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Home My WebLink AboutSchermer, Janet 4ac z�� AGREEMENT TERMINATION 7as "? ., F x? P Please complete this form when the attached agreement is no longer in effect.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 647 523`$`if -y' aw iave any questions. The agreement with Sd W/uy6 - No.ly -300- 0& d was completed on I n+ and final payment has been made.. ,j -z;> (J f) 4, - bLe-0 -ba D 00L+ -0 LA() — 03 ti --a-ao4- 0 Lao �-®L�- tj a0c)L+- Ocacr -05 Revised 8 -7 -03 V,� 00 (-P Ofd" 0®i Department: F4 Signature: 1 n T�{ ✓� Date: t x$3114 City of Santa Ana Clerk of the Council N -.JJJO <I - o(aD-t:J-I INSUkANU 0" , , WORK Wi Y PROCh L UNTIL INSURMiCI i,';'p,'t I), -1$1-0'1 CLERK OF COIINCI,-'''-- , DATE 1;1-!>" ~ FIRST AMENDMENT TO CONSULTANT AGREEMENT ~: pI?1,$. (J).~) THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into this 30tr\. day of ~~~ , 2004, by and between Janet Schermer ("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-2004-060, dated May 11, 2004, (hereinafter "said Agreement") by which Consultant has provided piano lessons through the City's leisure class program. 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: 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: ~;;;t ~ Executive Director - Parks, Recreation And Community Services Agency EVANSTON INSURANCE COMPANY CERTIFICATE NO.: CERTIFICATE 01" INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDmONAL INSURED) Driver Alliant Insurance Services Cay on San-ta. Ana P. O. Box 28323 20 C.i.v.i.c. Cel!.tvr. Plaza, M-28 Santa Ana, CA 92799-8323 Sal'lta Ana., CA 92701 (949) 660-8163 License No: OC 36861 NAMED INSURED (EVENT HOIDER): EVENT INFORMAPJON: Jane;(: Sc.hvunvr. TYPE: .(.(/.no CR.a.6 <I eA 34 Bwbane Way DATE(S): ~/UIIU4 - IZ/jljU4 Iltv.i.l'le, CA 92612 LOCATION: Vcvu.OM Lo c.a..tc.o M This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, lenns or conditiollS 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 hcrein is subject to all the terms, exclusions and coodi lions of such policies. Limits shown may have been reduced by paid c1ain1S. It,",SURANCE CARRIER: EVlIlISton Insurance Company MASTER POLICY NUMBER: 04SEPlOOOOOl MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2004 EXPIRATION: JANUARY 1,2005 COMM ERClAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE 0en..aI A&grepte Limit S 2,1lOO,OOO Products &. Completed Operations 1.000,000 Personal & Advertising lnjury 1,000.000 Each Occurrence Limit ],000.000 Fire Damage {Any One Fire) 50,000 Medical Payrnc;nts (Any One P<<son) 5.000 The limitsQfinsu~ncc apply sepantely 10 each event il1JUred by tbispPIicy lIS if; separate pcljcy ofin5urancc has been wued for that ~cnt. "Who is. insured" is anlQ1l,!cd 10 in~Judc. as an insurr:d,lhc person or organization sboWtl in thCi schedule, bul only wilh respect to liability arising out aflhl: ownersbip, mainlCnance or use arthc prc:miSCi used by the named insured (event holder). This inslIAncc does not apply to: An)' '''occurrence'' which takes place after the event hoklcr ceases 10 be a tenant in that premises. o TIlER ADDITIONAL INSUREDS CANCFI I A TION: Should the above described policy to cancelled before the expiration date thereof, the: issuil18 conlj)JlllY will mai130 d.ays written notice 10 the certificate holder and additional insureds listed. DATE ISSUED: AUTHORlZED REPRESENTATIVE: ~-t~ 4/"/04 ~i n r ,/'-1f.-J!\f :fly (v1J /V.2 [}[}.If- D6:,[)-D2 EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2007-13 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) - --- - - --- - City <>f-Santa AWL -- - ---- Alliant Insurance Services, Inc. in cOrUunction with 20 Civic Center Plaza, M-28 Apex Insurance Services Santa Ana, CA 92701 P. O. Box 6450 Newport Beach, CA 92658 (949) 660-8163 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Janet Schermer TYPE: Music Class - Piano 34 Brisbane Way DATE(S): 02/27/07 - 12131/07 Irvine, CA 92612 LOCATION: Corbin Senior Center "Liouor Liability after 2am 0 This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this certi1kale may be 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 CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 04SEPIOOOOOI MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2007 EXPIRATION: JANUARY 1,2008 COMMERCIAL GENERAL UABILlTY OCCURRENCE FORM DEDUCTIBLE: NONE Genet>! Aggregate Umil $ 2,000,000 Products & Completed Operations 1.000,000 Personal & Advertising Injury 1,000,000 Each Occurrence Umit 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 this policy as if a separate policy of insurance has been issued for that event. . "Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: AIly "occurrence" which takes place after the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL fNSUREDS CANCEL! AnON: Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days W"fitten notice to (he certificate holder and additional insureds listed. ~~~ -' AUTHORIZED REPRESENTATIVE: DATE ISSUED: Februarv 27.2007 Generated by Risk Management Division by: &> J~ Yl7 ~"~r1~