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INSURANCE ON FILE
WORK MAY PROCEED
IL INSURANCE EXPIRES
_,3 /- 18 N/C
CLERK Of 9` II0 6 r v
DATE: u �J
0:PRCS(/)
Silvia Cuevas
N-2018-006-01
THIS FIRST AMENDMENT to the above -referenced agreement is entered into on August 20, 2018, by and
between Academy of International Dance, a California corporation ("Provider"), and the City of Santa Ana, a
charter city and municipal corporation organized and existing under the Constitution and laws of the State of
California ("City").
RECITALS
A. The parties entered into Agreement #N-2018-006, dated December 6, 2017 ("Agreement"), by which
Consultant agreed to provide ballet and hip hop classes in its recreation class program.
VOW ke-
B. The Term of the Agreement is for January 1, 2018 through December 31, 149, and is currently in effect.
C. The parties wish to amend and replace Exhibit A (Scope of Services) to the Agreement to revise the Scope of
Services regarding the classes provided by the Provider. The amendment will not affect the compensation
agreed upon by the Parties.
The Parties therefore agree:
L Exhibit A, Scope of Services, is amended and replaced by the attached Exhibit A.
2. Except as modified by this First Amendment, all terms and conditions of the Agreement shall remain in full
force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement on the date
and year first written above.
ATTEST
M
01
D MARIA D. HU AR
ti Clerk of the Council
APPROVED AS TO FORM
SONIA R. CARVALHO
City Attorney
By: & UkV,
LAURA A. ROSSINI
Senior Assistant City Attorney
CITY OF SANTA ANA
RAUL GODINE II
City Manager
PROVIDER
By: Sonia Miskulin
Title' Executive Director,
Academy of I ternational Dance
"c-
MMENDEZR%A1�IPROVAL
Page 1 of 1
i Executive
Recreation
Agency
N-2018-006-01
Exhibit A
First Amendment to Agregment N-2018-006
SCOPE OF SERVICES
A. Provider shall conduct professional level classes in the following subjects provided below
for Ages 4-12.
B. Provider shall teach such or similar activities at the times provided below at facilities to
be designated by the City.
CLASSICAL BALLET
Has your child dreamed of being a ballerina? For over 15 years, the Academy of International
Dance has trained children in classical ballet and has been successful teaching students to reach
point level. But it all starts with beginning ballet classes. Your child will learn various rhythms,
barre exercises that will improve their technical and strength ability, center work, spatial
awareness and coordination, and choreographies that will impress their family and friends.
Lastly, we take pride in not only teaching children ballet but also that they learn etiquette and
gracefulness. Join us this semester! Make your child's dream come true. Classes begin on June
1st.
INSTRUCTOR: Academy of International Dance
LOCATION: Jerome Center, 726 S. Center St., Santa Ana, (714) 647-6559
LOCATION: Salgado Center, 706 N. Newhope St., Santa Ana, (714) 571-4267
LOCATION: Roosevelt Walker, 816 E Chestnut Ave., Santa Ana, (714) 647-5220
HIP HOP
Come and join our high energy class which incorporates the fundamental movements derived
various forms of Hip Hop Dance. Styles ranging from popping and locking to current popular
dance trends teach kids how to engage their bodies while expressing themselves in a fun positive
learning environment. This class encourages the kids to develop a sense of rhythm, style and
artistic presence through learning basic dance choreography and movements, while experiencing
the fun and excitement of hip hop culture through music and dance. This class is designed for
beginners. Class begins June 411
INSTRUCTOR: Academy of International Dance
LOCATION: El Salvador Center, 1825 W. Civic Center Dr., Santa Ana, (714) 647-6558
HIP HOP! Come and join our high energy class which incorporates the fundamental movements
derived various forms of Hip Hop Dance. Styles ranging from popping and locking to current
popular dance trends teach kids how to engage their bodies while expressing themselves in a fun
positive learning environment. This class encourages the kids to develop a sense of rhythm, style
and artistic presence through learning basic dance choreography and movements, while
experiencing the fun and excitement of hip hop culture through music and dance. This class is
designed for beginners. Class begins July 31a
INSTRUCTOR: Academy of International Dance
LOCATION: Roosevelt Walker„ 816 E Chestnut Ave., Santa Ana, (714) 647-5220
C. Provider will provide and be responsible for equipment, records, and personnel and cleanup
of the facilities and materials necessary to ensure the safety and effectiveness of said instruction.
CLASS SIZE REGISTRATION
A. Each class must have a minimum of 5 paid students and no more than 20 students,
B. No registration will be accepted after the second meeting of classes.
C. If the minimum registration has not been reached by the second class.
CLASSFEES
A. Each participant shall pay class registration fee as established by City.
B. Provider may not waive class participation/registration fees.
C. Only registered participants may participate in class.
D. Any refunds to participants will be made in accordance with City policy.
E. Any material fee shall be established by mutual agreement of City and Provider and shall
be payable directly to Provider.
N-2018-006-01
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2018-22
CERTIFICATE OF INSURANCE
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER
PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with
City of Santa Ana
Apex Insurance Services
20 Civic Center Plaza
P. O. Box 6450
Santa Ana, CA 92701.
Newport Beach, CA 92658
License No: OC 36861
NAMED INSURED (EVENT FIOLDER):
EVENT INFORMATION:
Sonia Miskulin- Academy of International Dance
TYPE: Dance
2019 S. Main Street
DATE(S): VO4/18— 12/31/18
Santa Ana, CA 92707)
LOCATION: Jerome, Salgado & EI Salvador Center
*Liquor Liability Yes ❑ No
"Liquor Liability after 12 am ends before 2 am El
This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy
period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless
amended as described in Special Conditions.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: SEP41026
MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2018 EXPIRATION: JANUARY I, 20 t9
COMMERCIAL. GENERAL LIABILITY
OCCURRENCE FORM
DEDUCTIBLE: NONE
General Aggregate Limit $ 2,000,000
Products & Completed Operations 1,000,000
SPECIAL CONDITIONS
Personal & Advertising Injury 1,000,000
The following endorsements attached to
Each Occurrence Limit L,000,000
the Master Policy do not apply to this
Damage To Premises Rented To You (Any One Premises) 100,000
Certilicate Of Insurance:
Medical Payments (Any One Person) 5,000
MEGL643
Liquor Liability (If purchased) 1,000,000
Optional Limits Purchased
❑ $1,000,000/$3,000,000
❑ $2,000,000/52,000,000
Damage To Property (If purchased)
The limits or insurance apply separately to each event insured by this policy as ifa separate policy of insurance has been issued for that event.
OTHER ADDITIONAL INSUREDS
Donald Sevilla
Chaye Jackson
CANCELLATIOM Should the above described policy be cancelled before the expiration date thereof, notice will be delivered I1'ao-kUrnce with the pol'
rovisions.
Yv
AUTHORIZED REPRESENTATIVE.:
DATE ISSUED:
N-2018-006-01
WORKERS' COMPENSATION DECLARATION
I Sonia Miskulin, Director hereby affirm under penalty of perjury, the
(Name/Title)
following declaration
Academy of International Dance
I certify on behalf of that during the ten -n of my
Dance Instruction (ConsultatiHComrany Name)
contract for services with the City of Santa Ana, I will
not employ any person in any manner so as to become subject to the workers'
compensation taws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shalt forthwith
comply with those provisions and provide proof of workers' compensation coverage.
DATE: 01130/2018
By — --
Name: Sonia Miskulin
Title: Director
Telephone: (714) 550-9285
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.