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Home My WebLink AboutMAD SCIENCE OF ORANGE COUNTY 1AAGREEMENT TERMENATION KVI M -I Al Please complete this form when the attached agreement is no longer in effe is �, Return form, to the Sr. Deputy Clerk of the Council questions. 47 ' Hn have any G2op� -------------------------------------------- i The agreement with VAOA s6f-ALP ec—cy-a-yl,-C� Nt7 kNo. N- aDCF- o37--0i was completed on 6-24-31 I (i,5 and final payment has been made. Department: F N- 200{ -031 Signature: Date: City of Santa Ana Revised 8 -7 -03 Clerk oflthe Council . " IN:;URANCE NOT ON FILE WORK MAY NOT PROCEED ::lERK OF COUNCIL DATE: 8'-1'1-(5 N-2QQ4-Q37-Q1 FIRST AMENDMENT TO CONSULTANT AGREEMENT C' f0'S CD ~,M,"" THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into this 1 r day of TV L I , 200,r/by and between Mad Science of Orange County ("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-2004-037, dated April 22, 2004, (hereinafter "said Agreement") by which Consultant has instructed "Mad Science" camps through the City's leisure class program, R 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: L Section 2,a, COMPENSATION, shall be amended to increase compensation $7,500,00, and shall read in full as follows: "City agrees to pay, and Consultant agrees to accept as full payment for its services, the rates and charges as set in Exhibit A, The total sum to be expended pursuant to this Agreement shall not exceed $10,000,00 during the term of this Agreement" 2, Section 3, TERM shall be amended to extend the term through December 31,2005, 3, Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect II II II II II '" . 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 ATTEST: CC,./ ~;c c '^. '- d.-L.k,( ~ '- - ..-~~,. ~~ PATRICIA E. HEAL Y Clerk ofthe Council aHa DAVIDN. REAM City Manager v^ APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney ,/ By: '(;',..,. y.,. :'" Lama Sheedy / Assistant City Attorney APPROVED AS TO CONTENT: CONSULTANT h~ GERARDO Executive Dir tor Parks, Recrea on and Community Services Age cy , /'/ // '/'/ /A/ .0.." /./: .11 . ~ / ....... ~/' /.,/ . fJA7<{ BRODERICK Director \ ACORD. CERTIFICATE OF LIABILITY INSURANCE I.) -;;)CD'f -b3 i- II - c9C:b4- 63+-01 OP ID 1 BRODE-3 09 28 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 05 PRODUCER Hylant Group - Toledo 811 Madison Ave Toledo OH 43624 Phone: 419-255-1020 Fax:419-255-7557 INSURERS AFFORDING COVERAGE INSURED Jay Broderick dba Mad Science of W,st Orange County 1.2 W~ntermist. Irvine CA 92614 INSURER A INSURER B INSURER C' INSURER 0 INSURER E COVERAGES THE POLICIES OF INSURANCE USTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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 P:)LlCIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS SRlA01J'I:J l TR IINSRD TYPE OF INSURANCE .. GENERAL LIABIUTY X !-x---~ COMMERCIAL GENERAL liABILITY PHPK097701. k....m.-'__._. , i : CLAIMS MADE X OCCUR ~x!AbUse/Molestation PHPK097701 1"-G~l'~~A;G~E-~;-~:-LI:I~'~::-L'I:~';E~~: r - 1 POLICY ~~8T AUTOMOBILE LIABILITY .1 ANY AUTO : ALL OWNED AUTOS 'I SCHEDULED AUTOS I : X ; HIRED AUTOS r~1 NON OWNED AUTOS :- ',-- ,. -- ----~ POLICY NUMBER --l "PD~\~YJ~JJ'JW~Rltt~y ~b~iO'f~'T LIMITS 10/15/04 10/15/05 ~ ;~;;gi~g,:~~...---- _-_.l..~s...,..13""'..0'.._OO" O,.---.00...-.0,...-90..-Q_g................. ~:'~?M!;S,!=:,S.{"'lJ,lJc~lJr~~c~) .. _ "_ . _.. ..____ '. ~-~~~,,~:~-(""~X-~~-~__pers:-:':) __ i~_ * 5, 000 ; PERSONAL & ADV INJURy _.1 s -i"': 00 a"', 000 ; GENERAL AGGREGATE ! $2':-0-00';'00-0--- riRO~UC~;; co",P;OP;OG1'~~~; ~~ ~JlO. I COMBINED SINGLE LIMIT S 1, 000 , 000 iEaaccldenl) 1-- + j BODll Y INJURY i s ! (Per person) I s f :$ 10/15/04 10/15/05 PHPK097701 10/15/04 10/15/05 I BODilY INJURY : (Per~C~i~enl},.____ I;;~P~R;~ ~;MAGE-- I (Peraccldenl) EXCESS/UMBRELLA UABILITY OCCUR [__on: CLAIMS MADE l~.U~T_O__~~l. Y - EA _~C~_I?