HomeMy Public PortalAboutC-21-112 - Service Agreement - Marlene TrujilloCity of Carson
Community Services Department
Service Provider Anplication Agreement
Check one (staff use):
[|Carson Event Center|]HumanServices |Recreation |Transportation
Foisia Park,Carson 09/18/21HispanicHeritageMonthCelebration.t:?Event Location:Event Date:_rccven
Name of Service Provider:a MARLCHE TRajiilo
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Business Form/Entity Type(if individual,sole proprietorship,corporation,or limited liability
company,specify here):
Individual
Business Form/Entity Type (if general partnership,limited partnership,limited liability partnership,
or other,specify here):
Business Entity State of incorporation (if applicable):
Type af Service:Live musica!performance
Contact Person:Wa Vln c Try \Ye Phone #:(30)WOU -lO&SG!J
Emer.Contact:Anthea,Va len ZuU€Ly Phone #:(4/0 )180 -139¢/
Billing Address-}}}te—areca
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Gods Fallbrek.Canyon “Pr.
StreetNumberCa|g 2&8 2
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Proof of Insurance (check one)?[Ives
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If no,would you like to purchase special event insurance through the City (check one)?
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Special Instructions /Notes:$100 for a 15-minute performance
Estimated performance time is 12:45-1:00 p.m.(subject to change)
State ZIP
NoiG:wai VALENS 1S THE PECFoRMER,BUT sve 1S only Q yYEARs OW.
TWMECERORE ALL OF TYE ROCUMENTATION IS In)WARLENE'S NAME.
WRRLENE TRUNUO 1S MYAH'S MOTHER.ae
§32227.5 CFN AS OF 1-22-2020
If Service Provider wishes to request any special accommodation needed to facilitate provision of the
services,please identify it here or contactthe staff member referenced on Page 1 of this application:
$100TotalServiceFee
NOTE:If service provideris unable to provide the services as proposed or requested or the City
of Carson cancels the service for any reason,the associated fees will not be paid.
[remainder ofpage intentionally left blank]
532227.5 CFN AS OF 1-22-2020
Further Terms of Service Provider Application Agreement:
The undersigned signatory of Service Provider (Service Provider being the above-referenced person
or entity seeking to provide services at the above-referenced event,includingall its officers,agents,
employees and volunteers)hereby represents and warrants that he or she is duly authorized by
Service Provider to execute and deliver this application on behalf of Service Provider,and that by so
executing this application,and in consideration for the City’s review of this application,Service
Provider is bound by these terms.
Service Provider understands and agrees to comply with the City’s “Service Provider Rules &
Regulations,”which are set forth below and incorporated herein by this reference.
Service Provider agrees to indemnify and release City in connection with its proposed services in
accordance with the “Waiver,Release,Hold Harmless,Agreement Not to Sue,Indemnification,and
Photo Release”submitted concurrently herewith.
Service Provider agrees to maintain all required insurance coverages and comply with all associated
insurance requirements as set forth on the above “Insurance Requirements”page,which is
incorporated herein by reference.Service Provider agrees that all required policies shall contain,or
be endorsed to contain,an agreement by Service Provider to waive all rights of subrogation and
contribution against the City,its elected or appointed officers,officials,employees and agents,for all
losses andliabilities paid under the terms of any policy which arise from the activities or operations
of,or the services performed by,Service Provider,regardless of any prior,concurrent,or subsequent
non-active negligence by the City.
In the event there is more than one person or entity named in this Service Provider Application
Agreement as the Service Provider,then all obligations,liabilities,covenants and conditions
hereunder shall be joint and several.
This Service Provider Application Agreement,unless and until accepted,approved,and executed by
the City Manageror designee,is only an application for provision of services to City,and does not
constitute an approval or authorization for Service Provider to perform or provide any service to City.
Neither Service Provider nor any of its agents or employees shall be deemed agents or employees of
the City,nor a member of a joint enterprise with the City.Neither Service Provider nor any of its
agents or employees shall at any time or in any manner represent that Service Provider or any of its
agents or employees are agents or employeesof City,or that it is a memberof a joint enterprise with
City.Subject to the requirements of this Service Provider Application Agreement,neither the City
nor any of its employees shall have any control over the manner,mode or means by which Service
Provider,its agents or employees,perform the services set forth herein.
In the event that part of this Agreementis declared invalid or unenforceable by a valid judgment or
decree of a court of competentjurisdiction,such invalidity or unenforceability shall not affect any of
532227.5 CFN AS OF 1-22-2020
the remaining portions of this Agreement which are hereby declared as severable and shall be
interpreted to carry outthe intent of the parties hereunder.
