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HomeMy WebLinkAboutARC MID-CITIES 1D-2011rust EIV T INSURANCE NOT ON FItE N-2007-070-04 WORK MAY NOT PROCEED CLERK OF COUNCIL FOURTH AMENDMENT TO GRAFFITI DATE: I $ ZOT? REMOVAL SERVICES AGREEMENT o -. PWA ?27 JUL ppine ? THIS FOURTH AMENDMENT TO AGREEMENT is entered into on June 23, 2011, by MgYOado and between ARC MID-CITIES -ORANGE COUNTY ("Contractor") and the City of Santa Ana RECITALS: A. The parties entered into Agreement #N-2007-070, dated May 1, 2007, (hereinafter "said Agreement") by which Consultant has provided supervision for graffiti removal services. 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 provide compensation for services during that 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 Fourth Amendment to Agreement, the parties agree as follows: 1. Section 2, COMPENSATION, shall be amended to increase compensation by $16,200 to pay for services during the FY 2011-2012 fiscal year, at the rate of $1,350.00 per month. 2. Section 3, TERM, shall be amended to extend the termination date an additional year, through June 30, 2012. 3. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Fourth Amendment to Agreement on the date and year first written above. CITY OF SA TA ANA ATTEST: N (_? ? !? `?'? MARIA D. HUIZA PAUL M. WALTERS Clerk of the Council Acting City Manager APPROVED AS TO FORM: ARC MID-CITIES ORANGE COUNTY OSEPH STRA'?CA?- QZ?L n Interim City Attorney _ Ji lei ?? ??.Y'GYi C??.. ?$jp? ? JOHN WAG ER _ P VE AST NTENT: President -Executive Director RAUL GODINE ?ICK ROBISON Executive Director - Senior Procurement Officer Public Works Age y Contract Liaison CERTIFICATE OF WORKERS' COMPENSATION COVERAGE T Feb 3 2012 PRODUCER NonPro£ts' United Workers' Compensation Group THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 431 1 Street, Suite 200 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Sacramento. CA 95814 Phone- (916) 764-005 6 THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Fez: (916) 880.5251 COVERAGE AFFORDED BY THE POLICIES BELOW. Marsh Risk 8c Insurance Services 345 California Street Suite 1300 _ San Francisco, CA 94104 INSURERS AFFORDING COVERAGE INSURED INSURER A Non Profits' United Workers' Compensation Group Association tDr Retarded Citizens Mitl-Cities INSURER B: ACE American ]nsurance Company [NAIL a 22667) '14208 Towne Ave. Los Angeles, CA 9006'1 N,?OU'7-O?O INSURER C: ? / Y / t ? U '? t - INSURER D- - ? Z ? U y ? ? INSURER E COVERAGES This Certificate is not intended to s eci all entlort;emenls, Covera es, terms, contlitions aril exdusions of the olicies shown. THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSVED TO THE AFFILIATE MEMBER NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREM ENT, TERM, OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS GE RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SVBJECT TO ALL THE TERMS, E%CL USIO NS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDVGED BY PAID CLAIMS. INSR LTR TYPE OF COVERAGE POLCY NUMBER POLICY EFFECTIVE DATE POLICY E%PIRATON DATE LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY RRE DAMAGE (Any one fire) $ CLAIMS MADE OCCUR MED EXPENSE (Any one person) $ GENERAL AGGREGATE LIMIT APPLtE9 PER: PERSONAL 8 ADV IWURY $ POLICY PROJECT LOC GENERAL AGGREGATE $ PRODUCTS-GOMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (??.>_?TTTa (? ?? , O 1 (Each aori0enl) $ ALL OWNED AVTOS ? ?? ?"? d (_? AA'' )?D??,?p?tURY $ SCHEDULED ALROS \- (Per pereo^I $ HIRED AUTOS -°?rr?. -'__: ? BODILY INJVRY $ NON-OWNED AUTOS j-[I ( `. _, ,? (Per ecotlent) --- $ ?. SSI.tiI R;] -, ,I;?r(1y l ?: [ PROPER TY DAMAGE $ y /f, I f ? ? 