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HomeMy WebLinkAboutMAD SCIENCE OF ORANGE COUNTY 1CC, 2601 AGREEMENT TERMINATION Please complete this form when the attached agreement is no lonp—I effect Return form to the Deputy Clerk of the Council (M -30 )_ Call 64 X23 'questions- - The agreement with O224 , 2 doj . No. A1- AOo!/- 037 -G,3 was completed on ul and final payment has been made. N'Z004 -031 Department: pcc-,'S Signature: CA/) Date: q 1 t City of Santa Ana Revised 08 -28 -06 Clerk of the Council INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES /0- /,J- 0? CLERK OF COUNCIL DATE r z - rs -06 o.UdrK+'Recxz) CeQrki T1otnPKMa� THIRD AMENDMENT TO AGREEMENT N- 2004 - 037 -03 THIS THIRD AMENDMENT TO AGREEMENT is made and entered into this 21 " day of November 2006 by and between the City of Santa Ana, a charter city and municipal corporation of the State of California ( "City") and Jay Broderick dba Mad Science of Orange County, a sole proprietorship ( "Consultant "). RECITALS: 1. City and Consultant entered into Agreement N- 2004 -037, dated April 22, 2004, hereinafter "said Agreement ", by which Consultant has instructed "Mad Science" 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: 1. Section 3, TERM, shall be amended to extend the term of said Agreement through December 31, 2007. 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 Third Amendment to Consultant Agreement on the day and year first set forth above. APPROVED AS TO FORM: �4 t FL Y 4 !c -)OS PH WW ETCHER City Attorney i RT=$ C TR /C /A E. ff ro rP - rrr THE CO1 WIL, CITY OF SANTA ANA GERARD0 MO ET Executive Direc or Parks, Recreation and Community Services F, ry Dana Cable At Hylant Group, Inc TSAI D Hylant Group To Karla Date: 12x0006 0199 PM Page. 2 AT 5 ?CORD CERTIFICATE OF LIABILITY INSURANCE e oP!D 1d ° "TE` "M ^ °° ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hylant Group - Toledo HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Ell Madison Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Toledo OH 43604 7tore:419- 255 -1020 Fax:419- 255 -7557 INSURERS AFFORDING COVERAGE NAIL9 's.eEV, m:awrRa enu.a.LPn ma.,n.,Ler roar co 1805 N- 2oo4 - o3� o -s _ SOHFR 9 Co n say Broderick dba science --- -- -- - of West Orange Ave. uastREF- 3501 W. Moore ve. Ste J INSURE +n Santa Ana CA 99702 - - -.._ INSURER E ` =l _ IF MSURAN'E LI-TED BELOW HAVE BEEN SSJFD TO FPS 'NQ L?D NAI ED PROVE FOP THE MI 1, F IFPI,-D IKFIYA7F1 J TNIUl F ..V,F ]L M_N,1trUa R Al ) VF ANY NIH41 19_Tt F LMLHIIII -HR I 1 TIC VaHeF F /IHVVMM BE ULFF? VAY PERTAIN , THE INSLPAH E AWORDED BY THE POLICIES LESCUBED Fe FIN IS SUB EC T ACDOTERN C LL _91GN- JL ETILA o CF SUCH 99C'FSA ,i FFATFI IUll l,D'NIJ MAY IWVF PF- NRIFL -F P, AT- fI AIAAF POLICY NUMBER LIMIT3 !TP ,NERD TYPE OF INSURANCE BATE IMMIDDhYI oATE (MMrDO,v'R GENERAL LIABILIFY CY.,I I0CCJW.LNC ¢1,000,000 NVtALi T_PElEF A x �NMMERCIAL GENERAL JnewTl PMPK187988 10/15/06 10/15/07 11 -11 sr ' b300,000 CLAIMS VA E LX] OCCUN ?'15,000 x Abuse /Molestation PHPKI87988 10/15/06 10/15/07 F EYGVHAL G IF L IJJJP Y T1,000,000 NEA ATE Y2,000,000 F_1__N THFORl LOU FEEL A PEP PI, P`_ CO tP F A d 7 2,OD0,D0 0 FOLIC° F LC A S M 500,000 AIffOMOBILE LIPBILITY ' J. �AN -?Urn PHPK187988 TAE NFH SUru urnlT 10/15/06. 10/15/07 r- `I I 1 00(),000 ALL JwNmAllps '__IL T u._DO'I s '1 Dlt AI.R -s F •� X DDLYN IN YV X Jomneu AU ros F� �._} i Peco�� wnroor I way a,�a.m1 Y, .?RAPE LIABILITY AL "9ML IFFIJ aNrU,I VFFEPTHTN EPA y` "Ir.ONIY 6 FXCFSSiLJMRRFI I A I ITY rySY GC C'J3RRt F 1 N Cp.R U.LNSMA", .GREGATF ___ Y DED.ICRPL.F �K I RETENTION W09NER C COMPENSATION AND EMPLOYERS' LIABILITY T^FI_IMI3 rF' {i 'ANPHOPRI °IOWYAHIVLWt}Y LL IVL I ALI L'1 PF F =" I I I'VI AQ MILL I . LW_LAll Y KF FA � ' FNPP - ,r I, PVIRI AL F. VIS.ON.S'oomry _ DSL '> 10 LIMI- D1HER DESCRIPTION OF OPERATIONS D LOCATIONS I VEHICLES I EXCLUSIONS? ED BY ENDORSEMENT I SPECIAL PROVISIONS Medical Payments excludes Participants. City of Santa Ana Parks, -_.ra_ien, 5 Community Services Agency, its officers, agents, employees, ::eoresentatives and volunteers are included as an Additional Insured ATIMA =r Form CG2010. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WFITEN ATtn: Dolores Ramos NOTICE TO THE CERTIHCATE HOLDER NAMED TO THE LEFT, GET FAILURE TO DO SO SD ALL 888 W Santa Ana Blvd., STe 200 IMPOSE NO OBLIGATON OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 1988 M -23 Santa Ana CA 92702 REPRESENTATIVES. 1L3 TO F+ RI DREPRESENTATIVk / /`(/i / / B 1—.3 ! © ACORD QORPORATION 1988 t0l Hoy / (/. _I I a�a Cabla At Hylant Group, Inc. FaxI D'. Hylant Group To Karla Date' 1282006 01'09 PM Page'. 3 of 5 W "* V Vm If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does riot confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER the Certificate of Insurance on the reverse side of this form does not constitute a Conti act batween the issuing insurer(s), authorized representative of producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. TO FORM ._ cdy � -I v Attorncy