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HomeMy WebLinkAboutJAIL ADVERTISING NETWORK (PARTNERS FOR A SAFER AMERICA, INC)INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES CITY CLERK DATE: DEC 0 2 2024 0: PDT i) IC.iY1Y�L}11 WAVi+� (KF, N-2024-376 ADVERTISING AGREEMENT BY AND BETWEEN CITY OF SANTA ANA AND PARTNERS FOR A SAFER AMERICA, INC., DBA JAILADVERTISING NETWORK This Agreement is made by and between the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California on behalf of the Santa Ana Police Department, hereinafter referred to as "City", and Partners for a Safer America, Inc., dba Jail Advertising Network, a Nevada corporation, hereinafter referred to as "Contractor". The parties hereby agree to the following terms, covenants and conditions: I. Contractor's Signboards and Scooe of Work A. Contractor's signboards shall exclusively provide information and referral services for Individuals at the Santa Ana Jail, located at 62 Civic Center Plaza, Santa Ana, CA 92701 ("Premises'l. The information and referral services shall Include the names and telephone numbers of bail agents. The signboards may also include advertising information by qualified criminal defense attorneys if attorney advertising is authorized by the City B. Contractor agrees to maintain a minimum of three (3) ads on the signboards during the term of this Agreement. The spaces for ads will first be sold to licensed bail agents in City of Santa Ana, second to City of Santa Ana criminal law attorneys, and third to licensed bail agents and attorneys outside of City of Santa Ana. All ads shall be approved by the City. C. All signboards shall contain the following disclaimer: "Neither Contractor nor City warrants the qualifications or competence of any person listed on this signboard." D. It is mutually agreed that Contractor's right to install and maintain signboards on the premises shall be an exclusive right during the term of this Agreement. E. Contractor shall be solely responsible for the assembly, construction, printing, and delivery to City of all signboards. If signboard encasements are used to display signboards, they must be constructed of safety material (break -resistant frames, clear plastic covers, and security screws) to deter the Inmates from removing, damaging, or defacing the signboards (all materials used must be approved by the City prior to installation). Any damaged signboard or encasement will be removed by the City and must be replaced by the Contractor within thirty (30) days after written or e-mail notice to the Contractor. City agrees to install all original signboards and will also Install replacement inserts provided by Contractor semi-annually. In the event that the Contractor must change the information provided on the signboards more often than semi- annually, the Contractor agrees to reimburse the City for the actual costs incurred for replacement of the signboards, not to exceed $250.00 for each occurrence. F. Contractor Is responsible for: 1. Securing and executing an agreement with each Bail Bond Agent, who desires to advertise on the signboards using the following criteria: a. All Agency Trade Names appearing on signboards must be registered with the City of insurance and approved for use by the licensed agency owner. b. Each bail bond agency owner wishing to place an ad on signboards must hold a valid bail bond license with the California Department of Insurance. The City reserves the right to block or remove any non -licensed or non -qualified bail agency ad from signboards. c. All employees licensed to conduct bail must also be approved to solicit bail bonds under the owner's approved trade name, d. All display ad style information cards must comply with City of Insurance regulations and may Include agent pictures, agency name, telephone numbers, address, services available and any other information the agency owner feels is pertinent to the business. Nothing on the display cards can be obscene, immoral or illegal. 2. Placing the names of all licensed bail bond agents wishing to do business in the City of Santa Ana and wishing to advertise their services in the Santa Ana Police Department Jail Facility, in a fair and equitable manner, on reasonably sized, professionally crafted, poster like boards, not to exceed 24" x 32" in size unless pre -approved by City. 3. Randomly placing all advertisements on the signboards, and rotating all advertisements on these signboards semi-annually through the use of its web -based "Internet Drawing Program." This program allows all advertisers to participate In specially scheduled random rotation drawings held on the Internet. Details for participation will be provided to qualified advertisers at the time they execute an advertising agreement with Contractor. 