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HomeMy WebLinkAboutCity of Diamond Bar Bid 2023-24Company Name Ultimate Entertainment •LLC , Address 12104 Park Street, Cerritos CA 90703 Name & Title Steven P. Nero CEO Phone 714.231.2779 Email stevennero7@gmail.com / ideal@megaoutdoorentertainment.com Please bid on example. • 13 hours of service •,Event Time: 9 a.m. - 12 p.m. • Ltocation: Pantera Park - 738 Pantera Drive, Diamond Bar, CA 91765 .. Halloween Party Ebtertainment ' Item Description QTY Cost/Item Total Cost make announcements, MC/ Disc Jockey lead games for dogs, 1 $800.00 800.00 play family friendly background music Delivery 150.00 Tax Total 9 * your com6gny does not offer any oT these products please put a $0 in jhe total aost. r Please bid on example. •4 hours of service 9am-1 pm • Event rime: 8 a.m. - 2 p.m. • Location: Pantera Park - 738 Pantera Drive, Diamond Bar, CA 91765 minter 5riovKFest. Ef itertaintnent , Item Description QTY Cost/item Total Cost Santa Santa Claus 1 $600.00 60000 Walking Christmas Tree 1 600.00 600.00 Stilt -walking Elf Elf to Asst. 1 $600.00 600.00 Delivery 150.00 Tax Total 195000 *If your company do6� not Qffer any ¢f these products please, puf a $0 in th6 total cost. Please bid on example. •8 hours of service 9am-5pm • Event Time: 9 a.m. - 5 p.m. • Location: Summitridge Park -1600 Grand Ave, Diamond Bar, CA 91765 Cify;BictWay, Attrdc ont8 Sritertctinii ent Item Description QTY Cost/Item Total Cost Ferris Wheel Carnival Ride 1 6,000.00 6,000.00 Climbing Wall Icarnival Ride 1 950.00 950.00 Giant Slide Carnival Ride 1 JE75.00 1,675.0 Large Pirate Ship Carnival Ride 1 10,000 10,000.0 Kid Power Carnival Ride 1 5,000.00 Carousel Carnival Ride 1 6,000.00 Paratrooper ICarnival Ride 1 8,000.00 8,000.0 Scat ICarnival Ride 1 8,000.00 8,000.0 Traffic Circle Carnival Ride 1 6,000.00 6,000.0 Large Swing Chair Carnival Ride 1 6,000.00 6,000.0 Zipper Carnival Ride 1 10,000.00 10,000.00 Winer Carnival Ride 1 800.00 Scrambler ICamival Ride 1 8,000.00 8,000.0 Joust Inflatable lInflotable Attraction 1 1200.00 1,200.0 Raceway Inflatable Track linflatable Attraction 1 1,200.00 1,200.00 3-in-1 Inflatable inflatable Attraction 1 500.00 500.00 Bounce Houses inflatable Attraction 2 400.00 800.00 Ocstacle Course linflatable Attraction 1 750.00 750.00 Inflatable Slides linflotable Attraction 1 675.00 675.00 Axe Throw (Inflatable AttractiQn 1 300.00 300.00 Wacky Ball linflatable Attraction-- 1 950.00 950.00 Face Painter 1350.00 350.00 Balloon Artist ( l 350.00 350.00 Magician 1 Photo Booth 1 300.00 300.00 Stilt Walker 2 hour $580.00 1 580.00 580.00 Wacky Hair Stylist 1 400.00 400.00 Game Booths w/staffing 25 300.00 7,500.00 Power for all attractions, rides, and game booths 7,000.00 7,000.00 Custodial Staff 12 7,200.00 Delivery Tax 0.00 Total i 102,780.00 4If ouC Orman does'npt offer a a hese �ct�eal e a 0 In the Y Y 'pY.S�f� p � � $ total cost. Please bid on example. * 2 hours of service * Svent Time: 6:00 p.m. - 8 p.m. • Location: Summitridge Park - 1600 Grand Ave, Diamond Bar, CA 91765 ':Concbrts in„the ,dark Ented ininent- ' Item Description QTY Cost/item Total Cost Face Painter 2 350.00 350.00 Balloon Twister 1 350.00 350.00 Wacky Hair Stylist 2 350.00 350.00 Juggler 1 350.00 350.00 Statue of Liberty Stilt Walker 1 600.UO 600.00 Delivery 150.00 Tax Total 1.950.00 *if y`)ur c+3ri! a0y does not offer any of these prdoricts please put a in the total cast: Please bid on example. *3 hours of service * Location: Heritage Park - 2900 S. Bea Canyon, Diamond Bar, CA 91765 'k i Rummer Day Camp Enfertoinment Item Description QTY Cost/item Total Cost Face Painter 1 350.00 350.00 Wacky Hair Stylist 1 350.00 350.00 Delivery 150.00 Tax Total 850.00 *If your corripany-does'r ff&,any cif these pp' od0�ts,bleasQ pyt 6 $0 in the total cost. Questions 11. Do you have an emergency call number? Yes 714.231.2779 12. Do you provide discount pricing for government agencies? Yes ,ate AKNbWl EDGEMENT OF REVIEW "I affirm that I have reviewed the Request for Proposal (RFP). I have completed the Cost Proposal - Bid Sheet to the best of my knowledge. I understand that all information submitted about this RFP may be subject to the provisions of the Public Records Act. The City shall have the right to terminate at any time any contract awarded to an RFP