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HomeMy WebLinkAboutMEDINA, ANTHONY (4) N-2026-194-01 6 2025 a.U40 (0) FIRST AMENDMENT TO COUNCIL AIDE PROFESSIONAL SERVICES 5.CJUru-a.(D7-) AGREEMENT WITH ANTHONY ME'DINA THIS FIRST AMENDMENT is made and entered into this 25th day of August, 2026 by and between Anthony Medina ("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 ("City"). City and Consultant shall hereinafter collectively be referred to as "the Parties". RECITALS A. On July 27,2026,the Parties entered into Agreement 4N-2026-194("Agreement")to provide administrative, constituent,and legislative support for a member of the City Council. B. The term of the Agreement runs through June 30,2027 and established a set hourly rate for the Consultant at$31 per hour with a total amount of compensation to be expended,under the terms of this Agreement,not to exceed$30,000. The Agreement is current and in-effect. C. The parties now wish to amend the Agreement to increase the hourly rate to the Consultant. No other changes are contemplated by this First Amendment to the Agreement. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said Agreement, except as herein modified,the parties agree as follows: 1. Section 2.a, Compensation, is amended to increase the hourly rate to $35.00 per hour. City shall recognize and compensate Consultant at this increased hourly rate for all services provided beginning July 27, 2026. i 2. Except as modified by this First Amendment,all terms and conditions of the Agreement remain in full force and effect. 3 i [signatures appear on following page] f i i Page 1 of 2 i i SIGNATURE PAGE: FIRST AMENDMENT TO COUNCIL, AIDE PROFESSIONAL SERVICES AGREEMENT WITH ANTHONY MEDINA IN WITNESS WHEREOF, the parties hereto have executed this Amendment the date and year first above written. ATTEST- CITY OF NTA ANA :_ .. . l ni fer all Alvaro Nunez !/ City C City Manager APPROVED AS TO FORM: CONSULTANT Sonia R. Carvalho City Attorney01 V 40, /11 Jonathan T. Martinez Anthony Medina Assistant City Attorney Page 2 of 2 First Amendment - CAO Signed(2223679. 1 ) Final Audit Report 2026-08-26 Created: 2026-08-26 By: Stephanie Garcia(SGarcia5@santa-ana.org) Status: Signed Transaction ID: CBJCHBCAABAAN4GgXeegjhckiZlW9x98S1gkIRfNlxiT "First Amendment - CA© Signed(2223679.1 )" History T') Document created by Stephanie Garcia (SGarcia5@santa-ana.org) 2026-08-26-5:03:48 PM GMT Document emailed to amedina5@santa-ana.org for signature 2026-08-26-5:03:52 PM GMT Email viewed by amedina5@santa-ana.org 2026-08-26-5:04:08 PM GMT '© Signer amedina5@santa-ana.org entered name at signing as Anthony Medina 2026-08-26-5:07:40 PM GMT 6a Document e-signed by Anthony Medina (amedina5@santa-ana.org) Signature Date:2026-08-26-5:0T42 PM GMT-Time Source: server-Signature captured from device with phone number XXXXXXX1284- Signature Appearance Seiected:MOBILE—DRAW © Agreement completed. 2026-08-26-5:07:42 PM GMT Adobe Acrobat Sign State Farm Mutual Automobile Insurance Company AO Box 2358 � �a^tateFarn Bloomington 1L 61702-2358 1 AT2 A-8761 A MEI]INA, ANTHONY AUTO RENEWAL PREMIUM PAID: $672.00 DO NOT PAY. Your premium is billed through the State Farm Pa meat Plan State Farm Payment Plan Number: Your State Farm Agent PEGGY BATES Policy Number Office: 714-543-0422 Policy Period: June 10, 2026 to December 10, 2026 Address; Vehicle: APPROVED By Tu Tran Nguyen at 7:59 am,Jul 28,2a2e If you Piave a new orditfeerent car,have added any drivers,orhave moved, Principal Driver: please contact your agent. ANTHONY MEDINA Thank you for choosing State Farm. Notice of insurance information collection practices- You have the right to submit a written request to access, personal,family,or household insurance transactions: correct,amend, or delete your personal information and the We may collect customer information from persons other right to receive a response within 30 days of submitting your than the individual or individuals applying for coverage. request. If we deny your request, you have the right to file a Such customer information as well as other personal or statement with us containing the information you feel is privileged information subsequently collected may, in certain accurate and fair along with the reasons you disagree with circumstances, be disclosed to third parties without your our denial. Instructions on how to file such request and our authorization as permitted by law. full privacy notice can be found (continued on next page) Policy Number:737 4537-Fl0-75C Page number 1 of 5 Prepared April 17,2026 1004583 143562 202 01-15-2018 CONVENIENCE SAVES TIME, MONEY ... AND TREES, You have the option to pay your bills online by opting for ePayment on statefarm.comf. Get to a better State". TKo WI&IStateFarm- www.statefarm.com/customer-care/privacy-security/privar,y When you provide