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Home My WebLink AboutMERCY HOUSE LIVING CENTERS, INC. (4)UW11l11 E ]P*4IQI1(? MAYOR I URANCE ON FILE Miguel A. Pulido 0 K-MAY PROCEED yryW' MAYOR PRO TE IL INSURANCE EXPIRES Juan Villegas S �_ e COUNCILMEMBERS "G Cecilia Iglesias CLERK OF COUNCIL w La David Penaloza DATE NOV 1 1 2019 Vicente Sarmiento Jose Solorio0 1\ � / CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.org October 23, 2019 Mercy House Living Centers, Inc. P.O Box 1905 Santa Ana, CA 92702 Attn: Larry Haynes, Executive Director Dear Mr. Haynes, CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Daisy Gomez Pursuant to Section 2 ("Term") of Agreement No. A-2018-221, entered by Mercy House Living Centers Inc., and the City of Santa Ana, dated September 18, 2018, with an Effective Date of October 15, 2018, the parties hereby mutually agree to extend the Term of the Agreement for a period of up to one (1) year, thus extending the time period of said Agreement from October 14, 2019 to October 14, 2020. The parties may continue to discuss additional partial or full year extensions, which would require City Council approval. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Please sign and return a copy of this letter agreement to confirm Mercy House's approval of the extension of the Term of the subject Agreement. If you have any questions regarding this matter, please contact Hafsa Kaka, Homeless Services Manager at 714-647-5375. Sincerely, l Steven A. Mendoza City of Santa a Executive Director Kristine Ridge Community Development Agency City Manager MUM `4 i 1 0 -/CLERK OF SANTA ANA CITY COUNCIL Miguel A. Pull Juan Villegas Vicente Sarmiento DaA Penaloza Jose Scioto Vacant Cecilia Iglesias Mayor Mayor Pro Tern, Ward 5 Ward 1 Ward 2 Wand 3 Ward 4 Ward 6 moulido0sants-ana om ' nlieus(asantaana.ora mrmlenloRsanla-angora GDenalo¢a(tosanta-ana.oro 'solorio(dsanta-ana.cro ciolesias(&santa-anaom APPROVED AS TO FORM: Sonja . Carvalho M- Assistant City Attorney ATTEST: Signed in counterpart Daisy Gomez Clerk of the Council By executing this letter agreement, Mercy Housing Living Centers, Inc. hereby approves of the up to one (1) year extension of the Term of Agreement No. A-2018-221 with the City of Santa Ana until October 14, 2020. Larry Haynes Executive Director Mercy House Living Center's, Inc. SANTA ANA CITY COUNCIL - Miguel A. Pulide Juan Villages Vleenle garmlent. David Panalo,oa Jos. Solaria Vawt codlia Ig:aslas Mayor Mayor Pro Tem. Ward 5 WardI Ward Ward Word m (d I'd 1 - ivlilaoaa(Aeanta-ena.orc vsarmlenfoldsanla-one om do= 4 (A 1 Isolorioldsenla-ana ore VJerJ"a 1- ACQ MERCY-2 OP 10: $0 �.... CERTIFICATE OF LIAaILITY IN.qIIR®IJI-'= I DATa(MIAMO/Y" 7126/2. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON019 LY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW, POLICIES THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORVEp REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the ceniBCate holder IS an ADDITIONAL INSURED, the pollty(tes) must be e111: 1 1 d, H SUBROGATION IS WAIVED, sub)eat to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this cartlgcato does not confer rights to the oortigcato holder In lieu of such andorsemant s , PRODufour Insurance NAME Stephanie Dufour 6611LitlerDriveServicae,LLC Huntngtor Drive Huntington Beach, CA92648� _ _ �� c s, .714-SS9.2998 t c Nor 714- 40.83S7 