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HomeMy WebLinkAboutDREAM SHAPERSuSUF',�CE ON FILE N-2018-128-01 W01", MAY PROCEED 1IIi ;I,.INSURANCE EXPIRES CQUNCIL TE. P1AR Q 4 2019 A `j FIRST AMENDMENT TO SPEAKERIPERFORMER ® AGREEMENT WITH DREAM SHAPERS THIS FIRST AMENDMENT to the above -referenced agreement is entered into on February 7, 2019, by and between Dream Shapers ("Speaker/Performer"), 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"). RECITALS A. The parties entered into Agreement #N-2018-128 dated June 28, 2018 ("Agreement"), by which Provider agreed to provide variety -type performances to entertain patrons. The term of the Agreement is from July 1, 2018 through June 30, 2019 and is still in effect. B. The parties agree and understand that the Agreement shall be amended to revise and replace the prior scope of work and include a provision that all performers undergo a LiveScan background check and comply with the City's policies and codes of conduct. The Parties therefore agree: 1. Section 1 is amended as follows: 1. Event Description: Variety -type performances to entertain patrons with performances selected and agreed upon by the parties per Exhibit A-1, attached hereto to this First Amendment. Exhibit A -I shall replace Exhibit A to the Agreement. 2. Section 9 is amended to add the following: Speaker/Performer contracts with third parties for the services listed in Exhibit A-l. Speaker/Performer will require pursuant to written agreement that all third parties performing work pursuant to this Agreement, shall adhere to all of the terms of this Agreement between Speaker/Performer and City. 3. Section 18 shall be added to the Agreement and read: 18. LiveScan Background Check and City policies: Speaker/Performer shall arrange for and confirm, in writing with the City, that any of its performers, speakers, employees, subcontractors or substitutes, have submitted to a Live Scan electronic background check for criminal history available through the California Department of Justice as a condition of this Agreement and provide proof of compliance prior to performing services hereunder. Speaker/Performer shall also include in its contract or agreements with its performers, speakers, employees, subcontractors or substitutes that they shall comply with all the terms of the City's Agreement with the Speaker/Performer including, but not limited to, the LiveScan requirements and the City's insurance requirements. 4. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date and year first written above, ATTEST • y Wes"' h APPROVED AS TO FORM SOMA R. CARVALIIO, City Attorney By: .) �n J K (t {4 t4 l V LAURA A. ROSSINI Senior Assistant City Attorney RECOMMENDED FOR APPROVAL: n We Director, Recreation and Community Services Agency CITY OF SANTA ANA STEVEN MENDOZA Acting City Manager DREAM SHAPERS By: Title: (<A')jk e— rxt� [Signature Page — First Amendment to Dream Shapers Agreement (#N-2018-128)] Exhibit A-1 SCOPE OF SERVICES VENDOR INFORMATION: Dream Shapers P.O. Box 3831 Orange CA 92865 (714)771-1981 EVENT: Variety Type Performances SERVICE DATE(S): July 1, 2018 through June 30, 2019 COMPENSATION: Not to exceed $5,000 DESCRIPTION: This vendor will provide entertainment performances from the list below for the period of July 1, 2018 through June 30, 2019. The total amount for this Agreement shall not exceed $5,000. The various performances will range in cost per the list below and is at a cost per per performance. Performances will be presented at any of the following locations: Main Library, 26 Civic Center Plaza, Santa Ana CA 92701, the Newhope Library Learning Center, 122 N. Newhope Street, Santa Ana CA 92703, Centennial Regional Park, 3000 W. Edinger Avenue, Santa Ana CA 92704 and Plaza Calle Cuatro- 325 E. 0' St., Santa Ana CA 92701. Location, Date of event and event time will be mutually agreed in writing by the parties when scheduled. 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. City staff will be present at all times during the performance. List of Performers — Types of Performance — Rates Brettso the Great (magic, balloons) $300 Ken Frawley (music, storytelling, puppets, trick roping) $325 Joe Gandelman (ventriloquism) $300 Rebecca Martin (storytelling, puppets) $300 Michael D. McCarty (storytelling) $330 Chazz Ross (percussion) $345 Christopher Yates (circus arts including juggling, balloons, unicycle, stilt walking, music, magic) $320 ***Christopher already completed his live scan Ranger Jack (music, puppets) $345 Teresa Smith (dance) $325 Arty Loon (magic, balloons, puppets) $325 Auntie Kayte (children's music) $300 Dennis Forel (balloons) $315 Georgia Frawley (American Sign Language) $325 Zoomation (animals, puppets, songs) $325 ACIQR[- CERTIFICATE OF LIABILITY INSURANCE DATE (hIMIDD,YYYYI 09(2572018 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 Pobcy(les) must have ADDITIONAL INSURED provisions or be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the Polley, 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 NAME, DlAnlla Maf1la Ali-605 PHONE 1, (916)7049070 �a Nnt (91S)78A-U15R Vernonal StreAgency 805 VrOn Street ADDaSEE: diarimsoialicalinsurance.com INSURERS AFFORDING COVERAGE NAICN Roseville CA 95678 INSURERA: Nonprofits' Insulance Alliance Of California 011845 NSURED INSURER : Stela Compensation lDSUrantrl Fund 35076 The LDS Angeles Dream Shapers P.0 Box3831 