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HomeMy WebLinkAboutFRIDA CINEMA, THE (19) INSURANCE ON FILE WORK MAY PROCEED LI: URgNrF EXP REs A-2025-175-01 CITY CLERK CITY MANAGER MAYOR DATE;SEP 0 9 �� Valerie Amezcua tnr?Fy°." Alvaro Nunez MAYOR PRO TEM CITY ATTORNEY David Penaloza Sonia R.Canralho COUNCILMEMBERS CITY CLERK Phil Bacerra Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA 0 Will ( 0) COMMUNITY DEVELOPMENT AGENCY T,Le lf D O 20 Civic Center Plaza j PO Box 1988 Santa Ana,California 92702 www.santa-ana.oro September 2, 2026 The Frida Cinema Attn: Logan Crow, Executive Director 305 E. 41h Street, Suite 100 Santa Ana, CA 92701 Re: Extension of Agreement No.A-2025-175 for Sponsorship of the Downtown Santa Ana Art Walk Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by The Frida Cinema. and the City of Santa Ana,which commenced on October 21,2025,the parties hereby exercise their option to extend the term of the Agreement for an additional one (1) year through October 20, 2027, Any insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect, Sincerely, �1 Sylvia Vazquez,Deputy City Manager Acting Executive Director for Community Development Agency ATTEST CITY F SANT 4A o s+r re 4 ? ennifer ali '`'•°`� lvaro Nunez Ci City Manager APPROVED AS TO FORIM CONSULTANT: THE FRIDA CINEMA. d� X Andrea N. Garcia y: Logan Crow Senior Assistant City Attorney Title: Executive Director SANTA ANA CITY COUNCIL Valerie Amezcua David Penaloza Thai Vial Phan Benjamin Vazquez .Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Mayor Mayor Pro Tom-Ward 6 Ward 1 Ward 2 Ward 3 Ward n ward 6 vamezcua(r�santa-ana,orq doenalozafasanta-ana.ora lohan5santa-ana.om bvazauez(&santa-anaarn iessielopez(a�sanla-ana.orsl pbacarra(gsanta-ana.orp }nranhemande 6 anlaana_om Act CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDDfYYYY) 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 CONTACTNAMJ Keir Jones State,Rarm Keir Jones 562-433-5573 FAX Ext: A!C.CNo-: # Y 5150 E.Colorado Street E-MAIADDSL . ke1r.jones.ug42@statefarm com INSURER(S)AFFORDING COVERAGE NAIC 9 Long Beach CA 90814 INSURERA: State Farm General Insurance Company 25151 INSURED INSURER 8 THE FRIDA CINEMA INSURERc: 305 E 4TH ST STE 100 INSURER D INSURER E: SANTA ANA CA 927014639 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. IICY EXP LT R TYPE OF INSURANCE ADD UB MM1DWYYW MMPOLICY EFF LDDIYYYY LIMITS LTR INS❑ UB POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 2,000,000 CLAIMS-MADE ®OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 5 300,000 MED EXP(Any one person) $ 10.000 A Y Y 92-AO-ZO74-5 12/0812025 12/08/2026 PERSONAL&ADV INJURY s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 4,000,000 PRO- POLICY JECT X LOG PRODUCTS-COMPIOP AGG s 4.000,000 OTHER, $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accide $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY Per accident $ S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S QED RETENTION 5 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY S ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERYMEMBER EXCLUDED? ❑ N!R EL.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE_ $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIM[T $ DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana,it's City Council,Officers,Officials, Employees,Agents&Volunteers are listed as additional insured with waiver of subrogation and primary& non-contributory coverage. CAPIP!ROVED�n Ngu CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Attention:Executive Director Community ACCORDANCE WITH THE POLICY PROVISIONS. Development Agency 20 Civic Center Plaza M-25 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 Ty` � This farm was system-generaied on 0610912026 p 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1001486 2005 155279 205 01-19-2023 AC R® CERTIFICATE OF LIABILITY INSURANCE 011202 MfODlYYYY) 1`� o7ro vz026 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 CT NAME° Paychex Insurance Agency, Inc. PAYCHEX INSURANCE AGENCY, INC. PHONE E 877-266-6850 A X No 225 KENNETH DRIVE E-MAIL l Cers a ROCHESTER,NY 14623 ADDREss:Flex @P Ychex.