HomeMy WebLinkAboutFIESTA DE CARNIVAL (A-2015-188-02)-2016City of Sang 4na
f Clerk of the C incil
AGREEMENT TERMINATION FORM ----- —._.-._-_--______.___.
COTC Office Use Only
i --
Please complete this form when the attached agreement and all
amendments (if any) are no longer in effect. CITCL Y �h SaNTA ANC
E�RK OF COUNCIL
Return form to the Clerk of the Council Office (M-30).
Call 647-6520 if you have any questions. j
The agreement with V-1 f , l i - CLLY o 1 vao
No. -A --,-�C%LS Ci�CA was completed on and final payment has been made.
(List all amendments. Use space below if needed.)
4 IS f I Department:
Phone/Ext.:
Y'r ..52Cb,S7- j s�< OZ
rD C IS - I -( Signature:
Date:
Revised 08-23-10
iWUAANCE, M91 ON FILL
ORK MAY NQT PROCEED
CLERK OF COUNCIL,
DATE: q _ ZEA -'I 0
SECOND AMENDMENT TO NON-EXCLUSIVE AGREEMENT
TO PROVIDE CARNIVALS ATCITY PARKS
A-2015-188-02
THIS SECOND AMENDMENT` to the above -referenced agreement is entered into on September 21, 2016 by and
between Fiesta de Carnival ("Promoter"), and the City of Santa Ana, a chatter city and municipal corporation
organized and existing under the Constitution and laws of the State of California ("City"),
RECITALS
A. The parties entered into Agreement tIA-2015-019, dated February 3, 2015 ("Agreement"), by which
Promoter agreed to provide carnival events at various City parks.
Ii. The original terns of the Agreement was from February 3, 2015 through February 2, 2016, and was extended
for an additional one-year period, from February 3, 2016 though February 2, 2017, by letter agreement #A-
2015-188-01.
C. 'Che parties entered Into First Amendment #A-2015-188, dated August 20, 2015, to include a "fun zone" event
at the City's 2015 Fiestas Pataias event.
D, The Agreement remains in effect, and the parties now wish to further amend the Agreement to delete from the
scope of services certain obligations of the Promoter,
The Parties therefore agree-
I. Section 2, Scope of Services, is amended to delete all carnival set -vices for the event referenced as No, 8 and
entitled "Cesar Chavez/Campesino October 16-18 Fri -Sun".
2. Section 3, Fees/De,positslPermitslL.iceuses, is amended to delete the fee payable to the City for the event
referenced as No. 8 and entitled "Cesar ChavezlCampesino October 16-18 Fri -Sun".
3. Except as modified by this Second Amendment, and all prior amendments, all terms and conditions of the
Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement on the
date and year first written above.
ATTEST"
(v1X1tlA D.1.It.lIZAR j
Clerk of the Council
APPROVED AS TO FORM
By: YV — --
JOH M.FUNK
Assistant City Attorney
C,'I ' (O S NA
DAVID CAVRLOS — ^�
City Manager
PROMOTER
Name:
Title:
pRECOMMENDED I�' RAPPROVAL
Gerardo Monet, Executive Director, Parks, Recreation, and Community Services Agency
DATE (MWDDfYYYY)
A" R" CERTIFICATE OF 'LIABILITY INSURANCE 3r3i2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CON'F'ERS 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 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 Christine Nidel
NAME:
Governor Insurance Agency, Inc.
.,.IPHO,No,Ext): (330)539-9999 _ (AIC,..Nnj:tS�OI..539-9998.
MAIL
972 Youngstown -Kingsville Rd.
EACH OCCURRENCE
P.O. Box 770
INSURER(S) AFFORDING COVERAGE NAIL #
Vienna Oka 44473
_.INSURED....
INSURERA:R-T Specialty LLC
'..X VEA457676 5/27/2016 5/27/2017
INSURER B: ...._. ....... -.... ...
