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Home My WebLink AboutQuiroz, Leticia 1aCity of Santa Ana Clerk of the Council AGREEMENT TERMINATION C~2op 9 1~n ,,,~ ~ Please complete this form when the attached agreement is no longer in effec .~I` f Retum form to the Clerk of the Council Office (M-30). ~ ,~jVq Call 647-2520 if you have an ``''~' y questions. ; ~_~~ jC The agreement with i ~c ~ ~ ~ __ ____________________________________________ G1~ No. .~ ~~ ~ ~ ~ ~ ~ '~ ~ was completed on ~j tr 3Q y and final payment has been made. JJ AGREEMENT Department: ---~-y ~, , NAME NUMQER SUFFIX Phone/Ext.: ~ ' i,~-- ~ ~J QUIROZ, LETICIA N-2004-133-01 1A ~ 'y S QUIROZ, LETICIA N-2004-133-02 1 B QUIROZ, LETICIA N-2004-133-03 1C ~--~~~~ Signature: ~ QUIROZ, LETICIA N-2004-133-04 1D ~`-'~ ''~ Date: /j ~ J //~ ~~~ Revised 05.04-0$ ~ ~-~ ('' 4J N-2004-133-01 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES 1-I-oLP CLERK OF COUNCIL DATE: 10-lq- 05 FIRST AMENDMENT TO CONSULTANT AGREEMENT 0: ?I) /;;1.) nSCp.-v THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into on September 20, 2005, by and between Leticia Quiroz ("Consultant") and the City of Santa Ana, a charter city and municipal corporation ofthe State of California ("City"). RECITALS: A. The parties entered into Agreement N-2004-I33, dated November 4,2004 (hereinafter "said Agreement") by which Consultant has provided teacher assistance for jail inmate instruction in GED and computer classes. B. In accordance with the terms and conditions of said Agreement, the parties wish to extend said Agreement for an additional one-year term and increase compensation to pay for services during the extended term. 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: I. Section 2.a., COMPENSATION, shall be deleted in its entirety and replaced with the following: "a. City agrees to pay, and Consultant agrees to accept as total payment for its services, an hourly fee of $15.00. The total sum to be expended under this Agreement shall not exceed $ I 0,000.00 per fiscal year, during the term ofthis Agreement." 2. Section 3, TERM, shall be amended to extend the termination date from August 31, 2005 through August 31, 2006. 3. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. 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 ATTEST: ~L2.- DAVIDN. AM City Manager //~' -, \~e./ --.( PATRICIA E. HEAL Clerk of the Council APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney / Of ~ 'i . ,..., ',",' r; .", By. r;{;uA./('" '..J',. Laura Sheedy j Assistant City Attorney ~/ RECOMMENDED FOR APPROVAL: CONSULTANT ~w(\J~ PAULM. WALTERS Chief of Police ~ LETICIA QUIROZ ,. :ANTA ANA RISK ~MT. . Fax:714-647-S311 Mar 82006 11:22 P.Ol BV ANSTON INSURANCE COMPANY CERmICATE NO.: Post-it' Fax Note To 7671 Date.:1 "om CERTIFICAl EXCLUDES COVERAGE FOR NOMINEE EVENTS. S SPECIAL EVENT - Co. Phone # Fax. PRODUCER: PUBLIC ENTITY (ADDmONAL INSURED) City of Santa Ana Driver Alliant Insurance Services in CoJ\jullction with 20 Civic C....t.r Plaza, M-28 Apex InsU(llnce Services Santa Ana, CA 92701 P. O. Box 28323 Santa Ana, CA 92799-8323 (949) 660-8163 Li=e No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Leticia Quiroz )J - ~~'-I- /33' TYPE: Instruct1onallSelf-Imnrovement N - -;).004 -( 33 -01 DATE(S): January 1 - December 31. 2006 LOCATION: Santa Ana Jail This is to certify that the policies of illsurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement>, terms or conditions of any contract or othsr 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. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTERPOUCY NUMBER: 04SEPlOOOOOl MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2006 EXPIRATION: JANUARY 1, 2007 COMMERCIAL GENERAL LIABILITY OCCIJRll.ENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $ ;1,000,000 Products & Completed Operations 1,000,000 Personal & Advertising Injury 1,000,000 Bach Occurrence Limit 1;000.000 Fire Damag< (Any One Fire) 50,000 Medical Payments (Any One Person) 5,000 The limits of insurance :apply $ep.ilr~Y to eu:h event insl..lfl!!d by this pOlicy as jf.a separate policy of insurance has been iss.ued for that event. <<Who is insured" is amendoo to include, .as a.n insured, the person or organization ahQwn in thiQ ~hedule, but only with respect to liability arising out of the ownership, maintenance Of use of the premises used by the named insured (evetltholder). this insurance d~ not apply to: Any "occurrence" whicb takes place after the ~cnt holder ceases to be a tenant in that premises. 011{J!:R ADDITIONAL INSUREDS r.ANrFT T A TION: Should the above de:;lcril::Jed poli.cy to canccl1cd before the expiration date thereof, t1u: issuing company will mail 30 days written notice to tbe certificate holder and addjtional imiurec:1!;; listed. . ~;Z~ , ' l ,'.' "-,"""10 .,--.......-.....,- r.",-' 1 ;-: ,I.'" ',,' AUTHORlZED REPRESENTATIVE: DATE ISSUED: Januarv 20. 2006 ~ ,., ----- "., . ,,~~. < . ..... '~'-.. -......:/ y . ,_ " _ --.,,:' ",':,1, '\ ':"; :""~.!~: . \.,. , bV ANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE OF INSURANCE EXCLUUES COVERAGE ~'OR NOMINEE EVENTS. SEE SEPARATE APPLlCATIO]'(S FOR NOMINEE EVE:'ITS. SPECIAL EVENT LIABILITY PROGR~M PRODL;CER: PUBLIC ENTITY (ADDITIONAl. INSURED) City of Santa Ana Driver AHiant Insurance Sl:fvices in conjunction with 20 Civic Center Plaza, 1\1-28 Apex Insurance Services Santa Ana, CA 92701 P. O. Box 2R32J Sanla Ana, CA 92799-8323 (949) 66U.R 163 Lil:tl1se No~ OC 36861 ],(A~1ED lliSL:RFD (EVENT HOLDER): EVENT I"iL'ORVlA TION: l,cticia Quiroz 1v',(J.OVI-/33- 01 TYPE: lnstructional/Self-J mnrovemenl DATE(S): .January 1- December 31. 2006 LOCATION: Santa Ana Jail This i" to certify Lhat the policies of insurance hstcd below have been issued to the insured named above for the policy period indIcated. Notwithstanding any requirements, teffilS or conditions 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 lu all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. I~SlJRAXCE CARRIER: Evanston Insurance Company :VIASTER POLICY NUMBER: 04SEPIOOOOOI MASTER POLICY DATES: E~'FECTlVE: JANUARY 1,2006 EXPIRATI01>": JANUARY 1,2007 COMMFRCIAL GE:-.!FRAL LlARILllY QCCURRENCF FORM DFI1{JCTlBLE: ;-';ONE GencralAggl"cgalc Limit $2,000,000 Produ~ts & Clllllpkled Operations 1,000,000 Pnsonal & Adverli~ing Injury \,000,000 Facl1 OCClllTl:nce Limil 1.000.000 Fin: Dnmngc(AnyOne Fine) 50,000 \1eJicall',tymcnts (AnyOne Persoll) 5,000 The limits of insurancc apply separately to each even< in~llltd hy this policY as iea scparah; pulicy of insuram:e Ilas hecn Issued for tllat evcnt "\Vho is ill~lIrtd" is amended to im:llIJe, as an insured, the person or organization .hOWll ill this schedule, but only with re~pcct to liubility arisil1E, nut 01 the u\vner~hip, maintcnan\:e ur u.e uCtlle premises used hy 1\1<.: mllll\:d insured (event holun) This insurance does not apply to: i\ny "uc..:um:nn:" whid1 tukes place alter till: event hulder ccase's to hc, a tenant in tllut prc\TIisc~. OTHER ADDITIONAL I:'iSLJREDS rANC1:lL\T\ON~ SliL1llld the above describ<.:u prllicy to cancelled bermc: Ihe expiration date thL,reoL the issuing cumpany will mail 30 days written n()\ict to tile certificate hL1IJ<.:r awl additiOl1ul insureds li~ted ALiTHORlZED REPRESE'orl A TIVE: / -- ,J~ p: ~N DATE ISSl~ED: _lanuarv 20.2006 Ifl<.t>'-d'l , c EVANSTON INSURANCE COMPANY CEIHIFICATE :'iO.: 2007-08 CJi:RTlFICATE OF INSURANCE EXCLlJD~:S COVERAGE FOR NOMINEE F:VENTS. SEE SEPARATE APPLICATIONS F'OR NOMINEE Ji:VENTS. SPECIAL EVENT LIABILITY PROGRAM !f I'RODlJCcR PUULIC ENTITY (ADDITIONAL INSURED) I, City of Santa Alia II if ,\illant Insurance SerVH.:e:.:, 1m.:, in conjunction with 20 Civic Center Plaza, M-28 ,I }\po Insuram:e Service:; Santa Ana, CA 92701 'I II O. Box 6450 r ~.:wport Beach, CA 92658 I (<J49) 660-8163 i LlCt"llSt,;' No: OC 36861 I !