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2019/11/26 3HM Entertainment
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 E41AAILDDRE : contact@hiscox.com 32nd Floor ---New York,NY 10022 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: 3HM Entertainment 1925 Pinehurst Drive INSURER C: Nashville,TN 37216 INSURER D: 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 SS3UR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD POUCYNUMA.ER MM/DD A4WDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 CLAIMS-MADE aMA OCCUR PREMI ES(EF i occccurrunca $ 100,000 MED EXP(Any one person) $ 5,000 A X Primary&Noncontributory Y UDC4003855-CGL-19 11/26/2019 11/26/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JECTT LOC PRODUCTS-COMP/OP AGG $ S/T Gen.Agg FITFII A� $ AUTOMOBILE LIABILITY CEa secid9nOMBINEDt SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED AUTOS ONLY AUTOSULED UDC-4003855-CGL-19 11/26/2019 11/26/2020 BODILY INJURY(Per accident) $ x HIRED X NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident CGIHNOAL 1 $ 1,000,000 0 UMBRELLA LIAB [I OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ -DE 1 RETENTION$ $ WORKERS COMPENSATION PERT T OTH- AND EMPLOYERS'LIABILITY Y/N STA ANYPROPRIETOR/PARTNER/EXECU I E.L.EACH ACCIDENT $ ❑ OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 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. " Lq!-W W-W";C-P--P— M u 9\L A 1-+D (arv+r4 �s t-�v A-` 2d-La - \;N co V_A'Y11 5 eve i r.-c s 1__fto 14 V-\,^CERTIFICATE HOLDER 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 AC�RE]� CERTIFICATE OF LIABILITY INSURANCE FDATE(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 FAIC,NO: 520 Madison Avenue E-MAIL contact@hiswx.com 32nd Floor ADDRESS: 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 ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE E OCCUR PREMISES iEa occumariceI $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JE� CJ LOC PRODUCTS-COMPIOP AGG $ OTHER' $ AUTOMOBILE LIABILITY COMBIaINNE�D1SIHGLE LIMIT $ (EaANY AUTO BODILY INJURY(Per person) $ OWNED f— SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PR❑PERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per a6t1 nI UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N TATUTE F.R _ ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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. V_-4 Lq I2c9 W�2x+ -x M�s�c_ t�e-�A JCS �resT� \ �oo1��v�9 Senuice5 ii1'�9 W�I�NA 2w 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(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:9F2EBE03-16FC-4ECA-9276-1092051E32DF Aeo HI,SCO> Hiscox Insurance Company Inc. Policy Number: UDC-4003855-CGL-19 Named Insured: 3HM Entertainment Endorsement Number: 18 Endorsement Effective: February 19, 2020 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 f few I"I I SCOX Hiscox Insurance Company Inc. Policy Number: UDC-4003855-CGL-19 Named Insured: 3HM Entertainment Endorsement Number: 19 Endorsement Effective: February 19, 2020 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 C. Cap On Insurer Participation In Payment Of Of Terrorism Losses Terrorism Losses The United States Government, Department of the If aggregate insured losses attributable to terrorist Treasury, will pay a share of terrorism losses in- acts certified under the Terrorism Risk Insurance sured under the federal program. The federal Act exceed $100 billion in a calendar year and we share equals a percentage (as shown in Part II of have met our insurer deductible under the Terror- the Schedule of this endorsement or in the policy ism Risk Insurance Act, we shall not be liable for Declarations) of that portion of the amount of such the payment of any portion of the amount of such insured losses that exceeds the applicable insurer losses that exceeds $100 billion, and in such case retention. However, if aggregate insured losses at- insured losses up to that amount are subject to pro tributable to terrorist acts certified under the Ter- rata allocation in accordance with procedures es- rorism Risk Insurance Act exceed $100 billion in a tablished by the Secretary of the Treasury. calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. 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 Comejo 1 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 `A MENIFEE New. Better. Best. DocuSign Envelope ID:9F2EBE03-16FC-4ECA-9276-1092051E32DF poaccvnn PO Accounting Report by Vendor Name Page: 1 11/04/2020 2:19:18PM City of Menifee Vendor#: 01500 Name : 3HM ENTERTAINMENT PO# Date Ln# Description Account# Original Amt Amount Owing Status 01739 11/01/2018 1 FY18/19 MUSIC&ARTS FESTIVAL(MUSIC E 100-4660-51700 8,940.00 0.00 full PO Totals 8,940.00 0.00 02174 07/01/2020 1 FY19/20 MUSIC&ARTS FESTIVAL(BOOKING E 100-4660-51700 8,700.00 4,700.00 partial 02301 07/01/2020 1 PROFESSIONAL SERVICES AGREEMENT FOR E 100-4660-51700 24,856.00 12,456.00 partial Vendor Totals 42,496.00 17,156.00 Grand Totals 42,496.00 17,156.00 Page: 1