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HomeMy Public PortalAboutC-23-080 - PEDRO PEREA - CINCO DE MAYO AUDIO SPA2 City of Carson Community Services Department Service Provider Agreement Check one (staff use): — Carson Event Center_ Human Services X Recreation —Transportation Event: Cinco de Mayo Carson Park 5/6/23 Event Location: Event Date: Name of Service Provider Pedro Sergio Perea Business Entity Type: N 11 Type of Service: Entertainment/Audio Contact Person: Pedro Sergio Perea Emer. Contact: Billing Address: 1543 N. Yucca Avenue Jurisdiction: P /A Phone #: (626 ) 378-5538 Phone #: ( ) Number Street Rialto CA 92376 Uty State ZIP Tax I.D. / SSN #: 603-32-5746 Proof of Insurance (check box) FlYes [Z/No If no, would you like to purchase one day insurance through the City (check box)?1-1 Yes ®No Special Instructions / Notes: Audio for event will be provided from 11:00am - 4:OOpm. Total Service Fee $600.00 NOTE: If provider is unable to perform or cannot 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. The undersigned, on behalf of the above -referenced Service Provider, agrees that Service Provider seeks and is willing to provide the above -referenced service(s) for the City of Carson on the date and time of the above -referenced event. 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 fi•om or in connection with Service Provider's noncompliance with same. 5 Further Terms of Agreement between Service Provider and City of Carson: The undersigned signatory of Service Provider (being the above -referenced person or entity seeking to provide services at the above -referenced event, including all its officer, 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, 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 and liabilities 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 Agreement as the Service Provider, then all obligations, liabilities, covenants and conditions under this Agreement shall be joint and several. This Service Provider Agreement 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. 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 the remaining portions of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder. [signatures on the following page] Service Provider and City have executed this Agreement on the dates written below. SERVICE PRO inment Signature of Service Prdvider's Authorized Representative Pedro s perea Prinled Name of der's Authorized Representative CITY OF CARSON OA Rvyrparr- 22P `1 ignature of City Manager or Desibmee Suti ice I'r vid�:r :\:;ri cutrnt - AS OI 4- 1 :;_ [ �� 04/06/2023 Date 9JO 12.10 Date 7 Service Provider Rules & Regulations 1. SERVICE PROVIDER APPLICATION: Upon acceptance 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 Agreement between the applicant (being the entity providing a specified service to City), including its officers employees and agents ("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 Agreement. 2. PAYMENT/CANCELLATION: If the Provider is unable to perfonn 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 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 teens 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, riles, 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 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 frilly set up and manned until the event is officially over. Please note that these times are subject to change. S. 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. 9. VOLUME/LIGHT CONTROL: The City reserves the right to regulate the volume or intensity of any and 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 — 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: 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. ti rvvir i'rc:ci<krr ,lcrccnticnt - AS 01 4-1 9 Waiver, Release, Hold Harmless, Agreement Not to Sue, Indemnification, and Photo Release I,Pedro Sergio Perea ("individual") [on behalf of Audio Entertainment ("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, employees, agents and volunteers), seek acceptance by the City of Carson of an application to provide services in/at Cinco de Mayo at Carson Park ("Event") on May 6, 2023 ("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 reproduction of the voice or appearance of Signatory taken during or in connection 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 entitlement to any license fee or royalty 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 alleged to 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 belo, acknowl ge and represent that I have read and understand the above, and that 1 voluntarily a ee to its terms. Signed: NAME: Pedro S rgio Perea ORGANIZATION: Audio Entertainment Date: giq,z 3 S; IA ice P10Vid 1 Vut'CC? ImIt - ati t tp 4-1,. 9 Please note: The City of Carson's own insurance will cover the City's liability but will not cover an Entertainer's liability. All service providers (including entertainers) are still required to carry insurance. We must require this because it is a condition of the City's Excess insurance policy. Acknowledgement: 1. I am an entertainer that will perform at the City of Carson (Cisco de Mayo Celebration) event. 2. 1 am confirming that I and my business do not have commercial general liability insurance as required by the City of Carson but am still interested to provide services at the (Cisco de Mayo Celebration) event. 3. 1 acknowledge and agree that in the event of a loss the City of Carson or its insurance carrier will not provide coverage to me or to my business. 4. 1 further acknowledge and agree that in the event of a loss resulting from my or my business wrongful or negligent acts, the City of Carson or its insurer will seek to recover its financial loss from me or my business. I will cooperate in every way with the said recovery efforts. 5. The City of Carson may approve this request or may r ' t its discretion Print: Pedro s perea Signe 04/06/2023 Date: Form W-9 Request for Taxpayer Give Form to the (Rev. December 2014) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Pedro ser io pere N 2 Business name/disregarded entity name, if different from above ° m m °- 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to ° Individual/sole proprietor or © p p ' ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ TrusUestate certain entities, not individuals; see rn O single -member LLC instructions on page 3): C u E]y,, Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) 10. Exempt payee code (if any) `p L Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification the Exemption from FATCA reporting c c of single -member owner. code (if any) a — v ❑ Other (see instructions) ► (Applies to accounts maintained outside the U.S.) v 5 Address (number, street, and apt. or suite no.) Requester's name and address (optional) Q. 1543 N Yucca Av 6 City, state, and ZIP code u) Rialto. Ca. 92376 7 List account number(s) here (optional) Identification Number [7 Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other 6 0 3 -M32 - 5 7 4 6 entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for I Employer identification number guidelines on whose number to enter. F—T --j 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 divi you are not required to sign the certification, but you must provide your correct TIN. See the instructions on oaoe 3. Sign Signature of Here U.S. person ► pate ► 04/20/2022 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.irs.gov/fw9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information, Cat. No. 10231X Form W-9 (Rev. 12-2014) Name: Pedro Sergio Peea Address: 1543Yucca Ave Rialto, Ca9237h mum --------- City ofCarson w20/202y Invoice #562023 Payment due: May 6, 2023