HomeMy WebLinkAboutMONROY, ANGELICA (MCCHARMLYS, THE)INSURANCE NOT ON FILE AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT N-2024-255
WORK MAY NOT PROCEED
CITY CLERK
DATE- p 6 2024
o . 42CsA (4fG AGREEMENT WITH ANGELICA MONROY TO PROVIDE
6VA,n; J� a teon)m_q- A LIVE PERFORMANCE AT CITY OF SANTA ANA'S 2024
CHICANO HERITAGE FESTIVAL
THIS AGREEMENT is made and entered into this 1st day of August, 2024, by and between
Angelica Monroy ("Contractor"), an individual, Fs/o The McCharmlys ("Artist"), 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 artists to provide live performances at the City's Chicano
Heritage Festival.
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 performed 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 provide a performance by Artist for the City's Chicano Heritage
Festival on Sunday, August 11, 2024 between 2:00 p.m. — 7:00 p.m. at Centennial
Park.
b. Artist shall provide a thirty (30) minute live performance to be coordinated with
event staff.
Contractor's Initials:
C. Contractor must provide song list of family friendly, clean edit songs with lyrics
to be approved by the City of Santa Ana prior to performance.
2. COMPENSATION
a. City agrees to pay, and Contractor agrees to accept as total payment for its services
for City, including all travel expenses and performance by Artist, the rates and
charges identified in Exhibit A. The total amount to be expended under this
Agreement shall not exceed $3,105.
Page 1 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
b. Contractor agrees that the City is not responsible for payment directly to Artist nor
anyone else purporting to represent them.
C. Union fees, manager and/or agent commissions, and insurance obligations are part
of the cost of production and City shall not be liable or responsible for any such
payments under this Agreement.
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 commence on August 3, 2024 and terminate on August 31, 2024,
unless terminated earlier in accordance with Section 17, below.
4. ROYALTY -FREE LICENSE
The City shall have the right and royalty -free license to simulcast or produce and show a
tape -delayed broadcast of the Artist's performance to the City community or general public,
through the internet or any other means. This license shall be non-exclusive and the copyright
shall remain with the Artist. Copies of Artist's performance may be maintained by the City, and
Artist consents to use of such recordings.
5. INDEPENDENT CONTRACTOR
Contractor and Artist shall, during the entire term of this Agreement, be construed to be
independent contractors and not employees 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
and/or Artist perform the services which are the subject matter of this Agreement; however, the
services to be provided by Contractor and Artist 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. INSURANCE
Contractor on behalf of Artist shall procure and maintain for the duration of the contract
insurance against claims for injuries 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
Page 2 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
(1) Commercial General Liability (CGL). Insurance Services Office ("ISO")
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 and
$2,000,000 aggregate.
(2) Automobile Liability (AL). ISO Form CA 00 01 covering Code 1 (any auto),
with limits no less than $1,000,000 per accident for bodily injury and property
damage.
(3) Workers' Compensation. As required by the State of California, with
Statutory Limits, and Employer's Liability Insurance with limit of no less than
$1,000,000 per accident for bodily injury or disease. Coverage is not required
if Contractor has no employees and signs request to waive.
(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
The above required insurance policies are to contain or be endorsed to contain the
following provisions:
(1) Additional Insured Status. The City, its officers, officials, employees, and
volunteers are to be covered as additional insureds on the CGL and AL policies,
above, with respect to liability arising out of work or operations performed by
or on behalf of the Contractor including materials, parts, or equipment famished
in connectionwith such work or operations.
(2) Waiver of Subrogation. Contractor's insurance company(ies) agree(s) to
waive all rights of subrogation against the City, its City Council, its officers,
officials, employees, agents, and volunteers for losses paid under the terms of
any policy which arise from work performed by Contractor under this
Agreement.
(3) Primary Coverage. For any claims related to this Agreement, Contractor's
insurance coverage shall be primary and any insurance maintained by City, its
City Council, its officers, officials, employees, agents, or volunteers shall not
contribute with it.
(4) Severability. A severability of interest provision must apply for all the
additional insured, ensuring that Contractor's insurance shall apply separately
Page 3 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
to each insured against whom a claim is made or suit is brought, except with
respect to the insurer's limits of liability.
(5) Cancellation. Insurance policy(ies) herein shall provide that coverage shall not
be canceled, suspended, voided, reduced in coverage or in limits, non -renewed
by the carrier, or materially changed except after thirty (30) days prior written
notice has been given to City. Ten (10) days prior written notice shall be
provided to City for policy cancellation or non -renewal due to non-payment.
