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HomeMy WebLinkAboutTaller San Jose 5aC,"-n/ ✓ AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Sr. Deputy Clerk of the Council (M -30). Call 647 -5238 if you have any questions. --------------- - - - - -- QQ(� -- --- The agreement with � ` , No.lT -ao O Y� e was completed on R? Q - 2003- 161 eom Revised 8 -7 -03 �, and Department: Signature: Date: has been made. City of Santa Ana Clerk of the Council INSURANCE ON FILE A- 2004 -064 WORK MAY PROCEED UNTIL INSURANCE EXPIRES CLERK OF COUNCIL DATE: tp �—Oy FIRST AMENDMENT TO AGREEMENT LK-T ) THIS FIRST AMENDMENT TO AGREEMENT is entered into on April 5, 2004, by and between Taller San Jose ( "Consultant ") and the City of Santa Ana ( "City "). Recitals: A. The parties entered into Agreement # A- 2003 -164, dated July 21, 2003, (hereinafter "said Agreement ") by which Consultant has provided vocational /occupational training, employment strategies, education and supportive services to individuals residing in the Federal Empowerment Zone. B. In accordance with the terms and conditions of said Agreement, the parties wish to increase the compensation available to Consultant for additional marketing and outreach efforts provided by Consultant. Wherefore, in consideration of the covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, except those amended in this First Amendment to Agreement, the parties agree as follows: 1. Section 2.a., COMPENSATION, shall be amended to increase the compensation by $276.00, for a total amount not to exceed $132,662.00 during the term of said Agreement. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to Agreement on the date and year first written above. ATTEST: � ATRICIA E. HEALY C Clerk of the Council APPROVED AS TO FORM: X�4��4 JOSEPH W.FLETC ER City Attorney CITY OF SANTA ANA a'su - --- DAVID N. REAM _ City Manager CONSULTANT � SISTER EILEEN MCNERNEY Executive Director RightFax 9/11/2003 7:28 PAGE 2/3 RightFax AC0RD„ CERTIFICATE OF LIABILITY INSURANCE.Pass I of 2 09/ll/2003 PRODUCEII 877 -559 -6769 Mi111a Ma=th America, Ina. — AeQioaal cart Cantat 11201 w. :stn Blvd. abi:oim, Ax 03025 THIS CERTIFICATE JS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTFICATE. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFOROINGCOYERAGE mrsUBEn 9iyt ra of Alt. Ses. ph or 0r,.ngm 150 leuth n rata i Ocaaga, 925c9 0 T 1'},, �yfl{'� y'�..rr) uJSI1RERA: Aoaciman %ity Or.up Ltd 0929 -061 9ESInEnB: 5L4URERC: eamMLLIOUry JX RE: COVERAGES THE POLICIES OF 14SURANCE USTED BELOW HAVE BEEN MMJEOTO THE INSURED NAMEDABOVE FORTHEPOUCYPERIOD NDICATEO. NOTWrrHWANOFIO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEw WITH nasPwr TO WHICH THIS CERTIFIOATE MAY BE 13SUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU BJECT TO ALL THE TERMS EXCLUSIONSAND CONOMONS OF SUCH PouaES jucAREoATE uums SHOWN MAY HAVEBEBI REAUO618Y PAID mAim. tOt OFYEBURaNOE roUCTNUWSER P UC7 UMTS JA eamMLLIOUry JX MMMER(NALGENERALLU9UTY CLOAMUAOE ©OWUI Mix- CGL- 03 --01-019 APFRO 6/3012003 ED AST 6/30/2001 FORM EADHOCO"IENCE a RREDAWOE m11" MmEXP mw �) { P9VKMisAOVIHIURV _ { 21 000, 000 OENEFI LAC IRECATE s 2 0 o DOD OEWLAOOM0ATt LWIl APPLESPEH: PODGY LOO PRCOUCTS- OONP,OP AGG E AUTONOWLEUAMUTY ANYAULO KL DYREDAUIOS BCEEDUEDAUTOS NEffiOAUMa NOH01M'EDAUrOB Laura Shealy Deputy Ci t ou �NNLxEUAmr i Atlorncy 9001LYIIAAPRY (RwPwwn) = BODILYmI.A1RY WPE� aoM MtOWAOE A aARAGEUMUTY ANYAUro AUTOONLY- EAACCAB/T t OTHER THAN EAACC ALIfoONLY: AGO $ ETCEN UAKny OCCUR CLAOM MAOE OEDUOrIOL.E lET81ffCN >♦ EACHOCC- MRENOE A00REOAlE s _ roI5c1015 caMFwSaTNJaAND 9RPLAYigf' LIANIrTY OTHd EL EACH ACCWENT j EL INSEAM - FAUPLOYEE 1 EL INSEAM - POLICY LLST f nE9C19f7fOMOF OPiRATCNfA .00AY'gIR/Y@4CLFfE7COLEW ON6400EO 57 alOON>sIBfTAiPSGAL NIOYWO� Certilieats Solder Lidded &s Additloml Insured by endoreeoent to policy eubjeat to the tame met Earth in the endoreasent. sslo dba ?