response that contains false information." Signature g1--- Date 06/12/2023 Printed Name Steven P. Nero Title CEO Company Name Ultimate Entertainment LLC rjJorAtiO�.NDcaBr' AR )INIA REQUEST FOR PROPOSAL The City of Diamond Bar is currently accepting proposals for entertainment services for special events during the 23/24 fiscal year. Introduction The City of Diamond Bar has several special event's that require entertainment services during the 23/24 fiscal year. Events Include: Halloween Party, Winter Snow Fest, City Birthday, and Concerts in the Park. Please bid on the information listed below. Scope of Services All proposal must be itemized per event and include tax, delivery and any other additional charges. Please submit your quote based on the information provided. Once the vendor has been selected, actual event information and locations will be provided. Please quote on the following: Halloween Party • MC/ Disc Jockey - make announcements, lead games for dogs, play family friendly background music • 3 hours of service • Event Time: 9am-12pm • Location: Pantera Park - 738 Pantera Drive, Diamond Bar, CA 91765 Winter Snow Fest • (1) Santa • (1) Walking Christmas Tree • (1) Stilt -walking Elf • 4 hours of service from gam-Ipm • Event Time: 8am-2pm • Location: Pantera Park - 738 Pantera Drive, Diamond Bar, CA 91765 City Birthday (1) Ferris Wheel • (1) Climbing Wall • (1) Giant Slide • (1) Large Pirate Ship • (1) Kid Power • (1) Carousel • (1) Paratrooper (1) Scat • (1) Traffic Circle • (1) Large Swing Chair • (1) Zipper • (1) Wizzer (1) Scrambler (1) Joust inflatable • 0) Raceway Inflatable Track • (1) 3-in-1 inflatable • (2) Bounce houses • (1) Obstacle Course • (1) Inflatable slides • (1) Axe Throw • (1) Wacky Ball • (1) Face Painter • (1) Balloon Artist (1) Magician • (1) Photo Booth (1) Stilt Walker • (1) Wacky Hair Stylist • (25) Game booths w/staffing • Power for all attractions, rides, and game booths. • (12) Custodial staff • 8 hours of service from 9am-5pm • Event Time: 9am-5pm • Location: Summitridge Park -1600 Grand Ave, Diamond Bar, CA 91765 Concerts in the Park • (2) Face Painter • (1) Balloon Twister • (2) Wacky Hair Stylist • (1) Juggler • (1) Statue of Liberty Stilt Walker • 2 hours of service • Event Time: 6:00 - 8 p.m. • Location: Summitridge Park- 1600 Grand Ave, Diamond Bar, CA 91765 Summer Day Camp • (1) Face Painter • (1) Wacky Hair Stylist • 3 hours of service • Location: Heritage Park - 2900 S. Bea Canyon, Diamond Bar, CA 91765 Vendor Reauirements l . Fill out and submit the Cost Proposal - Bid Sheet on PlanetBids. 2. Vendor will be required to sign a Vendor Service Agreement and meet all requirements outlined in the agreement including insurance and provide documents prior to beginning work. 3. Please provide three references from either another municipality or closely related customer to help with the selection. 4. Delivery/ pick up/ service of all items. 5. Must be able to accept payment in check form and provide itemized invoices. 6. Must be able to submit W-9 Form. ,Insurance Coverage: Vendor must provide Certificate of Liability Insurance $1,000,000.00 per occurrence and Additional Endorsement as required by City policy. (See draft Vendor Services Agreement sample for specific additional requirements coverage) Selection Criteria, In reviewing and evaluating the response to this RFP, City staff will be considering the following: • Responsiveness and comprehensiveness of the proposal with respect to this Request for Proposal (RFP). • Availability of the company and their ability to meet the proposal scope of work. • References • Cost of quoted items. Please provide three references from either another municipality or closely related customer to help with the selection. The City reserves the right to reject any or all proposals and may elect to make a decision without further discussion or negotiation. This solicitation for proposals is not to be construed as a contract or order of any kind. The City is not liable for any costs or expenses incurred in the preparation of the proposal. Additional Information Questions (please respond to in Cost Proposal - Bid Sheet) 1. Do you have an emergency call number? 