a check as payment, you authorize us or contact your State Farm Agent. either to use information from your check to make a Your auto insurance rates are impacted by the mileage your one-time electronic fund transfer from your account or to vehicle is driven. To ensure we've priced our insurance process the payment as a check transaction.When we use coverage accurately based on the number of miles you information from your check to make an electronic fund drive,we obtained valid mileage information for this vehicle transfer,funds may be withdrawn from your account as soon through a third party provider and/or from you.Annual as the same day we receive your payment, and you will not mileage was determined using this data and applied. Please receive your check back from your financial institution, contact your State Farm agent with questions within 30 days of your policy's renewal date. VEHICLE INFORMATION Review your policy information carefully. If anything is incorrect,or if there are any changes to your vehicle information,please let us know right away. Vehicle Identification Vehicle Description Number(VIN) Who principally drives this vehicle? How is this vehicle normally used? ANTHONY MEDINA,a single individual, To Work,School or Pleasure. who will have 11 years of driving experience as of June 10,2026, Other Household Vehicle(s) Your premium may be influenced by other State Farm policies that currently insure the following vehicle(s) in your household: The premium on the expiring policy term was based on The premium on the renewal policy term was based on 9,700 miles per year. 9,600 miles per year. DRIVER INFORMATION Assigned Driver(s) The following driver(s) are assigned to the vehicle(s)on this policy. Driving Experience as of Marital Name June 10,2026 Status ANTHONY MEDINA 11 years Single Policy Number: Page number 2 of 5 Prepared April 17,2026 StateFarm. Other Household Driver(s) In addition to the Principal Driver(s)and Assigned Driver(s),your premium may be influenced by the drivers shown below and other individuals permitted to drive your vehicle. This list does not extend or expand coverage beyond that contained in this automobile policy. The drivers listed below are the drivers reported to us that most frequently drive other vehicles in your household. It is your responsibility to inform us of all regular For business related vehicles, also include the drivers of your vehicles and changes to those drivers business owner(s)and employee(s)that drive the throughout the life of your policy. Failure to disclose vehicle(s)in any capacity drivers may result in denial of coverage. Regular Principal Driver&Assigned Drivers drivers, regardless of their relationship to the primary For each automobile,the Principal Driver is the individual named insured or their residence address„include: who most frequently drives it. • All drivers who drive the vehicle(s) on the policy Each driver is designated as an Assigned Driver on the once or more in a typical month household automobile that they most frequently drive.Your • All drivers who regularly drive the vehicle(s)at premium may be influenced by the information shown for least three months of the year these drivers. COVERAGE AND LIMITS See yourpolicy for an explanation ofthese coverages. A Liability Bodily injury 30,000160,000 Property Damage 25,000 $548 74 H Emergency Road Service $3 41 U Uninsured Motor Vehicle Bodily Injury 30,000/60,000 $82 47 U1 Uninsured Motor Vehicle Property Damage _ ^„ 327.38 Total Premium $672.00 If any coverage you carry is changed to give broader you the broader protection without issuing a new policy, protection with no additional premium charge, we will give starting on the date we adopt the broader protection. DISCOU NTS These adjustments have already been applied to your premium. Multicar Driving Safety Record s (continued on next page) Policy Number: Page number 3 of 5 Prepared April 17,2026 •• SfateFar DISCOUNTS continued California Goad Driver ✓ Loyalty J Total Discounts $2,024.06 SURCHARGES AND DISCOUNTS Driving Safety Record Rating Plan more than $1000. For accidents occurring prior to Your driving safety record, along with other rating factors, December 11,2011,an accident shall be chargeable determines what you pay for Liability, Medical Payments, provided it resulted in death or in payment(s) by an insurer Comprehensive, Collision,and Uninsured Motor Vehicle due to damage to any property in the amount of more than Coverages. Policyholders with no accidents and convictions $750, pay less than those with accidents and convictions. For applicants without prior insurance at the time of the The Driving Safety Record Rate Level that is assigned to accident,an accident shall be chargeable provided it your policy moves up, down, or stays the same every policy resulted in damage to any