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INSURANCE ON FILE
WORK MAY PROCEED N-2018-010-01
C_NTIL INSURANCE EXPIRES
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CLERK OF COMM��
DATE: YAV FIRST AMENDMENT TO RECREATION SERVICES
O: PRCS (/) AGREEMENT WITH BERTHA JAUREGUI
Silvia Cuevas
THIS FIRST AMENDMENT to the above -referenced agreement is entered into on May 9, 2018,
by and between Bertha"Jauregui ("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 ("City").
RECITALS
A. The parties entered into Agreement #N-2018-010 dated December 6, 2017 ("Agreement"),
by which Provider agreed to provide and conduct Early Childhood Education classes for
children 3 - 5 years of age. The term of the Agreement was from January 1, 2018 through
December 31, 2018 and is still in effect.
B. The compensation for the Agreement provided a split of the gross revenues received from
program participants to pay the Provider seventy percent (70%) of the gross revenues with
the City to retain the remaining thirty percent (30%). The total amount of revenue to the
Provider shall not exceed $25,000 during the term of the Agreement.
N -go 1t. -I .7 5
C. Prior to the execution / of the Agreement, Provider and City were engaged for similar services
under Agreement TMs --2016-175 dated November 23, 2016, for a term from January 1, 2017
through December 31, 2017. Under the compensation terns of the November 2016
agreement, Provider received 80% of the gross revenues with the City retaining 20% (80/20
split).
D Due to a clerical error, the compensation terms for the current Agreement were not set forth as
an 80/20 split of the revenue. It was the intent of the City to continue the payment split as
provided in the prior 2016 agreement. City's intent was manifested in that it continued 80/20
payments to the Provider for the month of January 2018 under the Agreement. Payments under
the 80/20 split were halted upon discovery of the clerical error in February 2018.
E. The parties now wish to correct the payment split amounts to reflect the 80/20 arrangement
that was originally intended. City will recognize and pay for invoices for all services rendered
during the term of this Agreement under the amended compensation terms below. Provider
agrees and understands that the City has paid for said services under the amended terms for the
month of January 2018. The total not to exceed amount will not be increased.
The Parties therefore agree:
1. Section 2, COMPENSATION, is amended to read as follows:
In consideration for the provision of the programs set forth in Exhibit A, City agrees to pay the
Provider eighty percent (80%) of all gross revenue received from program participants. Total
revenue to Provider shall not exceed $25;000:00 annually. Payment to Provider shall be made
monthly within thirty (30) days following completion of the last class taught by Provider the prior
month. City shall be responsible for collecting all fees from program participants. Provider shall
N-2018-010-01
not collect fees but will refer all interested participants to City for registration information.
Provider agrees that City shall retain twenty percent (20%) of all gross revenue received from
program participants as an administrative fee.
2. Except as modified by this First Amendment, all terms and conditions of the Agreement shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the
Agreement on the date and year first written above.
ATTEST
MARIA D. HUIZAR
.r ,.
Clerk of the Council
APPROVED AS TO FORM
SONIA R. CARVALHO, City Attorney
11,4y,c /Lc B -i -o /
LISA STORCK
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
�61
) GERARDO MOUET,
Executive Director,
Parks, Recreation and Community Services Agency
CITY OF SANTA ANA
vjov;/�-
RAUL GODINEZ
City Manager
PROVIDER
Bertha Jauregui
N-2018-010-01
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2018-12
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. 0. Box 6450
Santa Ana, CA 92701
Newport Beach, CA 92658
License No: OC 36861
NAMED INSURED (EVENT HOLDER):
EVENT INFORMATION:
TYPE: Preschool/Daycare
Bertha Jauregui
DATE(S): 01/01/18-12/31/18
2422 S. Shelton Street
LOCATION: Memorial Center
Santa Ana, CA 92707
*Liquor Liability Yes ❑ No
"Liquor Liability 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. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless
amended as described in Special Conditions.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: SEP41026
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 20t8 EXPIRATION: JANUARY 1, 2019
COMMERCIAL GENERAL LIABILITY
OCCURRENCE FORM
DEDUCTIBLE; NONE
General Aggregate Limit $ 2,000,000
Products & Completed Operations 1,000,000
SPECIAL CONDITIONS:
Personal & Advertising Injury 1,000,000
The following endorsements attached to
Each Occurrence Limit 1,000,000
the Master Policy do not apply to this
Damage To Premises Rented To You (Any One Premises) 100,000
Certificate Of Insurance:
Medical Payments (Any One Person) 5,000
MEGL643
Liquor Liability (If purchased) 1,000,000
Optional Limits Purchased
❑ $1,000,000/$3,000,000
❑ $2,000,000/$2,000,000
Damage To Property (if purchased)
The limits of insurance apply separately to each event insured by this policy as fa separate policy of insurance has been issued for that event,
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
rovisions.
AUTHORIZED REPRESENTATIVE:
DATE ISSUED:
N-2018-010-01
Ihereby affirm under penalty of perjury, the
(NamerTide)
following declaration
I certify on behalf of 6e-�hcv 3r LLJ- Cj,v) that during the term of my
(Conau
WmVCompmy Name) U
contract for recr 't—Q�Ly)(" ` services with the City of Santa Ana, I will not
employ any person in any manner so as to become subject to the workers' compensation
laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply
with those provisions and provide proof of workers' compensation coverage.
DATE:L_�
By:
Name:f E r'i JC
Title: 0 ,una
( -k df
Telephone: 1W (9,5` 5��i�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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