HomeMy WebLinkAboutCREATIVE PARTIES FOR KIDSCity of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and
amendments (if any) are no longer in effect.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.
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The agreement with
COTC Office Use
ILIL 19 PN ?: 116
CITE' Or SANTA ANA
CLERK OF COUNCIL
No. N-2018-057 was completed on t and final payment has been made.
(List all amendments. Use space below it needed.)
Department: t51r
Phone/Ext.: `S
Signature:
Date: S1 I51(
Revised: 10-18-16
06URANCE ON FILE iNc 044MM6h0
WORK MAY PROCEED 01 .
UNTIL INSURANCE EXPIRES
CLERK OF COUNCIL a
0: PON / ) loll 2015
Silvia Cuevas
April 18, 2018
Creative Parties for Kids ("Speaker/Performer„„)
337 E. Grove Ave
Orange, CA 92865
Re: Sneaker/Performer Engagement A eement
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: Children's Day/Book Day (Dia de los Niiios) event.
2. Date(s): Saturday, April 21, 2018
3. Event Time(s): 11:30am — 1:30pm
4. Location: Santa Ana Public Library, 26 Civic Center Plaza, Santa Ana, CA 92701 ("Property„„)
5. Compensation: $340.00 (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: No equipment provided, however, City is responsible for setting up the space for the
patrons attending and advertising the program.
7. Equipment provided by SpeakerlPerformer: All equipment, materials, supplies and personnel necessary to provide the
entertainment services for two (2) costumed characters (Belle and Spiderman) for a period of two hours during event.
8. City Contact Person (for coordinating purposes only): Michelle Loera (714) 647-5231
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, 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.
12. Commercial General Liability Insurance. Speaker/Performer shall maintain commercial general liability insurance
naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall
Letter Agreement — Creative Parties for Kids N-2018-067
Page 2
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 webeast 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 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/Performer of copyright laws.
16. 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.
17. 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.
18. 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 SANTA ANA
RAUL GODINE I
City Manager
ATT>�
7 MARIA D. HUIZAR
Clerk of the Council
RECOMMENDED FOR APPROVAL:
Gerardo Monet, Executive Director, PRCSA
SPEAKER/PERFORMER
Name: Lisa Cohen
Title: Owner
APPROVED AS TO FORM:
By: Qt.UA- � , V
LAURA A. ROSSINI
Senior Assistant City Attorney
CERTIFICATE OF LIABILITY INSURANCE
OATE(MM
041161201YV)
2018
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 CONTRACT BETWEEN THE ISSUING INSURER)S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and condltlons of the policy, certain policies may require an endorsement, A statement on
this certificate does not confer rights to the Certificate holder In Ilsu of such endorsement(s).
PRODUCER
No Hassle Insurance Agency
N AC
BOA JORGE oaozco
FAx
A61AIo MIS 888 440-4094 e; 908 783.7900
PHONEEi
1400 E. Cooley Dr. Ste. 202-A
oroxco nohassleins.net
Colton, CA 82324
License #: OE74924
INSURERE)APPORDINOCOVERAGE
NAIC9
NSURERA: Insurance n
INSURED N-2018-057
INSURER B;
Lisa Cohen
INSURERO:
DBA: Creative Parties For Kids
INSURER D:
337 East Grove Ave
INSURER E:
Orange, CA 92867
INSURER FI
COVERAGES CERTIFICATE NUMBER: 00000000.40983 REVISION NUMBER: 33
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 RESPECTTO WHICH TI•118
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.
MSR
LTRPOLICY
TYPE OF INSUMN09
DL
SUER
NUMBER
POICY Elf
pp
0812312017'0812312018
POLICY EXP
LIMITS
A
COMMERCIAL ISBN ERAL LIABILITY
CLAIMS -MADE FX OCCUR
y
USA4182884
EACH OCCURRENCE
$ 1000000
DREAGETORo
$ 100000
MED EXP (Any one arson
$ rJ 000
_
PERSONAL&ADVINJURY
S 11000,000
GEN'L AGGREGATE UMITAPPLIES PER:
X POLICY ❑ PF° LOC
GENERAL AGGREGATE
S 2000000
PRQbUCTS-CCMPIOP AGG
g 2.000.000
$
OTHER:
AUTOMOBILE
LIABILITY
ANYAUTG
COMBINED DELIMIT
' Ea accltlanl
$
OWNED SCHEOULC-D
AUTOS ONLY AUTOS
HIRED NON-OVVNED
AUTOS ONLY AUTOS ONLY
BODILY IIJJURY (peracGdenQ
$
PROPERTY DAMAGE
UPer accident
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CI -AIMS -MADE
DED RETENTION $
_
If
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICEWMEMBER EXCLUDED?
(Mandatory In NH)
If yyes doecrlho under
DESCRPTLgN..OF OPERATIONS be-E.L.
NIA
PEq i•
S TUT6 ER
E.L. EACH ACCIDENT
$
E,L, DISEASE -EA EMPLOYEE
$
DISEASE. POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLE$ (AGORD 101, Addltlonal Ramarke Snodule, may be aNac,M4If Moro ap000 le required)
The City of Santa Ana, It's officers, agents and employees representative are named as addition�lurec�
30 days cancelation notice to be mailed out to Certificate Holder.
CITY OF SANTA ANA
20 CIVIC CENTER PLAZA
Santa Ana, CA 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
reserved.
