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HomeMy WebLinkAboutGALAXY PARTY RENTALS 5City of Santa A, COTC Office Use Only i Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreemMARA161 Pry >,f. amendments (if any) are no longer in effect. 3 Note: If your agreement is grant related, please ensure that all grant retention requirern y D1 S 4 i c have been satisfied prior to signing the termination form.ER{ j r� �� 6 OU�dCIL 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-2018-160 No. was completed on and final payment has been made. (List all amendments. Use space below ff needed.) Department: PRCsipt Phone/Ext.: �gRlgq Signature: Date: 101,30liq Revised: 10-18-16 14SURANCE ON FILE K MAY PROCEED WC Declaration on file. NTIL INSURANCE EXPIRM CLERK OF COUN L— DATE: AUG 0 9 2018 os PRCS (/ ) Silvia Cuevas THIS AGREEMENT is made and entered into this 1st day of August, 2018 by and between Galaxy Party Rentals ("Contractor"), 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"), N-2018-180 RECITALS AGREEMENT WITH GALAXY PARTY RENTALS A. The City desires to retain a Contractor having special skill and knowledge in the field of providing rental equipment for special events. held by the Parks, Recreation and: Community Services Agency ("PRCSA") for the enjoyment of the corns unity. B. Contractor represents that Contractor is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in this field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. 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: I. SCOPE OF SERVICES a. Contractor shall provide, install, set-up, maintain and remove rental event equipment, including but not limited to, tables, chairs, umbrellas and heat lamps (the "Equipment"). A list of Contractor's equipment for rent is set forth in Exhibit A. Contractor will be responsible for providing equipment, materials, supplies and personnel necessary for the setup and break down of the space after the event. b. Upon request by the City, Contractor shall provide to City an invoice or quote in writing detailing the requested services for an Event. No work shall commence for an Event until the Executive Director of PRCSA approves the invoice or quote in writing. Changes to the details of an Event, including location, addition or removal of services, or costs for that Event shall require approval by the Executive Director of PRCSA in writing. c. The City will be responsible for obtaining the proper approvals for use of City space and for advertising the event to patrons. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $15,000. b. Payment shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on August 31, 2019, unless terminated earlier in accordance with Section 12, below. 4. INDEPENDENT CONTRACTOR Contractor 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 Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor 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. 6� W(.� 17 LC�1 P Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability, Insurance. Consultant shall maintain commercial general 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 Consultant'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 (a) name the City, its officers, employees, agents, and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self- insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. iv. Where the amounts or coverage provided by the certificates of insurance provides coverage greater than those listed by this Agreement, the amounts provided by the certificates of insurance shall be incorporated by reference into the Agreement. V. Consultant shall supply City with a fully executed additional insured endorsement. e. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to and shall defend, indemnify and hold harmless the City, its officers, agents, employees, Contractors, 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 direct or indirect operations of the Contractor or its 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. 9 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. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises 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. 7. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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. 8. CONFLICT OF INTEREST CLAUSE Contractor 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. 9. 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: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax:(714) 647-6956 With copies to: Parks, Recreation and Community Services Agency City of Santa A 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 571-4221 and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 647-6515 To Contractor: Galaxy Party Rental 11787 Cardinal Circle Garden Grove, California 92843 Phone: (714) 569-1638 A party may change its address by giving notice in writing to the other party. 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. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter therein, 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 Contractor. 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 Contractor nor 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 are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor 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. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the s'abject to this Agreement performed by City personnel or by other Contractors retained by City. 12. TERMINATION This Agreement may be terminated by the City upon fifteen (15) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination. 13. NONDISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any services performed under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. 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. 15. PROFESSIONAL LICENSES Contractor 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. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set IVIIIi in the VUUY Gf thiS Agreement. N-2018-160 IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date and year first above written. - ATTEST: CITY OF SANTA ANA £yF� Marra D. Huizar Raul Godinez II Clerk of the Council City Manager APPROVED AS TO FORM: SONIA R. CARVALHO CONTRACTOR: CITY ATTORNEY Galnly Rentals Laura A. Rossini Name: Senior Assistant City Attorney Title: 0 LO AL: s„ Recreation & Community Sekvico Agency Exhibit A PRICE LIST N-2018-160 ram_ Party Rentals Equipment Price List 2018 E-Mail: roberto@galaxypartyrents.com Phone 1:714-719-9498 Phone 2:714-589-9242 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com .Chairs Standard Samsonite White................................................... .85 Fanback White................................................ 1.35 Children Purple/Red/Blue.................................... 1.25 White................................................. 1.25 Cafe Vienna White................................................ 1.50 Cafe Bistro White.............................................. 1.45 Black................................................. 1.50 Plastic Resin w/ Padded Seat White................................................ 2.50 Black................................................ 2.50 Wood Resin w/ Padded Seat Fruitwood........................................... 2.75 Natural.............................................. 2.75 Chiavarl (cushion included) White................................................ 4.75 Barstool (Swivel Seat/Black) .................. 6.00 Rectangular 6'x3O" (Seats 8)................................... 6.50 Adjustable Height 6'x3O" .............................. 7.00 8'x3O" (Seats 10).................................. 8.00 48" Diameter (Seats 6-8) ........................ 7.00 60" Diameter (Seats 8-10) ....................... 8,00 72" Diameter (Seats 10-12) .................... 10.00 Cocktail 36" Diameter ..................................... 9.00 (Available in 30" or 40" Heights) Specialty 6'Xl8" Conference/Classroom .................... 9.50 8'xl8" Conference/Classroom .................. 10.50 *Serpentine (811).................................... 12.50 *Serpentine Riser (8ft) .............................. 10.00 Serpentine Bar w/ Drapes (8ft) ................. 75.00 %2 60" Round Moon ................................... 10.50 Linen Mahogany........................................... 4.75 Polyester (Solid Colors) Gold................................................. 4.75 Napkins 20"x2O.. .................................... .65 Silver................................................ 4.75 90"Diameter (Round) ............................ 9.50 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com 102" Diameter (Round) ......................... 11.00 108" Diameter (Round) ......................... 12.50 120" Diameter (Round) ......................... 14.50 132" Diameter (Round) ......................... 17.50 60"xl20" (Rectangular) .......................... 9.00 40" Square (Overlay) ............................. 7,25 54" Square (Overlay) ............................. 7.25 60" Square (Overlay) ............................. 7.25 88'"x130" (6ft Table Drape) .................... 14.00 88"xl56" (8ft Table Drape) .................... 15.00 Cocktail Spandex Cover 36"x 42" ............. 16.00 Table Runner 18"x108" (18in x 9ft) ............ 3.50 Chair Cover (Samsonite) ......................... 3.00 ChairSash .......................................... 1.00 Specialty.,.Unen Skirt Drapes Yz 60 Round Skirt Drape .......................... 10.50 13.5' Table Skirt wt Velcro Clips.. ............ 18.00 88"x 130" (0) Skirt Drape ..................... 22.00 88"x156" (8ft) Skirt Drape ..................... 25.00 Satin Napkins 20"x20".................................. 1.20 90" Diameter (Round) ........................... 19.00 108" Diameter (Round) ......................... 20.00 120" Diameter (Round) ......................... 25.00 132" Diameter (Round) ......................... 27.00 60"x120" (Rectangular) ............................ 