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HomeMy WebLinkAboutDANCE ARTS ACADEMY FOUNDATION (2) N-2026A 75 .0.�( Ztiv f Z02�- JUL ) 0 2026 ARTS AND CULTURE ARTIST GRANT PROGRAM AGREEMENT BETWEEN 01b0pit0) THE CITY OF SANTA ANA AND DANCE ARTS ACADEMY FOUNDATION 1_V_L(bz) This Artist Grant Agreement ("Agreement") is made and entered this 18th day of May, 2026, by and between the City of Santa Ana, a charter City and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"), and Dance Arts Academy Foundation, a California nonprofit public benefit corporation ("Grantee")for the purpose of providing grant funding pursuant to the Investing in the Artist Grant Program ("Grant Program"). City and Grantee may herein individually be referred to as a "Party" and collectively be referred to as the "Parties" to the Agreement. RECITALS: A. On April 19th, 2026, the Arts and Culture Commission reviewed all applicants and recommended that Grantee be awarded an artist grant based on its Application for its art project ("Project"). A true and correct copy of Grantee's Application is attached hereto as Exhibit A and incorporated herein by reference. B. In undertaking the performance pursuant to this Agreement, Grantee represents that it is skilled and knowledgeable in the arts and culture arena and that the Project created or performed hereunder will be created or performed in compliance with such standards as may reasonably be expected from an artist. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the Parties agree as follows: 1. Term. This Agreement shall be effective upon signature by both Parties and shall expire one year from the date first written above, unless terminated earlier in accordance with this Agreement. 2. Funding. 2.1. Subject to Grantee's performance of all required actions under this Agreement, City shall provide funding, in two disbursements, as detailed below, of an amount not to exceed Fourteen Thousand, Seven Hundred, Twenty-Two Dollars ($14,726) ("Grant Amount" or "Grant"). 2.2. Grantee will be paid in two (2) installments. First payment will be one-half of the funding amount provided above or $7,363 and will be provided within thirty (30) days of the full execution of the Agreement by the Parties along with a complete invoice submitted by Grantee. The second and final payment will include the remaining amount of$7,363 and will be issued within thirty(30) days after the Grantee submits to the City all the proper receipts, invoices, and final report for the Project. 2.3. Appropriate performance of the Grantee will be determined by City in its sole discretion. City reserves the right to cease funding after the first disbursement detailed above, and to be reimbursed the initial payment, if Grantee's performance is determined to be insufficient or unacceptable in the City's sole discretion. 2.3. City represents that there is no correlation or connection between its selection of individuals for grant awards and an individual's business relationship or potential business relationship with City. 1 3. Grant Activities. Grantee agrees: 3.1. To perform the activities described in Grantee's Grant Application submitted to City for consideration dated March 7, 2026, a copy of which is attached as Exhibit A and incorporated into this Agreement as if set out in full. 3.2. To submit all reports(each, a "Report"), which shall include, at a minimum, the items set forth as required by the Application. No personally identifiable information shall be included in any of the Reports, except where specifically requested. The Reports shall be in a format that is reasonably acceptable to City. City may request additional information as City, in its sole discretion, determines is necessary to monitor performance of this Agreement. City shall have the right to use any Reports submitted by Grantee, or any portion thereof, for any reason. 3.3. To maintain all pertinent financial and accounting records pertaining to this Agreement in accordance with generally accepted accounting principles and other procedures reasonably specified by City. Upon termination or expiration of this Agreement or request by City, Grantee shall provide, at its expense, copies of all financial and accounting records produced by Grantee arising out of this Agreement. 3.4. To allow audits, compliance or special reviews and inspections, including on-site inspection, with or without prior notice, of Grantee's facilities by City or by third parties designated by City, or their authorized representatives. Grantee shall provide its full cooperation for any such audit, review or inspection, including providing timely access, for examination and copying of records (including computerized records) pertinent books, documents, papers, computer programs and records and reasonable access to its personnel. 3.5. To ensure that any areas utilized for the Project are maintained and restored to a well- maintained, safe, sanitary, and clean condition, and kept free of any hazardous waste at all times. All equipment associated with the installation of the artwork, trash and debris shall be removed and cleaned up on a daily basis. If applicable to the Project, Grantee shall place a drop cloth or similar barrier on the ground below the artwork while installation is underway, which barrier shall be removed each day upon completion of an installation session. 