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HomeMy WebLinkAboutPROFESSIONAL ENTERTAINMENT - 2017City of Santa A %i Clerk of the Cour,.,,f AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. COTC Office Use Only City of Santa Ana A(j 02 2621 Clerk of the Council The agreement with (� � �(� V l(� 1�E Y\sQV 1 Yt�k- Lf`)As lky,6 l:!, No. 0 aU 11-099c 2 was completed on 1 l and final payment has been made. (List all amendments. Use space below N needed.) (2V-3C,\1—Cs�-0\ Department:-Q1x—�6\al P\- 0V-7-.isa Phone/Ext.: n� �ate � � Signature: `l�'`�-1 C�r�Ctl/� Revised: 10-18-I6 A-2017-052 AGREEMENT WITH PROFESSIONAL ENTERTAINMENT cp u_i THIS AGREEMENT is made and entered into this 2 1 " day of March, 2017 by and between LU "Professional Entertainment Consultants ("Contractor"), and the City of Santa Ana, a charter city if LU and municipal corporation organized and existing under the Constitution and laws of the State of c� `� G , alifornia ("City"). zc CIO a u_� y � co W RECITALS 00 CC cc A. The City desires to retain a contractor having special skill and knowledge in the field of providing entertainment services for various City hosted events. B. On January 18, 2017, the City issued a Request for Proposals for various event services. C. The proposals were evaluated based on experience, understanding, capacity and price. Contractor's proposal was rated the second highest score, therefore, the City recommends entering into an agreement with Professional Entertainment for performer entertainment services for City hosted events. D. In undertaking the performance of this Agreement, Contractor represents that it is knowledgeable in this field and that any services performed by Contractor under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Contractor shall provide performer entertainment services for City hosted events. The Contractor will be expected to provide insurance for performers. Additionally, the Contractor will be responsible for any special requests from the performer. The Contractor is also expected to coordinate with various City departments and other contractors associated with the event(s). The Contractor must provide a listing of talent they represent. Due to the differences in pricing based on the performer, each performance pricing will be negotiated with the City for each event. 2. COMPENSATION a. City agrees to pay, and Contractor agrees to accept as total payment for its services under this Agreement the total sum of Twenty Thousand Dollars ($20,000) for each annual term. The total sum to be expended under this Agreement shall not exceed Sixty Thousand Dollars ($60,000) for the entire term of the Agreement, including any renewals. Page 1 of 7 b. Payment shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may be expected by the City. 3. TERM This Agreement shall commence on March 21, 2017 and terminate on December 31, 2017, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended for an additional two, one-year renewal options, by a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Contractor shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Contractor performs the services which are the subject matter of this Agreement; however, the services to be provided by Contractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Contractor shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Contractor shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Contractor shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Contractor's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. Page 2 of 7 b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the California Labor Code, Contractor, if Contractor has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance, Prior to commencing the performance of the work under this Agreement, Contractor agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Contractor is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Contractor pursuant to this section: (i) Contractor shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect, by consultant, without thirty (30) days prior written notice to the City. (iv) Contractor shall supply City with a fully executed additional insured endorsement. f. If Contractor fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such tenmination shall not affect Contractor's right to be paid for its time and materials expended prior to notification of termination. Contractor waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Contractor agrees to defend, and shall indemnify 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 Page 3 of 7 claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Contractor 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. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Contractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Contractor's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Contractor. 7. CONFIDENTIALITY If Contractor receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Contractor 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. 8. CONFLICT OF INTEREST CLAUSE Contractor 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. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this . Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication. in the manner provided in this Section, to the following persons: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: (714) 647-6956 Page 4 of 7 With copies to: Parks, Recreation and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 571-4221 To Contractor: Professional Entertainment Consultants Dan Haley 6722 Timaru Circle Cypress, CA 90630 A party may change its address by giving notice in writing to the other party. 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. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Contractor regarding the subject matter therein, 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 Contractor. 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 Contractor nor 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 are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Contractor, Contractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Contractors retained by City. Page 5 of 7 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Contractor shall be entitled to receive and the City shall pay Contractor compensation for all services performed by Contractor prior to receipt of such notice of termination. 13. NON-DISCRIMINATION Contractor shall not discriminate because of race, color, creed, relation, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities under this Agreement. Contractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. 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. 15. PROFESSIONAL LICENSES Contractor 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. Contractor shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall because for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. Page 6 of 7 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first alcove written. ATTEST: MARIA D,HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: I A STORCK Assistant City Attorney RECOMMENDED FOR APPROVAL: CITY OF SANTA ANA GERARDO MOUET Actin; City Manager CONTRACTOR Professional Entertainment Name: Darrell Wagner Title: CEO, Professional Entertainment ConsultantSTM JEANNII. UARDO, Acts g Executive Director Parks, Recreation and Community Services Agency Page 7 of 7 �•" ^� DARRWAG-01 BRGBERTS �C'oRom CERTIFICATE OF LIABILITY INSURANCE DATE 03/2812017YI 4312$12017 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 Brian Roberts NAME: Blue Lion Brokers PHONE 4208 198th St. SW Suite 206 FAX IA1c, No, Exq: (425j 988-2236 (A1c, Nol,(818) 827-3380 E-MAIL Lynnwood, WA 98036 ADD.-brian bluelionbrokers.com E _..., .INSURERS} AFFORDING COVERAGE _ NAIC ft INSURI Mesa Underwriters 5pecialt� INSURED INSURER B : Darrell Wagner dba Professional Entertainment INSURER C : P.O. Box 78593 INSURER D : Seattle, WA 98178 IN5U RER E INSURER F r`n%1FI7Af-9=C rr-0TI9:IrATFZ Kn IMRGQ- A11111Ac2co. 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP ' LIMITS LTR INSR WVD DDPMY A X COMMERCIAL GENERAL LIABILITY i CLAIMS4ADE X OCCUR X, MP0002007001476 12/05/2016 1210612017 EACH OCCURRENCE DAMAGE TO RENTED PRE Ea occUfrence) : $ 2,000,000 100,400 $ MED EXP (Any oae-I ..... _ $ 5,000 $ 1,400,000 _PERSONAL &ADVINJURY _ GEN'LAGGREGATE LIMIT APPLIES PER X POLICY Pn LOG GENERALAGGREGATE PRODUCTS-COMPlDPAGG $ 2,000,000 $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT _(Ea accident) $ BODILY INJURY(Per person BODILY INJURY Per accident ANY AUTO OWNED SCHEDULED AURRT��OppS ONLY ASUTOpSyy� $ - -- $ PPe�acciden �AMAGE $ AUTOS ONLY AU OS 6NLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y 1 N I PER 1OTH- _ _J STATUE I I FIR ANY PROPRIETORIPARTNERIEXECUTIVE EXCLUDED? NIA E.L. EACH ACCIDENT — $ E,L, DISEASE- EA EMPLOYE (�pFECERR'MEMBER iAandatory m NH} If yes, describe under $ _ _ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Abuse Sr Molestation MP0002007001476 12105/20161! 12/0512017 100,000 300,000 DESCRIPTION OF OPERATIONS f LOCATIONS) VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. 10-day notice of cancellation for nonpayment. 9rc17T1CIrrATC Lint nCo r`Akle c1 I ATU-M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana y Attn: PRCSA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza M-23 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS' COMPENSATION DECLARATION I Darrell K. Wagner hereby affirm under penalty of perjury, the (Name/Ttle) following declaration I certify on behalf of Professional Entertainment Consultants that during the term of my (Consultant/Company Name) contract for Entertainment services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: 3/31/2017 By: Name: Darrell K. Wagner Title: CEO Telephone: 800-8901-2484 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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. DARRWAG-01 BRt78ERTS ACORO� CERTIFICATE OF LIABILITY INSURANCE E IMMlD D1YYYY) aDATE 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 pollcy(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 endorsements . .PRODUCER NO T CT Brian Roberts Blue Lion Brokers 4208198th St. SW Suite 206 Lynnwood, WA 98036 (PA NE., Ext): (425) 968-2236 I'AArc, Nn :(818) 827-3380 RMbss, briars blueiionbrokers.com INSURERISI AFFORDING COVERAGE NAIC # INSURER A! Mesa Underwriters Specialty INSURED INSURER a; INSURER C ; Darrell Wagner dba Professional Entertainment INSURER D ; P.O. Box 78593 Seattle, WA 98178 INSURER E ; INSURER F ; nnVFRAPFC r_I=PTIFiCATR NIIMRFR• RPVL4I()N NIIMRER. 