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HomeMy WebLinkAboutIVAN JESUS MARQUEZ - DIAMOND ORTIZ, ZACHEY FORCE FUNK IINMANCE ON FILE WORK MAY PROCEED N-2025-214 UNTIL aN.}su ,�N�L�E ExPiRFs _101 LV - DATE:41 11 2025 'F,Gs+a ( } R aCA o l Fb Xf r%co-du L pz) July 3 1, 2025 Ivan Jesus Marquez, f/s/o Ivan Jesus Marquez, Diamond Ortiz, and Zachey Force Funk("Speaker/Performer") 3126 West First Street 917 Santa Ana, CA Re: Speaker/Performer Engagement Agreement This letter represents your agreement with the City of Santa Ana (`City") as entered into on the above date for the engagement described below: 1. Event Description: Speaker/Perfortner to perfonn at Chicano Heritage Festival event per details in Exhibit A. 2. Date(s): August 24,2025 3. Event Time(s): 2:00 PM — 7:00 PM; City shall provide written confirmation of scheduled performance times; Speaker/Performer to perform for 90 minutes. 4. Location: Centennial Park, Santa Ana(`Property") 5. Compensation: $6,500(payable by check in full the day of event); Speaker/Performer must provide IRS form W-9 before payment can be made. Speaker/Performer shall be solely responsible for payment of additional performers at event,including,but not limited to: Diamond Ortiz,and Zachey Force Funk. City shall not be liable or responsible for any additional payments under this Agreement. 6. Equipment provided by City: Advertising the program, space For the patrons attending, stage, sound and lighting equipment, and staff to assist with setup 7. Equipment provided by Speaker/Performer: all equipment necessary, including without limitation laptop/music, table,and headphone. Contractor shall provide services further described and set forth in Exhibit A. 8. City Contact Person(for coordinating purposes only): Monique Leon 9. Independent Contractor: Speaker/Performer shall, during the entire term of this Agreement,be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship,a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Speaker/Performer performs the services that are the subject matter of this Agreement; however, the services to be provided by Speaker/Performer shall be provided in a manner consistent with all applicable standards and regulations. Speaker/Performer shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 10. Indemnification: Speaker/Performer, his or her agents, or employees(if applicable) agrees to and shall indemnify, defend,and hold harmless the City, its officers,agents,employees,consultants,special counsel,and representatives from and against all loss, expenses, or liability(including costs and attorney's fees) arising from the negligence or willful misconduct of Speaker/Performer, his or her agents, or employees. 11. Release: Speaker/Performer accepts the Property and any City-provided equipment used in connection with the performance in their "as-is" condition, with all faults. Speaker/Performer frilly releases, waives and discharges forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not Speaker/Performer Agreement—Ivan Jesus Marquez Page 2 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 Property or City-provided equipment or Speaker/Performer's use thereof. 12. Insurance Requirements attached hereto as Exhibit B. 13. The City shall have the right and royalty-free license to simulcast or produce and show a tape-delayed broadcast of Speaker/Performer's presentation to the City community or general public, through webcast or any other means. This license shall be non-exclusive and the copyright shall remain with the Speaker/Performer. Copies of Speaker/Performer's presentation may be maintained by the City, and Speaker/Performer consents to use of such recordings. 14. Speaker/Performer is solely responsible for payment of royalty fees, performance fees, or similar fees that may be required by unions or similar organizations. Speaker/Performer shall indemnify the City against any liability or damages, including attorney's fees,that may arise as a result of violation by Speaker/Performer of copyright laws. 15. Speaker/Performer shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, disability, or any other basis protected by applicable law in connection with any activities related to this Agreement. 