HomeMy WebLinkAboutCOMMUNITY SERVICE PROGRAMS, INC. 5A~.
City of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer ~, _,
,~ ~ ,
in effect. Return form to the Clerk of the Council Office (M-30). ~ 5 ~ ~ ~ f`~
Call 647-5237 if you have any questions. ~- - ~- ~ `~ ' `-
The agreement with
No. A-2007-210 was completed on +~I ~'' I ~~ "~
and final payment has been made.
Revised 07-23-07
Department:
Phone/Ext.:
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Signature: `~iA~'G1.t.P et^~~/
Date: ~1~IS1 ~~'
INSURANCE NOT ON FILE
~~-ORK MAY NQI PROCEED
FpK OF COUNCIL
D~-TEAUG 3 1 2001 FIRST AMENDMENT TO GRANT AGREEMENT
O: Police C27
~l~ B , THIS FIRST AMENDMENT TO GRANT AGREEMENT is entered into on
August 20, 2007, by and between Community Service Programs, a California non-profit
corporation ("CSP") and the City of Santa Ana, a charter city and municipal corporation
of the State of California ("City").
RECITALS:
A. The parties entered into Agreement A-2007-052, dated March 5, 2007, (hereinafter
"said Agreement") by which CSP has operated a domestic violence victim advocacy
program.
B. The City has been awarded additional DVVA grant funds, a portion of which City
desires to pass on to CSP to provide continuing services.
C. In accordance with the terms and conditions of said Agreement, the parties wish to
increase the Compensation to extend the program for an additional six-month 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 Consultant Agreement, the parties agree as follows:
1. Section 1, PURPOSE, shall be amended to increase the DVVA grant funds available
for disbursement by $33,683.00, for a total amount of $92,973.00.
A-2007-210
2. Section 4, DISBURSEMENT OF FUNDS, shall be amended to increase the allocated funds
to $92,973.00.
a. Section 4.A. shall be amended to extend the time during which services may be
provided from June 30, 2007 through December 31, 2007.
b. Section 4.C. shall be amended to read, in full:
"C. SUBGRANTEE agrees to submit requests for disbursement fifteen (15)
days after the end of each calendar quarter during the term of the AGREEMENT.
The dates for the requests for disbursement are:
1. July 1, 2006 through January 31, 2007
2. February 1, 2007 through March 31, 2007
3. April 1, 2007 through June 30, 2007
4. Julv 1, 2007 through September 30, 2007
S. October 1, 2007 through December 31 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
Grant Agreement on the date and year first written above.
ATTEST:
~~ _
PATRICLA E. HEALY
Clerk of titer Council
APPROVED AS TO FORM:
~~~,
J PH W. FLETCH
City Attorney
CITY OF SANTA ANA
~~ % ~~
~~~,,~DAVID N. REA
City Manager
COMMUNITY SERVICE PROGRAMS
sr~~~ .
A )
(Title)
ACORD CERTIFICATE OF LIABILITY INSURANCE oP ID p DATE IMMIDDIYYVY)
COMMU-6 12/26/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
Chapman & Associates ~ -~op~- al0 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
License #0522024
A- ~~~- 0 5 a HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P . 0. Hox 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO
Pasadena CA 91117-0455
Phone: 626-405-8031 Fax: 626-405-0585 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A. RiVexport Ineuaartce Company
INSURER B. $VE!re9t National
Community Service Programs, Inc INSURERC '
1821 H. Dyer Road Ste. 200 INSURER D.
Santa Ana CA 92705
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 BV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED 8Y PAID CLAIMS.
LTR NSR TYPE OFINSURANCE POLICY NUMBER DATEYMM OINYYE PUATEV MMIDO TION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 10000 OO
A X COMMERCIAL GENERAL UnawTY RI00008559 10/01/07 li 10/O1/OB PREMISES (Ea nccurenca) $ 100000
CLAIMS MADE rrX OCCUR ~!