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TO TYPE OF INSURANCE ADD-INSp SUBp POLICY NUMBER POLICY EFP POL.ICY EXPI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE )( OCCUR X MP0002007001476 1210512016 12 O612017 EACH OCCURRENCE 2,0001000 DAMAGE rO RFNTED REMESES =aoccunwee 10D,D00 VIED EXP (Any one erson $ 6,000 GEN'L X PERSONAL &ADV INJURY 'I1000'000 AGGREGATE LIMITAPPLIES PER POLICY❑ Toa LOG OTHER: GENERALAGGREGATE 2,000,000 PRODUCTS - CCMPIOPAGG 2,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOSoS®� ALTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT $ aODfLYINJURY Per arson $ BODILY INJURY Peraccldenl Pe�accigent AMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMSMADE s+f1 EACH OCCURRENCE $ AGGREGATE $ PEP RP'7PNTICN $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y l N AANFICEOMR IET RIPFJARTNERlp CECUTIVE ❑ (Mandatory in NEH) If yyos, describe under ❑ESCRIPTION OF OPERATIONS below N A - SER OTH- F.L. EACH ACCIDENT $ E.L. DISEASE. -EA FMPLOYE $ E.L. DISEASE -POLICY LIMIT 1 $ A Abuse $ Molestation MP0002007001476 1210512016 12/05/2017 100,000 300,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is re uired) Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as add�tlonal insured(s); (b) be primary with respect to insurance or self -Insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. 10-day notice of cancellation for nonpayment. City of Santa Ana Attn: PRCSA 20 Civic Center Plaza M-23 Santa Ana, CA 92701 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 ACORD 25 (2016103) O 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DARRWAG-01 BROSERTS ACOR�� CERTIFICATE OF LIABILITY INSURANCE DATE IMMroDmYYi03130120'17 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. Y IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the policy(€es) 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 endorsements . PRODUCER - A TgcT Brian Roberts Blue L€on Brokers 4208198th St. SW Suite 208 Lynnwood, WA 98036 �a c°NrJ ext ; (425) 968-2238 wc, Na :(818) 827.33$0 dLss; Brian@biuellonbrokers.com INSURER(S) AFFORDING COVERAGE NAIC H • _ SURER A: Mesa Underwriters Spec !al INSURED INSURERS INSURER C : Derrell Wagner dba Professional Entertainment INSURER D : P.O. Box 78593 Seattle, WA 98179 INSURER E INSURER F • Cr]VFFlARPR CFRTIFICATF_ NUMRER- 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 CONTRACTOR OTHER DOCUMENTWMTH RESPECT70 WHICH THIS CER7IFICATE 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. INER TYPE OF INSURANCE ADCL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY OLAIMS-MADE [ OCCUR X MP0002007001476 1210512016 12/0612017 EACH OCCURRENCE $ 2,000,000 DAEAGETORENTED 900000 MEDBXP (Any one araan $ 5,000 PERSONAL&ADVINJURY 11000,000 GEN'LAGGREGATELIMIT APPLIESPER: X POLICY ❑ j LOC OTHFR: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPiOP GG $ 2,000,005 $ AUTOMOSILELIABILITY ANY AUTO OWNED SCHEDAUTOS AUTOSONLYAUTOSaS ALTOS ONLY AaTI]SNLB �� �j�e� �6a _ f !- I ✓ E'n,'%.: INGLELIMIT $ BODILY INJURY Perperson) 5 BODILY INJURY Peraccldenl S ' R Pa�a cRt DAMAGEIII S JEX.Er,"5 BRLLA LIAR LIAa OCCUR CLAIMS -MADE �® ° 1 EACH CCCURRENCE AGGREGATE E D RETENTION$ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN AA�NppYICCPERROPRIE70RIPXCLU Eno ECUTIVE 7 iMarldatory9n N)� fyas deacrlbeunder DESCRIPTION OF CPE ATIONS below N! A PER OTH- E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE- POLICY LIMIT S A Abuse & Molestation MP0002007001476 12/0512016 12f0512017 100,000 300,000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD tin, Additional Remarks Schedule, may be attached if more apace Is required) Certificate holder, its officers, agents, and employees are named as addAional Insured in regards to General Liability per attached CG 2015 11188. 10•day notice of cancellation for nonpayment. City of Santa Ana Attn: PRCSA 20 Civic Conter Plaza M-23 Santa Ana, CA 92701 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 ACORD 25 (2016103) O 1988-2016 ACORD CORPORATION. All rights reserved. The ACORQ name and logo are registered marks of ACORD POLICY NUMBER: MB60020o700147E COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VENDORS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL. LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Vendor): City of Santa Ana, Its officers, agents, and employees 20 Civic Center Plaza Your Products: Santa Ana, CA 92701 (if no entry appears above, information required to complete this endorsement will be shown In the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization (referred to below as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business, subject to the follow- ing additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by rea- son of the assumption of liability In a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b, Any express warranty unauthorized by you; c. Any physical or chemical change in the product made Intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjust- ments. tests or -servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in con- nection with the distribution or sale of the prod- ucts; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which; after distribution or