3.6. The Project may not contain advertising, religious art, sexual content, negative or violent imagery, convey political partisanship or include any hidden, subliminal, or camouflaged messages or statements of any kind or nature. Appropriateness of the content of the Project will be determined by City in its sole discretion. 3.7. The Project may not include any breach of intellectual property, trademarks, brands, or images of illegal activity, and the Grantee must be the copyright holder for the Project. It is the sole responsibility of the Grantee to obtain any and all applicable copyrights or trademarks associated with the artwork for the Project. 3.8. To be responsible for the maintenance of the Project, which includes but is not limited to, graffiti removal, touch-up, and restoration, for the duration of the Project's existence. 3.9. If the artwork is a mural, it must be covered in an anti-graffiti coating at the Grantee's expense. 3.10. The City holds all rights to public art on City property, and as such the Project artwork may be removed at the sole discretion of the City. Should the Project artwork be defaced and/or not repaired, maintained, preserved and/or conserved, the City has the authority to repair, maintain, preserve, and/or conserve the Project artwork, or alternatively, the City has the sole authority to 2 remove, alter, or destroy the Project artwork. Grantee will have first right of refusal to restore said Project artwork. If Grantee is unwilling to perform or unable to be contacted within a reasonable time, the City has the right to request the services needed from a different artist, in the City's sole discretion. 3.11. Grantee shall execute and deliver to City any instruments that City may reasonably require to confirm ownership of any artwork. 3.12. Grantee shall be responsible for complying with all Federal, State and local laws, ordinances, statutes and regulations, including, but not limited to zoning and other environmental requirements (if applicable), and for obtaining all required licenses, permits, or other authorizations applicable to the performance of Grantee's Project under this Agreement. 3.13. The estimated dates of completion and proposed Project locations contained in the Grantee Application, Exhibit A, are just that, estimates and proposals, as they were provided to the Arts & Culture Commission. It is the responsibility of the Grantee to secure all necessary permits, approvals, location confirmation, and facilities confirmation, from the appropriate entities, City departments or City facilities for the use of the proposed site for the Project. Execution of this Agreement does not guarantee any specific City permit, City location, or City site for the Project. 4, Termination. 4.1. City may immediately terminate this Agreement upon one or more of the following: 4.1.1. Grantee's violation of any federal, state or local law or regulation. 4.1.2. Grantee's breach of any of the terms or conditions of this Agreement, including the Application, or any unapproved deviation from said documents that has not been cured within 30 days of written notice of such breach. 4.1.3 Grantee's failure to provide documents to the City, as requested by the City by a date no later than three (3) months from the date of this Agreement, in order to maintain compliance with the Grant Program, City Policies or Procedures, or this Agreement. Such paperwork can include but is not limited to, completed vendor forms (City's administrative forms, IRS W-9 form, ACH payment forms), proof of insurance, and signed orientation paperwork. 4.2. In the event the Agreement is terminated under Section 4.1, City reserves the right to require Grantee to refund any or all grant funds awarded to Grantee under this Agreement, and Grantee agrees to refund to City any or all grant funds awarded under this Agreement. 5.. Limitation of Liability. 5.1. IN NO EVENT SHALL CITY BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES OR EXPENSES FOR ANY NEGLIGENCE, BREACH OF CONTRACT OR ANY OTHER ACT ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE ACTIVITIES COVERED HEREUNDER. 5.2. Section 5 and Section 6 do not limit Grantee's rights, including its ability to seek recovery, against anyone other than City, its City Council, officials, directors, officers, employees, agents, successors, assigns and volunteers. 3 6. Indemnification. 6.1. Grantee shall defend, indemnify, protect and hold harmless the City, and its City Council, elected and appointed officials and officers, employees, members, volunteers, or agents from and against all claims for damages, liability, cost and expense (including without limitation attorney's fees) arising out of or alleged by third parties to be the result of the negligent acts, errors or omissions or the willful misconduct of the Grantee, and Grantee's employees, subcontractors or other persons, agencies or firms for whom Grantee is legally responsible in connection with the execution of the work covered by this Agreement. Grantee shall have no duty to indemnify or hold harmless the City if claims, damages, liability, costs, expenses (including without limitation, attorney's fees) arise from the sole negligence or sole willful misconduct of the City subsequent to declaration by the Grantee. Grantee's obligations shall survive the termination of this Agreement. 