HomeMy WebLinkAboutPINEDA, ANGELA 2 - 2006
INSURANCE ON fiLE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
/_/-~OO7
CLERK OF COUNCIL
DATE: J!-JCJ -0'
N-2005-095_0 1
FIRST AMENDMENT TO AGREEMENT
THIS FIRST AMENDMENT TO AGREEMENT is entered into on June 26,
2006, by and between A[lgela P0Eda, an individual ("Consultant") and the City of Santa
Ana, a charier cily amI municipal corporation of the State of California ("City").
RECITALS:
A. The parties entered into Agreement IIN-2005-095, uatetl June 1,2005, (hereinafter
"said Agreement") by which Consultant has provided aerobic classes as part orthe
City's Leisure Class program.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
renew said Agreement lor an additional one year period.
WHEREFORE, in consideration of the covenants contained in said Agrccmcnt, and
subject to all the terms anti conditions of said Agreement, except those amended in this
First Amendment Agreement, the parties agree as 10110ws:
I. Section 3, TERM, shall be amended to extend the termination datc to June 30, 2007.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Agreement on the date and year first written above.
APPROVED AS TO FORM:
CITY OF SANTA ANA
~ ~*CHER
City Attorney
hV-~_~W
GERARDO MOl T
Executive Direct r
,.
L
\II TRIOlA E. IIPICI
~I "fI'1( 1)1' THE COtINC/l.
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.:
CERTIFICATE OF I"ISURANCE
EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEP ARA TE APPLICATIONS FOR ""OMINEE EVENTS.
SPECIAL EVENT LIABILITY PROGRAM
PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED)
City of Santa ADa
Driver Alliant Insurance St::rvices in conJunction with 20 Civic Center Plaza~ M-28
Apex [nsurance Services Santa Ana, CA 92701
P. O. Box 28321
Santa Ana, CA 92799-8323
(949) 661J.-8163
License No; DC 36861
NAMED INSURED (EVENT HOLDER): EVE:>!T JHOR MA TION:
Angela Pineda TYPE: Aerobics -
4122 West Kemp Avenue tJ- ~OD5- 005 DATE(S): Anrill - December 31. 2(106
Santa Ana, CA 92703 IV- oaOOS-09'6"-O/ LOCATION: Sal Gado Center
This is 10 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 ~onditions of any contrac~ or other document Vlith respect to which this
certificate may be issued or may pertain, the insurance afforded by the polic~es described herein is subject to aU 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 04SEP100000I
MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2006 EXPIRATION: JANUARY 1,2007
COMMERCIAL GENERAl. UABILlTY OCCURRENCE FORM DEDUCTIBLE; ND~E
Genml Aggre~(e Llmit $ 2,000,000
?roducls &. Compleled Operations 1,000,000
Personal &. Ad....enising Injury 1,000,000
Each Occ\luence limil r ,{IOO,OOO
FiR Damage (Any One fire) 50,000
Medica~ Paymems (Any Om: Person} 5,000
The limits ofinsuraJ'.ce apply separately 10 eacn event insured by this policy as if a separate policy ofinsurarlC"e has been iSSued for that event.
"Who is insured" is amended [0 include, as an insured, the PersOll or organi1:lluon shown in this sc!ledule, but on!}' with respe~t to li,bility arising: OUI of(ne
OW[lcrshilJ. maintcnar.ce or llse oflhe pr~mi&es used by the named in~urc;d (~cnt ho:der). This il'l$U1"ll.ftcc docs 1'101 "Pp1y to' Any "1le:cuTTcnee" which takes place
aOer the event hoJder ceases tc be a tenant ill that premises
OTHER ADDITIONAL INSUREDS
CANCELLA nON: Should the: above describL'..d po:~cy to cancelled before the expiration date thereof. tbe i5suing company will mail 30 diys wrillen notice to the
certificaLeholder and adJitional insurcds listed,
~~~
AUTHORlZED REPRESENTA TIVE:
DATE ISSUED- March 31 2006
Y~/,i
/-./'-~-c.;7
' - : " - - ~ '