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HomeMy WebLinkAboutFUN SKATEBOARDING CAMP LLC N-2026-1 46 JUN 2 5 2026 RECREATION SERVICES AGREEMENT WITH FUN SKATEBOARDING CAMP LLC FOR SKATEBOARDING CLASSES THIS AGREEMENT is made and entered into on this 12th day of May, 2026 by and between FUN Skateboarding Camp, LLC, a California limited liability company ("Provider"), 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"). City and Provider may be collectively referred to as the "Parties" or individually as a "Party." RECITALS A. The City desires to retain a recreation service provider having special skills, resources and knowledge to provide skateboarding classes in its recreation class program. B. Provider represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Provider represents that it is knowledgeable in their field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected. D. The Parties acknowledge that the City intends to provide recreational activities to the public but must balance the need to comply with all COVID-19 guidance and restrictions. 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. Provider shall perform those services as set forth in Exhibit A attached hereto and incorporated in reference to this Agreement. b. All classes operated pursuant to this Agreement for conducting recreation classes at City facilities, including parks, will comply with all applicable guidance and public health orders, including those from the Centers for Disease Control ("CDC"), California Department of Public Health ("CDPH"), the Orange County Health Care Agency("OCHCA")and the City itself for as long as those orders and guidance remain in place. Provider will remind participants of these guidelines. To the extent that Provider needs assistance with enforcing any rules or requirements, Provider will contact a City Parks' employee or City security for assistance. c. Provider shall not attend a class or teach any class if Provider is sick or has any symptom(s)associated with COVID-19 including but not limited to,fever above 100.4, chills, cough, shortness of breath, loss of taste or smell, nausea, muscle or body aches, vomiting, headache, sore throat or diarrhea. Page 1 of 8 d. Provider will not attend class or teach a class if Provider or any member of Provider's household has been asked to quarantine or self-isolate due to symptoms of C0V1D-19 or a positive test result for COVID-19. e. Provider acknowledges that, to the extent that City is able to and chooses to conduct classes indoors, this Agreement will also cover classes conducted at one of City's recreational centers during the term of this Agreement. f. City reserves the right to change the location(s)at which the services contemplated by this Agreement are provided. g. Provider shall comply with the City's recreation class policy manual and any other City rules and regulations regarding the operation of recreation classes. 2. COMPENSATION a. In consideration for the provision of the programs set forth in Exhibit A, City agrees to pay, and Provider agrees to accept as total payment for their services for the City, seventy percent(70%) of all gross revenue received from program participants. Total annual revenue to Provider shall not exceed Fifteen Thousand Dollars and Zero cents ($15,000). b. Payment to Provider shall be made monthly within thirty (30) days following completion of the last class taught by Provider the prior month. City shall be responsible for collecting all fees from program participants. Provider shall not collect fees but will refer all interested participants to City for registration information. Provider agrees that City shall retain thirty percent(30%)of all gross revenue received from program participants as an administrative fee. 3. TERM This Agreement shall commence on June 1, 2025 and end on May 31, 2027 unless terminated earlier in accordance with Section 14 below. The term of this Agreement may be extended for up to one (1) one-year period upon a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Provider 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 manner in which Provider performs the services which are the subject matter of this Agreement; however, the services to be provided by Provider shall be provided in a manner consistent with all applicable standards and regulations governing such services. Provider 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 Page 2 of 8 applicable withholding taxes. Provider is not an agent, representative or employee of City and Provider shall have no authority to act on behalf of the City. 5. INSURANCE Insurance requirements attached hereto as Exhibit B. 6. INDEMNIFICATION Provider agrees to and shall indemnify, defend and hold harmless the City, its officers, agents,employees,consultants, 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 Provider or its contractors, 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, to the extent that the injury, damages,just compensation, restitution,judicial or equitable relief is caused by the negligence of the Provider. 