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2019 CON Christiansen Amusements Corp. - Ferris Wheel Rental
SHORT FORM SERVICES AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND CHRISTIANSEN AMUSEMENTS CORPORATION THIS AGREEMENT is entered into this 27 day of October, 2019, by and between the CITY OF NATIONAL CITY, a municipal corporation (the "CITY"), and CHRISTIANSEN AMUSEMENTS CORPORATION, a corporation (the "CONTRACTOR"). NOW, THEREFORE, CITY agrees to engage CONTRACTOR to perform the services set forth herein in accordance with the following terms and conditions: 1. Description of Services. CONTRACTOR shall provide services as outlined in attached proposal, Exhibit "A". Services provided will include transportation, installation and removal, operators and supervisors of a 40 foot Ferris Wheel. Generator not included. 2. Length of Agreement. The schedule is set forth below: Work to be started at 9:00am on December 14, 2019, and ready to use by 12:00pm on December 14, 2019. Removal will begin at 10:00pm on December 14, 2019, and must be completed by 2:00am on December 15, 2019. 3. Compensation. The total compensation to CONTRACTOR for providing the services set forth herein shall not exceed a one-time cost of $4500. The compensation for CONTRACTOR'S work shall be based upon and not exceed the rates given in Exhibit "A" (the labor rates) without prior written authorization from CITY. 4. Payment Schedule. CITY will make payment within thirty (30) days of receiving and approving a billing statement for the satisfactorily completed services of CONTRACTOR. 5. Termination. CITY may terminate this Agreement at any time by providing one (1) day's written notice to CONTRACTOR. 6. Independent Contractor. It is agreed that CONTRACTOR is an independent Contractor, and all persons working for or under the direction of CONTRACTOR are CONTRACTOR'S agents, servants and employees, and said persons shall not be deemed agents, servants, or employees of CITY. 7. Insurance. CONTRACTOR shall obtain: A. ❑ If checked, Professional Liability Insurance (errors and omissions) with minimum limits of $1,000,000 per occurrence. B. Automobile insurance covering all bodily injury and property damage incurred during the performance of this Agreement, with a minimum coverage of $1,000,000 combined single limit per accident. Such automobile insurance shall include non -owned, and hired vehicles. The policy shall name the CITY and its officers, agents, employees, and volunteers as additional insureds, and a separate additional insured endorsement shall be provided. C. Commercial General Liability Insurance, with minimum limits of either $2,000,000 per occurrence and $4,000,000 aggregate, or $1,000,000 per occurrence and $2,000,000 aggregate with a $2,000,000 umbrella policy, covering all bodily injury and property damage arising out of its operations, work, or performance under this Agreement. The policy shall name the CITY and its officers, agents, employees, and volunteers as additional insureds, and a separate additional insured endorsement shall be provided. The general aggregate limit must apply solely to this "project" or "location". The "project" or "location" should be noted with specificity on an endorsement that shall be incorporated into the policy. D. Workers' compensation insurance in an amount sufficient to meet statutory requirements covering all of CONTRACTOR'S employees and employers' liability insurance with limits of at least $1,000,000 per accident. In addition, the policy shall be endorsed with a waiver of subrogation in favor of the CITY. Said endorsement shall be provided prior to commencement of work under this Agreement. If CONSULTANT has no employees subject to the California Workers' Compensation and Labor laws, CONSULTANT shall execute a Declaration to that effect. Said Declaration shall be provided to CONSULTANT by CITY. E. The aforesaid policies shall constitute primary insurance as to the CITY, its officers, employees, and volunteers, so that any other policies held by the CITY shall not contribute to any loss under said insurance. Said policies shall provide for thirty (30) days prior written notice to the CITY's Risk Manager, at the address listed in subsection G below, of cancellation or material change. F. Said policies, except for the