~J>J_T _~~_ .1: OTHER THAN _~~,~_~ I s_ AUTO ONLY: AGG t s : EACH OCCURRF\lCE , AGGREGATE GARAGE LIABILITY r---l ANY AUTO DEDUCTII3L[ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER ! I ~ ,,,- i___jIQB'(_~I,MI"1."_sJ : _ EJ3 --'-____ i EL EACH ACCIDENT '~ IE"'L_-DISEASE:"""E-A-E~;P-L~-;EE: S-- !~:-L:C;;SE.~S-E~~O~ICY-LI~IT'1 $ --- , .-1 '- /127 . --" ~-{-' --.--- .-- -1-.-'--. ../: ',', ,., (\"jj::>W;J] C'll Y DESCRIPTION OF OPERATIONS {lOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *Medical Payments excludes Participants. City of Santa Ana Parks, Recreation, & Community Services Agency, its officers, agents, employees, representatives and volunteers are included as an Additional Insured ATIMA. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Parks, ATtn. Dolores Ramos 888 W Santa Ana Blvd., STe 200 P.O. Box 1988 M-23 Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORI D REPRESENT ATIJlE @ACORD ORPORATION 1988 ACORD 25(2001108) . ISO I Commercial General Liability Forms I 07101/04 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 1007 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART City of Santa Ana, its officers, agents, representatives, and volunteers 888 W Santa Ana Blvd Ste 200 P.O. Box ]988 M-23 Santa Ana, CA 92702 employees, SCHEDULE Name Of Additional Insured Person(s) Or Oroanizationisl: Location/s' Of Covered OllArations Information reauired to comolete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organlzation(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage" or 'personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf: in the pertormance of your ongoing operations for the additional insured(s) at the location(s) deSignated above. B. With respect to the Insurance afforded to these additional insureds, the following additional exclusions apply: This Insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be pertormed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 ,'e), d\" J.,:,:':' /\>~ PJ l'OrZJVI 'i/>/ .:>!, /~-;;;?_-~~-",._,.~;._-_.._~-,,_._- ' : I "'r~!~:\ ACORlJ,. CERTIFICATE OF LIABILITY INSURANCE OP ID V~ DATE (MMlDOIYY'fY) BRODE-3 10/06/06 PRODUCER N - '2oCI-I- 03'/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hylant Group - Toledo N-2.oc:A-O~?..o I HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 811 Madison Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . Toledo OR 43604 Phone: 419-255-1020 Fax:419-255-7557 INSURERS AFFORDING COVERAGE jNAle"-- - - -- - -- --_.-- -- - --_.--- - ---"- _.,---- - - - --- --. - -- --- -- - INSURED N - z.oo'-l-037 -0 2- ~, INSUR~~ Phib<1.el1'-J:i0nd~itY~SI" c~_ 18058 -- -- , INSURERS' --- ---~ Jay Broderick dba Mad Science ~------ - --,----- of West Orange count~ INSURER C t------ -.--,.-.-.'- ------.-'.- --- - 3501 w. Moore Ave. S e J INSURER D Santa Ana CA 94702 -"---'- --,-- - -------.-..- INSURERE THE POLICIES Uf' INSURANCE LISTED D[LOW HAVl:: ~EEN ISSUFD TO THE INSURED NAMED ABOVE FOR THE POLICY PERIUD INDICATED NOTWITHSTANDING ANY Rl::QUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH lHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN_ THE INSURANCl:: AFFORDED flY THE POLICIES DESCKIBED HEREIN IS SUBJECT TO ALL lHE TERMS, EXCLUSIONS AND CONDITIUNS OF SUCH POLICIES. ACGREGAIE LIMITS SHOWN MAY I lAVE BEEN KI:DUCED BY PAID CLAIMS I::i:~~--C- TYPEOFI~SU~~C--;- POUCYNUMBER- GENERAL LIABILITY A X x~ COMMERClALGENFRALLIABILlTY I PHPK187988 I I -I CLAIMS MADE 1,,_~.1 OCCUR ~ ribuse/Mo_~st_ation PHPK~87988 ~~EN'L AGGREGATE LIMIT APPLIES 1"l::R: ;- , I"OUCY r' I m?1 '-1 LOC , AUTOMOBILE LIABILITY COVERAGES POLlC'YEFFECTIVE P UCY EXPIRATION DATE MMlDDNY DATE MMlDDNY 10/15/06 10/15/07 10/15/06 10/15/07 A ANY AUTO tj' ALL OWNeD AUTOS . SCHFr]ULEDAUTOS r!.' HIRED AUTOS ~x~ NON-OWNED AUTOS PRPK187988 10/15/06 10/15/07 1- l_~J DEDUCTIRLE I Rl::Il::NTION r, WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY I"ROPRIETOR/PARTNER/CXECUTIVl:: OFFICl::R.'MEMBER FXCLUDED? 