Stephanie Dufour ADpNE89 Ste phanie(�dufourinauranca,aom INSURERIBI, AFFORDING COVERAGE._. NAN7,f INSURED erC 0U8e Living Centers i y P.O. Box 1905 IN$DRERA,Phiiadei hIa IndBmni 18058 NSUREReIPhiladelehla Indemnl _ 18068 Santa Ana, CA 92702 INSURERc I NOVA Casual Company 42652 mauaaa U I Philadelphia Indemnity 18058 INsOREk a,c Phl. ladelphia Indemnity 98gg8 COVERAGES CMIR-1'IF11-TG arl lumen. THIS INDICATEO, IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN.ISSUED TO THE INSUREOEN�ASION NUMBER: ' I ABOVE. FOR THE POLICY CERTIFICATE NOTWITHSTANDING ANY REQUIREMENT, MAY SE ISSUED OR MAY PERTAIN, TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY CONTRACTOR THE POLICIES OTHER DOCUMENT WITH RESPECT PERI00 TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RECUCEO BY DESCRIBED PAID HEREIN IS SUS ECT TO ALL RM THE TE S. CLAIMS, LTn TYPE OrINSVRANeE'. POLICY NUMBER M .P.. .. LIMITS `.... eENERAL LIABILITY A X" X X PHPK1978777 05/02/2019 05/02l2020 EACH OCCURS ENDS b 1,000,00 CIAIOWGENEMLLIABIi.ITY CtAIMS•lAAOE aOOCUR EMI$ 6 a men S 100,00 MED E%P (AnYTrM Wreon) PERSONAI.SADVWJURY S iQ,00 A X Prof, Liability PHPKI976777 0610212019105/02/2020 X SaxAbu$alMiacond A pHpK1978777 OB/A2/2019 05/0212020 _ GEN'L AGGREGAE LIMIT APPLIES PER; a pENERALAGGREOATE y 2,000,00 PRODUCTS :OOMplOP ADD $ $000,00 X POLICY ! R L00 Ded,• $0 $ AUTOMOBILE LIABILITY I A � ANYAUTo AU.OWN06102f2019 AUr EO X SCHHEEDULED X X AUU?UTTO$ WNEDp X.I X PHPKI976M OBIOPJ2020 §S aDISIN -I.I ; 1100 101 �— BODILY INJURY (For person) BODILY INJURY IPararAdnnO $ $ �' HIREDANTD$ R E IDES E S � 130,00 XUMBRELLA LIAB XOOIjIJN :Com 1CDIi Ded•. EACH OCCURRENCE_ 3 So 5,000,00 B E0aE30UA9 CLAIMS -MADE X X P1I1.18674538 05/0212019 06/02/2020 DEB X R E 10000 X GPi•WK•1900094343 i AGGaEGATE S 5,000,00 C n1QNf WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY ECUTIVE Y� X 0STATU• X OT t E CTIICRAIM MNORE CCLUDERO MIA 02/061201910210812020 E.L.FADHAODIDENT $ 1,000,00 (MendI In NH) 9-deeullkuhdw !(ACCIDENT) PHLY7892886R 11121/2019 11/21l2018 E,L_DISEASE• PA EMPLOYE t 1,000,00 15 DE er OFOPEM7 NS &OIEPLI eblli(y X X NLP3642044 o1129/20i9 01/29/2020 E.L. DISEASE-p041CY LIMIT Per Occ 3 4,000,00 E D8:01EP X X PHS01973663 1011712018 10/17/2019 Aggregate 1,000,e0 100000 DBSCRIPTN)N OFOPERATIONS! LOCATIONS / VOM13LIO (AMaoh A0OR0101, Addaional Ramme Sohedule, N more $W' '; ulredl City of Santa Ana, its officers employess, agents, volunteers and representatives are named additional insureda with respect to the operations of the named insured 8 this policy is primary par the attached endorsement. Narkes onmpennation waiver of subrogation included. 30 days notice of cancaliation for non-payment of preacitun, REVIEWED & APPROVED By f21c1_Ma A n1I45l()ru icy, pNT RF0TIMIraTc O c _.. 062019 City of Santa Ana Risk Management Div 20 Civic Center Plaza, Santa Ana, CA 92702 DATE AUTHORIZED REPRESENTATIVE 0 ES BE CANCELLED BEFORE WILL BE DELIVERED IN resarved •-, ,,.o....w. w name ana logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company Philadelphia Indemnity This endorsement modifies such insurance as is afforded by the provisions of Policy # PHPK1976777 relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 5/2119 this endorsement form as a part of Policy # .PHPK1976777 Issued to Mercy House Living Centers Inc Named Insured Countersigned by Lpru2 Duun A thorized Repr entative