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HomeMy WebLinkAboutSijia Chen dba Sijia Chen Studio; 2023-09-14; PSALCA-23138CAAGREEMENT FOR ARTWORK LOAN AND GUEST ARTIST RESIDENCY SERVICES SIJIA CHEN DBA SIJIA CHEN STUDIO THIS AGREEMENT is made and entered into as of the ___ day of ____________, 2023, by and between the City of Carlsbad, California, a municipal corporation, ("City"), and Sijia Chen, a sole proprietor, ("Contractor”, “Artist”, “Lender”, “Agent”) (collectively, the “Parties.”) RECITALS City requires the professional services of an Artist to loan Artwork for an exhibit and conduct community outreach events. Contractor has the necessary experience in providing these professional services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A”, attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of one (1) year from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be not to exceed seven thousand five hundred dollars ($7,500). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or the Services specified in Exhibit “A.” Incremental payments, if applicable, should be made as outlines in attached Exhibit “A”. 4. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C PSALCA-23138CA 14th September PSALCA-23138CA 2 6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non- admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims- made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Richard Schultz Name Sijia Chen Title Cultural Arts Manager Title Artist/Owner Department Library & Cultural Arts Address 5633 Observation Lane City of Carlsbad Los Angeles, CA 90028-3411 Address 1775 Dove Lane Phone No. 310-993-9538 Carlsbad, CA 92011 Email sijia@sijiachen.com Phone No. 442-339-2086 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 8. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests as required in the City of Carlsbad Conflict of Interest Code. Yes No DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C □ ■ PSALCA-23138CA 3 9. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. 10. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 11. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 12. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 13. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 14. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. \\ \\ \\ \\ \\ \\ \\ \\ \\ \\ DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C PSALCA-23138CA 4 15. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California By: By: SIJIA CHEN, Owner SUZANNE SMITHSON Library & Cultural Arts Director As authorized by the City Manager ATTEST: For SHERRY FREISINGER City Clerk If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: For CINDIE K. McMAHON, City Attorney By: Assistant City Attorney DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14B99D3C For SHERRY FREISINGER PSALCA-23138CA 5 EXHIBIT “A” SCOPE OF SERVICES Artist will loan Artwork to City to exhibit in the exhibition “Dual Visions” at the City’s William D. Cannon Art Gallery, 1775 Dove Lane, Carlsbad from Sept. 30 to Dec. 15, 2023. The loan of the Artwork will be from Sept. 20 to Dec. 22, 2023. Artist will lend six artworks that are a compilation of papercut collage paintings using materials of personal significance. Various items are turned into cutout shapes, woven together, reflecting multifaceted layers of individual and share experiences. In addition, Artist will participate in three (3) community outreach events as agreed upon by Parties which focus on heightening the awareness of the City’s arts and culture programming, providing a greater awareness of local and regional artists, and elevating the visibility of the arts in Carlsbad, which directly correlates to the City’s Arts & Culture Master Plan. 1. CONTACT INFORMATION Artist: Sijia Chen, 310-993-9538, sijia@sijiachen.com City: Cultural Arts Manager, Richard Schultz, 442-339-2086, richard.schultz@carlsbadca.gov Community Arts Coordinator, Tonya Rodzach, 442-339-2087, tonya.rodzach@carlsbadca.gov Gallery staff, Brittney Nemerow, 442-339-2021, brittney.nemerow@carlsbadca.gov Cultural Arts General Phone, 442-339-2090 Email may be the initial preferred method of reaching staff. 2. EXHIBIT LOCATION William D. Cannon Art Gallery, 1775 Dove Lane, Carlsbad, CA 92011 3. ARTWORK LOAN Artwork loan period: Sept. 20 to Dec. 22, 2023 Gallery exhibit period: Sept. 30 to Dec. 15, 2023 Lender agrees to loan the Artwork specified on the checklist attached as Exhibit "B," which details the submitted artwork. Artwork shall be conducive to being on display in a municipal art gallery and designed to fit the designated wall space. Lender shall prepare the Artwork in anticipation of Artwork being on a wall-mounted display and be appropriate for the intended use. The Artwork will remain in the City’s possession during the loan period but may be withdrawn from the exhibition at the City’s sole discretion. City will notify Lender when any Artwork is withdrawn from the exhibit. City and Lender may agree in writing to extend the duration of this Agreement. Acceptance of the Artwork does not imply that the Artwork will be placed or maintained on public display for the Agreement's exhibit duration. DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C • • • • • • PSALCA-23138CA 6 3.1. Transportation and Packaging. Lender certifies that the work to be loaned to the City under the terms and conditions of this Agreement is in good condition. City shall inspect the Artwork and complete and sign the opening condition report for each piece of Artwork, which will constitute the condition of the property at the time of the receipt of the Artwork loan. Any discrepancies, losses, or evidence of damage to the Artwork noted at the time of inspection or at any time while in the City’s custody will be reported immediately to the Lender. City or designated representative will transport and deliver Artwork to the Cannon Art Gallery before the loan start date, as described above. At the end of the exhibition, City or a designated representative will be responsible for delivering Artwork to Artist within three (3) days by the date described above unless other written arrangements are made between City and Lender. All drop- off and pickup deliveries shall be coordinated with the City’s Cultural Arts Manager or Designee. 