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HomeMy WebLinkAboutWEI, QUINGCity of Santa Ana -- Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M--30). Call 647-1520 if you have any questions. The agreement with L',i V► N-2022-254 No. was completed on (List all amendments. Use space below if needed.) COTC Office Use Only C2,(:)z:2- Cjtv of Santa Ana JAN 11 2024 City Clerk's Office r� and final payment has been made. Department: tit Phone/Ext.: Signature: Date:r�L! N-2022-254 iNSURANCE ON FILE VVORK MAY PROCEED UNTIL INSURANCE EXPIRES q I`6'22 .;LERK OF COUNCIL WiE. k_ y r N 2022 M (Month) (Day) 0 cl- Qing Wei ("Speaker/Performer") N 15911 Rochester Street Westminster, C�2683 O'.L;6mr�,(,�gvl� L'J�S=� Re: Speaker/Performer Engagement Agreement This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the engagement described below: 1. Event Description: As further detailed in Exbibit A, the Qing Wei Lion & Dragon Dance Cultural Troupe will provide a live dance performance for The Moon Festival. 2. Date(s): Saturday, September 17, 2022 3. Event Time(s): 2:00 p.m. — 4:00 p.m. 4. Location ("Property"): Santa Ana Public Library, Newhope Branch, 122 N Newhope Street, Santa Ana, CA 92703 5. Compensation: $888.00 (payable by check within 30 calendar days of event); Speaker/Performer must provide IRS form W-9 before payment can be made 6. Provided by City: advertising the program, space for the patrons attending, and staff to setup the space for patrons. 7. Provided by Speaker/Performer: All other equipment and materials necessary. 8. City Contact Person (for coordinating purposes only): Maria Miranda Castro 9. Independent Contractor: Speaker/Performer shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Speaker/Performer performs the services that are the subject matter of this Agreement; however, the services to he provided by Speaker/Performer shall be provided in a manner consistent with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 10. Indemnification: Speaker/Performer, his or her agents, or employees (if applicable) agrees to and shall indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from and against all loss, expenses, or liability (including costs and attorney's fees) arising from the negligence or willful misconduct of Speaker/Performer, his or her agents, or employees. II. Release: Speaker/Performer accepts the Property and any City -provided equipment used in connection with the performance in their "as -is" condition, with all faults. Speaker/Performer fully releases, waives and discharges forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not to sue, City, its elected officials, officers, employees, agents and volunteers, and all persons icting on behalf of, by, through or under each of them, under any present or future laws, statutes, or regulations for any claim or event relating to the condition of the Property or City -provided equipment or Speaker/Performer's use thereof. Letter Agreement — Qing Wei Page 2 12. Commercial General Liability Insurance (CGL). Speaker/Performer shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, not be limited to protection against claim arising from bodily and personal injury including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Speaker/Performer's operations in the performance of this Agreement, including without limitation, acts involving vehicles; The amounts of insurance shall be not less than the following: Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including property damage, bodily injury and personal and advertising injury with limits no less than $1,000,000 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 require occurrence limit. 13. Workers' Compensation. If Speaker/Performer has employees, workers' compensation insurance is required by the State of California, with Statutory Limits, and Employer's Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. 14. Broader Coverage. If Speaker/Performer 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 Speaker/Perfonner. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. 15. Certificates of Insurance. Speaker/Performer shall furnish the City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications, at any time. 16. Primary Coverage. For any claims related to this contract, the Speaker/Performer's coverage shall be primary insurance coverage at least as broad as ISO CG 20 0104 13 as respects to the City, its officers, officials, employees, agents and volunteers. 17. Waiver of Subrogation. The Insurance Company agrees to waive all rights of subrogation against the City, its elected or appoints officers, officials, agents, and employees for losses paid under the terms of any policy which arise from work performed by the Speaker/Performer for the City. This provision also applies to the Speaker/Performer's Workers' Compensation policy. 18. Cancelation of Insurance Policy. Each insurance policy required shall not be canceled, except with thirty (30) days written notice to the City. 19. Self -Insured Retentions. Self -insured retentions must be declared to and approved by the City. The City may require the Speaker/Perfo Tier 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. 20. 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 ANII, unless otherwise acceptable to the City. 21. Claims Made Policies. If any of the required policies provide claims -made coverage: (1) the retroactive date must be shown, and must be before the date of the contract or the beginning of contract work; (2) insurance must be maintained and evidence of insurance must be provided for at least five (5) years after completion of the contract of work; (3) if coverage is canceled or non -renewed, and not replaced with another claims-inade policy form with Letter Agreement — Qing Wei Page 3 N-2022-254 a retroactive date prior to the contract effective date, the Speaker/Performer must purchase "extended reporting" coverage for a minimum of five (5) years after completion of work. 22 Verification of Coverage. Speaker/Performer shall famish the City with original certificates of insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsement to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Speaker/Performer'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. 23. The City shall have the right and royalty -free license to simulcast or produce and show a tape -delayed broadcast of Speaker/Performer's presentation to the City community or general public, through webcast or any other means. This license shall be non-exclusive and the copyright shall remain with the Speaker/Performer. Copies of Speaker/Performer's presentation may be maintained by the City, and Speaker/Performer consents to use of such recordings. 