16. This Agreement shall in all respects shall be interpreted,enforced, and governed exclusively by and under the laws of the state of California. Both parties agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 17. This Agreement represents the complete and exclusive statement between the City and Speaker/Performer regarding the subject matter herein and supersedes any and all other agreements, oral or written, between the parties. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Speaker/Performer. CITY OF NTA SPEAKER/PERFORMER PEAKER/PERF ORMER OZL E Ivan Jesus Marquez City Manager ATTEST: �� APPROVED AS TO FORM: NNIF L BfVONDON SALVATIERRA City Cle Deputy City Attorney RECOMMENDED FOR APPROVAL: ��`' Hawk Scott, Executive Director, Parks, Recreation, and Community Services EXHIBIT A Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Ivan Jesus Marquez EVENT: Chicano Heritage Festival SERVICE DATE(S): August 24, 2025, Event will be held from 2:00pm—7:00 pm; City will provide written confirmation of exact scheduled performance time(s) COMPENSATION DUE TO THE VENDOR:Not to exceed $6,500 for the event. DESCRIPTION: Ivan Jesus Marquez will provide: • Music entertainment at the City's Chicano Heritage event for a total of an hour and a half • Additional artists performing alongside Ivan: Diamond Ortiz and Zachey Force Funk Ivan Jesus Marquez will be paid the total amount of compensation, $6,500, on day of event prior to artist performance. Ivan Jesus Marquez will be responsible for compensating any, and all, additional artists, singers,musicians, dancers, or crew whom contribute to this scheduled performance. l Exhibit B— Insurance Requirements Speaker/Performer shall procure and maintain for the duration of the agreement, the following insurance coverages: MINIMUM SCOPE AND LIMIT OF INSURANCE Speaker/Performer 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 Speaker/Performer 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. • 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 Speaker/Performer has no employees. If Speaker/Performer 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 Speaker/Performer. 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 Speaker/Performer 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 Speaker/Performer for City. 3. All required insurance policies: For any claims related to this contract, Speaker/Performer'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. All required insurance policies: A severability of interest provision must apply for all the additional insureds, ensuring that Speaker/Performer'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 notice shall be provided to City for policy cancellation or non-renewal due to non-payment. Page 1 of 2 Exhibit B— Insurance Requirements 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: (Parks, Recreation, and Community Services Agency), 20 Civic Center Plaza, M-23, Santa Ana, CA 92701.The name and location of the event 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 Speaker/Performer to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. 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 ANII, unless otherwise acceptable to City. Verification of Coverage Speaker/Performer 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 Speaker/Performer'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. 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 contract 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, Company must purchase "extended reporting" coverage for a minimum of three (3) years after completion of work. Subcontractors Speaker/Performer shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein, and Speaker/Performer 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. Page g i Ivan Jesus Marquez - Speaker—Performer Agreement (Chicano Heritage Festival - 2g25)_F I NAL_7.31 .25 Final Audit Report 2025-08-04 Created: 2025-07-31 By: Julie Hoang ahoang@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAAYQ6HfdSTgBM4J16y6p9CTt_7rf_syzlNa "Ivan Jesus Marquez - Speaker_Performer Agreement (Chicano Heritage Festival - 2025)_FINAL_7.31 .25" History Document created by Julie Hoang ahoang@santa-ana.org) 2025-07-31 -7:58:48 PM GMT '+ Document emailed to Ivan Jesus Marquez(funkfreaksrecordsshop@gmail.com)for signature 2025-07-31-7:58:56 PM GMT �L Email viewed by Ivan Jesus Marquez (funkfreaksrecordsshop@gmail.com) 2025-08-04-5:45:20 AM GMT dp Document e-signed by Ivan Jesus Marquez (funkfreaksrecordsshop@gmail.com) Signature Date:2025-08-04-5A6:26 AM GMT-Time Source:server T-► Document emailed to Hawk Scott (hscott@santa-ana.org)for signature 2025-08-04-5:46:28 AM GMT Email viewed by Hawk Scott(hscott@santa-ana.org) 2025-08-04-6:17:05 AM GMT Document e-signed by Hawk Scott(hscott@santa-ana.org) Signature Date:2025-08-04-6:17:19 AM GMT-Time Source:server Q Agreement completed. 