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Home My WebLink AboutCAMBODIAN FAMILY, THE 6A-2004 INSURANCE ON EILl WORK ['MY PROCEED UNTIL INSURANCE EXPIRE" 3'[i-(j~ CLERK OF COUNCIL DAn SEP 1 5 Z005 c (\)H- (Lt~~ A-2004-211 FIRST AMENDMENT TO AGREEMENT THIS FIRST AMENDMENT TO AGREEMENT is entered into on October 4, 2004 by and between The Cambodian Family ("Consultant") and the City of Santa Ana ("City"). Recitals: A. The parties entered into Agreement A-2004-167, dated July 1,2004, (hereinafter "said Agreement") by which Consultant has provided vocational/occupational training, employment strategies 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 training and supportive services 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 $23,310, for a total amount no to exceed $108,939.00 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: CITY OF SANTA ANA ~//~d . 4 ~. ~ ~,#-+ Patricia E. Healy Clerk of the Council !2.~42a~ David N. Re'am City Manager APPROVED AS TO FORM Joseph W. Fletcher, City Attorney By: tii.:cu fA.:lt ru dr' Laur Sheedy . Assistant City Attorney THE CAMBODIAN FAMILY R~~ Rifka Hirsch Executive Director I ACORQ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY) 02/08/2006 PRooueER (714)838-1912 FAX (714)838-7568 THIS CERTIFICA TE IS ISSUED AS A MA TTER OF INFORMATION Lake Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 13891 Newport Ave., Suite 285 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lic #0747473 Tustin, CA 92780 INSURERS AFFORDING COVERAGE NAIC# INSURED Cambodian Family ,4-~[)()'f- ~3 INSURER A Philadelphia Ind. Ins. Co. 1111 East Wakeham Avenue 4- ;;I{XJ4-;).03- DI INSURER 8: Suite E A-;;.ro5 -D18- rx:4> INSURER C Santa Ana, CA 92705 A-.;>.a:>5- liN INSURER 0 .. INSURER E THE POLlClES OF INSURANCE LISTED BELQWHAVE BEEN 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS, II~~~ ~'1:CJ:r TYPE OF INSURANCE POLlCY NUMBER POL-ICY EFFECTIVE POLlCY EXPIRATION LIMITS ~NERAL LIABILITY PHPK155246 03/09/2006 03/09/2007 ~~_?CC~RRENCE , 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED , 400,000 ~ ~ CLAIMS MADE [!] OCCUR MEO EXP (Anyone person) , 5,000 A - PERSONAL & ADV INJURY , 1,000,000 GENERAL AGGREGATE , 3,000,000 ~. GEN'!... AGGREGATE UMIT APr~Y PER PRODUCTS. COMP/OP AGG , 1,000,000 h ,hPRo. POLICY JECT lOC AUTOMOBILE LIABILITY PHPK155246 03/09/2006 03/09/2007 COMBINED SINGLE LIMIT -.. , ANY AUTO (Eaacddent) 1,000,000 f.- All OWNED AUTOS BODilY INJURY f.- , SCHEDULED AUTOS (Per person) A X HIRED AUTOS 800ll Y INJURY X , NON-OWNED AUTOS (Per accident} X $0 Deductible PROPERTY DAMAGE 2. (Peraccidenl) , ==i~GE LIABILITY AUTO ONLY. EA ACCIDENT , ANY AUTO OTHER THAN EA ACC , AUTO ONLY AGG , 3ESS1\lMBRELLA l.IABll.lTY /~ p;i' 1,,- EACH OCCURRENCE , OCCUR 0 CLAIMS MADE 0::<./"Lj AGGREGATE , .~ , ~ DEDUCTIBLE , RETENTION , , WORKERS COMPENSATION AND '1 ~5i~J~'<1 IOJ,t<. EMPLOYERS' UABILlTY .