2. Do you provide discount pricing for government agencies? If you have any questions, please contact A+ndee Williams at 909.839.7067, To be considered, proposals must be submitted to the City of Diamond Bar by Wednesday, June 14, 2023 @ 5PM SERVICE AGREEMENT THIS AGREEMENT (the "Agreement") is,, made as of August 18, 2021 by and between the City of Diamond Bar, a municipal corporation ("City") and COMPANY NAME, a California limited liability company ("Vendor "). 1. Vendor's Services. Subject to the terms and conditions set forth inh'Agreement Vendor shall provide to the reasonable satisfaction of the Citythe Verb ` ery s �drs �y.��s et forth In the attached Exhibit "A", which is incorporated herein by this e;er�ce. As a material inducement to the City to enter into this Agree , Vendor r tti�t` sents an warrants that it has thoroughly investigated the work and understand a di c 'Ities and restrictions in performing the work. Vendo en at it is fully Rle tc perform such consulting services by virtue of i r e a e training;' education and expertise of its principals and employee Andee Williams, Recreatio ervis "[[ee�� referreds the "City's Project Manager"), shall be the person to he d'r will report for the performance of services hereunder. It is understoo dorI coordinate its services hereunder with the City's Project a er to th xttr equf ' ,by the City's Project Manager, and that all Vendor s re d her dqr Ven 6r shall be performed to the satisfaction of the City's P Eer d the- .Y Manager. 2. shall N,Ttle City shall years s , o written notice'o'� t e of the initial Term. 0 $ement shall take effect July 1, 2021, and unless earlier terminated pursuant to the ..0 e option to extend this Agreement for up to three additional terms and conditions contained herein, by giving Vendor ,„of this option at least thirty (30) days prior to the expiration Basic free Amount. Except as provided in Section &A, the CITY agrees to compensate the Vendor, and the Vendor agrees to accept in full satisfaction for the service provided for in Section 1, Payment will be made only after the conclusion of services and submission of proper invoices in the form specified by City. Total payment to Vendor pursuant to this Agreement shall not exceed $$$$$ per fiscal year. 1 Professional Services - Snow Services 1571951.1 A. Deductions. Should the Vendor fail to adhere to the time schedule set forth in Exhibit A, the City may in the CITY's sole discretion either: (1) immediately terminate this Agreement; or (2) deduct $100 from the fixed fee prescribed in Section 4.1 for every fifteen (15) minutes that the Vendor is late. B. Payment shall constitute payment in full for all services, authorized costs and authorized extra work covered by that invoice. 4. Change Orders. No payment for extra servi aused by a change in the scope or complexity of work, or for any other reason, rbe made unless and until such extra services and a price therefore have been prev autho ' ed in writing and approved by the City Manager or his designee as an ammo4. etthis Agreement. The amendment shall set forth the changes of ork, exten�,af time, if any, and adjustment of the fee to be paid by City to Vendo . 5. Status as Independent Ve�ndc�r.� A. Vendor is, and shall Vendor. Vendor shall have no po� of City or otherwise act on behalf herein. Neither City nor any of its or any of Vendor's em , ex( at any time, or in any m �Rl any manner employees of ' �iq as to N— wholly independent bt, obligatidlor liability on behalf nt, except as specifically provided %n,rol over the conduct of Vendor inAgreement. Vendor shall not, Iny of its agents or employees are in B. VeagQees to II re`c;0 taxes on amounts paid to Vendor under this Agreement, 'Ph,emni d hold City harmless from any and all taxes, assessj�e s, pen es, rite asserted against City by reason of the indepgtrnde Vendor �tic�{is = ate by this Agreement. V Nfa�� 1 fully comply with Workers' Compensation laws regarding Vendor = V oyees. Vendor further agrees to indemnify and hold City harmless from anendor to comply with applicable Worker's Compensation laws. D. Venderlhall, at Vendor's sole cost and expense fully secure and comply with all federal, state and local governmental permit or licensing requirements, including but not limited to the City of Diamond Bar. E. In addition to any other remedies it may have, City shall have the right to offset against the amount of any fees due to Vendor under this Agreement any amount due to City from Vendor as a result of Vendor 's failure to promptly pay to City any reimbursement or indemnification required by this Agreement or for any amount or penalty levied against the City for Vendor 's failure to comply with this Section. 