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Home My WebLink AboutRIVERA, SALOMON 1bG 200b J AGREEMENT TERMINATION MHO ,E,ff # 6 v'i`a Please complete this form when the attached agreement is no longer in-effect. (il Return form to the Sr. Deputy Clerk of the Council (M -30). Call yquhavxaiy questions. The agreement with Si/L f,no j ,lzg P� , No. -* H z was completed on 1-43 L I Ou and final payment has been made. M - ).004-033 Department: Me-S4 Signature: &L QJO-W, Q iAd Date: City of Santa Ana Revised 8 -7 -03 Clerk of the Council SECOND AMENDMENT TO CONSULTANT AGREEMENT / (",^ .�Lpoy — v.3v -u �_ ASURANCE NL_ ON FILE 14ORK MAY NOT PROCEED CLERK OF COUNCIL GATE: , -3i -o & THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is made and entered into this 30'h day of December 2005 by and between the City of Santa Ana, a charter city and municipal corporation of the State of California ( "City ") and Salomon Rivera ( "Consultant "). RECITALS: City and Consultant entered into Agreement N- 2004 -033, dated April 27, 2004, hereinafter "said Agreement ", by which Consultant has instructed salsa dance classes through the City's leisure class program. 2. In accordance with the terms and conditions of said Agreement, the parties wish to renew the said Agreement for an additional one -year period. WHEREFORE, in consideration of the mutual and respective covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, City and Consultant agree as follows: Section 3, TERM, shall be amended to extend the term of said Agreement through December 31, 2006. 2. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, City and Consultant have executed this Second Amendment to Consultant Agreement on the day and year first set forth above. APPROVED AS TO FORM: W.FU CHER City Attorney ;i: t.z�ldlMClL CITY OF SANTA ANA GERARDO MOl f ET Executive Director Parks, Recreation and Community Services Agency EVANSTON INSURANCE COMPANY CERTIFICATE NO.: - CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM AUTHORIZED REPRESENTATIVE: DATE ISSUED: Febhualty 23, 2005 PUBLIC ENTITY (ADDITIONAL INSURED) FAIWant Insurance Services C1t y o b Santa Ana 23 20 C.iv.ic Center[. Ptaza, M -28 92799 -8323 Santa Ana, CA 92701 3 cense o: OC 36861 NAMED INSURED (EVENT HOLDER): o4:? Satomon R.iveha EVENT INFORMATI N: TYPE: `nso-tionat -SaCaa Dancing 709 S. Pahton Street /�` °( DATE(S): 2/23 Santa. Ana, CA 92701 LOCATION: SOut lulebt Sen:iae Center This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms 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 to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 05SEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY 1, 2006 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit S 2,000,000 Products & Completed Operations 1,000,000 Personal & Advertising Injury 110001o00 Each Occurrence Limit 11000,000 Fire Damage (Any One Fire) 50,000 Medical Payments (Any One Person) 51000 The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. "Who is insured" is amended to include, as an insured, the palm or organization shown in this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the 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 ADDITIONAL INSUREDS APPROVED AS TO FOR,,. t hee Assistant City Attorn-- 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: Febhualty 23, 2005 EVANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) City of Santa Ana Driver Alliant Insurance Services in conjunction with 20 Civic Center Plaza, M -28 Apex Insurance Services Santa Ana, CA 92701 P. O. Box 28323 Santa Ana, CA 92799 -8323 (949) 660 -8163 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Salomon Rivera A) ..33 TYPE: Salsa Classes 709 S. Parton Street DATES O January 1 - December 31, 2006 Santa Ana, CA 92701 LOCATION: Southwest Senior Center N— �CO�l— c33 —c.,Z This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms 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 to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 04SEPI00o001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2006 EXPIRATION: JANUARY 1, 2007 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit 52,000,000 Products & Completed Operations 1,000,000 Personal & Advertising Injury 1,000,000 Each Occurrence Limit 1,000,000 Fire Damage (Any One Fire) 50,000 Medical Payments (Any One Person) 5,000 The limits or insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. "Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the 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 ADDITIONAL 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: Ltsl1