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21-001 Swan Entertainment/The Peelers (Daniel Swan) SHORT FORM ENTERTAINMENT AGREEMENT CITY OF CUPERTINO Parks & Recreation Department 10185 N. Stelling Road Cupertino, CA 95014 408-777-3120 --USE OF THIS FORM IS ONLY VALID FOR AGREEMENTS UP TO $3,500.00-- Contractor Name: Swan Entertainment Client Trust Account Contractor Authorized Representative: Daniel Swan By the signature of its Authorized Representative below, Contractor hereby agrees to the following: A. SCOPE OF SERVICES. Contractor shall provide or furnish the following specified services and/or materials: Family show concert performance. Contractor shall provide their own sound system equipment. Location: Memorial Park Time: 3:00 pm to 10:00 pm B. TERM. The services and/or materials furnished under this Agreement shall be provided from 8/12/2021 to 8/12/2021. C. COMPENSATION. For the full performance of this Agreement, the City of Cupertino shall pay Contractor a total of $3,000.00 in a lump sum to be paid following receipt of Contractor’s invoice. D. EXHIBITS. The following attached exhibits hereby are made part of this Agreement: - Exhibit "C" - Affidavit of No Employees GENERAL TERMS AND CONDITIONS 1. Indemnification. To the fullest extent allowed by law and except for losses caused by the sole negligence or willful misconduct of City personnel, Contractor agrees to indemnify, defend, and hold harmless the City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers and Contractors (collectively, “Indemnitees”), through legal counsel acceptable to City, from and against any liability for damages, claims, actions, causes of action, demands, charges, losses, costs and expenses (including attorney fees, legal costs and expenses related to litigation, arbitrations, administrative and regulatory proceedings), of every nature, arising out of or in any way related to Contractor’s or Contractor’s agents performance of the Scope of Services. This includes but is not limited to liability resulting in personal injury, death, property damage, or economic losses. Contractor must pay any costs City may incur in enforcing this provision and must accept a tender of defense upon receiving notice from City. Contractor’s payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this agreement. 2. General Liability Insurance. The undersigned shall maintain general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury, and property damage. Undersigned’s general liability policies shall be endorsed to provide that City and its officers, officials, employees, and agents shall be additional insureds under such policies. 3. Compliance with Laws. Contractor shall comply with all laws applicable to this Agreement including, without limitation, laws regarding workers’ compensation, antidiscrimination, and conflict of interest. If Contractor has no employees an affidavit to that effect shall be attached to this agreement. If the scope of work involves providing services to children, the City of Cupertino, Contractor Declaration shall be attached. 4. Assignment. Contractor may not assign, transfer, or subcontract this Agreement or any portions thereof, without prior written consent of City. 5. Termination. City may terminate this agreement at any time. In the event of cancellation within 24 hours of the time Contractor is to begin providing services City shall pay contractor one half of the total agreement amount unless cancellation occurs after Contractor’s personnel have arrived at the location where services are to be performed in which case the total contract amount shall be paid. 6. Interest of Contractor. It is understood and agreed that this Agreement is not a contract of employment and, at all times, Contractor shall be deemed to be an independent contractor and Contractor is not authorized to bind the City to any contracts or other obligations in executing this Agreement. Contractor certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of City. City shall have no right of control as to the manner Contractor performs the services to be performed. Nevertheles s, City may, at any time, observe the manner in which such services are being performed by the contractor. Contractor shall comply with all applicable Federal, State, and local laws and ordinances including, but not limited to, unemployment insurance benefits, FICA laws, and the City business license ordinance. 7. Changes. No changes or variations of any kind are authorized without the written consent of the City. CONTRACT COORDINATOR and representative for CITY shall be: Kelsey Christian. May 5, 2020 IN WITNESS WHEREOF, the parties have executed this Agreement effective the date last signed below. CONTRACTOR By ________________________ Name______________________ Title ______________________ Date_______________________ Tax I.D. No.: Refer to W9 CITY OF CUPERTINO A Municipal Corporation By ________________________ Name______________________ Title ______________________ Date_______________________ APPROVED AS TO FORM: _____________________________ CHRISTOPHER D. JENSEN Cupertino City Attorney ATTEST: _____________________________ KIRSTEN SQUARCIA City Clerk Date ________________________ Daniel Swan Jul 28, 2021 Agent Christopher D. Jensen Rachelle Sander Jul 28, 2021 Assistant