HomeMy WebLinkAboutSergio's Photobooth - Photo Booth Employee Holiday - 2024Docusign Envelope ID. 773D9A3A-58744B73-A4C4-213F76138C22
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lqATIONAL CITV
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CITY MANAGER'S OFFICE
SERVICE AGREEMENT
This Community Services Service Agreement ("Agreement") is made and entered into by and between the CITY OF
NATIONAL CITY, a general law city and municipal corporation ("CITY"), and SERGIO'S PHOTOBOOTH
("CONTRACTOR") who agree as follows:
1. Services to be Performed by CONTRACTOR: The CONTRACTOR makes the following representations and agrees
to do the work described in accordance with the stated terms and conditions herein.
2. Description of Services: Provide a 360 photo booth. This will include but not limited to, a recording device,
decoration supplies for pictures.
Date: December 5, 2024 Start Time: 2:00 pm End Time: 4:00 pm
Location: 140 E 121h Street, National City CA 91950
3. Term: The term of this Agreement shall commence on the 5th day of December 2024, and shall terminate on the 51h
day of December 2024, unless earlier terminated pursuant to Section 11.
4. Compensation: The following shall be the terms of payment to CONTRACTOR for services rendered:
To Fee for Services Not to Exceed: $489.00 Payment Terms: CITY will make payment with check on Thursday,
December 5, 2024 once work is completed.
5. Method of Payment: The compensation provided in Section 4 shall be paid in full upon completion of services
rendered. The compensation provided in Section 4 shall be paid by CITY in the amount of $489.00
6. Independent CONTRACTOR: For all purposes, CONTRACTOR shall be an independent contractor and not an agent
or employee of the CITY. CONTRACTOR has and shall retain the right to exercise full control and supervision of all
persons assisting the CONTRACTOR in the performance of the services hereunder, the CITY only being concerned with
the finished results of the work being performed. As such, the CONTRACTOR and CONTRACTOR's employees are not
entitled to any of the rights, benefits, or privileges of a CITY employee including, but not limited to, overtime, medical or
Workers' Compensation Insurance, retirement benefits, or injury or other leave benefits. CONTRACTOR is solely
responsible for all such matters, as well as compliance with social security and income tax withholding and all other
regulations and laws governing such matters. CONTRACTOR's employees providing services under this Agreement
shall not qualify for or become entitled to, and hereby agree to waive any claims to, any compensation and benefit,
including, but not limited to, eligibility to enroll in California Public Employees Retirement System ("PERS") as an
employee of CITY and entitlement to any contributions to be paid by CITY for employer contributions and/or employee
contributions for PERS benefits.
7. Indemnity: To the fullest extent available under the law, the CONTRACTOR agrees to defend (with counsel acceptable
to CITY), indemnify and hold harmless the CITY and its respective officers, officials, agents, employees, and volunteers
(collectively "INDEMNITEES") against and from any and all claims, demands, liabilities, losses, damages to property,
injuries to, or death of any person or persons, and costs (including attorneys' fees and expert costs), of any kind or
nature whatsoever, resulting from or arising out of: (a) this Agreement; (b) the CONTRACTOR'S performance or failure
to perform the services; (c) any act or omission of the CONTRACTOR or its employees, agents or subcontractors or
their violation of any law; or (d) alleged PERS eligibility of any person performing services on CONTRACTOR's behalf
or any employer and employee contributions for PERS benefits on behalf of such persons as well as for payment of any
penalties and interest on such contributions. This section survives termination of this Agreement.
