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HomeMy WebLinkAboutHOLISTIC YOGA AND HEALTH LLC DBA BODY AND BRAIN 2-2017 6 if : a : e : 'No ..ccE t II c X § :\ X _0 :3 : & - § :u �� - -C \ 1S - ,\, \ E % . . ..... . © . - ....... � " a© g C/ , E \O a- , _ , ~ a m E = / ° E E / Lab D - 2 0 d, & > / 0 /) o . f o / 0 k % - 0 -E-. 1 . � / 0 % ) e o _ a -c / - ± @ 2 C • \ 1. / ± 2 03 a o 0 \ f \ \ C . 0 . e 2 = m , 0 2 2 ' ƒ ( » \ \ U . § 2 i § \ k \ \ o $ CD E m £ D o C , / 0 k\ \ 0 ^ I / ° = 2 E e & / 2 6 / I O ° 2 � � 6a co 0r) / U / / • w /° > .5 a § c w / _ 0 t- _o \ � b � o E 0 0 a \ 7 2 9 o k 2 =y E % o q \ E - ) ) © E 2 0 G -0 \ g 2 / g 2 I` �$\ \ c ± 2 E 7 0 \ \r . . r 60 ~ � / 0 d \ / / / \ \ \ (MURANCE ON KE WC. WiORK MAY PRUCEg p, rye X1-2018-008 09PTIL INSURANCE EXPIRES a5-43`18 CLERK OF COUNCIL RECREATION SERVICES AGREEMENT DATE: q �pN t 1 pia THIS AGREEMENT is made and entered into this 6`t' day of December, 2017, by and w between Holistic Yoga and Health LLCAba -Body &a Brain ("Provider") and the City of Santa t Ana, a charter city and municipal corporation organized and existing raider the Constitution and v laws of the State of California ("City"). a !� > RECITALS in A. The City desires to retain a recreation service provider having special skills, resources and knowledge to provide Holistic Yoga and Health classes in its recreation class program. B. Provider represents that he/she/it is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Provider represents that he/she/it is knowledgeable in their field and that any services performed by Provider under this Agreement will be performed in compliance with such standards as may reasonably be expected. 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: SCOPE OF SERVICES Provider shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION In consideration for the provision of the programs set forth in Exhibit A, City agrees to pay the Provider seventy percent (70%) of all gross revenue received from program participants. Total revenue to Provider shall not exceed $25,000.00 annually. Payment to Provider shall be made monthly within thirty (30) days following completion of the last class taught by Provider the prior month. City shall be responsible for collecting all fees from program participants. Provider shall not collect fees but will refer all interested participants to City for registration information. Provider agrees that City shall retain thirty percent (30%) of all gross revenue received from program participants as an administrative fee. 3. TERM This Agreement shall commence on January 1, 2018 and end on December 31, 201 -8 - unless terminated earlier in accordance with Section 12 below. The term of this Agreement may be extended by a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Provider 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 manner in which Provider performs the services which are the subject matter of this Agreement; however, the services to be provided by Provider shall be provided in a manner consistent with all applicable standards and regulations governing such services. Provider 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. Provider is not an agent, representative or employee of City and Provider shall have no authority to act on behalf of the City. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Provider shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a, Commercial GeneralLiability Insurance. Provider shall maintain commercial general liability insurance which 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 Provider'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 and $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 and not contributory with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insured's provisions. b. Worker's Compensation Insurance. In accordance with California State law, Provider, if Provider 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, Provider agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. The following requirements apply to the insurance to be provided by Provider pursuant to this section: (i) Provider shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City. (ii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. d. If Provider 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 2 and is in force and paid for, the City shall have the right, at the City's election, to terminate this Agreement. Such termination shall not affect Provider's right to be paid for its time and materials expended prior to notification of termination. Provider 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 Provider agrees to and shall indemnify, defend 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 claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Provider 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, to the extent that the injury, damages, just compensation, restitution, judicial or equitable relief is caused by the negligence of the Provider. 