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Home My WebLink AboutOLSEN, KRIS 1A Ai - ;¡ 00-l-OIJ1- <.'1 . INSURANCE NOl ON mE WORK MAY _NOT PROCEED CLERK OF COUNCil DATE: .3 .'1-05 FIRST AMENDMENT TO CONSULTANT AGREEMENT ().' p¡!.(J. LD.~) THIS FIRST ENDMENT TO CONSULTANT AGREEMENT is entered into this 9'<£ day of .. , 200,8,y and between Kris Olsen ("Consultant") and tl1 City of anta Ana, a charter city and municipal corporation of the State of Cali fomi a ("City"). Recitals: A. The parties entered into Agreement N-2004-067, dated May 25, 2004, (hereinafter "said Agreement") by which Consultant has provided golf instruction through 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 ofthe 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 1, SCOPE OF SERVICES, shall be amended to remove reference to class dates in order that the classes may be continued through the extended term. 2. Section 3, TERM shall be amended to extend the term through December 31,2005. 3. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. II II II II II II II . . 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 A .~~..~S; . ?fl-.. - ./ ~~~' D. G/ . -+P~RICIAE.HEALY. ! Clerk of the Council . / ~~ AVID N. REA City Manager APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney By: Laura Sheedy Assistant City Attorney APPROVED AS TO CONTENT: CONSULTANT ~{¡h SOLS N V{>~ GERARDO MOU Executive Directo - Parks, Recreation and C mmunity Services Agency \j°cJ AûLf4t'Y( 1/4V!!:- ~s II()Fo OÆJ r:LE ~IJ 'jffL / C¡ry /fir)) ys O¡r-¡(!£ rlUJpv( ¿ffs¡ Y¿/fIZ-s (~s EXHIBIT By,. " /Jo ADDITIONAL INSURED ENDORSEMENT ~ ~ FOR COMMERCIAL GENERAL LIABILITY POLICY dJ-.j; 0/0.5 Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 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 limits 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 ifnot 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 Center Plaza, Santa Ana, California 9270 I. (Completion of the following, including countersignature, is required to make this endorsement effective. ) Effective Policy # Issued to , this endorsement form as a part of Named Insured Countersigned by Authorized Representative 8 May, E, 1llE ':20)~ 5 row n & 8 row r [n c (0,24 [ [ p. 2 BJR CERTIFICATE OF INSURANCE , ~DATE~ 1131687 5/04/05 PRODUCER THIS CERilFICATE IS ISSUEO M A MATTER OF INFORMATION ONI.,.Y K & K Insurance Group, Inc. AND CONFERS NO RIGHTS UPON THE CERTIFICAiE HOLDER rl-flS 1712 Magnavox way CERTIFICATE DOES NOT AMEND. ~TEND OR ALToR THE P.O. Box 2338 COVERAGE AFFORDeO BY THE POLICIES BELOW. Fort. wayne I In 46801 COMPANIES AFFORDING COVERAGE INSUR.D oL5e-.J 7 ~vi 5 COMPANY A LEITER GREAT AMERICAN ASSURJ\NCE COMPA LADIBS PROFESSIONAL GOLF ASSOCIATION AND ITS MEMBERS tV -.Joo1-oiP7 COMPANY B lOD INTERNATION~ GO~P' DRIVE LETTER DAYTONA BEACH, FL 321241092 N<".DO'i-- U"'7-01 COMPANY C LEITER COVERAGES rHI$ 1$ TO CERTIFY THAT THE POLICIes OF INSURANCE LISTED BELOW HAVE BEEN IssuED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERloP INDICATED, NOTWITHSTANDING MY REQUIREMENT, TERM OR CON01TION OF ANY CONTRACT OR OTHER ooc.UMENTWITH RESPECT TO WHICH THIS CEffnFICATE MAY BE ISSUED OR MAY pe;RTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS, EXCI.USION$ ANO CONDITIONS OF sUCH POLICIES. UMfTS sHOWN MAY HAVE BEEN REDUCED BY PAID CL.AIMS . CO, TYPE OF INSURANCE POliCY NUWlER ~!-,CY EFFCCT1\IE POLICY EXPIRATION LTR DATE (r.NIDOIYY) DATE (fNJOOl'(Y) UMITS (;n thouSands) Gtiln9ral Liability 12,01l\M 12,01AM GMeml AggregQ1e . NONE A SU Commercial General Uability GL~0568996'00 1/01/05 1/01/D~ Producl~.co~ Aggrq;31e $ 1000 o Claims Made 1iU0ccu" PersoDal & Adverlif.lng Injlll)' $ 1000 o Qwr\t:!r's & eontractlYS ~rot Each Occ:urrence . 1000 0 Fire DafM!]& (Anyone fire) $ 300 I Medico] E~nae (Anyone person) $ < Pal1icipilnl Legal Liabilitv $ 1nnn AUltImobl1e Uabilly Ct)Il'lblned DAnyillJto Single . Limit BAllovmedautos 6CJdlly SeheduJed autos Injury =' $ o HI"'" autos BodIlV o Non-owned .utos ....juty $ (rr.r aeeldenO o Garage Li.biity Property 0 03mag9 $ EXCI!!:5S Liability APPROVE ) AS TO Each Ag~rl'!g3te 0 Occurrence o Olher lhan UmbreUp form , R1/. I /. . 