professional liability and workers' compensation policies, shall name the CITY and its officers, agents, employees, and volunteers as additional insureds, and separate additional insured endorsements shall be provided. G. The Certificate Holder for all policies of insurance required by this Section shall be: City of National City c/o Risk Manager 1243 National City Boulevard National City, CA 91950-4397 H. If required insurance coverage is provided on a "claims made" rather than "occurrence" form, the CONTRACTOR shall maintain such insurance coverage for three years after expiration of the term (and any extensions) of this Agreement. In addition, the "retro" date must be on or before the date of this Agreement. I. Insurance shall be written with only insurers authorized to conduct business in California which hold a current policy holder's alphabetic and financial size category rating of not less than A:VII according to the current Best's Key Rating Guide, or a company of equal financial stability that is approved by the City's Risk Manager. In the event coverage is provided by non -admitted "surplus lines" carriers, they must be included on the most recent List of Approved Surplus Line Insurers ("LASLI") and otherwise meet rating requirements. J. This Agreement shall not take effect until certificate(s) or other sufficient proof that these insurance provisions have been complied with, are filed with, and approved by the CITY's Risk Manager. If the CONTRACTOR does not keep all insurance policies required by this Section 7 in full force and effect at all times during the term of this Agreement, the CITY may treat the failure to maintain the requisite insurance as a breach of this Agreement and terminate the Agreement as provided herein. Standard Short Form Agreement Page 2 of 6 City of National City and Revised May 2019 CHRISTIANSEN AMUSEMENTS CORPORATION K. All deductibles and self -insured retentions in excess of $10,000 must be disclosed to and approved by the CITY. CITY reserves the right to modify the insurance requirements of this Section 7, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. L. If the CONTRACTOR maintains broader coverage or higher limits (or both) than the minimum limits shown above, the CITY shall be entitled to the broader coverage or higher limits (or both) maintained by the CONTRACTOR. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the CITY. 8. Indemnification and Hold Harmless. To the maximum extent provided by law, the CONTRACTOR agrees to defend, indemnify and hold harmless the City of National City, its officers, officials, agents, employees, and volunteers against and from any and all liability, loss, damages to property, injuries to, or death of any person or persons, and all claims, demands, suits, actions, proceedings, reasonable attorneys' fees, and defense costs, of any kind or nature, including workers' compensation claims, of or by anyone whomsoever, resulting from or arising out of the CONTRACTOR'S performance or other obligations under this Agreement; provided, however, that this indemnification and hold harmless shall not include any claims or liability arising from the established sole negligence or willful misconduct of the CITY, its agents, officers employees, or volunteers. CITY will cooperate reasonably in the defense of any action, and CONTRACTOR shall employ competent counsel, reasonably acceptable to the City Attorney. The indemnity, defense, and hold harmless obligations contained herein shall survive the termination of this Agreement for any alleged or actual omission, act, or negligence under this Agreement that occurred during the term of this Agreement. 9. EMPLOYEE PAYMENTS AND INDEMNIFICATION. 9.1 PERS Eligibility Indemnification. If CONTRACTOR'S employee(s) providing services under this Agreement claims, or is determined by a court of competent jurisdiction or the California Public Employees Retirement System ("PERS") to be eligible for enrollment in PERS of the CITY, CONTRACTOR shall indemnify, defend, and hold harmless CITY for the payment of any employer and employee contributions for PERS benefits on behalf of the employee as well as for payment of any penalties and interest on such contributions which would otherwise be the responsibility of the CITY. CONTRACTOR'S employees providing service under this Agreement shall not: (1) qualify for any compensation and benefit under PERS; (2) be entitled to any benefits under PERS; (3) enroll in PERS as an employee of CITY; (4) receive any employer contributions paid by CITY for PERS benefits; or (5) be entitled to any other PERS-related benefit that would accrue to a CITY employee. CONTRACTOR's employees hereby waive any claims to benefits or compensation described in this Section 9. This Section 9 applies to CONTRACTOR notwithstanding any other agency, state or federal policy, rule, regulation, law or ordinance to the contrary. 