sale. by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor, 2. This insurance does not apply to any insured per- son or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. CG 20 15 11 88 Copyright, Insurance Services Office, Inc., 1986, 1988 Page 1 of 1 13 MESA UNDERWRITERS SPECIALTY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. Al -- PRIMARY NON-CONTRIBUTORY - WAIVER OF SUBROGATION This endorsement modlfies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Blanket Additional Insureds -As Required By Contract A. Subject to the Primary and Non -Contributory provision set forth In this endorsement, SECTION II - WHO IS AN INSURED Is amended to Include as an additional Insured any person or organization wham you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your policy, Such person or organization is an additional Insured only with respect to liability for "bodily Injury° or "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury" caused, in whoie or in part, by: Your ongoing operations, "your product", or premises owned or used by you; With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily Injury", "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services by or for you, Including; a. The preparing, approving, or failing to prepare cr approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrong -doing in the supervlsion, hiring, employment, training or monitoring of others by that insured, If the "occurrence" which caused the "bodily Injury" or "property damage", or, to the extent applicable under the Coverage Part to which fts endorsement applies, the offense which caused the "personal and advertising injury", Involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. 2. Your maintenance, operation or use of equipment, other than aircraft, "auto" or watercraft, rented or leased to you by such person or organization. A person or organization's status as an additional Insured under this endorsement ends when their contract, or agreement with you for such rented or leased equipment ends. With respect to the insurance afforded to these additional Insureds, this insurance does not apply to any "occurrence" which takes piace after the rental agreement or equipment lease expires. The previsions of this coverage extenslon do not apply unless the written contract or written agreement has been executed (executed means signed by the named insured) or written permit issued prior to the "bodily injury" or "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury", MUS 01 01 20128 0316 INSURED Page 1 of 2 Primary and Non -Contributory Provision The following is added to Paragraph 4. Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance shall be excess with respect to any person or organization Included as an additional insured under this policy, any other Insurance that person or organization has shall be primary with respect to this insurance, unless: 1) The additional insured is a Named Insured under such other insurance; 2) . You have agreed in a written contract, written agreement or written permit to Include that r additional insured on your General Liability policy on a primary and/or non-contributory basis; and 3) The written contract or written agreement has been executed (executed means signed by the named Insured) or written permit Issued prior to the "bodily injury" or "property damage" or, to the extent applicable under the Coverage Part to which this endorsement applies, "personal and advertising injury". Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us under SECTION IV . COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery we may have against a person or organization because of payments we make for "bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a written contract or written agreement and included in the "products -completed operations hazard", If: You have agreed to waive any right of recovery against that person or organization in a written contract or written agreement; 2. Such person or organization is an additional Insured on your policy; or You have assumed the liability of that person or organization In that same contract, and it is an "Insured contract". The section above only applies to that person or organization Identifled above, and only If the "bodily Injury" or "property damage" occurs subsequent to the execution of the written contract or written agreement, All other terms and conditions of this policy remain unchanged, MU5 0101 20128 0316 Page 2 of 2 WORKERS' COMPENSATION DECLARATION I Darrell K. Wagner hereby affirm under penalty of perjury, the (Name/Title) following declaration I certify on behalf of Professional Entertainment Consultants that during the term of my (Consultant/Company Name) contract for Entertainment services with the City of Santa Ana, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: 3/31/2017 By: Name: Darrell K. Wagner Title: CEO Telephone: 800-8901-2484 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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. .alco/20 CERTIFICATE OF LIABILITY INSURANCE `� GATE IYYYV) 3/2/2022/2020 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: Brian Roberts Blue Lion Insurance, LLC PHONE 800-665-5154 A/C Ext : (AIC, No : 888-221-9537 IN. ADDRESS: Brian@bluelioninsurance.com 10224 Airport