4. Developing a fair process for displaying all Attorney advertisements on the signboards, If Attorney advertising is approved by the City. 5. Charging persons purchasing advertising space on the signboards a minimum of $175 per month, during the first year of this agreement, with an optional per month increase of twenty-five dollars ($25) each year for the remainder of the contract term with the approval of the City. II. Compensation A. As compensation for allowing Contractor to Install its signboards on the premises, the City shall receive sixty percent (60%) of gross advertising revenue earned annually. B. Contractor shall make a complete and accurate accounting of the gross revenue produced by the signboards and shall deliver the accounting and City's first compensation payment no later than fourteen (14) days after receiving official notification by the City of the timely installation of all new signboards and inserts. C. The first payment shall be equal to the City's share of the initial six (6) months revenue generated by sales of advertising spaces on the initial signboards. Thereafter, Contractor shall deliver payments semi-annually through the term of this Agreement. Contractor shall deliver each semi-annual payment to City within fourteen (14) days after receiving official notification by the City of the timely Installation of all new replacement signboards and Inserts, D. As used in this Section II. of this Agreement, the term "gross revenue" shall mean the total amount of the advertising fees paid to Contractor from persons and agencies placing advertisements on Contractor's signboards, including the amount of advertisers, not Including any amounts paid for bad debt, late payments, non-payment, credit card fees, processing fees, etc. This report shall include yearly and total amounts accrued under this Agreement. E. Contractor understands and agrees that this Agreement Is subject to Section 2-748(a) of the Santa Ana Municipal Code and that reported gross revenue, as detailed in Sections F.5, and Sections II, A-D, shall not exceed $50,000. In the event that the gross revenue generated, as determined by the City, approaches a total aggregate amount of forty-five thousand dollars ($45,000), the City will notify the Contractor that an Amendment is required to present to the City Council of the City of Santa Ana to seek approval of the receipt of monles that exceed fifty thousand dollars ($50,000). In the event the Amendment is not approved by the City Council, or upon notification that the Contractor does not agree to an amendment, the Agreement shall effectively terminate on the date of either occurrence. F. Contractor shall mail all payments to City at the following address: Santa And Police Departmenx/Jall Bureau c%Jalme Manniquez, Jai/Administrator 62 Civic Center Plaza M-BB Santa Ana, CA 92701 III. Term A. This Agreement shall have an initial term of three (3) years, which shall commence on November 1st, 2024. B. This Agreement may be terminated without cause by City or contractor upon thirty (30) days written notice of termination. C. Upon expiration or termination of this Agreement, City will remove the signboards and encasements, and return them to Contractor at 104 E. Fairview Ave., #224, Meridian, ID 83642. IV. General Contract Provisions A. Nondiscrimination Clause: Contractor shall comply with all applicable federal, state, and local laws and regulations including City of Santa Ana's policies regarding nondiscrimination and equal opportunity in contracting. Such laws Include but are not limited to the following: Title VII of the Civil Rights Act of 1964 as amended; Americans with Disabilities Act of 1990; The Rehabilitation Act of 1973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code sections 12900 et seq.); California Labor Code sections 1101, 1102, and 1102.1. Contractor shall not discriminate against any subcontractor, employee, or applicant for employment because of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or other forms of compensation. Contractor shall not discriminate in the provision of services provided under this contract because of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital status. CGL u � .1 Contractor shall Indemnify, defend, and hold harmless City, the City of Santa Ana and Its City Council, officials, officers, agents, employees, contractors, and volunteers from any and all liability, claims, judgments, or demands, Including reasonable attorneys fees and costs, which may arise from all Injuries, deaths, and property damage arising out of this agreement. C. Insurance Contractor shall maintain limits of Insurance coverage in the following minimum amounts and shall be at least as broad as: Commercial GeneralLiability (CGL): 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 and $2,000,000 aggregate. • Workers' Compensation (W/C): 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, per employee, per policy for bodily injury or disease. This requirement can be waived if Contractor has no employees. If Contractor maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions I The insurance policies are to contain, ot be endorsed to contain, the following provisions: 1. CGL policy; City of Santa Ana, its C ty Council, Its officers, officials, employees, agents, and volunteers are to be covered as addidor ial insureds with respect to liability arising out of work or operations performed by or on beN If of the Permittee including materials, parts, equipment, and personnel furnished in Connaction with such work or operations. I 2. CGL and W/C policies: Insurance company(ies) agrees to waive all rights of subrogation/recovery against 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 Permittee for City, 3. All required insurance policies: For any claims related to this contract, Permittee's insurance coverage shall be primary and any Insurance maintained by City, Its City Council, its officers, officlals, employees, agents, or volunteers shall not contribute with It. 4. All required insurance policies: A severabillty of Interest provision must apply for all the additional Insureds, ensuring that Permittee's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. S. Each insurance policy required 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 shall be provided to City for policy cancellation or non -renewal due to non-payment. 