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Home My WebLink AboutSUTTER, KATHERINE (2) 61SURANU ON FILE tidt�' �!'X,rROCEEG ty-2025-134-41 MAYOR 1_ d I TY LL'_RK CITY MANAGER Valerie Amezcua' Alvaro Nunez MAYOR PRO TEM DATE MAY i � �Ory� CITY ATTORNEY David Penaloza I L Sonia R,Carvalho COUNCILMEMBERS CITY CLERK Phil Bacerra ~' , Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA 0: p R(,sA C &) PARKS, RECREACTION AND ots'ki tge scott Anc?Co-) COMMUNITY SERVICES AGENCY 20 Civic Center Plaza 1 PO Box 1988 Santa Ana,California 92702 Www.santa-ana.ora April 20, 2026 Katherina Sutter Attn: Katherina Sutter 4307 Archway, Irvine, CA 92618 Re: Extension of Agreement No. N-2025-134 to provide Dance Programming Pursuant to Section 3 ("Term")of the above-referenced Agreement, entered into by Katherina Sutter and the City of Santa Ana, which commenced on June 1, 2025, the parties hereby exercise their option to extend the term of the Agreement for an additional one (1) year through May 31, 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. Sinc L t 1 Scott Executive Director of Parks, Recreation and Community Services Agency CITY OF NTA ANA ATTEST Alvaro Nunez ennifer L. City Manager City Cler APPROVED AS TO FORM PROVIDER /�raA.w Katherine Sutter(Apr 20. 2026 12:02:29 PDT) Jonathan T. Martinez By: Katherina Sutter Assistant City Attoc/,rn Title:Instructor SANTA ANA CITY COUNCIL Valerie Arnemia David Penalom Thai Viet Phan Ben{amn Vazquez Jessie Lopez Phil Bacerm Jonnainm Ryan Hemander Mayor Mayor Pro Tern•Ward 6 Ward I Ward 2 Ward 3 Ward 4 Ward 5 a ;anla ana.om dcenA10?@AW0tJ-an2 C) JohanitbSanta-ana.ora (NaZgUPS�5ar4a-ana.ar5] Le55iE'-0CaL�75an48•ana.ord ana�om Santa-ana.oi CERTIFICATE OF LIABILITY INSURANCE P�0.,24..,2. (MYYYI 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. THISCERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZEtl REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Maguire insurance Agency.Inc.FVu1 NAME: 1 Bala PV Ste 1 OC PHONE FAX Pala Cynwyd_PA 19004-1401 (AIC,No,Ext): (AIC,No): 610 617.7900 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC i! _ INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: Katherina Sutter 43C7 Archway INSURER C: {wine,CA 92616.8829 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADOL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE )NSD WVD POLICY NUMBER (MNDDfYYYY) (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X PHPK2304127-OD4 07)2112025 C712112026 EACH OCCURRENCE S1.000,000 CLAIMS-MADE11 OCCUR DAMAGE TO RENTED PREMISES{Ea occurrence) S100,000 X PROFESSIONAL LIAStLITY MED EXP(Any one person) 52500 PERSONAL$ADV INJURY $1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 53.000,000 PR OLICY ❑PROJECT ❑LOC PROCUCTS-COMPIOP AGO S3.000,C00 OTHER SAM AGGREGATE $300,000 SAMOCCURENCE $1W.U00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) S ANY AUTO BODILY INJURY(Per person) S OWNED AUT05 SCHEDULED AUTOS ONLY BODILY INJURY(Per acciden_) S HIRED AUTOS NON-DIMMED PROPERTY DAMAGE ONLY AUTOS ONLY (Per accident) $ 5 UMBRELLA LIAB OCCJR EACH OCCURRFNCE 5 EXCESS LIAR -H CLAIMS-MADE AGGREGATE S CED I I RETENTION S WORKERS COMPENSATION PER OTHER AND EMPLOYERS'LIABILITY YIN STATUTE At,IYPRCPRIETORIPARTNERiECECUTIVE NIA CFFICERIMEMBER EXCLUDEC7 E.L EACH ACCIC'N-r S (Mandatory in NH) If yes,describe under E.L.DISEASE•EA EMPLOYEE S DESCRIPTION OF CPERATION5 below EL DISEASE-POLICY LIMP S DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,m ay be attached it More space is required) It is understood and agreed that the Following entity is added as an additional insured but only with respect(5)to the operations of the narred insured except that lial»6ty resulting from the additional insured's sole negligence CERTIFICATE HOLDER CANCELLATION City of Santa Ana,its City Council,officers,officials,employees,agents and volunteers SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Parks,Recreation and Community Services Agency,20 Cv c Center r aza,FI SiDnta Ana,CA 92701 EXPIRATION DATE TH EREOF,NOTICE WILL BE DELIVERED 1N ACCORDANCE WITH San THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Tu Tran ". APPROVED By Tu Tran Nguyen at 11:09 am,Jul 25,2025 -- ----- ------- ii�)1988-2015 ACORD CORPORATION,All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK2304127-004 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Organization(s): Location(s) Of Covered Operations City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers 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 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. 