- ANY PROPRIETORfPARTNER/EXECUTIVE EL.. EACH ACCIDENT , OFFICER/MEMBER EXCLUDED? EL-_ DISEASE - EA EMPLOYE , It yes, describe under EL DISEASE - POLICY LIMIT SPECIAL PROVISIONS below , ~HER . PHPK155246 03/09/2006 03/09/2007 $1,000,000 Each Claim A use & Molestatlon $1,000,000 Aggregate $0 Deductible DESCRIPTION OF OPERA no~ I LOCATIONS I VEHICLES / EfLUSIONS I'DDED BY ENDON'EMENT I SPe:C~L PROVISJON\ "Except 10 days or non payment 0 prem,um. E"1' oyee D,s onesty 200,000/$2,500 Oed. Professional Liability $1,000,000 Each Occ/$3,OOO,OOO Aggregate. City of Santa Ana 's named additional insured per contract with named insured. Schedule of vehicles nd drivers on file. "Non Profit organization" COVERAGES The City Of Santa Ana: Its Officers,Employees Agents, representatives 20 Civic Center Plaza (101-30) Santa Ana, CA 92705 CANCEL 11 N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPlRA TtON DATE THEREOF, THE ISSUING IN$URER WILL r,)6(X~li MAlI.. 30.... DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT llIXOO(l(~JOOOO(~ltKllMO(lW<Il~X~XX: XJll VM<<XXXXXXXX CERTIFICATE HOLDER ACORD 25 (2001/08) FAX: (714)571-1974 ~/ "'(..~. @ACORDCORPORATION 1988 L. i,. . AoomONALINSURED ENDORSEMENT Insurance Company ,_'pHILADELPHIAl~!DEMNITY INSURANCE COMPANY This at'ldorsemel'lt modlfies such insurance as IS afforded by the provisions of Policy #PH P f( 1 ~ " j " . ralalit'lg to me folloWing: ' 1 ' The Cily of Santa Ana. 20 CMc: Center Plaza. Santa Ana, Catlfomla 92701; its officers. employees. agents and repre~es are named as additional Insureds radditJonal insureds.) with reg<;rd to liabUity and defense of sUits arising from the o!'€r;ljjons and,uses petfooned bv 01 on beha~ 01 the named insured 2 .. Wrthrespect to ~msarislng out 01 theoperatiillns and QsesperfO(l'rted by or onbetlll\fQf~ flaI'tled insUled,such insuranCElas 15 afforqsr;j by-this poliCy is p(ilnary at'ldlshot addllioneJ to .oroontributirlg witheny other insUfa.t'lC(il ~by oder \l1e benefit oHlle addltfQrlalinsured$ Except in the c/!$e of sole negligence or willful misconduct. . 3,. 1b!slOsuranceappfies separately to e~ii1$t1rt!dagajnst whom. claim .is madaor $lJitiSl:lr()light~t wllh resp~cl to the CQll1pany'slftrjitsofliabflity . The inclustonof fSny~or or9S"li<:alionas an Insured shaU nota.ffe<:t arlY rightwt\ieh such person oror~n would h<we as a claimarnif not so included. 4.. Wl!tt(~to the ad~inllure:ls, thjsinsU~$halJ not be CaocellaO. or lTI~redUC<<lincoverage olnmits.~afterthirty (8O}dayswri!ten fl()~ nas beengi1lent<:>U1e..C1ty' \1fSanta )\ria, 20 eMs Clll'lt$rPI9Ul,$antciAn6..Califomia. 92701,. (Compl.etion of W~ (ollowIng, lnclUQlng countersIgnatUre, jS required to make tills endorsement ~ectllre.)' EffecllvQ ,__.03(U2J06 ,thiselldorsemef\tfoJ'tn as sparta! ~......._-~.~_....._._---_. Policy 1/ PHPK155246 ---------. Issued to _THE CAj>1BODIAN :l<'AMILY_.~" '. Named Insured . ~ ~ CountersIgned by _.. .. .... .... " .. ,~ .---.-' f5;~ 1'/2- EXIHP.1T 0