International Promotions, Inc.A-2015-188-02
INSURER C:
Fiesta de Carnival A-2015-188-01
INSURER D:
11278 Los Alamitos Blvd
INSURERS :
Los Alamitos CA 90720
INSURER F.
COVERAGES CERTIFICATE NUMBER:CL166108412 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH' THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ..... .RODE 3UBR.. __.POLICY NUMBER _. MMIDDIYYYY POLICY MMIoDIYYVPN...'
LTRIN"
LIMITS
X COMMERCIAL GENERAL. LIABILITY
EACH OCCURRENCE
$ 1, 000, 000
A CLAIMS -MADE ! X OCCUR.
DAMAGE TO RENTED
PREMISES (Ea occurrence)
..... 100, 000...
$
'..X VEA457676 5/27/2016 5/27/2017
MED EXP (Any one person)
$ FXa17Aded
PERSONAL 8 ADV INJURY
$ 1, 000, 000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X POLICY PRO-
JECT LOC
PRODUCTS - COMPIOP AGG
$ 2,000,000
',.... OTHER:
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
_
(Ea accident)_..
ANY AUTO
BODILY INJURY (Per persen)
S
_.
_ ALL OWNFU SCHEDULED
BODILY INJURY (Per accident)
S
AUTOS AUTOS
NON-OWNED
NON -OWNED
PROPERTY MAGE
$
HIRED AUTOS AUTOS
(Per accident).......
...... .....
UMBRELLA LIAB OCCUR _ , q ,g .� �I
EACH OCCURRENCE
S
EXCESS LIAB CLAVM_ S MADE O W�
AGGREGATE
$
DED RETENTION$r,,,�
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$
WORKERS COMPENSATION '" ,�
AND EMPLOYERS` LIABILITY y G n
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PER OTH-
STATUTE:. ER
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ANY PROPRIETORYPARTNER/EXECUTIVE
E L , EACH ACCIDENT
$
OFFICERIMEMBER EXCLUDED? NIA
(Mandatory In NH)
E L DISEASE - EA EMPLOYEE
S
If yes, describe under T "
......
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LpMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 1.01, Additional Remarks Schedule, maybe attached if more space is required)
Certificate holder is named as additional insured per the attached CG 2026
form
City of Santa Ana
20 Civic Center Dr.
Santa Ana, CA 92701
ACORD 25 (2014101)
IN 025onuni)
L91-20M.RP1111IF11116J9.1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Thompson, ,Jr./CNIDEL
Q 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: VBA457078OO
COMMERCIAL GENERAL LIABILITY
CG3U2G0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement nnoddieoinsurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
A. Section UU —Who Is An Insured is emended to
include as an additional insured the (a) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "'property
damage" or "personal and advertising injury"
oaused, in whole or in port, by your acts or
omissions or the acts or omissions of those acting
onyour beMa|f�
1. |mthe performance nfyour ongoing npemfione�
or
2. In connection with your premises owned by or
rented bzyou.
However:
1.The insurance afforded to such additional
insured only applies hzthe extent permitted by
law; and
2. If coverage provided tothe additional insured ia
vaqu/rmU by a contract or agreement, the
insurance afforded to such additional insured
will, not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these,
additional inaunada, the following is added to
Section III — Limits Of Insurance:
U coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf ofthe additional insured is the
amount ofinsurance:
1. Required bythe contract oragreement; or
2. Available under the applicable Limits of
Insurance shown inthe Dao|aratione-
.
whichever isless.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations. ~
CG 20 26 04 13 C Insurance Services Office, Inc., 2012 Page 1 of
COVINGTON SPECIALTY INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read It Carefully.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
- PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or
Organization(s)
Location(s) Of Covered Operations
City of Santa Ana
Location(s) as specified in written contract with the
20 Civic Center Dr.
Additional Insured shown in the schedule of this
endorsement
Santa Ana, CA 92801.
Information required to com tete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(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:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s) designated
above.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance
afforded to such additional insured will not be broader than that which you are required by the contract or
agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such work, on the project
(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s)
at the location of the covered operations has been completed; or
(2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by
any person or organization other than another contractor or subcontractor engaged in performing
operations for a principal as a part of the same project.
