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HomeMy WebLinkAboutSTANFORD SOUND AND STAGE N-2025-104 INSURANCE ON FILE WORK MAY PROCEED UNTIL INS'. •' !CE EXPIRES c'ITY CLEF;, ARTS AND CULTURE ARTIST GRANT PROGRAM AGREEMENT BETWEEN DAP=. MAY 7 2025 THE CITY OF SANTA ANA AND STANFORD SOUND AND STAGE GO 'J This Artist Grant Agreement ("Agreement") is made and entered this 13T" day of January, 2025, 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 ("City"), and Stanford Sound and Stage ("Grantee") for the purpose of providing grant funding pursuant to the Investing in the Artist Grant Program. City and Grantee may herein individually be referred to as a "Party" and collectively be referred to as the "Parties" to the Agreement. RECITALS.- A. On November 21, 2024, the Arts and Culture Commission reviewed all applicants and recommended that Grantee be awarded an artist grant based on its Application for its art project ("Project"). A true and correct copy of Grantee's Application is attached hereto as Exhibit A and incorporated herein by reference. B. In undertaking the performance pursuant to this Agreement, Grantee represents that it is skilled and knowledgeable in the arts and culture arena and that the Project created or performed hereunder will be created or performed in compliance with such standards as may reasonably be expected from an artist. 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. Term. This Agreement shall be effective upon signature by both Parties and shall expire one year from the date first written above, unless terminated earlier in accordance with this Agreement. 2. Fundincl. 2.1. Subject to Grantee's performance of all required actions under this Agreement, City shall provide funding, in three disbursements, as detailed below, of an amount not to exceed Five Thousand, Four Hundred Dollars ($5,400) ("Grant Amount" or "Grant"). 2.2. Grantee will be paid in three (3) installments. First payment will be one-third of the funding amount provided above or $1,800 and will be provided within thirty (30) days of the full execution of the Agreement by the Parties along with a complete invoice submitted by Grantee. The second payment will be the second one-third of the funding amount provided above or$1,800 and will be provided within thirty (30) days after the Grantee submits to the City all the proper receipts and invoices up to the mid-point of the Project. The third and final payment will include the remaining amount of $1,800 and will be issued within thirty (30) days after the Grantee submits to the City all the proper receipts, invoices, and final report for the Project. 2.3. Appropriate performance of the Grantee will be determined by City in its sole discretion. City reserves the right to cease funding after the first or second disbursement detailed above, and to be reimbursed the initial payment(s), if Grantee's performance is determined to be insufficient or unacceptable in the City's sole discretion. 2.4. City represents that there is no correlation or connection between its selection of individuals for grant awards and an individual's business relationship or potential business relationship with City. 1 3. Grant Activities. Grantee agrees: 3.1. To perform the activities described in Grantee's Grant Application and Timeline submitted to City for consideration dated October 21, 2024, a copy of which is attached as Exhibit A and incorporated into this Agreement as if set out in full. 3.2. To submit all reports (each, a "Report"), which shall include, at a minimum, the items set forth as required by the Application. No personally identifiable information shall be included in any of the Reports, except where specifically requested. The Reports shall be in a format that is reasonably acceptable to City. City may request additional information as City, in its sole discretion, determines is necessary to monitor performance of this Agreement. City shall have the right to use any Reports submitted by Grantee, or any portion thereof, for any reason. 3.3. To maintain all pertinent financial and accounting records pertaining to this Agreement in accordance with generally accepted accounting principles and other procedures reasonably specified by City. Upon termination or expiration of this Agreement or request by City, Grantee shall provide, at its expense, copies of all financial and accounting records produced by Grantee arising out of this Agreement. 3.4. To allow audits, compliance or special reviews and inspections, including on-site inspection, with or without prior notice, of Grantee's facilities by City or by third parties designated by City, or their authorized representatives. Grantee shall provide its full cooperation for any such audit, review or inspection, including providing timely access, for examination and copying of records (including computerized records) pertinent books, documents, papers, computer programs and records and reasonable access to its personnel. 3.5. To ensure that any areas utilized for the Project are maintained and restored to a well- maintained, safe, sanitary, and clean condition, and kept free of any hazardous waste at all times. All equipment associated with the installation of the artwork, trash and debris shall be removed and cleaned up on a daily basis. If applicable to the Project, Grantee shall place a drop cloth or similar barrier on the ground below the artwork while installation is underway, which barrier shall be removed each day upon completion of an installation session. 3.6. The Project may not contain advertising, religious art, sexual content, negative or violent imagery, convey political partisanship or include any hidden, subliminal, or camouflaged messages or statements of any kind or nature. Appropriateness of the content of the Project will be determined by City in its sole discretion. 3.7. The Project may not include any breach of intellectual property, trademarks, brands, or images of illegal activity, and the Grantee must be the copyright holder for the Project. It is the sole responsibility of the Grantee to obtain any and all applicable copyrights or trademarks associated with the artwork for the Project. 3.8. To be responsible for the maintenance of the Project, which includes, but is not limited to, graffiti removal, touch-up, and restoration, for the duration of the Project's existence. 3.9. If the artwork is a mural, it must be covered in an anti-graffiti coating at the Grantee's expense. 3.10. The City holds all rights to public art on City property, and as such the Project artwork may be removed at the sole discretion of the City. Should the Project artwork be defaced and/or not repaired, maintained, preserved and/or conserved, the City has the authority to repair, maintain, preserve, and/or conserve the Project artwork, or alternatively, the City has the sole authority to 2 remove, alter, or destroy the Project artwork. Grantee will have first right of refusal to restore said Project artwork. If Grantee is unwilling to perform or unable to be contacted within a reasonable time, the City has the right to request the services needed from a different artist, in the City's sole discretion. 3.11. Grantee shall execute and deliver to City any instruments that City may reasonably require to confirm ownership of any artwork. 4. Termination. 4.1. City may immediately terminate this Agreement upon one or more of the following: 4.1.1. Grantee's violation of any federal, state or local law or regulation. 4.1.2. Grantee's breach of any of the terms or conditions of this Agreement, including the Application and Timeline, or any unapproved deviation from said documents that has not been cured within 30 days of written notice of such breach. 4.2. In the event the Agreement is terminated under Section 4.1, City reserves the right to require Grantee to refund any or all grant funds awarded to Grantee under this Agreement, and Grantee agrees to refund to City any or all grant funds awarded under this Agreement. 5. Limitation of Liability. 5.1. IN NO EVENT SHALL CITY BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR EXPENSES FOR ANY NEGLIGENCE, BREACH OF CONTRACT OR ANY OTHER ACT ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE ACTIVITIES COVERED HEREUNDER. 5.2. Section 5 and Section 6 do not limit Grantee's rights, including its ability to seek recovery, against anyone other than City, its City Council, officials, directors, officers, employees, agents, successors, assigns and volunteers. 6. Indemnification. 6.1. Grantee shall defend, indemnify, protect and hold harmless the City, and its City Council, elected and appointed officials and officers, employees, members, volunteers, or agents from and against all claims for damages, liability, cost and expense (including without limitation attorney's fees) arising out of or alleged by third parties to be the result of the negligent acts, errors or omissions or the willful misconduct of the Grantee, and Grantee's employees, subcontractors or other persons, agencies or firms for whom Grantee is legally responsible in connection with the execution of the work covered by this Agreement. Grantee shall have no duty to indemnify or hold harmless the City if claims, damages, liability, costs, expenses (including without limitation, attorney's fees) arise from the sole negligence or sole willful misconduct of the City subsequent to declaration by the Grantee. Grantee's obligations shall survive the termination of this Agreement. 6.2. Grantee agrees to hereby fully release and forever discharge the City from any and all claims, demands, damages, losses, and liabilities (hereinafter collectively referred to as "claims"), which are or may be related to or in any way connected with the negligence or willful misconduct of its officers, officials, employees, or agents in connection with the creation, painting, performance or installation of the Project hereunder. 3 6.3. Grantee further agrees that City may in good faith and on reasonable terms settle any such claims and that City's right to indemnification shall extend to any such settlement, provided City has given notice of such claim and its intent to settle. City's right to indemnification is in addition to, and may be exercised independently of, any remedy held by City under this Agreement, at law or in equity. The indemnity provision set forth in this Agreement shall survive the termination or expiration of this Agreement indefinitely. 