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HomeMy WebLinkAboutULTIMATE ATTRACTION, LLCaTON f O o�. P R.c sa u1 (S� i0.1JU')�es� 1SICE: NOT ON FILE NOT PROCEED CLERK OF COUNCIL DATE: N-2022-169 AGREEMENT WITH ULTIMATE ATTRACTION, LLC, TO PROVIDE OUTDOOR INFLATABLE ATTRACTIONS THIS AGREEMENT is made and entered into this I4�lay of June, 2022, by and between Ultimate Attraction, LLC, ("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'). RECITALS A. The City desires to retain a contractor to fiunish inflatable attractions for its Juneteenth and Fourth of July Celebration events. 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 its field and that any services performed by Contractor under this Agreement will be perforated in compliance with such standards as may reasonably be expected. 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 a Contractor shall famish inflatable attractions, including setup and teardown, as well as the equipment and staff necessary to operate the attractions, as more fully described in Exhibit A attached hereto and incorporated by reference. b. City grants Contractor the right to enter its property for the purpose of delivery, set-up, operation, and pick-up. C. The equipment shall be disassembled and removed by Contractor at the conclusion of each event. 2. COMPENSATION a, City agrees to pay, and Contractor agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total amount to be expended under this Agreement shall not exceed Twenty -One Thousand Eight Hundred Dollars and Zero Cents ($21,800.00). b. Payment of deposit of half of invoiced Dollars and Zero Cents ($10,900.00), Agreement and receipt of invoice by City. Page 1 of 9 amount, Ten Thousand Nine Hundred shall be processed upon execution of C. Remaining balance of Ten Thousand Nine Hundred Dollars and Zero Cents ($10,900.00) shall be paid by to June 30, 2022. d. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. 3. TERM This Agreement shall continence on June 18, 2022 and terminate on December 31, 2022, unless terminated earlier in accordance with Section 17, below, 4. PREVAILING WAGES Contractor is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws, Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. 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. 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 Contractor under this Agreement ("Documents & Data"). Contractor shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement. Page 2 of 9 Contractor represents and warrants that Contractor has the legal right to license any and all Documents & Data. Contractor makes no such representation and warranty in regard to Documents & Data which were provided to Contractor 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. 7. INSURANCE Contractor shall procure and maintain for the duration of the contract insurance against claims forinjuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Contractor, his agents, representatives, employees or subcontractors. a. Minimum Scope and Limit of Insurance: 1. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance, which 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 Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability. ISO Form Number CA 00 01 covering any auto (Code 1), or if Contractor has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with a limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Worker's Compensation Insurance. In accordance with California State law, Contractor, if Contractor 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, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. 4. Broader Coverage. If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. b. Other Insurance Provisions Page 3 of 9 Additional Insured Status. The City, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connectionwith such work or operations. General liability coverage can be provided in the form of an endorsement to the Contractor's insurance (at least as broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is used). 2. Primary Coverage. For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 0413 as respects the City, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it. 3. Notice of Cancellation. Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City. 4. Waiver of Subrogation. Contractor hereby grants to City a waiver of any right to subrogation that any insurer of said Contractor may acquire against the City by virtue of the payment of any loss under such insurance. Contractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer'. 5. Self -Insured Retentions. Self -insured retentions must be declared to and approved by the City. The City may require the Contractor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide, or be endorsed to provide, that the self -insured retention may be satisfied by either the named insured or City. 6. Acceptability of Insurers. Insurance is to be placed with insurers authorized to conduct business in the state with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 7. Verification of Coverage. Contractor shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting Page 4 of 9 coverage requiredby this clause) and a copy of the Declarations and Endorsement Page of the COL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 8. Subcontractors. Contractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Contractor shall ensure that City is an additional insured on insurance required from subcontractors. 9. Special Risks or Circumstances. City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. S. INDEMNIFICATION Contractor agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, 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 Contractor or its subconsultants, 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. 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. Notwithstanding the foregoing, to the extent Contractor'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 of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Contractor shall defend, indemnify and hold harmless the City, its officers, agents, Page 5 of 9 representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Contractor to the City pursuant to this Agreement. 