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Technology Insurance Company 42376 INSURED INSURER B The Frida Cinema INSURER C: 305 East 4th Street Ste 100 INSURER 0 Santa Ana,CA 92701 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD MD POLICY NUMBER fMM1D0JyyM WM0DffYYYl LIMEYS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE � OCCUR DAMAGETORENTED PREMISES Ea occurrence $ ME)EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY1:1 PRO ❑ JECT LOG PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY{NJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESSLIAS CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LFAB ILITY y I N K 5TATUTE ER A ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 pFFtlCER1MEMBEREXCLUDED? NA Y TES4819371 07/2512026 07/2512027 (Mandatory in N") E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,fl0Q,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD tQ1,Additional Remarks Schedule,may be attached if more space is required) Waiver of Subrogation granted in favor of the certificate holder. APPROVED By Tu Tran lJguyerr at 1.32 pm,Jul 09,2026 CERTIFICATE HOLDER CANCELLATION City of Santa Ana 20 Civic Center Plz FI 4th SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Santa Ana,CA 92701 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE , ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Technology Insurance Company, Inc. 800 Superior Avenue East, 21 st Floor Cleveland, OH 44114 Policy Change Endorsement The Frida Cinema 305 East 4th Street Ste 100 Santa Ana, CA 92701 Enclosed is a Policy Change Endorsement for Policy Number: TES4819371 For questions, please contact our Underwriting Office at: 877-528-7878. 7/1/2026 AmTrust North America An AmTrust Financial Company WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 89 06 00 B POLICY INFORMATION PACE ENDORSEMENT Insured: The Frida Cinema Policy No: TES4819371 Policy Period: 7/25/2026 to 7/25/2027 Endorsement No: 2 Carrier Name: Technology Insurance Company, Inc. Endmt Effective: 7/25/2026 Authorized Rep: F The following item(s) * Insured's Name(WC 89 06 01) n Item 3.B. Limits(WC 89 06 12) * Policy Number(WC 89 06 02) o Item 3.C.States(WC 89 0613) * Effective pate(WC 89 06 03) ❑ Item 3.D. Endorsement Numbers(WC 89 06 14) u Expiration Date(WC 89 06 04) u Item V Class, Rate,Other(WC 89 04 15) © Insured's Mailing Address(WC 89 06 05) ® Interim Adjustment of Premium(WC 89 0416) © Experience Modification(WC 89 04 06) 13 Carrier Servicing Office(WC 89 0617) o Producer's Name(WC 89 06 07) o Interstate/Intrastate Risk ID Number(WC 89 06 18) ra Change in Workplace of Insured(WC 89 06 08) H Carrier Number(WC 89 06 19) ci Insured's Legal Status(WC 89 06 10) u issuing Agency/Producer Office Address(WC 89 06 25) © Item 3.A.States(WC 89 06 11) is changed to read: Specific Waiver of subrogation is amended to read: City of Santa Ana, Name(cont.): its City Council, officers, officials, employees, agents, and volunteers 20 Civic Center Plaza M-25 Santa Ana 92701 CA Class code 9155- 10000 Start Date: 2026-07-25 to End Date:2027-07-25 Amending form(s):WC040306 EndmtMailSheet WC890600B WC990001 E Class WC990001 E Pmt5ched WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule,(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description City of Santa Ana, its City Council,officers,officials,employees, grant approved for fundraiser agents,and volunteers 20 Civic Center Plaza M-25 Santa Ana CA 92701 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 7/25/2026 Policy No. TES4819371 Endorsement No. 2 Insured The 1=rida Cinema Premium$ 7,365 Insurance Company Technology Insurance Company, Inc. Countersignedby ......._......................... --- -- __.-----------.._._... _ - WC 04 03 06 (Ed. 04-84) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule.(This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2%of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by written contract. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 7/25/2026 Policy No. TES4819371 Endorsement No. 2 Insured . The Fdda Cinema Premium$ 7,365 Insurance Company Technology Insurance Company, Inc. Countersigned by WC 04 03 06 (Ed. 04-84) CITY OF SANTA ANA Risk Management a division of Human Resources Managing Risk through Awareness and Action .AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE p d[ 'Jt`t' i—r ydc_ 1(. ("Representative"),attest that I am an authorized ante and Title 3 Vendor Representative) representative of -1� �C;�s �'„,n�rvtiq ("Company"),and (ConsultantlCnmpany 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 A r 'sG2r ("Services-): (Services to he provided under agreemen0contract) 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. Signature Date t'rint Name a Title Contact information,i.e..Teleoo e Number anJ.or Email Address Affidavit of Exemption for Automobile Liability Insurance 11.12.2024 CM P-4860.2 Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number:92-AO-ZO74-5 Named Insured: THE FRIDA CINEMA Name And Address Of Additional Insured Person Or