2025-08-04-6:17:19 AM GMT Adobe Acrobat Sign A�® CERTIFICATE OF LIABILITY INSURANCE DADDIYYYY) o8/06/2r46rzD2s 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Next First Insurance Agency,Inc. PHONE (855)222-5919 FAX PO Boy 60787 Palo Alto,CA 94305 E-MAIL ADDRESS: pp su ortnextinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER : State Natioral Insurance Company,Inc. 12831 INSURED INSURER B Ivan Marquez Chanel Torrez city of Santa Ana risk management Division INSURER 20 Civic Center Piz Santa Ana,CA 92701 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:740939636 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MMlDDIYYYY MMlDDr^lYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000.00 CLAIMS-MADE a PREMISESS OCCUR DAMAGE ( RENTED Eaaccurrence) S1 O4,040.00 MED EXP(Any one person) s15,000.00 A X X NXT9W7H7TH-02-GL 10/07/2024 1OY0712025 PERSONAL&ADV INJURY S1,000,000.00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,004,000AG POLICY PROJECT LOC PRODUCTS-COMPIOPAGG S2,000,000.00 X OTHER_ S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONL AUTOS BODILY INJURY(Per accident) $ Y HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR H CLAIMS-MADE AGGREGATE S DIED RETENTIONS S WORKERS COMPENSATION PER OTH- STATUTE ER AND EMPLOYERS'LIABILITY Y 1 N ANYPROPRIETORIPARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT S OFFICERIMEMBEREXCLUDED? NfA - - (Mandatory in NH) E.L.DISEASE-£A EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) The Certificate Holder is City or Santa Ana Parks,Recreation,and Community Services Agency.A General Liability Waiver of Subrogation applies in Favor of this Certificate Holder.City of Santa Ana,its City Council,offcers,officials,employees,agents and volunreers are an Additional Insured an the General Liaoility policy with respect to completed operations.This Certificate Holder is an Additional Insured on the General Liability policy with respect to ongoing operations.All Certificate Holder privileges apply only If required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions. Tu Tran °'gT{'Jl 'gneddr Tu Tran Nguyen Nguyen APPROVED By Tu Iran Nguyen at 4.35 pm,Aug Or,212� CERTIFICATE HOLDER CANCELLATION City of Santa Ana Parks,Recreation,and Community LIVE CERTIFICATE Services Agency — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 Civic Center Piz THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Santa Ana,CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Click or scan to view 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NXT9W7H7TH-02-GL COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive such right of recovery In a written contract or agreement Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a 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 above. CG 24 04 05 09 O Insurance Services Office, Inc., 2008 Page 1 of 1 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES Policy Change Number 11 POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE NXT9W7H7TH-02-GL 08/06/2025 State National Insurance Company, Inc. NAMED INSURED AUTHORIZED REPRESENTATIVE Ivan Marquez Chanel Torrez City of Santa Ana risk management Division 1570 E Edinger Ave Ste 12 Santa Ana, CA 92705 Ann Ryan COVERAGE PARTS AFFECTED Commercial General Liability Coverage Part CHANGES SEE ATTACHED SCHEDULE Return Total $0.00 Authorized Representative Signature IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 2 ❑ Copyright, ISO Commercial Risk Services, Inc., 1983 SCHEDULE OF POLICY CHANGES It is understood and agreed that: The following forms are added: CG 20 10 04 13-Additional Insured-Owners, Lessees