(6) Certificate Holder. The Certificate Holder on each evidence of insurance
certificate shall be: City of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA
92701.
c. Self -Insured Retentions. Self -insured retentions must be declared to and
approved by the City. City may require 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.
d. 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.
C. 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 coverage requiredby this clause) and a
copy of the Declarations and Endorsement Page of the CGL policy listing allpolicy
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,inctuding endorsements required by these specifications, at any
time.
f Claims -Made Policies. If any of the required policies provide coverage on a
claims -made basis:
(1) The retroactive date must be shown and must be before the date of the
Agreement or the beginning of work.
(2) Insurance must be maintained and evidence of insurance must be provided for
at least three (3) years after completion of work.
(3) If coverage is canceled or non -renewed, and not replaced with another claims -
made policy form with a retroactive date prior to the contract effective date,
Contractor must purchased "extended reporting" coverage for a minimum of
three (3) years after completion of work.
Page 4 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
g. Subcontractors. Contractor shall require and verify that all sub -contractors
maintain insurance meeting all the requirements stated herein, and Contractor shall
ensure that City is an additional insured on insurance required from sub -contractors.
h. Special Risks or Circumstances. City reserves the right to modify these
requirements, including limits, based on the nature of therisk, prior experience,
insurer, coverage, or other special circumstances.
7. RELEASE
Contractor, on behalf of Artist, accepts any City -provided equipment used in connection
with the performance in their "as -is" condition, with all faults. Artist, on behalf of Artist, 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 Artist's use thereof.
8. INDEMNIFICATION
Contractor and Artist agree 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, Artist, or subcontractors, 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 and Artist further agree 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 and Artist'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 Artist.
9. INTELLECTUAL PROPERTY INDEMNIFICATION
Contractor and Artist shall defend, indemnify and hold harmless the City, its officers,
Page 5 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
agents, 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 and/or Artist 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 Artist 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 or Artist receive from the City information which due to the nature of such
information is reasonably understood to be confidential and/or proprietary, Contractor and Artist
agree that they 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 and/or Artist disclosed in a publicly available source; (c) is in
rightful possession of the Contractor and/or Artist without an obligation of confidentiality; (d) is
required to be disclosed by operation of law; or (e) is independently developed by the Contractor
and/or Artist without reference to information disclosed by the City.
12. CONFLICT OF INTEREST CLAUSE
Contractor and Artist covenant that they presently have 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
Page 6 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
the manner provided in this Section, to the following persons:
To City: City Clerk
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Fax: 714- 647-6956
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: Angelica Monroy
F/S/O The McCharmlys
1315 N. Broadway Apt. 2
Santa Ana, CA 92706
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 on behalf of Artist 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.
Page 7 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
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
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 that 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 five (5) 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, except that payment need not be made for work that 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.
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
Page 8 of 9
AGREEMENT FOR PERFORMER WITH A MANAGER OR AGENT
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. Contractor represents and warrants that it is in compliance and will maintain
compliance with all applicable laws including, but not limited to, the California
Talent Agency Act.
C. 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.
APPROVED AS TO FORM
SONIA R. CARVALHO
City Attorney
By:
Brandon Salvatierra
Deputy City Attorney
RECOMMENDED FOR APPROVAL
f�fsr'
Hawk Scott.
Executive Director, Parks, Recreation and
Community Services Agency
CITYZOANTA WANA
Alvaro Nunez
Acting City Manager
CONTRACTOR
Name: Angelica Monroy
Title:
Page 9 of
EXHIBIT A
Exhibit A
SCOPE OF SERVICES
VENDOR INFORMATION: Angelica Monroy dba The McCharmlys
EVENT: Chicano Heritage Festival
SERVICE DATE(S): August 11, 2024
COMPENSATION DUE TO THE VENDOR: Not to exceed $3,105 for the event. The
Vendor will be paid $3,000 for their performance and reimbursed $105 for their insurance
coverage cost.
DESCRIPTION:
The McCharmlys will provide:
• Music entertainment at the City's Chicano Heritage event for a total of 30 minutes
• Performance schedule to be determined at a later time
Open Hours —Event will be held from 2:00pm — 7:00 pm
The Vendor will be paid the amount of compensation, a total of $3,105, upon completion of
contract, due day of event prior to artist performance.
From: Naiera.Luisa
To: Leon,Moniaue;Garcia.Stephanie; Hoana.Julie
Subject: RE: Certificate&Receipt 19304787 from HUB International Insurance-Events
Date: Thursday,August 8,2024 3:13:33 PM
Attachments: imaoe006.12no
imaae007.0na
imaae008.12no
Hello Monique,
Yes, approved.