24. Speaker/Performer is solely responsible for payment of royalty fees, performance fees, or similar fees that may be required by unions or similar organizations. Speaker/Performer shall indemnify the City against any liability or damages, including attorney's fees, that may arise as a result of violation by Speaker/Performer of copyright laws. 25. Speaker/Performer 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. Speaker/Performer affirms that they are an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 26. This Agreement shall in all respects shall be interpreted, enforced, and governed exclusively by and under the laws of the state of California. Both parties agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 27. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Speaker/Performer. CITY OF SANTA ANA SPEAKER/PERFORMER Affdel,? wt,- d Austin Quach (Sep 2, 2022 09:26 PDT) KRISTINE RIDGE Austin Quach City Manager CEO [signatures continued on next page] Letter Agreement — Austin Quach Page 4 ATTEST: A i Clerk of the Council FOR APPROVAL Bnan Sternberg Executive Director Library Services Agency APPROVED AS TO FORM: By: B&ffd on Salvatierra Deputy City Attorney Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Name: Qing Wei / Austin Quach Address: 15911 Rochester St, Westminster, CA 92683 Phone Number: 714-766-2943 Email Address: gingweibooking@gmail.com EVENT: Harvest Moon Celebration LOCATION: Santa Ana Public Library, Newhope Branch, 122 N Newhope St, Santa Ana, CA 92703 TERM: One-time event: Saturday, September 17, 2022 — 2-4 p.m. COMPENSATION: $ 888.00 DESCRIPTION: Qing Wei Lion & Dragon Dance Cultural Troupe will provide a dance presentation, which includes: • Signature Pair Lions • Happy Buddha • Seven -piece percussion ensemble • Traditional, yet modernized choreography, with acrobatic stunts and lifts • Gift set & scroll from our group's behalf • Photo cps when lions open large scrolls with blessings in Vietnamese • Lion interaction with guests from table to table • Photo ops with our lions & Buddha with all guests! • 1045 minute performance. The Moon Festival is free to the public, and it will take place at the Newhope Library. The performance will be in person and attendees will have a chance to enjoy the presentation and meet the lions and dancers. The event will be hosted by Tony Lam, Technology Librarian. This celebration will take place on September 17a', 2022 from 2-4:00 p.m. Qing Wei Lion and Dragon Dance Cultural Troupe will be compensated $888 for their presentation. Samantha Digitally signed by Samantha M Ae"R& CERTIFICATE OF LIABILITY INSUR 7VC t Latebert , .07DATE(MM12022m THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 'IFIFICA E 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 endorsement(s). PRODUCER CONTACT Will Maddux NAME: PHGNE , (530) 477-6521 A No East Main Street Insurance Services, Inc. E-MAIL info lheeventhel er.com ADDRESS: @ P Will Maddux INSURERS AFFORDING COVERAGE NNC # PO BOX 1298 INSURER A: Evanston Insurance Company 35378 Grass Valley CA 95945 INSURED INSURER a : INSURER C: Qing Wei INSURER D : Austin Quach INSURER E: 15911 ROCHESTER ST 1 INSURER F: Westminster CA 92683 CUVERAGE5 CEH IIFICATE 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. x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FKOCCUR Host Liquor Liability A I I Retail Liquor Liability GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBBELLALIAB OCCUR EXCESS LIAR r,eiue EMPLOYERS' LIABILITY Y/N jROPRIETORIPARTNERIEXECUTIVE ❑ ,ERIMEMBEREXCLUDED9 Y I N 13DS5473-M2748331 09210/ 02 10 /18/ AM 02 2:01 Deductible $ 1 COMBINEDSINGLE LIMIT $ Ea amident BODILY INJURY (Perperson) $ BODILY INJURY(Peraoddent) $ PROPERTYDAMAGE $ Per accident DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule,may be attached if more space is required) ;ertificate holder listed below is named as additional insured per attached MEGL 2217 01 19. attendance: 40, Event Type: Event Vendor. -vent Location: Santa Ana Public Library, Newhope Branch, 122 N Newhope St, Santa Ana, CA 92703 City of Santa Ana is listed as additional insured and will be mailed written notice of cancellation SHOULD ANY OF THE ABOVE DESCF THE EXPIRATION DATE THEREO ACCORDANCE WITH THE POLICY PR City of Santa Ana Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana CA 92701 e REvtEWED&APPRcvmBr JM/v�tNPA [suh4rnM1 ® Risk Management Supervisor Of i4w/' /Gr/140 @ 1988-2015 ACI ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD All rights reserved. COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 3DS5473-M2748331 MARKEL" EVANSTON INSURANCE COMPANY 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 FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92701 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 of this endorsement, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by the acts or omissions of any insured listed under Paragraph 1. or 2. of Section II — Who Is An Insured: 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 permittel 2. If coverage provided to the additional insured is required by a contract or agreemE such additional insured will not be broader than that which you are required by provide for such additional insured. PJskMwwV"wdDMskn RtEWEo&AppmvmB1 I , s+41a Risk Management Supervisor MEGL 2217 0119 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 with its permission. 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. All other terms and conditions remain unchanged. Ian oM&Appa Vm&r. S�.�d� I.crnt:ert tom'. ® Ruk Manzgemenc Supervisor MEGL 2217 0119 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission. I, CITY OF SANTA ANA RISK MANAGEMENT dwaat 4HUMAN RESOURCES Managing Risk owwgh PosttJve Change WORKERS' COMPENSATION DECLARATION Austin Quach (Name/Title) following declaration: I certify on behalf of Qing Wei hereby affirm under penalty of perjury, the that during the term (Consultant/Company Name) of my contract for Lion Dance Performance services with the City of Santa Ana, (Type of service provided) 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 the provisions and provide proof of workers' compensation coverage immediately. Date: 9/2/2022 Print Name: Austin Quach Print Title: CEO Signature: Am4ti+v(Z"d-tl Telephone: 714-766-2943 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 ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTnRn v,c GGGc gam_-�., xmaMma�nvSDbidort e$-',•`:': "_._ REVIEWEafi App OvEDSV ®, Risk Management Sup !: )Risk MgmtVnsurance RequirementsJWC Declaration 08152019