Loading...
HomeMy WebLinkAboutDREAM SHAPERS 5City of Santa Ana Clerk of the COUk..-ll AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement a amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements I have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with N-2017-127 No. was completed on (List all amendments. Use space below if needed.) COTC Off ice Use Only 19 M4 3: 118 F SANTA ANA OF COUNCIL and final payment has been made. Department: Phone/Ext.: S� Signature: Date: Revised: 10-18-16 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE aEXPIRES CLER$,OF COUNCIL DATE . WIL 1 1 2017 0: PRCS (I ) Silvia Cuevas June 27, 2017 Dream Shapers ("Speaker/Performer") P.O. Box 3831 Orange, CA 92865 Re: Speaker/Performer Engagement A rg cement N-2017-127 This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagements described below: 1. Event Description: Up to ten (10) variety -type performances including without limitation storytelling, music, puppetry, magic, animals, mimes, juggling, as further agreed upon by the parties for each performance 2. Date(s): As specifically scheduled by the parties by mutual agreement during the period July 1, 2017 through June 30, 2018; approximately one performance monthly 3. Event Time(s): Each performance will be approximately one hour in length 4. Location: Santa Ana Main Library or Newhope Library Learning Center ("Property") 5. Compensation: Between $250 to maximum of $300 for each performance (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment; total sum to be expended under this Agreement not to exceed $3,000. 6. Equipment provided by City: none Equipment provided by Speaker/Performer: all equipment necessary for each performance 8. City Contact Person (for coordinating purposes only): Lupita Arroyo or Michelle Loera 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, its agents, or its 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, its agents, or its employees. it. Release: Speaker/Performer, its agents, and employees accept the Property and any City -provided equipment used in connection with the performance in "as -is" condition, with all faults. Speaker/Performer, its agents, and employees, fully release, waive and discharge forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenant not to sue, City, its elected officials, officers, employees, agents and volunteers, and all Letter Agreement — Dream Shapers Page 2 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 Property or City -provided equipment. 12. Speaker/Performer shall maintain commercialgeneral liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Speaker/Performer's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall: (1) name the City, its officers, employees, agents, volunteers, and representatives as additional insureds; (2) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (3) contain standard separation of insured provisions. 13. Worker's Compensation Insurance. In accordance with the California Labor Code, Speaker/Performer, if Speaker/Performer has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. 14. 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. 15. 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. 16. 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. 17. 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 S A CYNTHIA K TZ INTERIM CITY MAN ATTEST: �>. MARIA D. HUIZAR Clerk of the Council RECOMMENDED FOR APPROVAL: SPEAKER/PERFORME By: rHAPr� to c�z DRE SERS APPROVED AS TO FORM: By: JO .FUNK Assistant City Attorney Gerardo Mouet Executive Director of Paiks; Recreation, and Community Services Agency Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Dream Shapers P.O. Box 3831 Orange CA 92865 (714)771-1981 EVENT: Santa Ana Public Library's Entertainment Shows SERVICE DATE(S): July 1, 2017 through June 30, 2018 COMPENSATION: Not to exceed $3,000 DESCRIPTION: This vendor may provide up to 10 entertainment performances from July 1, 2017 through June 30, 2018. Amount shall not exceed $3,000 total per the term of the contract. The various performances we will be scheduling Dream Shapers for will range from $250 to a maximum of $300 per performance. Dream Shapers provides a wide variety of performances such as: storytelling, music, puppetry, magic, animals, mime, juggling, and many more. Shows will be presented at either the Main Library, 26 Civic Center Plaza, Santa Ana CA 92701, or the Newhope Library Learning Center, 122 N. Newhope Street, Santa Ana CA 92703. Location will be determined by the Project Manager. The City will be responsible for setting up the space for the patrons attending and advertising the program. Vendor will be responsible for providing all equipment, materials, supplies and personnel necessary to perform the act. AC6Rbr CERTIFICATE OF LIABILITY INSURANCE 1oATE(MAvoonrvp F 6/12/2017 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(les) 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 All -Cal Insurance Agency 505 Vernon Street Roseville CA 95678 221E0 DiAnna Martin PROM (: (916}784-9070 ac No:(916)784-0158 EMAIL ADDRESS: dianna@all-calinsurance. coon INSURERS AFFORDING COVERAGE NAIC0 INSURER A.Nonprofits I Insurance Alliance of 011845 INSURED The Los Angeles Dream Shapers P.O. BOX 3831 Orange CA 92865 INSURERB:State Compensation Insurance Fund 35076 INSURERC: INSURER D: INSURER E: 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1742506234 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 TYPEOFINSURANCE ADDL SUSR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY E%P MMIDD1YYYY Mine X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR PREMISES Me oecurence $ 50Dr OOO x MEO EXP(Any one person S 20,000 LIQUOR LIABILITY X 2017-0H609NP0 6/13/2017 6/13/2018 $1,000,00011,000,000 PERSONAL& ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JRO- LOC POLICY PRO PRODUCTS -COMPIOPAGG $ 2,000,000 S OTHER' AUTOMOBILE LIABILITY COMBINEOSINGLE LIMIT Ee acci. I S 1,000,000 BODILY INJURY (Par person) $ A ANYAUTO ALL OWNED SCHEDULED AUTX HIRED AUTOS X AUTOS 2017-08609NPO COt4P DED $500 6/13/2017 6/13/2018 BODILY INJURY (Per accident) $ Peerr�tle DAMAGE $ $ COLL DED $500 UMBRELLADAS OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLADAS-MAOE DED RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE (Mandatory In NH) SER �UOE07 NIA 9015327-17 6/6/2017 6/6/2018 X STATUTE FOR"'- E.E. EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 11000,000 11 yes, desuihe urtler DESCRIPTION OF OPERATIONS hat. E.L DISEASE -POLICY LIMIT S 11000,000 DESCRIPTION OF OPERATIONS( LOCATIONS/VEHICLES (ACORD 101, Additional Remark$Schedule, may be attached it more space is required) THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE NAME DITIONAL D IN REGARDS TO GENERAL LIABILITY. COVERAGE IS PRIMARY AND NON—CONTRIBUTORY. FORM CG 20 10 APPLIES NO, �Pd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA, CA 92701 AUTHORIZED REPRESENTATIVE An& l' - ©1988-20 4 ACOJM COR RATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) POLICY NUMBER: 2017-08609NPO COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE, FULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Named Of Additional Insured Person(s) Or Organization(s): I Location(s) Of Covered Operations THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE NAMED ADDITIONAL INSURED IN REGARDS TO GENERAL LIABILITY. COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. FORM CG 20 10 APPLIES 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 operation for the additional insured(s) at the location(s) designated above. HOWEVER: 1. The Insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be borader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, manintenance or repairs) to be qcjYned by or on behalf of the additional inW at the CG 20 10 0413 Insurance Services Office, Inc., 2012 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project C. With respect to the insurance afforded to these Additional insureds, the following is added to Section III— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or Page 2 of 2 2. Available under the applicable Limits of insurance show in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations Insurance Services Office, Inc., 2012 CG 2010 0413 6V� . �`e�e 1e A � fI.�e"'- 0\ / "�P,a e NONPROFITS INSURANCE L V ALLIANCE OF CALIFOMIA A Head fartasuranre. A Haar! for Nonproflis. �.»rrnnnlrx�z�yr �:.�• THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended to include any public entity as an additional Insured for whom you are performing operations when you have agreed in a written contract or written agreement that such public entity be added as an additional insured(s) on your policy, 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 negligent acts or omissions; or 2. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity is an additional insured for liability arising out of the "products -completed operations hazard" or for liability arising out of the sole negligence of that public entity. B. With respect to the insurance afforded to these additional insured(s), 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 equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the same project. C. The following is added to SECTION III -LIMITS OF INSURANCE: The limits of insurance applicable to the additional insured(s) are those specified In the written contract between you and the additional insured(s), or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. D. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV- COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Olherinsurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with att other insurance as described in c. below; or e3y (2) The coverage afforded by this insurance is primary and non-contributory e additio0lil�� insured(s)' own insurance. a NIAC-E61 0217 G;��G� I of 2 Q� Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for .your work'; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g, of SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. N a5 GvV, GCJ NIAC-E61 0217 �� Page 2 of 2 WORKERS' COMPENSATION DECLARATION 'U cx-u- (4C �fL��2c�Q I 6C� �`Q/y`Whereby affirm under penalty of pedury, the (Namerrille) following declaration I certify on behalf of NXR2NA 5it-f""$ that during the term of my (ConsulunHCompmy Nmne) contract for pX)t2Mfti A services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prv;ionsisand provide proof of workers' compensation coverage. DATE: 3 By: Name: I_ uLZA t� � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OP COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Q�G The Los Angeles Dream Shapers www.dreamshapers.org (888)499-1270 P.O. Box 3831, Orange, CA 92865 ♦ SCHOOLS ♦ LIBRARIES ♦ PRESCHOOLS ♦ FESTIVALS ♦ COMMUNITY EVENTS Dream Shapers PO BOX 3831 Orange, CA 92865 1/7/17 To whom it may concern, This letter is to certify that Dream Shapers does not hire presenters as employees. All presenters function as independent contractors; therefore, Dream Shapers does not carry worker's compensation on their behalf. We do carry a 2 million dollar general liability policy, which can be furnished upon request. If you have further questions, please let me know at info@dreamshapers.org or 888-499-1270. Thank you, Valerie Gabriel General Manager