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Home My WebLink AboutGRUVER, ERIC PH.D. (2) A-2022-190-01 INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES CITY CLERK111-2Z FIRST AMENDMENT TO AGREEMENT WITH ERIC GRUVER,Ph.D. for DATE MAR 0 5 2025 PSYCHOLOGICAL EVALUATION SERVICES b; 9oiI beU) THIS FIRST AMENDMENT to the above-referenced agreement is entered into on February 5, [OW'i naw 2025, by and between Eric Gruver, Ph.D., ("Consultant"), and the City of Santa Ana, a charter city DI, WthW and municipal corporation organized and existing under the Constitution and laws of the State of California("City"). RECITALS A. The parties entered into Agreement No. A-2022-190 on October 4, 2022 ("Agreement") for three (3) years for Consultant to provide psychological evaluation and counseling services to the City's Police Department. The Agreement provides the option for two (2) one (1) year renewals. The total not to exceed amount is $30,000. B. The parties now wish to exercise the first option to renew and increase the Compensation (Section 2)by an additional $19,000 for a total not to exceed amount of$49,000. The Parties therefore agree: 1. Section 2, Compensation is amended to increase the compensation by an additional $19,000 for a total not to exceed amount of$49,000. 2. Section 3,Term is hereby extended,pursuant to the right of the parties to exercise their option to extend the Agreement through September 30, 2026. 3. Except as modified by this First Amendment, all other terms and conditions of the Agreement shall remain in full force and effect. [Signatures on following page] Page 1 of 2 IN WITNESS WHEREOF,the parties hereto have executed this Amendment to the Agreement on the date and year first written above. ATTEST CITY OF SANTA ANA JENNIFE H L `�` ALVARO NUNEZ City Manager APPROVED AS TO FORM CONSULTANT SONIA R. CARVALHO City Attorney By. hRT MAR A OGOSIAN ERIC GRUVER, P .D. Senior Assistant City Attorney RECOMMENDED FOR APPROVAL ROBERT RODRIGUEZ Chief of Police Page 2 of 2 Account Number: CA GRUE 1440 Date: 11/19/24 Initials: LL CERTIFICATE OF INSURANCE ALLIED WORLD INSURANCE COMPANY C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 800-421-6694 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE_ Name and Address of Named Insured: Additional Named Insureds : ERIC WAYNE GRUVER, PH.D. 2021 E 4TH STREET SUITE 116 SANTA ANA CA 92705 Type of Work Covered: PROFESSIONAL PSYCHOLOGIST Location of Operations: N/A (lf d:fferei.t. Char: addren its ed above; Claim History: APPROVED By Cynthia Mora at 1:57 pm, Nov 19, 2024 Retroactive date is 03/01/1992 Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 2, 000, 000 LIABILITY 5010-7473 3/01/2024 3/01/2025 4 , 000, 000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED, WHO SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION_ Comments: THE COMPANY WILL NOTIFY THE CERTIFICATE HOLDER OF ANY TERMINATION OF COVERAGE AND FAILURE TO RENEW WITHIN 30 DAYS, HOWEVER, FAILURE TO GIVE SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY UPON THE COMPANY OR THE UNDERSIGNED. CITY OF SANTA ANA IS LISTED AS ADDITIONAL INSURED. This Certificate Issued to: Name: CITY OF SANTA ANA RISK MANAGEMENT DIVISION Address: 20 CIVIC CENTER PLAZA l( Authorized Representative SANTA ANA CA 92702 APA 00138 00 (06/2014) T^J' ti. .,i' 'tvL,n: ,',I',.i'';li .1 ,f!VI if,,'I ,I 1.•II:.,,., R 1\li:. ;I:i i'.i !' ,!ii :•i'i,',Il h.. , .It:f., . ; I.I;.1:. 4,M ' AFFIDAVIT OF EXEMPTION FOR WORKERS' COMPENSATION INSURANCE T, .. R /C'-; • Etti /(74- \ ,O.("Representative"),attest that f am an authorized Noma and.riile or Vendar Ropms niatIvo representative of r le 1,A t( l-4 /6 110. ("Company"), and (C'oisullnnt/Company Nome) • possess the authority to legally bind Company, In my capacity as Representative of Company, I represent and confirm the following,as relates to the agreement between Company and City of Santa Ana, agreement number ,---7) ("Agreement")to provide r Sy c= 4 'G r.c / rn- L . ("Services"): (Scrvirc::inik,provided under ngI'euwnucoturncil During the course and scope of Company's agreement with the City of Santa Ana,Company will not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if Company should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,Company shall forthwith comply with the provisions and provide prooiorworkers' compensation coverage immediately. If at any time it is found that Company is not adhering to any and/or all of the statements in this document and does not maintain the minimum professional liability insurance coverage as required in the Agreement,it will be considered a breach of Agreement rendering the Agreement null and vo I and Co; pony will be fully liable I'or any and all damages. • t.. 44/1,4k.