HomeMy WebLinkAboutSTUDIOFOLIA INCINSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES DEC P 0 2019 N-2019-251
0Z/Ot/Z6ZO
CLERK OF COUNCIL
DATE: AGREEMENT WITH STUDIOFOLIA TO PROVIDE
0: cA&0-(raver Le AS PROJECT MANAGEMENT SERVICES
THIS AGREEMENT is made and entered into on this 25T" day of October, 2019 by and between
Studiofolia, Inc. a California corporation ("Consultant'), 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 City desires to retain a consultant having special skill and knowledge in the field of
project management for the Willits & Sullivan Beautification Project Permanent Display
(a public art project).
B. Consultant represents that Consultant is able and willing to provide such services to the
City.
C. In undertaking the performance of this Agreement, Consultant represents that it is
knowledgeable in its field and that any services performed by Consultant 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:
1. SCOPE OF SERVICES
Consultant shall perform during the term of this Agreement, the tasks and obligations
including all labor, materials, tools, equipment, and incidental customary work required to fully
and adequately complete the services described and set forth in Scope of Services - Exhibit A,
attached hereto and incorporated by reference.
2. COMPENSATION
a. City agrees to pay, and Consultant agrees to accept as an amount not -to -exceed $22,0,00
during the term of this Agreement. Compensation shall be divided into two (2) separate
payments. The first amount in $1,000 shall be issued after final execution of the
Agreement. The second payment shall be issued upon the completion of the project.
b. Payment by City shall be made within forty-five (45) 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.
Page 1 of 8
3. TERM
This Agreement shall commence on the date first written above for a one (I year term
with the option for the City to grant up to a one. (.1-) year renewal, exercisable by a writing by the
City Manager and the City Attorney, unless terminated earlier in accordance with Section 15,
below. Consultant understands that payment will not be issued until completion of the project,
which may go into any extension period agreed upon by the Parties.
4. INDEPENDENT CONTRACTOR
Consultant 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 Consultant
performs the services which are the subject matter of this Agreement; however, the services to be
provided by Consultant shall be provided in a manner consistent with all applicable standards and
regulations governing such services. Consultant 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.
5. OWNERSHIP OF MATERIALS
This Agreement creates a non-exclusive and perpetual license for City to copy, use,
modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property
embodied in plans, specifications, studies, drawings, estimates, and other documents or works of
authorship fixed in any tangible medium of expression, including but not limited to, physical
drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or
caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant
shall require all subcontractors to agree in writing that City is granted a non-exclusive and
perpetual license for any Documents & Data the subcontractor prepares under this Agreement.
Consultant represents and warrants that Consultant has the legal right to license any and all
Documents & Data. Consultant makes no such representation and warranty in regard to
Documents & Data which were provided to Consultant by the City. City shall not be limited in
any way in its use of the Documents and Data at any time, provided that any such use not within
the purposes intended by this Agreement shall be at City's sole risk.
6. INSURANCE
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
Page 2 of 8
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. -If Consultant is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit
of not less than $1,000,000 per claim with $2,000,000 in the aggregate.
e. 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.
f. 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.
Page 3 of 8
7. INDEMNIFICATION
Consultant agrees to defend, and shall 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
negligent operations of the Consultant, its subcontractors, agents, employees, or other persons
acting on its 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. 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 Consultant
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. Notwithstanding the foregoing,
to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity
shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of,
pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant.
8. INTELLECTUAL PROPERTY INDEMNIFICATION
Consultant shall defend and indemnify the City, its officers, agents, representatives, and
employees against any and all liability, including costs, for infringement of any United States'
letters patent, trademark, or copyright infringement, including costs, contained in the work product
or documents provided by Consultant to the City pursuant to this Agreement.
9. RECORDS
Consultant shall keep records and invoices in connection with the work to be performed
under this Agreement. Consultant shall maintain complete and accurate records with respect to
the costs incurred under this Agreement and any services, expenditures, and disbursements
charged to the City for a minimum period of three (3) years, or for any longer period required by
law, from the date of final payment to Consultant under this Agreement. All such records and
invoices shall be clearly identifiable. Consultant shall allow a representative of the City to
examine, audit, and make transcripts or copies of such records and any other documents created
pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all
work, data, documents, proceedings, and activities related to this Agreement for a period of three
(3) years from the date of final payment to Consultant under this Agreement.
