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Home My WebLink AboutSEHUAME, RUDY R. 1bc a oob AGREEMENT TERMINATION 2011' . UIN 18 Pas 1� VII Please complete this form when the attached agreement is no longer in effect. Return form to the Sr. Deputy Clerk of the Council (M -30). Call 647 =1138 if you haveany questions. The agreement with � 1 r No. was completed on and final payment has been made. N _a- oou -MA- a - fv - a- O0 (t - a2.9 -03 v co Department: T �-� 4 Signature: Q—k Revised 3-2-07 Date: U 1 1 31 i -ci City of Santa Ana Clerk of the Council INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES / —/ -v e CLERK OF COUNCIL DATE: 5/ 3i 107 SECOND AMENDMENT TO CONSULTANT AGREEMENT N -2006- 029 -02 THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is entered into on April 20, 2007, between RUDY SEHUAME, an individual (hereinafter "Consultant ") and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). RECITALS: A. The parties entered into a Consultant Agreement N- 2006 -029 dated February 7, 2006, hereinafter referred to as "said Agreement," by which Consultant provides Karate instruction in the City's Leisure Class program. B. Due to a continued need for Consultant's services, the parties wish to extend the term of said Agreement. 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 Second Amendment to Consultant Agreement, the parties agree as follows: L Paragraph 3, TERM, of said Agreement shall be amended to extend the Term to June 30, 2008. 2. Except as hereinabove amended the terms and conditions of the said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Consultant Agreement on the date and year first written above. CITY OF SANTA ANA By: l v G RARDO MOUET Executive Director, P rks, Recreation and Com unity Services APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney A By: Lau Sheedy PATRICIA E. HEALY Assistant City Atto ey CLERK OF iNE COU/VCI[ ,#_ 000b- v z1 EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 200740 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. EVENT LIABILITY SEPARATE APPLICATIONS FOR NOMINEE EVENTS. Alliant Insurance Services, Inc. in conjunction with Apex Insurance Services P. O. Box 6450 Newport Beach, CA 92658 (949) 660 -8163 License No: OC 36861 Rodolfo R. Sehuame 2424 w. First Street #133 Santa Ana, CA 92703 City of Santa Ana 20 Civic Center Plaza, M -28 Santa Ana, CA 92701 TYPE: Karate Class DATE(S): 01/19/07 - 12131/07 LOCATION: Santa Anita Park 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 1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2007 EXPIRATION: JANUARY 1, 2008 COMMERCIAL OENERAL LIABILITY OCCURRENCEFORM DEDUCTIBLE: NONE Cmm-A Aggregate licit $ 2,000,000 Products & Conte Operations 1,0001000 Personal & Advaticatg lniurY 1'000'000 Each Occurrence Limit 1,0001000 Fne Damage (Any One Fire) 50,000 Medial Payments (Any One Person) 5,l= each event of insurance has been issued "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, meiutenana or use of the premises used by the named insured (event holder} Ibis insurance does not apply to: Any "oc turence" which rakes place be a tenant in CeNCFt 1 ATION: Should ate 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: Januar 29 2007 Generated by Risk Management Division by: 0 /'' 7- EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2011 -13 CERTIFICATE OF INSURANCE COVERAGE EXCLUDED FOR NOMINEE EVENTS SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance Services C> _ 20 Civic Center Plaza /� � %� _ C,� g —�,� � � P. O. Box 6450 Santa Ana, CA 92701 / l� �- "� Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Rudy Sehuame TYPE: Martial Arts 2424 West 1 °`, #133 DATE(S): 02/02/11 — 12/31/11 Santa Ana, CA 92703 LOCATION: Santa Anita Recreation *Liquor Liability Yes � No * *Li uor Liabilit after 12 am ends before 2 am � This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not constitute a contract between the insurance carrier, authorized representative, producer and certificate holder. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies). INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 11SEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2011 EXPIRATION: JANUARY 1, 2012 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $ 2,000,000 Products 8c Completed Operations 1,000,000 Personal 8c 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) l,000 000 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 (even[ 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 be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy rovi sions. Eve of %rt will be made to deliver 30 days written notice to the certi£cate holder and additional insureds) listed. AUTHORIZED REPRESENTATIVE: DATE ISSUED: February 02. 2011 by Briza Morales