9.2 Limitation of CITY Liability. The payment made to CONTRACTOR under this Agreement shall be the full and complete compensation to which CONTRACTOR and CONTRACTOR's officers, employees, agents, and subcontractors are entitled for performance of any work under this Agreement. Neither CONTRACTOR nor CONTRACTOR's officers, Standard Short Form Agreement Page 3 of 6 City of National City and Revised May 2019 CHRISTIANSEN AMUSEMENTS CORPORATION employees, agents, and subcontractors are entitled to any salary or wages, or retirement, health, leave or other fringe benefits applicable to CITY employees. The CITY will not make any federal or state tax withholdings on behalf of CONTRACTOR. The CITY shall not be required to pay any workers' compensation insurance on behalf of CONTRACTOR. 9.3 Indemnification for Employee Payments. CONTRACTOR agrees to defend and indemnify the CITY for any obligation, claim, suit, or demand for tax, retirement contribution including any contribution to PERS, social security, salary or wages, overtime payment, or workers' compensation payment which the CITY may be required to make on behalf of (1) CONTRACTOR, (2) any employee of CONTRACTOR, or (3) any employee of CONTRACTOR construed to be an employee of the CITY, for work performed under this Agreement. This is a continuing obligation that survives the termination of this Agreement. 10. Acceptability of Work. The CITY shall, with reasonable diligence, determine the quality or acceptability of the work, the manner of performance, and/or the compensation payable to the CONTRACTOR. 11. Business License. CONTRACTOR must possess or shall obtain business license from National City Finance Department before beginning work. 12. Prevailing Wages. State prevailing wage rates may apply to work performed under this Agreement. State prevailing wages rates apply to all public works contracts as set forth in California Labor Code, including but not limited to, Sections 1720, 1720.2, 1720.3, 1720.4, and 1771. CONTRACTOR is solely responsible to determine if State prevailing wage rates apply and, if applicable, pay such rates in accordance with all laws, ordinances, rules, and regulations. 13. Administrative Provisions. A. Computation of Time Periods. If any date or time period provided for in this Agreement is or ends on a Saturday, Sunday or federal, state or legal holiday, then such date shall automatically be extended until 5:00 p.m. Pacific Time of the next day which is not a Saturday, Sunday or federal, state, or legal holiday. B. Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which, together, shall constitute but one and the same instrument. C. Captions. Any captions to, or headings of, the sections or subsections of this Agreement are solely for the convenience of the parties hereto, are not a part of this Agreement, and shall not be used for the interpretation or determination of the validity of this Agreement or any provision hereof. D. No Obligations to Third Parties. Except as otherwise expressly provided herein, the execution and delivery of this Agreement shall not be deemed to confer any rights upon, or obligate any of the parties hereto, to any person or entity other than the parties hereto. E. Exhibits and Schedules. The Exhibits and Schedules attached hereto are hereby incorporated herein by this reference for all purposes. To the extent any exhibits, schedules, or provisions thereof conflict or are inconsistent with the terms and conditions contained in this Agreement, the terms and conditions of this Agreement will control. Standard Short Form Agreement Page 4 of 6 City of National City and Revised May 2019 CHRISTIANSEN AMUSEMENTS CORPORATION F. Amendment to this Agreement. The terms of this