HomeMy WebLinkAboutINDUSTRIAL MEDICAL SUPPORT, INC. (2)!NSUPA10- UPI EI_E
WORK MAY PROCEED
UN -I'll. INSURANCE EXPIRES
3'15.26r2
CLERK OF COUNCIL
,TY
N-2022-361-01
FIRST AMENDMENT TO AGREEMENT WITH INDUSTRIAL MEDICAL SUPPORT, INC.
Iti(� FOR STANDBY EMERGENCY SERVICES AT CITY'S 2022 WINTER VILLAGE EVENT
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lMort�d L / THIS FIRST AMENDMENT to the above -referenced agreement is entered into on January 27, 2023, by
-f L and between Industrial Medical Support, Inc., a Nevada corporation ("Contractor"), and the City of Santa
tv&�,e Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the
State of California ("City").
efo
o RECITALS
N
14
A. The parties entered into Agreement No. N-2022-361 ("Agreement") dated November 30, 2022, for
c Contractor to provide standby emergency medical services for the City's 2022 Winter Village
n Event ("Event").
u
a�
B. The parties wish to amend the Agreement to increase the overall compensation due under this
Agreement to provide compensation for the increased services provided by Contractor to City
during the Event.
The Parties therefore agree:
1. Section 2.a., Compensation, is hereby amended to increase the amount owed to Contractor under the
Agreement by an additional $2,689.00 as and for the increased services provided by Contractor to City
during the Event, as set forth in Contractor's invoice No. 18689, attached hereto and incorporated herein
as Exhibit A-1.
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
NORMA OROZCO
Acting Clerk of the Council
APPROVED AS TO FORM
SONIA R. CARVALHO
City Attorney
By:
Jdt athan T. Martinez,/'
Assistant City Attorney
Parks, Recreation, & Community Services Agency
CITY OF SANTA ANA
"ISTINEE RIDGE
City Manager
INDUSTRIAL MEDICAL SUPPORT, INC.
S aCA?44,
By:
Title: Shanna Ickler-Assistant Manager Media Suppol
Page 1 of 1
0 Industrial Medical Support, Inc.
3320 E Airport Way
Long Beach, CA 90806
(877)878-9185
Bill To
City of Santa Ana
Public Works Agency
Exhibit A-1 to Amendment
(N-2022-361)
Invoice
Date Invoice #
I18I2023 18689
Terms
Due on receipt
Invoice Period
11_.09-01.08
Description
Quantity
Rate
Amount
Overa_e to Contracted Amount
1
2.689.00
2,689.00
Total `16149.00
Payments/Credits So.00
Balance Due S2-o89,00
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENTTO THE CLERIC OF THE COUNCIL
Contractor Industrial Medical Support, Inc.
Name:
Project TBD (010)
Number:
Project Agreement With Industrial Medical Support, Inc., For Standby
Name: Emergency Medical Services At City's 2022 Winter Village
Event
The Certificate of Insurance (COI) submitted indicates that the coverages are in
compliance with the insurance requirements. No further action is required at this time.
The compliant coverages) are:
TYPE OF INSURANCE
POLICY
EXPIRATION
COI DATE
FILE NAME
NUMBER
DATE
GENERAL LIABILITY
HN033337
03/15/2023
11/30/2022
Certificate.pdf
HEALTHCARE PROFESSIONAL LIABILITY
HN033337
03/15/2023
11/30/2022
Certificate.pdf'
CLAIMS MADE
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
12/7/2022 11:57 AM
T10221176 04/10/2023
11/30/2022 Certificate,pdf