7. Insurance 7.1 Prior to undertaking performance of work under this Agreement, Grantee shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: MINIMUM SCOPE AND LIMIT OF INSURANCE Grantee shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: • Commercial General Liability(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. Automobile Liability (AL): Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with combined single limits of $1,000,000. In the event Grantee does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance with existing limits, which can be lower than $1,000,000. e Workers' Compensation (WIC): 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 Grantee has no employees. If Grantee 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 Grantee. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. CGL and AL policies: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Grantee including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. All required insurance policies: Insurance company(ies) agrees to waive all rights of subrogation 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 Grantee for City. 3. All required insurance policies: For any claims related to this contract, Grantee's insurance coverage shall be primary and any insurance maintained by City, its City 4 Council, Its officers, officials, employees, agents, or volunteers shall not contribute with it. 4. All required insurance policies: A severability of interest provision must apply for all the additional insureds, ensuring that Grantee'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. 5. 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: Executive Director, Community Development Agency, 20 Civic Center Plaza M-25, Santa Ana, CA 92701. The name and location of event should be included in the Description of Operations section of each certificate. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Hest rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Grantee 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 City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Grantee'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. Subcontractors Grantee shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein, and Grantee 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. 8. General Provisions. 8.1. Grantee shall acquire prior written permission from City for any use of the City name or logo in association with the Project. 8.2. If any parts of this Agreement are held to be invalid or unenforceable, the remaining parts of the Agreement shall continue to be valid and enforceable. 8.3. Grantee shall comply with all governmental requirements that may now or in the future become applicable to the activities under this Agreement. 5 8.4. This Agreement, including all exhibits, Application, and any amendments or schedules hereto, contain the full understanding and agreement of the Parties with respect to its subject matter, and no waiver, alteration or modification of any of the provisions to this Agreement shall be binding unless in writing and signed by an authorized officer of both Parties. 8.5. No waiver by either Party or any breach, default, or series of breaches or defaults, and no failure, refusal, or neglect of either Party to exercise any right, power, or option given to it under this Agreement or to insist upon strict compliance with the terms of this Agreement shall constitute a waiver of these provisions with respect to any subsequent breach or waiver by either Party or its right at any time thereafter to require exact and strict compliance with provisions of this Agreement. 8.6. Any notice or other communication required or permitted to be made or given by either Party pursuant to this Agreement will be in writing and will be deemed to have been duly given: (i) five (5) business days after the date of mailing if sent by registered or certified U.S. mail, postage prepaid, with return receipt requested; (ii) when transmitted if sent by facsimile, provided a confirmation of transmission is produced by the sending machine; or (iii) when delivered if delivered personally or sent by express courier service.All notices to City shall include a reference to the Project title. All notices will be sent to the other Party at its address as set forth below or at such other address as such Party will have specified in a notice given in accordance with this section: Grantee: Stanford Sound and Stage 2321 E. 41n Street Suite C503 Santa Ana, CA 92705 City: City of Santa Ana City Clerk (M-30) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702 FAX (714) 647-6956 8.7. This Agreement is subject to all applicable local, State and Federal laws. 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. 8.8. Grantee agrees to comply with all applicable equal opportunity and affirmative action laws as appropriate, Grantee shall not discriminate because of race, color, religion, sex, gender identity, gender expression, marital status, sexual orientation, age, national origin, ancestry, medical condition, military or veteran status, genetic information, request for family care leave, request for leave for an employee's own serious health condition, request for pregnancy disability leave, disability, or otherwise as defined and prohibited by applicable law, in the recruitment, selection, 6 training, utilization, promotion, termination or other employment related activities. Grantee affirms that it is an equal opportunity employer{if applicable} and shall comply with all applicable federal, state and local laws and regulations. 