Thank you,
Lai&cty NC1Je-Cv1 Senior Risk Management Analyst
City of Santa Ana I Human Resources Department
20 Civic Center Plaza I Santa Ana, CA 92701
Office: 714-647-6959
Email: Inajera aasanta-ana.org
From: Leon, Monique <mleon@santa-ana.org>
Sent:Thursday, August 8, 2024 3:09 PM
To: Garcia, Stephanie <SGarcia5@santa-ana.org>; Hoang, Julie <jhoang@santa-ana.org>; Najera,
Luisa <Inajera@santa-ana.org>
Subject: FW: Certificate & Receipt 19304787 from HUB International Insurance- Events
Luisa,
I have attached the insurance documentation for Chicano Heritage Festival. Before Aarti left she said
we could add bands to our additionally insureds. Could we please verify that the attached cert is ol<
to use for the McCharmlys and Vicky Tafoya? We need to send this approval to purchasing for
payment.
Thank you.
Monique Leon - MBA, CPRP
Recreation & Community Services Supervisor
City of Santa Ana I Parks, Recreation & CommunityService Agency
Sri Ana T: (714)975-4514
,P4-,6 a ,e ZeISM&A4 E: Mleon(a-)santa-ana.ora
A:20 Civic Center Plaza 12nd Floor I Santa Ana, CA 92701
From: Cummings, Joy<iov.cummings(cDhubinternational.com>
Sent: August 8, 2024 3:07 PM
To: Leon, Monique<mleon(@santa-ana.org>
Subject: Certificate & Receipt 19304787 from HUB International Insurance - Events
Attention: This email originated from outside of City of Santa Ana.Use caution when opening attachments or
links.
Thank you, Monique!
ivy O
Joy Cummings
Special Events Insurance Manager
License #OG64980
**OUT OF OFFICE FRI 8/16 & MON 8/26**
0 HUB
HUB International Insurance Services Inc.
3000 Executive Parkway, #300
San Ramon, CA 94583
License #0757776
PH: 925 609 6547; FX: 925 609 6550
Email: iovov.cummings(@hubinternational.com
To Obtain A Quote for your Special Event: www.eventinsure.com
The information contained in this e-mail is strictly confidential and for the intended use of the addressee only;it may also be legally
privileged and/or price sensitive.Notice is hereby given that any disclosure,use or copying of the information by anyone other than the
intended recipient is prohibited and may be illegal.If you have received this message in error,please notify the sender immediately by
return e-mail.Every reasonable precaution has been taken to ensure that any attachment to this e-mail has been swept for viruses. We
accept no liability for any damage sustained as a result of software viruses and advise you to carry out your own virus check(s)before
opening any attachment.
From: ePayPolicy<support(@epay3.com>
Sent:Thursday, August 8, 2024 3:02 PM
To: Reynolds, Karen <I<aren.reynoldsPhubinternational.com>;Johnson, Mark
<mark.iohnson(@hubinternational.com>; Cummings,Joy<iov.cummings(@hubinternational.com>;
Robinson, Devon <Devon.Robinson Phu binternational.com>; Haslem,John
<iohn.haslem(@hubinternational.com>; Guevara, Karolina
<karolina.guevara(@hubinternational.com>
Subject: [EXTERNAL] Receipt 19304787 from HUB International Insurance - Events
If you cannot read this email, please click here.
Monique Leon, City of Receipt # 19304787
Santa Ana
Payment on 8/8/2024
mleon(a)santa-ana.org. How do I reverse this payment?
How do I subscribe others to
notifications?
Event Date 8/11/2024
Event Holder(s) 081124 City of Santa Ana
Client ID CAONESH-01
Subtotal $2,953.40
Fee 103.37
Total $3,056.77
PAYMENT TYPE MASTERCARD XXXXXXXXXXXX0219
NOTES
Special Event Insurance Policy; Please do not edit prefilled invoice
information. Add any notes, after this sentence.
HUB processing fees are fully earned/non-refundable at the time
of purchase.
HUB International Insurance - Events
3390 University Ave #300 Riverside, CA 92501 United States
925-609-6547
snecialevent(a hubinternational.com
Copyright 2024 All Rights Reserved I ePayPolicy
CERTIFICATE OF INSURANCE ENDORSEMENT
SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST,A RISK PURCHASING GROUP
Certificate#
FACILITY OWNER-Additional Insured: (if multiple,continued
PRODUCER: CA License#0757776
on next page)
HUB International Insurance Services Inc.