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 events referred to in this Section or 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. In no case will Provider be required to indemnify or hold harmless the City from injury, damages,just compensation, restitution,judicial or equitable relief caused by the negligence of the City. 7. CONFIDENTIALITY If Provider receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary,Provider 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, including but not limited to student records. 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 Provider disclosed in a publicly available source; (c) is in rightful possession of the Provider without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or(e) is independently developed by the Provider without reference to information disclosed by the City. Page 3 of 8 S. COVID-19 ASSUMPTION OF RISK AND WAIVER Provider acknowledges that Provider could be exposed to persons that may have COVID- 19 providing services pursuant to this Agreement. Provider understands that interacting with any person currently comes with the inherent risk of exposure to COVID-19 and that COVID-19 is highly contagious. Provider assumes the risks associated with providing services pursuant to this Agreement, namely potential exposure to COVID-19. Provider acknowledges that while some people have no symptoms or mild symptoms from COVID-19,some people have become seriously ill requiring hospitalization and that some people have died from COVID-19. Provider acknowledges that persons over the age of 65 and persons with underlying health conditions are at greater risk of contracting COVID-19 and are potentially risking serious injury or death. Provider is agreeing to provide classes pursuant to this Agreement and does so of Provider's own free will. Provider intends to be legally bound by this assumption of risk, release and waiver and to bind Provider's heirs,personal representatives, next of kin and anyone who may make a claim on Provider's behalf. Provider knowingly releases and waives any and all claims that Provider may have or could have in the future and includes any claims resulting from potential exposure or actual exposure to COVID-19, this includes claims for personal injury, transmittal of COVID-19 to others, and/or wrongful death. Provider agrees to hold harmless, defend and indemnify the City, its public officials,officers,employees,volunteers,and agents from any and all claims for liability or damages, including those for exposure to or diagnosis with COVID-19 as a result of providing services pursuant to this Agreement. 9. CONFLICT OF INTEREST a. Provider covenants that it presently has no interests and shall not have interests, direct or indirect,which would conflict in any manner with performance of services specified under this Agreement. b. No immediate family members of either the Mayor, City Council Member, or any appointed City Official, including appointed board and commission members, as defined under the City's Municipal Code, whose position with the City shall award or influence the award of this Agreement, or any competing contract or amendment thereof, shall be employed in any capacity by the Provider or have any other direct or indirect Financial benefit or interest in this Agreement. c. The section also prohibits the awarding of any agreement, contract, grant, or any amendment to those awards, to any former full-time employee for one-year from date of employee separation except for any CalPERS retiree as authorized by City Council resolution d. Provider must comply with all conflict of interest laws, ordinances, and regulations now in effect or hereafter to be enacted during the term of this.Agreement.The Provider warrants that it is not now aware of any facts which conflict with the prohibitions defined above. If Provider hereafter becomes aware of any facts that might reasonably Page 4 of 8 be expected to create a conflict of interest, it must immediately make frill written disclosure of such facts to the City. Full written disclosure must include, but is not limited to, identification of all persons implicated and a complete description of all relevant circumstances. Failure to comply with the provisions of this paragraph will be a material breach of this Agreement. e. Provider covenants that none of its directors, officers, employees, or agents shall participate in selecting or administrating any subcontract supported(in whole or in part) by City funds stemming from the Agreement where the awarding of the subcontract has any direct or indirect financial benefit or interest to any individual, as defined in subsections (b) and (c) above. 