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Home My WebLink AboutU.S. HEALTHWORKS 2C -2006 AGREEMENT TERMINATION Please complete this form when the attached agreement is no longefai effect, Return form to the Sr. Deputy Clerk of the Council (M-30). Call 647-5238 if you have airy questions. The agreement with U-s , �L No. A ---170 was completed on p t ap)C , and final payment has been made. A - 2o0z-I51 (2.) cart, Department: rl •�C 4 A -20o9-V2o- 02 Signature: C A-2oo6- ib3 Date: 0/1-- City of Santa Ana Revised 8-7-03 Clerk of the Council ",':'1 fjU /JUi;:", i;~::()Ci:.[ [; A-2006-163 , I', .j !~::\NCr Ll~FH;:lS ')i'q ~'.1;J21_...__--_. nU{h: Uf l.;OiJNCit JAIEd. /;;'1 Ic? ec.;FD L8.~ FOURTH AMENDMENT TO AGREEMENT THIS FOURTH AMENDMENT TO AGREEMENT #A-2002-157. is ~l1lerd into on the 3'J day of July. 2006 by and between U. S. Healthworks. (I Calij('rnia corporation c-Consultanf'J and the City of Santa AJ13, a charter city and municipal corporation of the State of California ("'City''). R FCfTALS: A. The parties t'ntered into Agreement #A-2002-157, dated /\l..lgust 19, 2002. (hereinafter ';said AgreemenC) by which Consultant has provided cornprehensive physical examinations for the Police and Fire Departments, B. In accordance with the terms and conditions of said Agreement, the parties \\1sh to amend the Compensation per exam, extend the term of said Agreement and increase the compensation to pa,Y for services during the cxtt:nded term. \\/III-:RI-:1'ORE. in consideration of the covenants contained in said Agreement, and subject to all the ti;rIUS and conditions of said Agreement, except those anu:nded in thi:'> Fourth Amendment to Agreement, the parties agree as follows: 1. Section 2 a.. COMPENSATION, shall be amended to read as follows: "City agrees 10 pay. and Consultant agrees to accept as total paymentnH' its services. 5175.00 pl'r phy'sicaL 'The compensation to be paid under this Agreement shaH not exceed S98.000.00 during rhe 2006'07 nscal year" , Section 3. TFH,\'1. shall be amended to I't~ad as f()llows: "'This Agn:.'cm(~nt shall comrnence on August 19,2002 and tenninatc on June 30, 2007. unless terminated earlier in accordance with Section 12. below. The term of this Agreement may be extended upon a writing executl;~d by the Fire Chief and the City Attorney." 3 . Fxti::pt as amenckd hereinabove, all krlllS tind conditions of said i\.grccment shall remain in full force and efkcL 11'\ WITI'\ESS WHEREOE. the parties hereto have executed this FOllrth Amendment to Agreement on the date and yearlirst \\Tittcn above. CITY OF SANTA ANA ATTEST: //--, j L ..A<~. ~;~. .~:lS}~S (J. !11C!.j~~~.I'AJ;4.~~ PATRiCI!\ L HE/\LY ~viif;::J~~t.~~. Clerk of the COllneil City Manager APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney Altorney CONSllLTANT '/l{" l: i/ Ii ~1r!