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2019/11/26 3HM Entertainment Certificate of Liability Insurance (9)
DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-109205lE32DF DATE (MM/DD/YYYY) , CC)IIRr_�' CERTIFICATE OF LIABILITY INSURANCE 10/24/2019 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 _NAME;PAX Hiscox Inc. PHONE . (888) 202-3007 WC No). No: 520 Madison Avenue A41AAILDDRE: contact@hiscox.com 32nd Floor --- New York, NY 10022 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Hiscox Insurance Company Inc 10200 INSURED 3HM Entertainment 1925 Pinehurst Drive Nashville, TN 37216 INSURER C : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 AD4l SS3aR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD POUCYNUMA.ER MM/DD MWDD/YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE a OCCUR PREMI ES (EaaEoccccurrunca) $ 100,000 MED EXP (Any one person) $ 5,000 X Primary & Noncontributory PERSONAL&ADV INJURY $ 1,000,000 A Y UDC4003855-CGL-19 11/26/2019 11/26/2020 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECTT LOC PRODUCTS - COMP/OP AGG $ S/T Gen. Agg $ FlTFiI A� AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED AUTOS ONLY AUTOSULED UDC-4003855-CGL-19 11/26/2019 11/26/2020 BODILY INJURY (Per accident) $ x HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Par accident $ CGlHNOALkmil 0 $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PERT T OTH- STA ANYPROPRIETOR/PARTNER/EXECU I — E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under 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) City of Menifee and its officers, employees, agents and authorized volunteers are additional insureds. " Lg1-W W—W"lC-P--P— Mu9\L Ar'D (arvr4 POST \,vA-` 2dZc0 - \;Nt9owY1A 5evu_.�l1'c-c16 P__fto 14V-\,^ CERTIFICATE HOLDER CANCELLATION City of Menifee 29714 Haun Rd Menifee, CA 92586 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 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-109205lE32DF ,4+evRa� CERTIFICATE OF LIABILITY INSURANCE FiXTE (MMIDD/YYYY) �11 10/24/2019 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 NAME: Hiscox Inc. tPX.NE Ext): (888) 202-3007 A't FA1C, NO: 520 Madison Avenue E-MAIL contact@hiswx.com ADDRESS: 32nd Floor New York, NY 10022 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Hiscox Insurance Company Inc 10200 INSURED INSURER B : 31HM Entertainment 1925 Pinehurst Drive INSURER C : Nashville, TN 37216 INSURERD: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMBS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE E OCCUR PREMISES iEa occumariceI $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� CJ LOC PRODUCTS - COMPIOP AGG $ $ OTHER' AUTOMOBILE LIABILITY COMBIaINNEeD1SINGLE LIMIT (EaANY $ BODILY INJURY (Per person) $ AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PR❑PERTYDAMAGE Per a6t1 nI $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY f— UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OTH- TATUTE F.R _ $ E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ A Professional Liability Y UDC-4003855-EO-l9 11/26/2019 11/26/2020 Each Claim: $ 1,000,000 Aggregate: $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Menifee and its officers, employees, agents and authorized volunteers are additional insureds. Lq I2c9 Yr\,2X�•l'G'e_'� ��S\C� tie -+IA �S �eST\J�a� 001z.\Y,� i:tK i Wit;A l t MULUtK ZANY jrLLA I IUf4 City of Menifee 29714 Haun Rd Menifee, CA 92586 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-1092051E32DF Aeo HIS0OX Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC-4003855-CG L-19 3HM Entertainment 18 February 19, 2020 Hiscox Insurance Company Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Menifee and its officers, employees, agents and authorized volunteers are additional insureds 29714 Haun Rd Sun City,CA 92586 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-1092051E32DF 'rift, HISCOX Policy Number: Named Insured: Endorsement Number: Endorsement Effective: UDC-4003855-CGL-19 3HM Entertainment 19 February 19, 2020 Hiscox Insurance Company Inc. THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE — PART I Terrorism Premium (Certified Acts) $ 7.00 This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Cover- age Form(s) and/or Policy(ies): Additional information, if any, concerning the terrorism premium: SCHEDULE — PART II Federal share of terrorism losses 85% year 2015; 84% year 2016; 83% year 2017; 82% year 2018; 81 % year 2019 and 80% year 2020. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk In- surance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certi- fied under the Terrorism Risk Insurance Act. The portion of your premium attributable to such cov- erage is shown in the Schedule of this endorse- ment or in the policy Declarations. IL 09 85 01 15 © Insurance Services Office, Inc., 2015 Page 1 of 2 DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-1092051E32DF B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government, Department of the Treasury, will pay a share of terrorism losses in- sured under the federal program. The federal share equals a percentage (as shown in Part II of the Schedule of this endorsement or in the policy Declarations) of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses at- tributable to terrorist acts certified under the Ter- rorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terror- ism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures es- tablished by the Secretary of the Treasury. Page 2 of 2 © Insurance Services Office, Inc., 2015 IL 09 85 01 15 DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-1092051E32DF Maritsa Ramirez From: Margarita Cornejo Sent: Thursday, November 12, 2020 5:20 PM To: Maritsa Ramirez Subject: FW: Agreement Review Request: Professional Services Agreement Amendment No. 2: 3HM Entertainment (Music Act Booking/Management Services & Stage Rental Services) Attachments: 2021 CS- AMEND. NO. 2 PROFESSIONAL SERVICES AGREEMENT (3HM) (MUSIC ACT BOOKING & MANAGEMENT SERVICES).docx; 2021 CS AMEND. NO. 2 PROFESSIONAL SERVICES AGREEMENT (3HM) (STAGE RENTAL SERVICES).docx From: Margarita Cornejo Sent: Monday, November 9, 2020 10:57 AM To: Jeffery T. Melching <jmelching@rutan.com> Subject: Agreement Review Request: Professional Services Agreement Amendment No. 2: 3HM Entertainment (Music Act Booking/Management Services & Stage Rental Services) Good Morning Jeff, Attached for your review are the two (2) proposed Professional Services Agreement Amendment No. 2 with 3HM Entertainment for Music Act Booking & Management Services and Stage Rental Services as they relate to the City's Music & Arts Festival. This agreement request is from the City's Community Services Department. Can you please review and advise if this is ok to start routing for signatures or will require any changes? Thank you again! Margarita Cornejo Financial Services Manager Finance Department City of Menifee 29844 Haun Road Menifee, CA 92586 (*Please note our new location!) Direct: (951) 723-3716 City Hall: (951) 672-6777 Fax: (951) 679-2568 mcorneio@cityofinenifee.us //,,r MENIFEE New. Better; Best. DocuSign Envelope ID: 9F2EBE03-16FC-4ECA-9276-1092051E32DF poaccvnn 11/04/2020 2:19:18PM Vendor #: 01500 PO # 01739 02174 02301 PO Accounting Report by Vendor Name City of Menifee Name: 3HM ENTERTAINMENT Date Ln# Description Account # 11/01/2018 1 FY18/19 MUSIC & ARTS FESTIVAL (MUSIC E 100-4660-51700 07/01/2020 1 FY19/20 MUSIC & ARTS FESTIVAL (BOOKING E 100-4660-51700 07/01/2020 1 PROFESSIONAL SERVICES AGREEMENT FOR E 100-4660-51700 PO Totals Page: 1 Original Amt Amount Owing Status 8,940.00 0.00 full 8,940.00 0.00 8,700.00 4,700.00 partial 24,856.00 12,456.00 partial Vendor Totals 42,496.00 Grand Totals 42,496.00 17,156.00 Page: 1