HomeMy WebLinkAboutLIGHTNING YOUTH ACADEMY (4) JL N-2026-097
MAY 11 77
CREATION SERVICES AGREEMENT WITH LIGHTNING YOUTH ACADEMY
FOR PHYSICAL FITNESS AND MENTAL HEALTH CLASSES
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THIS AGREEMENT is made and entered into on this 17`h day of April,2026 by and
between Lightning'Youth Academy, a California nonprofit corporation("Provider"), 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"). City and Provider may be
collectively referred to as the"Parties"or individually as a"Party."
RECITALS
A. The City desires to retain a recreation service provider having special skills, resources and
knowledge to provide physical fitness and mental health classes in its recreation class
program.
B. Provider represents that it is able and willing to provide such services to the City.
C. In undertaking the performance of this Agreement, Provider represents that it is
knowledgeable in their field and that any services performed by Provider under this
Agreement will be performed in compliance with such standards as may reasonably be
expected,
D. The Parties acknowledge that the City intends to provide recreational activities to the public
but must balance the need to comply with all COVID-19 guidance and restrictions.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the
terns and conditions hereinafter set forth, the Parties agree as follows:
1. SCOPE OF SERVICES
a. Provider shall perform those services as set forth in Exhibit A to this Agreement.
b. All classes operated pursuant to this Agreement for conducting recreation classes at
City facilities, including parks, will comply with all applicable guidance and public
health orders, including those from the Centers for Disease Control ("CDC"),
California Department of Public Health ("CDPH"), the Orange County Health Care
Agency("OCHCA") and the City itself for as long as those orders and guidance remain
in place. Provider will remind participants of these guidelines. To the extent that
Provider needs assistance with enforcing any rules or requirements, Provider will
contact a City Parks' employee or City security for assistance.
c. Provider shall not attend a class or teach any class if Provider is sick or has any
symptom(s)associated with COV17)-19 including but not limited to,fever above 100.4,
chills, cough, shortness of breath, loss of taste or smell, nausea, muscle or body aches,
vomiting, headache, sore throat or diarrhea.
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d. Provider will not attend class or teach a class if Provider or any member of Provider's
household has been asked to quarantine or self-isolate due to symptoms of COVID-19
or a positive test result for COVID-19.
e. Provider acknowledges that, to the extent that City is able to and chooses to conduct
classes indoors, this Agreement will also cover classes conducted at one of City's
recreational centers during the term of this Agreement.
f City reserves the right to change the location(s) at which the services contemplated by
this Agreement are provided.
g. Provider shall comply with the City's recreation class policy manual and any other City
rates and regulations regarding the operation of recreation classes.
2. COMPENSATION
a. In consideration for the provision of the programs set forth in Exhibit A, City agrees
to pay, and Provider agrees to accept as total payment for their services for the City,
seventy percent (70%) of all gross revenue received from program participants. Total
annual revenue to Provider shall not exceed Fifteen Thousand Dollars and Zero cents
($1s,000).
b. Payment to Provider shall be made monthly within thirty (30) days following
completion of the Iast class taught by Provider the prior month. City shall be
responsible for collecting all fees from program participants. Provider shall not collect
fees but will refer all interested participants to City for registration information.
Provider agrees that City shall retain thirty percent(30%)of all gross revenue received
from program participants as an administrative fee.
3. TERM
This Agreement shall commence on June 1,2026 and end on May 31,2027,with the option
for the City to grant a one (1) year extension, exercisable by the City Manager and the City
Attorney, unless terminated earlier in accordance with Section 14 below.
4. INDEPENDENT CONTRACTOR
Provider 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 manner in which Provider performs the services
which are the subject matter of this Agreement; however, the services to be provided by Provider
shall be provided in a manner consistent with all applicable standards and regulations governing
such services. Provider 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
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applicable withholding taxes. Provider is not an agent, representative or employee of City and
Provider shall have no authority to act on behalf of the City.
5. INSURANCE
Insurance requirements attached hereto as Exhibit B.
