HomeMy WebLinkAboutMYERS, MICHAEL 1AAGREEMENT 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Please complete this form when the attached agreement is no longer in effect.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.
The agreement with ~~~ ~S , MtC~tA.2Q , No. ~l -o'YJOy-p1a6~01
was completed on ~ /~ 1 ~ a-o os ,and final payment has been made.
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Revised 8-7-03
Department: ~F--C S>~
Signature: ~~~ "'0
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City of Santa Ana
Clerk of the Council
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FIRST AMENDMENT TO
CONSULTANT AGREEMENT
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THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
this '3oTl-- day of 1) ~ ,2004, by and between Michael Myers
("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-2004-066, dated June 14, 2004, (hereinafter
"said Agreement") by which Consultant has provided tennis instruction for youth and
adults in the community.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
renew said Agreement for an additional one-year period.
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 Consultant Agreement, the parties agree as follows:
I. 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:
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,,{}- J6SEPH W. FLETC R
City Attorney
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GERARDO MO
Executive Direct r - Parks,
Recreation and ommunity
Services Agency
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)
Driver Alliant Insurance SelVices Cay 06 San:ta Ana
P. O. Box 28323 20 C.i.v.i.e Ce.n.tVt Piaza, M-28
Santa Ana, CA 92799-8323 Santa Anti, CA 92701
(949) 660-8163
License No: OC 36861
NAMED INSURED (EVENT HOLDER): EVENT INFORMATION:
. M.i.Qhae1. MyeJt6 TYPE: 1 YUdlU.LU-io na.i - T e.nlU.6
1 63 2 7 MilLI.tJte.am Lane. DA TE(S): 7 /12/04 - 12/31/04
CWt-UO.6, CA 90703 LOCATION: CabiUUo Te.nlU.6 C e.n.tVt
This is to certifY that the policies of insurance listed below have been issued to the insured named above for the policy period
indicated, Notwiths1anding any requirements, terms or conditions of any contract or other document with respect to which this
certificate may be issued or may pertain, the insurance afforded by the policies descnbed herein is subject to all the terms,
exclusions and conditions of such policies. Limits shown may have been reduced by paid claims.
INSURANCE CARRIER: Evanston Insurance Company
MASTER POLICY NUMBER: 04SEPlOOOOOI
MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2004 EXPIRATION: JANUARY 1,2005
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE
General Aggregate Limit $2,000,000
Products & Completed Operations 1,000.000
Personal & Advertising Injury 1.000,000
Each Occurrence Limit 1,000.000
Fire Damage (Any One Fire) 50.000
Medical Payments (Any One Person) 5.000
The limits of insurance apply separately to each event insured by Ihis policy as if a separate pclicy of insurance has been issucd for Ihat event
"Who is insured" is amended to indude, as an insured, the person or organization shown in this sehedule, bUI only with respect 10 liability arising out of the
ownership, maintenance or use of the premises used by the named insUTCd (event holder). This insurance does not apply to: Any "occurrencc" which takes place
after the event holder ceases ro be 8 tenant in that premises.
OTHER ADDITIONAL INSUREDS
CANCEl .LA nON: Should the above described policy to cancelled before the expiration date thereof. the issuing company will mail 30 days written notice 10 the
certificate holder and additional insureds listed.
AUTHORlZED REPRESENTATIVE: ~4~
DATE ISSUED:
5/78/04
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