8.9. Any funds provided under this Agreement that are not expended, obligated or otherwise committed by the termination or expiration of this Agreement shall be immediately returned to City. 8.10. Grantee grants to City a non-exclusive, irrevocable, transferable, royalty free, worldwide license to use, reproduce, display, distribute, and prepare derivative works, in any form or media at the discretion of the City for the Project conceived, performed or created as a result of this Agreement. 8.11. Grantee and any of the Grantee's agents, employees or representatives are, for all purposes under this Agreement, an independent contractor and shall not be deemed to be an employee of the City, and none of them shall be entitled to any benefits to which City employees are entitled including but not limited to, overtime, retirement benefits, work's compensation benefits, injury leave or other leave benefits. 8.12. Neither Party shall assign any rights or obligations under this Agreement. 8.13. Each Party covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 8.14. Each Party warrants that they have executed this Agreement knowingly, freely and voluntarily and with full knowledge of its legal consequences. All Parties involved warrant and represent that, prior to executing this Agreement, each Party has had the opportunity to review and consider this matter with legal counsel, and that the terms of this Agreement, and its consequences, are fully understood by each Party. 8.15. This Agreement represents the entire agreement and understanding between the Parties, and supersedes any and all prior agreements and understandings between the Parties, whether oral or written. 8.16. 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. {Signatures on following page} 7 i IN WITNESS WHEREOF,the Parties hereto have executed this Agreement the date and year first above written. ATTEST. CITY OF SANT ANA ENNIF tAMARONUVEZ City Clerk City Manager APPROVED AS TO FORM; GRANTEE, SONIA R. CARVALHO City Attorney iG1�� I y. Andrea Garcia-M,ler Name; ed o Briseno Assistant City Attorney Title:ARTIST RECOMMENDED FOR A OVAL: ! MICHAEL L.GARCIA Executive Director Community Development Agency i i i I i f S I i i EXHIBIT A INVESTING IN THE ARTS GRANT PROGRAM APPLICATION 9 Project Timeline "Input your information directly onto this form and upload onto Submittable.com. DATE ACTION OUTCOME 03/16/2025 Workshop on the fundamentals of a "PA Participants will learn about XLR cables, system"-what each item is, how they work microphones, and speaker systems that are together, and what is the ideal PA set up for best for their needs and how best to care different events. for this equipment to ensure longevity and the best quality sound. 5/18/2025 A hands-on workshop where participants will Participants will be able to work on a sound be able to learn about the audio mixing board and ipad sound mixing program while programs we use for live event sound they experiment with audio tracks from live engineering. performances. 7/20/2025 Learn all about setting up controller and Participants will learn the technical side of vinyl turntables. Meet women in the DJ controller and vinyl DJ set up, what each scene- DJ Gracy D and T Keys, and DJs Blue component is, and how to identify and Collar Scholar and Yellow Black Bird from trouble shoot audio issues when they arise. Chulita Vinyl Club's Santa Ana chapter. Women in the local and international DJ scene will share stories on their passion for DJing and their experiences in the scene. 9/21/2025 Be the sound engineer for a live Participants will run sound checks for audio performance by Chapis-a band comprised of equipment, instruments, and vocals and run Santa Ana raised musicians who are the audio for a live performance. seasoned professionals in the music industry. Line Item Budget **Input your information directly onto this form (2 pages)and upload onto Submittable.com. PERSONNEL Description of Personnel Grant (artist fees, consultants, administrative Total Compensation Funds fees, etc.) Requested Venue Crew-Crew for each workshop:set up 500.00 500.00 and strike Fee for Graphic Designer- Promotional 250.00 250.00 Material Chulita Vinyl Club-Jackeline Reyes 200 200 Vinyl DJ for the DJ Workshop+DJ for the Final Workshop/Show. Chulita Vinyl Club-Michelle Reyes 200 200 Vinyl DJ for the DJ Workshop+ DJ for the Final Workshop/Show, Gracy D&TKeys-Graciela Delgado&Theresa 500 500 Controller DJ's for the DJ Workshop Pay band for performance at the final 400 400 Workshop event. Fee for Teaching/Lessons by Modesto Briseno: 800 800 4 sessions at 4 hours each. EQUIPMENT, MATERIALS AND SUPPLIES Item Quantit Unit Total Grant (equipment, materials, supplies) y Cost Cost Funds Requested XLR Cables-used for giveaways for the 1st 3 30.00 900.00 900.00 workshop on cables.These cables are 0 made by Stanford Sound and Stage. Cost covers Materials and Labor to assemble for each unit. Promotional Banners-Banners will be used 2 125.00 250.00 250.00 at each event as backdrops and for directing people to the location of the workshop. Educational Pamphlets/Notebooks-these 50 10 600 600 are being developed as a take home item for each participant. Will include a summary of the topics we will go over in each workshop. Given out at the beginning of each workshop. (Cost to develop and create includes material cost and labor cost) Printed Flyers and Posters-Flyers will be 1 150 150 150 handed out at local events and left or posted at