6. INDEMNIFICATION
Provider agrees to and shall indemnify, defend and hold harmless the City, its officers,
agents,employees, consultants,special counsel,and representatives from liability: (1)for personal
injury, damages,just compensation,restitution,judicial or equitable relief arising out of claims for
personal injury, including death, and claims for property damage, which may arise from the
negligent operations of the Provider or its contractors, subcontractors, agents, employees,or other
persons acting on their behalf which relates to the services described in section 1 of this
Agreement; and (2) from any claim that personal injury, damages,just compensation,restitution,
judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement,
to the extent that the injury, damages,just compensation, restitution,judicial or equitable relief is
caused by the negligence of the Provider. 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. City may make all reasonable decisions with
respect to its representation in any legal proceeding. In no case will Provider be required to
indemnify or hold harmless the City from injury, damages,just compensation,restitution,judicial
or equitable relief caused by the negligence of the City.
7. CONFIDENTIALITY
If Provider receives from the City information which due to the nature of such information
is reasonably understood to be confidential and/or proprietary,Provider 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, including but not limited to student records. Confidential information includes not
only written information, but also information transferred orally, visually, electronically, or by
other means. Confidential information disclosed to either Partyby 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 Provider disclosed in a publicly available source; (c) is in
rightful possession of the Provider without an obligation of confidentiality; (d) is required to be
disclosed by operation of law; or(e) is independently developed by the Provider without reference
to information disclosed by the City.
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8. COVID-19 ASSUMPTION OF RISK AND WAIVER
Provider acknowledges that Provider could be exposed to persons that may have COVID-
19 providing services pursuant to this Agreement. Provider understands that interacting with any
person currently comes with the inherent risk of exposure to COVID-19 and that COVID-19 is
highly contagious. Provider assumes the risks associated with providing services pursuant to this
Agreement, namely potential exposure to COVID-19. Provider acknowledges that while some
people have no symptoms or mild symptoms from COVID-19,some people have become seriously
ill requiring hospitalization and that some people have died from COVID-19. Provider
acknowledges that persons over the age of 55 and persons with underlying health conditions are
at greater risk of contracting COVID-19 and are potentially risking serious injury or death.
Provider is agreeing to provide classes pursuant to this Agreement and does so of Provider's own
free will.
Provider intends to be legally bound by this assumption of risk, release and waiver and to
bind Provider's heirs, personal representatives, next of kin and anyone who may make a claim on
Provider's behalf. Provider knowingly releases and waives any and all claims that Provider may
have or could have in the future and includes any claims resulting from potential exposure or actual
exposure to COVID-19, this includes claims for personal injury, transmittal of COVID-19 to
others, and/or wrongful death. Provider agrees to hold harmless, defend and 'indemnify the City,
its public officials,officers,employees,volunteers, and agents from any and all claims for liability
or damages, including those for exposure to or diagnosis with COVID-19 as a result of providing
services pursuant to this Agreement.
9. CONFLICT OF INTEREST
a. Provider 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.
b, No immediate family members of either the Mayor, City Council Member, or any
appointed City Official, including appointed board and commission members, as
defined under the City's Municipal Code, whose position with the City shall award or
influence the award of this Agreement, or any competing contract or amendment
thereof, shall be employed in any capacity by the Provider or have any other direct or
indirect financial benefit or interest in this Agreement.
c. The section also prohibits the awarding of any agreement, contract, grant, or any
amendment to those awards, to any former fall-time employee for one-year from date
of employee separation except for any Ca1PERS retiree as authorized by City Council
resolution
d. Provider must comply with all conflict of interest laws, ordinances, and regulations
now in effect or hereafter to be enacted during the term of this Agreement.The Provider
warrants that it is not now aware of any facts which conflict with the prohibitions
defined above. If Provider hereafter becomes aware of any facts that might reasonably
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be expected to create a conflict of interest, it must immediately make full written
disclosure of such facts to the City. Full written disclosure must include, but is not
limited to, identification of all persons implicated and a complete description of all
relevant circumstances. Failure to comply with the provisions of this paragraph will be
a material breach of this Agreement.
e. Provider covenants that none of its directors, officers, employees, or agents shall
participate in selecting or administrating any subcontract supported(in whole or in part)
by City funds stemming from the Agreement where the awarding of the subcontract
has any direct or indirect financial benefit or interest to any individual, as defined in
subsections (b) and (c) above.
