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Home My WebLink AboutWeldy, Scott H. 1bR2 AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect � `l, s Return form to the Deputy Clerk of the Council (M-30). Call 647 65 0 `if you have any;'_ questions. '- ----------------------------------------------------------------- The agreement with { a.e a A- �0003 -174 was completed on �) )Qtf and final payment has been made_ N-2DD3-DDK (.0 LDM 14�- R - 20D3 -DKD (ZR) Revised 4-16-87 Department: Signature: �J�iC�% �A Date: `5— l V2I �L i City of Santa Ana Clerk of the Council C : PROS (k. AMV) ' flJ INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: SECOND AMENDMENT TO CONSULTANT AGREEMENT A-2003-178 THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT, # A-2003- 080, is entered into this 4th day of August, 2003, by and between Scott H. Weldy, DVM, a sole proprietor ("Consultant') and the City of Santa Ana, a charter city and municipal corporation of the State of California ("City"). Recitals: A. The parties entered into Agreement #N2003-008, dated February 6, 2003, (hereinafter "said Agreement") by which Consultant has provided veterinary services to the Santa Ana City Zoo. B. In accordance with the terms and conditions of said Agreem nt, the parties extended the term of said Agreement, by Amendment dated May 2003 (hereinafter "First Amendment'). C. The parties desire to enter into a second Amendment of said Agreement to increase the compensation by $30,000.00, to pay for additional services Consultant provided during the time City was looking for a primary veterinarian, and to pay for back-up and emergency veterinary services during the extended term. Wherefore, in consideration of the covenants contained in the Agreement, and subject to all the terms and conditions of said Agreement and First Amendment, except those amended in this Second Amendment to Consultant Agreement, the parties agree as follows: 1. Section 2.a., COMPENSATION, shall be amended to read as follows: "City agrees to pay, and Consultant agrees to accept as total payment for its services the rates and charges identified in Exhibit A. Maximum amount for reimbursable expenses shall be $2,000.00 per fiscal year. The total sum to be expended for services and reimbursable expenses under this Agreement, shall not exceed $50,000.00 during the term of this Agreement." 2. Except as hereinabove amended, all terms and conditions of said Agreement and First Amendment shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to Consultant Agreement on the date and year first written above. CITY OF SANTA ANA ATTEST: PATRICIA E. HEALY DAVID N. REAM Clerk of the Council City Manager APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney By La' a Needy Assistant City Attorney CONSULTANT JfOrF H. W D , DVM Tax ID# 33 0770084 K:\ W PDOC S\D002\P001 \00007953. DOC U __ Client#, 46200 SERRAANIMI A CORD M CERTIFICWE OF LIABILITY DATE (MM/DD/VYYV) IN NICE 11/20/03 PRODUCER THIS CERTIFICAT r3 ISSUED AS A MATTER OF INFORMATION Association Unit ABD Insurance &Financial Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 305 Walnut Street �> Redwood City, CA 94063 .A ':LI[J /`% �5 INSURERS AFFORDING COVERAGE NAIC # INSURED Serrano Animal & Bird Hospital, Inc. 21771 Lake Forest Drive #111 El Toro, CA 92630 INSURERA: Fireman's Fund Insurance INSURER B: INSURER C: INSURER D' INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD' IIINSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE tMM/DDNYI LIMITS A GENERAL LIABILITY AZC80727616 07/01/03 07/01/04 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAAMAGETo RENTED (Ea CCUn $250OOO MED EXP (Any one person) $10 000 PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG s2,000,000 17 POLICY 7 PRO-ECT LOC J AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR El CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND WZP60914440 07/01/03 07/01/04 X WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - al" LICV LIMIT $1,oQQ,000 A OTHER Professional AZC80727616 07/01/03 07/01/04 $1,000,000 occurrence Liability $2,000,000 aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Workers Comp Information Voluntary Compensation ** Supplemental Name ** (See Attached Descriptions) City of Santa Ana, Parks, Recreation & Community Services 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 f20n1/DRI 1 -s Q eGQDaae ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL EN,@X*X)BMCkXWL 30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BW)F7i1CXORr(30RQ.QQAO'BLXXX Bbcamceta xlaaxxaxaa�eaEXxxwxxxx F4*M X9TA30X=X AUTHq&ZED REPRESENTATIVE coeon nNusA� v,Ao n Ar.nRn Cr1RPnPATIr1N 1QAR IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AGURo 25-5 (2001M) 2 of 3 #530885 DIVRIPTIONS (Continued fro age 1) Doing Business As: Serrano Animal & Bird Hospital, Inc. City of Santa Ana, Its officers, agents, employees, representatives and volunteers are included as Additional Insured as respects to Operations Perfored by the Named Insured. AMS 25.3 (2001108) 3 of 3 #530885 POLICY NUMBER: AZC80727616 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON or ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Santa Ana, Parks, Recreation & Community Services 20 Civic Center Plaza Santa Ana, CA 92701 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your operations or premises owned by or rented to you. City of Santa Ana, Its officers, agents, employees, representatives and volunteers are included as Additional Insured as respects to Operations Perfored by the Named Insured. 'Z/s- CG 20 26 11 85 •� ��: �,p aerrano H ana H Hospital Oat 27 03 01r44p isnta Ana Zoo ADDITIONAL INSURED ENDORSEMENT 949 855 1070 p,4 7#W537401 p,3 Insurance Company: r f 2 t= dqA l.1 ,S, FV U D Z/J S &, This endorsormot modifiati such insurance as in afforded by the provlsinns of Policy 0 4Z 0 Leo 7,2 ZG / Relating to the following! 1. The City of Santa Ana, 20 Civu; Ceilter I'laza, Smtta Ana, California 927U], officers, employees, aLnnls and reprcwenmtivtm are named as additional insured with regard to liability and defense of suits arising from the operations and use-s performed by on behalf of the named insured. 2. With respect to claims arising outof the operations and uses performed by or on behalf of the named insured, .such insurance as is''affordW by this policy is prints ry and is not to cont0buting with any other insuranm carried by or for the benefit of the additional insured. 3. This insurance applies suparately to each insured against whom claim is made or suit is bntttght except with respect to the company'!: IintiL% of liability. The inclusion of any parson or organi=%tion as an insured shall not affect any right which such person or orZnnizatioin would have as a claimant if not so incloded. 4. With resfxxt to the additional insured, this iitsuramv. shall not be cancelled, or materially reduced in coverage or limits except after thirty-90 days written notice has 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 7 - / _ Ci „1 / , this tmdorsement form as part of Policy ,q . /4 2 C 2 eo .) -7 Issued to Namotl In6Ylaa ` Countersigned by VV, nc�- Q - •`��^`^^�" �-''� eg/m/47