HomeMy WebLinkAboutSCHERMER, JANET 4hc z��
AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer in effect.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 647 523`$`if -y' aw iave any
questions.
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was completed on I n+ and final payment has been made..
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City of Santa Ana
Clerk of the Council
INRURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES?
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CLERK OF COU?IL 2012
DATE: ,JAN 1
N-2004-060-008
EIGHTH AMENDMENT TO RECREATION SERVICES AGREEMENT
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Silvia Cuevas THIS AGREEMENT made and entered into this 12"' day of December, 201 ] by and between
Janet Schermer (hereinafter "Provider"), 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 Agreement N-2004,060, dated November 6, 2007, as amended from time to time
(hereinafter "said Agreement"), by which Provider has conducted piano lessons in the City's leisure
program.
B. In accordance with the terms and conditions of said Agreement, the parties wish to renew said
Agreement for an additional one-year period.
NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the all the
terms and conditions of said Agreement, except those amended in this Eighth Amendment to Recreation
Services Agreement, the parties agree as follows:
1. Section 3, TERM, shall be amended to extend the term through December 31, 2012.
2. 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 Agreement the date and year first above
written.
ATTEST:
'?'y)G?•-ACC .? • f7?? ???
MARIA D. HUIZAR
Clerk of the Council
CITY OF SANTA ANA
PAUL M. WALTERS
Interim City Manager
APPROVED AS TO FORM:
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JO9?EPH STRAI{.A
Interim City Attorney
RECOMMENDED FOR APPL?L:
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GERARDO MOUET
Executive Director of arks,
Recreation and Community Services
PROVIDER
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JAN CHERMER.
Tax ?-71-??fs - 1 (3-
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.. 2012-13
CERTIFICATE OF INSURANCE
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED)
Alliant Insurance Services, Inc. in conjunction with City of Santa Ana
Apex Insurance Services 20 Civic Center Plaza
P. O. Box 6450
Santa Ana
CA 92701
Newport Beach, CA 92658 ,
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
Janet Schermer TYPE: Music
34 Brisbane Way W-'1004-U60-008 DATE(S): 01/04/12 - 12/31/12
Irvine CA 92612
' LOCATION: EI Salvador Center
*Liquor Liability Yes Q 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: 12SEP1000001
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2012 EXPIRATION: JANUARY 1, 2013
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE
General Aggregate Limit $ 2,000,000
Products 8c Completed Operations 1,OOQ000 gpPI2 ?) v }_,1? ? ? TO FOIZIVI
Personal 8c Advertising Injury 1,000,000
Each Occurrence Limit 1,000,000
Fire Damage (Any One Fire) 100,000
Medical Payments (Any One Person) 5,000 ----- --? _.. _ _ _.__
Liquor Liability (If purchased) t,ooo,000 L.aw:., ? ._._:Iy
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Optional Limits Purchased i\s?tstant tty
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Q $1,000,000/$3,000,000
Q $2,000,000/$2,000,000
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, the 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 (event 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
rovti5iOn5.
AUTHORIZED REPRESENTATIVE:
DATE ISSUED: 01/04/12 by Briza Morales