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Home My WebLink AboutLE, CHOC 2BCity of Santa Ark Clerk of the Councii _= AGREEMENT TERMINATION 2W MAR -2 M 9= 2$ Please complete this form when the attached agreement is no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-5237 if you have any questions. The agreement with C Le - No. / j r % was completed on and final payment has been made. t� *,,ze- 40 Revised 07-23-07 l ^ o` — / J,5 Department: Phone/Ext.: Signature: Date: 0 N-2002-097 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURhNCE EXPIRES CLERK OF COUNCIL DATE: SECOND AMENDMENT TO CONSULTANT AGREEMENT THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT, is entered into on aIf ' ZLA� , 2002, by and between Choc Le, a sole proprietor ("Consultant') and the City oY Santa Ana, a charter city and municipal corporation of the State of California ("City"). Recitals: A. The parties entered into Agreement N 2001-108, (hereinafter "said Agreement') by which Consultant has instructed students in Karate. B. The parties entered into a First Amendment of said Agreement to extend the term and increase compensation to cover services provided during said extended term. C. In accordance with the terms and conditions of said Agreement, the parties wish to amend said Agreement for an additional one year term and to increase the Compensation to cover services during the extended term. 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 Second Amendment to Consultant Agreement, the parties agree as follows: Scope of Services. Consultant shall perform those services as set forth in Exhibit A to this Amendment to Agreement. 2. Section 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. The total sum to be expended under this Amendment to Agreement shall not exceed $10,000 during the extended term of said Agreement." 3. The term of said Agreement shall be extended to June 30, 2003. 4. Except as hereby amended, all terms and conditions of said Agreement shall remain in full force and effect. a4 0 E IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Consultant Agreement on the date and year first written above. CITY OF SANTA ANA ATTEST: ATRICIA E. HEALY AVID N. REAM Clerk of the Council City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By: La a Sheedy Assistant City Attorney APPROVED AS TO CONTENT: CONSULTANT -0 JON P" RIBBLE CHOC LE Executive Director of the Parks, Recreation and Community Services Agency Exhibit A Scope of Services A. Consultant will prepare and instruct students in the techniques of Karate, teaching classes periodically as follows: City and Consultant shall agree on a class schedule and location. No classes will be held on Labor Day, Thanksgiving weekend, the week of Christmas and New Years, Martin Luther King, Jr. Day, Presidents Day or Memorial Day. B. Consultant will provide and be responsible for equipment, records, personnel and clean up of the facilities and materials necessary to insure the effectiveness of said instructions. Class Size Registration A. The minimum number of participants is 10 per class. The maximum number is 65. B. No registration shall be accepted after the second week of classes. C. In the event the minimum number of enrollees is not realized by the second week of classes, the class shall be canceled and Consultant will be under no obligation to provide services, and City will be under no obligation to pay Consultant compensation. Fees A. The fee to participants shall be $20.00 per month per participant. No refunds shall be made to participants, unless class is canceled by the Parks, Recreation and Community Services Agency. B. City shall collect said fees from each participant during the registration period. Consultant shall not collect fees but shall refer participants to the City registration office. City agrees to pay Consultant seventy percent (70%) of the total fees collected within fifteen (15) working days after completion of the class. City and Consultant agree that City shall retain thirty percent (30%) of the fees collected. C. Consultant agrees that City representatives shall be entitled to audit Consultant's records to insure compliance with said Agreement. ACORD • CERTIFICATE W LIABILITY INSURANCEW OPID R MI OATE(MDDMYYY) 0375057 03 28 03 PRODUCE a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fitness & Wellness Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 380 Stevens Ave., First Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Solana Beach CA 92075 Phone:800-395-8075 Fax:858-519-0822 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Specialty National Insuranc INSURER B: Choc V. Le #0375057 Eff: 01-06-03 INSURER C: At - Z OVvz 4 Fabriano INSURER D: Irvine CA 92620 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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR ROW' INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIO POLICY EXPIRATION DATE (MM/DD1YY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE S1,000,000 A X X COMMERCIAL GENERAL ABILITY CLAIMS MADE [ X] OCCUR 3XZ126451-02 01/06/03 01/06/04 RTED PREMISES(Ea trance) f100,DUD MED EXP (Any one person) $2 , 5 0 0 A X Nisc.Professional PERSONAL dADVINJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S1,000,000 POLICY JECT LOC AUTOMOBILE UASILI7Y ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) HIREDAUTOS NON -OWNED AUTOS BODILY accide t) (Par accident) S PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER EA ACC S $ AUTO ONLY: AGO EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ S DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORYLIMITS I ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? IT s. descdba under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE S E.L. DISEASE -POLICY LIMIT E OTHER A Sexual Abuse 3XZ126451-02 100,000 300,000 IESCRtPT10Nn OPERATIONS/LOCATIONS/VEHICLES CityEXCLUSIONSof ADDEDBYENDORSEMENT/SPECIAL PROVISIONS APPROVED AS TO FORM It is understood and agreed City of Santa Ana, its officers, agents, 1VY1 employees, representatives, and volunteers are added as addition insuered per the attached form CG201011/85 La N Reedy 0riity City Attorney -=K I IrII.A 1 C KULMCK City of Santa Ana Parks and Recreation, & Community Services Agency P.O. Box 1988 N-23 Santa Ana CA 92702 SANANAC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATII DATE THEREOF, 30 DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, - E This Endorsement changes the Commercial Liability Policy. PLEASE read it carefully. This endorsement, effective on 01/06/02 at Standard time shown in the Policy Declarations, forms a part of Policy Number 3YZ126451-01 issued to Choc V. Le #0375057 by Hull & Company (Specialty Nat). Endorsement Number 001 This endorsement modifies insurance provided for under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ADDITIONAL INSURED - BLANKET FORM WHO IS AN INSURED (Section II) is amended to include as an insured the person(s) or organization(s) shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. Name of Person or Organization City of Santa Ana Parks & Recreation Dept PO Boa 1988 Santa Ana, CA 92702 All certificates of insurance holders you have agreed to include as an insured prior to an "occurrence" or offense. (8-97) APPROVED AS TO FORM Laur heedy Deputy City At may 01/10/03 15:23 Z 004 • • ADDITIONAL INSURED ENDORSEMENT Insurance Company Iy WU�fiY� rl This endorsement modifies such insurance as is afforded by the provisions of Policy # 'W412 P415 1- 0 Zrelating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Califomia 92701; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds') with regard to liability and defense of suits arising from the - - - -operations aad uses perfoaaed by Ax- oabebalf-of.the>named insumd-- 2. with respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and Is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's Iiirftits of liability. The Inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective ,2 this endorsement form as a part of Policy#_ Issued to MV. LP Named Insu Countersigned by A orized Representative `•t'PRO- €'O AS TO FORM 1Jt P,liY City Attorney