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Home My WebLink AboutMARTINEZ, RAUL (2) INSURANCE ON FILE WORK.MAY PROCEFO UN RL IN6URANCIL EXPIRES N-2025-236 DILM CITY CLERK DATE: SEP 1 5 2025 b=PRCSA(cat) PERFORMER AGREEMENT BETWEEN RAUL MARTINEZ"EL DIABLITO" AND RVCAVLFo Maryirlez 07) THE CITY OF SANTA ANA FOR MASTER OF CEREMONIES SERVICES THIS AGREEMENT is made and entered into on this 22nd day of July, 2025, by and between Raul Martinez"El Diablito", an individual("Performer"), 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 obtain the services of a performer to provide master of ceremonies ("MC") services at the 2025, 2026, 2027, and 2028 Fiestas Patrias events on behalf of the City's Parks, Recreation, and Community Services Agency. B. Performer represents that it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Performer represents that it is knowledgeable in its field and that any services performed by Performer under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. 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: ID 1. SCOPE OF SERVICES Performer shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described in the "Scope of Services," attached hereto and incorporated herein by reference as Exhibit A. 2. COMPENSATION a. City agrees to pay, and Performer agrees to accept as total payment for its services for City, the rates and charges identified in Exhibit A. The total amount authorized during the term of this Agreement shall not exceed$10,000,00, b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. City and Performer agree that all payments due and owing under this Agreement shall be made through Automated Clearing House(ACH) transfers. Performer agrees to execute the City's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, the City will be authorized to deposit payments directly into Performer's account(s) with financial institutions. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. Page 1 of 9 3. TERM This Agreement shall commence on July 22, 2025 and terminate on December 31, 2028, unless terminated earlier in accordance with Section 15, below. 4. INDEPENDENT CONTRACTOR 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 Performer performs the services which are the subject matter of this Agreement;however, the services to be provided by Performer shall be provided in a manner consistent with all applicable standards and regulations governing such services. 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. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Performer under this Agreement("Documents&Data"). Performer shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Performer represents and warrants that Performer has the legal right to license any and all Documents&Data. Performer makes no such representation and warranty in regard to Documents&Data which were provided to Performer by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. Performer retains all ownership rights, including copyrights,to all materials and designs created under this Agreement.The City is granted a limited, non-transferable license for use of such materials solely for the purposes outlined in this Agreement. Any other use requires prior written consent from Performer. 6. INSURANCE Performer 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 theperform:ance of the work hereunder and the results of that work by the Performer, his agents, representatives, employees or subcontractors. Page 2 of 9 Minimum Scope and Limit of Insurance. Coverage 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 property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall betwice the required occurrence limit. • Automobile Liability: ISO Form Number CA 00 01 covering any auto (Code 1), or if Performer has no owned autos, hired, (Code 8) and non-owned autos (Code 9), with limitno less than$1,000,000 per accident for bodily injury and property damage. • Workers' Compensation insurance 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. • If the Performer maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limitsmaintained by the Performer. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. Self-Insured Retentions. Self-insured retentions must be declared to and approved by the City. The City may require the Performer to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. The policy language shall provide,or be endorsed to provide, that the self-insured retention may be satisfied by either the namedinsured or City. Other Insurance Provisions. The general liability policy is to contain, or be endorsed to contain, the following provisions: • The City, 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 Performer including materials, parts or equipment furnished in connection with such work or operations. • For any claims related to this contract, the Performer's insurance coverage shall be primary insurance coverage at least as broad as ISO CG 20 01 04 13 as respects the City, its officers, officials, employees, agents, and volunteers. • The Insurance Company agrees to waive all rights of subrogation against the City, its elected or appointed officers; officials, agents, and employees for losses paid underthe terms of any policy which arise from work performed by the Recipient for the City. This provision also applies to the Performer's Workers' Compensation policy. • Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the City. 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. Page 3 of 9 Verification of Coverage. Performer shall furnish the 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. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications, at any time. Special Events Coverage for Contractors. Special events coverage is available for an additional fee to provide the liability insurance required by this agreement. Performer can obtain additional information and cost from the City. Subcontractors. Performer shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Performer shall ensure that City is an additional insured on insurance required from subcontractors. Special or Low Risk Activities. 