Director of Parks and Recreation Jul 28, 2021 EXHIBIT C AFFIDAVIT OF NO EMPLOYEES State of California County of Santa Clara City of Cupertino I, the undersigned, declare as follows: I am an independent contractor and agent for Swan Entertainment Client Trust Account. I wish to enter into a services contract with the City of Cupertino. I am fully aware of the provisions of section 3700 of the California Labor Code, which requires every employer to provide Workers' Compensation coverage for employees in accordance with the provisions of that Code. I am also aware that I must provide proof of workers’ compensation insurance to the City of Cupertino for any and all employees I may have, pursuant to Section 12 of the City of Cupertino’s contract. I hereby certify that I do not have any employees nor will I have any employees working for me or my business during the term of any service contract with the City of Cupertino. I am not required to have Workers’ Compensation insurance. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on this ____day of ____________, 2021, at , California. ______________________________ PRINT NAME ______________________________ SIGNATURE Daniel Swan VallejoJuly28 EVANSTON INSURANCE COMPANY CERTIFICATE NO.: - CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with Apex Insurance Services P. O. Box 6450 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: TYPE: 2021 Summer Concerts DATE(S): 7/15, 22, 29/21 & 8/5, 12/21 LOCATION: Memorial Park, 21121 Stevens Creek Blvd, Cupertino CA 95014 *Liquor Liability Yes No **Liquor Liability after 12 am ends before 2 am This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2021 EXPIRATION: JANUARY 1, 2022 COMMERCIAL GENERAL LIABILITY General Aggregate Limit Products & Completed Operations Personal & Advertising Injury Each Occurrence Limit Damage To Premises Rented To You (Any One Premises) Medical Payments (Any One Person) Liquor Liability (If purchased) Optional Limits Purchased $1,000,000/$3,000,000 $2,000,000/$2,000,000 Damage To Property (If purchased) $ 2,000,000 1,000,000 1,000,000 1,000,000 100,000 5,000 1,000,000 OCCURRENCE FORM DEDUCTIBLE: NONE SPECIAL CONDITIONS: The following endorsements attached to the Master Policy do not apply to this Certificate Of Insurance: MEGL643 The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. OTHER ADDITIONAL INSUREDS CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: 7/7/21 MPIL 1039-CA 01 20 Page 1 of 2 EVANSTON INSURANCE COMPANY IMPORTANT NOTICE CALIFORNIA SURPLUS LINES NOTICE (D-2) 1. The insurance policy that you have purchased is being issued by an insurer that is not licensed by the State of California. These companies are called “nonadmitted” or “surplus lines” insurers. 2. The insurer is not subject to the financial solvency regulation and enforcement that apply to California licensed insurers. 3. The insurer does not participate in any of the insurance guarantee funds created by California law. Therefore, these funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised. 4. The insurer should be licensed either as a foreign insurer in another state in the United States or as a non-United States (alien) insurer. You should ask questions of your insurance agent, broker, or “surplus line” broker or contact the California Department of Insurance at the toll-free number 1-800-927-4357 or internet website www.insurance.ca.gov. Ask whether or not the insurer is licensed as a foreign or non-United States (alien) insurer and for additional information about the insurer. You may also visit the NAIC’s internet website at www.naic.org. The NAIC – the National Association of Insurance Commissioners – is the regulatory support organization created and governed by the chief insurance regulators in the United States. 5. Foreign insurers should be licensed by a state in the United States and you may contact that state’s department of insurance to obtain MPIL 1039-CA 01 20 Page 2 of 2 more information about that insurer. You can find a link to each state from this NAIC internet website: https://naic.org/state_web_map.htm. 6. For non-United States (alien) insurers, the insurer should be licensed by a country outside of the United States and should be on the NAIC’s International Insurers Department (IID) listing of approved nonadmitted non-United States insurers. Ask your agent, broker, or “surplus line” broker to obtain more information about that insurer. 7. California maintains a “List of Approved Surplus Line Insurers (LASLI).” Ask your agent or broker if the insurer is on that list, or view that list at the internet website of the California Department of Insurance: www.insurance.ca.gov./01-consumers/120-company/07- lasli/lasli.cfm. 8. If you, as the applicant, required that the insurance policy you have purchased be effective immediately, either because existing coverage was going to lapse within two business days or because you were required to have coverage within two business days, and you did not receive this disclosure form and a request for your signature until after coverage became effective, you have the right to cancel this policy within five days of receiving this disclosure. If you cancel coverage, the premium will be prorated and any broker’s fee charged for this insurance will be returned to you.