6. Certificate Holder on each Evidence of Insurance certificate shall be; City of Santa Ana, Attention: Alexis Rea, 20 Civic Center Plaza M-88, Santa Ana, CA 92701. The name and event of location should be included in the Description of Operations section of each certificate. 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. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Permittee shall furnish 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 endorsements to Entity before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Permittee's obligation to provide them. City reserves the right to require complete, certified copies of all required Insurance policies, including endorsements required by these specifications, at any time. Sub -contractors 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. 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, Contractors Insurance coverage shall be effective on the start date or this Agreement and shall continue throughout the entire term of this Agreement, Proof of insurance shall be attached to this Agreement as Exhibit A prior to execution of the Agreement by City. D. Sgcurlty Clearance All of Contractors' employees, agents, and representatives wishing to enter the Santa Ana Jail must first receive a security clearance prior to entrance. Contractor should allow at least four (4) weeks prior to intended entrance for completion of the security clearance process. Requests for security clearances shall be done by contacting The Santa Ana Jail's Security Supervisor at (714)245-8115. City reserves the right to refuse entrance to any person(s) not in possession of a security clearance badge or to confiscate any security clearance badge issued at Its discretion. E. Type I Contract Lanouaoe Contractor shall, during the term of this contract, comply with all applicable federal, state, and local rules, regulations, and laws. Contractor shall maintain financial records adequate to show that City funds paid or received under this Agreement were used for purposes consistent with the terms of the Agreement. These records shall be maintained during the term of this Agreement and for a period of three (3) years following expiration or termination of this Agreement. F. Right To Conduct Business Contractor shall obtain all necessary certificates, licenses and permits required by City, County, State, and Federal law in order to perform the services described in this Agreement. Copies of all such documents shall be presented to City upon request. G. Assignment Contractor shall not assign this Agreement, either In whole or in part, without the prior written consent of the City. Any assignment without consent shall be null and void. This provision shall not prohibit Contractor from entering into separate Agreements with independent providers for limited individual services as long as such agreements shall not have the effect of accomplishing an assignment otherwise prohibited herein. Any assignment for which the City has given written consent shall be subject to all of the terms and conditions of this Agreement. H. Independent Contractor Status This is an Agreement by and between independent contractors and Is not intended and shall not be construed to create the relationship of agent, servant, employee, partnership, joint venture or association between the City and Contractor_ No party associated with or employed by Contractor shall have any claim under this Agreement or otherwise against the City for vacation pay, sick leave, retirement benefits, Social Security contributions, Workers, Compensation insurance beneflts, unemployment insurance benefits, or employee benefits of any kind. Regulatory & Legal Compliance contractor agrees that City may suspend or terminate this Agreement at any time if it Is found to be in violation of any state or regulatory ruling which adversely affects the use of the signboards. This includes, but is not limited to a change in ruling by the City of Insurance or a law enacted by the California State Legislature; and upon said suspension or termination, the City agrees to return any unearned portion of the advertising revenue previously paid to it under Section II of this Agreement. J. Waiver The failure of City to insist upon the strict performance of any of the terms, covenants and conditions of this Agreement shall not be deemed a waiver of any right or remedy that City may have, and shall not be deemed a waiver of its right to require strict performance of all of the terms, covenants and conditions thereafter, nor a waiver of any remedy for the subsequent breach of any of the terms, covenants and conditions. K. Notices Any notice given by either party shall be in writing and served either by email, personal delivery or sent by certified mail, postage prepaid, addressed as follows: To City of Santa Ana: With courtesy copies to: To Contractor• City Clerk City of Santa Ana 20 Ovic Center Plaza (M 30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 547-6956 ChlefOfPollce City of Santa Ana 20 Civic Center Plaza (M-96) P.O. Box 1988 Santa Ana, California 92702 Partners For A Safer America, Inc., DBA JailAdvertising Network Atin. Wanda Dunbar, President 5517 Western Rider Trail Reno, NV 89511 eregP iailadnetwork.com V. Entire Agreement This Agreement, along with any exhibits and attachments, constitutes