local stores along with posters where allowed. Additional supplies: Paper, Pencils, stapler 1 50 50 0 Table& Chair Rental for each Workshop 4 25 100 100 Event Food& Drinks for each workshop 4 100 400 400 ADDITIONAL EXPENSES Description Total Cost Grant Funds (permits,fees, facility rental for project) Requested Online Ads(Instagram, Facebook, Google) 100 100 Line Item Budget — Page 2 Enter budget categories and projected expenditures for the proposed program: Expenditures Expenditures Category Funded By Funded By Other Total Project Santa Ana Grant Sources Budget (Including in-kind) Personnel Total 2850.00 2850.00 Equipment Total 1250,00 1250.00 Supplies Total 400.00 400.00 Materials Total 750.00 50.00 750.00 Additional Expense Total 100.00 100.00 5350.00 50.00 5400.00 TOTAL PROJECT REVENUE LIST ALL OTHER PROJECT RESOURCES "Funding Source"total must equal"Total Project Budget" listed above. FUNDING SOURCE AMOUNT Santa Ana Artist Grant 5350.00 Artist 50.00 TOTAL PROGRAM BUDGET 5,400.00 ,4`"R o�® CERTIFICATE OF LIABILITY INSURANCE D02i17/20`25"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 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 CONTACTELIDA GARCIA CERVANTES NAME: Eddie Quillares Jr. State Farm Agency PHONED f.714-617-7150 FAX Ne:714-617-7158 StateFarm 415 N Broadway nooRESS,ELIDA.GARCIACERVANTES.VAF5S3@STATEFARM.COM Santa Ana, CA 92701 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:State Farm Fire and Casualty Company 25143 INSURED Modesto Briseno INSURERB: DBA Stanford Sound and Stage INSURERC: 2321 E 4th Street INSURER D: Santa Ana, CA 92707 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:75-0450 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 -rypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y 92-KN-B559-0 05/01/2024 05/01/2025 EACH OCCURRENCE S 1,000,000 CLAIMS-MADE �OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ X BUSINESS PROPERTY MED EXP(Any one person) $ 5.000 PERSONAL&ADV INJURY S 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 POLICY PRO LOC PRODUCTS-COMPIOP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Fa accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER ANY PROPRIETORIPARTNERIEXECUTIVE ElNIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are included as Additional Insured on the above referenced policy where required by written contract.A Waiver of Subrogation applies in favor of the Certificate Holder. Tu Tran yNig dby ruran Nguyen o5;,07W Location for All Events: Suavecito Headquarters, 2831 W. 1st Street, Santa Ana, CA 92703 APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 9:51 am,Apr 23,2025 City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attention: Executive Director, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Development Agency, ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, M-25 Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014 CITY OF SANTA ANA Risk Management a division of Human Resources $ Managing Risk through Awareness and Action ��� AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE ( M O D E STO B R I S E N O ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative of STANFORD SOUND AND STAGE («Company"), and (Consultant/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company, I represent and confirm the following, as relates to the agreement between Company and City of Santa Ana, agreement number NA ("Agreement")to provide INVESTING IN THE ARTIST GRANT PROGRAM (-'Services"): (Services to be provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not employ any person in any mamier so as to become Subject to the workers' compensation laws of California, and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,Company shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum workers'compensation insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. 04/19/2025 Signature Date MODESTO BRISENO Print Name PRESIDENT Title 714-417-8954 STANFORDSOUNDCO@GMAIL.COM Contact Information,i.e.,Telephone Number and/or Email Address WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANT 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 11.12.2024 CITY OF SANTA ANA Y Risk Management a division of Human Resources ^� Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE 1 M O D ESTO B R I S E N O ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative of STAN FO R D SOUND AND STAGE ("Company"), and (Consultant/Company Name) possess the authority to legally bind Company. In my capacity as Representative of Company, I represent and confirm the following, as relates to the agreement between Company and City of Santa Ana, agreement number NA ("Agreement")to provide INVESTING IN THE ARTIST GRANT PROGRAM (.Services"): (Services to be provided under agreemenUcontract) During the course and scope of Company's agreement with the City of Santa Ana, Company employees, consultants, representatives,and agents will not use and/or drive any Company owned/rented/leased/borrowed vehicles to perform Services to, for,or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum automobile liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. kGF 04/19/2025 Signature Date MODESTO BRISENO Print Name PRESIDENT Title 714-417-8954 STANFORDSOUNDCO@GMAIL.COM Contact Information,i.e.,Telephone Number and/or Email Address Affidavit of Exemption for Automobile Liability Insurance 11.12.2024