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Home My WebLink AboutSANCHEZ, NORA - 2018City of Santa Ana Clerk of the Council 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TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. LSu?+K a i THE MILINCIL Note: If your agreement is grant related, please ensure that all grant retention requirements ,r; V4 V- # 9•ry7 j have been satisfied prior to signing the termination form.¢ I Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with The \ N-2018-013'' C � No. was completed on and final payment has been made. (List all amendments. Use space below if needed) Department: PRCM Phone/Ext.: l� 521 Q Signature: Date: 111 % 11202 Revised: 10-18-16 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES L 0-3)1 ? b CLERK OF COUNCIL DATE: F11A1 5 2018 O: PRCS (/) FIRST AMENDMENT TO RECREATION SERVICES Silvia Cuevas AGREEMENT WITH NORA SANCHEZ N-2018-013 — ®� THIS FIRST AMENDMENT to the above -referenced agreement is entered into on May 9, 2018, by and between Nora Sanchez ("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-2018-013 dated December 6, 2017 ("Agreement"), by which Provider agreed to provide Tiny Tots classes for children 3 - 5 years of age. The terns 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. C. Prior to the execution of the Agreement, Provider and City were engaged for similar services under Agreement #A-2016-I89 dated November 23, 20t6, for a tern from January 1, 2017 through December 31, 2017, Under the compensation terms 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 tern 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"(90%) 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-2018-013 -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 (!� �Wm�l ' , - - - O-Zk— ® MARIA D. HUIZ'AR 7 Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO, City Attorney By: &I z /o� r� LISA STORCK Assistant City Attorney RECOMMENDED FOR APPROVAL: GERARDO MOUET, Executive Director, Parks, Recreation and Coinmunity Services Agency CITY OF SANTA ANA q1I— City AGODINNEZ Manager PROVIDER No ''Sane ez N-2018-013' 0, EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 20L8-23 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: Nora Sanchez TYPE: Preschool/Daycare 12061 Janette Lane DATE(S): 1/04/18 — 12/31/18 Garden Grove, CA 92840 LOCATION: El Salvador Center *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, 2018 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 if a 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 provisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: N-2018-013' ®� r+VORI<ERS' COMJ?ENSATION DEC1.1�1'vAT10N I Nth hereby affirm under penalty of perjury, the (vautefrl(1ul following declaration ; I certify on behalf of 0C)". SAAZkp= that during; the term of my (Cmullant'Company Nano) contract for kCdII&pTil7aCLA56E services with the City of Santa Ann, I wi 11 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: 62.- 8 —110 By; Name:._^�S\�5 (mayy1R�Z /� Title: Telephone:. �s✓�� 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). N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. red IF-e e . �gas J�aCJU �r�n