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Home My WebLink AboutBOYS AND GIRLS CLUB 1A-2002AMENDMENT TO AGREEMENT THIS AMENDMENT, made and entered into this 2nd day of December, 2002, by and between the Boys and Girls Club of Santa Ana ("Contractor") and the City of Santa Aha, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California ("City"). RECIIALS A. The City and Contractor entered into that certain Agreement dated June 3, 2002, hereinafter referred to as "said Agreement", to provide career preparation and basic skills services for disadvantaged youth who are in-school. B. The parties hereto now desire to amend the amount of the "City's Obligations" found in Section 2 of said Agreement. WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and made, and subject to all of the terms and conditions of said Agreement as hereby amended, the parties hereto do hereby agree as follows: 1. The "City's Obligation" section of said Agreement will be amended to read: "...a sum not to exceed ~174~866.00." 2. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to said Agreement the date and year first above written. Clerk of the Council David N'~ Ream, City IVl~n~g'~ APPROVED AS TO FORM: BOYS & GIRLS CLUB OF SANTA ANA By: Lisa E. Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: John 1~. Reekstin, Executive Director Community Development Agency irector INSURANCE NOT ON FILE WORK MAY NDT PROCEED CLERK OF COUNCIL DATE: Sent By: ZRM INSURANCE; 714 6327197; Feb-2f 10:02AM; ACORO.. CERTIFIC .,'E OF LIABILITY INSU.-.ANCE "RD~CeR IRM IN~Uz~ANCE BROKERS Page 1/2 / DATE(MM/DO?PO o~/2s/o3 INSURED P.O. BOX 17939 ANAHEIM, CA 92817 LICENSE % 0532703 PHONE %(714) 688-1167 BOYS A_ND GIRLS CLUB OF SANTA ANA, A CALIFORNIA CORPORATION 950 MST HIGHLAND SANTA ANA, CA 92703 ~.OVERAGES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON rile CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERA.~E THE POLICtES OF INSURANCE LISTED BELOW WAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. t~TWITHBTANDING ANy REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENt' WrTH 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 CONDrTIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS. x ~ "- ~ ~ ~.~ '- '.' ~,'.,~v 8502CY073003-5 12/20/02 12/2o/o3 : oooooo FiRE DAMAGE (ACy one ~rei !! 50000 ) PRODUCTS - COMPIOP AGO $ [000000 ~L~OMO.I~ ~mU~ 1002CY073004-5 12/20/02 12 / 20 / 03 ' CO~EO S,N~LE U.~ 460CY073010-5 APPR__~ AS TC CRISl~ LEE SH Deputy CIt? Attorr 12/20/02 M ~W -- ey 12/20/03 $ 1000000 4000000 4000000 E.L EACH ACCIDENT OTHER OE$CRIE33ON DF DP F. RATION $/LQCATIO NS/VEHICLES/EXC LUS[ONS ADDED ~1~ ~RSEMENT/SPECIAL PROVISIONS R:~; T~E CITY OF S~A ~A, ITS OFFICERS, AGE'S ~ ~PLOYEES ~ REPRESE~ATI~S ARE N~ED AS ~DITION~ INS~EDS WITH REGA~ TO LIabILITY ~ DEFENSE ~ISING FROM THE OPE~TIONS ~ USES PERFO~ED BY OR ON BEeF OF THE N~ED INSURED. ;E RTIFICATE HOLDER T~ CITY OF SANTA A~A 20 CIVIC CENTER PLAZA M-32 SANTA ANA, CA 92701 ATTN~ ;LLHA FLOP. ES ~CORD 2S-S (7/97) CANCELLATION Sent By: IRM INSURANCE; ' e2/~20e3 00:5i 7145434F"~ 714 6327197; Feb~2~ BOYS & GIRLS CLUR 10:03AM; Page 2/2 PAGE 04 EXHIBIT B ADDITIONA~ INSURED ENDOP~EMENT FOR COMMERCIAL OEN~KA.L LIABILI ,TY POLICY Insurance Company, MARKEL INSUKANCE COMPANY This endorsement modifies such insurance as is afforded by the provisions of Policy # 8502cY073003-5 relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Sm~ta Aha, C~lifornia 911701; it: of Scers, employees, agents, volunmers mhd representatives are named as additional insureds ("additional insureds") with regard to liability snd defense of suits arising from the operations and uses performed by or on behalf of the named insured. With respect to claims arising out of the operations ~nd 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 addidon~l insureds. 3. This insurance applies separately to each insured against whom claim is ma& or suit is brought except with respect to the company% limits of liability. The inclmion of any per, on or organization as an insured shall not affect any right which such person ot organization would have as a claimant if not so included. 