HomeMy WebLinkAboutSkidmore Cheryl 2bCity of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer in a ect. "
Return form to the Clerk of the Council Office (M-30).
Call 647-2520 if you have any questions. ~ ~ ; ~~ "~• F''
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The agreement with Cheryl Skidmore Kids Can Do Gymnastics dba Fun With Horses
No. N-2004-058; N-2004-058-01; N-2004-058-02; N-2004-058-03;
N-2004-058-04
and final payment has been made.
was completed on 12-31-08
Department: PRCSA
Phone/Ext.: 4203
Signature: e ~~~~1~~~
Date: 7-21-09
Revised 05-04-08
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SECOND AMENDMENT TO
CONSULTANT AGREEMENT
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THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is made and
entered into this 30th 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 Kids Can
Do Gymnastics dba Fun With Horses ("Consultant").
RECITALS:
I. City and Consultant entered into Agreement N-2004-058, dated May 1,2004,
hereinafter "said Agreement", by which Consultant has instructed
horsemanship camps 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:
I. 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.
CITY OF SANTA ANA
APPROVED AS TO FORM:
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City Attorney
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GERARDO MO
Executive Direct r
Parks, Recreation and Community Services
ATTESTI
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G!!t.r:i{ (;,:0::: . " II:- C{)i'.'N(:1l
ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP ID RD I DATE (UMlDDIYYYY)
SKJ:DM 1 03/03/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION
Cheval Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Lie. OC94257 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. O. Box 2933 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Fullerton CA 92837
Phone: 714-447-9191 Fax: 714-525-9191 INSURERS AFFORDING COVERAGE NAlC..
INSURED Cheryl Skidmore A1- rRCO<I-o~f/- INSURER A: American Bankers
INSURER B:
Kids Can Do ~astics 03 INSURER c:
dba Fun With orses
187 E. Wilson St. ----.- -.------
Costa Mesa CA 92627 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION 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 CONDmoNS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE U/NDDIYY1 D'k%TIMMlDONV)" LIMITS
GENERAL LIABILITY EACH OCCURRENCE 11.000.000
L-
A X ~ 3MMERCIAL GENERAL LIABILITY SL1103177 08/31/07 08/31/08 I PREMiSES lea occunnc:e) $ 50 .000
f--- ClAIMS MADE ~ OCCUR MED EXP (Any one person) I 5,000
PERSONAL & AI:N INJURY $1.000.000
GENERAL AGGREGATE $2,000.000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS.CDM~PAGG $ 2,000.000
Xl POLICY n ~8T n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE UI'IIT
- .
ANY AUTO NONE (b accident)
-
ALL OWNED AUTOS BDOIL Y INJURY
- .
SCHEDULED AUTOS (Per""......,)
-
- HIRED AUTOS BODILY INJURY
.
NON-OWNED AUTOS (Per accident)
--
- PROPERTY DAMAGE .
(Per Kcldlnt'
GARAGE LIABILITY AUTO ONlY. EA ACCIDENT .
R ANY AUTO NONE OTHER THAN EA ACC $
AUTO ONLY: AGG .
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAlIiIS MADE .
NONE AGGREGATE $
$
R DEDUCTIBLE I
.-
RETENTION $ $
WORKERS COMPENSATION AND I TORY" uMiT's I IO~.
EMPLOYERS LIABILITY NONE
M1Y PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? EL. DISEASE . I!A EMPLOYEE $
It yes., describe under
SPECIAL PROVISIONS below E.L DISEASE. POUCY UMIT .
OTHER
NONE
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is additional insured as sponsor of recreational program
but only insofar as insured operations in connection with said insured.
CERTIFICATE HOLDER
CANCELLATION
CITY SA SMOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Community Development Agency NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
M 25 Attn: Deborah
;po Box 1988 IMPOSE NO OBliGATION DR .1} ILfTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
Santa Ana CA 92702 REPRESENTATIVES.
AUTHORIZED REPRESENT} I~ ~ces
Cheval Insur
ACORD 25 (2001108) 4 ;/2... @ACORD CORPORATION 1988
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AAIS
This endorsement changes the Commercial
liability Coverages provided by this policy
-- PLEASE READ THIS CAREFULLY -
GL.B41
Ed. 1.0
ADDITIONAL INSURED
DESIGNATED PARTY
Iemental Declarations.
Designated party: CITY OF SANTA ANA PARKS & REC
Designated Activity: SPONSOR REC PROGRAM
Designated Interests: KIDS CAN DO GYMNASTICS INe
The Commercial Uability Coverage is amended as follows:
I DEFINITIONS
_.~
activities designated in the Schedule rating to:
The definition of Insured is amended to Include the
following:
a. your operations;
b. premises owned by or rented to you, or
c. other designated interests shown in the Schedule.
Insured also includes the party designated In the
Schedule but only with respect to liability arising oul of
GL-B41 Ed 1.0
Copyright MCMXCI, American Association of Insurance Servlces
AAIS