6.2. Grantee agrees to hereby fully release and forever discharge the City from any and all claims, demands, damages, losses, and liabilities (hereinafter collectively referred to as"claims"), which are or may be related to or in any way connected with the negligence or willful misconduct of its officers, officials, employees, or agents in connection with the creation, painting, performance or installation of the Project hereunder. 6.3. Grantee further agrees that City may in good faith and on reasonable terms settle any such claims and that City's right to indemnification shall extend to any such settlement, provided City has given notice of such claim and its intent to settle. City's right to indemnification is in addition to, and may be exercised independently of, any remedy held by City under this Agreement, at law or in equity. The indemnity provision set forth in this Agreement shall survive the termination or expiration of this Agreement indefinitely. 7. Insurance 7.1 Prior to undertaking performance of work under this Agreement, Grantee shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: MINIMUM SCOPE AND LIMIT OF INSURANCE Grantee shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: • Commercial General Liability(CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal &advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. • Automobile Liability (AL): Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with combined single limits of $1,000,000. In the event Grantee does not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance with existing limits, which can be lower than $1,000,000. • Workers' Compensation (WIC): as required by the State of California, with statutory limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident, per employee, per policy for bodily injury or disease. This requirement can be waived if Grantee has no employees. 4 If Grantee maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Grantee. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. CGL and AL policies: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Grantee including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. All required insurance policies: Insurance company(ies) agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Grantee for City. 3. All required insurance policies: For any claims related to this contract, Grantee's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. 4. All required insurance policies: A severability of interest provision must apply for all the additional insureds, ensuring that Grantee's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. 5. Each insurance policy required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non-renewed by the carrier, or materially changed except after thirty(30) days prior written notice has been given to City. Ten (10) days prior written shall be provided to City for policy cancellation or non-renewal due to non-payment. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Executive Director, Community Development Agency, 20 Civic Center Plaza M-25, Santa Ana, CA 92701. The name and location of event should be included in the Description of Operations section of each certificate. Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. Verification of Coverage Grantee shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause)and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to City before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Grantee's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 5 Subcontractors Grantee shall require and verify that all sub-contractors maintain insurance meeting all the requirements stated herein, and Grantee shall ensure that City is an additional insured on insurance required from sub-contractors. Special Risks or Circumstances City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 8. General Provisions. 8.1. Grantee shall acquire prior written permission from City for any use of the City name or logo in association with the Project. 8.2. if any parts of this Agreement are held to be invalid or unenforceable, the remaining parts of the Agreement shall continue to be valid and enforceable. 8.3. Grantee shall comply with all governmental requirements that may now or in the future become applicable to the activities under this Agreement. 8.4. This Agreement, including all exhibits, Application, and any amendments or schedules hereto, contain the full understanding and agreement of the Parties with respect to its subject matter, and no waiver, alteration or modification of any of the provisions to this Agreement shall be binding unless in writing and signed by an authorized officer of both Parties. 8.5. No waiver by either Party or any breach, default, or series of breaches or defaults, and no failure, refusal, or neglect of either Party to exercise any right, power, or option given to it under this Agreement or to insist upon strict compliance with the terms of this Agreement shall constitute a waiver of these provisions with respect to any subsequent breach or waiver by either Party or its right at any time thereafter to require exact and strict compliance with provisions of this Agreement. 