Service Provider acknowledges that the City of Carson’s consideration of Service Provider’s
application to provide the above-referenced services is on the express condition that Service Provider
represents and warrants that it is and will be in compliance with all applicable restrictions on the use
of intellectual property,including copyright laws,in connection with the services proposed to be
provided.Service Provider shall indemnify,defend,and hold harmless the City against any penalties,
claims,or liabilities arising from or in connection with Service Provider’s noncompliance with same.
The undersigned,on behalf of Service Provider,agrees that Service Provider seeks andis willing to
provide the above-referenced service(s)on the date and time of the above-referenced event.
This Service Provider Application Agreement has been executed on the dates written below.
APPLICATION SUBMISSION (wetsignature required;no electronic signatures):
SERVICE PRovIDER:Myah Valeamela
an A 6/v7 [203
(Signature of Service Provider’s Authorizeg&epresentative)(Date)
7
(Printed Name of Service Provider's orized Representative)
(Space below this line for City use only)
APPLICATION APPROVAL:
CITY OF CARS
of 30/97
(Signature of City Manageror Designee)(Date)
532227.5 CFN AS OF 1-22-2020
Service Provider Rules &Regulations
1.SERVICE PROVIDER APPLICATION: Upon acceptance,approval,and execution of a
service provider application by the City of Carson (“City”),these rules and provisions shall
become binding and a part of the Service Provider Application Agreement between the applicant
(being the entity providing a service to City as specified in the service provider application),
including its officers,employees,agents and volunteers (“Provider”),on the one hand,and the
City,on the other hand.Any additions and amendments thereto that may be established or put
into effect by the City,and provided in writing to the Provider,shall also become binding and a
part of the Service Provider Application Agreement.
2.PAYMENT/CANCELLATION:If the Provider is unable to perform or cannot provide the
services as requested, or the City cancels the service for any reason,the associated fees for
service will not be paid.
3.CANCELLATION:Norefunds will be given unless the subject event is cancelled by the
City’s Community Services Department.Applications may be denied or events cancelled in
favor of City programs.
4.PROPERTY LOSS OR DAMAGES:TheCity is not responsible for any damageto,loss or
theft of the Provider’s property,or that of Provider’s agents,employees or invitees.
5.CHARACTER OF ENTERTAINMENT:The Provider shall observe,obey and comply with
all applicable local,state and federal laws,and all applicable policies,rules,regulations and
terms and conditions governing use of City facilities.The Provider will forfeit all rents or other
fees paid if ejected from premises for violations of same.Ejection shall not release Provider
from any obligations for the payment of rents or other fees not yet paid under such permit or
additionally incurred.The policy of the City is to serve the public in the best possible manner.
The Provider shall at all times cooperate to this end.
The policies,rules,regulations and conditions governing use of City facilities are subject to
change without notice to Provider unless the change affects a permit already issued to Provider.
Provider shall be solely responsible for the orderly conduct of all persons using the premises by
its invitation,either expressed or implied,during all times covered by the Service Provider
Application Agreement.The City reserves the right to eject or cause to be ejected from the
premises any person or persons due to unlawful conduct.
6.RESPONSIBILITY:The Provider shall provide all material,equipment,and personnel
necessary for provision of the service described in this agreement.
7.MOVE-IN/MOVE-OUT:Move-in to the event area will be set for each venue.Unless
otherwise stated,Provider will be required to keep its area fully set up and manned until the
eventis officially over.Please note that these times are subject to change.
8.SAFETY:Standing on chairs,tables or other rental equipmentis prohibited.This equipmentis
not engineered to support your weight.The City of Carson,its employees,agents,or officers will
not be responsible for injuries or falls caused by the improper use of furniture.Please assist in
our efforts to provide a SAFE WORKING ENVIRONMENT.
532227.5 CFN AS OF 1-22-2020
9.VOLUME/LIGHT CONTROL:The City reserves the right to regulate the volume or intensity
of any andall noise or light generating mechanisms (including,but not limited to,loudspeakers,
radios,television sets,musical instruments,entertainers,or blinking or flashing lights)in the
reasonable judgmentof the City.
10.FLAMMABLE MATERIALS —All decorations,props and electrical equipment must be
fireproof or of fire retardant materials,must meet City requirements and are subject to removal.
Candles and other open flame devices will not be permitted except as authorized on this
agreement;subject to Fire Department regulations.