C. With respect to the insurance afforded to these additional insureds, the following is addedON III —
Limits of Insurance:
If coverage provided to the additional insured is required by a contract or agreement the mo t' 41 -0 on
behalf of the additional insured is the amount of insurance: 7e'4
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declaration
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
Policy No.: VBA457676
GBA 104025 0614
D. If the contract between the additional insured and you requires that the insurance afforded by this policy be
primary and noncontributory, this insurance shall be primary and noncontributory but only as to the general
liability policy(ies) where that additional insured is listed as the named insured on the declaration page(s) of
such policy(ies).
All other terms and conditions of this policy remain unchanged.
GBA 104025 0614
ADDITIONAL INSURED ENDORSEMENT
Insurance Company
This endorsement modifies such insurance as Is afforded by the provisions of Policy#
Relating to the followidg,:
The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; is named as
("additional Insured") with regard to liability and defense of suits arising from the
operations and uses performed by or on behalf of the named insured.
2- With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as Is afforded by this policy is primary
and is not additional to or contributing with any other insurance carried by orfor
the benefit of the additional insured.
& This Insurance applies separately to each Insured against whom claim is made or suit
is brought except with respect to the company's limits of liability. The inclusion of any
person or organization as an insured shall not affect any right which such person or
organization would have as a claimant if not so Included.
4, With respect to the additional insured, this insurance shall not be canceled, or
miateriall!y reduced in coverage or limits except after thirty (30) days written notice
has, been given to the City of Santa Ana, 20 Civic Center Plan, Santa Ana, California
92701.
(Completion of the following/ including countersignature, is required tomake thisendorsement
effective
Effective, this endorsement form, as a part of
VbA
Policy # h 45-1UM-19
COVINGTON SPECIALTY INSURANCE COMPANY
This Endorsement Changes The Policy, Please Read It Carefully.
POLICY CHANGES
This endorsement modifies insurance provided under the following:
❑ COMMERCIAL GENERAL LIABILITY COVERAGE PART
❑ COMMERCIAL PROFESSIONAL LIABILITY COVERAGE PART
❑ COMMERCIAL INLAND MARINE COVERAGE PART
❑ COMMERCIAL PROPERTY COVERAGE PART
❑ LIQUOR LIABILITY COVERAGE PART
® ALL COVERAGE PARTS APPLICABLE TO THIS POLICY
Policy Number: VBA457676 00
Named Insured: International Promotions
DBA Fies
Endorsement No.: 3
Endorsement Effective Date: 3/2/2017
By: R -T SPECIALTY, LLC
It is hereby, understood and agreed that the following additional insured is added to form CG2026: per the attached
Premium Fully Earned
❑ No change in premium
®
Additional Premium
$ 100.00
❑
Additional taxes and fees
$ .00
❑
Return Premium
$
❑
Return taxes and fees
$
®
Total
$ 100.00
All other terms and conditions of this policy remain unchanged.
Policy No.: VBA457676
GBA 904001 0208
COVINGTON SPECIALTY INSURANCE COMPANY
This Endorsement Changes The Policy. Please Read It Carefully.
CANCELLATION BY US TO OTHERS
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS
It is hereby understood and agreed that if we cancel this policy, written notice of cancellation will be mailed or
delivered to the First Named Insured and the following:
Schedule
City of Santa Ana
20 Civic Center Dr.
Santa Ana, CA 92801.
Number of Days: 30
COMMON POLICY CONDITIONS, A. Cancellation, 2. is replaced by the following:
2. We may cancel this policy by mailing or delivering to the First Named Insured and the entity shown in the
Schedule above written notice of cancellation at least:
a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or
b. The number of days shown in the Schedule above before the effective date of cancellation if we cancel
for any other reason.
This endorsement does not apply if this policy is cancelled by the Finance Company or the Insured.
Policy No.: VBA457676
G BA 904019 0814