8.6. Any notice or other communication required or permitted to be made or given by either Party pursuant to this Agreement will be in writing and will be deemed to have been duly given: (i)five (5) business days after the date of mailing if sent by registered or certified U.S. mail, postage prepaid, with return receipt requested; (ii) when transmitted if sent by facsimile, provided a confirmation of transmission is produced by the sending machine; or (iii) when delivered if delivered personally or sent by express courier service. All notices to City shall include a reference to the Project title. All notices will be sent to the other Party at its address as set forth below or at such other address as such Party will have specified in a notice given in accordance with this section: Grantee: Dance Arts Academy Foundation 165 Cozumel Laguna Beach CA, 92651 6 City: City of Santa Ana Clerk of the Council (M-30) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702 FAX (714) 647-6956 8.7. This Agreement is subject to all applicable local, State and Federal laws. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both Parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 8.8. Grantee agrees to comply with all applicable equal opportunity and affirmative action laws as appropriate, Grantee shall not discriminate because of race, color, religion, sex, gender identity, gender expression, marital status, sexual orientation, age, national origin, ancestry, medical condition, military or veteran status, genetic information, request for family care leave, request for leave for an employee's own serious health condition, request for pregnancy disability leave, disability, or otherwise as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Grantee affirms that it is an equal opportunity employer(if applicable) and shall comply with all applicable federal, state and local laws and regulations. 8.9. Any funds provided under this Agreement that are not expended, obligated or otherwise committed by the termination or expiration of this Agreement shall be immediately returned to City. 8.10. Grantee grants to City a non-exclusive, irrevocable, transferable, royalty free, worldwide license to use, reproduce, display, distribute, and prepare derivative works, in any form or media at the discretion of the City for the Project conceived, performed or created as a result of this Agreement. 8.11. Grantee and any of the Grantee's agents, employees or representatives are,for all purposes under this Agreement, an independent contractor and shall not be deemed to be an employee of the City, and none of them shall be entitled to any benefits to which City employees are entitled including but not limited to, overtime, retirement benefits, work's compensation benefits, injury leave or other leave benefits. 8.12. Neither Party shall assign any rights or obligations under this Agreement. 8.13. Each Party covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 8.14. Each Party warrants that they have executed this Agreement knowingly, freely and voluntarily and with full knowledge of its legal consequences. All Parties involved warrant and represent that, prior to executing this Agreement, each Party has had the opportunity to review 7 and consider this matter with legal counsel, and that the terms of this Agreement, and its consequences, are fully understood by each Party. 8.15. This Agreement represents the entire agreement and understanding between the Parties, and supersedes any and all prior agreements and understandings between the Parties, whether oral or written. 8.16. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective Parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. {Signatures on following page} s IN WITNESS WHEREOF, the Parties hereto have executed this Agreement the date and year first alcove written. ATTEST: CITY OF SANTA ANA NNIF H L °' ALVARO NUNE City Cle k City Manager APPROVED AS TO FORM: GRANTEE: SONIA R. CARVALHO City Attorney By: Andrea N. Garaa ame: Sakina Ibrahim Senior Assistant City Attorney Organization: Dance Arts Academy Foundation Title: Executive Director RECOMMENDED FOR APPROVAL: MICHAEL L. GARCIA Executive Director Community Development Agency 9 EXHIBIT A INVESTING IN THE ARTS GRANT PROGRAM APPLICATION 10 Project Timeline — Santa Ana Participatory Summer Movement Lab March -April 2026 Program planning and partnership coordination. Confirm teaching artists, community partners, and program schedule. Conduct outreach to Santa Ana schools, families, and community organizations. May— June 2026 Participant recruitment and registration. Finalize curriculum, teaching artist contracts, and program logistics, Launch community outreach and marketing to ensure broad participation and public awareness. July 2026 Implementation of the two-week Santa Ana Participatory Summer Movement Lab. Youth participants ages 4-13 engage in daily dance training, collaborative choreography, creative movement storytelling, and reflective activities led by professional teaching artists. End of Program— July 2026 Culminating public community showcase in Santa Ana