HomeMy WebLinkAboutR.T. CLOWN, INC. (2)�. City of Santa Ana
t Clerk of the Council corcOffice Use Only
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amendments (if any) are no longer in effect.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 W T H' C1139UNCIL
AUG 2'21 -m31:32
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
N-2017-236
No. was completed on
(List all amendments. Use space below if needed.)
Revised: 10-18-16
and final payment has been made.
Department: PR
Phone/Ext.: q�p/t ) q
Signature:
Date:
INSURANCE ON FILE.
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
CLERK OF COUNCIL
DATF, -1 A 2DAI
O: PRCS (/ )
November 2, 2017 Silvia Cuevas
R.T. Clown, Inc.
461 Altura Way
Manhattan Beach, CA 90266
(310) 376-2250 FAX (310) 376-2264
www.rtclown.com
Re: Speaker/Performer Engagement Agreement
N-2017-236
This letter represents your agreement with the City of Santa Ana ("City") as entered into on the above date for the
engagement described below:
1. Event Description: (1) Santa Claus for City -produced "PLAZA NAVIDENA" Event
2. Date(s): November 18, 2017
3. Event Time(s): 5:00 p.m. — 8:00 p.m.; Santa Claus to perform services from 5:00 p.m. - 8:00 p.m.
4. Location: Santa Claus to be stationed at location designated by City on Main Street in Santa Ana ("Property")
5. Compensation: $425 total; $71 will be deducted from total payment for every 30 minutes the character is late.
Payment will be made after the event upon execution of agreement and receipt of approved invoice;
Speaker/Performer must provide IRS form W-9 before any payment can be made
6. Equipment provided by City: two chairs
7. Equipment provided by Speaker/Performer: all Santa Claus supplies/attire.
8. City Contact Person (for coordinating purposes only): Sonia Batres
Independent Contractor: Speaker/Performer 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 Speaker/Performer performs the services that are the
subject matter of this Agreement; however, the services to be provided by Speaker/Performer shall be provided in
a manner consistent with all applicable standards and regulations. Speaker/Performer 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.
10. Indemnification: Speaker/Performer, his or her agents, or employees (if applicable) agrees to and shall indemnify,
defend, and hold harmless the City, its officers, agents, employees, consultants, special counsel, and
representatives from and against all loss, expenses, or liability (including costs and attorney's fees) arising from
the negligence or willful misconduct of Speaker/Performer, his or her agents, or employees.
1 I. Release: Speaker/Performer accepts the Property and any City -provided equipment used in connection with the
performance in their "as -is" condition, with all faults. Speaker/Performer fully releases, waives and discharges
forever any and all claims, demands, rights, and causes of action of any kind or nature against, and covenants not
to sue, City, its elected officials, officers, employees, agents and volunteers, and all persons acting on behalf of,
N.2017-236
3.c•tr�r Ayroe'lloaar— It I Clown, lne-
i'.Icl
by tfiroII zh ur 1nder caacb o!' dIC11% under any prci cm ar I'uhar laws, sLaItaus. or regula,ions fur any claim of avcut
n LInny. I ra It' .IIItIaW a Of Me 1'rcap lty at City -provided utpu'q)metit ar spoakerfl'os fornacr`s Et5¢ Ihcrcofl
t t iomas iiE'wnil IJah;hty ltistrin1n, Spuakdr+ cakinner 3drall maintain cornmerchl gonuml habHky
n I IKI: awnblg the CV1 a offl cre, emphiyQv_& ogcnrs, w hatncars and reprowanritivwas as uddiaionul insiurcd(s)
tnd shall inclndc, bue not lac limited to pros ction against claims arising; from bothly and persotual injury,
a mdIrg ac, ih ra+aatiae iharrfaam and damage ,o property. mhuhing Ront any act ear oncanaenc arising ow of
x1 eal.crPeilormer's epc awns in the perfornianoe of this Agreement, irebahng, without IiIIII411fon, acts
tn.olrAg whwk, Thu amount: orimurance shall be nor less than the dtallma'png. single limit Ceet.age applying
tl, bod ly ;and personal injury and },napery daaitagn in the total au000nt of 51,iyfftd,l7t1t2 per occurrence, with
429P.Srl,C'MU in dw aggiuWae, indudinu coverage of soaunl ntiseonduCL Such insurance shah: (d') name trite City,
w" toi'bara, employees;, agellts, Volutnaers, and acptxsentatsves a, additional insumds; (2) be primary and not
t 1,1atrltIctiovy wiM respect to ul.5ial move or stllf-amurancc pt1'igrams nWnNnW by Me Chy; atad Q1 cowman Standard
owpor:uinnof imiirf�d provis➢cins.