Agreement may not be modified or amended except by an instrument in writing executed by each of the parties hereto. G. Assignment & Assumption of Rights. CONTRACTOR shall not assign this Agreement, in whole or in part, to any other party without first obtaining the written consent of CITY. H. Waiver. The waiver or failure to enforce any provision of this Agreement shall not operate as a waiver of any future breach of any such provision or any other provision hereof. I. Applicable Law. This Agreement shall be governed by and construed in accordance with the laws of the State of California. The venue for any legal action arising under this Agreement shall be in either state or federal court in the County of San Diego, State of California. The CONTRACTOR shall comply with all laws, including federal, state, and local laws, whether now in force or subsequently enacted. J. Audit. If this Agreement exceeds ten -thousand dollars ($10,000), the parties shall be subject to the examination and audit of the State Auditor for a period of three (3) years after final payment under the Agreement, per Government Code Section 8546.7. K. Entire Agreement. This Agreement supersedes any prior agreements, negotiations and communications, oral or written, and contains the entire agreement between the parties as to the subject matter hereof. No subsequent agreement, representation, or promise made by either party hereto, or by or to an employee, officer, agent, or representative of any party hereto shall be of any effect unless it is in writing and executed by the party to be bound thereby. L. Successors and Assigns. This Agreement shall be binding upon and shall inure to the benefit of the successors and assigns of the parties hereto. M. Subcontractors or Subconsultants. The CITY is engaging the services of the CONTRACTOR identified in this Agreement. The CONTRACTOR shall not subcontract any portion of the work, unless such subcontracting was part of the original proposal or is allowed by the CITY. In the event any portion of the work under this Agreement is subcontracted, the subcontractor(s) shall be required to comply with and agree to, for the benefit of and in favor of the CITY, both the insurance provisions in Section 7 and the indemnification and hold harmless provision of Section 8 of this Agreement. N. Construction. The parties acknowledge and agree that (i) each party is of equal bargaining strength, (ii) each party has actively participated in the drafting, preparation and negotiation of this Agreement, (iii) each such party has consulted with or has had the opportunity to consult with its own, independent counsel and such other professional advisors as such party Standard Short Form Agreement Page 5 of 6 City of National City and Revised May 2019 CHRISTIANSEN AMUSEMENTS CORPORATION has deemed appropriate, relative to any and all matters contemplated under this Agreement, (iv) any rule or construction to the effect that ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this Agreement, or any portions hereof, or any amendments hereto IN WITNESS WHEREOF, this Agreement is executed by CITY and by CONTRACTOR on the date and year first above written. CITY OF NATIONAL CITY By: B APPROVED AS TO FORM: B orris ones Cit orney CONTACT INFORMATION CITY OF NATIONAL CITY 1243 National City Boulevard National City, CA 91950-4397 Phone: (619) 336-4358 Fax: (619) 336-4292 Contact: Juanita Castaneda Title: Recreation Center Supervisor Dep.: Community Services Department Email: jastaneda@nationalcityca.gov Standard Short Form Agreement Revised May 2019 CHRISTIANSEN AMUSEMENTS CORPORATION (Corporation — signatures of two corporate officers required) By: Z- By: (Name) Tom 1SJVotty n (Print) vi c1 pwesid e►l+ itle) L (Name) /�, \Sk1 O1CO 931(6 } (Print) Presi del+ (Title) CHRISTIANSEN AMUSEMENTS CORPORATION 1725 S Escondido Blvd. Ste E. Escondido, CA 92025 Phone: (760) 735-8542 Fax: (760) 735 8543 Contact: Tom Brown Title: Vice President Email: tom@amusements.com or info@amusements.com Taxpayer I.D. No.: 95-2569840 Page 6 of 6 City of National City and CHRISTIANSEN AMUSEMENTS CORPORATION Exhibit "A" Christiansen Amusements Mailing: Shipping: P. O. Box 997 1725 S. Escondido Blvd., Ste. E Escondido, CA 92033-0997 Escondido, CA 92025-6546 (760) 735-8542; (Fax) 735-8543; info@amusements.com Bill To: Invoice To: 4 AM JSEMENIS INVOICE A Kimball Park Holiday National City Attn: Juanita Castaneda via email; j castaneda@nationalcityca.gov Date Your # Our # Terms July 25, 2019 121419-KPH deposit upon receipt; balance due upon opening 12/14 Event Date Invoice Description Unit Price Total 12/14/19 Rental of (1) carnival ride; Ferris Wheel $ 4,500.00 for event in National City on December 14, 2019 Hours of operation 12pm-l0pm $ 4,500.00 PLEASE NOTE ALL PAYMENTS MADE BY CREDIT CARD WILL BE CHARGED 2.5% PROCESSING FEE Christiansen Amusements Fed. ID: 95-2569840 TOTAL DUE: $ 4,500.00 Deposit due upon receipt: $ 2,250.00 Balance due 12/14/19 $ 2,250.00 ACORL DATE (MM/DD/YYYY) 9/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 777 108th Ave NE, #200 Bellevue WA 98004 INSURED Christiansen Amusements, Inc. P. O. Box 997 Escondido, CA 92033-0997 COVERAGES CERTIFICATE OF LIABILITY INSURANCE CHRIAMU-01 CONTACT NAME: Bobby Walpole PHONE IA/C. No. Ext): 425-586-1006 E-MAIL ADDRESS: Bobby Walpole@ajg.com INSURER(S) AFFORDING COVERAGE INSURER A : T.H.E. Insurance Company INSURER B : FA X No): 425-451-3716 NAIC # 12866 INSURER C: INSURER D : INSURER E : INSURER F: CERTIFICATE NUMBER:775966555 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 ADDL SUER LTR TYPE OF INSURANCE POLICINSD WVQ. POLICY NUMBER (MM/DDY/YEYYY POLICY EXP (MM/DD/YYYY) LIMITS CPP 0100507 09 A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR A GEN'L AGGREGATE LIMIT APPLIES PER: AU POLICY OTHER: PRO- JECT OMOBILE LIABILITY ANY AUTO LOC Y Y 4/1/2019 4/1/2020 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY $1,000,000 $100,000 $ 1,000,000 GENERAL AGGREGATE $10,000,000 PRODUCTS - COMP/OP AGG $1,000,000 OWNED SCHEDULED AUTOS ONLY _ AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB EXCESS LIAR COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident)_ OCCUR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED9 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below ELP 0010135 4/1/2019 4/1/2020 EACH OCCURRENCE 54,000,000 AGGREGATE N/A I PE STATUTE I I ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cert holder is named as additional insured per form # CG 20 26 04 13. Primary noncon ributory and waiver of subrogation is included. Certholder , City and its officers, agents, employees, and volunteers as additional insureds but only in respects to the operations of the named insured Event Date 14-16 2019 CERTIFICATE HOLDER CANCELLATION City of National City c/o Risk Manager 1243 National City Boulevard National City, CA 91950 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE tilt)46 ,j ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPP0100507-09 COMMERCIAL GENERAL LIABILITY CG24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: CITY OF NATIONAL CITY AND ITS OFFICERS, AGENTS, EMPLOYEES & VOLUNTEERS. 1243 NATIONAL CITY BOULEVARD, NATIONAL CITY, 91950-4397 BUT ONLY WITH RESPECTS TO THE INSUREDS OPERATIONS AT KIMBRELL PARK - E-12TH ST. NATIONAL CITY, CA 91950 FOR THE PERIOD 12/14/19 - 12/16/19 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG24040509 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 /ACviro CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Arthur J. Gallagher Risk Management Services, Inc. NAME Bobby Walpole 777 108th Ave NE, #200 PHONE (A/C No. Ext): 425-586-1006 (A/cc. No): 425-451-3716 Bellevue WA 98004 ADDRESS: Bobby Walpole@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # I INSURER A: T.H.E. Insurance Company 12866 INSURED CHRIAMU-01 Christiansen Amusements, Inc. INSURER B INSURER C : P. O. Box 997 Escondido, CA 92033-0997 INSURER D : INSURER E : INSURER F : rn!Connoc .,r..,,..