HomeMy WebLinkAboutMENDEZ, BRAULIO 1ACity of Santa Ana
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AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer in effect. r ~ ~ r ^ ~ F, ~ „~
Return form to the Clerk of the Council Office (M-30).
Call 647-5237 if you have any questions. <• ° -~ ~ ,,
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and final payment has been made.
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Signature: ,,~ G~~;~,,tiZ~.
Date: ~~ ~ / ~- (~~
Revised 07-23-07
INSURANGt UN HLt
WORK MAY PROCEED
UNTIL Ii9SURAPlCE EXPIRES
CLERK OP CCUNCIi
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FIRST AMENDMENT TO
CONSULTANT AGREEMENT
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THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
this ~j0~ day of DeC.2m.lo~e-/ , 2004, by and between Braulio Mendez
("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 N-2004-102, dated August 26, 2004, (hereinafter
"said Agreement") by which Consultant has instructed "Introduction to Guitar"
classes for area youth and adults.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
renew said Agreement for an additional one-year period.
R'herefore, 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 Consultant Agreement, the parties agree as follows:
1. Section 3, TERM shall be amended to extend the term through December 31, 2005.
2. Except as hereinabove amended, all terms and conditions of said Agreement shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the date and year first written above.
CITY OF SANTA ANA
APPROVED AS TO FORM:
~ OSEPH W.FLETCH
City Attorney
Services Agency
Recreation and Community
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: -
CERTIFICATE OF INSURANCE
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED)
DriverAlliantInsuranceServices City a{ Santa. Ana
P. O. Box 28323 20 C.CV./,C Centers, P.Qaza, M-28
Santa Ana, CA 92799-8323 Santa Ana, CA 92701
(949) 660-8163
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
B2au,Q,Lo Mendez N-~~uf-rcz TYPE: Mr,nir
2313 S. Rene Dnive N- .~,ao'f-le~-mil DATE(S): ~/y3~ns _ 1
/3105
2
Santa Ana, CA 92704 .
,
LOCATION: FP S^e~t{o~Cerrt¢h
This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period
a
indic
ted. Notwithstanding any requirements, terrra or conditions of any contract or other document with respect to which this
certi5cate maybe issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms
,
exclusions and conditions of such policies. Limits shown may have been reduced by paid claims.
INSURANCE (.'ARRiF.R; Evanston Insruaace Cor~aay
MASTER POLICY NUMBER: OSSEPI000001
MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2005 EXPIRATION: JANUARY I, 2006
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM
General Aggregate Limit S 2,000,000 DEDUCIBLE: NONE
ProdaCls ~ campletea Operations t,ooo,ooo
Personal & Advertsin6lnimy' 1,000,000
Each Occurrence Limit 1,000,000
Fire Damage (My One Fire) 50,000
Medical Payments (My One Person) 5,000
The limits of insurance apply separately W each eventowred by this policy as if a separate policy of insurance has been issued far Orat event
"Who is insured" is amended to include, ere an insured, the persmr or organization shown in this scheduk, but only with respect to liability arising out of the
ownership, maintenance or use of the premises used by the named insured (event holder). Thin insurance does trot apply b: My "accufrence" which fakes place
aRer the even holder ceases to'Ix a tenant in that premises.
OTHERADDTTIONALINS ED A
TO FORT i
S
r
~
Laura Stitt eedy
Avsistan[ City~At[orncv
N eTION~ Should the above described polity to cancelled before the expiratlon date thereof
the issuin
,
g company will mail 30 days wriaen notice to the
certificate holder and additional insureds listed.
AUTHORIZED REPRESENTATIVE: ~'"""
DATE ISSUED: FebhucUty 23, 2005