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HomeMy WebLinkAboutA1 EVENT & PARTY RENTAL (2)-2017. City of Santa `na �• Clerk of the Cou . it coTc Office use only AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements City of Santa Ana have been satisfied prior to signing the termination form. oz N6 Is the agreement(s) a permanent record? Yes No Clerk of the Council Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with No. '4` ,�� '�J C was completed on I� I and final payment has been made. (List all amendments. Use space below N needed.) / 'n {4— 011— 05-.a 0 Department: PQS-4 ! ��Yy-UV\�, 4—ao I -I_ Phone/Ext.: -�C k�—r Signature: Date: -71 �a i Revised: 10-18-16 A-2017-053 *% MODIFICATION TO AGREEMENT TFIIS MODIFICATION, made and entered into this 1' day of Junc, 2017, by and between the City of Santa Arta, a charter city and municipal corporation duly organized and existing under tlae Constitution and laws of the I State of California ("City"), and CWF, Inc, a California corporation (dba "Al Party Rental") ("Contractor"). 2 °s RHITAL� Z C) C) m I o r A. The City and A I Party Rental entered into that certain Agreement dated March 21, 2017, hereinafter referred to as "said Agreement" (#A-2017.053), for Contractor to provide, install, maintain and remove various equipment t for various City hosted events. � civ B, Due to clerical error, the parties did not enter said Agreement with the actual corporate naive of Contractor. C. The parties hereto now desire to modify Contractor's name in said Agreement to reflect the legal corporate name of Contractor. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter oontained and made, and subject to all of the terms and conditions of said Agreement as hereby amended, the parties hereto do hereby agree as follows: 1. Contractor's name is hereby amended to reflect the actual corporate name "CWP, Inc, (dba Al Party Rental)" rather than "Al Party Rental". All payments shall be rendered under such legal corporate name. 2, Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN W11 'NE,SS WHEREOF, the parties hereto have executed this Modification to said Agreement the date and year first above written. ATTEST: Maria D. Huizar 401 Clerk of the Council APPROVED AS TO FORM; Sonia R. Carvallio, City Attorney By: Lisa Storck, Asst, City Attorney RECOMMENDED FOR APPROVAL; Gerardo Mouet, Executive Director Parks, Rec. & Corrvnunity Services Agency CITY OF SANTA ANA —4 thin kur Interim City Manager CONTRACTOR — CWF, Ino. ®4 By:5Fo4,a,{ M^V vtn ti Title; %'AC",�br CERTIFICATE OF LIABILITY t INSURANCE A Ilb DATE(MMIDDNYYYI 3/30/2017 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. 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 . PRODUCER Bolton & Company 3475 E. Foothill Blvd., Suite 100 NAME: CONTACT PRONE --------'PAX -- —` Pasadena, CA 91107 i82tiZ799-7000 1E.h AG Ns.�ntt. _.. _1.LIc,.HSL.._...—(6Z61 583-2117_ AIL -A948R$.S•___.—_..-.____--............................_.._._...._...._-..� INSURER(S)AFPORDINGCOVERAGE NAICs vnvw.boitonco.com 0008309 INSURERA New York Marine And General Insurance Co 16608 INSURED CWF, Inc. INSURERB 251 Party Rentals 251 E. All Pe Stre n INSURERO_, _ _ �� Covina CA 91723 INSURER INSURER E' ._._.___ .....-._._._. �. INSURER P. COVERAGES CERTIFICATE NUMBER naaneaRR RFa/IRUTAI NIIMIiCD. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOp INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ._......... ..... ...... _ ..._........A UgUER1-..-.. _. POL�ICY EFP LTR� TYPEOFIN$URMCE I POUCYNUMaER Wall DIY Y OtbCY E%P... .._.._.-_.. .. ._........_.._._--__ 1 IYYVY I LIMITS A �I. COMMERCIAL GENERAL LIABILITY ✓ PK201700007271 2/1/2017 2/1/2018 EACHOCCU_RRENCE $ 1,000,000 1 CLAIMS -MADE OCCURDiCMrAiiE-TO i....✓� PREMI$ES1Ea 500,000 XP MEDESAnYcne Person) IS 10,000 Ill PERSONAL SADV INJURY S 1000,000 1 !GFRL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE �S 200Q000 PRODUCTS AGO 2.000, Q_O_O J✓40CPOLICY g OTHER; i AUTOMOBILE LIABILITY !AU201700011938 2/1/2017 2/112018 I COVUll,tl T IN LE LI 1 OQO�OQO i ANY AUTO - ( ' .1.$___ ( BODILY INJURY (Per peraw) S - '- OWNED SCHEDULED AUTOS ONLY _,II AUTOS HIRED NON-0VYNED 1 BODILY INJURY (Per accMenry- PROP R VISAMAGE $ {� -- ---- ✓ ! AUTOS ONLY ✓ AUTOS ONLY rLr aaoldanU 9— A ✓j UMBRELLA LIAR / OCCUR EXCESS LIAR UM201700003772 1 2/1/2017 2/1/2018 LFLICHOCCURRENCE_ $ _.5 QQQQQQ AGGREGATE —_-_— S 51000,000 III CtAIMS-MADE �(_ .._ ..— .S_ — iL DED ✓ RETENTION 510,000 A 'WORKEft3 GOMPENSATIDN YIN AND EMPLOYERS' LIABILITY (WC2016000OG9970 11/112016 11/112017 TRT T_I TH ��Au,.-ST, ER �$ ,T OFFICER(MEMBERE%CLUDEO?ECUTIVE .7 NI0.1 E.L.EACHACCIDENT ...... .-...— 1000 OOQ (Mandatory In NH) ';I/y'os, tlescdoa untlet E L DISEASE -EA EMPLOYEE $ _ ,1,000 000 .E.L DISEASE -POLICY UMIT$ 1,OW,OO9 DESCRIPTION OF OPERATIONS baiow I I DESCRIPTION OF OPERATIONS LOCATIONS 2 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The certificate holder is Included as an additional Insured, but only as respects to claims arising out of the neglige�ncee aamed ��rr Insured. GL Primary & Nan -Contributory per form CG2026 attached. Additional Insured: The City of Santa Ana, it's officers, employees, agents, and representatives r ev�ca City of Santa Ana Finance & Managgement Services Agency PO Box 1988 M•96 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUIMURIZEDRURK55ENTATIVE -�, Jessica Poretla Q 1988.2016 ACORD CORPORATION. All rlahts reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 34905266 1 CWVINCA-01 117-16 ALL Master CCYCIEICACC I TLIs Adams 1 3130/201T 10!24:00 AM (PDT] I Page 1 of 2 POLICY NUMBER: PK201700007271 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • A i I I : I - :,Kiel M01 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons) Or Organization(s): Any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy prior to performance of the agreement. Any Person or Organization as Required by Contract. It is agreed that this insurance is primary and non-contributory and that no Insurance held or owned by the designated Additional Insured shall be called upon to cover a loss under said policy up to the limits of this policy if loss under this policy arises directly from work performed by Named Insured or If others performed on behalf of the Named Insured. A. Section Il — Who Is An Insured is amended to Include as an additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" 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: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured Is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 �Qel � AA I' Page t of 1 34905266 1 C'WFINCA-01 1 17-10 ALL MASt0[ Ce[CifiCAtt I TW& Ma08 1 1/30/2011 A0:24;0a AM (PM) I P.S. 2 of 2