8. Insurance: CONTRACTOR shall obtain and maintain Commercial General Liability ("CGL") Insurance, Commercial
Automobile Liability Insurance (Any Auto), and Worker's Compensation and Employer's Liability coverage, minimum of
$1,000,000 each occurrence, and $2,000,000 general aggregate; AND an Additional Insured Endorsement naming the
INDEMNITEES as additional insured. All defense costs shall be outside the policy limits. If the CONTRACTOR maintains
higher limits, INDEMNITEES shall be entitled to coverage for the higher limits maintained by the CONTRACTOR. Any
available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to
INDEMNITEES. CGL and auto liability policies shall be endorsed to provide that the policies are primary and non-
contributory to any insurance that may be carried by INDEMNITEES, which shall be submitted to the CITY. Any insurance
May 2022
Docusign Envelope ID: 773D9A3A-5874-4B73-A4C4-213F76138C22
or self-insurance maintained by INDEMNITEES shall be excess of the CONTRACTOR's insurance and shall not
contribute with it. The CONTRACTOR shall provide an endorsement that the workers compensation insurer waives the
right of subrogation against INDEMNITEES.
9. Commencement of Services: CONTRACTOR shall not commence the performance of services under this Agreement
until the required insurance is approved by the City's Risk Manager.
10. Termination: This Agreement may be terminated by the CITY upon one (1) day's written notice.
11. Form W-9: CONTRACTOR shall provide the CITY a signed IRS Form W-9: Request for Taxpayer Identification
Number and Certification.
12. Changes: This Agreement shall not be assigned or transferred without the prior written consent of the CITY. No
changes or variations of any kind in the Agreement or the services to be performed are authorized without the prior
written consent of the CITY.
13. Comoliance with Law: The CONTRACTOR represents and warrants that CONTRACTOR is familiar with the
requirements of all applicable federal, state and local laws and ordinances applicable to performing the services,
including, but not limited to, AB506 (Business and Professions Code section 18975) and the Child Abuse and Neglect
Reporting Act (Penal Code sections 11164 - 11174.3), unemployment insurance benefits, FICA laws, and income
reports, and that it and each and every person performing any of the services on CONTRACTOR's behalf does and will,
at all times, comply with such requirements whether now in force or subsequently enacted.
14. Signing Authority: The representative signing on the CONTRACTOR's behalf hereby (a) declares that authority has
been obtained to sign on the CONTRACTOR's behalf; (b) agrees to hold INDEMNITEES harmless if it is later determined
that such authority does not exist; (c) declares that such representative has read and understood this Agreement; and
(d) agrees on CONTRACTOR's behalf to be bound by the terms and conditions herein.
City of National City:
Contractor Name:sergio's Photobooth Prepared by: Alexa Chavez Date:12/3/2024
Representative Name: Sergio Josue Rodriguez Title: Human Resources Technician
Title: Owner/Pro ri ne br. Approved by: Date: 1Z o
Signature: Title: 4�tY hANAGEP.
Date:12/3/2024 oAW!n5IRR541845
Check: 0 Insurance submitted and approved
Address: 428 Rose Drive National city CA 91950
Email: Photoboothmaniac@gmail.com
May 2022
SERGIO'S PHOTOBOOTH AGREEMENT
Client: Phone Number: Comunication
City of National City Via Email.
Rental Date: 1f2/05/24Time: 2-4pm Pick-up Datd:21M24Time: 4:00pm
Unit setup area on: Grass() Concrete(} Dirt(} Other( )
Package/Hours Rented: 2hrs 360 booth
Total Balance: $489.00 Deposit: $0
Amount Paid: Amount owed: $489.00
Payment Type: CASH () Paypal() Venmo(} Cashapp( )
Address for rental: 140 E 12th Street, National City CA 91950
Client email:achavez@nationa1dtyW. o� _
Terms & Conditions:
NO MONEY BACK upon sudden cancellation or change in date!