2 Professional Services - Snow Services 1571931.1 6. Standard of Performance. Vendor shall perform all work at the standard of care and skill ordinarily exercised by members of the profession under similar conditions and represents that it and any subVendor s it may engage, possess any and all licenses which are required to perform the work contemplated by this Agreement and shall maintain all appropriate licenses during the performance of the work. 7. Indemnification. Vendor shall indemnify, defend with counsel app d by City, and hold harmless City, its officers, officials, employees and volunt('Indemnitees") from and against all liability, loss, damage, expense, cost (includi lthout limitation reasonable attorneys' fees, expert fees and all other costs and fees _'tigaliorV of every nature arising out of or in connection With: aN_ _ . (1) Any and all claims under WOW Compen "fin AS nd other employee benefit acts with respect jeVeR.4or d ployer: �..Or 's Vendor 's employees arising out of Vendcirc1er careement:eld (2) Any and all cl 'f hereunder or its failure to Agreement, regardless of C damage which is caused by City. Should City ' s sole d then Vendor sh rsE limitation reasonab " litigation. a Vendo I p Indemnit s expre i are intend s broa of Californi nd rvivi initees, s A anut Vendolrp�efformance of work y with , fits obligati ns contained in this ssive ligence, but excepting such loss or iye n i nce or willful misconduct of the do d Ve is legal counsel unacceptable, Ci cos of defense, including without exp ees and all other costs and fees of y any final judgment rendered against the and agreed that the foregoing provisions inclu ve as is permitted by the law of the State ination of this Agreement. Except for the not be construed to extend to any third party t}�r'sobligations to indemnify, defend and hold harmless the �-���-Tfl�ve o ation of this Agreement. 8. In A. Vendor shall at all times during the term of this Agreement carry, maintain, and keep in full force and effect, with an insurance company authorized to do business in the State of California and approved by the City the following insurance: (1) a policy or policies of broad -form comprehensive general liability insurance written on an occurrence basis with minimum limits of $1,000,000.00 combined single limit coverage against any injury, death, loss or damage as a result of wrongful or negligent acts by Vendor, its officers, employees, agents, and independent Vendor s in performance of services under this Agreement; 3 Professional Services - Snow Services 1571951.1 (2) property damage insurance with a minimum limit of $500,000.00 per occurrence; (3) automotive liability insurance written on an occurrence basis covering all owned, non -owned and hired automobiles, with minimum combined single limits coverage of $1,000,000.00; and (4) Worker's Compensation insurance when required by law, with a minimum limit of $500,000.00 or the amount requ)*r6 by law, whichever is greater. B. The City, its officers, employees, agents, an L lunt shall be named as additional insureds on the policies as to com rehensive e liability, property damage, and automotive liability. The policies to compre 've gener,I liability, property damage, and automobile liability shall pr �, that they a rim and that any insurance maintained by the City shall be�ec�ssigss lance only .01 C. All insurance policies sh be non -renewed, canceled, reduce; of additional insureds to the policy giving City at least ten (10) days pM not cancel, reduce or otherwise mo�' of the same by the insurgMcLimmedia t D. All policies o`>; the terms of thi greeme authorized to d .b eess the City; and sha e, (pbe,,d Vendo all with Ab minimum its or a requ in h \n% Itthe 7 anc cpverage shall not q ified ( torough the addition trier withduthe insurance carrier i thereof. Vendor agrees that it will I suraNbk.,coverage and in the event of any 10 the Il cove he obligations of Vendor pursuant to r r sued jay an insurance company which is 'fomia