— I 1 //1 0 'I Sig alum Wu &---1?/ C--it ,G—( 4 IIKA------ ....___... . Print Nemo ) Sei a i / 7ltt' ____ APPROVED By Cynthia Mora at 2:01 pm, Nov 19, 2024 Contact Inl'ur,►niiion_i.e.,'1'dcphonn Number and/or Iimail Adsh'os WARN ING; FAILURE'1'0 SI:CI_JRls WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP To ONE I IUNDRE1.)TIIOUSANT DOLLARS(S 100,000). IN ADDITION TO T11E COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370fi OF Tl IE LABOR CODE, INTEREST,AND ATTORNEY'S PEES. Affidavit of Exemption for Workers'Compensation insurance 11.12.2024 9 Ic d Z£54fr` 600L6c8666t ItE.AMID 'alI £Z:£Z 6Z0Z"II'LI CITY OF SANTA ANA Risk Management a division of Human Resources , Managing Risk through Awareness and Action w` AFFIDAVIT OF EXEMPTION FOR AUTOMOBILE LIABILITY INSURANCE /` 4)c. { - tf,fri ("Representative"),attest that I am an authorized (Nome mid Ilk of Vendor Representative) representative of /C 6-'eti!/ E, PO4 a ("Company"), and (ctaleuitnnl/L:ompnny Name) 1 possess the authority to legally bind Company. In my capacity as Representative of Company,I represent and confirm the following,as relates to the agreement between Company and City of Santa Ana,agreement number ("Agreement")to provide ("Services"); (Services to be provided under agreement/contract) During the course and scope of Company's agreement with the City of Santa Ana, Company employees,consultants, representatives, and agents will not use and/or drive any Company owned/rented/leased/borrowed vehicles to perform Services to, for,or on behalf of City of Santa Ana. If at any time it is found that Company is not adhering to any and/or all of the statements in this doe 'tnd does not maintain the minimum automobile liability insurance coverage as required in the greement, it will he considered a breach of Agreement rendering the Agreement ull and void an Colman will be fully liable for any and all damages. ‘S•-• 01/49 Si nature Dale Eflf C (4V64- , Cif, 1 Print Name • / f rill, APPROVED By Cynthia Mora at 2:01 pm, Nov 19, 2024 3 Cunlact I, a orritation ,Telephone Number and/or Email Address Affidavit of E><emptlon for Automobile Liability Insurance 11.12.2024 9 /9 d Z£59# b00Lb986b6t uwinuo 'aa £Z:£t 6Z0Z'SZ'LZ ACiORV PATr:(MM/qD/YYYY) CERTIFICATE OF LIABILITY INSURANCE _ os�oe�2)20 THIS CFAY101CATF IS ISSUED AS A MATTER OP INFORMATION ON LYAND CONFEks No RIGHTS U pON TOE CklfTIFICATE HOLDER.THIS CERTIFICATE DOES N&(AFFIRMATIVELY OR NEGATIVELY AMEND,EKTENDOR ALTERTHE COVRRAGRAFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUkrsk(s) AUTHORIZED REPRESENTATIVE OR PRODUCVR,ANDTHE CERTIFICATE HOLDER. IMPORTANT:III the cardRoots holder In en AbbIYIONALINSURED,the pOIICV(lee)must hevs AODTTIONAL INSUREb prov(slons or boendor"d.If SUBROGATION IS WAIVED,subJact to the terms and condition of the policy,certain pollelos may requireanandaMMant.Astatementonthlscardficata does not confer rights to thecerti leato holdarin Reu ofsuchondomornent(s). PRObUCER ^T CONTACT NAME: PHIL DONG Phli Dong(9720660) PHONE pA1i 16626 arookhurst St (A/C,No,I! r):714-5B7-6777 V►/c,No):088-866-9567 F-MAIL Westminster CA 92683-7673 ADDRIES5; commerolal9phlldong9genoy.com INSURER($)AFFORDING COVERAGE k"C R INSURED INSURERA: Trucklnsuranae Exchange 21709 1NSURERO: Farmers Insurance Exchange 21662 GFTUVER,ER1C INsuRERC: Mid Century insurance Company 21131217 2021 E 4TM ST INSURERM �. STE 116 — SANTA ANA CA 92706 INSUR M IN5UkERER A F: COVERAGES - CfrtTIFICATE NUMBER, — REVISION NUMBERS THIS ISTOCERTIFVYHATTHEP041CIESOF INSURANCE LISTED BELOW HAVE