1"rl C (Per accoenfJ $ WC STAT X OTHER WORKERS' COMPENSATION LIMITS A AND NPLJ-WCG OOI-2012 1/27/12 I/1/l3 E.L. EACH ACCIDENT $500,000 EMPLOYERS LIABILITY E.L. DISEASE - EA EMPLOYEE $ $00,000 E.L. DISEASE -COVERAGE LIMIT $ $00,000 OTHER B EXCESS Workers' Compensation WCL 046245283 1/27/12 I/1/13 535,000,000 x E500,000 WC $2,000 000 x $500.000 EL DESCRIPTION OF OPERATIONSA_OCATIONSNENICLES/E%CLUSIONS ADDED BY ENDORSEMENT/SPECIAUPROVISIONS Evidence of Workers' Compensation Coverage: Waiver of Subrogatio n provided by Endorsement No. NPUWCG-ARCMIDC-06 CERTIFICATE HOLDER woDlnoNAL INSURED; INSURER LETTER: CANCELLA"1'1(lN NPUWCG-ARC MIDC-W SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Cit f S nta Ana BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED y o a IN ACCORDANCE WITH THE POLICY PROVISIONS. Clerk of the City Council 20 Civic Center Plaza PO Bor 1988 Santa Ana,CA 92 702-1 988 ? " ? ? ??? ? ? Based on ACORD 25 (2009/09) POLICY CHANGE DOCUMENT POLICY NO.: PHPK733498 Philadelphia Indemnity Insurance Company 110917 Caiquo Insurance Agency NAMED INSURED Arc Mid-Cities MAILING ADDRESS 14208 Towne Ave Los Angeles, CA 90061-2653 POLICY PERIOD: FROM 07/19/2011 TO 07/19/2012 at 12.0 A.M. Standard Time at your mailing address shown above. CHANGE EFFECTIVE 04/26/2012 CHANGE # 2 DESCRIPTION In consideration of the premium reflected, the policy is amended as indicated below: Added: Additional Insured The City of Santa Ana its officers, employees, agents volunteers and representatives 20 Civic Center Plaza Santa Ana, California 92701 CG2026 Additional Insured-Designated Person or Organization Only as respects the primary insured's operations Per attached Path ID 6185976 Total Annual Additional/Return Premium $ 0.00 NO CHANGE Total Prorate Additional/Return Premium $ 0.00 NO CHANGE COUNTERSIGNED BY (Date) Insurance Policy (Authorized Representative) Page 1 of 1 POLICY NUMBER= PHPK733498 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE The City of Santa Ana its officers, employees, agents volunteers and representatives Section 11 -Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 ©ISO Properties, Inc., 2004 Page ? of ? O NONPROFIT uivz-rEr?? THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Non Profits' United Workers' Compensation Group Memorandum of Coverage: NPU-WCG 001-2012 This endorsement modifies the coverage provided under the following: Memorandum of Coverage: PART ONE: WORKERS' COMPENSATION COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name and Address of Person or Organization: City of Sonta Ano 20 Civic Center P/ozo, PO Box 1988 Sonto Ano, CA 92 702-1 988 DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BV ENDORSEMENT: - With regard to the City, its Officio/s Officers, Agents and emp/ogees. NPU-WCG waives any right of recovery it may have against the person or organization shown above because of payments made by NPU-WCG for injury or damage arising out of the Members' operations done under a contract with that person or organization shown above and included in the coverage provided by the Memorandum of Coverage. This waiver applies only to the person or organization shown on the Schedule Above. This endorsement is part of the Memorandum of Coverage and is effective on the date shown below. All other terms and conditions remain unchanged. Effective Date: January 27. 2012 Expiration Date: January 1. 2013 Member: Association for Retarded Citizens Mid-Cities Endorsement No: NPLlWCG-ARCMIDC-06 Date Issued: Feb 3. 2012 Aut prize epresent to ve fior P -W NPU-WCG Page 1 MOC: NPCi-WCG 001-2012