10. BACKGROUND CHECK Provider shall ensure that all employees, subcontractors, and any volunteers are fingerprinted and background checked prior to conducting any work pursuant to this Agreement. Provider shall not assign any employee,agent, subcontractor, volunteer or the Provider personally to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer, or the Provider personally are required to register as a sex offender under California Penal Code Section 290 et seq, have a conviction for any crime of moral turpitude, have a conviction for a sexual based crime, have a conviction for a violent felony as defined in California Penal Code Section 667.5(c), or has a conviction for a serious felony as defined in California Penal Code Section 1192.7(c).Disqualifying convictions include but are not limited to,violations of California Penal Code Sections 37, 128, 136.1 with Section 186.22, 187, 190-190.4 and 192(a), 205, 206, 207-209.5, 211, 212, 212.5, 213, 214, 215, 218-219, 220, 236.1(b) or 236.1(c), 243.4,261, 261.5, 273.5, 262, 264.1, 266, 266c, 266h, 266i, 266j, 267, 269, 272, 273a, 273ab, 273d, 285, 286, 288, 288a, 288.2,288.3,288.4,288.5,288.7,289,290,311.1,311.2,311.3, 311.4, 311.10, 311.11, 314, 347(a), 368,41.7(b),451(a),518 with 186.22,647.6, 653f(c),664 and 187, 667.5(c), 18745, 18750, or 18755, 12022.53, 1 1418(b)(1) or(b)(2); Business and Professions Code Section 729. 11. 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 Clerk City of Santa Ana 20 Civic Center Plaza(M-30) P.O. Box 1988. Santa Ana, CA 92702-1988 Fax(714) 647-6956 Page 5 of 8 With copy to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax (714) 571-4211 To Provider: FUN Skateboarding Camp, LLC Attn: Khang Cao & Charles Jeon 2132 Associated. Rd. Fullerton, CA 92831 skateboard ingoran eg c� cr mail.com 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 time frames, weekends, federal, state, County or City holidays shall be excluded. 12. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Provider 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 Provider. 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 Provider 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 is not embodied herein. 13. ASSIGNMENT The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider 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. Page 6 of 8 14. TERMINATION a. This Agreement may be terminated by the City upon thirty (30) days written notice of termination. b. Termination or cancellation of classes by the Provider must be given to the City, in writing, at least thirty (30) days prior to termination/cancellation. failure to provide adequate cancellation notice to the City may put future contracting of business with the City at risk. 15. RECORDS Provider shall use attendance sheets generated and supplied by the City to record attendance in each class. Provider shall keep these and any other records in connection with the work to be performed under this Agreement and shall permit City, upon request, to review such records for a period of three (3) years from the date of final payment to Provider under this Agreement. 16. NON-DISCRIMINATION Provider 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. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 17. 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. 18. LICENSES Provider 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. 19. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree Page 7 of 8 of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the Parties hereunder. 20. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if frilly set forth in the body of this Agreement. 21. AUTHORITY The person(s) executing this Agreement on behalf of the Parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said Parties and that by so executing this Agreement, the Parties hereto are formally bound to the provisions of this Agreement. IN WITNESS WHEREOF, the Parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANT ANA , �_" en f r L _ .,� Alvaro Nuriez Cit er City Manager APPRO D AS TO FORM: SONIA R. CARVALHO PROVIDER: City Attorney Jonathan T. Martinez By: Khang Cao Assistant City Attorney Title: Co-Founder REC MMENDED FOR APPROVAL: PROVIDER: i cott By: Charles Jean CExlecuttive Director o arks, Title: Co-Founder on and ices Agency Page 8 of 8 EXHIBIT A SCOPE OF SERVICES SCOPE OF SERVICES Program Overview: This Scope of Services outlines the responsibilities and expectations for engagement of Provider (or "Instructor") to provide skateboarding classes for ages 5 - 14 years at City recreation facilities and parks, as defined below. The aim is to promote health and wellness in the community by offering affordable recreation opportunities that encourage creative activity and teamwork. A. Program and Class Offerings: 1. Seasonal programs and class offerings may include, but are not limited to the following class options: i. Skateboarding ii. Instructor shall teach such or similar classes at available City facilities to be designated by the City on a schedule agreed upon by the parties, in writing, for each class session or term, including the location, specific days and hours when classes will be held, and holidays to be observed, in accordance with City's needs. Provider and City agree that