&Iles A&n Joee, 220th Grant, 810 IN. polaaett &, Sant■ Ana, CA 92701 i CERTIRPATF WOULD AEN6/THEA50VE DESOM9l0 AOUOIPS aE aANCSLLlb arose TNi A%PIAATWK RATS Y A WP, THS a9VN0 M Um" TAIL @IDTAVOR TO AWL 30 DAYS WWT EM City OS z4=A and, its OEtiaeza, agent■ NOTIce TDTTI90L %RP"TCHOLDFRNAMEOTDYHELST, alld mployee r,m...lry Dewlopaeut 1Lysnnt 20 Chia Ca=ter plaza Mop U23 - r,0. BOY 3980 Attm: Lucy Tloras A ED F BtBRAi1YE ju Santa Ana, CA 92102 / ACOAD2"(71M Coll:812178 Tpl:202105 Cent: 414504 OACORO CORPORATION 1We' / -1, RightFax 9/11/2003 7:34 PAGE 2/3 RighEFax ACORD„ CERTIFICATE OF LIABILITY INSURANCE �iof2 09111 /2003 PEODIICEA 877- 559-6769 THIS CERTIFICATE 18 ISSUED AS A'MATTER OF INFORMATION ONLY AND COtWER9 NO RIGHTS UPON THE CERTIFICATE Millie Poxth Asortaa, X". - llogional Cort Centex 11201 IN, satin alTd. HOLDER. THIS GCEERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ^ Y T awta 30 0 Vhoania, AL 65021 1NSURER$AFFO ROM COVERAGE INWKD Sistas^ If Ht. Josoph of Ocaago *OJEAA: Hartford'Ltansae0a CAnomby of Silo K4dwat 37479-991 460 South aataria Orange, CL 91660 WSURER9: IH6URER C[ FIRE DAMM (AMY me In IIFSL' i7ERD• INSURIERE: COVERAOE9 THE POUGIES OF NSURMIOE USTED BELOW HAVE BEEN 333UED TO THE INSURED NAMED ABOYE FORTH E POLICY PERIOD INDICATED. NOTW ITHSTAN DNO ANY REQUIREMENT, TERM OR GONDITKM OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE 11,130RANOE AFFORDED BY THE POLICIES DESCRIBED HERON IS SUBJECT 70 ALL THE TERMS, EXGLUSIONSAND CONDITIONS OF SUCH POLIOIEB. ADdREOATE UMITSSHOV4NTMY HAVE BEEN REDUCED BY PAID CLAWS. IN TIPt9ppoU6AWA POl1CYNU^BBt Y E ^ Y T umrm GENERAL Uaau" EACHOCLU RENCZ FIRE DAMM (AMY me In 60Ia6lCA.GEN6411AMI Y wwSMAOE ❑OCCUR NEDEXP vope ) Is PEP90WLBADVIMURY IS OENEAALAGQpE0A7E S 0MLA0oREGATEU►TA-MIESPEtt Pstoarcra•carA>PAOO f I POLICY LAC AuTOL909 SW"Urr ANVAIlfp Q-aA ®gNGLEUYIT 4 ALLOVaEDAUMS DOICIMEDAM06 p-p- INJURY l�P�m^I t HIREDAUTO6 NGMOYMtEDAITrot APPRO ED AST FORM BODLYt7.AAY �R•"b• 1, t PROPEMMMAGIF 4 a CEUAaI VOAVTO I_a ra S AUT0OIIY- EAM0JDEW dY OTHER noAN EAAW AUrOCNILV AGGIS 4 Exem uAmITTY scan cLAaleuADe EACHOOQWffNCE ! Anom +AYe 4 OEtX1CT OZ AEIHrOW t ! A SUPLOTOWLIAM ulYatANO 72MC93300 3/31/2003 BPLOYita�lYalllY 5/31/2004 ELEACHA=oMT 4 ELOIWASE- EAEMRANEE ! &TH" EL CISEAUE- POLICY LMT ! OeaewPnaN OPwaM7t0NVtDGT701aAfiHOLfL10fCJ- I�CNEAOOmaY a00aawEN716psaAt PRONNOw P.O. 8300 dbs tr San Joae, Bleak Grant, 810 N. PoinAatta, Santa Ana, CA 92701 CERTlFICATEHOLDER I aeeruW......a..�..- --• --- �...� -.. __._.- city Of yaota atu, it■ and NaoaTployaa ,.--.---, ty 20 C',Lo Cwater Plana SO. S25 - N.O. yen 1900 eta: Laay llotaa aaata Ana, CA 92702 aaLA. 0ANY0PTH ^A60HEeESCAl4i0POUCIPatECA �e.a000aTN4EXgaAT1ON OATS TlMRMP,, THE =U* M INdLUAEt YRLL UJDfAVOM TO a4L 30 OAYa ww"EN Of1•LO , agwrta NOTCC 70 TINS OERHgGTE NOtDi3t NA11m IO THytiT Dawlopm*nr Aeogb:y 77 .. . •POLICY NUMBER: UNI- CGL -03 -01 -018 t1- 146014)0 -03) *INSURED COMPANY NAME: American Unity Group ENDORSEMENT 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: St. Joseph Health System City of Santa Ana and its Officers, Agents, Employees and Volunteers are named as additional insured as respects their interest in connection with the named insured. (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 11) 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. IT IS AGREED THAT ANY INSURANCE MAINTAINED BY THE CITY OF SANTA ANA SHALL APPLY IN EXCESS OF, AND NOT CONTRIBUTE WITH, INSURANCE PROVIDED BY THIS POLICY. Agent's Signature: CG 2010 11 85 (218 )C SAMPLE — Additional Insur ud with Pri mary/Non- Contri but i ng Langu age Added APPROVED AS TO FORIs; La ra Slrcedy Deputy City Attorney