10. BACKGROUND CHECK
Provider shall ensure that all employees, subcontractors, and any volunteers are
fingerprinted and background checked prior to conducting any work pursuant to this Agreement.
Provider shall not assign any employee, agent, subcontractor,volunteer or the Provider personally
to provide services pursuant to this Agreement, if that employee, agent, subcontractor, volunteer,
or the Provider personally are required to register as a sex offender under California Penal Code
Section 290 et seq, have a conviction for any crime of moral turpitude, have a conviction for a
sexual based crime, have a conviction for a violent felony as defined in California Penal Code
Section 667.5(c), or has a conviction for a serious felony as defined in California Penal Code
Section 1192.7(c),Disqualifying convictions include but are not limited to,violations of California
Penal Code Sections 37, 128, 136.1 with Section 196.22, 187, 190-190.4 and 192(a), 205, 206,
207-209.5, 211, 212, 212.5, 213,214, 215,218-219,220, 236.1(b) or 236.1.(c), 243.4, 261, 261,5,
273.5, 262, 264.1, 266, 266c, 266h, 266i, 266j, 267, 269, 272, 273a, 273ab, 273d, 285, 286, 288,
288a, 288.2,288.3,288.4,288.5,288.7,289,290,311.1, 311.2,311.3, 311.4,311.10,311.11,314,
347(a),368,417(b), 451(a),518 with 186.22, 647.6,653f(e), 664 and 187, 667.5(c), 18745, 18750,
or 18755, 12022.53, 11418(b)(1) or(b)(2);Business and Professions Code Section 729.
11. 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 snail, 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, CA 92702-1988
Fax(714) 647-6956
Pace 5 of 8
With copy to: Executive Director of Parks, Recreation
and Community Services
City of Santa Ana
20 Civic Center Plaza(M-23)
P.O. Box 1988
Santa Ana, California 92702
Fax (714) 571-4211
To Provider: Lightning Youth Academy
Attn: Jose Antonio Cholula Bruno, CEO
600 W Santa Ana Blvd.,Suite 530A
Santa Ana, CA 92701
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.
12. EXCLUSIVITY AND AMENDMENT
This Agreement represents the complete and exclusive statement between the City and
Provider regarding the subject matter herein, and supersedes any and all other agreements, oral or
written, between the parties. In the event of a conflict between the terms of this Agreement and
any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be
modified except by written instrument signed by the City and by an authorized representative of
Provider. 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 Provider 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.
13. ASSIGNMENT
The experience, knowledge, capability and reputation of Provider were a substantial
inducement for City to enter into this Agreement. Therefore, Provider 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.
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14. TERMINATION
a. This Agreement may be terminated by the City upon thirty (30) days written notice of
termination.
b. Termination or cancellation of classes by the Provider must be given to the City, in
writing, at least thirty (30) days prior to termination/cancellation. Failure to provide adequate
cancellation notice to the City may put future contracting of business with the City at risk.
15. RECORDS
Provider shall use attendance sheets generated and supplied by the City to record
attendance in each class. Provider shall keep these and any other records in connection with the
work to be performed under this Agreement and shall permit City, upon request, to review such
records for a period of three (3) years from the date of final payment to Provider under this
Agreement.
16. NON-DISCRIMINATION
Provider shall not discriminate because of race, color, creed, religion, sex, marital status,
sexual orientation, gender identity, gender expression, gender, medical conditions, genctic
information, or military and veteran status, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization,
promotion, termination or other employment related activities or any services provided under this
Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all
applicable federal, state and local laws and regulations.
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. LICENSES
Provider 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.
19, SEVERABILITY
In the event that one or more of the phrases, sentences, clauses, paragraphs or sections
contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree
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of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the
remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be
interpreted to carry out the intent of the Parties hereunder.
20. EXHIBITS
All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth
in the body of this Agreement.
21. AUTHORITY
The person(s) executing this Agreement on behalf of the Parties hereto warrant that they
are duly authorized to execute this Agreement on behalf of said Parties and that by so executing
this Agreement, the Parties hereto are formally bound to the provisions of this Agreement.