or which is approved in writing by it lkV Best's rating of no less than A-, VII, -ft City (1) insurance certificates indicating compliance r' ce uirernents above, and (2) insurance policy of the insurance policy evidencing the additional insured rent, in a form acceptable to the City. F. SeOal(' Retention/Deductibles. All policies required by this Agreement shallity, as additional insured, to satisfy the self -insured retention ("SIR") and/or d of the policy in lieu of the Vendor (as the named insured) should Vendor fail to pay the SIR or deductible requirements. The amount of the SIR or deductible shall be subject to the approval of the City. Vendor understands and agrees that satisfaction of this requirement is an express condition precedent to the effectiveness of this Agreement. Failure by Vendor as primary insured to pay its SIR or deductible constitutes a material breach of this Agreement. Should City pay the SIR or deductible on Vendor 's due to such failure in order to secure defense and indemnification as an additional insured under the policy, City may include such amounts as damages in any action against Vendor for breach of this Agreement in addition to any other damages incurred by City due to the breach. R Professional Services - Snow Services 1571951.1 G. Subrogation. With respect to any Workers' Compensation Insurance or Employer's Liability Insurance, the insurer shall waive all rights of subrogation and contribution it may have against the Indemnitees. H. Failure to Maintain Insurance. If Vendor fails to keep the insurance required under this Agreement in full force and effect, City may take out the necessary insurance and any premiums paid, plus 10% administrative overhead, shall be paid by Vendor, which amounts may be deducted from any payments due Vendor. I. Vendor shall include all subVendor s, if any, sureds under its policies or shall furnish separate certificates and endorsements ach subVendor to the City for review and approval. All insurance for subVendor s I�be ject to all of the requirements stated herein. It 9. Termination. The CITY may c cause. The Vendor may not cancel the majeure). In the event of such can _ Ili damages to the City, including, bu replacement Vendor, unless the Ct; part of resulting damages. 10. Force Majeure. A. The Vendor si result of unavoid,, riots, stjI�Qea, civil \X/*", at any time.0h or without an son luding force is res for all ensuing t associatQ with retaining a es in writing to waive all or any M for'�is failure to perform hereunder as a N�r' , public enemies, pandemics, epidemics, act reasonably beyond the control of the B. The City shall not esnsible for any cancellation of the services as a result of unavoidable accident, ' of God, public enemies, pandemics, epidemics, riots, strikes, civil commotion, or ther act reasonably beyond the control of the City. 11. Non -Discrimination and Equal Employment Opportunity. A. Vendor shall not discriminate as to race, color, creed, religion, sex, marital status, national origin, ancestry, age, physical or mental handicap, medical condition, or sexual orientation, in the performance of Its services and duties pursuant to this 5 Professional Services - Snow Services 1571951.1 Agreement, and will comply with all rules and regulations of City relating thereto. Such nondiscrimination shall include but not be limited to the following: employment, upgrading, demotion, transfers, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. B. Vendor will, in all solicitations or advertisements for employees placed by or on behalf of Vendor state either that it is an equal opportunity employer or that all qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, marital status, national origin, stry, age, physical or mental handicap, medical condition, or sexual odentation.yel C. Vendor will cause the foregoing pro subcontracts for any work covered by this Agreement for standard commercial supplies or raw material 12. Time Is of the Essence. Vendor shall do all things necessary anq 13. Assignment. Vend Agreement nor the performance o prior written consent of City, and a any rights, duties, or oblQns ari 14. Complial ordinances, codg,S,and Agre ant shall be duringkftular busine or (b) tr prepaid, to`' I a >i addresses as the pa provisions of this sed "VENDOR " to