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Home My WebLink AboutSEVERON, MONICA DBA TONALNACity of Santa Ana i Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements 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. COTC Office Use Only ,1111. 19 I M 31 12 :ITY OF SANTA ANA CLERK OF COUNCIL The agreement with �G il� Fti ti FNCYI (1190 'lrt . f lck hG N-2018-035 was completed on Jf �41y (List all amendments. Use space below if needed.) and final payment has been made. Department: 9 V—C-5��4 Phone/Ext.: u Signature: c!^a " '�' �� i QyJIL �• L,vCN(V) Date: 2J.'/ L V Revised: 10-18-16 INSURANCE NOT WORK MAYPROCEED CLERKOF COUNCIL 0- PRCS • } Silvia Cuevas Monica Scveron dba Tonahna ("Speaker/Performer") 800 S. Atlantic Blvd. Alhambra, CA 91803 Re: Speaker/Performer Engagement Agreement N-2018-035 This letter represents your agreement with the City of Santa Ana ("City"} as entered into on the above date for the engagement described below: 1. Event Description: motivational speaker "El Poder de Is Mujell' event. 2. Date(s): Thursday, March 8, 2018 3. Event Time(s): 6:30PM - 8:OOPM 4, Location: Santa Ana Public Library 26 Civic Center Plaza, Santa Ana ("Property") S. Compensation: $360.00 (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment can be made 6. Equipment provided by City: None Equipment provided by Speaker/Performer: None 8. City Contact Person (for coordinating purposes only): Patty Lopez 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 emoloyes-womplaxee_relationship,_a jom_t _v�mtuce relattimslatp,,srr_t ailo the_City to_ erorse _--- 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: SpeakeriPerformer, his or her agents, or employees (if applicable) agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from and against all loss, expenses, or liability (including costs and attorney's fees) arising from the negligence or willful misconduct of Speaker/Performer, his or her agents, or employees. 11. Release: Speaker/Performer accepts the Property and any City -provided equipment used in connection with the performance in their "as -is" condition, with all faults. Speaker/Performer fully releases, waives and discharges forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not to sue, City, its elected officials, officers, employees, agents and volunteers, and all persons acting on behalf of, by, through or under each of them, under any present or future laws, statutes, or regulations for any claim or event relating to the condition of the Property or City -provided equipment or Speaker/Performer's use thereof. N-2018-035 Letter Agreement — Monica Severon dba'fonalna Page 2 12. Worker's Compensation Insurance. In accordance with the California Labor Code, Speaker/Performer, it Speaker/Performer has ally employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. 11 The City shall have the right and royalty -free license to sinudcast 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 [lie City, and Speaker/Perl'onmcr consents to use of such recordings. 14. Speaker/Perforner is solely responsible for payment of royalty fees, performance fees, or similar fees that may be required by unions or similar organizations, Speaker/Performer shall indemnify the City against any liability or damages, including attorney's fees, that may arise as a result of violation by Speaker/Pcrforner of copyright laws. 15. Speaker/Perforrner 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/Porfoimer 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 instnrment signed by the City and by an authorized representative of Speaker/Performer. CITY OF S TA NA r RAUL GODINE I City Manager ATTEST: . MARIA D. UUIZAR Clerk of the Council RECOMMENDED FOR APPROVAL: Gerardo Monet,, Executive'Director Parks, Recreation.and Community Services Agency �RrkT{'s 1, MER `�Ar1 rve'�t Name: N' un,ca Severson l'itle:CCO oroNAUNA APPROVED AS TO FORNI: By:> )uz_Gd P, . Rem rLV.- LAURA A. ROSSINI Senior Assistant City Attorney N-2018-035 WORKERS' COMPENSATION DECLARATION Anuc �eVe osoy hereby affirm under penalty of perjury, the (Namerritle) following declaration I certify on behalf of —� 0 W.PLN P that during the term of my g} ` (ConsulinnVC'empuny Name) contract for r..a0 re,karye� 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 provisions and provide proof of workers' compensation coverage. DATE: Oa Iag dok8 By:— -- Name: 90 VAf (i Se d e-r s c) Title: _ e.c e t e 5k" r Telephone: 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 OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECT'ION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. WORKERS' COMPENSATION DECLARATION I �Ontca (oeverso. hereby affirm under penalty of perjury, the (Nameaitle) following declaration I certify on behalf of T 0 N A L N P� that during the term of my ` (C'unsultantKompnny Name) contract for Vre5en'g\t on S o c4K�Y,�� 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 provisions and provide proof of workers' compensation coverage. DATE: OD, I a a' a 01 R By:�entc. - -- Name: (Ac nt (. s-e v er S 1� n Title: So�-aker'e5t �er Telephone: (81;�O S (,?- (off f,ri 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 OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.