PAYMENT COMPLETION must be before or day of rental event
Owner/ Lessor: Josue Rodriguez
Phone Number:(619)254-1845 Email: Photoboothmaniac@gmail.com
Signature: ✓ W A00dt ue�
Client/ Lesee:
Signature:
x
(By signing this rental agreement, you are agreeing to abide by our terms and conditions for
your services render by Photo Booth maniac)
RV CERTIFICATE OF LIABILITY INSURANCE DATE(l�
ACO12ro2/2024
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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(les) 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 Simply Business
1 Beacon Street
Floor
Boston, MA 02108
CONTACT Simply Business
NA
FAX
ac No, Ext : 866 538-7491HONE A/C Noll:
sim I contactus business.com
ADDRESS: @ � P Y
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Spinnaker Insurance Company
4376
INSURED Sergio's photo booth
INSURER e :
428 Rose Drive
INSURER C :
National City, California 91950
INSURER D :
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
LTR
TYPE OF INSURANCE
ADDL
INSR
sus
VVVD
POLICY NUMBER
POLICY EFF
MM10OMM
POLICY EXP
(UMMDIYYM
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
X
HBW3514538XB3
04/14/2024
4/14/2025
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE X$100,000
OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
MED EXP Any oneperson)
$5,000
PERSONALS ADV INJURY
$1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
X
POLICY ECT LOC
PRODUCTS - COMP/OPAGG
$2,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE
Ea accident
BODILY INJURY (Per person)
ANYAUTO
AUTOS OWNED SppE
BODILY INJURY (Per accident)
AUTOS ONLY
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Per accident
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
AGGREGATE
EXCESS LIAR
CLAIMS -MADE
DED
RETENTION
WORKERS COMPENSATION
PER OTH-
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
STATUTE ER
E.L. EACH ACCIDENT
OFFICER/MEMBEREXCLUDED?
N I A
E.L. DISEASE - EA EMPLOYEE
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
PROFESSIONAL LIABILITY
EACH CLAIM
AGGREGATE
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is requlrod)
Certificate holder is included as an additional insured on the General Liability policy per written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of National City,
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
140 E 12th Street,
ACCORDANCE WITH THE POLICY PROVISIONS.
National city, CA 91950
AUTHORIZED REPRESENTATIVE
r'
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
Form W-9 Request for Taxpayer Give Form to the
(Rev. October2018) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ► Go to www.1rs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your Income tax return). Name is required on this line; do not leave this line blank.
Sergio Josue Rodriguez
2 Business name/disregarded entity name, if different from above
Seraio's Photobooth
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3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to
following seven boxes. certain entities, not individuals; see
instructions on page 3):
Q Individual/sole proprietor or ❑ C Corporation ElS Corporation ElPartnership ElTrust/estate
single -member LLC Exempt payee code (if any)
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting
LLC if the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is code Of any)
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Lj Other (see instructions) ►
6 Address (number, street, and apt. or suite no.) See instructions.
428 Rose Drive
6 City, state, and ZIP code
NATIONAL CITY CA
7 List account number(sl here
n Number
Z
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and
Number To Give the Requester for guidelines on whose number to enter.
I (Apples M O=GW is malnta&W MI&We the U.S.)
name and address (optional)
Social security number
6 1 3- 7 2- 9 [31 T39
or
Employer Identification number
No
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2.1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3.1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of
Here 1U.S. person ► �InDate ► 11 /25/24
General Instructions
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise
• Form 1099-MISC (various types of income, prizes, awards, or gross
noted.
proceeds)
Future developments. For the latest information about developments
. Form 1099-B (stock or mutual fund sales and certain other
related to Form W-9 and its instructions, such as legislation enacted
transactions by brokers)
after they were published, go to www.1rs.gov/FbrmW9.
• Form 1099-S (proceeds from real estate transactions)
Purpose of Form
• Form 1099-K (merchant card and third party network transactions)
An individual or entity (Form W-9 requester) who is required to file an
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
information return with the IRS must obtain your correct taxpayer
1098-T (tuition)
Identification number (TIN) which may be your social security number
• Form 1099-C (canceled debt)
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
e Form 1099-A (acquisition or abandonment of secured property)
(EIN), to report on an information return the amount paid to you, or other
Use Form W-9 only if you are a U.S. person (ncluding a resident
amount reportable on an information return. Examples of information
alien), to provide your correct TIN.
returns Include, but are not limited to, the following.
If you do not return Form W-9 to the requester with a TIN, you might
• Form 1099-INT (interest earned or paid)
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form w-9 (Rev. 10-2018)