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement the date and
year first above written,
ATTEST: CITY OF SANTA A
ll Alvaro Nunez
City Clerk City Manager
APPROVED AS TO FORM:
SONIA R. CARVALHO PROVIDER:
City Attorney
Dr.Jose Chulula,MA,EdD(Apr 28,2026 15:52:28 PDT)
Jonathan T. Martinez Jose Antonio Cholula Bruno
Assistant City Attorney CEO
RECOMMENDED FOR APPROVAL:
Ha 'fit Scott
Executive Direct of Parks,
Recreation an mmunity Service gency
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EXHIBIT A
SCOPE OF SERVICES
SCOPE OF SERVICES
Program Overview:
This Scope of Services outlines the responsibilities and expectations for engagement of
Provider to provide physical fitness and mental health classes for ages 5 - 17 years at City
recreation facilities and parks, as defined below. The aim is to promote health and wellness in
the community by offering affordable recreation opportunities that encourage creative activity
and teamwork.
A. Program and Class Offerings:
1. Seasonal programs and class offerings may include, but are not limited to the
following class options:
i. Breathing and Mindfulness
ii. Lightning"Youth Running Club
ii. Instructor shall teach such or similar classes at available City facilities to be
designated by the City on a schedule agreed upon by the parties, in writing, for
each class session or term, including the location, specific days and hours when
classes will be held, and holidays to be observed, in accordance with City's needs.
Provider and City agree that class locations and/or scheduling are subject to
change due to unforeseen events or needs beneficial to the class participants.
The Parties agree that changes to scheduling or location of classes shall be
agreed upon, in writing, prior to the allowance of said change(s).
W. Class Size
i. At the City's discretion and upon mutual agreement, the minimum and
maximum number of participants required for each class will be determined
to ensure the quality and safety of the class participants.
ii. Class ratio of participants to instructor(s)will be set for each class to ensure
effective instruction and safety based on statewide standards.
iii, If the minimum registration has not been reached by the second class, it is
up to the discretion of the City upon mutual agreement with Instructor, that
the class shall be cancelled. Instructor will be under no obligation to
provide services for the cancelled classes, and the City will have no further
obligations to pay Instructor compensation for the remaining classes that
were cancelled in that session.
iv. Class Pees
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I. Class pricing is dependent on session length per season and subject to
City staff approval. Class pricing is limited to no more than a 5% increase
annually.
ii. Each participant shall pay class registration fees as established by City.
Instructor may not waive class participation/registration fees. Only
registered participants paid in full may participate in class.
iii. Any refunds to participants will be made in accordance with City policy.
B. Instructor Responsibilities:
L Planning and delivering engaging and age-appropriate physical fitness and
mental health classes as defined by class curriculum and description to be
approved by City staff.
ii. Ensuring the safety and well-being of all participants during class sessions.
• Instructor will immediately report to City staff, by phone or email, any
injuries as a result of class participation, damages to the facility that could
cause potential injury to a class participant and/or require facility repairs.
■ Instructor will notify parent/guardian of minors under the age of 18 and city
staff regarding any injuries experienced during class.
iii. Submitting seasonal program proposals to City staff for seasonal approval of
class descriptions, details, and schedules. Proposals must be submitted in writing
by way of the provided City form(s) to City staff for review and approval at least
60 days prior to the start of the new season, unless otherwise specified by City
staff. City staff will review and approve written proposals based on community
needs, facility availability, and alignment with City goals.
iv. Adhering to all City policies and procedures related to the use of facilities and
interaction with participants.
v. Adhering to all City deadlines for required documentation.
vi. The instructor's organization is responsible for fingerprinting, monitoring, and
managing all staff that will be instructing.
vii. Promotion of class(es) with City approved marketing materials outside of City
managed platforms. Publicizing on additional channels and networks outside of
City platforms is the sole responsibility of the instructor.
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viii. Instructor shall provide all materials, supplies, equipment, records and personnel.
Instructor shall be responsible for repairing and maintaining all equipment and
supplies, and ensuring that it is in good working condition. Instructor shall ensure
clean-up of the facilities and materials to ensure the safety and effectiveness of
instruction. The City will not responsible for any damage, repairs, misplaced, or
stolen supplies or equipment, and will not be responsible for storing supplies or
equipment.
C. City Responsibilities:
i. City shall manage participant registration and class information through
registration software. Instructor shall be granted access to the class roster on the
City registration system and is responsible for tracking attendance.