Worker's Compensation tnmimma+, in uceordance with the California labor Code, SpeakeuPci'1'ornuor, if
iSpvakca:'llubr.+renew Us any employees, is required to be Knuavd aaguinm AbiHiy for worker's aonpcnaation or io
ll tad 2((a its �tift"IFtiiElralEC4.
"I nc, City shall lsav'e Me right and royalty-treu Ietc IItc to shnulCust or proadut:u dads show a rape -delayed broadcast
at" spunhu l orformer'R karcacntnritao to tide City eorninunity or 1crieral pdbtie, sdirough wvbcast Or any other
means This hearse shall be minnvslusiva and the ccpyright shall iumain with the Speakeril'erfornior. Copkci of
cpu aker PcriEmnan 4 daecsun utiaan natty be mai afnecd by dw Cary, and SpaaArTerforma costume Cca max: of suds
rmoning ,
15 SIvaker,Per6oInwr represtnts and warrants- Spat it lugs engaged an uae7cpcnfcnr kniddy W Coatd'w a background
chak Eat' all t,mploi cQ& 'usdependent ccarmaeors, or uther individuals who are perfx-miaog, services for
Kpolerwith iNs ragr'eameat. Vi laackground wimck sUld insiude al a air;irrnttn usttne
ao f wayori MIami hisawy'nVestigation where such indivtinduid w ides mend a search of the aa,nional and California
s roffrradCr ruuisniu�s. Prool'ofil e h,,ac&groklnd check recµLitCd under this section shall be provided to City upon
I'CtlttCha.
SlaCakef Pertojrta r shall not da>cranonau: heCm6se of mace, color, Laved, rcli'jy+ion, UN, aaaarttal SiatltR, suXUal
ortentat Han. fly, national origin, anveml-', disability, or any other Vis premed by applialble Iact, it) conneutdon
whi-any activ airs related toflik Agreeuaent.
'this Agmenwnl Wl in .all reMwers shOl be interpwal, enkewd, and governed exclusively by and under the
Isa+xn of the ,race of CtalHAnda_ Both punks aagme that Orange Cow, caliParnia, shall be the venue liar any
aE4ic.41 Of Po.a:uCtfing that maybe 1hnnuiht or arise out ol, in cor nce6on with or by reason of this ,Agrcojnew,
'gams Agrecawin ivjaeRCnR the complete and exclusive swremunt bvLwecn the City and 5peakerl1'crfsrmer
regarding the etahjQcT ma4w herein and anpersedus any and nH cilki, a'3'L'.CI7A@t1tR, oral or wlann, between tills'
paCues. Thlg Agreernam may not be mod hed except by written 'histrunient Signed by the City and by as
Suthorrzud rcfause'ntative ul 1t9C{a.'�'e'`T�la6'I'foraa7er.
11ICaI,V V. Wcut4 this letter tt) reflect your a regiment to the terim rind conditions 'SCR fborth herein
C'1T4('WS,4iCt:4:1; A Sff;rlKi:9t'1'Ellif34�ti1£It ,
R.\ L 60DIXC7 Id Nattte:.
C ni klmin?er Tic!: ((}}
Letter Agreement — R.T. Clown, Inc.
Page 3
ATTEST:
MARIA D. HUIZAR
-Clerk of the Council
RECOMMENDED FOR APPROVAL
GERARD6 MOUET
Executive Director of Parks,
Recreation and Community Services Agency
APPROVED AS TO FORM:
By
JOHN K
Assistant City Attorney
EXHIBIT A
Attn: Sonia Batres
City of Santa Ana
Finance & Management Services
20 Civic Center Plaza
Santa Ana, CA 92702
RE: Community Holiday Event
Saturday, November 18, 2017
At: Plaza Calle Cuatro
320 E 4th Street, Santa Ana, CA
INVOICE:#SA-11/18-17
For Services Rendered:
October 16, 2017
Santa Claus (fake beard)............................................................................. 5:00-8:O0pm
Fee: $425.00 (includes $5.00 parking fee)
TOTAL FEE: $425.00 (Due upon receipt of invoice)
Payable to: R.T. Clown, Inc.
