HomeMy Public PortalAboutC-21-130 - SPA - LORENA DAHILIG - FIL-AM HIST. MO. CELEB.
CITY OF CARSON —INTERNAL CONTRACT ROUTING SLIP
All fields are required to be completely filled out.If not applicable,enter N/A.
FROM:JOSE EMMANUEL TINGSON
DOCUMENT TYPE:SERVICE PROVIDER
EXT.224
N/A APPROVAL DATE:N/A
DEPT:RECREATION ATTORNEY ASSIGNED:N/A
ITEM NO:N/A
VENDOR NAME:LORENA DAHILIG SERVICES/PRODUCT:EMCEE
TERM OF CONTRACT:9/29/2021 tHroucH 10/3/2021 AMOUNT OF CONTRACT:N/A
PAGE COUNT13SINGLE-SIDED DOCUMENT?XIYES
PRE-APPROVAL/PRE-CITY SIGNATURES CHECKLIST
ASSISTING STAFF ACTION REQUIRED COMPLETION (INITIALS)
DIRECTOR Confirm approval to proceed.
CONTRACT OFFICER Confirm funds are budgeted and/or available.GQ [Eery CONTRACT OFFICER Preparation of specifications.
This includes coordinating with Risk Management on the Insurance/Bond requirements.
PURCHASING Advertise bids,compliance with bid requirements;including posting on City’s website.
*RFP/RFQ must include form contract.
PURCHASING OR
CONTRACT OFFICER
Evaluate bids/proposals and determine recommended bidder(s).
CONTRACT OFFICER
&CITY ATTORNEY
Complete contract negotiations/finalize contract (including attachments)with City
Attorney’s Office.
CONTRACT OFFICER Present appropriate contract form to the recommended vendor.
*Verify correct agencytitles/corps.are listed.(ie:City Council-Mayor vs.CRA-Chairman)
CONTRACT OFFICER Verify compliance with business license requirements,obtain 3 original signatures of
vendor,and request W-9 (once received,submit w-9.to purchasing).
*Signatures must be notarized for every original*
CONTRACT OFFICER
&RISK MANAGEMENT
Verify corporate status,state of Incorporation and Principles.
CONTRACT OFFICER Request insurance documents for approval'with Risk Management for all contracts.
Verify approval of insurance requirements:with Risk Management.
*Communication through e-mail is preferred;Please provide the written agreement,certificate of
insurance as well as all endorsement forms.
CONTRACT OFFICER Provide W-9 to Purchasing.on Agenda Thursday if contract is on the upcoming agenda.
*Non-Council items:provide W-9 to Purchasing on date submitted to City Clerk’s Office.
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PURCHASING OR
CONTRACT OFFICER
Present Department's recommendation to legislative body to award/approvecontract,if
applicable.v4
POST-APPROVAL/POST-VENDOR SIGNATURES CHECKLIST
CONTRACT OFFICER Collect-and assemble.insurance(initialed by Risk Management),*Certificate of Insurance with
endorsement mustbe attached to be processed;even on amendments*0 CONTRACT OFFICER Collect and assemble bond requirements and forms.*Public Works contracts MUST attach
verification the bond has been executed by an admitted surety insurer*MWA
CONTRACT OFFICER Transmit 2 complete original sets with this routing slip to the City Clerk’s Office for further
processing.
**Note any special servicesneeded,including all prior Contracts,Amendments or Awards.IA‘AA
CITY CLERK Verify approval/routing slip completion;obtain signatures:City Attorney,City official,and °
City Clerk.
CITY CLERK Provides electronic copy and 1 original of executed contract to Contract Officer,City Clerk’s
Office retains 1 original and enters into Laserfiche Wy
PUBLIC WORKS Tyler Entry and Release for City Clerk approval “fA
CITY CLERK Tyler approval;email staff upon completion A//4
CONTRACT OFFICER
&PURCHASING
Create a requisition in Tyler for Purchasing to issue a Purchase Order.
*Vendor is not to proceed with work until the Purchase Order is approved.
CONTRACT OFFICER Provide Notice to Proceed to vendor. VK
CONTRACT OFFICER Tickler contract expiration and insurance expiration N/A
FINANCE Process contract purchase order and provide copies to department.w/e
)
CONTRACT OFFICER Process progress payments.0
CONTRACT OFFICER Process contract completion forms.
*Notice of Completion to City Clerk’s Office NAA
CHOOSE ONE FOR INTERNAL SIGNATURE PROCESSING:
C]Route for City Attorney>Mayor or Chair WITHOUT NOTARY>Clerk
C]Route for City Attorney>City Manager WITHOUT NOTARY>Clerk
[]Route for City Attorney>Mayor or Chair WITH NOTARY>Clerk
L]Route for City Attorney>City Manager WITH NOTARY>Clerk
[1 Other:
SPECIAL COMMENTS/INSTRUCTIONS/REQUESTS:
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Checklist
Before submitting your application packet make sure eachof the below
indicated items have been attached or completed.