20.00 88"x130" (611 Table Drape) .................... 23.00 88"x156" (8ft Table Drape) .................... 27.00 60" Square (Overlay) ........................... 11.00 ,,Glassware Champagne Flute (6oz) ............................... .65 Water Goblet (8oz)....................................55 Wine Glass (12oz)............................................ .65 Aishware Avalon 10" Dinner Plate ..................................... .65 7" Plate ............................................... .60 6" Plate ............................................... .55 Gold Rim 10" Dinner Plate ..................................... .70 7" Plate ............................................... .65 6" Plate ............................................... .65 Charger Gold or Silver ........................................ 1.00 Fanfare............................................... .50 Avalon................................................ .55 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com ._Buffet Service Chafing Dish w/ Burners (1 Compartment) ... 20.00 Chafing Dish w/ Burners (2 Compartments).. 25.00 Deluxe Chafing Dish w/ Burners (1 Comp)... 30.00 40-Cup (8 oz.) Coffee Maker ..................... 17.00 Beverage Tub (Red Plastic) ...................... 4.00 Ice Chest (120gt)................................. 18.00 Ice Chest (150gt)................................. 22.00 Champagne Bucket ................................. 5.00 Cazos (Stainless Steel) (Top Diameter x Depth x Bottom Diameter) 26 %2" x 13" x 18.. ............................... 30.00 28 %2" x 15" x 17.. ............................... 35.00 30" x 13" x 20.. .................................. 35.00 Cazo Burners 14.5" Diameter ................................... 15.00 19.5" Diameter ................................... 15.00 23" Diameter ..................................... 15.00 Double Griddle (w/ 5 Gal Propane Tank).... 65.00 5 Gallon Propane Tank ......................... 25.00 .Flooring Dance Floor Oak Parquet (3'x3' Sections) 9x9................................................. 96.75 9x12............................................... 129.00 12xi2............................................. 172.00 12x15............................................. 215.00 15xi 5............................................. 268.75 Additional Section ............................... 10.75 Astro Turf Green (sq. ft.)........................................ .40 Black (sq. ft.)......................................... .40 Carpet Runners Red Carpet 3' x 25............................... . 75.00 Red Carpet 3'x 50................................. 120.00 Staging 4x4 Section (6in-2ft High) ...................... 25.00 4x4 Section (Over 2ft) ........................... 30.00 Stage Step (6" High) ................................ 15.00 Stage Stairs (2' High) W/O Handrail ........... 25.00 Stage Stairs (2' High) W/ Handrail ............ 30.00 Stage Stairs (3' High) W/ Handrail ............... 65.00 Stage Skirts (1'-2' High) Per Foot .............. 1.50 Stage Skirts (30"-3 High) Per Foot ................ 2.00 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com ***Safety Rail (4') .............................. 12.00 ***Diagonal Bracing ........................... 12.00 Stage Stairs W/ Carpet and Handrail (2' H) ... 65.00 Stage Stairs W/ Carpet and Handrail (3' H) ... 95.00 Stage Ramp Set (1' High) .............................. 95.00 Stage Ramp Set (2' High) ............................. 215.00 Stage Ramp Set (3' High) ............................. 350.00 *°• Safety Rails required for stages 30" high and over *'* Diagonal Bracing required for stages W high and over .Crow,,Cou'l-0/,Rc►Gli-ri �INY der Free Standing Drapery: Adjustable Height (6'-10') and Adjustable Length (6'-10') ................ 40.00 Wedding,&.Garden Roman Colonnade (9 Pieces) ................. 175.00 Roman Column (4') ............................. 17.00 Roman Column (6') ............................. 27.00 White Balustrade (4')................................... 25.00 Patio Umbrella ................................... 15.00 UmbrellaBase ..................................... 5.00 Temperature.Control 8' Sunglo Patio Heater .......................... 70.00 Forced Air Heater (80,000 BTU) .............. 85.00 Forced Air Heater W/ Duct and Diffuser ..... 125.00 18" Industrial Floor Fan ........................ 30.00 ,Lighting ParCan 38........................................ 20.00 Par Can 56........................................ 25.00 Pole Lights w/ 3 Par Can 38.................... 50.00 Pole Lights w/ 3 Par Can 56.................... 65.00 String Lighting w/ Installation (Per Foot) ....... 1.50 . Canopy .Accessaries Solid Sidewall 8' High (per foot) ............... 1.50 Window Sidewall 8' High (per foot) ........... 2.00 Food Mesh Sidewall (per foot) .................. 2.50 High Bay Light ................................... 50.00 Fire Extinguisher (8 lb.) .......................... 15.00 "No Smoking" Sign ............................... 2.00 Lighted "Exit" Sign .............................. 