City of Santa Ana,its officers,officials,employees and volunteers,20 Civic 3000 Executive Parkway,Suite 300
Center Plaza,Santa Ana,CA 92701
San Ramon,CA 94583
PH:925 609 6500 FX:925 609 6550 specialevent(o�hubinternational.com
EVENT HOLDER-Named Insured: (if multiple,continued on EVENT INFORMATION
next page)
City of Santa Ana TYPE OF EVENT: Festival/3vs3 Basketball
20 Civic Center EVENT DATE(S): 8/11/2024
Santa Ana, CA 92701
EVENT LOCATION(S): Centennial park,3000 W.Edinger Ave.,and Diamond Elementary,1450 S.
Center St.,Santa Ana,CA
This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated above. 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.
INSURER A: COLONY INSURANCE COMPANY
INSR LTR Type of Insurance Policy Number Effective Expiration Policy Limits
Each Occurrence $1,000,000
General Aggregate $2,000,000
Personal&Advertising Injury $1,000,000
Products/Completed Operations $2,000,000
Commercial Aggregate
A 103 GL 0021111 1/1/2024 1/1/2025
General Liability Damage to Premises Rented to You $1,000,000
Medical Payments $5 000
Liquor Liability Each Occurrence
(Aggregate included in General n/a
Liability Aggregate)
COVERAGE TERMS:
Occurrence Form(CG 0001)
The coverage afforded by this insurance is primary and non-contributing with any
Host Liquor Liability Included. insurance held by the "Additional Insured" as Named Insured,when the "Additional
Insured" is shown on this Certificate of Insurance Endorsement as "Additional Insured"
Full Liquor Liability Included when a or WHEN REQUIRED BY WRITTEN CONTRACT.
separate premium has been charged.
COVERAGE EXCLUSIONS:(REFER TO POLICY FOR COMPLETE LISTING OF EXCLUSIONS)
--Communicable Diseases
Specific Events are excluded from coverage. Please see second page for list of excluded events.
--Sexual Abuse&Molestation
--Terrorism On behalf of the Risk Purchasing Group and each Member,the Trustee has declined coverage for the Terrorism Risk
Insurance Act(TRIA).
Additional Insureds,next page—
SPECIAL EVENT LIABILITY GROUP INSURANCE TRUST DATE
CERTIFICATE OF INSURANCE ENDORSEMENT 8/8/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE ENDORSEMENT DOES NOT CONSTITUTE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
PRODUCER: CONTACT NAME: JOY CUMMINGS
HUB International Insurance Services Inc. PHONE 925 609 6500 FAX 925 609 6550
3000 Executive Parkway,Suite 300 EMAIL specialevent(a)hubinternational.com
San Ramon,CA 94583 INSURER(S)AFFORDING COVERAGE NAIC#
CA License#0757776 INSURER A: Colony Insurance Company 39993
NAMED INSURED:
City of Santa Ana
20 Civic Center
Santa Ana, CA 92701
COVERAGES
This is to certify that the policies of insurance listed below have been issued to the insured named above for the event date(s)indicated below. 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.
INSURED MEMBER
INSR COVERAGE EFFECTIVE
TYPE OF INSURANCE ENDORSEMENT / LIMITS
LTR NUMBER EXPIRATION DATE
A GENERAL LIABILITY EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY 41511 08/11/2024 DAMAGE TO RENTED PREMISES $1'ooa'000
(Ea occurrence)
CLAIMS-MADE ❑X OCCURRENCE MED EXP(Any one person) $5,000
PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
PRODUCTS-COMP/OPAGG $2,000,000
LIQUOR LIABILITY PER
OCCURRENCE(AGGREGATE
INCLUDED IN GENERAL LIABILITY n/a
AGGREGATE)
MASTER POLICY#103 GL 0021111 -EFFECTIVE DATE 1/1/2024; EXPIRATION 1/1/2025
DESCRIPTION OF OPERATIONS/LOCATIONS
City of Santa Ana,its officers,officials,employees and volunteers,20 Civic Center Plaza,Santa Ana,CA 92701
is/are included as an additional insured(s)per attached endorsement T5409-0118.Policy is Primary and Non-contributing per attached endorsement T1095-0108;Waiver of
Subrogation applies per attached endorsement CG 24 04 05 09.
Event Type: Festival/3vs3 Basketball
Event date(s): 8/11/2024
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Santa Ana,its officers,officials,employees and volunteers,20 Civic Center Plaza,Santa Ana, AUTHORIZED REPRESENTATIVE
CA 92701