the entire Agreement by and between the parties relative to Contractor's signboards being installed and maintained on the premises. Any prior or contemporaneous oral or written agreements by and between the parties or their agents or representatives relative to this matter are hereby revoked and extinguished by this Agreement. IN WITNESS WHEREOF, the parties have executed this Agreement as follows: CO T CTOR Wanda Dunbar, President Partners for a Safer America, Inc. DBA Jail Advertising Network ATTEST: APPROVED AS TO FORM: SONIA R. CARVALHO Ci Attorney By: TA ARA SOGOSIAN Senior Assistant City Attorney CITY OF SANTA A ALVARO NUNEZ City Manager RECOMMENDED FOR APPROVAL: 1L," ROBERT RODRIGUEZ Acting Chief of Police AccoRil' CERTIFICATE OF LIABILITY INSURANCE DATE iMMIDOMYYI 11/04/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE D058 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Ileu of such endorsement S , PRODUCER slfd{'eFartill Jade Yap 9440 W Sahara Ave., Suite 125 N A T Jade Yap _ _ PHONEPAX 1: 702.333-1080 LgLc, Nol: E-MAIL statefar ADDRESS,)ade.ya p yzt_j@ m.com _.........M.CO INSURERS) AFFORDING COVERAGE HAICC INSURER A: State Farm Fire and Casualty Company 25143 Las Vegas NV 891178819 INSURED W INSURER a: _ INSURER c: PARTNERS FOR A SAFER AMERICA ING _ INSURER D: 6617 WESTERN RIDER TRL INSURER E : 1 INSURERF: RENO NV 895118568 nrIVFRAGFA 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.ADD LTR TYPE OF INSURANCE INSD SUBI WVO POLICY NUMBER POUCY SET MMIDO POLICY UP MMIDD.. LIMITS q GOMMEkCIAL GENERAL LIABILITY CLAIMS -MADE < OCCUR Y Y 98-AP-0509.E 10/1112024 10/1112025 EACH OCCURRENCE 5 2,000.000 P AGE O a El ce $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL d ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY �jECT [X]LOC OTHER: GENERAL AGGREGATE s 4,000,000 PRODUCTS - COMPIOP AGO $ 4.000,000 $ Y AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTO$ONLY AUTOS ONLY IFS acddent) MBINED SINGLE LIMIT BODILY INJURY (Par person) $ $ BODILY INJURY (Par eccklent) $ a cItimt) $ $ UMBRELLA UAB EXCESS UAB J_ICLAIMS OCCUR MADE EACH OCCURRENCE $ AGGREGATE $ OEO RETENTION $ S WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETORIPARTNEWEXECUTNE YIN OFFICERIMEIdOER EXCLUOEQ� IMand0lory In NH) fI as, descdhe ender DES. PTIO OFOPERATIONS slow NIA PER I OTH- $ E.L. EACH ACCIDENT g E.L DISEASE - EA EMPLOYE E.1. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be ausobed Umore spaco is raqulrod) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN POLICE DEPARTMENT/ JAIL BEREAU ACCORDANCE WITH THE POLICY PROVISIONS, 62 CIVIC CENTER PLAZA M-88 AurrwalzeoR Nr rivE SANTA ANA, CA 92701 ✓� m 198 R CORAfION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered mar-A>;ORD Itl9t48 2005 165279 205 0'1-19-2023 CMP-4543 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number:98-AP-0509-6 Named Insured: PARTNERS FOR A SAFER AMERICA INC DBA JAIL ADVERTISING NETWORK Name And Address Of Additional Insured Person Or Organization: CITY OF SANTA ANA POLIECE DEPARTMENT/JAIL BUREAU 62 CIVIC CENTER PLAZA M-88 SANTA ANA CA 92701 SECTION II — WHO IS AN INSURED of SECTION II — LIABILITY is amended to include, as an additional insured, any person or organization shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Premises And Ongoing Operations Your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises; or (2) In the performance of your ongoing operations; or b. Products -Completed Operations "Your worK' performed for that additional insured and included in the "products -completed operations hazard". 2. Any insurance provided to the additional insured shall only apply with respect to a claim made or a "suit" brought for damages for which you are provided coverage. 3. Primary Insurance. The insurance afforded the additional insured shall be primary insurance. Any insurance carried by the additional insured shall be noncontributory with respect to coverage provided by you. All other policy provisions apply. CMP-4543 1010236 2001 154980 201 01-21-2022 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2018 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CMP-4787 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number:98-AP-0509-6 Named Insured: PARTNERS FOR A SAFER AMERICA INC DBA JAIL ADVERTISING NETWORK Name And Address Of Person Or Organization: CITY OF SANTA ANA POLIECE DEPARTMENT/JAIL BUREAU 62 CIVIC CENTER PLAZA M-88 SANTAANA CA 92701 The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or It. "Your work' done under 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. All other policy provisions apply. CMP-4787 10OM98 2001 151229 201 05-1M2019 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CITV OF SANTA ANA (V Risk Management a division of Human Resources Managing Risk through Awareness and Action Affidavit of Exemption for Workers' Compensation Insurance I, c2A16-A JINf n%/, �� GFo hereby affirm under penalty of perjury, the (Name/Tlde) T following declaration: I certify on behalf off /L /� 8V,6-X -1 S1m A1h(-7W o1(K that during the term (Consultant/Company Nome) of my contract for ��f /L ITk614&X T7-SIA)6 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: 1n1-?11poe- Print Name: DOIV " &IA)/ZA,4y� Print Title: c Signature:.-�. �; Telephone- 7p7 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALLSUBJECTAN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UPTO 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. Affidavit of Exemption for Workers' Compensation Insurance