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Home My WebLink AboutFETTERS, PAUL 1ACity of Santa Ana - Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and alf amendments (if any) are no longer in effect. Return form to the Clerk of the Council Office (M-30). Call 647-6520 if you have any questions. The agreement with Paul Fetters dba The Training Spot COTC Office Use Only 7015 SPAY -11 P9 -�: 19 S lr;A, K' in LSa friY:i) No. N-2002-150 was completed on 04/30/2015 and final payment has been made. (List all amendments. Use space below if needed.) N-2002-150-01 Department: Police Department N-2002-150-02 N-2002-150-03 Phone/Ext.: (714)245-8004 Signature: Dater 4/30/2015 Revised 08-2310 INSURANCE -- - oil r�LE WORK MAY _W1 PROCEED CLERK OF COUNCIL DATE; �c. vv+`IJ�a�us1 lt/- l51) _01 FIRST AMENDMENT TO CONSULTANT AGREEMENT TPIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into this / day of Zoq 2004, by and between Paul Fetters dba The Training Spot., a California corporatio ("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). Recitals: A. The parties entered into Agreement N2002 -15m dated October 4, 2002, (hereinafter "said Agreement") by which Consultant has provided health and fitness classes to the City's Police Department. B. In accordance with the terms and conditions of said Agreement, the parties wish to renew said Agreement for an additional one-year term 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 First Amendment to Consultant Agreement, the parties agree as follows: 1. Section 2, COMPENSATION, shall be increased $1,000.00 for a total not to exceed amount of $4,000.00. 2. Section 3, TERM, shall be amended to extend the term as follows: "This Agreement shall commence on October 4, 2002 and terminate on June 30, 2005 unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Chief of Police and the City Attorney. // // // // l •. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Consultant Agreement on the date and year first written above. ATTEST: PATRICIA E. HEALY Clerk of the Council APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By - Laura Sheedy Assistant City Attorney APPROVED AS TO CONTENT: r\ PAUL M. WALTERS Chief of Police CITY OF SANTA ANA AVID N. REAM City Manager CONSULTANT D tmu:D PAUL FETTERS * 06/03/2004 15:59 8585190822 FITNESS AND WELLNESS PAGE 02/03 ACORDI (MMIDD1YYYY) k CERTIFICATE OF LIABILITY INSURANCE I JUN 304 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FITNESS AND 1 IELLNESS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 360 STEVENS / VENUE, SUITE 206 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SOLANA BEAC i CA 92075 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # _ Agency Lie*:OD28716 INSURED INSURER A: ZURICH AMERICAN INSURANCE CO. _ PAUL H. F 'ITERS INSURER B: DBA THE' RAINING SPOT _ DBA -._.. _. INSURER C: 7602 ONTO RIO DRIVE HUNTINGI ON BEACH CA 92848 INSURER D: INSURER E: rn�ee A r_aa THE POLICIES OF ISURANCE LISTED BELOW HAVE BEEN k9$UEO TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED DR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREG TE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A1313'L---- ... — POUCYRFFEGTFVE POLrCYExPIRAnON ...--- TYPE (=INSURANCE I POLICY NUMBER DATE MrDUNY DATE MMIDD LIMITS DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT GENERAL LIABILITY FOL9012320-00 I MAY 31 04 MAY 31 05 EACH_OCCURR�NCE � 1,000,000 $ 100,004 Attention: Jeffrey E. Frick, CEO X C01 MERCIAL GENERAL LIABILITY --•_ - CLAIMS MADE17X I OCCUR DAMAGI! TO RENTED AR"$98 (Ex .oa MED. EXP (Any one perean) $ 2,500 $ 1,000,000 A PERSONAL &ADV INJURY 8 3,000,000 GENERAL AGGREGATE GE IL AG SREGATE LIMIT APPLIES PER:i PRODUCTS-COMPIOP AGG. $ 3,000,000 x I POL 'Y PRwEcr LOC AUTOMO ILE LIABILITY i AN) AUTO COMBINED SINGLE LIMIT (Ea Rccldenl) $ ALL )WNED AUTOS BODILY INJURY SO °DULED AUTOS (Per perecn) S HIR D AUTOS NOI-OWNEDAUTOS BODILY INJURY (PereCCldeni) $ — .—.. ........—.