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. City may make all reasonable decisions with respect to its representation in any legal proceeding. In no case will Provider be required to indemnify or hold harmless the City from injury, damages, just compensation, restitution, judicial or equitable relief caused by the negligence of the City. CONFLICT OF INTEREST Provider covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 8. LIVE SCAN BACKGROUND CHECK Provider, and any employees, subcontractors or substitutes, in contact with minors under eighteen (18) years of age shall arrange for and submit to a Live Scan electronic background check for criminal history available through the California Department of Justice as a condition of this Agreement and provide proof of compliance prior to performing services hereunder. 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 With copy to: Executive Director of Parks, Recreation and Community Services City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Fax (714) 571-4211 To Provider: Holistic Yoga and Health LLC dba Body & Brain Attn: Joohee Son 10015 Garden Grove Blvd. Garden Grove, CA 92844 Phone: (310) 901-4267 Email: rzalalaganoroc.com A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. 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 Provider regarding the subject matter herein, 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 Provider. 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 Provider or 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 is not embodied herein. 11. ASSIGNMENT/SUBSTITUTES a. Assignment. The experience, knowledge, capability and reputation of Provider were a substantial inducement for City to enter into this Agreement. Therefore, Provider 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. b. Substitutes. In the event Provider is not able to teach a class due to illness or some other cause beyond Provider's reasonable control, Provider must procure, at its sole expense, a qualified substitute instructor to teach the class at its regular time and place. Provider shall ensure that substitute instructors are at least twenty-one (21) years of age and comply with the City's insurance and live scan requirements contained herein. Evidence of compliance with City's insurance and live scan requirements shall be provided upon request. Provider must immediately notify the City of the substitute instructor's name, qualifications, address and phone number. If Provider cannot procure a qualified substitute and the City is unable to assist in this regard, then the class shall be canceled and a make-up class must be added to the session. Provider must notify participants as soon as possible of any class cancellation and make-up class. Provider must personally teach at least seventy-five percent (75%) of its offered classes. 12. TERMINATION a. This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Provider shall be entitled to receive, and City shall pay Provider, compensation for all services rendered prior to the effective date of termination. b. Termination or cancellation of classes by the Provider outside of Section l Lb. must be given to the City at least thirty (30) days prior to termination/cancellation. Failure to provide adequate cancellation notice to the City may put fixture contracting of business with the City at risk and will result in the City's retention of ten (10%) percent of the final payment to Provider. 13. RECORDS Provider shall use attendance sheets generated and supplied by the City to record attendance in each class. Provider shall keep these and any other records in connection with the work to be performed under this Agreement and shall permit City, upon request, to review such records for a period of three (3) years from the date of final payment to Provider under this Agreement. 14. NON-DISCRIMINATION Provider shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided under this Agreement. Provider affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 15. JURISDICTION—VENUE N-2018-008 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. 16. LICENSES Provider 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. 17. SEVERABILITY In the event that one or more of the phrases, sentences, clauses, paragraphs or sections contained in this Agreement shall be declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs or sections of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. 18. EXHIBITS All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 19. AUTHORITY The person(s) executing this Agreement on behalf of the parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said parties and that by so executing this Agreement, the parties hereto are formally bound to the provisions of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA /Maria D. Huizar Raul Godinez II "Clerk of the Council City Manager [Signatures continue on next page] APPROWD AS TO FORM, SOMA R. CARVKLRO City AMGmey M, Funk kutetant City Attomq RECOMM13NDED FOR AYPROVAII (acral* Mouct " Executive, Dirimor of Parks, R"mitioa ana Community Fervites Ap,cw:y I PROVIMA: Exhibit A SCOPE OF SERVICES A. Provider shall conduct Holistic Yoga and Health classes for ages 15yrs and up. B. Provider shall teach such or similar classes (1) at the times below at facilities to be designated by the City or (2) on a schedule agreed upon by the parties for each class session or term, including the location, specific days and hours when classes will be held, and holidays to be observed, in accordance with City's needs. • Yoga and Health Healing classes will consist of monthly sessions, 1 day per week, 1 hour and 30 Minutes per day. C. Provider shall provide all materials, supplies, equipment, records and personnel. Provider shall be responsible for clean-up of the facilities and materials and shall ensure the safety and effectiveness of instruction. CLASS SIZE A. Each class must have a minimum of 8 paid students and no more than 50 students. B. No registration will be accepted after the second meeting of classes. C. If the minimum registration has not been reached by the second class, the class shall be cancelled. Provider will be under no obligation to provide services for the cancelled classes, and the City will have no further obligations to pay Provider compensation for the remaining classes that were cancelled in that session. CLASS FEES A. Each participant shall pay class registration fees as established by City. B. Provider may not waive class participation/registration fees. C. Only registered participants may participate in class. D. Any refunds to participants will be made in accordance with City policy. E. Any materials fee shall be established by mutual agreement of City and Provider and shall be payable directly to Provider. DATEAO M.CERTIFICATE OF LIABILITY INSURANCE 0611012017 PRODUCER Phone 714433.7084 Fax: 7145803073 EG INSURANCE AGENCY, INC. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE OWnFICATE 018 S. EUCLID ST. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ANAHEIM CA 92802. ALTER THE COVERAGEOROhD '• INSURERS AFFORDING COVERAGE NAIC d N-2018-008 AgencyUb#: COMMINSURED AUTHORIZED REPRESENTATIV Attention: GB E ALLABLITY INSURER N. NAUTILUS 00103117 INSURER B: EA28 20Q'0 HOLISTIC YOGA & HEALTH LLC 10015 GARDEN GROVE BLVD. _ INSURER G: X COMMERCIAL GENERAL LIABILITY GARDEN GROVE CA 92844 A, ^-rytr��+s` ��yq _7 _ ��^aq IV'iPr.A U-4' 4 --00, INSURER D.•--� - INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS ED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMCNT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIPIOATE 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILM IN9R TYPE OF INSURANCE POLICYNUMBER POLICY BPPBOTIVe POLOYMPIRATION LIMITS AUTHORIZED REPRESENTATIV Attention: GB E ALLABLITY NN713330 00103117 08/03118 EA28 20Q'0 DAMA35 m RENT T—S 30,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MRO. EXP (Any one Prean) $ � 0,000 A PERSONAL &ADV INJURY- $ 1,000,000 GENERALAOOROOATE S 2,000,000 71,11 AGGREGATE LIMIT APPLIES PER: 21 POLICY 0 PRO LOC PRODUOTS-OOMPIOP AGO. $ Included $ AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (ER eccldent) $ ALL OWNED AUTOS BODILYINJURY SCHEDULEDAUTOS (Per person) $ BODILYINJURY (Per 000ldene $ HIREDAUTOS NON•OWNEO AUTOS PROPERTY DAMAGE S (Peraccidont) GARAGE LIABILITY AUTO ONL E ACCT E T $ ANYAUTOOTHRRT14AN \< EAACC $ AUTO ONLY: AGG $ EXCESS/ UMBRELLA LIABILITY . EACH OCCURRENCE a OCCUR CLAIMS MADE DEDUCTIBLE RETENTION a\� n.�'i G AGGREGATE $ IS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AWPROPMBTORIPARTNOROMMUTIVa /+, ^d 'S�• w C a' OTHER PRv rAra Lewis ILL, EACH ACCIDENT $ E.L. DISCAS&EA EMPLOYEE $ OPPICBtUMEMBaR a%OWCaOY Ifyes,dSa,ribeender aPSCIAL PROVISIONS below I I ""'"-'-�•' E,L. DIEEASE-POLICY LIMIT $ .... OTHER: DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES!EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS Certificate holder, Its officers, agents, and employees are named as Additional Insured in regards to General Liability per attached 002028 / All terms and conditions are based upon the aotuai policy <A'dcaild[NL11aZ11:LeT11*1e7fJC.T�M : A L ACORD 25 (2001108) Certificate # 10529 ©ACORD CORPORATION 1988 SHOULD ANY OF TNR ABOVE DESCMI S BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE IER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NOR LIABILITY OF ANY KIND UPON City Of Santa Ana THE INSURER, IT'S AGENTS OR REPR At1n: PRCSA 20 Civic Center Plaza, Santa Ana, CA 92701 AUTHORIZED REPRESENTATIV Attention: � Jay Lee ACORD 25 (2001108) Certificate # 10529 ©ACORD CORPORATION 1988 POLICY NUMBER: NN773339 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Santa Ana, it's officers, agents and representatives Address: 20 Civic Center Plaza Santa Ana, CA 92701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organizatlon(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: app` � A. In the performance of your ongoing operations; or jNO u� B. In connection with your premises owned by or rented to you. CG 20 26 07 04 Copyright ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER: NN773339 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - AUTOMATIC STATUS WHEN REQUIRED IN CONTRACT OR AGREEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Commercial General Liability Conditions: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf in the performance of your ongoing operations or "your work" done under a written contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only when you and that person or organization have agreed to such waiver in writing in a contract or agreement. All other terms and conditions of this policy remain unchanged. L609 (05/09) Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: NN773339 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 PART A. Section It - 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 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", "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, but only for "occurrences" or coverages not otherwise excluded in the Coverage Part to which this endorsement applies. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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. Ends when: a. Your ongoing operations for that additional insured are completed; b. The contractor's contract or agreement is terminated; or c. Your policy cancels or expires; whichever occurs first. C. With respect to the insurance afforded to the additional insured, the following This insurance does not apply to: 1. "Bodily injury', "property damage", "personal and advertising injury' or medical payments arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising Injury', involved the rendering of or the failure to render any professional architectural, engineering, or surveying services. L806 (01/17) Includes copyrighted material from Insurance Services Office, Inc., with its permission. Page 1 of 2 2. 'Bodily injury" or "property damage" occurring after: a. 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 b. 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. D. With respect to the insurance afforded to the additional Insured, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. The following is added to 4.a. of Other Insurance of Section IV - Commercial General Liability Conditions: If required in a written contract, the Coverage Part to which this endorsement applies is primary and noncontributory in the event of an 'occurrence" caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf that occurs while performing ongoing operations for the additional insured. All other terms and conditions remain unchanged. .C5 QQ.. L805 (01/17) Includes copyrighted material from Insurance Services Office, Inc., with its peonisslon. Page 2 of 2 N-2018-008 WORKERS' COMPENSATION DECLARATION 1 r CA v E, N. 2�4 v4c 4hereby affirm under penalty of perjury, the (Nome/'title) following declaration I certify on behalf of 11614IJ7-1e, MEA1-77'f F Ye'611 that during the tern of my (ConsultnnVCompany Nmne) contract for — Renregtinn Classes 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 sliall forthwith comply with those provisions and provide proof of workers' compensation coverage. DATE: cJliiN By: (�e� , a?. �_ E HESE ..: Title: Recreation Class Instructor Telephone: v310.' � _v <Cvl 6 7 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL MES 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. ACO D DATE(MMIDDNYYY) —IM CERTIFICATE OF LIABILITY INSURANCE 05101/2018 PRODUCER Plrone: 7145317089 Fax: 714-533-8873 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION EG INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 616 S. EUCLID ST. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ANAHEIM CA 92802 ALTER THE COVFRAOF AFFnRnFn RY THP Pnl Icrcc RFI nw INSURERS AFFORDING COVERAGE I NAIC It THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING Agency Lkk009093 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH INSURED NSS LTR INSURER A' HOLISTIC YOGA & HEALTH LLC POLICY NUMBER INSURER B' 10015 GARDEN GROVE BLVD. GARDEN GROVE CA 92844 LIMITS INSURER G 20 Civic Center Plaza GENERAL LIABILITY INSURER D' INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSS LTR ADD INSR TYPE OF INSURANCE POLICY NUMBER PoucYEFFECTIVE )ATE MM/nn POLICY EXPIRATION ppi MMIODIW LIMITS AUTHORIZED REPRESENTATIVE _ 20 Civic Center Plaza GENERAL LIABILITY NN930980 05/03118 05103119 EACH OCCURRENCE is 1,000,0 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED $ 30,000 PREMISES IE9 aY oeme MED. EXP (Anyone person) $ 5,000 CLAIMS MADE Q OCCUR A X Primary and Non ContobNory PERSONAL S ADV INJURY S 1,000,000 X Waiver or Subrogation GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. X POLICY PRO- 7 LOC PRODUCTS-COMP/OP AGG. S Included S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) S All OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE iPer acedent) $ GARAGE LIABILITY �„ q VA AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO /��j AUTO ONLY. AGG $ EXCESS/ UMBRELLA LIABILITY'`N. OCCUR 1:1 CLAIMS MADE 4 ? EACH OCCURRENCE S AGGREGATE $ - DEDUCTIBLE$ I ,A( RETENTION $ Gash' $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY t` a� V �eGC �` RS'L Mi 5 CTHER E.L. EACH ACCIDENT S aNYPEIRIMEM EREX EXCLUDED? PFFIOER/Mlb BU. E%CL))E)? E. L. DISEASE -EA EMPLOYEE $ tl yec, tlL under E.L. DISEASE -POLICY LIMIT $ SPECIAL PRovISI)Ns below PROVISIONS OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDEDBY ENDORSEMENT/ SPECIAL PROVISIONS Certificate holder, its officers, agents, and employees are named as Additional Insured in regards to General Liability per CG20261 All terms and conditions are based upon the actual policy ......