INSURER C — INSURER D: INSURER 9: Orange CA 92865 INSURERF: R IV VIO THIS IS TO CC-RTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOOP R THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR O'THERDOCUMENT 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 OP SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOFINSURANCE —ADO INSD SI VIVID POLICY NUMBER LI MMIDDIYYVV MMMOrfYYY LIMITS__ x COMMERCIAL GENERAL LIABILITY CWIMS•MAOE ® OCCUR EACH OCCURRENCE S 1,000,000 f $00,000 X Liquorllability PREMISE' Eaommm�ce> S MEDEXP n onepe,som 3 20,000 A Y 2018-08000NPO OW13/2018 W/13(2010 $1,000,000/1,000,000 PERSONAL&AOV INJURY S 1.000.000 AGGREGATE LIMIT APPLIES PER POLICY ❑jet,{ GENERALACOREQATE $ 2,000,000 GENT. N+ PROOUCi9-GP41ploP AGO S 2.000,000 LGC OTHER. S AUTOMOBILE LIADIUTY COhI IN -0 SINGLE LIMIT 3 1,000,000 O Ea epeaenp BODILY INJURY (Per per,") S A 2018-08609NPO 08/13/2010 06IM2019ONLY ONLY !YComp/Colt LD JUMOREL;LAUAB deductible S 500 EACHOCCURReNCE S -MADE AGGREGATE S ETENTION S S �— WORKERS COMPNSATION ANDE6PLOVER3LIABILTY SRH- YfN EL. EACFf (u:C10EPIT 3 1,000,000 B ANY MPARTHEMX OFFICER)`EMBPR EXCLUDED? ECUTIVE ❑ NIA 9010327-18 O6A16J2018 06V06/2U79 E.L. DISEASE -EA EMPLOYEE 3 1,000,000 (Afnaaalary In NH) IP))es,RIPTIOa antler EL. DISEASE - POLICY LIMIT S t,000,000 UESCWPTIpDI OF OPERATIONS CaIrnv DESCRIPTION OF OPERATIONS( LOCATIONS I VEHICLES IACLTRO 101,Addiftoal Reloatks Se6edule, nmy be aliacUea lTmore spa�eM Rgviretli `(�`1y The City of Santa Ana, Its officers, agents, Employees and Volunteers a(a named additional insured under their contract terms. Cover,Rge is at$r And norI'COnmbutorp and Form CG 20 26 applies A �- Y a "—••••• •••••••, •••••••", UANUt LLATIUN •((�}}jr`Yv^��TL [• SHOULD ANY OF THEABOVE ESCRIBELj�iILYCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 1" �yy{{rr l�.y TV ^r Vet ®198U-2016 ACORD CO PO RATION. Aff7killis, reserved, nv�rvun ca 14V InIVJ} I no ACURO name slid logo are registered marks ofACORD POLICY NIPIBER: 2018-08609NPO COMMERCIAL GENERAL LIABILITY CG 20 26 Od 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or¢nilzation(a) Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during tine teen of this policy, The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. The City, of Santa Ann, its officers, agents, employees and volunteers are named additional insured tinder their contract terms. Coverage is primary and non-contributory and Form CG 20 26 applies �d'wmation 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 included as an additional insured the persons) or organizations) 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 your acts or omissions or the acts or omissions of those acting on your behalf: I. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However; I. 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 broader than that which you are required by the contract or agreement to provide for such additional insured. & With respect to the insurance afforded to those additional insureds, the following is added to Section 111— Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the naost Nye will pay oil behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. CG 20 26 04 13 Copyright, Insurance Services Office, Inc., 20t2 Page t of I NONPROFITS POLICY NUMBER: 2018.08609 FORM: NIAC-E61 11 17 ® INSURANCE NAMED INSURED: Los Angeles Dream Shapers (The) ALLIANCE Of CALIFORNIA A Head for Insuronca. A Heart for Nonprofits. 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 fallowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization; (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 any public entity as an additional insured for whom you are performing operations, who may be named In the schedule above, 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 injunf, "property datnaga" 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 pubic 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 (otherthan 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 Ill — 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, whichevt[Wl less. These limits are part of and not in addition to the limits of insurance under this policy. 'tie NIAC-E61 11 17 \� j�r� G t Q k y\� page I of 2 NONPROFITS POLICY NUMBER:2018.08609 FORM: NIAC-E61 11 17 INSURANCE NAMED INSURED: Los Angeles Dream Shapers (The) NO ALLIANCE Of CALIFORNIA A Head for Insurance. A Heartfor Nonprofits. D. A. 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. Otherinsurance 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 all that other Insurance as described In c. below; or (2) The coverage afforded by this Insurance is primary and non-contributory with the additional insured(s)' awn insurance, Paragraphs (1) and (2) do not apply to other insurance to which the additional inured( 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. (a) 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 insurad(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 co22�first, If any other the other insurance available to the additional insured(s) doepermit contri on by equal shares, we will contribute by limits. Under this method, each in share Is b don the ratio of its applicable limit of insurance to the total applicable limits of 0r ce ail ins L%:J NIAC-E61 11 17 �jPage 2 of 2 4� ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `/ 05/15/2019 