11.COPYRIGHT INFORMATION:Provider is responsible for licensing fees as required by
law.Provider may be subject to legal action for the use,display or sale of any item using any
copyrighted and/or trademarked name or logo which has not been specifically authorized under
license from the trademark holder.
12.PERMITS AND LICENSE:Provider shall procure at its own cost and expense all the
required licenses and permits applicable to Provider’s use or activity .
13.OBLIGATION FOR CLEANLINESS:Provider agrees that the facility and any other
surrounding City property (including parking lots)used by the Provider must be left in a clean
and orderly condition (equal to or better than the condition existing prior to the event).If
additional maintenance is required,other than the normal cleaning process,the Provider will be
charged additional fees based on the cost of such maintenance.
14.DISPUTES:All points not covered by the Service Provider Rules &Regulations are subject
to the decision of the appropriate City representative.
15.FLOOR MANAGEMENT:The City will appoint a Floor Manager who is authorized to
enforce these rules and regulations.
16.SPACE ASSIGNMENT:Event space is assigned to providers at the sole discretion of the
City.Concerns regarding competitive or specific types of providers should be communicated to
the City at the time of application.
17.RULE CHANGES:TheCity reserves the right to make reasonable changes to the foregoing
rules,event hours and move-in/move-out arrangements at any time without notice to Provider,
unless the change affects a permit already issued to Provider.
532227.5 CFN AS OF 1-22-2020
10
Waiver,Release,Hold Harmless,Agreement Not to Sue,Indemnification,and Photo Release
I Mavlan<V u|il lo ,(“individual”)[on behalf .of
YNy4 Yn Val wizu C10.(“Service Provider”),and as a bona fide agent of Service Provider
duly authorized to execute this Waiver,Release,Hold Harmless,Agreement Not to Sue and Indemnification
agreement (“Agreement”).on behalf of Service Provider].(individual..and Service Provider hereinafter
collectively referred to as “Signatory,”and the term “Signatory”includes Service Provider’s officers,officials,
empioyees,agents and volunteers),seek acceptance by the City of Carson of an application to provide services
in/at Hispanic Heritage Month Celebration (“Event”)on Saturday,September 18,2021 (“Date”).
Signatory understands that accidents and injuries can arise out of the Event;knowing the risks,nevertheless,
and in consideration of the acceptance of an application to provide a service at the Event on the Date,
Signatory hereby waives,releases and discharges any and all claims for damages for death,personal injury,or
property damage which Signatory may have,or which hereafter accrue to Signatory,against the City of
Carson,its elected and appointed:officers,officials,employees,agents and volunteers (collectively “City”),
and from and against any and all liability arising out of or connected in any way with Signatory’s participation
in or presence at the Event,even though that liability may arise out of negligence or carelessness on the part of
City.It is further understood and agreed that this Agreement is to be binding on Signatory’s heirs and assigns.
Signatory hereby grants City the right to photograph or video-record Signatory during or in connection with
the Event,and to use Signatory’s photographed or video-recorded likeness,and any image,silhouette,or
seproduction of the voice or appearance of Signatory.taken during or in connec ion with the Event
(“Likeness”),for any purpose,including publicity and promotion of City and its events,and creation or
production of materials in any form for such purpose,with no claim of entitiement to any ticense fee or royaity
of any kind from City.Signatory hereby waives any right to the intellectual property of Signatory’s Likeness.
The rights granted by Signatory hereunder shall not expire.
Signatory further agrees to indemnify,defend and hold harmless City from and against any and all claims,
liabilities,losses,damages,expenses,and costs (including without limitation costs and fees of litigation)of
every nature (including,but not limited to,property damage,bodily injury,or death),whether imposed by law
or otherwise,sustained or allegedte be sustained by any person or entity (whether they be members of the
public visiting the Event,employees of the City,other service providers at the Event,or otherwise),occurring
at,arising from,or connected with Signatory’s preparation or performance of services at the Event,Signatory’s
actions,inactions,or use of facilities at the Event,or any equipment,machinery or items displayed or used by
the Signatory at or for the Event,except for such claim,liability,loss,damage,expense,or cost which was
caused by the sole negligence or willful misconduct of the City.
By signing below,I acknowledge ana represent that I have read and waderstand the above,and that I
voluntarily agree to its terms.
Signed —wg 22
NAME:Marlen Tru lo
ORGANIZATION:Myah Valenz
Date:6/3)/2
532227.S CFN aceraas.-22-2020