HomeMy WebLinkAboutNATIONAL HERITAGE FOUNDATION 2AAGREEMENT TERMINATION
Please complete this form when the attached agreement is no, onges 'in Ieffect 4
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Return form to the Sr. Deputy Clerk of the Council (M 30) gall 647-523$ a�yQt Lave any
questions.
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The agreement with N6-X`oZD0 &-1'13 Cf Al
was completed on and final payment has been made.
Department: T&A
Signature: SA-Q �-%VACA, /VC& j
Date: q h-I I L'
City of Santa Ana
Revised 8-7-03 Clerk of the Council
INSURANCE NOT ON FILE
WORK MAY NOT PROCEED
CLERK OF COUNCIL
DATE: 7 —,w7_c c,
ie.771axp"%
A-2006-143
FIRST AMENDMENT TO AGREEMENT
THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
on June 19, 2006, by and between National Heritage Foundation fbo Academy of
International Dance, a Non-profit Foundation ("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 Consultant Agreement a-2005-146, (hereinafter "said
Agreement") by which Consultant has provided dance instruction for participants
registered through the City's Parks, Recreation and Community Services Agency.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
extend the term for an additional one-year period and to increase the compensation to
pay for services during the extended term.
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 Agreement, the parties agree as follows:
1. Section 2.a., COMPENSATION, shall be deleted in its entirety and replaced with the
following language:
"City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in Exhibit A. The total sum to be expended under this
Agreement shall not exceed $22,000.00, annually, during the term of this
Agreement."
2. Section 3., TERM, shall be amended to extend the termination date from June 30,
2006 to June 30, 2007.
3. Except as herein 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.
ATTEST:
PATRICIA E. HEA
Clerk of. -the Council
APPROVED AS TO FORM:
JOSEPH W.FLETCHER
City Attorney
By: j
Laura Sheedy
Assistant City Attorney
APPROVED AS TO CONTENT:
Executive E
Parks, Recra
Community
and
es Agency
CITY OF SANTA ANA
At DAVID N. PEAM
City Manager
CONSULTANT
JO HOUK
CEO
EXHIBIT A-2
SCOPE OF SERVICES
1. Consultant will prepare and instruct students in martial arts techniques, with
an emphasis on Karate.
2. Consultant will confer with City to set the time and location of the classes,
including days and hours of class and holidays to be observed.
3. Consultant will provide and be responsible for equipment, records, personnel
and clean up of the facilities and materials necessary to ensure the safety and
effectiveness of said instruction.
4. If Consultant allows others to teach his classes, those teachers must be over
21, have obtained and maintain an instructor rating and be covered by
Consultant's insurance. Black -belt rated students may warm up beginning
students, however, Consultant must be present at all times.
CLASS SIZE — REGISTRATION
1. The minimum number or participants is 20 per class, the maximum is 40.
2. No registration will be accepted after the second week of classes.
3. In the event the minimum number of enrollees is not realized by the second
week of classes, the class shall be cancelled, Consultant will be under no
obligation to provide services and the City will have no obligation to pay
Consultant compensation.
FEES
1. Each participant shall pay a $20.00 per child, $30.00 per adult, class
registration fee per monthly session.
2. No refunds will be made to participants after the commencement of a session
unless the class is cancelled by the City.
3. City shall collect registration fees from each participant. Consultant shall
refer interested students to City for registration.
4. Consultant shall receive seventy percent (70%) of the total fees collected each
month. City and Consultant agree that City shall retain thirty percent (30%)
of the fees collected as an administration fee.
5. Consultant agrees City is entitled to audit Consultant's records and classes to
ensure compliance with this Agreement.
6. Consultant may not waive class participation/registration fees.
7. City shall prepare class rosters and provide a copy to Consultant. Only
registered participants may participate in class.
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: -
CERTIFICATE OF INSURANCE
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
:
PUBLIC ENTITY (ADDITIONAL INSURED)
City of Santa Ana
nt Insurance Services in conjunction with
FInsurance
20 Civic Center Plaza, M-28 ,
nce Services
44,A
A,
Santa Ana,CA.92701
323 A605—
92799-8323
_ J/ f 7J163
oZf10
License No: OC 36861
NAMED INSURED (EVENT HOLDER):
EVENT INFORMATION:
National Academy of International Dance
TYPE:
220 E. 410 Street, Ste 202
-Ballet
DATE(S): January I - December 31. 2006
Santa Ana, CA 92701
LOCATION: Salgado/Memorial Comm Canters
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 cootrut or other document with respect to which :.`Ls
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: 04SEPI000OOI
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2006 EXPIRATION: JANUARY 1, 2007
COMMERCIAL GENERAL LIABILITY
General Aggregaro limit
OCCURRENCE FORM
DEDUCTIBLL: NONE
$ 2,000,000
Products & Completed Operations 1,000,0W
Personal & Advertising injury 1,000,000
Each Occumcace Limit 1,000,000
Fire Damage (Any One Fite) 50,000
Medical Payments (Any One Person) 5.000
Tne limits of insurance apply aepmuely to each event insured by this polies,as if- separate policy uri"sumnee has been issued for that i,mt.
"Who is insured" is amended to include, as m insured, eha person or oraud,Auon shown In this schcduk, but only with respect to liability snshtg out of the
ownership, maintenance or use of the premises used by the mined insured (event holder). Ibis utsumtcc does not apply w: Any "occurtence" which lakes place
after the event holder ceases w be a truant in that premises.