25.00 Water Barrel (50 Gallon) ........................ 12.00 Steel Weight (90 LBS)...................................... 5.00 .CQncession Popcorn Machine (w/ 50 People Kit) .......... 65.00 Popcorn Machine (Machine Only) ............ 50.00 Additional Popcorn Kit (50 People) .......... 20.00 Cotton Candy Machine (w/ 50 People Kit) ... 65.00 Cotton Candy Machine (Machine Only) ....... 50.00 Additional Cotton Candy Kit (50 People) ... 20.00 Snow Cone Machine (w/ 100 People Kit) ... 65.00 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com Snow Cone Machine (Machine Only) ........ 50.00 Additional Snow Cone Kit (50 People) ....... 20.00 Pretzel Warmer .................................. 35.00 Miscellaneous Trash Bins w/ Liner (32 Gallons) ............... 7.50 Mahogany Lectern/Podium ............................. 20.00 Labor Charges Chair Set -Up and Take Down (per chair) ....... . 35 Cable Tic Chairs (Customer Provide Ties) ...... . 25 Table Set -Up and Take Down (per Table) ....... . 75 Linen Set -Up and Take Down (Per Cloth)...... 1.10 Galaxy Party Rentals 11787 Cardinal Circle, Garden Grove, CA 92843 www.galaxypartyrents.com CORd CERTIFICATE OF LIABILITY INSURANCE 3/OATE(MM/OD/YYYY) 2E/2010 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 INSURERS), 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 confor rights to the certificate holder In lieu of such Endorsements). PRODUCER A J INSURANCE 1000 Macarthur Blvd #66 Santa Ana, CA 92707 OF57419 NAMEA T PHDNE (7� 673-5549 1fA - �'DN°" ;AIL ESs.a 1nE111ranC0 Ye. COm INSUREADIR AFFORDING COVERAGE NAICN qUmj;P A.MESA UNDERWRITERS SPECIALTY INS. 36838 INSURED GALAXY PARTY RENTALS ZAVALA, ROBERTO AND EUGENIO PEREZ 11787 CARDINAL CIR GARDEN GROVE, CA 92843 INSURER B: _ IN NC INSURER D: e COVERAGES CERTIFICATE NUMBER: RFmginm NIIMRPR. THIS IS TO CERTIFY THAT THE F00014S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANV 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 CONOIDONSOF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS, INSIR I.TR TYPE OF INSURANCE B P Y P IpyyXyl LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR re S I,QQ' QQQ MEDEXP An oneelsan 3 QO A X DED: 6500 MP0004014000837 09/26/1709/26/18 PEESONALaAWiRIuRY _5 s 1,000,000 GENERAL AGGREGATE 3 2,000,000 GENt ADORE ATELIMITAPPIEB X P Y PRP PER: PRODUCTS COMPIDPAGG S 2,000,000 S AUTDMOEILEUAMUTY 0M N- OLELIMI LBIL� ANYAUTO BODILY INJURY(Perpes°n) 3 ALL OWNED SCHEDULED AUTOS AUTOS HIREOAUTOS NON -OWNED AUTOS BODILY INJURY (Par accitlenl ) $ PROPER7Y DAMAGE3 s UMBRELLA LIAO OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAa CLAIMS-MAOE WORKERSCOMPENSATION AND EMPLOYERS' UAWUTY y�q ANY PROPRIETONIPARTNERNOEWTIVE t-1 OFFICERNEMBER EXCLUOEDt 11`JI !Mandatary in NH) If ;despriaeunder RI TI N FQF6RATIONSral NIA WC STATW O H E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S CONTENTS: A PROPERTY 14P0004014000837 09(26/1709/26/18 $250,0000 DED: $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES (AltachACORD HH.Addihoml RemaM1s Srf umjfmaraspara Isrequiredl PARTY RENTAL STORE: City of Santa Ana, its officers, agents and employees are named as additional ins,5n�: �e City of Santa Ana Public Library 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE THE EXPIRATION DATE T AUTHORIZED REPRE I .. U ACORO 25 (2010/05) The ACORD name and logo are registered marks of ACORD FLIED BEFORE DELIVERED IN All rights reserved. t�tiN°r ADDITIONAL INSURED ENDORSEMENT Insurance Company MESA UNDERWRITERS SPECIALTY INS. MPO� 004OOTZTS�Ifll; ifies such insurance as is offered by the provisions of Policy Number: relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective,) Effective 0 3 / 0 8 / 18 this endorsement form part of Policy # MP0004014000837 Issued to (Name Insured) GALAXY PARTY RENTAL e° Countersignedby Q WORKERS' CONIPENSA"rION DECLARATION I _ Roberto Zavala hereby affirm under penalty of perjury, the (Namefl'itle) following declaration: I certify on behalf of _Galaxy Party Rentals that during the term of my (Consultant/Company Name) contract for Santa Ana Public Library 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: 03/21/2018 By: Name: Roberto Zavala Title: Co -Owner Telephone: 114-569-1638 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. ACORbP VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE lla� oA EpRmmon YYl 10511112018 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. This form Is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 forthat purpose. PRODUCER 6WOMT@AC Sarlah Devereaux $}afeFarM Sarlah Devereaux-Bavientos of nl: 714.541.7280 ---..F�.Ro, 714-384-3892 State Farm Agent WW E'MA sariah@71454117260.com 1202 W 1st St PUE�U& OF33249 INSUR@ S AFFORDING COVERAGE} NAIC4 Santa Ana CA 92703 INSURED INSURERA • State Farm Mutual Automobile Insurance Company 25178 Roberto Zavala Cardenas INSURER 0, 14132 Kerry at INSURER C:y `� INSURER D: Garden Grove CA 92844 I s NER . I.1�iF1:I1JtIL�P [e]�TI4CICdS3eT:� YEAR MAKEIMANUFACTURER MDOEL eODY TYPE VEHICLE