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HomeMy WebLinkAboutCOMMUNITY VETERINARY HOSP 1BAGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (M-30). Ca11647-6520 if you have any questions. The agreement with W1"IZ~yJ2Cfi12(_,p'~-~~r ~/~.t t't('j ~ p,Fw, F1 "' ~, A- ~i ~ ~~ ` ~ 1~ "~ was completed on ~Ll_J`,l~jT ~ ~~ Cr ,and final payment has been made. Deparhnent: I ~ ~ 1 Signature: -1(~~.tilr I Date: ~ 1r~r~~ City of Santa Ana Revised 4-16-87 Clerk of the Council A~•2003-D~I3-l THIRD AMENDMENT TO CONSULTANT AGREEMENT THIS THIRD AMENDMENT TO CONSULTANT AGREEMENT, is entered into on ~~t~ ~~` , 2003, by and between Community Veterinary Hospital, In ., a California corporation ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). a ~ ~ J ~ ~ Recitals: "oz~ oar ~ z ~ oJo ' ~ ~ N ; ~ A. The parties entered into Consultant Agreement No. A2001-228, dated January 1, Y z ~ Y ~~" 2002, (hereinafter "said Agreement") by which Consultant has provided veterinary N o z ~ W d services to sick and injured animals brought into the City's animal shelter. z~~ vn C ~~ ~d B. Said Agreement provided compensation in the amount of $80 600.00 whereas the L~;~u~) , City Council of the City of Santa Ana authorized the Agreement in the amount of %~r1 $90,000.00. The parties wish to amend said Agreement to reflect the entire compensation amount authorized by the City Council on November 19, 2001, in addition to the amount authorized by the City Council on April 7, 2003. Wherefore, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this Third Amendment to Consultant Agreement, the parties agree as follows: 1. Paragraph 2 a., COMPENSATION, shall be amended to read as follows: "City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A and Exhibit A-1. The total sum to be expended for said services shall not exceed $101,500.00 during the term of this Agreement." 2. Except as amended herein, all terms and conditions of said Agreement and the Second Amendment to Consultant Agreement, shall remain in full force and effect. // // // // // // } IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment to Consultant Agreement on the date and year first written above. ATTEST: CITY OF SANTA ANA ~_ PATRICIA E. HEAL AVID N. REAM Clerk of the Council City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney J i Laur heedy Assistant City Attorney CONSULTANT . ~ ~~~ WILLIAM A. GRANT, II Chief of Staff ,, ,, . ~ ~~~~ C~~R~'(F TE C-~ LIAF3(E..(T~ ((~~l~R~(o1CE ~-x~'aE/c ; ?!;opucc!1 D.E3S~.:~:.c1.t;.L'JTl U:-i1.L AB1 Insurance & Fina:Lciai Services -~--- THIS cEpTlFICATE 15 155uEp J'<s A MATTER OF INFORMATION dN:.Y AND CONFEpe NO fl3GNT6 UPON THE CERTIFICATI KOLpER, THIS GEFiTiFICAT~ pOES NOT AMi£NA, EXTENp OR ALTEFl THE COVERAGE J~FFOROEO ~Y THE POLICIES pELOdL', J .. r.~ T ~ ~~ i rz3~raod C1 Cy; CA 9~iC'63 IPiSURERSAFFOPDINGCOVERAGE Ni;JMt7 ;~~t:NE~A r irerr,ar. ` a Fu:1d I.zsurance Camnn;rllty b't;t.erinary Hosp;~i, lnc. ; . .