3.2. Artwork Insurance. Artwork transported by Lender is insured from the time of arrival at the Cannon Art Gallery until the time it is picked up by the Lender. Artwork transported by the City will be returned to the pick- up location and is insured only while in possession of the City. City will insure the Artwork against any loss or damage while it is in the City’s possession for the Fair Market Value as specified by the Lender in this Agreement. For purposes of insurance coverage, the City requires the Lender to value Artwork(s) accurately according to Artworks by the artist of similar size, style, medium, and if possible, based upon previous sales. City may require Lender to provide reasonable evidence of the Artwork's stated market value. In the event of loss or damage to the Artwork, Lender’s failure to provide supporting evidence of the Artwork's stated market value will result in the City’s sole determination of the Artwork's market value. The signing of this Agreement by the CITY does not constitute an endorsement of the Lender’s stated value. In the event of loss of or damage to the Artwork, Lender’s recovery from the City and/or insurer is limited to the maximum coverage amount specified in the Agreement. Lender agrees to hold the City and its officers, agents, employees and volunteers harmless from any and all claims in excess of maximum coverage amount indicated in this Agreement. In the event of partial loss or damage, the City’s liability shall be limited to the cost of repair or restoration or any resulting loss in fair market value. City shall not be liable for any indirect, special, incidental, punitive or consequential damages, even if the City has been advised of the possibility of such damages. 3.3. Installation. City shall install and exhibit the Artwork. City reserves the right to make the final decision on which items will be included in the exhibition, and the arrangement of the exhibit. CITY shall take reasonable steps to preserve the exhibited Artwork against adverse environmental conditions, deterioration, damage or theft. 3.4. Damage. Artwork will be visually inspected upon receipt and any noticeable damage will be documented on the shipping receipt. Evidence of damage to Artwork while in the City’s custody will be reported immediately to the Lender. City may elect to display damaged Artwork if in City’s sole determination the displaying of the damaged Artwork will not exacerbate the preexisting damage. DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C PSALCA-23138CA 7 3.5. Reproduction Rights, Publicity and Photography. Except as limited by this Agreement, Lender retains any or all copyright, licensing and/or ownership rights to the Artwork available to him/her under state and federal law. Lender grants City the right to photograph, telecast, or make similar visual reproductions of the Artwork covered by this Agreement for publicity and advertising purposes and other educational purposes in catalogues or posters that it distributes. City agrees to acknowledge the Artist on all related printed matter, exhibition announcements, publicity releases, invitations, posters, signs or other promotional or educational materials relating to the Artwork. 3.6. Warranty of Title. Lender warrants that Lender is either the owner of the Artwork or the authorized agent of the lawful owner or artist of the Artwork and has the authority to enter into this Agreement and to grant the rights to City as set forth in this Agreement. Lender also warrants that the Artwork(s) is not now or will be subjected to claims of ownership, lien, encumbrance, copyright infringement, or trademark infringement under any state or federal law. Lender shall indemnify the City, its officers and employees for all damages related to a claim asserting a violation or claim of violation of this Warranty of Title, including reasonable attorney fees and costs. 3.7. Withdrawals. Artwork cannot be withdrawn from an exhibition by the Lender at any time during its exhibition. 