Page 4 of 8
10. CONFIDENTIALITY
If Consultant receives from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Consultant 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. "Confidential Information" shall include all
nonpublic information. Confidential information includes not only written information, but also
information transferred orally, visually, electronically, or by other means. Confidential
information disclosed to either party by any subsidiary and/or agent of the other party is covered
by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any
information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the
Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant
without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e)
is independently developed by the Consultant without reference to information disclosed by the
City.
11. CONFLICT OF INTEREST CLAUSE
Consultant 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.
12. NON-DISCRIMINATION
Consultant 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. Consultant affirms that it is an equal opportunity employer and shall
comply with all applicable federal, state and local laws and regulations.
13. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Consultant, 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 Consultant. 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 Consultant or 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 is not embodied herein.
Page 5 of 8
14. ASSIGNMENT
Inasmuch as this Agreement is intended to secure the specialized services of Consultant,
Consultant 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 subject to this
Agreement performed by City personnel or by other consultants retained by City.
15. TERMINATION
This Agreement may be terminated by the City upon thirty (30) days written notice of
termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant
compensation for all services performed by Consultant prior to receipt of such notice of
termination, subject to the following conditions:
a. As a condition of such payment, the Executive Director may require Consultant to
deliver to the City all work product(s) completed as of such date, and in such case
such work product shall be the property of the City unless prohibited by law, and
Consultant consents to the City's use thereof for such purposes as the City deems
appropriate.
Payment need not be made for work which fails to meet the standard of
performance specified in the Recitals of this Agreement.
16. WAIVER
No waiver of breach, failure of any condition, or any right or remedy contained in or
granted by the provisions of this Agreement shall be effective unless it is in writing and signed by
the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or
remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not
similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies.
17. 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.
18. PROFESSIONAL LICENSES
Consultant 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. Consultant shall notify the City immediately and
Page 6 of 8
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.
19. 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 City 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 courtesy copies to:
Executive Director,
Community Development Agency
City of Santa Ana
20 Civic Center Plaza (M-25)
P.O. Box 1988
Santa Ana, California 92702
Fax:714-647-6549
To Consultant:
James Dinh
Owner
Studiofolia,Inc.
12723 Park Street
Cerritos, CA 90703
A party may change its address by giving notice in writing to the other party. Thereafter,
any communication shall be addressed and transmitted to the new address. 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.
Page 7 of 8
20. MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature herein below 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
attomey'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 forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
"tilt I D&W
:fry,
APPROVED AS TO FORM:
SONIA R. CARVALHO
City Atto�y A
By: '
Ryan
I�X�L�]uls•1_�I_►1�1�111��1.1�9.��1�1_�RI
Steven Mendoza
Executive Director,
Community Development Agency
CITY OF SANTA ANA
iv�00'�
Kristine Ridge
City Manager
CONSULTANT:
Jam46inh
Owner
Page 8 of 8
EXHIBIT A
SCOPE OF SERVICES — Willits & Sullivan Beautification Project Permanent Display
• Responsible for facilitating the construction and installation of public artwork and
tracking public art project to ensure artwork is completed and installed within budget and set
timelines.
• Review applications and attend selection panel convening.
• Coordinate project meetings with artists, contractors, and city staff.
• Liaison between artist and Abraham Lincoln Elementary School.
• Direct and coordinate project support services throughout the construction process.
• Confers and works with artists throughout the design, development, construction, fabrication,
and installation phases of a project to resolve construction and installation issues as they arise
A` ORO® CI
THIS CERTIFICATE IS ISSUED AS A MATTER OF I
AMEND, EXTENOOR ALTER THE COVERAGE AF
AUTHORIZED REPRESENTATIVE OR PRODUCEI
IMPORTANT: If Me certfficats holder Is an ADD
canditionsofthe Poilry, certainpolkles may it
PRODUCER
Kathy Lamm(975534H)
2915 Red Hill Ave Ste F201
Costa Mesa CA 9262
I INSURED
DINH, JAMES
STUDIOFOLIA
12723 PARK ST
CERRITOS CA
COVERAGES
THIS S TOCERTIFYTHATTHE POUCIES OF INSUR
REQUIREMENT. TERM ORCONDITION OF ANYCO
POLICIES DESCRIBED HEREIN 15 SUBJECT TOALLI
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CLAIMS MADE X - OCCL
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WORKERSCOMPENSATION
AND EMPLOYERS' LIABILDY
ANY PROPRIETOWPARTNERi
EXECUTIVE OFFICER/MEMBER
EXCLUDED? (Mandatory in NH)
If yes. describe under DESCRIPT'ON OF
OPERATIONS below
ICATE OF LIABILITY INSURANCE DATE(MM/DO;YYYY)
1o/2e/zols
ONLYAND CONFERS NO RIGHTS UPONTHE CETITIFICATE HOUER.THISCERTIFICATMIOE AFFIRMATIVELYOR NEGATIVELY
BE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSmUTE A CONIMCTB EEN THE ISSUING INSURER(S),
RTIFICATEHOLDER.