ACORD 25 (2015103) The ACORD name and logo are registered marks of ACORD
ENDORSEMENT
ENDT, NO.
PRIMARY BLANKET ADDI'TIQUAL INSURED
lad
IT IS AGREED COVERA$E IS PROVIDED TO THE ADDITIONAL IN$URBD(6) AS FOLLOW£:
M, SECTION II OF THE POLICY (WHO IS AN INSURED) IS AMSND90 TO INCLUDE ANY PERSON
OR ORGANIZATION THAT THE NAMED INSURED HAS AGREED IN AN INSURED CONTRACT
TQ NAME AS AN ADDITIONAL INSURRO PROVIDED THE BODILY INJURY OR PROPERTY
DAMAQE OCCURS SUSSEOUENT TO THE EXECUTION OF THE INSURED CONTRACT AND
THE BODILY INJURY OR PROPERTY DAMAGE ARISES FROM YOUR WORK PERFORMED
DURING THE POLICY TERM.
2, PARAORAPH SM. IS HERFBY ADDED TO SECTION IV, COMMSRCIAL GENERAL LIABILITY
CONDITIONS, OF THE POLIGY',ASFOLLOWS:
D. NOTWITHSTANOINC ANYTHING TO THE CONTRARY IN PARAGRAPHS S.A., 0,B„ OR 0.0.
HEREOF, THE INDEMNITY PROVIDED BY THIS INSURANCE IS PRIMARY AND NON-
CONTRIBUTORY FOR ANY PERSON OR OROAN12ATION THAI' IS AN ADDITIONAL INSURED
UNDER THIS POLICY AND THAT YOU HAVE AGREED, IN AN INSURED CONTRACT, TO
PROVIDE PRIMARY ADDITIONAL INEURF,D OOVSRA012.
3 THE APPLICABLE LIMIT OF THIN COMPANY`S LIABILITY SHALL NOT RR INCREASED 13Y THE
INCLUSION OF ANY NUMBER OF ADDITIONAL INSUREDS,
4 OTHER THAN A$ EXPRESSLY MODIFIED 1-101FIN, COVERAGE FOR THE ADDITIONAL
INSURED IS GOVERNED BY THE TFRM8 AND CONDITIONS OF THIS POLICY, INCLUDING'., THE
INSURING AGREEMENTS.
B THE COVERAQF PROVIDED FOR THE ADDITIONAL INSURED IS ONLY TO THE EXTENT OF
DAMAGE$ FROM BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE
NEGLIGENCE OR PTRIOT LIABILITY OF THE NAMED INSURED, NO COVERAGE W PROVIDED
FOR BODILY INJURY OR PROPERTY DAMAGE ARISING OUT OF ACTS, ERRORS OR
OMISSIONS OF THE ADDITIONAL INSURED.
0. NO COVERAGE IS PROVIDED TO AN ADDITIONAL IN5URNO FOR DAMAGES BECAUSE OF
BODILY INJURY TO AN EMPLOYEE Or THE NAMED INSURED, WHETHER SUIT IS BROUGHT
OR CLAIM IS MADE BY THE EMPLOYEE OR THE PARENT, 4PQUSE, CHILD OR SIBLING OF
SUCH EMPLQYCG, OR ANY ENTITY SIWKINC DAMAGES IdEGAUSE OF INJURY TO BUCH
EMPLOYCC.
ALL DYNGR TERMS AND CONDITION$ OFTHIS POLICY REMAIN UNCHANGED.
policy Number Insurad ifdellva
USA4182664 � Lisa Cohen D13A Creative Parlles For Kids
United Specialty Inaunanoo Company
R,
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT OAREFULLY,
PRIIUTARYAND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies Insurance provided under the following;
COMMERCIAL. GENERAL LIABILITY COVERAGI! PART
PROI)UC"I'$/COMPLETED OPSRATIOM LIABILITY COVERAGE PART
The following Is added to the Other Insurance Condition and supersedes any provision to the contrary;
Primary And Nonoontrlbutary insurance
This Insurance Is primary to and will not seek contribution fPam any other Insurance available to an addhonal Insured under
this policy provided that: ,
(1) The additions) Insured Is a Named Insured under such other Insurance; and
(A) You have egroed In writing Ina contact ar agrsomsnt prior to the 1pJary or damage that tills Insurance would ba primary
and would not seek contribution from any other insurance available to the additional Insured,
blowever, the insurance pnwiided under this andoreamert will not apply beyond the extent required by such contract or
egreement,
ALL OTNL'RTprims AND CONDITIONS OFTHIS POLICY REMAIN UNCHANGED.
This endorsomont forms a part of the Folioy to which attanhed, effective on the Inception data of the Polloy unlace otherwise
stated heroin.
(The following Information is required onlywhen this andorsement is Issued nubeaquent to preparation of the Policy.)
Cndersoment. effective 08/23/2017 Palley No. USA4182564
Named Insured Bay Pro Property Solutions Inc
rountarsigned
rM I .G1,-1 ao2(10/2016)
Endorsement NO. 4876-ED214
I
N_2018-067
WORKERS' COMPENSATION DECLARATION
hereby affirm under penalty of perjury, the
(Name/Title)
following declaration
I certify on behalf of that during the term of my
a (Consultant/ ompeny Name)
contract for F— 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.
ZKOMR/�6-410
w
Nam
Title
M
Telephone: !q �&— ( i7. "�- S �0 / I
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.