HomeMy WebLinkAboutTELFORDS 1B - 2003INSUR.~NCE ON FILE
WORK MAY PROCEED A-2003-265
CLERK OF COUNCIL
DATE:I,2)'/~q/g,$ SECOND AMENDMENT TO AG~EMENT FOR PROVISION OF SERVICES
THIS SECO~ ~E~MENT, made ~d entered into this 18t~ day of November, 2003,
by ~d be~een the Ci~ of S~ta ~a, a cheer city ~d m~cipal co~oration duly org~ized ~d
existing ~der the Constitution ~d laws of the State of CMifo~a ("Ci~"), ~d Telefords
("Consult~t").
RECIXALS
A. The City and the Consultant entered that certain agreement dated December 18, 2001,
hereinafter referred to as "said Agreement", pursuant to the Request for Proposals ("RFP") for
Consultant to provide temporary technical contract service persons and consulting services.
B. Said agreement was amended on December 19, 2002, in order to provide
continuous uninterrupted services under said agreement.
C. The parties hereto now desire to amend the Term and Compensation sections of said
agreement in order to provide continuous tminterrupted services to the City under the 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. Section 1, the "Term and Conditions" of said Agreement as amended is hereby amended to be a
period beginning on December 18, 2003, and ending on December 31, 2005.
2. Section 2, the "Compensation" term of said Agreement is hereby amended to provide the City will
pay to Consultant total compensation under this Agreement which shall not exceed $2,600,000.
Said total compensation shall be divided between any and all of the Consultants selected by the
City, as determined at the City's discretion.
3. Except as hereinabove modified, the terms and conditions of said Agreement and all Exhibits
thereto, remain unchanged and in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment to said
Agreement the date and year first above written.
ATTEST
Clerk of the Council
CITY O~
DAVID N. REAM
City Manager
(SIGNATURE, S CONTINUED)
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
Michael Vigliotta ~
Deputy City Attorney
~x°ec~u~iTe°lDi°~Z~r
Finance & Management Services Agency
[signature].
Name:
Title:
Employer 1D
or Individual
.~un ~17 O~ 10:26~
STATE FARM IMS
3103792436
at
CERTIFICATE OF INSURANCE
[] STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
[] STATE FARM GENERAL iNSURANCE COMPANY, Bloomington, Itlinois
[] STATE FARM FiRE AND CASUALTY COMPANY, Scarborough, Ontario
[] STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
[] STATE FARM LLOYDS, DAUBS, Texas
POLICY NUMBER
This insurance inc{udes:
insures the following policyholder for the coverages indicated below:
Poficyholder TELFO&D$
Address of policyholder C/O LINDA K. LARSON, 3.255 19t)' ST., NgKMOSA BEACH, CA. 90254-3309
LocaUon of operations
Description of operations
The policies listed below have bee~ issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions, and conditions of those policies, The limits of liability shown may have been reduced by any paid
claims,
I ........POLICY PERIOD LIMITS OF MABIMTY
TYPE OF INSURANCE I Effective Da~, F.~ralion Date {at beginning of policy period)
Comprehensive BODILY INJURY AND
Business Liability . J .................................... PROPERTY DAMAGE
0 Contractual Liabilib/
[] Underground HaZard Coverage
[] Personal Injury
[] Advertising Injury
[] Explosion Hazard Coverage
[] Collapse Hazard Coverage
EXCESS L~ABt LITY
[] Umbrella
[] O. thor
Workers' Compensation
and Employers Liability
POLICY PERIOD
Effective Date I~m'don Date
Each Occurrence $
General Aggregate
Products - Completed
Operations Aggregate
BODILY INJURY AND PROPERTY DAMAGE
(Combined Single Umit)
Each Occurrence $
Aggregate $
Part 1 STATUTORY
Part 2 8DOILY INJURY
Each Accident $
Disease - Each Employees
Disease - Policy Limit $
POUCY NUMBER
92-Q8-0204-7 G
TYPE OF INSURANCE
BUSINESS
1~3LICY PERIOD
Effective Date i Emplrali~.~ Data
[ 04/25/04
04/25/03 :
UMITS OF UABIUTY
(at beginning of policy periOd)
$1,000,000//GBN AGG-$2,000,000
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NErrHEE AFFIRItIATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
Name and Address of Certificate Holder
TH~ CITY O~' SANTA ANA
20 CIVIC CENTER
SANTA .~.NA, CA. 927 O 1- 40
/
If any of the described policies are canceled before
its expiration date, State Farm ~hall mail a
written notice to the certificate holder 30 ~lays before
cenceltatioo, if however, we fail to mail such notice,
no obligation Or liability will be imposed on State
Farm or it~.agents or representatives.
AGSNT 06/17/03
Title Date
Agenfs Cede Stamp
AFO Code F776
STRTE FRRH I~$
AUTO POLICY ST
I21RSON,LINnA K &
AKELEY, THOMAS E
1255 19TH ST
~ERMOSA BEACH CA
90254-3309
MUTL 03
2000
STATUS:PAID
AMT DUE:
DUE DATE:
0.00 OXD:JUN-05-01
JUNE t7, 2003
rUS
H PHONE: (310) 3'72-1538
6102-~'05-75A IRG: 20
ZIP: 90254
323I CLASS: 6B30At12
WAG ACC FREE: JUN-05-01
AAR3346YJM01825 BIRTH: JUL-28-54
RM DATE:
OV DATE:DEC-05-01
A /IMM / 301.36 R1 80% 500 16.80
C5000 ]7.76 U 100 /300 42.22
DS0 66.40 U1 1.76
6250 190.80
~ 2.40
/
AMT PAID: 639.50 DATE PAID: JUN-06-03
COR 1 491.40, MCD 124.37, CGDD 159.88
VSD 40% 11.84, ODM 12000 06-0~, MLD 68
TOT PREM: 639.50
PREV pREM: 610.07
NAME: LARSON,LiNDA K &
REPLACED POLICY: 0376102-75
EXCEP. & END: ADD'L INSURED - THE CITY
AGENTS, AND VOLUNTEERS 20 CIVIC CE5
DRVR DT OF LIC RL NXT RL-DT
LINDA 07/28/1970 1 SR-06/05/2004
H PHONE: {310) 372-1538
POLICY FOP. M: 9905A
F SANTA ANA ITS OFFICERS, EMPLOYEES,
FLA~A SANTA ANA CA 92701.
CC/CONV DATE INFORMATION
REC CMG:
COV. S & Z NAMES S AM'I~ Z
Jun 97 03 lO:P6a
STRTE FRRM IMS
ADDITIONAL tNSI
This endorsement modifies such insure.
¢* 9z-qa-o204-7. G.. relating to the tolto~
1. ']'be City o,~ Santa Aha, 20
its officers, employees, 8gents and repr
("additional insureds") with regard to
operations and uses performed by or on
2. With respect to claims arisir
or on behalf n,' the named insured, such
and is not additiOnal tO or contributing
benefk of the additional insureds.
3.' This insurance applies seF
mede or suk is brought except with re.'
inclusion of any person ur organi:.ation e:
person or organization would have as a
4. With respect to the addition:
or materially reduced in coverage or limit
been given to the City of Santa Aha, 20
(Completi0n of the following, includir
endursement ef'tective.)
Effective _. 04iA%./03
Policy # 92-0,8-9204-7 C
Issued to TE1',FOiIDiS
Named Irisured
~!.((.)V.t::[) ,\:> it ~OR~ounter$lgned
3103792436
RED ENDORSEMENT
STATE FARM
~ce as is afforded by the provisions el Policy
ivic Center Plaza, Santa Aha, California 92701;
~entatives a~'e ~amed ~ additlone~ in~urods
~bility and defense of suits arising from the
behalf of the riamed insured.
out of the operations and uses performed by
;urance as is afforded by this policy is primary
with any other insurance carried by or for the
aretely to each insured against whom claim is
pect to the company's limits of [iab.ility. The
; an insured ahall not effect any right which such
lalmant if not so included.
insureds, this insurance shell not be cancelled,
except at;er thirty (30) days wr[ften notice has
,ivic Center Plaza, Santa Aha, California 92701.
countersignature, is required to make this
this endorsement form as a pad of