Gratuity not included but graciously accepted
R.T. Clown, Inc. (Fed ID #95-4105347)
In the event you cancel our performance your entire deposit will be forfeited. However, if you reschedule your party
within thirty days of the date of your original performance, we will apply your deposit towards the rescheduled
performance.
In the event our performers are forced to work overtime as a result of a delay caused by you, there will bean
additional sum of $85 due and owing for each % hour of such overtime.
F �G �y "(
X. +v ' J M Private and Corporate Party Planning
461 Altura Way
Manhattan Beach, CA 90266
(310) 376-2250 FAX (310) 376-2264 www.rtclown.com
Entertaining Southern California since 1985.
°"TE°� °
AC CERTIFICATE OF LIABILITY INSURANCE °"Y""'
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 INSUREFSS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, ANO THE CERTIFICATE HOLDER,
IMPORTANT:: II the certificate holder is an ADDITIONAL INSURED, The pallcy(his) must have ADDITIONAI. INSURED proylSlons ar be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cerlai policies may require an endorsement. A statement on
this corfificate doas Doi ConfDr rights to the certificate holder In lieu of ouch endorserriont & ,
PNO""R Ed leivood Partners Insurance Center (EPIC)
19600 MacArthur Blvd, PH Floor
Name:"
PRONE -
-(94ei
Irvine, CA92612
PAX
p asia EeU' .....d649j 2G3 OtifhT_ „1. the, RRI: 263,0006
ADDrOESS:
iN3pRER.tbj APF{eRplNd CdVERAdE.... NAIL%
Y/kYW.HClge4voodirwx0m
INSURER A. NaUJUS IDS CO.
INellRED
R.T, Clown, Inc.
MISUREAa ...__..., .
461 Altura Way
INSURER C T,
Manhattan Beach CA 90266-2369
INSURER e:
WALKER F:
COVERAGES CERTIFICATE NUMBERI gAAAAcq. orviAlnr% NI l"PoR.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INEUnEO NAMCO ABOVE FOR TIdE PC}yiCY PER11�6
1"VDIC.ATLD, NOFAITHSTANtlINS ANY REOUTAEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT INIT'H RESPECT TO WHICH THIS
ChAITIFICATE. WAY BE "VED OR NIAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IB SUBALCT TO ALL THE TERMS,
EACLLIa'ION5 AND CONDITIONS OF SUCH POL&GOES, LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIIM$.
INSN: ,. _...Au0CRII3':"""'.... I POLICY EFFw.-PbTI tXll'..L...
LlR TrnE aF 4NSt1RANCEiftov7wa WM.Mc,'VyM MmalyrI, LIMITS
A COMMCNCIALU""AL LVRILITY V` 1
1`41`01271%)
1&1412017
811412U1e lF.A9HC CURaiENCE
I
IS I,M0000
`r' -
GLMIS PMEH yiF OGCUR T
CAMAGETb RLfIT€0
F`RtlY3 CS Eu eu
-- ; ---SST}--'
e........_ 10t),[IXlU
.f 8IIF'CepoGuetlh'I0:5500
IMEDEMp el � 1s_.
8000
KAZONAL A ADY INA)FIV
$ 1000.000
CEML AtiCiftEr%nTp LIA2IrAPPl Ih;3N}H
V_w"CMCRALACKGEGATS
v8 21000,000
�. POLICY 'PRO-
. ,a,u„'JGGT L u1C
i
iPMODUCTS=COdPWAGt71I^S
Included
I
I I bfHFN'
S -....
'
A1110MORRE LVOSAUTY
-
L M I N H ❑M1
5
AWAIflL
bfle&YIR RIMY IYRrTmMwl
-
S _.-
OAl7o SCHEDULED
AWli(H11Y Auto&
HIRPn iNON- MNEn
AUTOS OANLY .., AUl0KQNLY
I
S
f $
SOMY INJURY AwdknU
PSSGP'R7Y SNM1Anc'
(p}r AacmRnn
I Qoauit
I
EAW'H OCCURF�tWE
IS
i E%GIBE LIaB GCalr15-MAI]C�
'
ANURMeRe YERS'LSATInN
AND
TA
� STATUTE E
EMP4aYER5'LIA87LITY YtN
I
AN PR PRIG, IMRARTNEW&M-CUTIYe..
ril'r1:ErtiMErtEER EXCLUO_DY
0„
If
III^,-�
t -._.. ._
(Min"Wq in NMI
Lr Y h. �i Y' AI v YMjLM �
(
AipL4YFF",",
8 .. -.
