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THIS SECOND AMENDMENT to the above -referenced agreement is entered into on February S,
2019, by and between Mercy House Living Centers, Inc. ("Contractor"), 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 No. A-2018-221, dated September 18, 2018, by which
Contractor agreed to administer and operate an interim, low barrier emergency homeless
shelter in the City of Santa Ana ("Agreement"),
B. On October 16, 2018, the parties entered into First Amendment to Agreement No. A-2018-251
to provide additional indemnification in favor of Contractor relating to certain of Contractor's
obligations under the separate, written lease entered into by Contractor to secure the premises
for its obligations under the Agreement.
C, The Agreement remains in effect, and the parties now wish to further amend the Agreement to
increase the amount of funds to be expended in Year 1 of the Agreement due to additional
start-up costs incurred by Contractor for improvements made to the premises.
The Parties therefore agree:
Section 3(c), Start -Lip Funding and Compensation, is amended to increase the total sum to
be expended under Year 1 of the Agreement by up to $250,000, upon receipt from Contractor
of proper invoices evidencing costs for services and reimbursable items to be provided by
Contractor under the Agreement. In the event City and. Contractor agree to extend the
Agreement for any period of time beyond its original term of one year, there shall be no
contingency amount available for such extension period.
2. Except as modified by this Second Amendment, and all prior amendments, all terms and
conditions of the Agreement shall remain in full force and effect,
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the
Agreement on the date and year first written above.
ATTEST
NORMA MITRE
Acting Clerk of the Council
CITY OF SANTA ANA
STEVEN A. MENDOZA
Acting City Manager
Page 1 of 2
APPROVED AS TO FORM MERCY HOUSE LIVING CENTERS,
SONIA R. CARVALHO INC.
City Attorney
By:
JVfJN M. FUNK Name; A4
Assistant City Attorney Title; (�U<<}�
RECOMMENDED FOR APPROVAL
STEVEN A. MENDOZA
Executive Director
Community Development Agency
Pago 2 of 2
CERTIFICATE OF LIABILITY INSURANCE
DA0212112019Y
o2r2ar261s
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s).
PRODUCER
Dufour Insurance Services, LLC
5611 Littler Drive
CONTACT
N AME: Stephanie Dufour
Ac"u_369.2998 4840.6357
No, E :714
Huntington Beach, CA 92649
Stephanie Dufour
E-MAIL Ske hanfe dutourinsurance.com
ADDRESS: P
INSURER(S) AFFORDING COVERAGE
NAICR
CLAIMS -MADE a OCCUR
INSURER A;Great_American Insurance Cornice
16691
$ 10,00
_
INSURED Mercy House Living Centers
PA. Box 1905
Santa Ana, CA 92702
INSURER B: Great American Insurance Comps
16691
INSURER c: NOVA Casualty Company
42552
INSURER D:Greal American Insurance Group
37532
INSURER E:Philadelphia lndemnity
18058
A
INSURER F:
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
COVERAGES CERTIFICATE NUMBER: 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 AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INBR TYPE OF INSURANCEEFW POLICY NUMBER 'MXP
TR M@D EYY MM ODIYEYYY LIMITS
ACCORDANCE WITH THE POLICY PROVISIONS.
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,06
A
X COMMERCIAL GENERAL LIABILITY
Y PAC426088203 0510212018 05102/2019
PREMISES Ea oc�nDe<„-.e
$ 100,00
CLAIMS -MADE a OCCUR
MED EXP (Anyone person)
$ 10,00
A
X Prof. Liability
PAC426088203 OW0212018 05/0212019
PERSONAL& ADV INJURY
$ 1,000,00
X
Sex Abuse/Miscond
GENERAL AGGREGATE
$ 2,000,00
A
PAC426088203 05102/2018 05/02/2019
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,00
X _
POLICY .. PRO- LOC
Ded: $0
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
1,000,00
AANYAUTO
Y CAP 188045404 05/0212018 0510212019
BDDILY INJURY (Per person)
$
ALL OWNED SCHEDULED
X
BODILY INJURY (Per accident)
.�. _..__
$
$
AUTOS AUTOS
X NON -OWNED
IX
PROPERTY DAMAGE
$ 130,00
WIRED AU709 AUTOS
PER ACCIDENT
....
ComplColl Ded.
$ 50
X I UMBRELLA UAB X OCCUR
EACH OCCURRENCE
$ 5,000,00
B
EXCESS LIAR CLAIMS-MADF
Y LIMB 426088303 0510212018 05/0212019
AGGREGATE
$ 5,000,60
DED X RETEMION$ 10000
_
$
WORKERS COMPENSATION
WE STAT47. OT}'I'
X X
AND EMPLOYERS' LIABILITY
Y�
TORY OMITS t3,
C
ANY PROPRIErORIPARTNER/EXECUTIVE
CFI -WK -10000043-03 02108/2019 02108/2020
F.L. EACH ACCIDENT
$ 1,000,00
E
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
NIA
(ACCIDENT) PHLY78923350 1112112018 11/21/2019
E.L. DISEASE - EA EMPLOYE'
$ 1,000,00
Dyes, Resorunder
DESCRIPTIOONN OF OPERATIONS below
EL.DISEASE -POLICY LIMIT
"'
$ 1,000,00
D
Cyber Liability
Y NLP3642944 01/2912019 0112912020
Per Occ 1,000,00
E
D&O/EPLI
Y PHSD1173663 10/1712018 1011712019
Aggregate 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more space N roqulrod)
City of Santa Ana, its officers, employees, agents, volunteers and
representatives are named additional insureds with respect to the operations
of the named insured & this policy is primary per the attached endorsement. gg
Workes compensation waiver of subrogation included. 10 days notice of
cancellation for non-payment of premium.
CERTIFICATE HOLDER CANCELLATION
61988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Cit of Santa Ana
City
ACCORDANCE WITH THE POLICY PROVISIONS.
Frank Hernandez
20 Civic Center Plaza Box 1988
AUTHORIZED REPRESENTATIVE
Santa Ana, CIA 92702
(w L J�
61988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD