HomeMy WebLinkAboutNEGRETE, ABRA 2AClops
AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer fn eTfect, Q
Return form to the Sr. Deputy Clerk of the Council (M -30) Call 647=5
38j yPI' any
questions. IT
The agreement with No.h/ -- i3Ot3 —153 -01
was completed on "�
�� ���`y=J and final payment has been made.
N - 2003-153 Department: YU.S A--
Signature: S, D � Ax ,IjUao
Date: u l 1w. dq
City of Santa Ana
Revised 8 -7 -03 Clerk of the Council
Ai -,}.{)03 -1$3-of
INSURANCi:. UN ,II
WORK MAY PRocm
UNTIL INSURer~CI D'IRt~
1~-31-05
CLERK OF COIINell
DATE: 1;1. '50.-0'$
C-: pi2.tJ;
Ll>'~
FIRST AMENDMENT TO
CONSULTANT AGREEMENT
THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
this 3o~ day of 't)~-(.V' ,2004, by and between Abra Negrete
("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 N-2003-153, dated December 31, 2003,
(hereinafter "said Agreement") by which Consultant has provided "Mommy and Me"
music classes for the City's leisure class program.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
renew said Agreement for an additional one-year period.
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 3, TERM shall be amended to extend the term through December 31, 2005.
2. Except as hereinabove amended, all terms and conditions of said Agreement shall
remain in full force and effect
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the date and year first written above.
CITY OF SANTA ANA
APPROVED AS TO FORM:
~~o~
Ji5 PH W. FLETC R
City Attorney
GERARDO MO T
Executive Direct r - Parks,
Recreation and Community
Services Agency
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.:
CERTIFICATE OF INSURANCE ,
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPUCATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED)
Driver A1liapt Insurance Services Cay 06 Sllnta. Mtll
P. O. Box 28323 20 Civic. Ce.n;tQJt, P.iaZll, M-28
Santa Ana, CA 92799-8323 Sllnta. Ana, CA 92701
(949) 660-8163
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
AbJr.ll Ne.gJr.e.te. TYPE: I vu,;tJl1lr;tj ol11l1-mlu,A c.. hA YlgiYlg
223 S, Vove. S.tJte.e.t DATE(S): llQll0~ - 17/~110~
OJta.Ylg e., CA 92869 LOCATION: , nu'~ RnlAlP j V1grOWJ-Oh
1bis is to certify that the policies of insurance listed below bave been issued to the insured named above for the policy period
indicated. Notwiths1anding any requirements, terms or conditions of any contnlCt or other documenl 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,
exclu3ions and conditions of such policies. Limits shown may bave been reduced by paid claims,
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: 05SEPIOOOOOI
MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2005 EXPIRATION: JANUARY 1,2006
COMMERCIAL OENERAL LIABIUTY OCCURRENCE FORM DEDUCTIBLE: NONE
Oencnl Aggnple Limit $ 2,000,000
Products '" Completed Operations 1,000,000
Personal'" A_.. Injury 1,000,000
cach Occurrence Limit 1,000,000
Fi.. Damage (Any One Fire) 50,000
Medical Paym:nts (Any One Penon) 5,000
The limits of insurance apply separately to each event insured by this policy as if a separate policy of inlW'l.l'lCC has been issued for that evenL
"Who is insured" is amended to include, as an insured. the person or organization shO\W in this schedule, but only with respect to liability arising out ofthc
ownership, maintenance or use ofthc premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place
after the event holder ceases to'be a tenant in that premises.
OTHER ADDmONAL INSUREDS
,
CANCELLATION: Should the above: described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the
certificate holder and additional insureds listed.
"
AUTHORIZED REPRESENTATIVE:
~/~
DATE ISSUED:
IZ/28/04
~'Aoy~.