Title of Vendor Representative)
representative of Merritt Studio (`Company"), and
(Consultant/Company Name)
possess the authority to legally bind Company.
In my capacity as Representative of Company, I represent and confirm the fallowing, as relates to the
agreement between Company and City of Santa Ana, agreement number
("Agreement")to provideGraphic Design (`Services"):
(Services to be provided under agreement/contract)
Dttring the coarse and scope of Company's agreement with the City of Santa Ana,
Company will not use the services of an expert necessitating professional liability/errors
& omissions liability insurance coverage in the perfonrtance of Services to, for, or on
behalf of City of Santa Ana.
If at any time it is found that Company is not adhering to any and/or all of the statements in this
document and does not maintain the minimum professional liability insurance coverage as
required in the Agreement, it will be considered a breach of Agreement rendering the Agreement
null and void and Company will be fully liable for any and all damages.
Devin Daile Digitally signed by Devin Dailey
y Date: 2026.04.1710:14:36-07'00' 4-17-2026
Signature Date
Devin Dailey
Print Name
President
Title
949.370.3824
Contact Information,i.e.,Telephone Number and/or Email Address
Affidavit of Exemption for Professional Liability Insurance 11.12.2024
CITY OF SANTA ANA
Risk Management a division of Human Resources
Managing Risk through Awareness and Action
AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE
1 Devin Dailey, President "Re resentative"( p ), attest that I am an authorized
(Name and Title of Vendor Representative)
representative of Merritt Studio ("Company"),and
(Consultant/Company Name)
Possess the authority to legally bind Company.
In my capacity as Representative of Company, I represent and confirm the following, as relates to the
agreement between Company and City of Santa Ana, agreement number
("Agreement")to provide Graphic Design
("Services"):
(Services to be provided under agreement/contract)
During the course and scope of Company's agreement with the City of Santa Ana,Company will
not employ any person in any manner so as to become subject to the workers' compensation laws
of Catifornia, and agree that if Company should become subject to the workers' compensation
provisions of Section 3700 of the Labor Code, Company shall forthwith comply with the
provisions and provide proof of workers' compensation coverage immediately.
If at any time it is found that Company is not adhering to any and/or all of the statements in this
document and does not maintain the irlinimum professional liability insurance coverage as
required in the Agreement, it will be considered a breach of Agreement rendering the Agreement
null and void and Company will be fully liable for any and all damages.
Devin Daile�/ Digitally signed by Devin Dailey 04-17-2026
1 Date: 2026.04.17 10:0925-0700°
Signature Dale
Devin Dailey
Print dame
President
Title
949.370.3824
Contact Information,i.e.,"telephone Number and/or Email Address
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSANT 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.
Affidavit of Exemption for Workers'Compensation Insurance 11,12.2024