property in the amount of more renewal, depending upon your driving record. For every 12 than $1000 (more than $750 if the accident occurred prior to months since the renewal following the occurrence of a December 11, 2011). chargeable accident or the conviction of a minor violation, Chargeable accidents for renewal business are those which the initial assigned Driver Record Level for that chargeable resulted in bodily injury or death or State Farm claim accident or conviction shall be lowered by 1 level. For each payments totaling more than$1000 (more than $750 for 12 month period since the conviction of a major violation, accidents occurring prior to December 11,2011)under the initial assigned Driver Record Level for that conviction property damage liability coverage and collision coverage shall be lowered by 2 levels. The Rate Level is increased if combined, there are subsequent chargeable accidents or convictions. For more information about the rating plan, please contact Definition of Chargeable Accidents your State Farm agent. Chargeable accidents for new business are those which Superior Driver Rate Level resulted in bodily injury or death or in payment(s) by an insurer due to damage to any property in the amount of ADDITIONAL_INFORMATION IMPORTANT NOTICE If any information on this renewal notice is incomplete or For your protection California law requires the inaccurate,or if you want to confirm the information we have following to appear with this policy: Any person who in our records, please contact your agent. For additional knowingly presents false or fraudulent information to information regarding discounts or coverages, see your obtain or amend insurance coverage or to make a claim State Farm agent or visit statefarm.com®. for the payment of a loss is guilty of a crime and may be Endorsement 6130Q effective JUN 10 2026. subject to fines and confinement in state prison. Important Notice Regarding Your Premium State Farm works hard to offer you the best combination of price, service, and protection. The amount you pay for automobile insurance is determined by many factors including: • The coverage you have • Where you live • The kind of car you drive • How the car is used • Who drives the car Any premium adjustment is reflected on this Auto Renewal. If you have any questions, please contact your agent. (continued on next page) Policy Number: Page number 4 of 5 Prepared April 17,2026 StateFaorw Buying a new car? Remember to contact your agent! When you buy an additional car or one that replaces a car already on your policy,you need to report the change to your agent rom tl . Even though the dealership you purchased the car from may offer to notify your agent or insurance company,you, as the named insured,are responsible for reporting all changes to your auto policy. By contacting your agent,you can help: • avoid any complications or lack of coverage in the event of an accident or loss, • avoid insurance verification problems with a lienholder, the police,or the department of motor vehicles, and • ensure that you receive any new discounts you may be entitled to. Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state. If you have any questions about coverage for a newly acquired car,please contact your State Farm agent. Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage, The terms and conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number: Page number 5 of 5 Prepared April 17,2026 CITY OF SANTA ANA Risk Management a division of Human Resources Managing Risk through Awareness and Action AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE l Anthony Medina ("Representative"), attest that I am an authorized (Name and Title of Vendor Representative) representative Medina Solutions p (`.Company"), and (Consultant/Company Flame) possess the authority to legally bind Company. In my capacity as Representative of Company, I represent and confirm the following, as relates to the agreement between Company and City of Santa Ana, agreement number TB D ("Agreement")to provide Council aide services ("Services"); (5efvices to he provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, Company shall forthwith comply with the provisions and provide proof of workers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement, it will be considered a breach of Agreement rendering the Agreement null and void and Company will be fully liable for any and all damages. Anthortylteraditm(N; 2PS66f'd.Ri445F'BPT) Signature Date Anthony Medina Print Name Self - Title Contact Information,i.e.,Telephone Number and/or Email Adtiress WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANT DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION J706 OF THE LABOR CODE, INTEREST, AND ATTORINEY'S FEES. _Ifridavit of Exemption for workers'Compensation Insurance 11.12.2024