featuring youth-created works,Dance Arts Movement Collective artists, and invited local collaborators. Event is free and open to the public. August 2026 Program evaluation, participant feedback collection, documentation of outcomes, and community reporting. SAMPLE Line Item Budget "Input your information directly onto this form (2 pages) and upload onto Submittable.com (use Google Chrome). PERSONNEL Description of Personnel Grant (contracted instructors, lecturer honorarium, Total Compensation Funds artist stipend, etc.) Requested Teaching Artists $5000 $5000 Program Coordinator $1500 $1500 Program Director $2000 $2000 Professional Development Training $500 $500 EQUIPMENT, MATERIALS, AND SUPPLIES Item Unit Total Grant (equipment, materials, supplies) Quantity Cost Cost FundsRequested Skirts 25 $40 $1000 $1000 Jazz Shoes 25 $25 $625 $625 Leotards 25 $20 $500 $500 Folklorico Shoes 15 $40 $600 $600 SPECIAL EVENTS Description Grant Funds (permits, fees, facility rental for project, Total Cost Requested marketing) Marketing & Outreach $800 $800 Studio Rental $1,200 $1,200 Showcase Production $1,001 $1,001 SAMPLE Line Item Budget— Page 2 Enter budget categories and projected expenditures for the proposed program: Expenditures Total Expenditures Funded By Organization Funded By Other Total Program Budget Category Santa Ana Sources Budget Grant (Including in- kind) Administrative Staff Salaries and Benefits ME- Contractual/Professional 0 $5,500 $83,000 Services/Stipends $5,500 Equipment, Material, Supplies $2,725 0 $2,725 $83,000 Special Events Production $2,201 0 $2,201 $83,000 Marketing $800 0 $800 $83,000 Administrative Staff Salaries $3,500 0 $3,500 $83,000 and Benefits TOTAL 514,726 PROGRAM REVENUE LIST ALL OTHER PROGRAM RESOURCES "Funding Source"total must equal "Total Program Budget" listed above. FUNDING SOURCE AMOUNT Santa Ana Artist Grant Santa Ana Artist Grant $14,726 TOTAL PROGRAM BUDGET $14,726 DATE(MM1DDNY(Y) AC"R" CERTIFICATE OF LIABILITY INSURANCE 1 06/09/2026 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 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: Hiscox Inc.dlbla/Hiscox Insurance Agency in CA PHONE 888 2D2-3007 FAX 5 Concourse Parkway E-MAIL "° Ezt: ( ) ,uc No Suite 2150 ADDRESS: contact@hISCOX.COm Atlanta GA,30328 INSURERS AFFORDING COVERAGE _ NAIC# INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: DANCE ARTS ACADEMY FOUNDATION INSURERC: 165 Cozumel Laguna Beach, CA 92651 1INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDTYPE OF INSURANCE INBQ SUER POLICY EFF POLICY EXP LTR POLICY NUMBER MMfDDIYYYY MWDDlYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE � OCCUR PREM SESOEa o DAMAGE acE ante $ 100,000 MED EXP(Any one person) $ 5,000 A Y P106.639.814.1 05/26/2026 05/26/2027 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- 7LOC I PRODUCTS-COMPJOP AGG s SIT Gen.Agg. _ OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ -.._ AUTOS AT NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE1: $ DIED RETENTION$ $ WORKERS COMPENSATION PER CTH- AND EMPLOYERS"LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERfEXECUTIVE ❑ E.L. H ACCIDENT $ OFFiCERfMEMBER EXCLUDED? NIA _E_.L.EACH -- (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION CF OPERATIONS below I I I E.L DISEASE-POLICY LIMIT S J DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) APPROVED By Tu Tran Nguyen at 2:12 pm,JUI 06,2026 CERTIFICATE HOLDER CANCELLATION City of Santa Ana,its city council,officers,officials,employees,agents,and vol unteers.20 Civic Center Piaza,Santa Ana,CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 165 Cozumel THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Laguna Beach,California 92651 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD HISCOX encourage courage- Declarations Page 11e, HISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) encourage courage 125 S.Wacker Drive, Suite 2080, Chicago, IL 60606 Commercial General Liability Declarations In return for the payment of the premium, and subject to all the terms of this Policy, we agree with you to provide the insurance as stated in this Policy. Declaration effective from: June 9,2026 Policy No.: P106.639.814.1 Named Insured: DANCE ARTS ACADEMY FOUNDATION Address: 165 Cozumel Laguna Beach, CA 92651 Email Address: sakinanadiah@gm@il.com gmail.com Policy period: From: I May 26,2026 To: May 26, 2027 At 12:01 A.M. (Standard Time)at the address shown above. Form of Business: Not far profit Corporation Each Occurrence Limit: $1,000,000 Damage to Premises Rented to You Limit: $100,000 Any one premises Medical Expense Limit: $5,000 Any one person Personal&Advertising Injury Limit: $1,000,000 Any one person or organization General Aggregate Limit: $2,000,000 Products/Completed Operations Products-completed operations are subject to the General Aggregate Limit Aggregate Limit: Supplemental Business Personal Property Floater $0 Coverage Limit: Supplemental Business Personal Property Floater Not Applicable Coverage Deductible: All Premises You Own, Rent or Occupy Premises Number: - 1 Address: 165 Cozumel Laguna Beach, CA 92651 Total Premium: 434.00 Attachments. See attached Forms and Endorsements Schedule. CGL D001 10 18 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 its permission.