(FOR COMMUNITY SERVICES OFFICE USE ONLY)
Service Provider Application Agreement
Invoice for Future Event Date’
Business License (if applicable)
Proof of Insurance/Certificate of Insurance
Waiver,Release,Hold Harmless,Agreement Not to
Sue,Indemnification,and Photo Release
Current Copy of W-9 Form(if not on file already)
*The date of the Event shall be listed on the Invoice for Future Event Date (IFED).If the Service Provider Application is
approved,then the IFED will be processed as an invoice for services rendered for the Event.No payment will be made
until the conclusion of the Event,at earliest.
532227.5 CFN AS OF 1-22-2020
(Date)
(Company)
(Company Address)
(City,State ZIP)
Insurance Requirements
Dear Lorena Dahilig
(Enter Provider’s Name)
Please be advised pursuant to your desire to work with the City of Carson,youare required to
subinit the following:
Y Compliant Certificates of Liability Insurance (to be maintained for the durationofservices
against claims which may arise fromor in connection with the services),evidencing the
coverage(s)as indicated below.
Certificates of insurance,as well as additional insured and waiver of subrogation
endorsements in favor of the City,must be submitted in their entirety before any services
are provided or the event takes place.Failure to submit such required forms shall be cause
for City of Carsonto reject or terminate any service provider application agreement.
The City of Carsonreserves the right to modify these requirements based onthe nature of the
risk,prior events,insurance coverage,or other special requirements.
MINIMUM SCOPE AND LIMIT OF INSURANCE
General Liability Insurance:Coverage shall be at least as broad as Insurance Services Form
CG 00 01 covering CGL on an “occurrence”basis,including property damage,bodily injury
and personal &advertising injury with limits no less than $1,000,000 per occurrence and
$2,000,000 aggregate.
Additional Insured Status
The City of Carson,and its elected and appointedofficials,employees,volunteers and agents,are
to be covered as additional insureds with respect to liability arising out of their work or
operations performed at or on behalf of the City-sponsored event including materials,parts,or
equipment furnished in connection with the event,
532227.5 CFN AS OF 1-22-2020
ae Type if-or other,specifyhecre)
If Service Provider wishes to request any special accommodation needed to facilitate provision of the
services,please identify it here or contact the staff member referenced on Page |of this application:
$100.00TotalServiceFee
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,including all 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,forall
losses and liabilities paid under the terms of any policy whicharise 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
hereundershall 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 performor 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 memberof a joint enterprise with the City.Neither Service Provider nor any of its
agents or employees shall at any time or in any mannerrepresent that Service Provider or any of its
agents or employees are agents or employees of 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,performthe services set forth herein.
In the event that part of this Agreement is declared invalid or unenforceable by a valid judgment or
decree of a court of competent jurisdiction,such invalidity or unenforceability shall not affect any of
532227.5 CEN AS OF 1-22-2020
the remaining portions of thi
interpreted to carry out.
vider shall in
‘arising Tom
The undersigned,Sn behalf of Seprovidetheaboy:
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 betweenthe 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:No refunds 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:The City is not responsible for any damage to,loss or
theft of the Provider’s property,or that of Provider's agents,employees orinvitees.
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
event is officially over.Please note that these times are subject to change.
8.SAFETY:Standing on chairs,tables or other rental equipment is prohibited.This equipment is
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.
$32227.5 CFN AS OF 1-22-2020
9.VOLUME/LIGHT CONTROL:The City reserves the right to regulate the volume or intensity
of anyand all 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 judgment of the City.
10.FLAMMABLE MATERIALS —~AIl 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 ofthe
City.Concerns regarding competitive or specific types of providers should be communicated to
the City at the time of application.
17.RULE CHANGES:The City 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
INVOICE
‘DETAILS
DATE:October 2,2021
INVOICE NO.001
-LorenaR.Dahiig =”‘City of Carson
Attn:Lorena R.Dahilig Attn:Jonathan Nery
21914 Belshire Ave.,Unit 7 18601 S Main St.
Hawaiian Gardens,CA 90716 Carson,CA 90248
562-524-5034 (310)816 —9381
lam.inadahilig@gmail.com jnery@carsonca.gov
DESCRIPTION
RS |RATE(S/HR)|AMOUNT(s)
Fil-Am History Month Event Co-Hosting $100.00
SUBTOTAL|100.00
NOTES:DISCOUNT.
$100.00
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