class locations and/or scheduling are subject to change due to unforeseen events or needs beneficial to the class participants. The Parties agree that changes to scheduling or location of classes shall be agreed upon, in writing, prior to the allowance of said change(s). iii. Class Size i. At the City's discretion and upon mutual agreement, the minimum and maximum number of participants required for each class will be determined to ensure the quality and safety of the class participants. ii. Class ratio of participants to instructor(s)will be setforeach class to ensure effective instruction and safety based on statewide standards. iii. If the minimum registration has not been reached by the second class, it is up to the discretion of the City upon mutual agreement with Instructor, that the class shall be cancelled. Instructor will be under no obligation to provide services for the cancelled classes, and the City will have no further obligations to pay Instructor compensation for the remaining classes that were cancelled in that session. iv. Class Fees l i. Class pricing is dependent on session length per season and subject to City staff approval. Class pricing is limited to no more than a 5% increase annually. ii. Each participant shall pay class registration fees as established by City. Instructor may not waive class participation/registration fees. Only registered participants paid in full may participate in class. iii. Any refunds to participants will be made in accordance with City policy. B. Instructor Responsibilities: i. Planning and delivering engaging and age-appropriate karate classes as defined by class curriculum and description to be approved by City staff. ii. Ensuring the safety and well-being of all participants during class sessions. ■ Instructor will immediately report to City staff, by phone or email, any injuries as a result of class participation, damages to the facility that could cause potential injury to a class participant and/ or require facility repairs. • Instructor will notify parent/guardian of minors under the age of 18 and city staff regarding any injuries experienced during class. iii. Submitting seasonal program proposals to City staff for seasonal approval of class descriptions, details, and schedules. Proposals must be submitted in writing by way of the provided City form(s) to City staff for review and approval at least 60 days prior to the start of the new season, unless otherwise specified by City staff, City staff will review and approve written proposals based on community needs, facility availability, and alignment with City goals. iv. Adhering to all City policies and procedures related to the use of facilities and interaction with participants. v. Adhering to all City deadlines for required documentation. vi. The instructor's organization is responsible for fingerprinting, monitoring, and managing all staff that will be instructing. vii. Promotion of class(es) with City approved marketing materials outside of City managed platforms. Publicizing on additional channels and networks outside of City platforms is the sole responsibility of the instructor. 2 viii. Instructor shall provide all materials, supplies, equipment, records and personnel. Instructor shall be responsible for repairing and maintaining all equipment and supplies, and ensuring that it is in good working condition. Instructor shall ensure clean-up of the facilities and materials to ensure the safety and effectiveness of instruction. The City will not responsible for any damage, repairs, misplaced, or stolen supplies or equipment, and will not be responsible for storing supplies or equipment. C. City Responsibilities: i. City shall manage participant registration and class information through registration software. Instructor shall be granted access to the class roster on the City registration system and is responsible for tracking attendance. ii. City shall collect all enrollment fees through the registration software. Instructor shall not accept enrollment fees directly from a participant, and shall only collect materials fees that are pre-approved by City and published in advance as a part of the program marketing. Such material fees shall be collected by Instructor at the first scheduled class meeting. No additional fees shall be collected. for materials, uniforms, awards, etc. without written approval and advanced advertising. iii. City shall provide publicity for class(es) seasonally in the City's recreation magazine (published seasonally). City shall have the sole discretion to decide what information will be included in the recreation magazine about the class and Instructor. Publicity may also include flyers created by City. Instructor created flyers are encouraged, but must be finalized by City to include use of City logos before distribution. iv. City shall provide a location for the class(es). Instructor will request dates and times for the class(es) seasonally, in writing. The City will confirm the class(es) schedule seasonally. Location selection is based on need, size of class, type of activity and availability, and is reserved at the discretion of the City. v. City shall provide refunds to participants when: • The participant formally requests to drop the class before the second schedule class meeting. ■ The class is canceled by City or Instructor. 