--._. __ -._-- _-- I320C ~udid Street ~Ir: ~~rtc'ie ------~.__.. --------._ .. GarQel~ Gro~'e, CA 92843 + ~f,S_ f~ac JN5D(1°n 0. ~ ; INSUgER f.. (COVERAGES THE F04-~CiFS ~ INSURAhYCE LIS'iEN BELOYu' HAVE BEEN ISSiJEp TO TyE INSURED NAh1E0 AODVC FOR T}~E POLICY PcRl01~ INCICATcD~ NOYWITI-ISTAtfpING ANY flEGLi;flEME:F(T, IEF:1+1 Oq CONDIT oN OF ANY CUNTflACT ON OTrtGR pOCUidENT '/PITH RESPECT T.0 wH:CM THIS cEaTIFIGATE tdAY BI: ISSUGlJ Gil MAY FEF.TA!N, THE JNSUP,l~NCr AFFOROcJ BY THE PO:.JGF9 0.3CRI@EO NCHi:ih IS &U6JECT TO ALL THE Tf.R1a5, EXCLUSIONS AND CONDiT10N9 OF' SUCH j pO;.ICIES ANGFEGAT~ LIMITS SNOVIN MAY HAVt:• 86CN RcDUGEp OY PA.iD CLAIMS, sR: _.-. ...- _ .. ,..... ._.-... _.-.._ i TYPE OF Cr:UflANCE ` J POLICY NUNDCR _ ..-~-------POLICY EFfRChVE lraLlCr JCAF wT- ---._._. _._._....... ... ~y ~;Jfd61•'DC },~ DATE j},M/ D LIAi1Te A~cr'r:°.RA~LIA~ILI'~ 'AZC80%iC086 j 1G,/v? %G2 10/G1/C3 ~A~rl~-cuFr,~w~~_~.~i, J_OD _0_0~ '- t }, ~if IM R~!a. GC vC(9.t,.-InB,L r.. ' _ ' ~a GG C00 i i I F'RF OAMAaE laq/ ofA're~--i..- - a--•- -- ~---•- t ~-- G MNS MADE ;_ X ~ fCCufT I I I IlEO EY3 (Any ;,;c I:an) ; ! ). O U C J .. .-. -_ rerTSOnaL a npv I~~>U~T' ~ 5~ , C 0-C.;_ 0 Q 0 ._- . __ . . I _. - I I `GENERAL a~teoATE ! S~ ,GOO , ~ O O i _.r-- 13 ~ N'= /•G GF F. GAl E L (N(IT AF'i'L IE S l . ii: ~ . I I ~ PRCDUCTS__CAtip;GW AGf3 ~? J d Q Q ~ ~ () ~ I I Pf±O• I I lOC f ~ I P,o;.ICY I --- i it AUTp,~(O61LE LIA81L!TY I ~ cofAe~Ne:D 6,nGL6 I.i~!1' ! ~ -., ANY AUTO ~ i ; SIFa acciConU I ~ A,.I. 4WfitC Af. TO3 , I ~ I ~ euDiLY FLJURY ~ F • ~ 'I S::IIECU_EG.tiTCe I i r i O~ paroonl 1 ~ ; --.-_-. -~ I __~ ~ A., A.JTO~ - - - - - -- --- I - - -- I 9001LY!.NJU(iY I' ~ +IQti•OWNSp AUTOS i ~ !Fc• aa^.idarr) I " --~ i -. _-- ....._. ~napgrr P ,t.5,1G~ } i ;Pw pcatdcrnl 4 5 --- - .r -- ~ GAgAGE UAA1Ll1Y I AUl'O.Qh_LY :.fAACC~DuNT i ~, ._ ..-__ .__-__ i...-.~ .SwY AuTA f oinGq Tf+n,~ EA ACC j k. ._..----.. _. _ .. - ' ~ ~ I I AUTO ONLY ACO ~ EYC_E89uae11•ITY ~ j I I EACF!_OCC:JRflEI~CC 15. _.. -_--- a j i GCcuf- ~_-^; G,A~N5 ataut ~ i I I AGGREGAiE_ --`~ S -_ . ... i ~ , I I jf 4 ----__..._.... ._.. - A iW-~jiKBAECOMpF;N6ATfONnh9 jtdZP~U9G7523 lv~ 5 A U' f ;O FI• IQ7%ri'1~G2 ',a lj ~:-~,ri3 i~{ - y1,~. ~ , 10:1. 1174__- •-._T8_~ _~_----_ i Et4Pl CYEJi6' L~~TTIUIY I I t L FaC11 AcC(DC•r•T Y 1 , ~ Q Q , ~ G G ~ ; r ~ ESL. D:9E49C ~ Ea pMPLOYGL ~~.t.QC G ~ O G V .. ~ - -- i *, ~. , G Q ~ L Q ~ l~ _ _ F i. Di65nSG • POLICY LIMIT p, orh~R F.-ot2c~s.ora]. IALCai/71c~0a6 __ _ _ i 10~'~1/G2 10; c~1/03 ; $~., 000, G04/$~, OOG, OOG ~Ja 3)/~.~1L- f I • 1 GEBCR;pTIJN Dr• C`ER+3nOVS/LOCF,natiSlYEHiLL:SI:YCWSiCNf. ADD.D OY EfrDORSE,HENTISPECI~L PRAVIOiCN6 Cert:i~icate 2•o~.dE:x: ie :lamed Add' 1 Inaure?d aJ~ _eepects to Veterinary Serviceq Fer~ormed by the r.a~-red inel?red.. -- . 