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HomeMy WebLinkAboutDELHI CENTER (2)-2016City of Santa k . Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect.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 have been satisfied prior to signing the termination form. Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. COTC Office Use OMy C''Y of "anta Ana A ©2 L��3 rk of the Cour.-.il The agreement with DPVVtI No. was completed on /SFc /6ulll and final payment has been made. �\E —; 4i� p (List all amendments. Use space below it needed.) Department: 2Rc�SA Phone/Ext.: `{^ M Signature: Date: Revised: 01-07-16 A-2016-267 91 MAYOR Miguei A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS. P. David Benavides Vicente Samrlento Jose Salado Sal Tlnajero Juan Milegas May 23, 2017 :Jenny Rios, CEO Delhi Center 505 E. Central Ave. Santa Ana, CA 92707 CITY OF SANTA ANA OFFICE OF THE CITY ATTORNEY 20 Civic Center Plaza, M29 • P.O. Box 1988 Santa Ana, California 92702 714-647.5201 • Fax 714-647-6515 mvw.santa-sna.Ora INTERIM CITY MANAGER Cynthia J. Kurtz CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Maria D. Hulzar Re: "Facilities Use Agreement' Extension — Delhi Center (Children's Library Literacy Pilot Program) Dear Ms. Rios. Pursuant to Section 3 ("Term") of Agreement No. A-2016-267 entered by Delhi Center and the City of Santa Ana, dated September 20, 2016, the City of Santa Ana wishes to continue utilizing the Delhi Center to provide tutoring and literacy programming services to participants, including residents of the City. The time period of said Agreement is hereby extended for an additional one (1) year period, from July 1, 2017 to'June 30, 2018. All other terms and conditions of said Agreement remain unchanged and in full force and effect, If you have any questions regarding this matter, please contact Gerardo Monet in the Parks, Recreation and Community Services Agency at 714-571.4204. Sincerely, Gerardo Monet Executive Director, Parks, Recreation and Comrmm ty Services APPROVED AS TO FORM; Soria R. Cdrvalho City Attorney Lisa Storck Assistant City Attorney c: Clerk of the Council Aff OF S TA ANA Cynthia J. Kurtz Interim City Manager ATTEST: 1vSana Huizar Clerk of the Council SANTA ANA CITY COUNCIL Nit"t&retail Michele MaNnez Vicente satmeado Jese Salado P. David Benavides Juan Villegas Sal Tnalerl Maya Mayer Pro Tem, Ward 2 Ward Ward3 Ward ive7d5 Wald 6da(Aaa"0d, ».orl mlcearfi a wnia-arm.am ysyr_p (p(r139nta ana nra isobrw'.dsanfa-ana.orn �Qb ry�vlQ[!g@S.lnia.ana.oro vYlieaa5lcxsmNa-nna nra elina eroc�aenia e+fs aro A�ORL?® CERTIFICATE OF LIABILITY INSURANCE DATE ( 0/7/2016Y1 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must 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 endorsements . PRODUCER CONTACT NAME: Certificate Issuance Team Comprehensive Insurance Services PHD N )) 709-8800 ANM: (949)709-1669 26429 Rancho Parkway South aoo.S., info@ thecomprehensiveinsurance. Done Suite 120 INSURER(S) AFFORDING COVERAGE MAID# Lake Forest CA 52630 INSURERA:Non rofits Ins Alliance of CA 11845 INSURED '����� INSURER B:COm West Insurance Company 12177 INSURERC Delhi Center 505 E. Central Ave. INSURERD: INSURERE; _ 1 Santa Ana CA 927uSURERF: IN COVERAGES CERTIFICATE NUMBER:GL/Auto/WC REVISION NUMBER: THIS IS TO CERTIFY THAT 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN D CONDITIONS OF SUCH .POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSLTR TYPE OF INSURANCE INqn Well POLICY NUMBER POLKNEFF MMIDOI POUCYEXP MM100 V LIMITS A X COMMERCIAL GENERAL LIABILITY GtAIMSMADE OCCUR EACH OCCURRENCE_ § 1,000.,000 _ REMISES Be occurrence) $ 500,000 MED EXP(Any oneperson) _ 20,000 X 2016-01376-NPO 11/1/2016 I1/1/2017 PERSONAL& AOV IN..URY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY,E�T 1�1LOC GENERAL AGGREGATE 1 3,000,000 PRODUCTS-COMP/OPAGG $ 3,000,000 $0 DoWdible OTHER. AUTOMOBILE LIABILITY COMBINED SINGLELIMIT$ Ea acdidem L,000e 000 BODILY NJURY(Per person) $ A X ANYAUTO ABINNED LEG AUTOS HIRED AUTOS X NOT -OVdJED 2016-01376-FPO 1J �\ev.e� ` '11/112016 -7- 11/1/2017 BODILY INJURY Per accident t $ pendent $ Deduclve $ �f UMBRELLA LAI 1CCUR `Ia EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CLAIMSMADE !^ v '\r. DED RETENTION $WORKERS $ VcV B AND EMPLOY RS'LIABILITYYIN ANY PROPRIETORNPARTNERNEXECUTIVE OFFICERJMEMBER EXCLUDED? ❑N/A (Mandatory in NH) IT yes, describa Under DESCRIPTION 0F0PERATIONS below �'} •J WCV5900420. 1I/I/2016 11/l/2017 X STRTUTE ERH E.A.. EACH ACCIDENT $ 1,000,000 E.L. DISEASE EA EMPLOYEE $ 1,000,000 El DECADE POLICY LIMIT $ 1000 000 A Social Sery professional 2015-01376-FPO 11/1/2016 11/1/2017 $S.000.00QA29/1.000,0000cc $0 Deductible A Improper sexual Conduct 2016-01376-FPO 11/1/2016 11/1/2017 $100.000A,0000.0000cc $0 Deductible DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (ACORD 101, AddMonal Remarks Schedule, may be attacled Irmera space A required) The City Of Santa Ana its officers, employees, agents and volunteers are included as Additional insured automatically per written contract or agreement per attached endorsement CG2026. 30 day notice of cancellation with 10 day notice of cancellation for non-payment of premium per policy provision. City of Santa Ana 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. JEREMY-�.,-.....� , m 1988-2014 ACORD ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) POLICY NUMBER: 2016-01376-NPO COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ��� • 1 l A • • • � � 1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becomina effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager forthat person or organization. Information required to complete this Schedule,: if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured 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. 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 inthe Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. gas e p�G CG 20 26 0413 0 ISO Properties, Inc., 2012 Page 1 of 1