IDENTIFICATION NUMBER 1994 GMC 3500 Box TrucK IGOKC34N9RJ519011 DESCRIPTION VEHICIFJEOUIPMENT VALUE SERNLNUMBOR is COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICY(IES) OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S) INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICY(IES) DESCRIBED HEREIN ISIARE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). a1SR ADcL POUCYEFFECTIVE POLICYEKPIRATION LTR Near TYPEOFINSURANCE POLICY NUMBER OATE(MMOVA'YYY) PATE(MMIDDNVYY) LIMITS X VINANNALMBILITY COMBINED SINGLE LIMIT It A 1957791F-12.75E 12/1212017 12112/2018 BODILY INJURY (Per parson) 81000,000 BODILY INJURY (Per Ia ldard) 3 1,000,000 PROPERTYDAMAGE I 11000,000 O ENERAL LIABILITY EACHOCCURENCE It OCCURRENCE GENERALAGGREGATE I CLAIMS MADE $ INSR Nee POLICY EFFECTIVE POLICYMPIRATION LTR AYES TYPa OFINSURANCE POLICY NUMBER DATE(MMIOOIYYYY) DATE(MIAUDRYYY) UMITSIDEDUOTIBLE VEH COLLISION LOSS a❑ ACV Cl AGREED AMT 3 LIMO ❑ ❑STATED ANT 3 Bad VEHCOMP VEH OTC ❑i ACV ❑AGREED ANT 3 UNIT �.i. ❑ ❑STATEDAMT 3 Dan EQUIBASIC PMENT---- .t 1.(') i ❑ ACV ❑ AGRBBDAMT BROAD .\\V a RC ❑ STATED AM3 3 LIMIT DED Q`��\ hfi �,.(�� oe REMARKS (INCLUDING SPECIAL CONDITIONS I OTHER COVERAGES) (AtMeh RO tOLAAdd l Retneres Schedule, it rnon epaaela nquu d) Comprehensive deductible: 100: collision deductible: 800; Uninsured Mot st protection 250,0001500,000 of one of the folluwlnet The adds c ul InUMH doeaibed edow Ass been added to the pdig(lee) Baled herein by policy mrMb,d.s . A regw+pt hap pawn p�mllted'0 a_Id the Juon°I interost deaaribed bat . M the Parcylies) VEHICLE I EQUIPMENT INTEREST; I I LEJUAO I FINANCED NAME AND ADDRESS OF ADDITIONAL INTEREST i F CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA, CA 02701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCEWITH THE POLICY PROVISIONS. ADDRIONAL INSURED LOSE PAYEE LENDER'S L098 PAYEE (—'— LOAN ILEASE NUMBER A AUTHORIZED ACORD 23 (2016103) The ACORD name and logo are registered marks of ACORD` L", 100/381 142aeT.3 018&418 A`C°C1IROM' VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE, OATS IMM ONYYY) `L.-�' 6511112018 THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EMEND 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. This form is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report (lability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose. PRODUCER AME,C Sadah Devereaux StateFarm Sadah Devereaux•Bardentos aa o E ,; 714.641.7286 ae NO: 714.384.3892 ft • ar, State Farm Agent Eo0AlE95: StHIS 7145417200.00m - vao cE 1202 W tat St Santa Ana CA 92703 INSURER(th AFFORDING COVERAGE NAICX INSURED INSURER A: Slate Farm MUtU8[Automobile Insurance Company 25178 EUGENIO PEREZ MARTINEZ INSURE a: 1427 S DOUGLAS ST INSURER C: INSURER D: SANTA ANA - CA 92704 __-- INSURER E: 101119411911111 gJ1aI1IcK01:l YEAR I MAKE I MANUFACTURER MODEL 800Y TYPE VEHICLE ]CERTIFICATION NUMBER " 2003 HINO FE2620 Box Truck JHBFE2JG33i S10D52 DESCRIPTON VEHIOLEMOUIPMENT VALUE SERIAL NUMBER I COVERAGES CERTIFICATE NUMBER: - REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODS) INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO ' WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCY(iES) DESCRIBED HEREIN ISIARE SUBJECT 70 . AUL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). INSR LTR an MSRa TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE(MMmOM(YY) POLICYEXPIIWTION DATEIMMMONYYY) LIMITS X I VEHICLE LIABILITY COMBINED SINGLE LIMIT S A 5065359E11750 02/22/2018 02/22/2019 BODILY INJURY (Pat ao,een) E 1,000,000 BODILY INJURY (Pal amident) S 1,000,000 PROPERTY DAMAGE S 11000,000 GENERAL LIABiUTY EACH OCCURENCE 5 OCCURRENCE GENERAL AGGREGATE 5 CLAIMS MADE 5 INSR LTR LOSE AM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE OATS (MMa3OANNY) POLICYEXPIRATiON DATE IMMIOOP Y li, DMRS ICmucrBLE VEH COLLISION LOSS ❑' ACV [I AGREED AMT S LIMIT ❑ ❑ STATEDAMT S DELI VEH COMP VEH OTC N ° (] ACV ❑ ACREEa AMT 5 UMR F� [] 0 STATED AMT S OEO EQUIPMENT BASIC BROAD SPECIAL �e PJ� F �A5 ❑ ACV ❑ AGREED AMT ❑ RC ❑ STATED AMT ❑ S LIMIT 7 CEO Z cg\\ < REMARK$(INCLUDING SPECIAL CONDITIONS I OTHER COVERAG 68) (AHQ,h ACORD I dd;donalR cAaduto, IF mom F"aa Is Awamd) Comprehensive deductible: 100; collision deductible: 500; Uninsured Material protection 250,0001500,OD0 ADDITIONAL INTEREST CANCELLATION Select one of IhB following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Intl Addleenat Mtertnt dosobod INImi line bw added to the PailMlaa) Wall Fatah by polay numow(o). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE n"M'e�atrat C:.nwHtdadisw V:D gd:IJrn,eline.. �t a.:.—ww eale:+wlne wnc>eeci DELIVERED IN ACCORDANCE WIT' THE POLICY PROVISIONS. VEHICLE I EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST X ACOTRONALINSUREO LOSS PAYEE NAME AND ADDRESS OF A01TRONAL INTEREST CITY OF SANTA ANA LENDER'S LOSS PAYEE 20 CIVIC CENTER PLAZA LOAN I LEASE NUMBER SANTA ANA, CA 92701 AUINORUED PRESE ' --IE-TV97.2015 AgORD CORPORAITN: IGAll rights reserved. ACORD 23 (2016103) The ACORD name and logo are registered marks of ACO D 4 1001381 fd]98).3 eI-E61tl14 aCt�A'C]' CERTIFICATE OF LIABILITY INSURANCE MIDDIVYYVf 3/21/2021/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions or the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER A J INSURANCE 1000 Macarthur Blvd #66 Santa Ana, CA 92707 N-2018-160 OP57419 W_ NAME CT PNGNE (714 673 5549 �"%� C. J:stl ..