BeEN15SUEOTOTHE INSURED NAMEABOVEFORTHEPOLICY PERIOD INDICATII0,NOIWITHSTANDINGANY - REQUIREMENT,YERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE I$$UEp OR MAY PERTAIN,THE INSU RANCEAFFORDEO BYTHE POLICIES DESCRI130D HEREIN IS SUBJECT TO ALLTH E TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDTL SUER POLICY Err POLICYEXP �- LTR TYPEOFINSURANCE INSR vivoPOLICYNUMBER (MM/DD/YYYV) (MM/DO/VYVY) LIMITS COMMERCIAL GENERAL LIABILITY �- EACHOCCURRENCE $ 1000000 7 CLAIMS•MMA 11�I OCCUR DAMAG$70 RENTED $PREMISES(EaOccurrence) 75,000 MEDSXP(Any one potion) $ 5000 A Y Y 016044007 00/2512025 06/2612026 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREOATELIMITAPPLIGSPER: GENERAL AGGREGATE $ 2000000 POLICY L] PROJECT LOC PRODUCTS-COMP/OPA00 3 1 )00,000 OTHER; $ AUTOMOBILE LIABILITY �•_--� COMBINCIPSINGLELIMIT $ (Eauddent) ANYAUTO _BODILY INJURY(Porparson) S OWN EDAUTOS SCHEDULED ONLY AUTOS BODILY INJURY(Per eccldant)$ p HiRED AUTO$ NON-OWNED PROPERTY DAMAGE $ µ ONLY AUTOSONLY (Peroccldent) $ UMBRELLAUAII HCLAIMS-MADE OCCUR 6ACHOCCURRENCE $ EXCBSSLIA9 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTHER $ AND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ Y/N E.L.EACH ACCIDENT $ EXECUTIVE OFFICER/MEMBER N/A �--� EXCLUDED?(Mandatory In NH) E,L,DI$tA5F.FA EMPLOYEE 1103,descrlbo under DESCRIPTION OF OPERATIONSbelow E1,0ISEASE-POLICYLIMIT $ Tt t Iran Digi ally signed by By Tu Tiara Nguyen at 9:rC a „Seta 10,2025 Tu T an Nguyen --------------------------------------------- Dat :2025.09.10 DESCRIPTION OFoPERATIONS/LOCATIONS/VEHICLES(ACORD 101,AddltlQnal RemarkaSchedule,maybe attached If more space Is ragUlred) LOCATION,2021 E FOURTH STE 110,SANTAANA,CA 92705 ADDITIONAL INSURED:CITY OF SANTA ANA,ITS CITY COUNCIL,OFFICERS,OFFICALS,EMPLOYEES,AGENTS,AND VOLUNTEERS CERTIFICATE HOLIER CANCELLATION w- CITY OF SANTA ANA SHOULD ANY OPINE ABOVE DESCRIBED POLICIES BE CANCELLED 0EFORETHEEXPIRATION ATTN;SANTA ANA POLICE DEPARTMENT DATE Y14CAROR NOTICE WILL BE 131:LIVERBDINA000RDANCE WITH THE POLICY PROVISIONS, 60 CIVIC CENTER PLAZA,M-18 AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701 ACORD'25(2016/03) 01988 2015 ACORD CORPORATION.All Rights Reserved 31-1769 11.15 TheACORD name and logo are registered marks afACORD 0 /Z d LED4# VO0LT7996PGZ ZIG11f]Lr� "zQ 6E 1 L 9Z0z'G0 LO THIS ENIDOItSIEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, POLICYNUMBER; 015044007 j7238 1 st Edition FARMS RS INSURANCE ADDITIONAL INSURED— DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COVERAGE FORM APARTMENTOWNERS LIABILITY COVERAGE FORM CONDOMINIUM LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person(s)Or Organiza4ion(s): ;1fis CiTY OUNCIL, TS; EMP'L':0Y ES, VOLUNTEE♦ZS Information required to complete this Schedule,if not shown above,will be shown In the Declarations, A. The following is added to Paragraph C,Who is An insured of the applicable Coverage Form: Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury" caused,In whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf In the performance of your ongoing operations or in connection wlthyour premises owned byorrented to you. However: a. The Insurance afforded to such additional insured only applies to the extent permitted by law;and b. if coverage provided to the additional Insured Is required by a contractor agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide forsuch additional insured. 0. With respect to the insurance afforded to these additional Insureds, the following is added to Paragraph D. Liability And Medical EKpanses Limits Of Insurance of the applicable Coverage Form: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contractor agreement;or 2. Available under the applicable Limits Of Insurance shown in the Declarations; whichever Is less, This endorsement shall notincrease the applicable Limits Of Insurance shown in the Declarations. This endorsement Is part of your policy, It supersedes and controls anything to the contrary. It is otherwise subject to all the terms of the policy. 7238-ED102-19 Includes with Its permission, PageIof1 1 937238 17238101 E /8 d LE64# 600L6986T76T Ui311MD 'aa PERT 520E-60-Lo