1~oc~t• ~. ^- 1.3200 8uc1 i d St . ; GARDEN GROVE, C'A - Co~Tnunity L'eter~.na~x KospitalInc 7~a.;# 2 - 13220 E>~~~Ild St . ; GARDEN GROVE, CA - Anin~l Fa-ienda Pet :-iote7. Loci. 3 - 13%S2 I/uca a.d St.; GARDEN GROVE, CA - Ana.~t.al D~.scourt Clinic ( _ CER7IFIGATE HOI.DER____! ){. I act:i~orva~Iwsuf3eG;IH6uciERLETTER: CAhCELl1~TlON ^j e : I'Ja~ \ic>.,,,;~ c~ f nr \Tr_r*i - ~~. _^~ ~ - gFiuJLDANYOF~(Iy54gGVEDRa'CR:'9FPP0~10166dE('0.NCR:.LkAdEPOfiEr^SEEXPIReroN L~iy of Santa Ana ~D4il: T11`R~sOF, ?H£ ISSUING INSUASA W'L~A3Cti8~.SC9QdAlL .u -. GAY&`NRI'!£fr 2C Civlc Center P~a:a, M-3G . Nane_roTre ce~nF:cA;s ~soLU:~~rwr:aTaTHeL~F-,~a;x~cdl~~~ao~r~ccx I S3i!I:d Ana, CA 92702 ±aa~s,:xx>~s~c~,-x~ ~ ~xu+:aaxvRs I _ AIJTN ^4£C pEpREBENY~rIVE AC(3riD 2G•S (?;aT; ~ G ~ ? ~ 4 4 a G a ~ COh'IdUll~ ~`ir, VAPT ~ AcORC GOFPaRATlON 1~nd _ ~p~a . ~?zplJty Cit}/ Attorney ~~liPOiRT~NT if lhf3 cortiiica:e holds. Is ar. kDE71TjONAI INSURED, the pclicy(iesl mus; ba enporsed. A state,~ant cn this cerlltkate dons no! confer rights to the certifica:a ho',d6r in lieu of such endoresment(s'. It StJBROCiATION IS WAIVED, suotect to the terms and condl'tlcns of the policy. certain pohcles may raauire an endorsement. A statemarn nn this certifics!a does not confer rights Io tho certificate holder In Ilan of such andorsQmani(s). DISCLAIMER The Cei~i(icata o; Insurance Gn the reverse slue of this form does not constitute a ccniract between tna issuing it•,surar(s), authori=ed reprasentativo or producer, and lha certificate holder, nor does it aftirnsllve;y or negatively amend, extond or alter the coverage afforded by the pollci3s listed thereon. ~.; ~.. • POLICY NUMBER: ~:~C6 a 7:~ ~ G c3 r'. C6hPlt'AtcRCIAL GENERAL LtABILi"tY THIS ENDURSEM=NT CHANGES THE POLICY. E'LEASi= Rl`AD 17 CAREFULLY. ~~D~TI(~N~L lNSUR~a - aESl~N~4T~~ PARSON car ORCANl~~RTl~DN This endorsement rnod~fles insurance provided under the following: COMMERCIAL GENCRAL t.lAl31LITY COVt°_r2AGE PART SCHEDULE Name o. Fersan or Orga^ixation: Citx of sar~~a Ana 2C~ Civ_C Center Plaza, b;-30 Sa~zta Ana, CA 92'1D2 (If no entry sppaars abo~re, Information required ko complete this endorsement will Ce sha~vn in thA Reclara:lons as apps+ca le ~ this endorsement.) VJHO IS AN INSURED (5e;,tion il) is amended to Include as an insured ihs person or organizatian sho~t~n +n the Scrisduie, :ut only with respsc'. to 1'iaUi'iiy arising otlt of your operations ar prern~ses owned by or ren~gd to you. C°rtificate Holder is named Ad~3'1 Tnaured as respects to Veterir:ary Services pex~For_med by tre rained insured, A~;~~~OVED AS TO FORA s • Sheedy ;jeputy City A orney CC 7.0 26 1 ; 95 _ - EXTIII3IT B • ,~OI~Tt0?~.~;L fI~SLTRED ENDORSE~iEN"r ~~(~Ft CU~;>WLERCI~I-GENERAL LIABILITY POLICY' Insurance Company ~,'rc r„~+ ~ 's ~u H.~ ,~n s This ~ndorseciem modifies such irsur:tnce as is afforded by the provisions of Policy __. ~ ,~ ~ C ~~.?7l ee ~'~ relating to tho follo~~ing: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 93701; its officers, cxnployees, agents, volunteers and representatives are named 1s additional insitrcds ("additional insureds"} wish regard to liability and defense of suits arising frori the operations and uses performed by or on behalf. of the named insured. ~. With respect to claims arising out of the operations and rises performed gay or op be'-~alf of file named insured, such iristuance ,ts is afforded by this policy is primary sold is not additiora! to or contribut:n~ '~'itlz any other insur~rce c~uried by ar fur tba benefit of the additional insur;,ds, ?. ! ills insur~:nce applies separately to each inst;red against whom claim is made or suit is brought except with respect to the eouipany's limits of ]lability. `The inchtsiotl of any parson or organization es an insured shall not affect any right which sgch person ot• organization would have as a claimant if not so included. h. With respect to the additional insureds, this insurance shall not be eaneellyd, or materially radueed in eavarage ar limits except aflar till. ~y (3G) days uTittect notice has been given to the City of S=utra Ana, 20 Civic Center Plaza (M-30), Sa.rta Ait~., Califon~ia 92701.. (Completion of the foIlowi.ng, incl~td;'ng countarsigrtsture, is required to make this erlrl0?'Sc'•I7tCltt effeCtlVC.} I/ffecti~~e to - ~ -_ C ~ ,this endor9ament fora as a pant of Policy ~ _ Z t.` t'~ i/oe a' issued 1a 1'n n. n.. :~ .~ .~)E.~TO r`~.~A/-~ a ^n. TJ-/ l't r~ ~ rn ,, .i L ~ .S r d c n -f [.-I • "~ . C ~~ jj'' Q Countersigned by V~"~ - ~ 1- ~ - /J~.~..._.l~ Authorized Representative APPROVED AS TO Ii~QR1~l . - a Sheedy ip Deputy City ttorney _ _ .. ,, • ~• _~Cdi1Eia irrJs~~~ii~1, ~ ,. ~~~ hover ~h~~t Date: 1 ; i610? Tirne: To: -Sgt. Marty Shirty Phone: Company: City oFSet~ta Ana Fax, 713-3~5•&SSO Prate: Vicki Buendin Fhone~ ~ ~ ~" (~ 10) tS..S-~~ 11 en:ai: vcbt~obd;.cAm raa: (S 1 Q) tSZS-254Q • F.L: C'ornmur.ity Vcttrinary HospiCnl • NumUer of 1,ageA including cover sleet: S If you do not rceclve ull pages of thls trAnsmission , (ilease ca11 as soon as pwsibla. tJrgcnil Please respond immediately Uri it:als to follow- i il ~] No response needed. ^ g . n ma Call upon receipt. A3 rec]uC~l'ec , i~~r~ is prow. of cover=oe.- --- __ _.. _ _ . -- - - _ - - - -- COI,f C~Zlltiulity J~:~t~ 'Ihe CtCCUIII~'.rt[$ g~~C;ILU111}~;r,p. Ihi~ cover shari ccutain inienn=iia~~ ft'um 4s v.ltieh is r,eniider,da! or pt,~ ~_brG. T~~ inL`rmc,.i.?n IS int•_ndec u'~ b. lilt :hr wr ilf Lh: indiviau[:! ur entity name! tier! illt'S uansmis~ion si,ecl. ;f ycu ~-r no: the inlcn~a~ rcci~ent, be gaarc ?tat any d x osurr, cppy~it, ; jsiri~tllicn, or u~c of the contents of this f~;cd information is pwtibi:ed. 1fy~u h::~e feceivea this fez in ~r~ur, plcas2 ~1~[!') ui Cy trt'-o!;u~;d I+T!t1cQl:1:~1'r Aso ~+r t:~r :a•rnnye Ice zh:: ^euern o(the Sri Final cocNm~'rtt (c u>. Client#: 18321 COMMUVETE ACORD CERTIFICATE OF LIABI LITY INSURANCE D~1 ,M 06/18/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Association Unit ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ABD Insurance 8 Financial Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2480 Natomas Park Dr. Suite 200 Sacramento, CA 95833 INSURERS AFFORDING COVERAGE NAIC # INSURED R~ °~~~_~~ INSURER A: Fireman's Fund Insurance -- Community Veterinary Hospital; Inc. A"'~3-a$ INSURER B: 13200 Euclid Street `(-"-~3-073~1 INSURER C: Garden Grove, CA 92843 INSURER D: INSURER E: COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDD/YV LIMITS A GENERAL LIABILITY AZC80733297 10/01/03 10/01/04 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED n S1 DD DUD CLAIMS MADE ~ OCCUR MED E%P (Any one person) $1 D DDU PERSONAL 8 ADV INJURY $1 OOO OOO GENERAL AGGREGATE $2 DDD OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGG $2 DDD DDD POLICY PRO- JECT LOC AUT OMOBILE LIABILITY D ' INGLE LIMIT B ~ $ ANV AUTO l Cide a 1 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NONAWNED AUTOS (Per accitlenp PROPERTY DAMAGE $ (Per accitleniJ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ L{ C ~ ~ $ DEDUCTIBLE ..- . .2.O.J J / $ RETENTION $ $ WORKERS COMPENSATION ANO WC STATU- OTM- EMPLOVERS' LIABILITY ANY PROPRIETDRIPARTNEfLEXECVTIVE E.L. EACH ACCIDENT E OFFICER/MEMBER EXCLUDED? If es tlescnbe antler EL DISEASE - EA EMPLOYE $ , SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS "Supplemental Name *' Doing Business As: Community Veterinary Hospital, Inc. (dba) Animal Friends Pet Hotel (dba) Animal Discount Clinic (See Attached Descriptions) City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL EN$n[p)pJrJP.IL ~0_ DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ^'--"° `" ~`"" """I I or a rFDavYOD GOMMUVETE DF ©ACORD CORPORATION 1998 /' IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. G~~%l~p,e~j L~~ ACORD 25S !2001/081 n so rvn.-.... DESCRIPTIONS (Continued from Page 1) William A Grant 8 Virginia L Grant, Trustees of the Grant Family Trust, agreement dated 3/26/80 as respects improved real property Certificate Holder is named Add'I Insured as respects to Veterinary Services performed by the named insured. Loc# 1 - 13200 Euclid St.; Garden Grove, CA Loc# 2 - 13252 Euclid St.; Garden Grove, CA Loc# 3 -13220 Euclid St.; Garden Grove, CA AMS 25.3 (2001108) 3 of 3 #584786 POLICY NUMBER: AZC80733297 COMMERCIAL GENERAL LIABILITY 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 Person or Organization: City of Santa Ana 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 (If no entry apppears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your operations or premises owned by or rented to you. Certificate Holder is named Add'1 Insured as respects to Veterinary Services performed by the named insured. !~ j/~ C CG 20 26 11 85