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. The City reserves the right to modify or waive insurance requirements for certain low risk recreational activities. 7. INDEMNIFICATION Performer agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees,contractors,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 Performer, its subcontractors, agents, employees, or other persons acting on its 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 Performer further agrees 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 Performer'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 out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Performer. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Performer shall defend and indemnify the City, its officers, agents, representatives, and Page 4 of 9 employees against any and all liability, including costs, for infringement of any United States' letters patent,trademark,or copyright infringement,including costs,contained in the work product or documents provided by Performer to the City pursuant to this Agreement. 9. RECORDS Performer shall keep records and invoices in connection with the work to be performed under this Agreement. Performer 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 Performer under this Agreement. All such records and invoices shall be clearly identifiable. Performer 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. Performer 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 Performer under this Agreement. 10. CONFIDENTIALITY If Performer receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Performer agrees that it 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 Performer disclosed in a publicly available source; (c) is in rightful possession of the Performer without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or(e) is independently developed by the Performer without reference to information disclosed by the City. City agrees to maintain the confidentiality of any proprietary information, trade secrets, or designs disclosed by Performer, except as required by law. 11. CONFLICT OF INTEREST CLAUSE Performer 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. 12. NON-DISCRIMINATION Performer 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 Page 5 of 9 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. Performer affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Performer, 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 Performer. 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 Performer 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 is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Performer, Performer 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 which are the subject to this Agreement performed by City personnel or by other contractors retained by City. 15. TERMINATION This Agreement may be terminated by the City upon five (5) days written notice of termination. In such event, Performer shall be entitled to receive and the City shall pay Performer compensation for all services performed by Performer prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Performer to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Performer consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 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 Page 6 of 9 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. 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. 18. PROFESSIONAL LICENSES Performer shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals,waivers, and exemptions necessary for the provision of the services hereunder 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. Performer 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. 19. 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 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, California 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director Parks and Recreation City of Santa Ana 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702 Page 7 of 9 To Performer: Raul Martinez 205 S. Myrtlewood St. West Covina, California 91791 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 time frames, weekends, federal, state, County or City holidays shall be excluded. 20. 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. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. [signatures appear on follow page] Page 8 of 9 SIGNATURE PAGE TO PERFORMER AGREEMENT BETWEEN RAUL MARTINEZ "EL DIABLITO" AND THE CITY OF SANTA ANA FOR MASTER OF CEREMONIES SERVICES IN WITNESS WHEREOF,the parties hereto have executed this Agreement the date and year first above written. ATTEST CITY OF NTA ANA �I Jennifer al Alvaro Nunez City Cler City Manager APPROVED AS TO FORM PERFORMER SONIA R. CARVALHO City Attorney B1r �actl Mcutrhez nar.v4rin=.uWs aa.anzs; m von onathan T.Martinez Raul Martinez Assistant City Attorney RECOMMENDED FOR APPROVAL: Hawk Scott Executive Director Parks, Recreation, & Community Services Agency Page 9 of 9 Exhibit A SCOPE OF SERVICES VENDOR INFORMATION: Raul Martinez"El Diablito" DESCRIPTION: This Performer will provide master of ceremonies (MC) services at.the annual Fiestas Patrias events :for years 2025-2028. The total amount due under this agreement shall not exceed $10,000.00. City staff will be present at all times during the events. EVENT: Annual Fiestas Patrias Event SERVICE DATE(S): see tables below 2025 September 13 - September 14, 2025 Location: Downtown Santa Ana DAY 1: 12:00pm— 10:00 pm DAY 2: 12:00pm—9:00pm 2026 September,TBD Location: TBD DAY 1: TBD DAY 2: TBD 2027 September, TBD Location: TBD DAY 1: TBD DAY 2: TBD 2028 September TBD Location: TBD DAY 1: TBD DAY 2: TBD COMPENSATION DUE TO THE VENDOR: Not to exceed$2,500.00 per year and per two-day event. Total compensation due shall not exceed $10,000.00 for the entirety of the Agreement. The Performer