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FOURTH AMENDMENT TO AGREEMENT <br />THIS FOURTH AMENDMENT TO AGREEMENT is made and entered into this I" day of <br />July, 2011, by and between the City of Santa Ana, a charter city and municipal corporation of the <br />State of California ("City") and Pulmonary Consultants & Primary Care Physicians Medical <br />Group, Inc. ("Consultant'). <br />RECITALS: <br />City and Consultant entered into Agreement N-2007-192, dated August 20, 2007, (hereinafter <br />"said Agreement"), by which Consultant has provided SWAT physicals and annual <br />hazardous materials medical examinations for Police and/or Fire Department personnel who <br />handle hazardous materials, pursuant to Title 8, Section 5144 of the CALOSHA Respiratory <br />Protection Regulation. <br />2. In accordance with the terms and conditions of said Agreement, the parties now wish <br />to extend the term of said Agreement for an additional one-year period and increase <br />compensation to pay for services during the extended term. <br />WIIEREFORE, in consideration of the mutual and respective covenants hereinafter contained <br />and made, and subject to all the terms and conditions of said Agreement as hereby amended, the <br />parties do hereby agree as follows: <br />Section 2.a., COMPENSATION, shall be amended to add $30,000 to pay for medical <br />examination services during the 2011-12 fiscal year, <br />Section 3, TERM, shall be amended to extend the term of said Agreement for an <br />additional one-year period, through June 30, 2012. <br />3. Except as hereinabove modified, the terms and conditions of said Agreement and any <br />amendments thereto remain unchanged and in .full force and effect. <br />IN WITNESS WHEREOF, City and Consultant have executed this Fourth Amendment to <br />Consultant Agreement on the day and year first set forth above. <br />ATTEST: CITY OF SANTA ANA <br />MARIA D. HUIZAR DAVID N. REAM <br />Clerk of the Council City Manager <br />Additional signatures on next page <br />25C-3