Way, Ste C INSURER(S) AFFORDING COVERAGE NAIC# Snohomish WA 98296 INSURER A: Mesa underwriters Specialty INSURED INSURER B Darrell Wagner ribs Professional Entertainment INSURERC: PO BOX 78593 INSURER D : INSURER E : Seattle WA 98178 INSURER F: CERTIFICATE NUMRFR: 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. MIER LTR TYPE OF INSURANCE DO INSD WVD POLICY NUMBER (MMIDDNYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ©OCCUR EACH OCCURRENCE $ 2,000,000 PREMISES (Ea occurrence) $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y MP0046001003112 12/05/2019 12/05/2020 GSEEN'L AGGREGATE LIM IT APPLIES PER: I^ POLICY �JECOT Lac GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY o (Ea accident) $ BODILY INJURY Per person) S ANY AUTO OWNED 5CHEOULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per accitlent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ ORKERS COMPENSATION _ ND EMPLOYERS' LIABILITY YIN NY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? ❑ NIA STATUTE I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ Mandatory in NH) If yes, describe under E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space is required) City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are listed as additional insured. Coverage is primary and non-contributory. Certificate of Insurance provides thirty (30) day prior written notice of cancellation. REVIEWED & APPROVED at, Biel; MAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza, 4th Floor (3 0j Rlrircrf$ I Santa Ana, CA 92702 V 1S66-ZU15 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: MP0046001003112 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered Operations City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers Information required to complete 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) desig- nated above. CG 20 10 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment 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 in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 34? Page 1 of 1 0 Policy Number: MP0046001003112 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 PEMCO Insurance December 9. 2019 Proof of insurance for: DARRELL K. WAGNER PO BOX 78593 SEATTLE WA 98178.0593 1300 Dexter Avenue N Seattle, WA 98109-3571 Representative: PEMCO Customer Service 1-800-GO-PEMCO (1-800-467-3626) This confirms that our customer (named above) has insurance with PEMCO. Please see details below on the car, coverages including limits and deductibles, and others named on the current policy. This letter is proof of auto insurance as of the date above. It doesn't take the place of an insurance identification card, isn't an insurance policy, and doesn't change the coverage provided by this policy. Coverages, limits, and deductibles are accurate as of the date of this letter. If you have any questions, please call 1-800-GO-PEMCO (1-800-467-3626). PEMCO Mutual Insurance Company AUTO POLICY Policy number: CA 0658600 Policy period: 07/23/2019 to 07/23/2020 2020 SUBARU ASCENT TOURING VIN 4S4WMARDXL3430479 COVERAGES Bodily Injury Property Damage Liability Underinsured Motorist Bodily Injury Underinsured Motorist Property Damage Personal Injury Protection Loss of Income Collision Comprehensive Auto Loan/Lease Rental Reimbursement OTHER INTERESTS Limits/Deductible $100,000 each person/$300,000 each occurrence $100,000 each occurrence $100,000 each person/$300,000 each occurrence $100,000 each occurrence $10,000 $200 max per week/$10,400 max per occurrence each person Deductible: $1,000 Deductible: $200 $30 per day/$900 per occurrence Loss Payee, Loan Number— 193341326020 JP Morgan Chase, PO Box 901098, Fort Worth, TX 76101-2098 13803.001 Rev. 0912017 3t /1P�,I ofI CITY OFSANTAANA RISK MANAGEMENT, drulalac 4HUMAN RESOURCES WORKERS' COMPENSATION DECLARATION Darrell Wagner hereby affirm under penalty of perjury, the (Name/Title) following declaration: I certify on behalf of Professional Entertainment that during the term (Consultant/Company Name) of my contract for Entertainment services with the City of Santa Ana, (Type of service provided) I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. Date: 2/28/2019 Print Name: Darrell Wagner Print Title: CEO Signature' Telephone: g - 1-2 4 ext 103 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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. I:�Risk Mgmtllnsuronce Requirements�WC Declaration 08152019 City of Santa Ana Risk Management Division 20 Civic Center Plaza, 4" floor Santa Ana. CA 92702 To whom it may concern, Professional Entertainment does meet the following requirement: PROFESSIONAL LIABILITY (ERRORS AND OMMISSIONS) If contractor is or employs a licensed professional such as an architect or engineer please provide this insurance. If contractor isn't and will NOT employ a licensed professional - please provide a signed letter on company letterhead stating that you do not meet this requirement. Nor will it employ any license professional in carrying out the duties of booking entertainment for the City Of Santa Ana. Yours, =/�W� Darrell Wagner - CEO Professional Entertainment PO Box 78593 Seattle WA 98178 darrell@gigroster.com 8700-801-2484 Gig Roster TM Professional Entertainment PO Box 78593, Seattle WA 98178 800.801.2484 GigRoster.com AAi