� ..... — At No$. pQRR:ajinaurance Va.Com INSURERS) AFFORDING COVERAGE NAIC» kI RA.MESA UNDERWRITERS SPECIALTY xNS. 36838 INSURED GALAXY PARTY RENTALS 2AVALA, ROBERTO AND EUGENIO PEREZ 11787 CARDINAL CIR GARDEN GROVE, CA 92843 INSURERS: INSURCRC msuRERo II F COVERAGES CPFTTIFIrATF NI IMFIFW 0C1/ICR1M elan.... 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 DE 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 BYPAID CLAIMS. Use I.TR TYPE OF INSURANCE NUMBERMe POLICY POLICY IUY yXy LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 000 000 COMMERCIAL GENERAL LIIABILITY F llfflION S 100 000 MEDEXP Arrane anon 5 5 000 CtAIMSMADE L^' OCCUR A 8 DED: $500 MP0004014000837 09/26/1709/26/18 PERSONAL. aADVINJURY 5 1 000 000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLI BPER: PRODUCTS CtlMPIOP AGOM-000PO I PRO OAUTOMOBILE LIABWTY COMB/ SN' EL IrANYAUTO BODILY INJURY(Par person) ALLOWNEO SCHEDULED AUTOS AUTOS AUTOS BODILY INJURY (Peraccleanl INOWOWNED ft0 Efi MAGHIREDAUTOS ec,eenUMBRELLA LIAS OCCUR EACH 0 CURRENCE EXCESSCIAIMS•MADE AGGREGATE DEB RETENTION WORKERS COMPENSATION AND EMPLOYERTUABILITY y�q ANY PROPRIETCRIPW17NERIE%ECUTIVE F�1 OFFICERIMEM6ER EXCLUDED? IL_!I NIA WC STAN OTH EL. FACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE 5 (M.tshtcry in NH) II sUeecebe under R TI N F P R T SCol. 1 CONTENTS: A PROPERTY MF0004014000837 69/26/1709/26/18 $250,0000 DED: $1,000 DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES IAeach AGORD UNAddillonat Rema,xs SCHeJula,irmonsPerefsrequima) PARTY RENTAL STORE: City of Santa Ana, its officers, agents and employees are named as additional inz��. I-� City of Santa Ana Public Library 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE THE EXPIRATION DATE T ACCORDANCE WITH THE POL AUTHORIZED REPRE / 1- Lil ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD '.LIED BEFORE DELIVERED IN All rights reserved. 0 ADDITIONAL INSURED ENDORSEMENT Insurance Company MESA UNDERWRITERS SPECIALTY INS. MPO� 00401ZT6�l t ,� Iifies such insurance as is offered by the provisions of Policy Number: relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured, 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature. is required to make this endorsement effective.) Effective 03 / O8 / 1$ this endorsement form part of Policy # MP0014014000137 Issued to (Name Insured) GALAXY PARTY RENTAL Countersigned by ACOK/7® VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE GATE (NMMDNM) 1 051111201E 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. This form Is used to report coverages provided to a single speoi9c vehicle or equipment. Do not use this form to report liability coverage Provided to multiple vehicles under a single POIICy. Use ACORD 25forthat purpose. PRODUCER C ME CT Sariah Devereaux $iYiiBFdRli Sariah Devereaux-Barrientca CNH MId: 714-541.7280 aC No: 714-384ryA892 State Farm Agent E'NAIL Sariah 7145417280com 1202 W lot St PRooucER OF33249 Santa Ana CA 92703 INSUREPAS) AFFORDING COVERAGE N ICa INSURED INSURER : State Farm Mutual Automobile Insurance Company 25178 Roberto Zavala Cardenas. NSURErG: s 14132 Kerry St. INSURER C: Garden Grove Ci+2844 'L•I7[•7�9q:[[9fdvl7x.T YEAR MAKEIMANUFACTURER MOOEL BODY TYPE VEHICLE IDENTIFICATION NUMBER _1994 GMC 3500 Box Truck I iGDKC34N9R3519011 DeSONPnON VEHICLFJEOUIPMeNTVALUE SERWLNUMBER S I COVERAGES CERTIFICATE NUMBER: REVISION NUMRFR! THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S) INOICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICYQES) DESCRIBED HEREIN ISfARE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). "SR LTR ADO'L menu TYPE OF INSURANCE POLICY NUMBER POUCYEFFECBVE DATE(MMIGOIYYYY) POLICY EXPIRATION OATE(MWODNYYYI LIMITS X VEHICLE LIABILITY COMBINED SINGLE LIMIT S A 7957781E-72-758 12/9212017 -121t2l2tl18 BODILY INJURY(Perpormn) S 1,000,000 BODILY INJURY (ParauNem) S 1,000,000 ' PROPERTY DAMAGE $ 1xio,o00 GENERAL LIABILITY EACH OCCURENCE S OCCURRENCE GENERALAGOREDATa S CLAIMS MADE to INSR LTR was AYEE TYPe OFINSURANCE POLICY NUMBER POUCYEFFECTIVE DATE(MMIDDIYYYYI POLICY EXPIRATION DATE(MWODW" LIMITSIDEOUCTIBLE VEH COLLISION LOSS ©ACV ❑AGREEDAMT $ UMIr ❑ ❑ STATEDAMT S DED VEHCOMP VEH OTC + Q ACV ❑ AGREEDAMT S LIMIT �.