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Home My WebLink AboutMAD SCIENCE OF ORANGE COUNTY 1BC 200! i AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in Mar; -7 p * 47 ri t 3f Yi Return form to the Sr. Deputy Clerk of the Council (M -30). Call 647- 5`4-&'ifyo haveg� questions. The agreement with A4 - F D_ G No. was completed on nu and final payment has been made. Department: "T ¢— 4 N -2ooy -03� Signature: Ste L£ of Date: City of Santa Ana Revised 8 -7 -03 Clerk of the Council i )/~)- 001 - 0;1-0-"- SECOND AMENDMENT TO CONSULT ANT AGREEMENT i,,:,,:\,\;U. iJOT ON FILE NvRK MAY NQIPROCEED CLERK OF COUNCIL DATE, I <J/-Ot. \f THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is made and entered into this 30th day of December 2005 by and between the City of Santa Ana, a charter city and municipal corporation of the State of California ("City") and Mad Science of Orange County ("Consultant"). RECITALS: I. City and Consultant 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. 2. In accordance with the terms and conditions of said Agreement, the parties wish to renew the said Agreement for an additional one-year period. WHEREFORE, in consideration of the mutual and respective covenants contained in said Agreement, and subject to all the terms and conditions of said Agreement, City and Consultant agree as follows: I. Section 3, TERM, shall be amended to extend the term of said Agreement through December 31, 2006. 2. Except as herein amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, City and Consultant have executed this Second Amendment to Consultant Agreement on the day and year first set forth above. CITY OF SANTA ANA APPROVED AS TO FORM: ~ . ... .'. ...~ ,/',' .'~ . {'/' '/ fy-Y{)SBPH W. FETCHER City Attorney /;;;;:~f:/L~ Executive Director Parks, Recreation and Community Services ATTEST, /~;;?;- ':-../ ' ,,-,J i J:)' '--PA T'rf1r1itF Hf!n r~ c.!fJ'/'( (: r . ':;..: (, ;~!L'I."cn 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