1ft . $ Workers' COMpensation ~- Statutory and V Lau ~~ Sheedy $ El5Ch AcCId~ Employers' Uability Assist" ity Attorn v $ Dle.ea&e-Policy Linllt $ Di~aBe-Each 5mgkM!le AD&D $ Participant Prlmarv Medical $ Accident ~Medjcal S Weeklv Indemnltv S X OESCRIPTION OF OPERA TIONSILOCA'nONsNEJ-ftCLESIRESTRICTIONSlSPECIAL ITEMS CERTJFICATE HOLDER IS NAMED ADDITIONAL INS~ED AS RESPECTS THEIR INTEREST IN THE OPERATIONS OF THE NAMED INS~ED. RE: KRlS OLSEN ACTIVITIES, GOI,F INSTRUCTION LOCATION, RIVERvIEW GOLF C01.lRSE: CERTIFICATe HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CITY OF SANTA ANA, ITS OFFICERS CANCE.LLED BEFORE THE EXPIRATION DATE THER~OF, THE EMPLOYEES, AGENTS, VOLUNTEERS AND ISSUING COMPANY WILL oNDEAVOR TO MAIL 30 DAYS REPRESRNTATIV.b:;S WRIITEN NOTleo TO THE CERTIFICATE HOLDER NAMED TO PO BOX 1988 M-23 THE LEFT. BUT FAILURE TO MAIL SUCH NOTiCE SHALL IMPOso .sANTA ANAl CA 9:nO, NO OBLIGATION OR L1ABIUTY OF ANY Kli UPON THE COMPANY, ITS AGENTS OR REPRESENTATIIII ~ AVTHO""'EO .".R""",AT1_ :~(; VI ...... / ~J ) '-92 <: May. J. 200 j 1: 2 J QM , B r 0 IV r & B r 0 wr [n c '~ 0 24 [ [ p. 3 POUCY NUMBER: GLPOO00568996400 COMMERCIAL GENERAL LIABILITY CG 20 1101 911 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL liABILITY COVERAGE PART SCHEDULE 1. Designation of Premises (Part Leased to You): 2.. Name of Person or Organization (Additional Insured): AS REPORTED AND APPROVED APPROVED AS TO FORM YB5 2/ C; / Laura Stitt Sheedy Assistant City A HorneY 3. Additional Premium: INCL1lIlED (If no entry appears above, the informa~on required to complete this endorsemant will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is emended to Include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or uSe 01 that part of the premises leased to you and shown In the Schedule and subject to the following addillonal exclusions' This insurance does not apply to: t. Any "occurrence' which takes place after you cease to be a tenant in that premises. 2. structural alterations, new construction or demolition operations performed by or on b<lhalf of the person or organization shown in the Schedule CG20 11 0196 Copyrigh~ 'nsur.""" Servlcee OItlce. Inc.. 1994 Page 1 ot 1 I' , I' 2Y . 2m 1 Tfyl 31' OVin & 3 r OH ,r,c 1',0,2411 ~,L Policy Change 0 0 01 Number GU 269 (11-ll5) THE ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IL 12 01 11 85 POLICY CHANGES 05/04/05 I COMPANY GREAT AMERICAN ASSURANCE COMPANY POLlCY NO. GLP00005689.96400 POUCY CHANGES EFFECTive NAMED INSURED AUTHORIZED REPRESENTAllVE LADIES PROFESSIONAL GOLF ASSOCIATION K&K INSURANCE AGENCY,INC. COVERAGE PARTS AFFECTED PAGE 01 OF 01. COMMERCIAL GENERAL LIABILITY CHANGES THE POLICY IS AMENDED AS FOLLOWS: ADD ADDITIONAL INSURED PER FORM CG 201.1." ADDITIONAL INSURED _ MANAGERS OR LESSORS OF PREMISES. CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES. FORM GAC35BOCG "POLICY CONDITIONS" IS BEING ADDED TO THE POLICY WITH RESPECTS TO THE ABOVE MENTIONED ADDITIONAL INSURED. THE INSURED IS IMPAIRED RESPONSIBLE HEREBY ACKNOWLEDGES THAT THEIR CANCELLATION OF THE POLICY DUE TO THE ATTACHED GAC 35BOCG (07/03) AND WILL BE FOR ANY PREMIUM PAYMENT DUE DURING THE NOTIFICATION PERIOD.. INSURED NAME -DATE APPROVED AS TO FORM ;;/!!D 3/C:; Y Laura Stitt Sheedy Assistant City Attornev Copyright Insurance Sorvicos Office, Inc, 1983 Copyright, ISO Commercial Risk Services Inc 1983 JA 05/04/05 ~'aY. :. 2m 1 :2'F\1 3:cwn ':, Lawn Inc I: a . 2411 F 5 GLP0000568996400 GAC 3580 CG (Ed 07 03) 11-IIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CONDITIONS This endorsement modifies insurance under the following' COMMERCIAL GENERAL L1ABILI1Y COVERAGE PART SECllON IV - COMMERCIAL GENERAL L1ABILl1Y CONDITIONS, 4 Other Insurance is deleted and replaced with the following: o If other valid and colleclible insurance with any other insurer including any folTl'lal self~nsured retention pro- grams is available to you covenng a loss also covered by this Policy, other than insurance that is in excess of the insurance afforded by this Policy, the insurance afforded by this Policy shall be in excess of and shall not conlfibute wilh such other insurance. Nothing herein shall be construed to make this Policy subject to the tenns, conditions and limitations of other insurance o Coverage afforded under this Policy is primary insuranae and OTHER iNSURANCI: shall not apply as respects .SEE BELQW as additional Named Insureds The CANCELLATION condition of this policy is amended by the addition of the lollowing: o CANCELLATiON - The following i. added to the Policy: Itis a condition of the Policy by this Endorsement that the Policy will not be cancelled without 3D days' prior written notice to: 'SEE BELOW __ and further, that the persons named above are not liable for the payment of any prernurm or assessments on this Policy . CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES APPROVED AS TO FORM fi33 ;;1)1 -- Laura Stitt ~ Assistant. City Attorney G^.C 35 80 CG (Ed 07/03) (Page 1 Of 1)