OTTIER ADDITIONAL INSUREDS
C_ A�'�I:1-LAT10N. Should the above described policy io Cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the
ccrtificase heidu and additional insvreda listed.
AUTHORIZED REPRESENTATIVF:
DATE ISSUED:
r: i::a::,r., —
Td WIJZ17:60 90OF E0 -dos SOE60SSbU : 'ON XHd
alli: WOW
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2007 -03
A -,�bo 5 - N(p
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
Alliant Insurance Services, Inc. in conjunction with
20 Civic Center Plaza, M-28
Apex Insurance Services
Santa Ana, CA 92701
P. O. Box 6450
Newport Beach, CA 92658
(949)660-8163
License No: OC 36861
NAMED INSURED (EVENT HOLDER):
EVENT INFORMATION:
National Heritage Foundation
TYPE: Ballet Class
Academy of International Dance
DATE(S): Jan. 1, 07 - Dec. 31, 07
Sonia Miskulin
LOCATION: Saleado Center and Memorial Park
220 E. 4th Street, Suite 202, Santa Ana, CA 92701
"Liquor Liability after tam ❑
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: 04SEP 100000I
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2007 EXPIRATION: JANUARY 1, 2008
COMMERCIAL GENERAL LIABILITY
OCCURRENCE FORM
DEDUCTIBLE: NONE
General Aggregate Limit S 2,000,000
Products & Completed Operations I,000,00O
Personal & Advertising Injury 1,000,00()
Each Occurrence Limit 1,000,000
Fire Damage (Any One Fire) 50,000
Medical Payments (Any One Person) 5,000
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, (he 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
l
soI
NCELI.A"PION Should the above described policy to cancelled before the expiration date thereof,the issuing company will mail 30 days written notice to the
Lcrf
ficate holder and additional insureds listed.
AUTHORIZED REPRESENTATIVE:
DATE ISSUED:
Generates! by Risk Management Division by:
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2009-07
A - z.00(o - 1-13
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
Alliant Insurance Services, Inc. in conjunction with
20 Civic Center Plaza
Apex Insurance Services
Santa Ana, CA 92701
P. O. Box 6450
Newport Beach, CA 92658
(949)660-8135
License No: OC 3686I x
NAMED INSURED (EVENT HOLDER):
EVENT INFORMATION:
Sonia Miskulin
TYPE: Ballet
Academy of International Dance
DATE(S): Jan. 12 - Dec. 31
220 E. 4" Street, Ste 202
LOCATION: Salsado Center
Santa Ana, CA 92701
*Liquor Liability Yes ❑ No ❑
**Li uor Liabili after 12 am ends before 2 am ❑
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 ail 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: 04SEP1000001-5
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2009 EXPIRATION: JANUARY 1, 2010
COMMERCIAL GENERAL LIABILITY
OCCURRENCE FORM
DEDUCTIBLE: NONE
General Aggregate Limit S 2,000,000
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
Liquor Liability (If purchased) 1,000,a00
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 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 'bocurrence' which takes place
after the event holder ceases to be a tenant in that premises.
OTHER ADDITIONAL INSUREDS
t
CANCELLATION: Should the above described policy to cancelled before the expimdon date thereof, the issuing -company will mail 30 days written notice to the
certificate holder and additional insureds listed.
AUTHORIZED REPRESENTATIVE:
DATE ISSUED: January 12 2009 •
CHECKLIST FOR PROCESSING
AGREEMENTS AND AMENDMENTS
TO: CLERK OF THE COUNCIL OFFICE
FROM: DEPT.: Parks, Recreation & Community Services Agency MAIL STOP: M-23.
CONTACT PERSON: Carla Thompkins EXT.: �i 4�2,22�_
AGREEMENT NUMBER (if amendment): A / N
AMENDMENT NUMBER (if applicable): ❑ 1ST
COUNCIL APPROVAL DATE:
AMOUNT:
❑ OVER $25,000- (A)
A-2006-143
❑ 2ND ❑ 3RD ❑
® UNDER $25,000* (N)
NAME OF CONSULTANT: National Heritage Foundation dba Academy of International Dance
TERM OF AGREEMENT: EFFECTIVE DATE: 6/19/06 TERMINATION DATE: 6/30/07
INSURANCE REQUIRED: ❑ NO (Provide City Attorney Office approval)
® YES
❑ AUTO
❑ PROFESSIONAL LIABILITY
® CGL (Commercial General Liability)
❑ WORKERS COMPENSATION
(INSURANCE APPROVAL REQUIRED BY CAO PRIOR TO SUBMITTING TO COTC)
SIGNATURES REQUIRED:
❑ VENDOR ❑ AGENCY (UNDER $25,000*)
❑ CITY ATTORNEY ❑ OTHER
COMMENTS: Attached City -provide insurance herewith for Clerk's Office files.
FOR CLERK
❑ PROCESS ❑ DO NOT PROCESS
❑ MISSING CONTACT/PROJECT MANAGER INFORMATION
❑ MISSING SIGNATURES
❑ NEEDS COUNCIL APPROVAL
❑ OTHER
ADDITIONAL REMARKS:
* rharter amenrlmenf effective Deeember 21. 2006 for Citv Manaaer contract