— PROPERTY DAMAGE Per Bccld6nt GARAGE .IABiLJTY AUTO ONI.Y • F.A ACCIDENT OTHER THAN EA ACC AN` AUTO $ AUTO ONLY: $ EXCESS, UMBRELLA LIABILITY EACH OCCURRENCE $ OCA UR CLAIMS MADE AGGREGATE AGGREGATE $ ... --- i A DE( JCTISLE $ RE" nNT10N $ $ WORKERS COM SENSATION AND EMPLOYERS' LI %BILITY--- ANY PROPRI67011 WRTNEWEXECUTIYEjl- / L� WC STATU• UTHsR 3 E.L. EACH ACCIDENT El, DISEASE -EA EMPLOYEE OMWeRtMEMBEF EXCLUDED? $ - Rym, Csfarltm um v BPEGAL PROVIS14 43W0. E.L. DISEASE•POUCY LIMIT $ OTHER: DESCRIPTION )F OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS THE CITY OF 3 NTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701. ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESE JTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIC NS AND USSES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED, n CDTIElf'ATE' 1^1 Man f•ArdPCI f ATUIrJ ACORD 25 (2( )1/08) Certificate # 3037 L)UZ7571 b W AL:UKlLI L:UKYUKA I IUIN l VtIb dd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE- THEREOF, THE ISSUNG COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT CITY OF S 1NTA ANA FAILURETO DO 90 $HALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE 20 CIVIC C ENTER PLAZA INSURER, ITS AGENTS OR REPRESENTATIVES, SANTA AF 4, CA 92701 AUTHORIZED REPRESENTATIVE! Attention: Jeffrey E. Frick, CEO ACORD 25 (2( )1/08) Certificate # 3037 L)UZ7571 b W AL:UKlLI L:UKYUKA I IUIN l VtIb dd 06/03/2004 15:59 8585190822 FITNESS AND WELLNESS PAGE 03/03 DA.TI :. June 3, 2004 POLI ;Y NUMBER: EOL9012328-00 INSU ;,,ED NAME: Paul H. Fetters THI S ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CG 20 10 11. 85 A )DITICONAL INSURED --OWNERS, LESSEES OR CONTRACTORS (FORM B) This ei 3orsernent modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Nance - f Person or Organization: City of Santa Ana 20 Civic Center Plaza Santa. Ana, CA 92701 (If no ( 1try appears above, information required to complete this endorsement will be shown in. the Declarations as applicr -)lc to this endorsement.) WHO * S AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedt [c, but only with respect to liability arising out of "your work" for that insured by or for you. Primar - Insurance it is agreed. that such insurance as is afforded by this policy for the benefit of the additional insure( shown shall be primary insurance, and any other insurance maintained by the additional insureds) shall be excess tnd non-contributory, but only as respects any claim, loss or Liability arising out of the operations of the named nsured(s) or its subcontractors, and only if such claim, loss or liability is determined to be soley the negli.gt -.ice or responsibility of the named insured. Notice :)f Cancellation or Non -renewal it is agreed that the company will provide the additional insured shown below with 30 days notice of cancellation of this policy in the event of cancellation due to company election only. Hold F armless Clause it is agreed that such insurance as is afforded by this policy for the benefit of the additional insure( shown below shall indemnify and hold hamn]ess the additional insured, but only as respects any claim, loss or liah ity arising out of the operations of named insured(s) or its sub -contractors. Severa Pility of interest as is afforded by this policy for the benefit of the additional insured shown below shall apply separai 4y to each additional insured against whom a claim is trade or suit is brought, except with .respects to the limits 4 f insurance under this policy. WAIVER OF SUBROGATION It is agreed that we waive any right of recovery we may have against the person or organization shown in the schedule because of payment we make for injury or damage arising out of. "your work" done under a contract with that person or organization. The waiver applies only to the person or organization shown in the schedule. SCHEDULE NAME OF PERSON OR ORGANIZATION FROM FITNESS AND WELLNESS INSURANCE %N)JUN 20 2005 12: 01/ST.12:00/No.6820420804 P 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (Tf012008 ) 0812012008noo6 TM. IYPE OF INSURANCE DDNERALLIAIRIm X� COMMERGAL GENERAL LW&LItY PRODUC ER Ph": ISM) M-5075 Pee IMel E1M )SM FITNESS AND WELLNESS INSURANCE AGENCY 380 STEVFNS AVENUE, SUITE 200 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE GElTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SOLANA BEACH CA 92076R Tilt owAATE Tonamo s 100,000 PREMIEEE bRca..w — INSURERS AFFORDING COVERAGE MAIC # Ammi LION: 0D28718 _ VISUREDINSURER PAULH, FETTERS NI - P00d— 15 L DEBAIHETRAINING