L ~ MED E%P (Anyone person) $SOOO
X _
Sexual Abuse RI00008559
10/01/07 ' 10/01/08
PERSONALSnovINJURY
$ 1ppp000
X PROFHSSIONAL CONTRACTUAL LIABIL TY10/01/07 10/01/08 GENERAL ACCRECnre $ 3000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1000000
POLICY 'PRO- LOC ~
JECT Sm Ben. 1000000
AUT OMOBILE LIABILITY COMDINED SINGLE LIMIT $ 1000000
A X ANV AUTO RIC0008559 10/01/07 10/01/09 IEa accident)
ALL OWNED AUTOS BODILY INJURY
S
'i SCHEDULED AUTOS I (Per person)
' X HIRED AUTOS ~ BODILY INJURY
$
X NON~OWNED AUTOS (Per accident)
PROPERTY DAMAGE $--.
IPer accidenry
I GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
~! ANV AUTO OTHER THAN EA ACC $
~' AUTO ONLY'. AGG 3
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1000000
A X OCCUR ~ CLAIMS MADE R$LD008560 10/01/07 10/01/08 AGGREGATE $ 1000000
$
DEDUCTIBLE S
RETENTION $ 8
WORKERS COMPENSATION AND X TORY LIMITS ER
B EMPLOYERS'LIABNTY
ANY PROPRIETOR/PARTNERIEXECUTIVE 6600000007071 07/01/07 ', 07/01/08 EL. EACH ACCIDENT $ 1000000
OFFICERIMEMBER EXCLUDEDP E.L. DISEASE-EA EMPLOYEE $ 1000000
It yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE-POLICY LIMIT
$lOOOOOO
OTHER
A $mployee Dishonest RI00008559 10/O1/07i 10/O1/OB Limit 450,000
A Pro ert RICD006559 10/01/07 '. 10/01/08 Contents 249,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I E%CLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Re: Agreement #A-2007-210. The City of Santa Ana, Ito Officers, Employees,
Agents, Volunteers and Representatives are named as additional insured with
regard to Liability and defense of suite arising from the operations of the
named insured per the attached endorsement. Such insurance is primary and
non-contributory. Workers compensation coverage excluded, (Contd...)
CANCELLATION
SANTANA ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
City of Santa Ana
20 Civic Center Plaza
Santa Ana CA 92701
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O OAVS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND UPON THE INSURER, RS AGENTS OR
REPRESENTATIVES.
~{ ~~ ,iy
only. 10 days notice of cancellation for non-payment of premium.
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 not 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 contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
~I)I~ITId~`AL IA51'Rt:l) I:y1X)RSF,~1F;tiT
FdR COLI~IFRCIAL. GENERAL LI.YBILITI' PdLICYr
lnsurance Company Rivarport Insurance Company --
Thin andarszmant modifies snob ijrsttrance as is afforded lay the provisions of Policy
ti RIC0008559 relating to the following:
Y. 'Ihe City ol'Sanla Ana, 20 Civia Center Plaza, Santa Ana, Calit'omia 92741: its
officers, employees, agents, volunteers zmd representatives are Warned as additional insureds
("additional insureds"} with regard to liability and defense of suits arising from the operatirnrs
and uses pth-fiarnted by or un haltalf of the named. insured.
2. With respect to claims arising otrt ofiha operations and uses parfi~rmed by or on
bzhalFofthz namedtnsured, such insurance as is alTurded by this policy is primary and is not
additional to ar contribtning with any other insurance carried by or for the beneFit of the
additional insureds.
3. 'This insurance 7pplies separately to each insured against whom claim is made ur
suit is brought except with respect to the compare}~s limits of liability. The inclusion of any
parson or organization as an insured shall not affect any right which such person or organization
would Nava as a elaimazt[ if not su included.
4, LUith respect to the additional. insureds, this insurance shall not be cancellzd, or
materially reduced in aovcrage or limits except after thirty {30} days written notico has bean
given to the City of Santa Arta, 2p Civic Canter Plaza, Santa r1na, Califarnia 42701.
{Completion o#'tlte fallowing, including countersignature, is required to make this endorsement
effective:}
Effective __ 1001 X67-10,'Q1i0R ,this endorsement frtrm as a part of
Policy =' R1Ct'1CI08559
- -- -
Issued W __ ~tnnntuttity Senica Proerams. lnc.
Nanrad lnsrtrad
Countersigned by G~~~`--'~
_.. __
Authorized Itepreserttaiivc