T1rJA'SLeL
(
'RL. DIACIHAECCEgNI
LIGYLUdIT
S
„
"SCRIPT41N OF MERATIONSJ LOCATR)N$ V VKHACLSS IACaHD 1D'1,Addlllmll ftlelkp SOlxpdu4,1,., p%rrJeatled a mm vpace is roquVeYll „L
The City of Santa Ana
20 Civic Center Plaza
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.
reserved,
ALeVKU Ga ILUI UneJ)
I ne AI.;UHU name and logo are rogISLOwed marks of ACORD
�..:, t'o-Vf L ;At 1 YxrtX i zm:nc ] NSZ'lY YL3avRE AR Owl I P., I rzi a
NN827tOg
R.T. Clown, inc.
712712017
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
. ADDITIONAL INSURED - PRIMARY AND NONCONTRIBUTORY -
AUTOMATIC STATUS WHEN REQUIRED IN CONTRACT OR AGREEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FART
A, Section 11 - Who is An Insured is amended to include as an additional insured any person or organization
when you and such person or, organization have agreed in writing in a contract or agreement that such person
f� or organization be added as an additional insured on your policy. Such person or organization is an additional
tfv insured 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 omissions of those acting on your behalf:
1. in the performance of your ongoing operations for the additional insured; or
2. In connection with premises owned by or rented to you,
But only for.
1. The limits of insurance specified in such written Contract or agreement, but in no event for limits of
insurance in excess of the applicable limits or insurance of this policy; and
2. "Occurrences" or coverages not otherwise excluded'in the policy to which this endorsement applies.
B. Status as an additional insured for the person or organization to which this endorsement applies:
1, Commences during the policy period and after such written contract or agreement has been executed; and
2. Endswhen:
a. Your ongoing operations for that additional insured are completed;
b. The contractor's contractor agreement is terminated;
C. The tease of premises expires; or
d. Your policy cancels or expires;
whichever occurs first.
C. The following Is added to 4.a. of Other Insurance of Section IV - Commercial General Liability Conditions:
If required in a written contract, your policy is primary and noncontributory In the event of an "occurrence"
caused, in whole or in partby your acts or omissions, or the acts or omissions of those acting on your behalf
v that occurs while performing ongoing operations for the additional insured, or in connection with premises
owned by or rented to you.
0.. Win respect to the insurance afforded to the additional insured, the following exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1, All work on'this project, including materials, parts, or equipment furnished In connection with such work
(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.
All ether terms and conditions of this policy remain unchanged. (b�\A\Z"i
��P(�
Q1G
L805 (0&09) Indudes ccpyn&ed material rrorr. Insutance- Senelces office, Inc., Willi Is pe=1510n.
j"e 6t=s I to to <y "Xt 1 1"" I *J:+rmm 4,2s.a6 an lnm s i V", 't of x
\N01W.RS" CONII'FNSA`ION DF(A.ARATION
_GW +fat rcbv affirm nncier Penalty of perjury, the
(Naoie; r,ii:a - -
f)llvwing declaration ;
1 certiN on behalf'of i w.J� -T-N4^' that (luring the taut army
tC'onsudt;nUOnns uy Now)
comi-nct for `ems to fV A services with the Chy of Santa Arta, I will
not employ any person in any )Wanner so as to become subject to the workers'
compensation lakes of California, and agree that if I should became subject to the
workers° compensation prtavisions of Scclion 3700 of the Labor Code, I shall firrthwith
comply with those provisions and provide proof of workers" compensation coverage.
Name: ok k4V CS Ad'1r'✓
Lille:
I'elepltorac: 1 '7G C
NARNINU I AILURE 10 SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ON'E HUNDRED THOUSAND DOLLARS {SIft0,00Q'}, IN
ADDITION '1't:? "I'I li: C OSTOF C OMPENSAT ION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 01--fill" LABOR CODE, INTEREST, AND A rt`OR'NFY S FF.ES.