© ISO Properties, Inc.,2000 r�fm H ISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) encourage Courage" 125 S.Wacker Drive, Suite 2080, Chicago, !L 60606 IN WITNESS WHEREOF,the Insurer indicated above has caused this Policy to be signed by its President and Secretary,but this Policy shall not be effective unless also signed by the Insurer's duly authorized representative. 41�? &Tli President Secretary G04 ? &Tli Authorized Representative CGL D001 10 18 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 its permission.©ISO Properties, 112000 4ev HISCOX HISCOX INSURANCE COMPANY INC. (A Stock Company) encourage Courage" 125 S.Wacker Drive, Suite 2080, Chicago, IL 60606 Forms and Endorsements Schedule Forms and Endorsements made part of this policy at time of issue: CGL D001 10 18-Commercial General Liability Declarations INT D001 01 10- Forms and Endorsements Schedule CGL E5410 CW(03110)- Policy Changes CG 20 26 07 04-Additional Insured - Designated Person or Organization INT 13001 01 10 Page 1 of 1 *Ar4 HISCOX encourage courage- Endorsements HI SCOX Hiscox Insurance Company Inc. Policy Number: 1?106.639.814.1 Named Insured: DANCE ARTS ACADEMY FOUNDATION Endorsement Number: 31 Endorsement Effective: 06/09/2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES This endorsement will not be used to decrease coverage, increase rates or deductibles or alter any terms or con- ditions of coverage unless at the sole request of the insured. The following item(s): ❑ Insured's Name ❑ Insured's Mailing Address ❑ Policy Number ❑ Company ❑ Effective/Expiration Date ❑ Insured's Legal Status/Business of Insured ❑ Payment Plan ❑ Premium Determination ❑ Additional Interested Parties ® Coverage Forms and Endorsements ❑ Limits/Exposures ❑ Deductibles ❑ Covered Property/Located Description ❑ Classification/Class Codes ❑ Rates ❑ Underlying Insurance is (are)changed to read (See Additional Paye(s)): The above amendments result in a change in the premium as follows: ® NO CHANGES ❑ TO BE ADJUSTED ADDITIONAL.PREMIUM RETURN PREMIUM AT AUDIT CGL E5410 CW(03110) Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 ❑ with its permission. POLICY CHANGES ENDORSEMENT DESCRIPTION It is understood and agreed that effective 06/09/2026, Endorsement#32 entitled Additional Insured- Designated Person or Organization is added. All other terms and conditions remain unchanged. CGL.E5410 CW(03/10) Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission. AM HISCO Hiscox Insurance Company Inc. Policy Number: P106.639.814.1 Named Insured: DANCE ARTS ACADEMY FOUNDATION Endorsement Number: 32 Endorsement Effective: 0B10912026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Santa Ana, its city council, officers, officials, employees, agents, and volunteers. 20 Civic Center Plaza, Santa Ana, CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section It — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 40 HI SCO Hiscox Insurance Company Inc. Policy Number: P106.639.814.1 Named Insured: DANCE ARTS ACADEMY FOUNDATION Endorsement Number: 30 Endorsement Effective: 06/09/2026 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MODIFIED WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph B. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions; You may waive your rights against another party so long as you do so in writing prior to: (i) an offense arising out of your business that caused a "personal and advertising injury"; or (ii) an "occurrence" that caused "bodily injury" or"property damage'. CGL E5402 CW(03110) Page 1 of 1 Includes copyrighted material of insurance Services Office, Inc.,with its permission. CITY OF SANTA ANA Risk Management a division of Human Resources �Ya Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE ("Representative"),attest that I am an authorized (Name and Title'of Vendor Representative) representative of ("Company"),and (ConsultandCom ny ame) 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 / / ("Services"): {Servic s 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. Signature rate Print Name Title Conmet Information,i.e.,Telephone Number and'or mail Address WARMING: 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(S[00,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND ATTORI EY'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 M2 AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE 1, S,/1 r� w.t ("Representative"],attest that I am an authorized (Name and Title of Vrndor Representative) representative of �2 h m 1 ("Company"), and (Consultant/.otnpany Na !eZ 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�� /G L 1, ("Services"): f Services to be provided under agercemcnt'com=t} During the course and scope of Company's agreement with the City of Santa Ana, Company employees,consultants,representatives,and agents will not use and/or drive any Company owned/rented/leased/borrowed vehicles to perform Services to,for,or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this document-and does not maintain the minimum automobile liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. j Signature Date Print Name a Title Contact In ronnalian i.e.,Telephone Number and or EmalE Ad Tress Affidavit of Exemption for Automobile Liability Insurance 11.12.2024