��..... --- - rteVIJIUry NUMIStK: 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 IYSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PRO- PER: GENERAL AGGREGATE $ P POLICY JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY ANY AUTO X CPP010050709 4/1/2019 4/1/2020 COMBINEDSINGLELIMIT (Ea accident) $1,000,000 — OWNED — X SCHEDULED BODILY INJURY (Per person) $ X AUTOS ONLY HIRED AUTOS NON -OWNED BODILY INJURY (Per accident) $ — AUTOS ONLY X — AUTOS ONLY PROPERTY DAMAGE (per accident) $ $ — UMBRELLA LIAB EXCESS LIAB — OCCUR EACH OCCURRENCE $ CLAIMS -MADE AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. EACH ACCIDENT $ (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ D DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certholder , City and its officers, agents, employees, and volunteers as additional insureds but only in respects to the operations of the named insured Event Date 14-16 2019 rCDTICIt'ATC LIAI nor) - - TION City of National City c/o Risk Manager 1243 National City Boulevard National City, CA 91950 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPP0100507-09 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: CHRISTIANSEN AMUSEMENTS, INC. AND SOUTHLAND SHOWS, INC., ETAL Endorsement Effective Date: 12/14/19 SCHEDULE Name(s) Of Person(s) Or Organization(s): CITY OF NATIONAL CITY, CITY AND ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS C/O Risk Manager 1243 National City Boulevard National City CA 91950-4301 Event Date: December 14-16, 2019 Event Location: Kimball Park - E 12th St., National City, CA 91950 BUT ONLY WITH RESPECTS TO THE OPERATIONS OF THE NAME INSURED. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 SOUTSHO-01 CERTIFICATE OF LIABILITY INSURANCE MBIGHAM DATE (MM/DD/YYYY) 10/23/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0B48084 Wraith, Scarlett & Randolph Insurance Services, Inc. 509 Bush Street Woodland, CA 95695 INSURED Christiansen Amusements Inc & Southland Shows Inc Stacy Brown PO Box 997 Escondido, CA 92033 CONTACT NAME: PHONE (A/c, No, Ext): (530) 662-9181 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Markel Insurance Company INSURER B : FAX No):(530) 662-6452 NAIC # 38970 INSURER C : INSURER D : INSURER E : INSURER F : COVER • KtvISIUN 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 ,JNSD SUBR �IYV• POLICY NUMBER (MM/DDY 1 EFF POLICY L LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ P POLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY (EO aBINED SINGLE LIMIT $ ANY AUTO OWNED r— SCHEDULED BODILY INJURY (Per person $ AUTOSOONLY AUTOS BODILY INJURY (Per accident)_ $ _ AUTOS ONLY _ yyNEp AUTO ONLY (Per aailTent) AGE $ $ — UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAB I CLAIMS -MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X STATUTE ERPER H _ ANY PROPRIETOR/PARTNER/EXECUTIVE QFFICER/MEMBER EXCLUDED? n N /A X MWC0123015-02 2/6/2019 2/6/2020 E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes, describe under E.L DISEASE - EA EMPLOYEE $ 1,000,000 D DESCRIPTION OF OPERATIONS below DISEASE - POLICY LIMIT 1,000,000E.L. $_ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: December 14-16, 2019 Verification of Insurance. Waiver of Subrogation applies per attached MWC14000510. CANCELLATION City of National City c/o Risk Manager 1243 National City Boulevard National City, CA 91950 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY MWC 1400 05 10 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Premium: The additional premium charge for this endorsement shall be 3 percent of the California Workers' Compensation pre-mium otherwise due subject to a minimum premium of $750 per policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 02/06/2019 Policy No. MWC0123015-02 Endorsement No. Insured: Southland Shows Inc. Premium (See Attached) Insurance Company: MWC14000510 Markel Insurance Company Countersigned by Includes copyrighted material of National Council on Compensation Insurance with its permission Copyright 1983 National Council on Compensation Insurance. 29 of 33 CITY OF NATIONAL CITY Office of the City Clerk 1243 National City Blvd., National City, California 91950-4397 619-336-4228 Michael R. Dalla, CMC - City Clerk November 25, 2019 Mr. Tom Brown Christiansen Amusements Corp. 1725 S. Escondido Blvd., Ste. E Escondido, CA 92025 Dear Mr. Brown, On October 27`h, 2019, an Agreement was entered into between the City of National City and Christiansen Amusements Corporation. We are forwarding a fully executed original Agreement for your records. Sincerly, riti Michael R. alla , CMC City Clerk Enclosure CONTRACT TRANSMITTAL FORM (Attach as cover sheet to Documents dropped off to City Clerk's Office) From (Dept.): S 9 Submitted by (First & Last Name): Vendor: Cas ntdn Resolution: YES / NO Resolution No. (if applicable): 1 4 Originals Provided to City Clerk (circle quantity) Department has Copy / Duplicate Original 1VO Vendor has Copy / Duplicate Original