will be paid within 7 days following completion of the event. El Diablito - 2025-2028 - CAO signed Final Audit Report 2025-07-22 Created: 2025-07-22 By: Julie Hoang Ohoang@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAARWDDmfUFho7DYMCmUILbMs3fU2VuB8-d "El Diablito - 2025-2028 - CAO signed" History 6 Document created by Julie Hoang ahoang@santa-ana.org) 2025-07-22-7:03:28 PM GMT C°b Document emailed to Raul Martinez(radiotoxiko@gmail.com)for signature 2025-07-22-7:03:33 PM GMT Email viewed by Raul Martinez(radiotoxiko@gmail.com) 2025-07-22-8:00:04 PM GMT dQ Document e-signed by Raul Martinez (radiotoxiko@gmail.com) Signature Date:2025-07-22-8:01:12 PM GMT-Time Source:server Document emailed to Hawk Scott (hscott@santa-ana.org) for signature 2025-07-22-8:01:14 PM GMT Email Viewed by Hawk Scott (hscott@santa-ana.org) 2025-07-22-8:04:06 PM GMT i�a Document e-signed by Hawk Scott(hscott@santa-ana.org) Signature Date:2025-07-22-9:18:25 PM GMT-Time Source:server Q Agreement completed. 2025-07-22-9:18:25 PM GMT Adobe Acrobat Sign Garcia, Stephanie From: Najera, Luisa Sent: Thursday, September 4, 2025 2:24 PM To: Garcia, Stephanie Subject: RE: Insurance for Raul Martinez Hello Stephanie, RMD does not have a waiver for General Liability, but I will waive the insurance this year. However, next year, Mr. Martinez will need to purchase this coverage if your department decides to rehire him. Kindest regards, Luis,a,Nayera.J Acting Risk Manager City of Santa Ana I Human Resources Department +' 20 Civic Center Plaza I Santa Ana, CA 92701 � c Office: 714-647-6959 • ' Email: lnai ra(cDsanta-ana.org City Hall hours are 8 a.m.to 5 p.m.Monday through Thursday,and 8:00 a.m.to 5:00 p.m.every other Friday. Click he for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Google Play. Click here to report an issue directly from the City website. From: Garcia, Stephanie <SGarcia5@santa-ana.org> Sent: Wednesday, September 3, 2025 12:25 PM To: Najera, Luisa <Inajera@Santa-ana.org> Subject: RE: Insurance for Raul Martinez Hi Luisa, The insurance is too expensive and out of our budget. Can we get the waiver please? Sincerely, Stephanie Garcia, Management Aide City of Santa Ana, Parks, Recreation and Community Services Santa Ana 20 Civic Center Plaza, Santa Ana, CA 02701 �'# —Z (714) 571-4217 1 sgarcia5Ca7santa-ana.org "City Nall is closed every other Friday. Click here for dates" 1 Hello Stephanie, RMD does not have a waiver for General Liability, but I will waive the insurance this year. However, next year, Mr. Martinez will need to purchase this coverage if your department decides to rehire him. Kindest regards, Luc cvN y;e ra,J Acting Frisk Manager City of Santa Ana I Human Resources Department 20 Civic Center Plaza I Santa Ana, CA 92701 Office: 714-647-6959 ` • Email: Ina0era(a7santa-ana,org City Hall hours are 8 a.m.to 5 p.m. Monday through Thursday,and 8:00 a.m.to 5.00 p.m.every other Friday. Click here for a list of observed holidays and Friday closure dates. The mySantaAna mobile app puts the power of the Santa Ana city government in the palm of your hand! The free app allows residents to quickly and easily report issues to the City, access City services, and find news and events. It is available to download from the Apple App Store and on Gao Ice Play. Click here to report an issue directly from the City website. From: Garcia, Stephanie <5Garcia5@santa-ana,org> Sent: Wednesday, September 3, 2025 12:25 PM To: Najera, Luisa <Inaiera@Santa-ana.org> Subject: RE: Insurance for Raul Martinez Hi Luisa, The insurance is too expensive and out of our budget. Can we get the waiver please? Sincerely, Stephanie Garcia, Management Aide City of Santa Ana, Parks, Recreation and Community Services 20 Civic Center Plaza, Santa Ana, CA 92701 Santa,Ana �714) 571-4217 sgarcia5(cDsanta-ana.org *City Hall is closed every other Friday. Click here for dates" From: Najera, Luisa Sent:Wednesday, September 3, 2025 9:34 AM To: Garcia, Stephanie <SGarcia5@santa-ana.org> Subject: RE: Insurance for Raul Martinez You're welcome. Kindest regards, 2 California Insurance Card T 5 L n I INSURANCE Policy Number - TLA-CA-A-T-8GHCN31J4 Underwritten by: Effective Date Expiration Date State National Insurance Compary, Inc 09/12611C25 12:01 A M C3iC6/202rc 12-C1 A M NAIC = 12831 19CC L. Dor Dodson Dr.. Bedford, 7X 76021 Toll-Free Phone Number 1-844-34-TESLA Named Insured Year,Make,Model and VIM raul martinez 2C22 Testa Model 3 2C5 S MYRTLEWOOD ST 5Y43EtEBi3NF196386 WEST COVINA CA 91791 Drivers: raol martinez Examire policy exclusions carefully This form does,not Warning -the following Drivers are excluded from the policy: constrtute any part of yotir orsurarce policy Canra2e Frovided by the Policy Meets the Mirimum Liability Limats Prescribed by Law APPROVED By Tu Tran Nguyen at 7:52 am,Sep 10,2025 Tu Tran °u9T�a`nNg signed n6y Nguyen Date.11-0�o0° CITY OF SANTA ANA Risk Management a division of Human Resources S '•'c f Managing Rlsk through Awareness and Action y. AFFIDAVIT OF EXEMPTION FOR WORKERS' CON1 IT NSATIOIN INSURAIN (.T ,,-Raul Martinez _ _("Rcpresentative") attest that f am an .rmhr,rizcxi (Name and Title of Vendor Representative) Raul Tl Qiablito" Martinez representative of ("('ornpanv"), 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 _ ("Agreement")to providemaster of ceremonies —(Services to be provided under agreeinenucontract) 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 a and Company will be fully liable for any and all damages. 9f5f25 �._ Signature . .. Data Raul Martinezt �- _____ Print itinme self-employed 'Title -' 818-325-6727 — —�Contact Information,i-e„Telephone Number andlor Email Address WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERACI IS UNL.AWFUL, AND SHALL SUBJECT AN EMPLOYER TO C111�1�LINAL PENALTIES AND CIVIL FINES UP 10 ONE HUNDRED THOUSANT DOLLARS($100,000), IN ADD(TION'1TO TI IE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORNEY'S FEES. I Affldavit of Exemption for Workers'Compensation Insurance 11.12.2Q.1 — - I I