~~(LJl&-~-~ .. industrial Accounts Coordinator ACQBJ:t CERTIFICATE OF LIABILITY INSURANCE I i i DATI' {MM,POIY)''(Y) 10/19!2006 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, PRODUCER Arthur J, Gallagher & Co. License #0726293 505 North Brand Blvd, Suite 600 Gler;t:Jale, CA 91203.3944 Phone_ 818,539-2300 rme 818,.539-230, INSURERS AFFORDING COVERAGE NAIC# IN$'JRED U.S. HealthWorks, Inc. 3655 North Point Parkway, Suite 150 A!pharetta, GA 30005 INSUREr< A _,!j~~~?_~i:!,!:iE:.,l0.~~E~0,~,~_S~9!':"P~ ny INSUR,,;:'l a Hartford IP,SJRER D IN$JRFRf COVERAGES THE POLICiES O~ iNSURANCE LISTED BELO'N H/IVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERiOD INDIC,\TED NOTVi!THSTANDING ANY REQUIREMENT, TERM OR CONDITiON Or: ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE r.,'AY BE ISSUED OR MAY PERTAIN, THE !NSURANCE- AFFORDED BY THE POLJCIES DESCRI8ED HEREIN JS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLlCES, AGGREC',ATE LIMITS SHOWN r.1AY HAVE BEEN REDUCED BY PAID CLAJMS. ^ " 72UENUM8309 LIMITS 09/01106 09/01/07 _,~i:~gg;::!,~H~,I\PVI~.JURY q?t_~:")~LA:q<:;!'lS(;ATC 300,00G 10,000 '1,000,000 3,000,000 3.:;)00,'060 CCCUR I'~/(r ,;"'p:d~S "iiiK A POliCY 09/01107 1 ,000.000 ANY AUTO A.LlCWVNE~AJT()..,> BODilY IN...'URY lPeqxvUJI! X SC!,EOU",PCAUTOS X X H)I~f.:; AUTOS BO(}ll Y IN.;;JRY li'tHaccid(l1)1; I\ON.owr;;:[;AUros GII.:RAGE LIABILITY AuTOO....L Y .f:.AACClQEN1 ANY Al!f(, OTHER'rH^," AiJTOONLY G ,_ €XCESS!iJMBREL ~~1~6IL1T Y 09/0'1/06 09101;07 X OCCUR : 0_AIM$ MADE ~~~~::;;;:~,!E D~DUCT-i>:~E X R[TF'H'O'1 S 10000 ^ WORl{ERS COMPENSATION ANO EMPLOYERS' LlABIUTY 72WNi',.1G3070 09(0 1 1lJ6 09;01/07 X ~,::L^, ~t:Cl1 ACCIDeNt is ~" YSEASE. ;'OUCY!.i'tiT 1,000,000 1,000,000 OTHER - .----.- .-- DESCRIPTION Of' OPERA nO~lS.' LOCATIONS i VEHICLES! EXCLUSIONS AOoeo &V ENDORSEMENT I SPECIAL PROVISIONS 'Except ~o days notice for r,on-poyrr)l;ml of premium The City 01 Santa Ana. 20 Civic Center Plaza, Santa J\na, California 92;'0'1. its officers, employees. agents volunteers and represontatives are named as additior,QI insureds with regard to liability ar:d defense of suits arising from the operations and uses performed by or on behalf of the namBd ifl$!Jred. CERTIFICATE HOLDER CANCELLATION 20 OAc Center Pklza S.an:",1 Ana. C/\ 92701 SHOULD ANY OF THE ABOVE OESCRlIlEO POLICIES 6f CANCELLED BEFORE THE EXPlRA TlON OATe THEREOF, THE ISSUING INSUReR WILL XXXXXXl<.XXXXMAlt. ,,,;?St,, DAYS WR:rrTEN ~~:pfi Tp THE CERTifICATE HOLOER NAMEO TO THE lEFT, XXXXYJ0lXXx.xXXXXXXXXXXXX l.iJ...!:xiidXyy'XXJ(xXXXXXX:XXXXXXXXxYJOC';XXXXXXXXXXXXXXXXXXXXX;<.XXXXXXXXXxxxx.>: XXYJ;XXXXMXXXXX AUTHORIZEO REPRESEtHATlVE City of Santa An;) City of Santa An~l Fire DepiOrtmeh! A:!ll'lltb'VtH::I AS '1'0 ~ ACORD 25 (2001108) @ ACORD CORPORATION 1988 L. c, ADDITIONAL INSURED ENDORSEMENT Insurance Company Hartford Fire Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # 72UENUM8309 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2 With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 911106 - 911107 Policy # 72UENUM8309 Issued to u.s. Healthworks, Inc. , this endorsement form as a part of Named Insured Countersigned by ~- Authorized Representative ['0 ]i'01~M ~~/ ,_ ~'ll L. L Urii Stitt Sheedy \<,I~li';H