H. City shall collect all enrollment fees through the registration software. Instructor
shall not accept enrollment fees directly from a participant, and shall only collect
materials fees that are pre-approved by City and published in advance as a part
of the program marketing. Such material fees shall be collected by Instructor at
the first scheduled class meeting. No additional fees shall be collected for
materials, uniforms, awards, etc. without written approval and advanced.
advertising.
iii. City shall provide publicity for class(es) seasonally in the City`s recreation
magazine (published seasonally). City shall have the sole discretion to decide
what information will be included in the recreation magazine about the class and
Instructor. Publicity may also include flyers created by City. Instructor created
flyers are encouraged, but must be finalized by City to include use of City logos
before distribution.
iv. City shall provide a location for the class(es). Instructor will request dates and
times for the classes) seasonally, in writing. The City will confirm the class(es)
schedule seasonally. Location selection is based on need, size of class, type of
activity and availability, and is reserved at the discretion of the City.
v. City shall provide refunds to participants when
• The participant formally requests to drop the class before the second
schedule class meeting.
■ The class is canceled by City or Instructor.
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EXHIBIT B
INSURANCE REQUIRMENETS
Insurance Requirements
Provider shall procure and maintain for the duration of the agreement, the following insurance
coverages:
MINIMUM SCOPE AND LIMIT OF INSURANCE
Provider 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.
• Sexual Abuse or Molestation Liability (SAML): If the CGL policy referenced above is
not endorsed to include affirmative coverage for sexual abuse or molestation,Provider shall
obtain and maintain a policy covering Sexual Abuse and Molestation with a limit of no less
than $1,000,000 per occurrence or claim.
• 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 Provider does not
maintain commercial automobile liability insurance, City will accept evidence of
personal automobile insurance, provided that such policy is endorsed for business use and
provides coverage with a minimum limit of$1,000,000. Required policy limits can be
met with primary and umbrella/excess insurance policies.
• Workers' Compensation (WC): 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 Provider has no employees. Provider attests that its workers' compensation
coverage extends to all persons who will be working with the City under the agreed scope
of services.
If Provider maintains broader coverage and/or higher limits than the minimum shown
above, City requires and shall be entitled to the broader coverage and/or the higher limits
maintained by Provider. 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, SAML 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 Provider including materials,parts, equipment, and personnel furnished in
connection with such work or operations.
2. CGL, AL, and WC 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 Provider for City.
3. All required insurance policies: For any claims related to this contract,Provider'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 Provider'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 to Coverage or in limits,non-renewed by the
carrier, or materially changed except after thirty(30) days prior written notice has
been given to City. Ten(10) days prior written notice shall be provided to City for
policy cancellation or non-renewal due to non-payment.
6. Certificate Holder 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 the location of 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
Provider to purchase coverage with a lower retention or provide proof of ability to pay losses
and related investigations, claim administration, and defense expenses within the retention.
Acceptability of Insurers
Insurance is to be placed with insurers authorized to conduct business in the state of
California with a current A.M. Best rating of no less than A:VI1,unless otherwise acceptable
to City.
Verification of Coverage
Provider 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 Provider'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,Provider must purchase
"extended reporting" coverage for a minimum of three(3) years after completion of work.
Subcontractors
Provider shall require and verify that all sub-contractors maintain insurance
meeting all the requirements stated herein, and Provider shall ensure that City is an
additional insured on insurance required from sub-Providers.
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.
PRACTICE THIRD PARTY CERTIFICATE OF INSURANCE
AMATEUR ATHLETIC UNION OF THE U.S.,INC.
CERTIFICATE HOLDER The City of Santa Ana Parks&Recreation
20 Civic Center Plaza COVERAGE DATES:
Santa Ana,CA 92701 9/112025-8131/2026
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
issuin insureds),authorized reoresenta ive or producer.and the certificate holder.
PRODUCER INSURED MEMBER CLUB INSURED CERTIFICATE ID: PLBNBMFGMV
All iant Insurance Services,Inc. Amateur Athletic Union of the U.S.,Inc. CLUB CODE: UGU2DYSXZ
101 Park Avenue,14th Floor Walt Disney World Resort Lightning Youth Running Club
New York,NY 1017E P.O.Box 22409 } 600 W.Santa Ana Blvd.Suite 530A
Lake Buena Vista,FL 32830-L000 Santa Ana,CA,92701
INSURER(S)AFFORDING COVERAGE
Company A United State Fire Insurance Company NAIC#21113
Company B Everest National Insurance Company NAIC#10120
*For box below,INSR LTR refers to Company A,B,or C.