be) inserted in all 5afras or subcontracts essence greement. secution o ndor's work. h or trans`fet' any interest in this Ven r obligations hereunder, without the iby or to so assign this Agreement or W ' der sh"aMe void and of no effect. comply with all applicable laws, and local governments. rday invoices, or reports required by this iced on (a) the day of delivery if delivered by hand by facsimile before or -during regular business hours; following deposit in the United States mail, postage fore set forth in the Agreement, or to such other may, from time to time, designate in writing pursuant to the Ultimate Entertainment LLC 12104 Park Street Cerritos, CA 90703 Attn.: Steven P. Nero Phone: 714.231.2779 "CITY" City of Diamond Bar 21810 Copley Drive Diamond Bar, CA 91765-4178 Attn.: Andee Williams Phone: 909.839.7067 6 Professional Services — Snow Services 1571951.1 E-Mail: E-mail: 16. Governing Law. This Agreement shall be interpreted, construed and enforced in accordance with the laws of the State of California. The venue for any action brought under this Agreement shall be in Los Angeles County. 17. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed to be the originggnd all of which together shall constitute one and the same instrument.' 18. EntIre Agreement. This Agreement, ,an they documents incorporated herein by reference, represent the entire a grated agreement between Vendor and City. This Agreement ersedes a ' or oral ,Qr written negotiations, representations or agreements. Thy reement of Ynended, nor any provision or breach hereof waiv ,, pt writing sig a parties which expressly refers to this Agreeme en behalf of h "' City will only be valid if signed by a person duly atcg,�zed�td so ter th. ity's Purchasing Ordinance. ��� 7 Professional Services - Snow Services 1 S719S 1.1 IN WITNESS of this Agreement, the parties have executed this Agreement as of the date first written above. " Vendor " By. Ultimate Entertainment Printed Name: Steven P. Nero Title: CEO By: Ultimate Entertainment LLC Printed Name: Ideal Gandariila Title: Event P anner Sa es Rep Apprc By:_ Omar "City" CITY OF DIAMOND BAR By: Daniel Fox, City Manager 8 Professional Services - Snow Services 1571951.1 Eortn W-9 Request for Taxpayer (Rev. October201M identification Number and Certification lntemel Revenue servme 1 ► Go to www.1rs.gov/FbrmW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Memo Is required on this line; do not leave this line blank Ultimate Entertainment LLC name, If Give Forrtl to the requester. Do not send to the IRS. 3 Check appropriate box for federal tax classification of the person whose name Is entered on fine 1. Check only one of the 4 Exempilons (codes apply only to following seven boxes, certain entitles, not Individuals; see ❑ IndMduaVeole proprietor or 110 Corporation 0 S Corporation ❑ Partnership ❑ Trust/estate instructions on page 3): single -member LLC Exempt payee code Of any) Q Umited liability company. Enter the tax classification (C-C corporation, S•S corporation, P-Partnemh'p) ► S Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting LLC it the LLC Is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC is code (if any) anotfter LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a singe -member LLC that Is disregarded from the owner should check the appropriate box for the tax classification of Its owner. ❑ Other (see hustnxftns) ► ma�+cana,,,r,umdadaN.rn.usi 6 Address (number, street, and apt or suite no.) See instnrctlorm Requester'e name and address (optionaq 7 List account number(s) here lootlonan Enter your TiN in the appropriate box. Tice TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Instructions fot Part 1, later. For other entities, it is your employer Identification number (EiN). It you do not have a number, see How to get a TIN, later. NOW. If the account is in more than one name, see the instructions for One 1. Also see What Name and Number To Give the Requesterfor guidelines on whose number to enter. or Under penalties of perjury, ) 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 Intemal Revenue Service ORS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (0) the IRS has notified me that 1 am no longer subject to backup withholding; and 3.1 am a U.S. citizen or other U.S. pennon (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 retum. 