1 ,,~CS, descr,be under SPECIAL I"H.OVISIONS hRluw I OTHER I -.-.--,-.---- LIMITS 1 ~~~gR=- _~s 1 ~Oo... O.QO ~R.[M\-~ES~O~cUrence) _$19_ ~..!...9 O. 0 _ MEOI:::XP(Anyonep..rson). $ *15,000 ~ERSONAL & AOV INJURY $ :L:"o 00-,000. ------ --.--------.- GCNERALAGGkEGATE 1$2,000,000 -----.--------1---=-- .--------- ~RODUCTS~OMP~OI" AGG ~~ 000,0 Q.Q. A&M 500,000 I' COMBINED SINGLE LIMIT .(EaaCCldent) --;~DILYINJURY.- i~-' - --- I ~~~~e:~I:nJ}UR-; - - ~1.. - (peraccldf'lll) $ ~OPl::RTY DAMA"F - I $ -- --- I rp~raCCldent) I AUTOONL ~A A,CClD,ENT -l-~-- OTHER THAN _Ell. ACC::_..:....$ _ AUTO ONLY: AGG . S ~CH OCCURRENCE _ _+: _ __ ____ rAGGR>"'T' ~~ _ ~ -- - - - -~-- [$ - $1,000,000 LL DISEASlo - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLESI EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *Medical payments excludes Participants. Certificate Holder is included as an Additional Insured/Landlord ATIMA. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR L1AIiILlTY OF ANY KINO UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORI D REPRESENTAT~VE CERTIFICATE HOLDER CANCELLATION City of Santa Ana 888 W Santa Ana #200 P.O. Box 1988 M-23 Santa Ana CA 92702 ACORD 25 (2001108) @ACORD ORPORATION 198B l"~~r'l": Dana Cable At: Hylant GrallP, Int: FOlxID: Ilylant Grollp To: Carla I-hompkins POLICY NUMBER PliPK187988 Date: 10/1312006 03:32 PM I-'age: L of 3 COMMERCIAL GENERAL LIABILITY CG 20 1007 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL Y. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifioP-s insurance provided under the follovving: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s} Or Organization{s); LocationJ~) Of Covered Operations City of Santa Ana (with respect to Santiago Lawn Bowling C1ubhollSf' at 510 E Memory Lilne) Information reauired to compl~te this Schedule, if not shown above, will be shown in the Declarations A. Section II - Who Is An Insured is amended to "~\;(~e as an additional insured the pen;on(s) 01 crganization(s) ~Ilown in the Schedule, but only V'Jith respect to liability fOl' "bodily injury". "property damage" or "personal and advel1isin~J injury" caused, in whole or in part, by: 1. Your acts or omissions: or 2. The acts or omissions of those acting on your behan: in the pertormance of YOllr ongoing opelatiolls for the additional insured(s) at the location(s) deSIg- nated above ..,H____ B. \^Jitll respecl tu tile illsmance afforded to these additional insllleds, the following additional exclu- sions apply: This insurance does not apply to "bodily injmy" 01 "property damage" occlllTing after. 1. All Walk, Includin~ materials, parts or equip- ment furnished in connection Witll such work, on the project (other than service. maintenance or repairs) to be performed by or on hoP-half of the additional inslIrcd(s) at the location of tile Gavered opel<itiollS I1ds been completed: 01 2. That portion of "your work" out of which the injury or damage ,UI""e"" hss been put to its ill tended use by any person 01 01 ~Jdllizatlon other 111dn ,lIlother contractor or subcontractol engageclln performing operations fOl a princi- pal as a part of tile same project. " : r;fJ ( /;, CG 20 100704 (Q) ISO Propelties, Inc. 2004 Page 1 of 1 o "'-(~". O"l'a Cable At: Hylant GroLlp, lnc FaxlD: Hylant Group To: Carla Thompkins Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHPK187988 Add itional Insured MAD SCIENCE GROUP 8360 BOUGAINVILLE ST., STE, 201 MONTREAL, QU H4P2G-1 CG2029 - CA - Lac #1 Additional Insured City of Santa Ana (with respect to Santiago Lawn Bowling Clubhouse at 510 E Memory Lane) 888 W Santa Ana #200 POBox 1988 M-23 Santa Ana, r:A 9/l02 CG2010 - General liability Page 1 of 1 '~/J / ?~:.f, ~~ /'" /." :; ./ Date: 10/1312006 03-32 r'M Page: 3 013