Company C HDI Global Specialty SE NAIC#AA-1340041
COVERAGES- This is to certify that the policy(ies)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 pulicy(ies)described herein is subject to all the terms,exclusions,and conditions of such policy(ies),limits shown may have been reduced by paid claims.
INSR TYPE OF POLICY COVERAGE EFF. COVERAGE EXP. COVERAGES LIMITS
LTR INSURANCE NUMBER DATE"NUDD1YY) DATE(MMMD1YY)
A Participant US 1132736 TO V202512:01 AM. 9/01/2026 12:01 Alvl. Accident Medical 100,000
Accident Accidental Death and Dismemberment 20,000
B Excess GCN0012707-251 9;01/2025 12:01 AM. 9/01/2026 12:01 AM. Each Occurrence 1,000,000
Liability Policy Aggregate 1,000,000
C Excess 25QS1244 9/01/2025 17:01 AM, 9/01/2026 12:01 A.M. Each Occurrence 4,000,000
Liability Policy Aggregate 4,000,000
B General GCN0012693-251 9MU2025 12:01 AM. 9/01/2026 12:01 AM. Each Occurrence Limit 1,000,000
Liability General Aggregate Limit 3,000,000
�t Participant Legal Liability 1,000,000
Personal and Advertising Injury Limit 1,000,000
Products-Completed Operations Aggregate 3,000,000
Fire Damage to premises Rented to You 1,000,000
Policy Aggregate Cap 20,000,000
Medical Expenses Limit(Any One Person) 5,000
Abuse or Molestation Incident 1,000,000
Abuse or Molestation Aggregate 2,000,000
ADDITIONAL INFORMATION 1 RESTRICTIONS I SPECIAL ITEMS
Coverage applies to Lightning Youth Running Club,License#PL8NBMFGMV AAU Practice License 2026 APPROVED
from 911/2025 through 8131 t2026,for the gross negligence and/or liabilities of the AAU Club(s)or registered members. By Tu Tran Nguyen at 3.01 pm,Mar 10,2026
t
For said club to have coverage,all membership requirements in the AAiJ must be met.
Primary non-contributory applies as per attached endorsement ECG 24 520 04 02.
Waiver of Transfer of Rights of Recovery Against Other to Us applies per attached Endorsement ECG 24 522 04 02.
The Certificate holder shall be an Additional Insured,but only with respect to the operations of the Named Insured,subject to the provisions and limitations of
the olic ies attached CG 20 11 0413 applies.
CANCELLATION—Should any of the above described policies be cancelled before the expiration date thereof,notice will be delivered in accordance with
the policy provisions. But,failure to mail such notices shall impose no obligation for liability of any kind upon the insurer,its agents or representatives.
REVOCATION OF MEMBERSHIP-will result in cancellation of coverage.
FACILITY OWNER SHOULD VERIFY THIS CERTIFICATE.
Go to www.aauspurts..org,Membership,Insurance,Issued Thud Party Certificates, Insert member club code
t Certificate No. UZV5TYNXGUSM Fil
Autho'z Representative — d-it,ysp,
POLICY NUMBER:GCN0012693-251 COMMERCIAL GENERAL LIABILITY
CC 20 1104 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
ADDITIONAL INSURED - MANAGERS OR
LESSORS OF PREMISES.. L
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART. .'
SCHEDULE {'
Designation flf Premises(Part Leased To You):
All locations owned,operated or leased by Name Of Pers6n(s)Or Organization(s) listed below •.
Name Of Person(s)Or Organization(s)(Additional Insured):
City of Santa Ana,its City Council,officers officials,employees,agents and volunteers
20 Civic Center Plaza
Santa Ana,CA 92701
Event: AAU Practice License 2026 4�S
Date: 9/112025 through 8/3112026
Additional Premium: 5 VIA f
Information required to complete dais Schedule,if not shown above,will be shown in the Declarations.