4. GUEST ARTIST COMMUNITY OUTREACH Artist “Community Outreach Events” will provide on-site visitors with a more casual and social interaction with the Artist, staff and provide visitors with a hands-on activity provided in support by City staff. Artist will participate in three (3) community outreach events over two (2) to three (3) separate days totaling at least fifteen (15) hours of interaction with Artist and staff. These outreach events consist of one (1) on-site workshop with Artist in attendance at the Dove Library complex, and two (2) Meet the Artist in-school community site visits. All guest artist community outreach events and times will be pre-arranged and coordinated in writing a minimum of thirty (30) prior to the event date by Parties. City will provide direction and assistance for best practices for all on and off-site activities. In preparation for the outreach programs, Contractor will discuss content and materials with Cultural Arts Manager or his Designee prior to the events. Artist will be demonstrating and then guiding participants on a hands-on art project at each two (2) to three (3) hour event. Proposed events will occur between October 2 to December 16, 2023. Event details to be determined in coordination with community partners, Artist and City. All community outreach event materials will be provided by the City. DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C PSALCA-23138CA 8 4.1. Community Outreach Event Materials. City will provide materials and supplies needed for community outreach events. Artist will be responsible for all materials for demonstration purposes of the community outreach events. Materials include but are not limited to specific materials for the onsite community outreach events. City will provide a staff person to support Artist during these community outreach events over two (3) separate events. Contractor will meet with City or designee at least four (4) hours for the discussion planning period, as needed. City will coordinate community outreach events set up with Contractor. Any changes in dates can be authorized by and with notification to the City’s Cultural Arts Manager or Designee in writing via email at least 30-days in advance to the predetermined date listed above. 5. CONTRACTOR: 5.1. Programming. Contractor will be available to participate in in-person programming such as tours and discussion of Artwork, audio, and/or on-camera interviews and any media opportunity. All programming will be coordinated in advance with the City's Cultural Arts Manager or designee and shall constitute “work made for hire” under the United States Copyright Act of 1976 [17 U.S.C. §§ 101, et seq.] and any other applicable law. City reserves the right to audio and/or video record and to reproduce and distribute any lecture, reading or speaking engagement, and musical concert or musical performance performed under this Agreement as virtual programming. City may retain the recording in its files, may replay the recordings for its employees and the public, including the right to post, replay, or broadcast the recordings on the City’s YouTube channel, the City’s cable channel, the City’s Library Facebook Live account, and other similar City internet-based platforms, and may make the recording available for non-circulation use at its library facilities. City shall not sell the recording. City shall provide a copy of the recording to the Contractor, upon the Contractor’s request. 5.2. Press Kit. Upon execution of Agreement, Contractor agrees to provide a high-resolution image of self (headshot preferred) and written biography (up to 300 words) as well as four (4) to five (5) high- resolution images of Artwork being shown in the City. Images shall be delivered to the City's Cultural Arts Manager or Designee in electronic form immediately upon the Agreement's execution. 6. HEALTH & SAFETY During a county or state mandated health-related emergency, all activities occurring at City facilities, all Parties must adhere to the guidance from the state, county, and local authorities on health and safety protocols. City staff will inform Artist what the current guidelines are prior to their DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C PSALCA-23138CA 9 arrival and entering any City facility. Safety protocols may include, but are not limited to, hand washing, temperature testing, requiring face covering, maintaining physical distancing of six feet. The safety protocols may be modified at any time due to changing rules, regulations, or circumstances. 7. PROJECT PAYMENT SCHEDULE Total cost of project amount shall not exceed seven thousand five hundred dollars ($7,500), based on billable activities. Payment Schedule Activity Initial Payment A payment of $3,750 due upon the execution of the Agreement. Final Payment A payment of NTE $3,750 due upon the completion of the third or final Guest Artist Community Outreach events. All fees will be paid as specified above. All invoices shall be submitted to City’s Cultural Arts Manager Richard Schultz or his Designee and shall be sufficiently detailed to include related activities and costs. Final invoice approval will be completed by City’s Library & Cultural Arts Director or Designee. If, at the expiration or termination of the agreement, if Contractor has not completed any portion of the tasks, Contractor shall refund the remaining portion of the deposit. DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C City of Carlsbad, Cannon Art Gallery Loan Details, 2023 William D. Cannon Art Gallery Loan Detail Artist Name Sijia Chen Address 5633 Observation Lane, Los Angeles, CA 90028 Phone number 310-993-9538 Email sijia@sijiachen.com Title of Artwork Where Waters Converge Media Personal documents, immigration forms, photographs, magazines, restaurant menus, tissue paper on canvas Description Triptych Year Made 2023 Credit Line, lent by Insurance Value 80,000 Size, Dimensions Overall Weight Each piece 35 lbs, total 105 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C EXHIBIT 11 811 22' width, 6'7" height D Rings on each frame's vertical bars ( City of Carlsbad City of Carlsbad, Cannon Art Gallery Loan Details, 2023 Title of Artwork Dream Basin Media Personal documents, immigration forms, photographs, magazines, restaurant menus, tissue paper on canvas Description Year Made 2023 Credit Line, lent by Insurance Value 