4. With respect to the additional insured% this insurance shall not be cancelled, or matcriaily reduced in coverage or l/mits except after thirty (30) days written notice has been given to the City of Santa Alta, 20 Civic Center Plaza, Santa Aha, Cali£omia 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy ~ Issued to ! ~-20-02 .' , this endorsement form as ~ part of 8502CY07qmm3-~ .. Boys and G~]r~ ~l,,x ~¢ gallo a.~ a Cali~n~ Cerporztlcn Au hofizedR presentative ' Deputy G,t> Attorney CERTIFICATE OF INSURANCE PRODUCER Markel Insurance Company P.O. Sox 3870 Glen Allen, VA 23058-3870 CODE SUB-CODE INSURED Boys & Girls Club of Santa Aha, A California Corporation 950 W Highland SantaAna, CA 92703 COVERAGES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A MARKEL INSURANCE COMPANY LETTER COMPANY B LETTER COMPANY C LETTER COMPANY D LETTER COMPANY E ~""~-,~ LETTER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT ; WITH RESPECT TO WHICH THIS CERTIF CATE MAY BE SSUED OR MAY PERTAIN, THE HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF THE INSURED NAMED ABOVE FOR THE ~,NY CONTRACT OR OTHER DOCUMENT E AFFORDED BY THE POLICIES DESCRIBED ; SHOWN MAY HAVE BEEN REDUCED BY LIMITS TYPE OFINSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY __ CLAIMS MADE ~] OCCUR. OWNERS & CONTRACTOR'S PROT, AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY POLICY NUMBER EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER Inland Marine Property 12-20-2003 8502CY073003-5 12-20-2002 12-20-2003 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHiCLES/SPECiAL ITEMS Certificate holder is included as additional insured for operations conducted by the named insured. CERTIFICATE HOLDER CANCELLATION GENERAL AGGREGATE 3,000,000 PRODUCTS-COMP/O PS AGGREGATE 1,000,000 PERSONAL & ADVERTISING INJURY 1,000, 000 EACH OCCURRENCE 1,000,000 FIRE DAMAGE IAn¥ one fire) 100,000 MEDICAL EXPENSE (Any one person} 5,000 COMBINED SINGLE LIMIT BODILY INJURY {Per Person} BODILY INJURY (Per accident) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE STATUTORY LIMITS EACH ACCIDENT DISEASE - POLICY LIMIT DISEASE-EACHEMPLOYEE Clerk of the City Council -City of Santa Ana 20 Civic Center Plaza PO Box 1988 Attn: Maria Yanez Santa Ana, CA 92702 ACORD 25-S(7/90) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, Bruce A. Kay CPO (c) JKCORD CORPORATION 1990 ADDITIONAL INSURED ENDORSEMENT Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: 1. The City of Santa And, 20 Civic Center Plaza, Santa And, California 92701; its officers, employees, agents and volunteers 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 canceled, 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 Aha, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # , this endorsement form as a part of Issued to Named Insured Countersigned by Authorized Representative ~R COPY · STATE F'.O. E~OX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION I=UN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 08-t4-2003 CITY OP SANTA ANA COMMUNITY DEVELOPMENT AGENCY PO BOX 1988 M-25 SANTA ANA CA 92702 GROUP: 000723 POLICY NUMBER: 75-2003 CERTIFICATE ID: 2 CERTIFICATE EXPIRES: 06-01-2004 06-01-2003/06-01-2004 This is to certi~;,' that we have issued a valid W,,r~e,)'~ c:r,mpensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy pedod indicated· This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer· We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration· This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein· Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance 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· AUTHORtZEO REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 08-14-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: CITY OF SANTA ANA APPROVED AS ~10 t ORM · ,,,~it~ City Attorney EMPLOYER BOYS AND GIRLS CLUB OF SANTA AMA CORPORATION) 950 HIGHLAND ST SANTA ANA CA 92703 (A NON PROFIT SCIF 10262E Accept this cedifTcate only if ~u see a faint waterrner~ that reads "OFFICIAL STATE FUND DOCUMENT" LTY SP PAGE 1 OF 1