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Home My WebLink AboutLE, CHOC 2DCity of Santa P--i Clerk of the Coun< d AGREEMENT TERMINATION 2MY:.' -2 AN 9. Please complete this form when the attached agreement is no longer in effect.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. ---------------------------------j--h-----Von ------------------ The agreement with - No. l ?' t / was and final payment has been made. v J Department:5 J urn �p�yy v Phone/Ext.:�o Signature: Lu l Date: - -,)- (� Revised 07-23-07 City of Santa Ana Clerk of the Council AGREEMENT TERMINATION 2M9 MAP - 2 AM 9: 27 Please complete this form when the attached agreement is no longer in effect.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 No. ��U�'� c� was completed on , �U� A" and final payment has been made. v 1 Revised 07-23-07 Department: Phone/Ext.: Signature: - Date: INSURANCE ON FILE • WORK MAY PROCEED UNTIL INSURANCE EXPIRES 1— &— C# CLERK OF COUNCIL D.AT& /t) 019'ecs C f-earro14) A-2003-157 FOURTH AMENDMENT TO CONSULTANT AGREEMENT ri THIS FOURTH AMENDMENT TO CONSULTANT AGREEMENT is entered �� into on July 21, 2003 by and between Choc Le ("Consultant') 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. City and Consultant entered into Consultant Agreement N-2000-186, dated December 1, 2000 (hereinafter "said Agreement') by which Consultant has instructed students in Karate. The term of said Agreement has twice been extended by Amendment. B. The parties amended said Agreement for a third time by Amendment #A-2003-094, dated May 19, 2003, by which the compensation was increased to pay for an increased level of service during the 2002-03 fiscal year. C. In accordance with the terms and conditions of said Agreement, the parties wish to amend said Agreement for the fourth time extend the term of said Agreement for an additional year and to increase compensation to pay for 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 Amendment to Consultant Agreement, the parties agree as follows: 1. Section 1, SCOPE OF SERVICES, shall be amended to read as follows: "Consultant shall perform those services as set forth in Exhibit A-1 to this Fourth Amendment to Consultant 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 Fourth Amendment to Agreement shall not exceed $24,000.00 during the term from July 1, 2003 through June 30, 2004." 3. Section 3, TERM, shall be amended to read as follows: "This Agreement shall commence on the July 26, 2002 and terminate on June 30, 2004, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Parks, Recreation and Community Services and the City Attorney." IN WITNESS WHEREOF, the parties hereto have executed this Fourth Amendment to Consultant Agreement on the date and year first written above. ATTEST: PA RICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney g By. AClill[f'9/ Laura Sheedy Assistant City Attorney CITY OF SANTA ANA L( /Z� DAVID N. REAM City Manager CONSULTANT CHOC LE EXHIBIT A-1 SCOPE OF SERVICES A. Consultant will prepare and instruct students in the techniques of Karate, teaching classes periodically as follows: Consultant and City 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 instruction. Class Size Registration A. The minimum number of participants is 10 per class. The maximum number is 130. B. No registration shall be accepted after the second week of classes. C. In the event the minimum number of enrollees is not met by the second week of classes, the class shall be canceled, Consultant will be under no obligation to provide services, and the City will have no obligation to pay Consultant. Fees A. Each participant shall pay $20.00 per month to participate. No refunds shall be given unless class is cancelled by the City. B. City shall collect said participant fees 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 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. CORD - CERTIFICATE LIABILITY INSURANC OP ID R DATE (MM OD/03 0375057 03 28 03 PR DUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fi neSS & Wellness Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Ag 38 ncy Stevens Ave., First Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. So ana Beach CA 92075 Pk. one:800-395-8075 Fax:858-519-0822 INSURERS AFFORDING COVERAGE NAIC# INSL RED INSURERA: Specialty National InsuranC INSURER B: Choc V. Le #0375057 Eff: 01-06-03 - INSURER C: _ OZ INSURER D: 4 F riano Irvine CA 92620 INSURER E: CO ERAGES TI iE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING V REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR M V 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. NSRE TYPE OF INSURANCE POLICY NUMBER DATE MMID DATE MWD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 PREMISES(Eaccarence) $100,000 A X X COMMERCIAL GENERAL [ABILITY 3XZ126451-02 01/06/03 01/06/04 CLAIMS MADE FX] OCCUR MED EXP (Any one Pe mn) $2 , 50 0 PERSONAL SADVINJURY $1,000,000 A X Misc.Professional GENERAL AGGREGATE $3,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG S1,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per Person) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Par accident) S HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ ANY AUTO S AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ S $ DEDUCTIBLE S RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE TORYLIMRS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S OFFICER/MEMBER EXCLUDED? M yes. describeunder SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT S OTHER A Sexual Abuse 3XZ126451-02 100,000 300,000 ]ES It RIPTION OF OPERATIONS T LOCATIONS T VEHICLES T EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS APPROVED AS 1O FORM is understood and agreed City of Santa Ana, its officers, agents, employees, representatives, and volunteers are added as additions, in uered per the attached form CG201011/85 Ladfn glicedy P) rwy City Attorney 'E TIFICATE HOLDER CANCELLATION sBNANAc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, 30 DAYS WRITTEN City of Santa Ana Parks and Recreation, & Community NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Services Agency P.O. Box 1988 M-23 01� AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 Jeffrey E. Frick 25 (2001/08) 0ACORD CORPORATION 1988 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 Box 1988 Santa Ana, CA 92702 All certificates of insurance holders you have agreed to include as an insured prior to an "occurrence" or offense. X= APPROVED AS TO FORM Laor*licGdy• Deputy Oty At rnoy 01/10/03 15:23 0 004 u ADDITIONAL INSURED ENDORSEMENT Insurance Company 20tit.0y1 b Cfi� j This endorsement modifies such insurance as is afforded by the provisions of Policy # 3�-Z tZCo4c5 I -OZrelating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 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 - - ---0perations-aad uses perfoaaed by.or oa-behaiLof.the�named kaumd- _ 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 IirAits 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 t .2 this endorsement form as a part of Policy# 3X� Zf�.4hI-62 Issued to Named Countersigned by pR0 v r�i7 AS TO FORM "R .r��r SnLeay J-" 'Y City Attorney