3 EXHIBIT B INSURANCE REQUIREMENTS Insurance Requirements Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require 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. Total cost of such insurance shall be borne by Provider. MINIMUM SCOPE AND LIMIT OF INSURANCE 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. Required policy limits can be met with primary and umbrella/excess insurance policies. 2. Automobile Liability (AL): ,insurance Services Office 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 Provider does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance,provided that such policy is endorsed for business use and provides coverage with a minimum limit of $1,000,000, Required policy limits can be met with primary and umbrella/excess insurance policies. 3. Workers' Compensation (WC): 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, policy or employee, for bodily injury or disease. Coverage is not required if Provider has no employees and signs request to waive such insurance. Contractor attests that its workers' compensation coverage extends to all persons who will be working with the City under the agreed scope of services. 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, Provider 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. If Provider maintains broader coverage and/or higher limits than the minimum requirements for each line of coverage shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Provider.Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The above required insurance policies are to contain or be endorsed to contain the following provisions: I. City of Santa Ana, its City Council, its officers,officials,employees,agents,and volunteers are to be covered as additional insureds on Provider's CGL, AL, and SAML policies with respect to liability arising out of work or operations performed by or on behalf of the Provider including materials,parts, equipment,and personnel furnished in connection with such work or operations. 2. Provider's Insurance company(ies) agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of Provider's CGL,AL,and WC policies which arise from work performed by Provider under this Agreement. 3. For any claims related to this contract, Provider'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. A severability of interest provision must apply for all the additional insureds, ensuring that Provider'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. S. Insurance policy(ies) required 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 on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Parks, Recreation, and Community Services Agency, 20 Civic Center Plaza M- 23, Santa Ana, CA 92701. The name and location of project must be included in the Description of Operations section of each certificate. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Provider shall furnish City with original Certificates of Insurance including all required amendatory endorsements(or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Provider's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. Special Events Coverage Special events coverage is available and can be purchased by Provider. Use this link to learn more: https://www.theeyenthelper.comgynu 1 p2. Special Risks or Circumstances City reserves the right to modify these requirements, including limits, based on the nature of the risk,prior experience, insurer, coverage, or other special circumstances. I ACO,RO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIY Ofi122I202613 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(ies) must 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 NAME: Sportslnsurarlce.com PHONE 1-866-889-4763 FAX C No Ext: A/C No: E-MAIL info@sportsinsurance.com P,O.Sox 1155, ADDRESS: PRODUCER Lake Placid,NY,12946 CUSTOMERID INSURERS AFFORDING COVERAGE NAIL# INSURED Spurts Marketing Program Management Inc, INSURER A: NIS Tmnsvene Specialty Insurance Company 41807 FUN Skateboarding Camp LLC INSURER R: INSURER C: 39004 Alpine Street Newark,CA,94560 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: A-SP-SI-26-06-03-377289 E2 508323 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. VSR t TIP TYPE OF INSURANCE ADDL SUER �-�� �� LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000.00 q Y Y M0465GL000001-04 06f2212026 08107(2026 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE TO PREMISES S 300,00fl.0a RENTED An one remises CLAIMS-MADE F-9 OCCUR MED EXP(any one person) $5 0Q0.00 X INCLUDES ATHLETIC PARTICIPANTS PERSONAL&ADV INJURY S 000,000.00 GENERAL AGGREGATE s 3,000,000.00 GENERAL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO s 2.000.000.00 POLICY PROJECT D LOC $ AUTOMOBILE LIALiJrI' COMBINED SINGLE LIMIT ANY AUTO HIRED AUTOS (Ea accident) S ALLOVNJED NON-OWNED AUTO BODILY INJURY(Per person) 8 AUTOS BODILY INJURY(Per accident) 5 SCHEDULED PROPERTY DAMAGE AUTOS Per accident S UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE S AGGREGATE $ DEDUCTIBLE S RETENTION S S VAX4 RSCOMPENSATION WCSTATU- OTH- AND EMPLOYERS LIABILITY ANY PRCPRIETCILPARTNEREXECUUVE OFFICERMIEMBER EXCUUDED? watx"01NA) N!A E.L.EACH ACCIDENT S If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-EA EMPLOYEE S E.L.DISEASE-POLICY LIMIT I$ OTHER A AbuselMolestation Y Y MD405GL000001-00 06122/2026 0810712026 Each Occurrence:S 1.000.000.00 Aggregate:5 1,000,000.00 Ap Iroved by Tu Tian Nguyen 6/17/26 9:48 AM DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101.Additionai Remarks Schedule,4 more space is required) Endorsed Date:Jun 22 2023 12,4OAM EST Liability Policy Deductible:50.00 Deductible for Bodily Injury and 5 1000.00 per Property Damage Claim.ISO Occurrence farm CIS 00 01 04 13 and company's specifrc forms. Coverage for Participant Legal Liability requires that every participant signs a waiverlrelease. City of Santa Ana,its City Council,officers,officials,employees,(continued on next page) CERTIFICATE HOLDER CANCELLATION City of Santa Ana Attention:Parks,Recreation and Community Services Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 20 Civic Center Plaza M-23 DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana,CA,92701 AUTHORIZED REPRESENTATIVE Mark Di Perno ACORD 26(2D16103) The AGORD name and logo are registered marks of ACORD 01988.2009 ACORD CORPORATION.All rights reserved. AGENCY NAMEDINSURED Sportsinsurance.com FUN Skateboarding Camp LLC POLICY NUMBER 39004 Alpine Street M0405GL000001-00 Newark, CARRIER NAIL CODE CA,94560 MS Transverse Specialty Insurance Company 41807 EFFECTIVE DATE; 06/22/2026 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance agents,and volunteers are named as Additional Insured with respect to negligent acts or omissions of the Named Insured and only with respect to the Operations of the Insured during the coverage period. RE:Registered Skateboarding participants:06122/2026-08107f2026: ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 01988-2009 ACORD CORPORATION.All rights reserved. POLICY NUMBER: M0406GL000001-00 COMMERCIAL GENERAL LIABILITY CERTIFICATE#: A-SP-SI-26.06-03-377289_E2 CG 24 04 06 09 NAMED INSURED: FUN Skateboarding Camp LLC POLICY PERIOD: June 22, 2026 to August 07, 2026 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 Attention: Parks, Recreation and Community Services Agency 20 Civic Center Plaza M-23 Santa Ana, CA, 92701 Any person or organization if required by an insured contract provided such contract was executed prior to the occurrence or offense. 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. CG 24 04 06 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ COMMERCIAL GENERAL LIABILITY CG 20 26 0413 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 Organ ization(s): Any person or organization that you have agreed to include as an additional insured under an insured contract provided such contract was executed prior to the date of loss. 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury", "property If coverage provided to the additional insured is damage or personal and advertising injury required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contractor agreement;or 1. In the performance of your ongoing operations; or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the applicable 1. The insurance afforded to such additions! Limits of Insurance shown in the Declarations. 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. CG 20 26 0413 c0Insurance Services Office, Inc., 2012 Page 1 of 1 I CITY OF SANTA ANA Risk Management a division of Human Resources Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE Khang Cao, Charles Jeon, Founders « I, { Representative ), attest that I am an authorized (Name and Title of Vendor Representative) representative of Fun Skateboarding Camp LLC p ("Company"), y"), 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 Skateboarding Classes ("Services"): (Services to be provided under agreementicontract) 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. 05/28/2026 Signature Date Khang Cao, Charles Jeon Print Name Founders Title 510 541 9316, 714 388 4049 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 (`5100,000). 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 GEICO GEICO PROTECTION INSURANCE COMPANY VERIFICATION OF COVERAGE ('SEE BELOW UNDER CAUTIONARY NOTE) MAILING ADDRESS Policy Number: 6240604758 CHARLES M JEON Effective Date: 01-17-26 3236 FLOWER HILL LN Expiration Date: 07-17-26 HACIENDA HEIGHTS CA 91745 Registered State: CALIFORNIA To whom it may concern: This letter is to verify that we have issued coverage under the above policy number for the dates indicated in the effective and expiration date fields for the vehicle listed. This should serve as proof that the below mentioned vehicle meets or exceeds the financial responsibility requirement for your state. This verification of coverage does not amend, extend or alter the coverage afforded by this policy. Vehicle Year: 2019 Make: SUBARU Model: I MPREZA VIN: 4S3GTAM6OK3740059 COVERAGES LIMITS DEDUCTIBLES Bodily Injury Liability Each Person/Each Occurrence $30,0001$60,000 Property Damage Liability $25,OGO Uninsured &Underinsured Motorists Each Person/Each Occurrence $30,0001$60,000 Uninsured Motorists Property Damage $3,500 Lienholder Additional Insured Interested Party Additional Information: City of Santa Anna Parks and Recreation and Agency If you have any additional questions, please call 1-800-841-3000. CAUTIONARY NOTE:THE CURRENT COVERAGES,LIMITS,AND DEDUCTIBLES MAY DIFFER FROM THE COVERAGES,LIMITS AND DEDUCTIBLES IN EFFECT AT OTHER TIMES DURING THE POLICY PERIOD.THIS VERIFICATION OF COVERAGE REFLECTS THE COVERAGES,LIMITS,AND DEDUCTIBLES AS OF THE ISSUED DATE OF THIS DOCUMENT WHICH IS SHOWN UNDER"ADDITIONAL INFORMATION"OR IF AN ISSUED DATE IS NOT SHOWN,THE DATE OF THIS FACSIMILE OR EMAIL. U33(12-24) Nguyen, Tu Tran From: Uribe, Juan Sent: Friday, June 12, 2026 3:36 PM To: R M D Cc: Soriano, Destinee Subject: RE: Request for COI Review: FUN Skateboarding Camp LLC Attachments: Certificate_GL_Primary_Sport_A-SP-SI-26-06-03-377289_E2.pdf Hello, Thank you for confirming the waived items. Attached is the updated COI to reflect FUN Skateboarding Camp LLC. Furthermore, I can confirm the vehicle on Charles M Leon's auto policy will be the only vehicle used as both instructors will be travelling together. Thank you, Juan Magana Uribe I Management Aide City of Santa Ana, Parks, Recreation and Community Services kJ 20 Civic Center Plaza, Santa Ana, CA 92701 (714) 571-4276 1 juribe@santa-ana.or_g_ "City Hall is closed every other Friday. Click here for dates" From: RMD Sent:Thursday,June 11, 2026 8:51 AM To: Uribe,Juan <juribe@santa-ana.org> Cc:Soriano, Destinee <dsoriano@santa-ana.org> Subject: RE: Request for COI Review: FUN Skateboarding Camp LLC Hi Juan, Brandon approved waiving the personal auto and the Workers' Compensation. Please request the following: 1. The Name Insured on the COI is Khang M Cao, but the agreement states FUN Skateboarding Camp LLC. 2. Only Charles M Leon's auto policy was provided. Is that vehicle the only one they will be using? Kind regards, Tu Tran Nguyen I Risk Management Technician City of Santa Ana - Human Resources Department ° 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-5141 Email: tnguyen20Ccbsanta-ana.orq I santa-ana.orp/human-resources Linkedln I Instagram City Hall hours are 8 a.m. to 5 p.m. Monday through Thursday, and &00 a.m.to 5:00 p.m. every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Uribe,Juan <iuribe@santa-ana.org> Sent: Wednesday,June 10, 2026 12:02 PM To: RMD <rmd@santa-ana.org> Cc:Soriano, Destinee<dsoriano@santa-ana.org> Subject: Request for COI Review: FUN Skateboarding Camp LLC Hello, Please see the attached COI and insurance documents for the new recreational classes agreement with FUN Skateboarding Camp LLC.The instructors have informed us that they will be using their personal vehicle with the insurance limits outlined in the attachment. Furthermore, the co-founders have notified that they have no employees. May we waive the Automobile Liability and Workers' Compensation limits? Request Type(check only one): ® Standard C01 Review-Risk Management will review and approve insurance documents submitted. This applies to PO, Event, R Permit, and Agreements. ❑ Renewal COI Review-Risk Management will review and approve renewal insurance documents submitted. This applies to PO, Reservations, Permit, and Agreements. Please attach insurance requirements and previously approved COI(s). ❑ Request Insurance Requirements - Risk Management will provide insurance requirements for agreements and RFPs. ❑Review Agreement/RFP Language- Risk Management will review Insurance, Indemnification/Hold Harmless, Limitation of Liabil of agreements and RFPs. All fields required to advance the process-do not delete or modify. City Contact 1 Department: PRCSA Project Manager Name: Destinee Soriano Project Manager Email: dsoriano@santa-ana.orci Contract Details: 1 Business Name: FUN Skateboarding Camp LLC 2 Agreement Number and Agreement N/A Link: Instructors will provide skateboarding classes to Brief description of services: participants ages 5-14 at City recreation Contractor/Insured Contact Contact Name: Khang Cao &Charles Jeon Contact Email Address: skateboard ingo ran cLecounty@gnaail.com Contact Phone: 510-541-9316 T Insurance Contact(may be found at top right of the ACORD form) Contact Name: Sports Insurance Contact Email Address: info sportsinsurance.com Contact Phone: N/A Sincerely, Juan Magana Uribe [ Management Aide City of Santa Ana, Parks, Recreation and Community Services " 20 Civic Center Plaza, Santa Ana, CA 92701 (714) 571-4276 1 juribe(cDsanta-ana.orq "City Nall is closed every other Friday. Click here for dates" 3