Organization: CITY OF SANTA ANA ITS CITY COUNCIL OFFICERS OFFICIALS EMLOYEES AGENTS&VOLUNTEERS 20 Civic Center Plz FI 4th Santa Ana CA 92701-4058 1. SECTION If—WHO IS AN INSURED of SECTION II—LIABILITY is amended to include,as an additional insured,any person or organization 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: a, Premises And Ongoing Operations Your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with your premises;or (2) In the performance of your ongoing operations; or b. Products—Completed Operations "Your work"performed for that additional insured and included in the"products-completed operations hazard". However,Paragraph 1.above is subject to the following: a. The insurance afforded to the additional insured only applies to the extent permitted by law; b. If coverage provided to the additional insured is required by a contract or agreement,the insurance provided to the additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured;and c, If the contract or agreement between you and the additional insured is governed by California Civil Code Section 2782 or 2782.05,the insurance provided to the additional insured is the lesser of that which: (1) Is allowed for the satisfaction of a defense or indemnity obligation by California Civil Code Section 2782 or 2782.05 for your sole liability;or (2) You are required by contractor agreement to provide for such additional insured. We have no duty to defend or indemnify the additional insured under this endorsement until a claim or"suit" is tendered to us, 2. Any insurance provided to the additional insured shall only apply with respect to a claim made or a "suit" brought for damages for which you are provided coverage. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations. CMP-4860.2 1010154 2000 154446 200 02-08-2023 ©,Copyright,State Farm Mutual Automobile Insurance Company,2022 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CM P-4860.2 Page 2 of 2 3, With respect to the insurance afforded to the additional insured,the following is added to SECTION II—LIMITS OF INSURANCE: If coverage provided to the additional insured is required by contract or agreement,the most we will pay on behalf of the additional insured will be the lesser of the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits Of Insurance shown in the Declarations. This endorsement shall not increase the applicable Limits Of Insurance shown in the Declarations, 4. With respect to the insurance afforded to the additional insured, the following is added to Paragraph 3. Duties In The Event Of Occurrence,Offense,Claim Or Suit of SECTION II--GENERAL CONDITIONS: The additional insured must: a. See to it that we are notified as soon as practicable of an"occurrence"or an offense which may result in a claim.To the extent possible,notice should include: (1) How, when and where the"occurrence"or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the"occurrence"or offense; b. Tender the defense and indemnity of any claim or"suit" to us and to all other insurers who may have insurance potentially available to the additional insured; and c. Agree to make available any other insurance the additional insured has for defense or damages for which we would provide coverage under SECTION II—LIABILITY. 5. With respect to the insurance afforded the additional insured, the following replaces SECTION II — LIABILITY of Paragraph 7. Other Insurance of SECTION I AND SECTION II—COMMON POLICY CONDITIONS: a. This Insurance is primary to and will not seek contribution from any other insurance available to the additional insured, - provided that the additional insured is a named insured under such other insurance. b. Regardless of any agreement between you and the additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. All other policy provisions apply CMP-4860.2 1010154 2000 154446 200 02-08-2023 0,Copyright,State Farm Mutual Automobile Insurance Company,2022 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CMP-4787 Page f of 7 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number:92-AO-ZO74-5 Named Insured: THE FRIDA CINEMA Name And Address Of Person Or Organization: CITY OF SANTA ANA ITS CITY COUNCIL OFFICERS OFFICIALS EMLOYEES AGENTS&VOLUNTEERS 20 Civic Center Piz A 4th Santa Ana CA 92701-4058 The following is added to Paragraph 10.b.of SECTION I AND SECTION II—COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations;or b. "Your work" done under contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP-4787 1008495 2001 151229 201 05-14-2019 (�J,Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. j