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 endomement(s). PRODUCER CONTACT DiAnna Martin NAME: All -Cal Insurance Agency AIc No Eat: (916)784-9070 FAX, NoJAIC1: (916J 784-0158 505 Vernon Street E-MAIL dianna@all-cafinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAICN Roseville CA 95678 INSURER A: Nonprofits' Insurance Alliance of California NIAC INSURED INSURER B: INSURER C: The Los Angeles Dream Shapers N D �'p�,� P.G. BOX 3831 lV_�,O I�_f 3��' INSURER D: NSURER E : Orange CA 92865 1 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1951508301 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE OF INSURANCE INSD MD POLICYNUMBER POLICY EFF MMIDDn'YYY POLICY UP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE $ 1,000,000 OAMAUL KILN LU PREMISES Ea occurrence) $ 500,000 X MED UP (Any one person) $ 20,000 Liquor Liability $1,000,000/1,000,000 PERSONALSADV INJURY $ 1,000,000 A Y 2019-OB60gNPO 06/13/2019 06/13/2020 GEN'LAGGREGATE X LIMITAPPLIES PER: POLICY DPRG ❑ JECT LOC GENERALAGGREGATE s 2.00O,000 PRODUCTS - COMPIOP AGO $ 2,000,000 Increased Aggregate s OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadent s 1,000,000 BODILY INJURY (Per person) $ ANVAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 2019-08609NPO 06/13/2019 06/13/2020 BODILY INJURY (Per accident) $ X HIRED H NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraoddenl $ Comp/Coll deductible s 500 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE IS EXCESS LIAB CLAIMS -MADE OEO I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) It yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below e DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) p�-� Cityof Santa Ana, its officers, agents, employees, representatives and volunteers are named additional insured under their cont l'�P2rITS yq/r�e�'agIs aC, primary and non-contributory, and Form CG 20 26 applies. City of Santa Ana 20 Civic Center Plaza Santa Ana CA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1D 1989-2016 All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACUti^ NONPROFITS POLICY NUMBER: 2019-08609NPO FORM: NIAC-E61 11 17 INSURANCE NAMED INSURED: The Los Angeles Dream Shapers �9 ALLIANCE OF CALIFOILNIA A Head for Insurance. A Heart for Honprof/ts. 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 SCHEDULE Name of Person or Organization: City of Santa Ana, its officers, agents, employees, representatives and volunteers A. Section II — Who Is An Insured is amended to include any public entity as an additional insured for whom you are performing operations, who may be named in the schedule above, 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: 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 pubic 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: I. 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 ope tions or a principal as apart of the same project. �eDv�1 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 thi2itten co 46en you and the additional insured(s), or the limits available under this policy, whichever are less. Thy' part of and not in addition to the limits of insurance under this policy. NIAC-E61 11 17 Q� Page 1 of 2 NONPROFITS POLICY NUMBER:2019-08609NPO FORM:NIAC-E611117 INSURANCE NAMED INSURED: The Los Angeles Dream Shapers ALLIANCE OF CALIEORNIA A Head jor Insurance. A Heartfor Nonprofits. D. A. 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: 3. Other Insurance 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 all that other insurance as described in c. below; or (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. 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 Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing 0�\e ` (J—/ �C If all of the other insurance available to the additional insured(s) permits contribution b� equal shay we will follow this method also. Under this approach each insurer contributes equal amounts u paid its applicable limit of insurance or none of the loss remains, whichever comes first. �J If any other the other insurance available to the additional insured(s) does not permit c Abut' y equal shares, we will contribute by limits. Under this method, each insurer's share is Sased on le ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 11 17 Page 2 of 2 POLICY NUMBER: 2019-08609NPO COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. City of Santa Ana, its officers, agents, employees, representatives and volunteers 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 included 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 broader 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 is added to Section I I I — 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 contract or agreement; or 2. Available under the applicable limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. 6 Q� C CG 20 26 04 13 Copyright, Insurance Services Office, Inc., 2012 Page I of I WORKERS' COMPENSATION DECLARATION I T4.e iguuag'f G"hereby affirm under penalty of perjury, the (Nmndritle) following declaration I certify on behalf of �� �fiafring the term of my 3u i nUCompaM Ne ) ^ (Cauulle contract for 4:�°� ` rr�i'r °' T 1lrservices 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: v a� By - Name: Title: f >r+t Gi Q. Telephone: .I N • `1-1 N ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL 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.