20,000 Size, Dimensions height Overall Weight 25 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C S'S" width, S'S" D Rings on frame's vertical bars City of Carlsbad, Cannon Art Gallery Loan Details, 2023 Title of Artwork Landing Media Personal documents, immigration forms, photographs, magazines, restaurant menus, tissue paper on canvas Description Year Made 2023 Credit Line, lent by Insurance Value 20,000 Size, Dimensions Overall Weight 25 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C Dragon's S'S" width, S'S" width D Rings on frame's vertical bars City of Carlsbad, Cannon Art Gallery Loan Details, 2023 Title of Artwork Ridgeline Media Immigration forms, photographs, magazines, restaurant menus, tissue paper, acrylic on canvas Description Year Made 2021 Credit Line, lent by Insurance Value 15,000 Size, Dimensions Overall Weight 25 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C 5' width, 6' height D Rings on frame's vertical bars City of Carlsbad, Cannon Art Gallery Loan Details, 2023 Title of Artwork Climbing the Mountains and Crossing the Rivers Media Immigration forms, photographs, magazines, restaurant menus, acrylic on canvas Description Diptych Year Made 2019 Credit Line, lent by Insurance Value 15,000 Size, Dimensions Overall Weight 25 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C 6'8" width, 3' 4" height D Rings on each frame's vertical bars City of Carlsbad, Cannon Art Gallery Loan Details, 2023 Title of Artwork On The Other Side Media Immigration forms, photographs, magazines, restaurant menus, acrylic on canvas Description Year Made 2020 Credit Line, lent by Insurance Value 80,000 Size, Dimensions Overall Weight 25 lbs Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) Handle using outer frame Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) vertical bars Insert photo submission DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C 6' width, 5' height D Rings on frame's DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14B99D3C ~ ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY) ~ 08/09/2023 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 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 Bunker Support NAME: Bunker Protect, Inc. wgN:o Extl: 877-968-9108 I FAX IA/C Nol: 2701 International Ln ~flJ~ss: support@buildbunker.com Suite 200 INSURERISl AFFORDING COVERAGE NAIC# Madison WI 53704 INSURERA: OHIO SECURITY INS co 24082 INSURED INSURERB: sijia chen INSURERC: 5633 Observation Lane INSURERD: INSURERE : Los Angeles CA 90028 INSURERF : COVERAGES CERTIFICATE NUMBER: BKR04940 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 LTR TYPE OF INSURANCE ,.,c:D wvn POLICY NUMBER IMMIDDIYYYYI IMMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1 ,000,000 ~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES /Ea occurrence I $ $500,000 u CLAIMS-MADE KJ OCCUR MED EXP (Any one person) $ $15,000 ~ $1,000,000 A BKS (24) 59 88 02 05 05/17/2023 05/17/2024 PERSONAL & ADV INJURY $ ~ GENERAL AGGREGATE $ $2 ,000,000 ~ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ $2 ,000,000 5l7 POLICY n P,fP,: n LOC $ AUTOMOBILE LIABILITY fE~~~~~~tflNGLE LIMIT ~ $ $1 ,000,000 ANY AUTO BODILY INJURY (Per person) $ ~ ALL OWNED ~ SCHEDULED BKS (24) 59 88 02 05 05/17/2024 A AUTOS AUTOS 05/17/2023 BODILY INJURY (Per accident) $ '&= .&= NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS /Per accident) $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ ~ EXCESSLIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION $ $ WORKERS COMPENSATION I WC $TATU-I IOTH- AND EMPLOYERS' LIABILITY TORY• IMITS ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE □ N/A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ I I DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Addlllonal Remarks Schedule, If more space Is required) The City of Carlsbad, its officials, employees, and volunteers must be named as an additional insured with respect to liability arising out of activities performed by or on behalf of the Named Insured (General Liability only). The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Coverage under this policy shall be primary insurance as respects the City, its officials, employees, and volunteers. All rights of subrogation are waived as respects all additional insureds hereunder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Carlsbad 1635 Faraday Avenue, Carlsbad, CA 92008. AUTHORIZED REPRESENTATIVE: -·s---,i.;,,i,.i,;;,,;.j,;,;,~--: 1 08/09/23 19:30 UTC , cft--1 ~,, ~ _ ~ _ ~l~A_l'!_C~-_2'!_090_0~f-__ : I l ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: C634BDD9-ADB1-4662-A446-771 E14899D3C CERTIFICATE OF EXEMPTION WORKERS' COMPENSATION/EMPLOYERS' LIABILITY INSURANCE Sijia Chen sole proprietor I,---------------~ am the _______________ _ [insert name] Sijia Chen Studio of ____________ _ [ name of company] [title] Sijia Chen Studio Thereby certify that _________ _ [name of company] has no employees and is not required by law to maintain workers' compensation or employers ' Should Sijia Chen Studio liability insurance. _________________ employ any person [name of company] . . . the loan of artwork for the exhibition dunng the term of the Agreement with the City of Carlsbad for ___________ _ at the William D. Cannon Art Gallery from Sept. 20 to Dec. 22, 2023 and re lated guest residency events [ description of project or work that is being contracted] then workers' compensation and employers' liability insurance will be obtained. Sijia Chen Sole Proprietor of Sijia Chen Studio [Title and name of company or corporation]