` ❑ ❑ STATED AMT S DED EQUIPMENT ---�nq 4 ❑ ACV ❑ AGREEO AMT BASIC BROAD SPECIAL V�\V �* �' f� ,` ❑ RC ❑ STATED AMY Cl It LIMIT E DED REMgRK3(INCLVOINO SPECIAL CONOmONS t OTHER COVERAGES)~h tOt,Ad k6 Remarks SoheOate, It man a pan is required) CDmprehensNe deduc0ble: 100; collision deductible: 500; Uninsured MI: it 250,0001500,000 ADDITIONAL INTEREST CANCEL I ATION Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The addvnN lotemat 4burlbed Wow has bean added to the pdicy(ies) Ivted homin by potoy%mber(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE A seat bee bean sabmillod to add the aabuonai interest dmdbad Move v the polirylvst a. DELIVERED IN ACCORDANCE WITH TH€PID CYPROVISIONE. VEHICLEI EQUIPMENT INTEREST: LEASED FINANCED DESGRtPTNJN OR IHEADDRNJNAL WTEREST X ADDDIONALINSURED LOSS PAYEE NAME AND ADDRESS OF AODITWNAL INTEREST CITY OF SANTA ANA LENDER'S 6436 PAYEE 20 CIVIC CENTER PLAZA LOAN I LEASE NUMBER J— SANTA ANA, CA 02701 AUTHDRIZEDR RESENTA 7• COR g is reserved. ACORD 23 (20103) The ACORD name and logo are registered marks of ACORD 9004161 102987.1 OtB&a116 ACPRb" VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE, DATE`MMu"m L..-"' bsnvaDle 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. This form Is used to report coverages provided to a single specific vehicle or equipment, Do not use this torn to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose, PRODUCER cc NAME6 Sedan Devereaux 5fateFarm Sarah Devereaux Bar arras ac° No E.1 714.541.7260 P"x . 714.384.3802 Slate Farm Agent ADO IE89: sadah 7145417280.com FRS° ° IOP. OF33249 ' 1202 W 191 St Santa Ana CA 92703 INSURERS AFFORDING COVERAGE NAICA INSURED INSURER A: Stale Farm Mutual Automobile Insurance Company 25178 EUGENIO PEREZ-MARTINEZ - INSURER D: 1427S DOUGLAS ST INSUFTER C : MBVRER O; SANTA ANA - CA 92704 INBVRER E: Ito] :[11;04 SItd11411P1a YEAR MARE I MANUFACTURER MODEL 800Y TYPE VEHICL610ENTIPICATION NUMBER " 2003 HINO F52620 I Boz Truck JHSFE2JG331S10052 DfiBCRiPRON VEHICL2ROUIPMENT VALUE SERIALNUMOER $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODS) INDICATED, NOTWITHSTANOING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCY(IES) DESCRIBED HEREIN tS/ARE SUBJECT 70 . ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES), INSR ADGT POLICYEPFECTIVE POLICYEXPIRATION LYR NsRn TYPE OF INSURANCE POLICY NUMBER DATE(MMMONYYI') DAMjMMNOrYYY) LIMITS X I VEHICLE LIABILITY COMBINED SINGLE LIMIT S A 5085359E11750 02I2212010 02J22/2019- BODILY INJURY(Par Poem) S 1�000,000 BODILY INJURY (PM RcoAenl) S 11000,000 PROPERTY DAMAGE S 1,000,000 GENERALLIASIRY EACH OCCURENCE S OCCURRENCE GENERAL AGGREGATE S CLAIMS MADE S INSR tm3e POLICY EFFECTIVE POLICY EXPIRATION ' LTR AYE TYPE OF INSURANCE POLICY NUMBER DATE (AMATDfWYY) DATE(MMIDOrYfYY) UMJTSIOEDUCT16Le ve" COLLISION LOSS © ACV ❑ AGREED AMT S LIMIT E3 ❑ STATED ANT S DEC VEHCOMPJ IvaHOTO El ACV ❑ AGREED ANT $ LIMIT V ❑ ❑ STATED AMT $ BED EQUIPMENT n� \rL ❑ ACV ❑ ADREEDAMT i 9 LIMIT BASIC BROAD Z� ❑ RC ❑ STATEDAMT SPECIAL -1ra� ❑ 1 CEO REMARKS (INCLUDING SPECIAL CONDITIONS/OTHER COVERAGE3)(ANaeh ACORD I9P%JdItI..IR dh.dulo. Ilm m ,..a Is q.1mid) Comprehensive deductible: 100: collision deductible: 500; Uninsured Motorist protedlon 250,000/500,000 ADDITIONAL INTEREST CANCELLATION Select one of the following. SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED The 4010net lNereat dasdremd below nos baen Added to Me PMlcAies) erred herein by Rolcynumnet(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE A mmHeesbaseeNt P,LehLNete aM'he eddNenN bdsee dw—�Fi terms m the mwies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.IIaIM vmoe VEN16lEf E0U1PMENT INTEREST: LEASED I FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST X AODMONALIRSURED LOSS PAYEE NAME AND ADDRESS OF ADDITIONAL INTEREST CITY OF SANTA ANA LENDER'S LOSS PAYER 20 CIVIC CENTER PLAZA LOAN F LEASE NUMBER SANTA ANA, CA 92701 AUTHORIZED PREBE --rM-T 97.2015 AC RD CORP0 7f ION: All rights reserved. ACORD 23 (2016103) The ACORD name and logo are registered marks of AC0 D (/ 1004301 142287.4 01-262010 WORKERS' COMPENSATION DECLARATION 1 Roberta Zavala hereby affirm under penalty of perjury, the (Nome!Title) following declaration I certify on behalf of _Galaxy Pay Rentals that during the term of my (Consultant/Company Name) contract for Santa Ana Public Library_ 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: 03/21/2018 By: Name: Roberto Zavala Title: Co -Owner Telephone: 714-569-1638 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES 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. CERTIFICATE OF LIABILITY INSURANCE 2/13/2019D YYY) 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 5 . PRODUCER A J INSURANCE 1000 Macarthur Blvd #66 Santa Ana, CA 92707 OF57419 CONTACT NAME P"°NE (714) 673-5549 FM AIC P E-DMAIE _imnsurance ive.com INSURERS AFFORDING COVERAGE NAIC# IN A MESA UNDERWRITERS SPECIALTY INS. 36838 f �'yy INSURED GALAXY PARTY RENTALS � �. L —1 �V INSURER B' ZAVALA, ROBERTO AND EUGENIO PEREZ INSURER C' INSURER D: 11787 CARDINAL CIR GARDEN GROVE, CA 92843 RER EINSURER E COVERAGES CERTIFICATE NUMBER: RFVI.RION NIIMRFR- 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 SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONSOF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMSINSR . LTR TYPE OF INSURANCE INSR MD POLL YN B MM/DD/YYYYY MM/DDNYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE s 1 000 000 MMXMPREMI E oIrmirosl $ 100 000 g COMMERCIAL GENERAL LIABILITY MED EXP An one rmn $ 5 000 CLAIMS -MADE 0OCCUR PERSONAL $AR $ 1,000,0001 A S DED: $500 MP0004014000837 09/26/18 09/26/19 AGG$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: -C $ 2 000 000 x POLICY PRO- LOG $ OMOBILE UABIUTY SINANYAUTO ffPRODUCTS RY$ALLOWNED SCHEDULED AUTOS H URY$AUTOS )NON -OWNED HIREDAUTOS AUTOS DA Peracci en $ UMBRELLA UAB OCCUR occ,MS-MADE EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB DED ETENTION WORKERS COMPENSATION WCSTATt ][ OTH- AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEMMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) ifyes, destn'be under DESCRIPTION F OPERATIONS W, P 1 rYqP&qP-POLICY LIMIT CONTENTS: A PROPERTY MP0004014000837 09/26/1809/26/1 $250,0000 DED: $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Aaach ACORD 101,Additimal Remaft Schedule, if more space is required) PARTY RENTAL STORE: City of Santa Ana, its officers, agents and earployees are named as additi wo001 d. City of Santa Ana Public Library 26 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DPMRIBED PO' Xg-BE CANCELLED BEFORE THE EXPIRATION DATE TI{EREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATI' ©1988-20 eserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT Insurance Company MESA UNDERWRITERS SPECIALTY INS. This n 0 rSITF&9Qq ifies such insurance as is offered by the provisions of Policy Number: MP relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective_ o 2 / i -� / ig , this endorsement form part of Policy # nrtpnnnan14nooR�7 Issued to (Name Insured) GALAXY PARTY RENTAL Countersigned by y y ACOR& VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE fmmmorYYY) 02/13/2019 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. This form Is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose. PRODUCER °°"T^°T Sariah Devereaux State&)IM Sarah Devereaux-Barrientos ac°Nro Ex: 714-541-7280 FA C. ND; 714-3843092 • State Farm Agent • • . 9 E-MAIL ADDRE s: SaLh3@714541728O.com cu0sr0orein ID :aLh3@74145417280.com 1202 W 1 st St Santa Ana CA 92703 INSURERS AFFORDING COVERAGE NAICX INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178 Roberto Zavala Cardenas & Cristina Zavala Reyes INSURER B: DBA Galaxy Party Rentals INSURER C : 14132 Kerry St INSURER D ; GARDEN GROVE CA 9284$ INSURER E: DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE I MANUFACTURER MODEL BODYTYPE VEHICLE IDENTIFICATION NUMBER 1994 1 GM( 3500 Box Truck 1GDKC34N9RJ519011 DESCRIPTION VEHICLEJEQUIPMENT VALUE SERIAL NUMBER COVERAGES CERTIFICATE NUMBER' RFVICITIN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S) INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICY(IES) DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). INSR LTR ADDL INSRD TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE DATE(MMIDDNYYY) PODCYEXPMATKIN DATE(MLVDbNYYY) LIMITS X I VEHICLE LABILITY COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per pomm) $ A 1957791-F12.75B 02/13/2019 12/12/2019 BODILY INJURY (Pm accident) $ PROPERTY DAMAGE $ GENERALLMSILITY EACH OCCURENCE $ OCCURRENCE GENERAL AGGREGATE $ CLAIMS MADE Med Pay $ 5,000 INSR LTR Lose A TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTNE DATE(MMIDOIYYYY) POLICYEXPIIIATNON DATE (MI DD/YYY'n LIMITS I DEDUCTIBLE VEH COLLISION LOSS - ❑` ACV ❑AGREED AMY $ LIMIT ❑ ❑ STATED AMT f DEC, VEH COMP VIER OTC ❑' ACV ❑AGREED AMT $ LIMIT ❑ ❑ STATED AMT f DED EQUIPMENT ❑ ACV [I AGREED AMT BASIC R BROAD SPECIAL ❑ RC ❑STATED AMT ❑ $ LIMIT f DED REMARKS (INCLUDING SPECIAL CONDRION$ I OTHER COVERAGES) (Atfaah ACORD 101, Additional Remarks Salwdui. if men apace is mquln ) 1 1'�� Comprehensive deductible: 100; Collision deductible: 500; Uninsured motorist protection: 250,000/500,000 :A\Ik ADDITIONAL INTEREST CANCELLATION 1�— "I Ilia' Select ors of the following: SHOULD ANY OF THE ABOVE DESCR FEQL-)CI E'CANCELLED Theetlditionel interestdmaibed bebr has bean added mow pdig(ias)Ilsled herein by pdicy numbar(s). BEFORE THE EXPIRATION DATE ILL BE A has Deer) submiMul m and the additimal interest descabad below to Me policy(m) DELIVERED IN ACCORDANCE P 11'PROVISIONS. Munt m n —e VEHICLE I EQUIPMENT INTEREST: I ILEASED I I FINANCED DESCRIPTION OF THEADD LINTERGa t-' X ADDITIONALINSURED RLOSSPAYEE NAME AND ADDRESS OF ADDITIONAL INTEREST LENDER'S LOSS PAYEE CITY OF SANTA ANA LOAN /LEASE NUMBER 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 AurHORIZED REPRESENTA 01997-201S ACORD CORPO,R74TION. All rights reserved. ACORD 23 (2016/03) The ACORD name and logo are registered marks of ACORD 1004361 14nfr`3 01-2&2016 WORKERS' COMPENSATION DECLARATION I Roberto Zavala hereby affirm under penalty of perjury, the (Nmelritle) following declaration: I certify on behalf of Galaxy Party Rentals that during the term of my (Consulmt/Company Name) contract for Santa Ana Public Library 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: 2/19/19 By: Name: Roberto Zavala Title: Co -Owner Telephone: 714-569-1638 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.