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 ORA), and generally, payments other than Interest and dividends, you are General instructions • Form 1099-DIV (dividends, Including those from stocks or mutual Section references are to the internal Revenue Code unless otherwise funds). noted Font 1099-MISC (various p � hypes of income, prizes, awards, or gross Fatttre developments. For the latest Information about developments proceeds) related to Form W S and its Instructions, such as legislation enacted after they were published, go to wivw./rs gov/FonrtW9. • 10ns b (stock or mutual fund sales and certain other transactions brokers) Purpose of Form 0 Eon orm 10098-S FS (proceeds from real estate transactions) An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain taxpayer • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage Interestj, 1098-E (student loan interest), your correct identification number MN) which may be your social security number 1098 T (tuition) (SSN), indMdual taxpayer Identification number (ITIN), adoption . Fen„ 1099-C (canceled debt) taxpayer Identification number (AMM, or employer identification number (EIN), to report on an information return the amount to 1099 A (ac . Form cluisition or abandonment of secured property) Use Form paid you, or other amount reportable on an Information realm. Examples of Information W-9 only If you are a U.S, person (including a resident alien), to provide your correct TIN. returns Include, but are not limited to, the following. ' Form 1099-INT (interest earned or paid) /f you do not retum form W-9 to the requester with a 77N, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev.10-2018) DATE I CERTIFICATE OF LIABILITYNSURANCE �oiai2o2z _._._.__....._.------.._ ._ __._...- ...._...__............_....._._._.._._.........--.._....._--._......_.._ _ .... 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(les) 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 JContact Name: I Todd Tyler Cossio insurance Agency Phone (864) 688 D121 Fax PO Box 5987 - - - Greenville, SC 29606 (864)688-0121 INSURED Ultimate Entertainment LLC, Dba Mega Outdoor Movies, Mega Outdoor Entertainment, 12104 Park Street Cerritos, CA 90703 INSURER A: INSURER B: INSURER C- INSURER D: tammy@oossloinsurance.com INSURER(S) AFFORDING COVERAGE !Berkley Specialty Insurance Company 'Berkley Life & Health Insurance Company y INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: N/31295 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE P ICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOY THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. __._........._._._.._....._.... __ INSR TYPE OF POLICY ADOL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MMIDO/YY) (MM/ODlYY) X COMMERCIAL GENERAL LIABILITY ❑ L__1 CLAIMS MADE ® OCCUR A C TBD GEN'L AGGREGATE LIMIT APPLIES PER X POLICY ❑ PROJECT ❑LOC ❑ OTHER' AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED J AUTOS ❑ AUTOS HIRED AUTOS ❑ NON -OWNED \ ❑ ❑ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE DIED ::] RETENTION $ ~ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ N/A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 10/5/2022 1 10/5/2023 Products/Co eted Operations Aggr $2,000,000 Medical Ex rises (any one person) Excluded , Damage Premises Rented to you $100,000 BI/PD mbined Deductible Per Gal $2,500 ' Pe al & Advertising injury (Any On $1,000,000 1 E Occurrence $1,000,000I general Aggregate $2,000,000 ' COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per Person) $ i BODILY INJURY (Per accident) $� PROPERTY DAMAGE (Per accident) OTH- ER Total Benefit Maximum for all Accident M $25,000 Class 1 Principal Sum $25,000 B Accident Medical PAI L012010778503 10/5/2022 10/5/2023 Benefit Maximum $500,000 ! Accident Medical Deductible $100 DESCRIPTION OF OPERATIONS / LOCATIONS / HICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) Party Equipment Rentals Operations located at 1 04 Park St. Cerritos, CA 90703. Verification of Insurance Only I LwCM Ifrl •AiG MULUCK: , - CANCELLATION Ultimate Entertainment LLC 12104 Park Street Cerritos, CA 90703 ACORD 2e(2016/03) •�� C ucaa -CU rvL %,4=0 6C L,1AN% r_LLCU tSttUKt THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD