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HomeMy WebLinkAboutPageantry Productions - 2019-07-04PROFESSIONAL SERVICES CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND PAGEANTRY PRODUCTIONS FOR COORDINATION AND PRODUCTION OF THE 2019 FOURTH OF JULY PARADE THIS AGREEMENT ("Agreement") is made and entered into by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY, and Pageantry Productions, a sole proprietor, hereinafter referred to as "CONSULTANT." WHEREAS, CITY desires to engage the services of a consultant to coordinate and produce the 2019 Fourth of July Parade; and Pursuant to documentation on file in the office of the City Clerk, the provisions of the Huntington Beach Municipal Code, Chapter 3.03, relating to procurement of professional service contracts have been complied with; and CONSULTANT has been selected to perform these services, NOW, THEREFORE, it is agreed by CITY and CONSULTANT as follows: SCOPE OF SERVICES CONSULTANT shall provide all services as described in Exhibit "A," which is attached hereto and incorporated into this Agreement by this reference. These services shall sometimes hereinafter be referred to as the "PROJECT." CONSULTANT hereby designates William Lomas, who shall represent it and be its sole contact and agent in all consultations with CITY during the performance of this Agreement. 19-7710/205761 2. CITY STAFF ASSISTANCE CITY shall assign a staff coordinator to work directly with CONSULTANT in the performance of this Agreement. 3. TERM; TIME OF PERFORMANCE Time is of the essence of this Agreement. The services of CONSULTANT are to commence on July 4th, 2019 (the "Commencement Date"). This Agreement shall automatically terminate on September 1, 2019, unless extended or sooner terminated as provided herein. All tasks specified in Exhibit "A" shall be completed on or before July 4, 2019. The time for performance of the tasks identified in Exhibit "A" are generally to be shown in Exhibit "A." This schedule may be amended to benefit the PROJECT if mutually agreed to in writing by CITY and CONSULTANT. In the event the Commencement Date precedes the Effective Date, CONSULTANT shall be bound by all terms and conditions as provided herein. 4. COMPENSATION In consideration of the performance of the services described herein, CITY agrees to pay CONSULTANT on a time and materials basis at the rates specified in Exhibit "B," which is attached hereto and incorporated by reference into this Agreement, a fee, including all costs and expenses, not to exceed Fifteen Thousand One Hundred Dollars ($15,100.00.). 5. EXTRA WORK In the event CITY requires additional services not included in Exhibit "A" or changes in the scope of services described in Exhibit "A," CONSULTANT will undertake such work only after receiving written authorization from CITY. Additional 19-7710/205761 2 compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. 6. METHOD OF PAYMENT CONSULTANT shall be paid pursuant to the terms of Exhibit "B." 7. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONSULTANT agrees that title to all materials prepared hereunder, including, without limitation, all original drawings, designs, reports, both field and office notices, calculations, computer code, language, data or programs, maps, memoranda, letters and other documents, shall belong to CITY, and CONSULTANT shall turn these materials over to CITY upon expiration or termination of this Agreement or upon PROJECT completion, whichever shall occur first. These materials may be used by CITY as it sees fit. 8. HOLD HARMLESS CONSULTANT hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands and defense costs (including, without limitation, costs and fees of litigation of every nature or liability of any kind or nature) arising out of or in connection with CONSULTANT's (or CONSULTANT's subcontractors, if any) negligent (or alleged negligent) performance of this Agreement or its failure to comply with any of its obligations contained in this Agreement by CONSULTANT, its officers, agents or employees except such loss or damage which was caused by the sole negligence or willful misconduct of CITY. CONSULTANT will conduct all defense at its sole cost and expense 19-7710/205761 3 and CITY shall approve selection of CONSULTANT's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as limitation upon the amount of indemnification to be provided by CONSULTANT. 9. PROFESSIONAL LIABILITY INSURANCE CONSULTANT shall obtain and furnish to CITY a professional liability insurance policy covering the work performed by it hereunder. This policy shall provide coverage for CONSULTANT's professional liability in an amount not less than One Million Dollars ($1,000,000.00) per occurrence and in the aggregate. The above - mentioned insurance shall not contain a self -insured retention, "deductible" or any other similar form of limitation on the required coverage except with the express written consent of CITY. A claims -made policy shall be acceptable if the policy further provides that: A. The policy retroactive date coincides with or precedes the initiation of the scope of work (including subsequent policies purchased as renewals or replacements). B. CONSULTANT shall notify CITY of circumstances or incidents that might give rise to future claims. CONSULTANT will make every effort to maintain similar insurance during the required extended period of coverage following PROJECT completion. If insurance is terminated for any reason, CONSULTANT agrees to purchase an extended reporting provision of at least two (2) years to report claims arising from work performed in connection with this Agreement. 19-7710/205761 4 If CONSULTANT 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 termination shall not affect CONSULTANT's right to be paid for its time and materials expended prior to notification of termination. CONSULTANT waives the right to receive compensation and agrees to indemnify the CITY for any work performed prior to approval of insurance by the CITY. 10. CERTIFICATE OF INSURANCE Prior to commencing performance of the work hereunder, CONSULTANT shall furnish to CITY a certificate of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverage as required by this Agreement; the certificate shall: A. provide the name and policy number of each carrier and policy; B. state that the policy is currently in force; and C. promise that such policy shall not be suspended, voided or canceled by either party, reduced in coverage or in limits except after thirty (30) days' prior written notice; however, ten (10) days' prior written notice in the event of cancellation for nonpayment of premium. CONSULTANT shall maintain the foregoing insurance coverage in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverage shall not derogate from CONSULTANT's defense, hold harmless and indemnification obligations as 19-7710/205761 5 set forth in this Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of the policy of insurance. CONSULTANT shall pay, in a prompt and timely manner, the premiums on the insurance hereinabove required. 11. INDEPENDENT CONTRACTOR CONSULTANT is, and shall be, acting at all times in the performance of this Agreement as an independent contractor herein and not as an employee of CITY. CONSULTANT shall secure at its own cost and expense, and be responsible for any and all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONSULTANT and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services to be performed hereunder. 12. TERMINATION OF AGREEMENT All work required hereunder shall be performed in a good and workmanlike manner. CITY may terminate CONSULTANT's services hereunder at any time with or without cause, and whether or not the PROJECT is fully complete. Any termination of this Agreement by CITY shall be made in writing, notice of which shall be delivered to CONSULTANT as provided herein. In the event of termination, all finished and unfinished documents, exhibits, report, and evidence shall, at the option of CITY, become its property and shall be promptly delivered to it by CONSULTANT. 13. ASSIGNMENT AND DELEGATION This Agreement is a personal service contract and the work hereunder shall not be assigned, delegated or subcontracted by CONSULTANT to any other person or entity without the prior express written consent of CITY. If an assignment, delegation or 19-7710/205761 6 subcontract is approved, all approved assignees, delegates and subconsultants must satisfy the insurance requirements as set forth in Sections 9 and 10 hereinabove. 14. COPYRIGHTS/PATENTS CITY shall own all rights to any patent or copyright on any work, item or material produced as a result of this Agreement. 15. CITY EMPLOYEES AND OFFICIALS CONSULTANT shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the applicable provisions of the California Government Code. 16. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONSULTANT's agent (as designated in Section I hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below. CITY and CONSULTANT may designate different addresses to which subsequent notices, certificates or other communications will be sent by notifying the other party via personal delivery, a reputable overnight carrier or U. S. certified mail -return receipt requested: TO CITY: City of Huntington Beach ATTN: Chris Cole 2000 Main Street Huntington Beach, CA 92648 TO CONSULTANT: William Lomas 8057 1" Street Paramount, CA 90723 19-7710/205761 7 17. CONSENT When CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be a consent/approval to any subsequent occurrence of the same or any other transaction or event. 18. MODIFICATION No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 19. SECTION HEADINGS The titles, captions, section, paragraph and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of matters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 20. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. 19-7710/205761 8 Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the provision of this Agreement which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 21. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any party who has signed it. 22. IMMIGRATION CONSULTANT shall be responsible for full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification. 23. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONSULTANT and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONSULTANT understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONSULTANT. 19-7710/205761 9 24. ATTORNEY' S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, each party shall bear its own attorney's fees, such that the prevailing party shall not be entitled to recover its attorney's fees from the non -prevailing party. 25. SURVIVAL Terms and conditions of this Agreement, which by their sense and context survive the expiration or termination of this Agreement, shall so survive. 26. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 27. SIGNATORIES 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 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. 28. ENTIRETY The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiation, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that 19-7710/205761 10 that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. This Agreement, and the attached exhibits, contain the entire agreement between the parties respecting the subject matter of this Agreement, and supersede all prior understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof. 29. EFFECTIVE DATE This Agreement shall be effective on the date of its approval by the City Attorney. This Agreement shall expire when terminated as provided herein. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized officers. CONSULTANT, PAGEANTRY PRODUCTIONS, a sole proprietor By: G print name CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California t tt s L t Director/Chief (Pursuant to HBMC § 3.03.100) Attorney N\X) RECEIVE AND FILEQ: 7i62 City Clerk -712-2 f /e-1 Date 19-7710/205761 11 EXHIBIT "A" A. STATEMENT OF WORK: (Narrative of work to be performed) B. CONSULTANT'S DUTIES AND RESPONSIBILITIES: C. CITY'S DUTIES AND RESPONSIBILITIES: D. WORK PROGRAM/PROJECT SCHEDULE: 19-7710/205761 12 March 8, 2018 Revised May 14, 2019 Pageantry Productions will perform the services required for the 2019 Huntington Beach ("City") 4th of July Parade ("Event"): 1. Coordinate with the 4th of July Board (the "Board") the activities of the Event including the parade entries (including, but not Limited to, rented cars, trucks and military vehicles; assisting with securing celebrities; assist with obtaining and coordinating VIP vehicles and float builders; etc.); line up; staging areas; and disbanding area. 2. Participate in distribution of parade application to potential parade entries. A link to online parade application to be emailed out to prior years entries. 3. Attend required planning meetings associated with the planning of the Event. 4, Provide Board updated approved entry spreadsheet at designated monthly meetings. S. Email all parade information (maps, formation route, times of arrival, disbanding information, etc.) to parade entries no later than June 21, 2019. 6. Mail Parade Participant Drop Off Passes to parade entries no later than June 7, 2019, provided that the entry has a signed contract, has paid all monies owed, and has provided a current mailing address 7. Assign an Event Coordinator from Pageantry staff upon signature of contract. 8. Assign a separate Coordinator to "pull entries" (i.e., start the parade) on the day of the event, and ensure that Parade is timed within broadcast limits. 9. Provide two (2) Float Judges on day of Event. 10. Designate an area as the parade check -in office for the day of the parade (past location has ,been on 9111 and Walnut). 11. Coordinate the formation areas (floats, bands, VIPs, equestrians, youth, novelty, etc.) on the day of the Event. 12. Mark formation areas by curb prior to the morning of July 4th in order to facilitate entries Line-up. 13. Provide personnel to oversee specific formation areas on day of event. 14. Assist with formulation of the parade line-up from the approved applications. 15. Provide Board updated lineups, including the final lineup seven (7) days prior to Parade. 16. Provide directional signs for parade staging area. 17.Oversee and review disbanding area and provide informational signs and directional memos for parade entries. 18. Provide all required insurance to standard limits and maintain licenses by June 1st. 19. Board and City to approve all expenditures outside of contractor fee. Must have written approval. 20. Contractor Service Fee of $14,500 to be paid the morning of July 4, 2019. 21. Minimum of one (1) golt cart to be provided by the City for Pageantry's exclusive use on the day of the Event. 22. Pageantry will assist w/obtaining Vendors for the below additional items, if needed, as part of their Parade Production Service. Vendor will be paid directly by the City, a. VIP/Dignitary Car Signs b. Parade Awards (Sweepstakes;Best Use Of Theme,- Firecracker, Equestrian; an Novelty PLEASE NOTE: First Place ONLY for 2019. c, Parade Opening acts)/entries d. Horse Drawn Vehicles e. VIP / Dignitary Ribbons f. VIP Cars g. VIP Plaques (Five (5) total) h. Balloons i. Banners j. Confetti FX k. Stilt Walkers I. Trolley / Street Car m. Train n, Drop Off Passes o. Barricades Contractor Service Fee $14,500.00 to be paid the morning of July 41h. Fee includes: Parade Production Services 2 Float Judges Unit Numbers & Pins 6 Announcer Stand Decorations Additional Insurance Additional Item to be paid as services are rendered and invoice is provided: VIP Car Signs (max 30 sets) - $600 Total to be paid to Pageantry Productions not to exceed $15,100.00 Presented by William Lomas CFFE Pageantry Productions (562) 618-5558 Paradeking@aol.com EXHIBIT "B" Payment Schedule (Fixed Fee Payment) 1. CONSULTANT shall be entitled to monthly progress payments toward the fixed fee set forth herein in accordance with the following progress and payment schedules. 2. Delivery of work product: A copy of every memorandum, letter, report, calculation and other documentation prepared by CONSULTANT shall be submitted to CITY to demonstrate progress toward completion of tasks. In the event CITY rejects or has comments on any such product, CITY shall identify specific requirements for satisfactory completion. 3. CONSULTANT shall submit to CITY an invoice for each monthly progress payment due. Such invoice shall: A) Reference this Agreement; B) Describe the services performed; C) Show the total amount of the payment due; D) Include a certification by a principal member of CONSULTANT's firm that the work has been performed in accordance with the provisions of this Agreement; and E) For all payments include an estimate of the percentage of work completed. Upon submission of any such invoice, if CITY is satisfied that CONSULTANT is making satisfactory progress toward completion of tasks in accordance with this Agreement, CITY shall approve the invoice, in which event payment shall be made within thirty (30) days of receipt of the invoice by CITY. Such approval shall not be unreasonably withheld. If CITY does not approve an invoice, CITY shall notify CONSULTANT in writing of the reasons for non -approval and the schedule of performance set forth in Exhibit "A" may at the option of CITY be suspended until the parties agree that past performance by CONSULTANT is in, or has been brought into compliance, or until this Agreement has expired or is terminated as provided herein. 4. Any billings for extra work or additional services authorized in advance and in writing by CITY shall be invoiced separately to CITY. Such invoice shall contain all of the information required above, and in addition shall list the hours expended and hourly rate charged for such time. Such invoices shall be approved by CITY if the work performed is in accordance with the extra work or additional services requested, and if CITY is satisfied that the statement of hours worked and costs incurred is accurate. Such approval shall not be unreasonably withheld. Any dispute between the parties concerning payment of such an invoice shall be treated as separate and apart from the ongoing performance of the remainder of this Agreement. 5. CONSULTANT shall be paid on or before July 4, 2019. 19-7710/205761 13 WORLWID-04 PEDENN , 11% R CERTIFICATE OF LIABILITY INSURANCE `-� DATD/YYYY) 6/27/22712019 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()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 endorsement(s). PRODUCER License # OE67768 CONTACT Nikki Peden IOA Insurance Services PHONE FAX 16000 Ventura Blvd. (A/C, No, Ext): (323) 951-4208 54208 (AIC, No): Suite 550 4EbmpAg'Ess, Nikki.Peden@ioausa.com Encino, CA 91436 INSURERS AFFORDING COVERAGE NAIC N INSURER A: Western World Insurance Company 13196 INSURED INSURER B : INSURER C World Wide Spectaculars dba Pageantry Productions INSURER D 8057 1st Street Paramount, CA 90723 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXPLTR DOIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7X OCCUR X NPP8618385 6/26/2019 6/26/2020 EACH OCCURRENCE $ 1,000,000 DAMAREMISES (Ea occurrence) TO RENTED $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG Included $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident $ BODILY INJURY Per person)$ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY AMAGE accdent $ HIRED NON V ED AUTOS ONLY AUTO ONLY(Par $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ El AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEC) RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 NER PET RTUT OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ %FICER/MEMBER EXCLUDED? (Mandatory in NH) N 1 A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is inquired) City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers are included as Additional Insured as respects claims arising out of the negligence of the Named Insured. The insurance captioned above is primary and non-contributory with any insurance held by or to the benefit of the Additional Insured. 30 Days' Notice of Cancellation, Except 10 Days' Notice for nonpayment of premium. RE: Special Event / 4th of July Parade 2019 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Huntington Beach (the "City"), Its City Council AUTHORIZED REPRESENTATIVE and all of its officers 6550 Miles Ave�- Huntwnaton Beach. CA 90255 \J ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: NPP8618385 COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648 City of Huntington Beach, its officers, elected or appointed officials, employees, agents and volunteers are included as Additional Insured as respects claims arising out of the negligence of the Named Insured. The insurance captioned above is primary and non-contributory with any insurance''(I held by or to the benefit of the Additional Insured. 30 Days' Notice of Cancellation, Except 10 Days' Notice for nonpayment of premium. J �/ RE: Special Event / 4th of July Parade 2019 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 in- clude as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au- thorization. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or "Bodily injury" or "property damage" included within the "products -completed operations hazard". APPROVED AS TO FORM MICHAEL. F. GATES CITY ATTORNEY CITY OF Mut4T'INGTON BEACH CG 20 12 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 13 Resolution No. 2008-63 CITY OF HUNTINGTON BEACH 2000 Main Street, Huntington Beach, CA 92648-2702 DECLARATION OF PERMITTEE I certify that no vehicle(s) will be used or operated in the performance of the task(s) or event(s) for which this permit is granted. 1 authorize the City of Huntington Beach to immediately and retroactively revoke the license or permit issued in connection with or in the performance of said task(s) or events(s) if any vehicle(s) is used. Signature of Permittee: Print Name: IA, -I /%1hn Z- 47 A.,, t Company Name (if applicable): Date Signed: 16407 EXHIBIT 1 ATTACHMENT #5 mubuiutlari 110. LUU8-63 CITY OF HUNTINGTO T BEACH 2000 Main Street, Huntington Beach, CA 92648-2702 Declaration of Non -Employer Status The State of California requires every enterprise or business to provide workers compensation insurance coverage. If you have no employees, you may make a declaration to that effect by completing and signing this form and returning to: City of Huntington Beach 2000 Main Street Huntington Beach, CA 92648-2702 I certify that in the performance of the activity or work for which this permit is issued, I shall not employ any person in any manner so as to become subject to California Workers' Compensation Insurance requirements. I authorize the City of Huntington Beach to immediately and retroactively revoke the license or permit issued under this declaration if 1 hire any employee(s) or become subject to the provision of the laws requiring Workers' Compensation Insurance. Company / Organization: Won u l y;," Address: _ 5(a S 7 / `-� *7 I? Applicant [please print]: 4t1i 11/Ar P_VW Title, if any: Applicant's Signature: Date Signed: Telephone Number: m R ATTACHMENT #7