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chendorsement(s).
CONTACT
NAME'
PHONE FAX
(A/c. NO, E%T): 866-416-8939 (A/C•N ):866.416-8939
E-MAII
ADDRESS: klamm@famlersagent.com
428
INSURER(S)AFFORDING COVERAGE
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INSURER B: Farmers Insurance Exchange
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INSURFRC: Mid Century Insurance Company
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ACORD25(2016/03) f198&2015 SAC CORP RATION. All Rights Reserved
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CITY OF SANTA A.
RISK MANAGEMENT d,*v oN HUMAN RE5OURc
ADDITIONAL INSURED ENDORESEMENT
Insurance Company: «, r �t -, l _r
This endorsement modifie such insurance as is afforded by the provisions of
Policy # uPc- , I ? relating to the following - A" t i c, ^ C ��
1. The City of Santa I Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its fficers, employees,
agents and volunteers are nameV as additional insureds ("additional insureds") with reg rd to liability and
defense of suits arising f m t e operations and uses performed by or on behalf of the amed insured.
2. With respect to claillns ari Ong out of the operations and uses performed by or on b half of the named
insured, such insurance a Iis a orded by this policy is primary and is not additional I r contributing with
any other insurance carrieq by o for the benefit of the additional insureds.
3. This insurance apj
with respect to the con
shall not affect any right
4. With respect to
in coverage or limits ex
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Completion of the
Effective
Policy #
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rately to each insured against whom claim is made or sui is brought except
nits of liability. The inclusion of any person or organ iz tion as an insured
ch person or organization would have as a claimant if not so included.
Inalinsureds, this insurance shall not be canceled, or aterially reduced
thirty (30) days written notice has been given to the C ty of Santa Ana, 20
,rnia 92701.
countersignature, is required to make this endorsement effective.
this endorsement form as a pgrt of
(Named Insured)
REVIEWED 8 Ag
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ENDORSEMENT CHANGES THE POLL• (. PLEASE READ ITCAREFULLY,
POLICY
FARMERS 16840
INSURANCE 2nd Edition
AL INSURED - SCHEDULED PERSON
ORGANIZATION
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
BUSINESSOWNERS COMMON POLICY CONDITIONS
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unl ass modified by the
endorsement.
SCHEDULE
'Name Of Additional Insured Per n(s) CITYOFSANTAANA,ITSOFFICERS
Or Organization(s): EMPLOYEES, AGENTS & VOLUNTEERS
II
Location Of covered Ope tion(8): 12723 PARK ST
CERRII'OSCA90703
Effective Date Of Endors ment: 10/28/19 If no entry appears above, f formaion required to complete this endorsement wllibeshown In the Decla dons. _1I
The BUSINESSOWNERS LIA131LITY COVERAGE FORM is amended as follows:
A. With respect to theadd tional Insured described In Paragraph B. of this endorsement, the following e) cl Uslons are added
to Paragraph 1. Applicable To Business Liability Coverage under Section B.Exclusions:
This insurance does not apply
1. "Bodily injury" or ' rope damage" for whkh the additional insured(s) is obligated to
the assumption of I ability in a contract or agreement. This exclusion does notapply to liability for dam ge thatthe
additional insured( )would have In the absence ofthecontract or agreement.
Z. 'Bodily Injury" or" ropedamage" occurring after:
a. Your ongoing operat ons at the location of covered operations other than service maintenance or repairs
performed by you or on your behalf have been completed: or
b. The portion of your ongoing operation out of which the "bodily Injury" or "property damage" arises has been
PuttoltsintenqieduseIIby any person or organization.