�.. .e iavv uv�l i.ol ullcmax IIao. 9 ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT PAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON City of Santa Ana THE INSURER. IT'5 AGENTS OR REPRESENTATIVES. Attn : PRCSA AUTHORIZED REPRESENTATIVE _ 20 Civic Center Plaza Santa Ana, CA 92701 Attention: Jay Lee ......�.. .e iavv uv�l i.ol ullcmax IIao. 9 ACORD CORPORATION 1988 POLICY NUMBER. NN930980 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): City of Santa Ana Attn:PRCSA Address: _'0 Civic Center Plaza Santa Ana CA 9`01 TIU )costa �cao)R�mp�?,el afiors 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; 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 is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 2604 13 Copyright Insurance Services Office. Inc., 2012 Page 1 of i POLICY NUMBER. NN930980 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -AUTOMATIC STATUS WHEN REQUIRED IN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Commercial General Liability Conditions: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf in the performance of your ongoing operations or "your work' done under a written contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only when you and that person or organization have agreed to such waiver in writing in a contract or agreement. All other terms and conditions of this policy remain unchanged. L609 (05/09) Includes copyrighted material of Insurance Services Office, Inc., with its permission, POLICY NUMBER: NN930980 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-PRIMARYAND NONCONTRIBUTORY - AUTOMATIC STATUS WHEN REQUIRED IN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 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", "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, but only for "occurrences" or coverages not otherwise excluded in the Coverage Part to which this endorsement applies. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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. Ends when: a. Your ongoing operations for that additional insured are completed; b. The contractor's contractor agreement is terminated; or c. Your policy cancels or expires, whichever occurs first. C. With respect to the insurance afforded to the additional insured, the following additional exclusions apply: This insurance does not apply to: "Bodily injury", "property damage", "personal and advertising injury" or medical payments arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory,inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege. g8ldLte or other wrongdoing in the supervision, hiring, employment, training or monitoring of others b�insured, if the „oe" which caused the "bodily injury" or "property damage", or the offense which caused the per dyertising injury", involved the rendering of or the failure to render any professional architectur en g '?`surveying services. ti ! ,1--` l Chu L805 (01117) Includes copyrighted material from Insurance Services Office, Inc... with its permission. Page 1 of 2 2. 'Bodily injury" or "property damage" occurring after: a. 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 b. 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. D. With respect to the insurance afforded to the additional insured, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. E. The following is added to 4.a. of Other Insurance of Section IV - Commercial General Liability Conditions: If required in a written contract, the Coverage Part to which this endorsement applies is primary and noncontributory in the event of an 'occurrence" caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf that occurs while performing ongoing operations for the additional insured. All other terms and conditions remain unchanged. L805(01117) Includes copyrighted material from Insurance services Office. Inc., with its permission. Page 2 of WORKERS' COMPENSATION DECLARATION I yLQQMYUN&__, SON hereby affirm under penalty of perjury, the (Nemerritle) following declaration: I certify on behalf of y r 571C. YO t NEAL71a tthhat during the term of my (CunsulianUC"n' N mu) contract for l80 px_ *W,,p__d�I¢A/A( 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: Title: OWNER.+ Telephone: 7/'{_-- 537-3#99 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.