\AMED INSURED (EVENT HOLDER): EVENT INFORMATION: I) Leticia Quiroz N-2.0cY-133 TYPE: Self-Improvement ii 71 I W. First Street. E-103 N-2DCY-J 3.3-0\ DATE(S): 01101107 - 12131107 II SOlllta Ana. CA 92701 LOCATION: Santa Alia Jail ~._- **L1quor LLabllity after 2am 0 :: 'llll~ i~ to certify that the policies of lllsurance listed below have been issued tu lhe insured named above for the policy period 1: llldic<.lted. Notwithstanding any reqUIrements, tenus or conditions of any contract or other document with respect to which this Ii ..:~rtilicatl' may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, ~ "::\:Clll.~lons and conditIons of s.uch policIes. LLUlits shown may have been reduced by paid claims. I ''''~'m '~m. ","~ '"'..- ,"-, : 'lASTER POLICY NUMBER: 04SEPIOOOOOl I EXPIRATION: JANUARY 1,2008 ' 'lASTER POLICY DATES: EHECTIVE: JANUARY 1,2007 ,I :: (l\Hvll-I-/:('I\1 \irNLRAI UAI3IIITY OCCURRENCE FORM DEDUCTIBLE: NONE :1 ',cllcl-~1 _'\ggreg:.Jl~ Llmil $ 2,000,000 j hldm;t-; & Completed Operatlom j ,OOO,OUO ~ I'cl~i<lllUI & :\ullnllslI1g Injury 1,000,000 I J.:h ()':cllrr~ll(l: l.llll11 I ,000,000 i I in: Dalllage (AllY One Firc) 50,000 .I ro..lcoi..:al Pavmems lAnyOnel'erSl1nj :',000 ~ . I ~ Ill' IllTlits ofinslIran<.:c apply separately \() each event insuretl by this policy as if a separate policy of insurance has been IssUed tor that C'o'cnt. I , ! \'dll' i, insured" i.;; amended w include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out ofthc l' '\Hr,llIp, lIlaiTlk'n;Jlil;e or u~e of the premises used by the named insllred (event holder). 'l11is insurance does not apply to: Any .'occuITcncen which takes place !L ..ih;:' th..: ~\'~nl h"ldn Lca~l~-, tll Iw a ttml!ll i" lhal prt:mises W._' ..___ _._ OTHER ADDITIONAL INSUREDS I~ -...-.. ! P// (? I 1}7~ " I~- ;! _.,~ II ..A~lliJ..A TI( IN SlillUld till: <Jbuve de,eribnl policy lU cancelled before the' expiration date thereof, the issuing company will mail 30 days written notice to the ! .l:r:iliLJte hnldtl,mdaddilillnal insureds listed A'~;f ~ \lJTHORIZED REPRESENTATIVE: DATE ISSUED: _---kHlli!IY__Ol'--2_QO~ r~'I'JII!rored In' Risk MUJHIKement Division by: 11!>~ 'I/?~'kU1~ Page 1 of2 Mitre-Ramirez, Norma From: Sheedy, Laura Sent: Wednesday, February 06, 2008 10: 16 AM To: Morales, Briza Cc: Mitre-Ramirez, Norma Subject: RE: Instructor's at Jail IN-2004-133 !N-2004-133-01 < IN-2004-133-02 IN ! -2004-133-03 I have forwarded this string of emails to let Norma know that commercial general insurance is not required for these instructors: Leticia Quiroz Daniel Achatz Felice Stinson Luis Martinez Norma, please let me know if you need something more. Thank you Laura From: Morales, Briza Sent: Wednesday, February 06,2008 10:14 AM To: Sheedy, Laura Subject: RE: Instructor's at Jail Does the Clerk's office need anything from you in order to note this on their database? Briza Morales Personnel Secretary Risk Management Division (714) 647-5475 Please note new email address: bmorales5@santa~ana.org From: Sheedy, Laura Sent: Wednesday, February 06, 2008 10:05 AM To: Morales, Briza Subject: RE: Instructor's at Jail They do not need insurance to provide counseling services. They will require Workers' compensation if they have any employees. Thanks Laura From: Morales, Briza Sent: Wednesday, February 06, 2008 9:57 AM To: Sheedy, Laura Subject: Instructor's at Jail Laura: These are the names of the instructors at the jail: 2/6/2008 Page 20f2 Leticia Quiroz Daniel Achatz Felice Stinson Luis Martinez Thanks for looking into this Briza Morales Personnel Secretary City of Santa Ana Risk Management Division 20 Civic Center Plaza, M-28 Santa Ana, CA 92701 Ph: (714) 647-5475 Fx: (714) 647-5311 bmorales5@sa!l!~~J!!H!",Q!1J 2/612008