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: 1. All work, including materials, parts or equip- ment 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended 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. CG 20 10 07 04 C ISO Properties, Inc., 2004 Page 1 of 1 13 POLICY NUMBER: PHPK2304127-004 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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: City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers 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. ISO Properties,Inc. CG 24 04 05 09 O Insurance Services Office, Inc., 2008 Page 1 of 13 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 Katherina Sutter Representative"),attest that I am an authorized (Name and Title of Vendor Representative) representative of Katherina Sutter ("Company"),and (ConsultantfCompany 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 2025-134 (`Agreement")to provide Dance Programming ("Services"): (Services to be provided under agreementicontract) 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. APPROVED By Tu Tran Nguyen at 9.04 am,Apr 29,2021 Signature Date Katherina Sutter Print game Ms. 1 L f-C"(-(Z- tit S r cam,C. cs� 949 290 89851 katherine.sutteraa g mail.com Contact Inrormation,i.e,Telephone ;umber and/or Email Ad,Jress Affidavit of Exemption for Automobile Liability insurance 11.12.2024 CITY OF SANTA MINA RISK MANAGEMENT a division of HUMAN RESOURCES Managing Risk through Awareness and Action __@- Agreement to Indemnify, Hold Harmless and Defend Title of Event/Activity: DanSing Kidz Fun with Sounds Event Date: Tuesdays Description of Event/Activity: Dance Programming Business or Organization Name: Katherina Sutter Full Name of Authorized Representative of Katherina Sutter Business/Organization: f� Title of Authorized Representative: Contract Instructor A5 In the event the above named Business or Organization does not maintain Improper Sexual Conduct a/k/a Sexual Molestation and Abuse Liability a/k/a Sexual/Physical Abuse/Molestation, or similar insurance coverage, it nevertheless is obligated to and agrees to indemnify, defend, and hold harmless, at its own expense, the City of Santa Ana, its City Council, officers, officials, agents, volunteers and employees from and against all suits or actions, claims, loss, damage, liability, cost or expense, including reasonable attorney's fees, against allegations of physical, emotional, sexual, and/or financial abuse, which may arise from the negligent or intentional actions of any of its contractors, sub-contractors, agents, employees, volunteers, or other persons acting on their behalf while participating in the above titled Event/Activity. By signing this document, the undersigned represents that he/she/they has full authority to bind said Business or Organization named above. Katherina Sutter -- 04/28/2026 Authorized Representative Signature of Authorized Representative Date of Business or Organization(Print Name) of Business or Organization CITY OF SANTA ANA r Risk Management a division of Human Resources Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE I Katherina Sutter ("Representative"),attest that I am an authorized (Name and Tide of Vendor Representative) representative of Katherina Sutter (`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 N-2025-1 34 ("Agreement")toprovide Dance Programming ("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 California,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 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. 04/28/2026 Signature Date Katherina Sutter Print Name IVIs rc�\- 4c�tW _� Title 949 290 89851 katherine.sutter@gmaii.com 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