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'° ' Clerk of the Co .cll
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amendments (if any) are no longer in effect.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
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FI"ME COUNCIL
1-1 . 2 FiW �g J
No. N-2022-295 was completed on ( and final payment has been made.
(List all amendments. Use space below if needed.)
Department: F (?LSA
Phone/Ext
Signature: ��Pv1 irs�
Date: 1 o/t O�a
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2022
(Month) (Day)
C
Cody Blackbird ("Speaker/Performer")
11557 W. Coloma Road
Arizona City, AZ 85123
Re: Speaker/Perfonner Engagement Ai eement
This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the
engagement described below:
Event Description: As further described in Exhibit A, attached hereto, the band, Cody Blackbird, will provide a
one (1) hour musical performance for PRCSA. The live performance will take place at the City's Indigenous
Peoples Day event at a time to be coordinated with event staff.
2. Date(s): Saturday, October 8, 2022.
Event ime(s): 12:00 p.m. — 8:00 p.m.
4. Location: Plaza of the Sun, 20 Civic Center Plaza, Santa Ana, CA 92701 (`.`Property")
5. Compensation: $7,500.00 (payable on day of the event, pursuant to City accounting procedures); Speaker/Performer
must provide IRS form W-9 before payment can be made.
Speaker/Performer is responsible for direct payment to individual band members/performers.
6. Equipment provided by City: advertising the program, space for the patrons attending, stage, sound and lighting
equipment, and staff to assist with setup..
7. Equipment provided by Speaker/Performer: insurance as required by the City and further detailed in Exhibit B, list
of family friendly songs with lyrics to be approved by the City of Santa Ana prior to performance, and all other
equipment and materials necessary.
& City Contact Person (far coordinating purposes only): Rodolfo Fernandez
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 be 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.
Speaker Agreement — Cady Blackbird
Page 2
1, Release: Speaker/Performer accepts any City -provided equipment used in connection with the perfonnance 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 acting 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 City -provided equipment or Speaker/Perfor-mer's use thereof.
12. 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 webeast or any other means.
This license shall be non-exclusive and the copyright shall remain with the Speaker/Perfonmer. Copies of
SpeakerfPerforrner's presentation may be maintained by the City, and Speaker/Performer consents to use of such
recordings.
13. 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.
14. Speaker/Performer shall not discriminate because of race, color, creed, religion, sex, marital status, sexual
orientation, age, national origin, ancestry, disability, or any other basis protected by applicable law in connection
with any activities related to this Agreement.
15. 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.
16. 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.
CITE' OF SANTA ANA
KRISTINE RIDGE
City Manager
ATTEST:
Clerk of the Council
Hawk
Parks, Recreation and Community Services Agency
SPEAKERIPERFORMER
Cody Blackbird
Musician
APPROVED AS TO FORM:
By:
AT-a--n-2—on Salvatierra
Deputy City Attorney
EXHIBIT A
Exhibit A
SCOPE OF SERVICES
VENDOR INFORMATION:
Cady Blackbird
11557 W. Coloma rd.
Arizona City, AZ. 85123
(520) 307-6383
EVENT: Indigenous Peoples Day
SERVICE DATE(S): October 08, 2022
COMPENSATION DUE TO THE VENDOR: $7,500 to be paid day of the event.
DESCRIPTION:
Cody Blackbird is a band and will be performing for 1 hour for the city of Santa Ana's 2022
Indigenous Peoples Day taking place October 08, 2022. The event will take place at The Plaza
of the Sun 20 Civic Center Plaza Santa Ana, CA 92701.
Open Hours -- event will open at 12 pm and close at 8 pm.
EXHIBIT B
Exhibit B — Insurance Requirements
Speaker/Performer shall procure and maintain, for the duration of the contract, insurance against
claims for injuries to persons or damages to property that may arise from or in connection with
products, materials, and/or services supplied to the City. The cost of such insurance shall be borne
by the Speaker/Performer.
a. Minimum Scope and Limit of Insurance:
1. Commercial General Liability Insurance. Coverage shall be at least as broad. as
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 $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 required occurrence limit.
2. Broader Coverage. If the 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/Performer. Any available insurance prods in excess of the specified
minimum limits of insurance and coverage shall be available to the City.
b. Self -Insured Retentions. Self -insured retentions must be declared to and approved by
the City. The City may require the Speaker/Performer 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.
c. Other Insurance Provisions
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
Speaker/Performer including materials, parts, or equipment furnished in connection
with such work or operations. General liability coverage can be provided in the
form of an endorsement to the Speaker/Performer's insurance (at least as broad as
ISO Form CG 20101.1 85 or if not available, through the addition of both CG 20
10, CG 20 26, CG 20 33, or CG 20 3 8; and CG 2037 if a later edition is used).
2. Primary Coverage. For any claims related to this contract, the
Speaker/Performer's insurance coverage shall be primary coverage at least as broad.
as ISO CG 20 01 04 13 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 Speaker/Performer'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. Speaker/Performer hereby grants to City a waiver of any
right to subrogation that any insurer of said Speaker/Performer may acquire against
the City by vine of the payment of any loss under such insurance.
Speaker/Performer agrees to obtain any endorsement that maybe 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. 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
AYII, unless otherwise acceptable to the City.
6. Verification of Coverage. 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 requiredby this clause) and a
copy of the Declarations and Endorsement Page of the CGL 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 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,
7. Subcontractors. Speaker/Performer shall require and verify that all subcontractors
maintain insurance meeting all the requirements stated herein, and
Speaker/Performer shall ensure that City is an additional insured on insurance
required from subcontractors.
S. 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.