A. Section Il-Who Is An insured is amended to include a `q 2. Tf coverage provided to the additional insured is
as an additional insured the person(s)or 91 required by a contract or agreement,the insurance
organization(s)shown in the Schedule.but only with " afforded to such additional insured will not be broader
respect to liability arising out of the ownership, \ .\ than that which you are required by the contract or
maintenance or use of that part ofthe premises leased"-� y agreement to provide for such additional insured
to you and shown in the Schedule and subject to the
following additional exclusions: 'r ` , B. With respect to the insurance afforded to these
�: �s� additional insureds,the following is added to Section
This insurance does not apply to:- III-Limits Of Insurance:
1. Any"occurrence"which takes place after you ',
cease to be a tenant in that premises. If coverage provided to the additional insured is
2. Structural alterations,new construction or required by a contract or agreement,the most we will
demolition operations performed by or on behalf of the,,' pay on behalf of the additional insured is the amount of
person(s)or organization(s)shown in the Schedule. n insurance:
However: "X s L Required by the contract or agreement:or
1. The insurance afforded to such additional insured 2. Available under the applicable Limits of Insurance
only applies to the extent pemiittedby law;and shown in the Declarations;whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
CG 20 1104 13 C Insurance Services Office,Inc.,2012 Page 1 of I
POLICY NUMBER:GCN0012693-251 COMMERCIAL GENERAL LIABILITY
ECG 24 520 04 02
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
ADDITIONAL-OTHER INSURANCE
(PRIlVIARY NONCONTRIBUTORY)
This endorsement modifies insurance provided under the following:.
COMMERCIAL GENERAL LIABILITY COVERAGE PARI
A.Paragraph a.Primary Insurnce of 4. Other In-surance of SECTION IV
COMMERCIAL GENERAL LIABILITY CONDITIONS is_,re laced bv the
following:
a. Primary Insurance
This insurance is primary except when b.below applies. If this
insurance is primary, our obligations are not affected unless any of the
other insurance is also primary. Then,we will share with all that other
insurance by the method described in c.below,except that we will not
seek contribution'from any parry with whom you have agreed in a
written contract of agrement that this insurance will be primary and' .'
noncontributory,if the written contract of agreement,was made prior to
the subject"occurrence"or offense. 1 ''
ECG 24 520 04 02 Includes copyrighted material of Insurance Services Office,Inc., Page I of I
with its permission
POLICY NUMBER:GCN0012693-251 COMMERCIAL GENERAL LIABILITY
ECG 24 522 04 02
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE REAL}IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE -
Name of Person or Organization:
Gr-
ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS
AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER
(if no entry appears above,information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition(Section
IV-COMMERCIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of the following:
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 operations or
"your work"done under a written agreement that requires you to waive your rights of recovery. The written
agreement must be made prior to the date of the"occurrence". This waiver applies only to the person or
organization shown in the Schedule above.
ECG 24 522 64 02 Includes copyrighted material of Insurance Services Office,Inc., Page 1 of 1
with its permission
APPROVED CITY OF SANTA ANA
ByTuTran Nguyen at11:40 am,Apr 85,2028 Risk Management a division of Human Resources + .
Managing Risk through Awareness and Action
AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE
1 Jose Cholula, President "Re resentative"( p ),attest that[ am an authorized
(Name and Title of Vendor Representative)
representative of Lightning Youth Academy ("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
("Agreement")to provide Physical & Mental Health Classes ("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 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.
4/28/26
Signature Date
Jose Cholula, MA, EdD
Print Name
President
I idc
714-699-3345, cholula@lyacademy.org
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 .,
Risk Management a division of Human Resources
Managing Risk through Awareness and Action
AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE
1 Jose Cholula' President
("Representative"),attest that I am an authorized
(Name and Title of'vendor Representative)
representative of Lightning Youth Academy ("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
("Agreement")to provide Physical & Mental Health Classes ("Services"):
(Services to be provided under agreement/contract)
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 perfonn 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.
4/28/26
Signature Date
Jose Cholula, MA, EdD
Print Name
President
Title
714-699-3345, cholula@lyacademy.org
Contact Information,i.e.,Telephone Number and/or Email Address
Affidavit of Exemption for Automobile Liability Insurance 11.12.2024