or Contractors-Scheduled Person or Organization CG 20 37 04 13-Additional Insured-Owners, Lessees or Contractors-Completed Operations All other terms and conditions remain unchanged, IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 2 of 2 Copyright, ISO Commercial Risk Services, Inc., 1983 POLICY NUMBER: NXT9W7H7TH-02-GL COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Santa Ana, its City Council,officers, officials, CA employees,agents and volunteers 20 Civic Center Plz Santa Ana,CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -- Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury"" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insureds) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 ©insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations, amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 POLICY NUMBER: NXT9W7H7TH-02-GL COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations City of Santa Ana, its City Council, officers,officials, DJ services in CA employees,agents and volunteers 20 Civic Center P17 Santa Ana,CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section Il — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement performed for that additional insured and amount of insurance: included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less, insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 / e'xyl.t5R5na aaYdR!trY+d►flxwt wf My elnlw...i.+�.1.R..n. h.nlleY rewTfltt..nM Yww.....vv<9w ahvn r�<m.r ahn+.wrwvMwaw.c.wiw f iaa r..Rl....rtw•Iw..:M ew.<.F•wr aM<n w InaM a w.wt..d k..w At<MSEtY<:ww r1+a..ws.wsl Iw.tf.raMP<ariFw.�[IR Iw.l w.lallF.w<. 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ROBERTO MARQUl Z Flferd.r Daxc 4 24 ZU25 12..01 AM-Ezomdat Dete:I0934aOM 12:O1 AM F.lfeetw,Da.4/24f2U25 12-.Ol AM-R:plratks Dwte.1pr24f2623 1101 A.3E Emar4nrr Ce@P..r: .'Pitv Genital I—C..Wy ls._,.C—P..Yl AV-Genera'fmur —Cemps6y f PCe 11—2426 PO F..;ate 1 Re b.CUs+tRr+n CA 91729-242h Ru hu Cncam n6a,CA 41=}24:6 NAIL Code:1329R NAIL Cole:15290 Veer:�laxri3lydd 7'~.ldrwtlDcwdws Nwmber Yt.r�6lahrfllndal Vrhk%idmdnl dww Nrwr6<r S.—XB JTI.ZF_4FC1A11033R2 !010&i—X13 JTt ZF4F7lA11033112 CtNmrr Srr•Irr AlOVI are.(9161 563-6313 C.,—!k-lee A.Nitawee:1916)503-63t3 CALIFUILVIA EVIDENCE OFLIABILITV ENSUTANCE A&asP'm CALIFORNIA EVIDENCE OF LIABILITY INSVRANC'x Thr.policy—.pf.r.-E6 Srctitxa 16056 or 16500-5 or the C.Jif a V.hrelr C,.k Thie policy c—pi,e w.lh Sections 16056 ox 16500.5 of toe Cahfutni4 V dllrla Cude.. 1orWned 1.sa Aeddeu17 C.H 4916)306-1931 1-1—d 1.an Acddant?Ct11(916)306-IK32 ,Vam.d(W&Y d:[VAN MARQUEZ PaUcy 9.OPCP-W379852-02 N4ML41 lmured:IV AN 4ARQUEZ "ky is GPCP-003?9552-1T2 C HANEL N'ORA TORREZ.JOSE C'NANEL NORA TORREZ.JOSE ROBERTO MARQUEZ ROBERTO MARQUEL Effecti"Otte:4124.2025 12:01 AM -Erplrstlud Dale:10 24202a 11 111 AM Effredve Dsla-4/14/2025 12.01 AM-E<plrttiwu Dale:10f24J21)25 L2:01 AM tn.urtsre Csapasy: Asp-General lln- u Comp—) luuftiaee C9m Aapde Ga--)buutatue C0s9pany Wn3: PO B[9s 2426 PCT BQ3 2426 Rancho C19canwRga,CA 91729-2420 R4Rehd Cw..4 Rex.CA 91729-142h NA1C Cwk:15290 NAIC C-k:1329a RI y°etrf3laltdet111a1d Vrhkle 1des11ik.n..t Number Yewel(11694d3IYdel Vehkk Idesdnctlion Number', 1961 Chevrokt MONTE CARLO LS IG lazI IZSJFI I t551 lgnh Chcvwtcl MONTE CARLO LS IGIGZS IZSJPI1 L555 Cwwwwer Serrkt A..W.—a:C914k1543-6313 Lwetafnar Servtee Aufatrsee:1916)5Y3.6313 CITY OF SANTA ANA Risk Management a division of Human Resources ef Managing Risk through Awareness and Action " AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE Ivan Marquez I, ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative of FUNKFREAKS (`'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 $6,500 Dj's and artist performances {"Agreement")to provide ("Services"): (Services to be provided under agrecment/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, Company shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. r3� J_r 8/5/25 Signature ! Dare Ivan Marquez Print Name Consulant Title Ivan marquez3345@gmail.com 714 949 7411 Contact Information.i.e.,Telephone Number and/or Email Address WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANT DOLLARS($I00,000). 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