10. RECORDS Contractor shall keep records and invoices in connection with the work to be performed under this Agreement. Contractor 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 Contractor under this Agreement. All such records and invoices shall be clearly identifiable. Contractor 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. Contractor 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 Contractor under this Agreement. 11. 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. "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 Contractor disclosed in a publicly available source; (c) is in rightful possession of the Contractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Contractor without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Contractor covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. 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: Page 6 of 9 To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) With copy to: Executive Director Parks, Recreation, and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 To Contractor: Ultimate Attraction, LLC. Att: Steven Nero 12104 Park Street Cerritos, CA 90703 Office:866-275-9197 Direct: 714-231-2779 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 timeframes, weekends, federal, state, County or City holidays shall be excluded. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter herein, 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 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 are not embodied herein. 15. 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 Page 7 of 9 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. 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. TERMINATION This Agreement may be terminated by the City upon thirty (30) 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, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Contractor to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Contractor consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 18. NON-DISCRIMINATION Contractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided 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. 19. 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. Page 8 of 9 N-2022-169 20. 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. 21. 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 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 forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: p DAISY GOMEZ Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: randon Salvatierra Deputy City Attorney FOR APPROVAL Steven Mendoza (Jun 13,202220:42 EDT) Executive Director Parks, Recreation, and Community Services Agency CITY OF SANTA ANA STINE RI City Manager CONTRACTOR ]Pz�a)4� Steven Nero President Page 9 of 9 EXHIBIT A Ultimate Attractions 11c EXHIBIT A 12104 Park Street Cerritos, CA 90703 olga Direct:714-231-2779 Office Number:866.275-9197 Olga Direct: 714-231-2779 Quote Bill To: City of Santa Ana Quote Date: May 29, 2022 c/o Sonia Batres Recreation and Community Events Supervisor 20 civic Center Plaza Santa Ana, CA 92701 Date Typa akrlption parkNalne Total Dub 8In fetes 7osa GBirtettiola�Park 2so. luneteenth Castle Combo Bouncer 350.00 Cole tatton f00t Zi lti ele cni,r $ 5tl0,00 Osh and splash 450.00 t 1A Ice, 660Y05" Milne $ 9,40b,00 sue" ngand� �nePaGt�r."s ^ : �5i30,ff0° Discount (1, 50.00) 7/4 2022 63n atop Total Centennial Park $16,660.00 rt " Ra b nikto"Bouncat , $0tl.0 t$bretion 50 fool Zip [$ obstacle course Y it DbshtYds ash • q Lava.TWW a . p c A. 7. Y a, $ 4,6000 Lost Tomb 4,600.00° stafWPld8;genvrratot Tr -WI ORAND,[Total Total $ 2il3ho.00 Reminder: Please Include the statement number on your check. Property Name Centennial Park Address 3000 W. Edinger Avenue City, State Zip Santa Ana, CA 92704 Event Date Juneteenth Celebration (6/18/22) & Fourth of July (714/22) Time 6/18/22:11am - 6pm (7 hrs); 7/4/22: 5:00 pm - 9:30 pm (4.5 hrs), Package Santa Ana City Events 2022 Payment Due on Receipt. Payment must be on He in order for an Event Crew to be dispatched to your event. THANK YOU FOR YOUR BUSINESSI Ultimate Atraction - City of Santa Ana Final Audit Report 2022-06-14 Created: 2022-06-14 By: Emerson Frankston (EFrankston@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAALTbhwlPceP9fz8FEEVONywlBlicnlO3 "Ultimate Atraction - City of Santa Ana" History Document created by Emerson Frankston (EFrankston@santa-ana.org) 2022-06-14 - 0:32:25 AM GMT C'y Document emailed to Steven Mendoza (smendoza@santa-ana.org) for signature 2022-06-14 - 0:32:45 AM GMT Email viewed by Steven Mendoza (smendoza@santa-ana.org) 2022-06-14 - 0:41:45 AM GMT bo Document e-signed by Steven Mendoza (smendoza@santa-ana.org) Signature Date: 2022-06-14 - 0:42:02 AM GMT - Time Source: server Agreement completed. 2022-06-14 - 0:42:02 AM GMT Q Adobe Acrobat Sign -- CERTIFICATE OF LIABILITY INS A"MfS F by MW2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CE ICATE HOLDER . HkS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLP ;IEJAcevedo BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISS G S R U r D REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Date. 2. 022.06.1 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONA I E provisions or oe endol1��s�d If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsemen'.. P statern entldi+:1 0.51 -07 00 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Contact Name: Todd Tyler Cossio Insurance Agency Phone (864)688-0121 Fax PO Box 5987 (A/C, No, Ext): (A/C, No): E-Mail: tammy@cossioinsurance.com Greenville, SC 29606 (864) 688-0121 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Nationwide Mutual Insurance Company 23787 Ultimate Attractions Ilc 2700 Angelo Dr. INSURER B: Berkley Life & Health Insurance Company 64890 INSURER C: Cerritos, CA 90703 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: 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 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF POLICY ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YY) (MM/DD/YY) X COMMERCIAL GENERAL LIABILITY General Agg (Other than Products-C $2,000,000 ❑ ❑ CLAIMS MADE 0 OCCUR Each Occurrence $2,000,000 Products and Completed Operations $2,000,000 ❑ Personal and Advertising Injury $2,000,000 ❑ A X X FWC000003192523100 8/27/2021 8/27/2022 Legal Liability to Participants $2,000,000 Professional Liability (for Event Plann $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY ❑PROJECT ❑LOC Damages to Premises Rented to You $300,000 Participant Accident -Excess Medica $10,000 ❑ OTHER: Deductible $0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑ ANY AUTO (Ea accident) BODILY INJURY (Per Person) $ ❑ALL OWNED ❑ SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ❑ HIRED AUTOS NON -OWNED ❑ AUTOS PROPERTY DAMAGE $ ❑ ❑ (Per accident) ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE ❑ DED ❑ RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) ❑ If yes, describe under DESCRIPTION OF OPERATIONS below Total Benefit Maximum for all Accident M $25,000 Class 1 Principal Sum $25,000 B Accident Medical PAI L012010778502 8/27/2021 8/27/2022 Benefit Maximum $500,000 Accident Medical Deductible $100 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Party Equipment Rentals Operations located at 737 S State College BLVD Unit 94 Fullerton, CA 92831. Certificate Holder is listed as additional insured per form CG2011 when required by written contract. The certificate holder is added as an additional insured, but only for liability caused, in whole or in part, by the acts or omissions of the named insured. Amusement devices on file with the company for special event(s) dated 6/8/2022 to 6/8/2022 located at 20 Civic Center Plaza, Santa Ana, CA 92701.Waiver of Subrogation included when required by written contract. CERTIFICATE HOLDER: CANCELLATION City Of Santa Ana, Its Officers, Agents, And Employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS.,, ACORD 25 (2016/03) AUTHORIZED REPRESENTATIVE RisMougemerd kDRR810R � e ° REVIEWED & APPROVED BY: POLICY NUMBER: FWC000003192523100 COMMERCIAL GENERAL LIABILITY CG 20 11 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designation Of Premises (Part Leased To You): Name Of Person(s) Or Organization(s) (Additional Insured): City Of Santa Ana, Its Officers, Agents, And Employees 20 Civic Center Plaza Santa Ana, CA 92702 Additional Premium: $ 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 as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to 1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: 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 III — 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. CG 20 11 04 13 © Insurance Services Office, Inc., 2012 RAMuaigmadDlMsian E REVIEWED & APPROVED BY. e Aeevaa '�--'Risk Management Specialist POLICY NUMBER: FWC000003192523100 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City Of Santa Ana, Its Officers, Agents, And Employees 20 Civic Center Plaza Santa Ana, CA 92702 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. RAMwugemadDiMsian E REVIEWED & APPROVED BY. e Aeevaa CG 24 04 05 09 © Insurance Services Office, Inc., 2008 — . - Hi5k Management Specialist CITY OF SANTA ANA RISK MANAGEMENT a d&w4a 4 HUMAN RESOURCES WORKERS' COMPENSATION DECLARATION Steven P. Nero (Name/Title) following declaration: hereby affirm under penalty of perjury, the certify on behalf of Ultimate Attractions LLC _ that during the term (Consultant/Company Name) of my contract for Inflatable Rentals _ services with the City of Santa Ana, (Type of service provided) 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 the provisions and provide proof of workers' compensation coverage immediately. Date: 06/16/2022 Print Name: Steven P. Nero Print Title: President Signature: /0 /(/Q Telephone: 714-231-2779 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. kkRisk Mgmtklnsurance Requirements kWC Declaration 08152019 Risk Muaigmad DMs� E o N,`P' REVIEWED & APPROVED BY: '�--'Rfsk Management Specialist Ultimate Attractions LLC June 15, 2022 City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 Re: Auto Insurance Requirement Dear City of Santa Ana Risk Management Division: Ultimate Attractions LLC has intent to enter into an agreement with the City of Santa Ana.Throughout the course of this agreement, Ultimate Attractions LLC attests to the following: 1. Ultimate Attractions LLC will not use/drive any vehicle during the course and scope of the services provided in the agreement/contract. 2. Ultimate Attractions LLC will not use any owned/rented/leased vehicles during the course and scope of the services provided in the agreement/contract. 3. Ultimate Attractions LLC consultants/independent contractors/employees utilize their personal vehicles/non-company owned, borrowed, or rented/leased vehicles for transportation to and from work and if applicable carry their own automobile insurance. By signing below, I, Steven P. Nero, attest that I possess the legal authority to enter into an agreement with the City of Santa Ana as well as the legal authority to attest to the statements above. If at any time it is found that Ultimate Attractions LLC is not adhering to any/allstatements in this document and has not provided the minimum Auto liability insurance coverage of $ 1 million per occurrence, the contract will be considered null and void andthe company will be held fully liable for any and all damages. Signature, Steven P. Nero President Ultimate Attractions LLC Phone: 714-231-2779 E: stevennero7@gmail.com Ride Mmuganad Divisian E o N Q` REVIEWED & APPROVED BY: e '�--'Risk Management Specialist Policy Number: FWC000003192523100 COMMERCIAL GENERAL LIABILITY This endorsement changes the policy. Please read it carefully. Primary Insurance — Additional Insured This endorsement modifies insurance under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, a. the following is added: Coverage afforded under this Policy is primary insurance and OTHER INSURANCE shall not apply as respects to the additional insured named below, however this insurance does not apply to the sole negligence of such additional insured. Further, we will have no duty to defend such additional insured against any suit to which this insurance does not apply. Additional Insured: City Of Santa Ana, Its Officers, Agents, And Employees 20 Civic Center Plaza Santa Ana, CA 92702 SRPG8018 Risk Muagment DlMsian ZREVIEWED & APPROVED BY. e Aeevaa '�--'Risk Management Specialist