But in no event shal this In'urance apply to"bodily injury" or "property damage" arising out ofyour operations that
were completed prior to the effective date ofth is endorsemen t.
3. "Bodily injury" or " 3roperty damage" arising Out Of any act or omission of the additional insu d(s) or any of its
"employees", agen s or c tractors other than you, except for general supervision by the addit onal insured(s) of
yourongoing opera Ions performed for thatadditional insured.
4. "Property damage" o:
a. Property owne , used or occupied by or rented to the additional lnsured(s);
b. Property in thE care cUstody or control of the additional insured(s) or over which the ad itional Insured(s)
exercise physic if control; or
c. Any work inclu g m�terials, parts or equipment furnished in connection with such work hich is Performed
fortheaddMon sured byyou.
j6840-209-18
ED�c des copyrighted material of Insurance Services office, Inc., with its pe,missron.
93 6e4o Page 1 of 2
1 J6840201
B. Section C. Who Is AI
Schedule, but only to
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1. Primaryand
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2. Excessinsuri
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16840-ED209-18
93-6840
surd is amended to include as an insured the person(s) or organization(s) shown in the
ext nt that the additional insured(s) is held liable for "bodily injury" or 'property damage"
by:
ens erformed forsuch person or organization at the location designatedove;
oty ur subcontractors acting on "your" behalf on the scheduled project in he performance of
ms rthe additional insured(s) which start and are completed within the effective periodof
additional insured(s) in connection with its general supervision of ch operations.
it, "wrap up policy" means an Owner or Contractor Controlled Isurance Program
as designed to cover a specific construction project that Insures all of the persons and
N POLICY CONDITIONS are amended as follows:
all. insured described In Paragraph B. of this endorsement, Section H. ther Insurance is
neor#ributory insurance
)vided to an additional Insured under this endorsement shall be primary a d noncontributory
rance issued directly to the additional insured if:
Insur d agreed in a written contract or written agreement to provide the additional insured
a prl;ary and noncontributory basis;
i contract or written agreement referenced in a. above was executed prioi to the issuance of
designated herein hasa policy with an Other Insurance provision (making that policy
"wrap up policy" in effect for the work performed at the location designated in the Schedule of
valid
collectable insurance available to the additional insured(s) as an dditional insured
ing the work performed at the location designated and described in the schedule of
urance will be excess over those policies.
It supersedes and controls anything to the contrary. It
services Office, Inc., with Its permission.
subject to all the
Page 2 of 2
36840202
1�
I
following declarat;
I certify on
contract with the S
any person in any r
California, and agr
provisions of Secti
provisions.
DATE: Septen
WARNING: R
UNLAWFUL, i
AND CIVIL Fn
ADDITION TO
IN SECTION 3'
hereby affirm under penalty of pe�ury, the
of Studiofolia that during the tern of my
(Organization Name)
fthy Dev�etonment Agency, City of Santa Ana, I will noi employ
so as to become subject to the workers' compensation 1 aws of
if I should become subject to the workers' comoensati n
m 377 of the Labor Code, I shall forthwith comply with tho;
ber 23, 2019
By:
Name:
Title:
Telephone:
James Dinh
JRE TO SECURE WORKERS' COMPENSATION COVERAGE
IS
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN
TIES
UP TO ONE HUNDRED THOUSAND DOLLARS ($lOQ,
). IN
E COST OF COMPENSATION, DAMAGES AS PROVIDE
a FOR
OF THE LABOR CODE, INTEREST, AND ATTORNEY'S
FEES,
& Al"PRO-VED
•,,.c xi<:V DivisiO:N
12019
M. LAMBERT
tudi lia
12723 Park Street Ce ritos, A9�703 1562.941.2512 1 james@studlofolia.com
October 10, 2019
To Whom It May
I will not be using a ehicl (any owned, rented, or non -owned automobiles) for
the Willits & Sullival Beau ification Project Permanent Display. The term of my
year from the signin oft a agreement.
James Dinh
AI'P ROVED
'PIF1r DiViSION
12019
M. LAMBERT
s related to
will be one
studi
12723 Park Street
November 14,
To Whom It May
I will not be hiring a
contract, which will
Sincerely,
James Dinh
CA 90703 1 562.841,2512 1 james@studiofolia.com
d professional such as an architect or engineer for the
year from the signing of the agreement.
D ei .A6'MOYLD
2120,19
M. L %ji1 :f;r
diofoha.com
of my