SPOT �OZ 78Q2 OITA=DRIVE HLJINT14GTON BEACH CA 9268 A: Zurich Mxrban hlsuranee _ INSURER B: JeFrickk,, INSURER C: INSURER D: A INSURER E: G CFRPAIEB THE POIIQI$ OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVIITNSTANORG ANY REG UNEMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TAB CERTIFICATE MAY DE ISSUED OR MAY PERTAN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ AWREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IWR' LTR MBR IYPE OF INSURANCE DDNERALLIAIRIm X� COMMERGAL GENERAL LW&LItY POLICY HUASER EOL9012328-01 M Yffm` a CATRImplYm 06131106 ralcY MI Ttn, 06!31/08 LIMITS EACH OCCURRENCE i 1,000,000 owAATE Tonamo s 100,000 PREMIEEE bRca..w — MED. EXP (Any" WB l E _ 2,666 SANTA ANA, CA 92701 AUTHOMMO REPRESENTATIVE / ,CCEO MAIMS MADE n OCCUR JeFrickk,, PERSONAL 4 ADV INJURY s 1,000,000 A GENERAL AGGREGATE 3 3,060,000 GFrv'L AODREOATE LIMIT APPLIES PER: PRODUCTS-OOM=AGG i 3,000,000 X POLICY JPERm LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E IF.B iCOiNBnq ANY AUTO ALL OWNED AUTOS BODILY INJURY (PN Batson) i SCHEDULED AUTOS BODILY INJURY i (Be Rwid.Rq .. HREDAUTOG NON -OWNED AUTOS PROPERTY DAMAGE E (PN occident GARAGE LIAyUTY AUTO ONLY• EA ACCIDENT i OTHER THAN FA ACC i AUTO ONLY: AGO S ANY AUTO E)CESS( UMBRELLA LIABILITY FACHOCCURRENCE E AGGREGATE .._� OCCUR F, CLAIMS MADE DEDuDEDUCTIBLEORNI APPROV i. ) I ,1k i'rJ F i s RETENTION S — WnRHERarLIABILBATIDN AND EMPLOYER%LI1IBILITY RIYPIIYAIINRI.'ARTNEI..FGURW PgICB.MMBBR lYBLWYRT ..IIA AsbiSt$ 7 SL L SIi C�(jV L (..TLB �?ItOT;�� Y,CyUMIT GSR @ E.L. EACH ACCIDENT i E,L.CISEASE-EAEMPLOYEE E E1. WASE -POLICY LIMIT E im AAMmRunr TIaA4 MRWlglibnw OTHER: DESCRM'TI7N OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS THE CITY OF SANTA ANA. 20 CMC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701. ITS OFFICERS. EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREDS WITH REGARD TO LIABILITY AND DEFENSE OF SUITS ARISING FROM THE OPERATIONS AND USSES PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. ERTIFICATE HOLDER CANCELLATION C SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORETHE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO CITY OF SANTA ANA DO SO SMALL IMPOSE NO OBLKIATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS 20 CMC CENTER PLAZA AGENTS OR REPRESENTAnVES. SANTA ANA, CA 92701 AUTHOMMO REPRESENTATIVE / ,CCEO AltenOon: CHRIS WO.LIAMS JeFrickk,, ACORD 26(2001/09) Certificate# 22764 W ACORD CDRPURAINUR Teen I FROM FITNESS AND WELLNESS INSURANCE (MON) JUN 20 2005 12:021T.'2:00/No.6820420804 P 2 POLICY NUMBER: EOL9012328-01 COMMERCIAL GENERAL LIABILITY 'THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS (Form B) "This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY SCHEDULE Name of Person or Organization; CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section ll) 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 work' for that insured by or for you 10 r—ORAQ CG 20 10 1185 Copyright. Insurance Services Office, Inc., 1984 Certificate 0 22764 FROM FITNESS AND WELLNESS INSURANCE (MON)JUN 20 2005 12:02/ST.12:00/No•6820420804vP ADDITIONAL INSURED ENDORSEMENT U InsurenceCompany Z-LtguA �M I��i iNSUIt?A✓JC [�. This andorsement modifies such insurance as is afforded by the provisions of Policy # EDOG3390 -vii relating to the following: Cine* 3lpgs 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Califomla 92701; ft officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds') with regard to Nability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to ciafms arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is affordad 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 limits of liability. The Inclusion of any person or organization as an Insured "I 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 cancelled, 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 Canter Plaza, Santa Ana, California 92701. (Completion of the following, inotuding c:ounterslgnature. Is required to make this endorsement affective.) Effective Vh%-i -3t; 2ppy5 -1 P01 31, this endorsement form as a part of Policy# tMtF10la3;-e—oW G t�►�Tax 3r�g� Issued to Countersigned by_...__ Representative '.crura Slit: Sl:�cdy . 45��'uult C7tm ,'FCnr-,rr