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HomeMy WebLinkAboutGEORGE, MARIE DBA ACT ONE ACADEMY OF DANCE (LITTLE STEPS DANCE SCHOOL) 2B N-2006-060-02 INSURANCE ON FilE WORK MAY PROCEED UNTil INSURANCE EXPIRES c:.o?J-o!l ~bCOND AMENDMENT TO CONSULTANT AGREEMENT CLERK OF CQUNCILz.OG& n^TE:~PRB 0" p r..l~ (1.) 0c,nn(~ S THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is entered into this 19 TH day of March, 2008, by and between Marie George, an individual dba Act One Academy of Dance (hereinafter "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-2006-060, dated April 3, 2006 (hereinafter "said Agreement") by which Consultant has provided dance classes through the City's leisure class program. B. In accordance with the terms and conditions of said Agreement, the parties wish to renew said Agreement for an additional one-year. WHEREFORE, in consideration ofthe covenants contained in said Agreements, and subject to all the terms and conditions of said Agreements, except those amended in this Amendment to Consultant Agreement, the parties agree as follows: 1. Section 3, TERM shall be amended to extend the term through June 30,2009. 2. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Amendment to Consultant Agreement on the date and year first written above. ATTEST: ~--> "ki. / ~ . tt /". . , ___... r , .' ~ "C{ 72L(/> <- /.c! d~ PATRICIA E. HML Y Clerk of the Council CITY OF SANTA ANA ~Y Executive Director APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attomey _ ~ yo' <1 / By: . '(/itl(z.'- \.(,;r'!c.C/ Laura Sheedy ~ / Assistant City Attorney -. Policy Nu mber 92-GA-8133-8 DECLARATIONS PAGE AMENDED JUN 23 2007 STATE FARM GENERAL INSURANCE COMPANY 900 OLD RIVER RD, BAKERSFIELD CA 93311-6000 A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS j\l- 200& - o&D- D/ 23-8821-F790 S Named Insured and Mailing Address GEORGE, MARIE DBA ACT ONE ACADEMY OF DANCE 1186 N TUSTIN AVE ORANGE CA 92867-6006 Cov A -Inflation Coverage Index: N/A BUSINESS POLICY - SPECIAL FORM 3 Cov B - Consumer Pricelndex: 203.9 AUTOMATIC RENEWAL - If the POLICY PERIOD is shown as 12 MONTHS, this pOlicy will be renewed automatically subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we win give you and the MortgageelLienholder written notice in compliance W11H the policy provisions or as required by law. Policy Period: 12 Months The policy peri?d begins and ends at 12:01 am standard time at the Effective Date: JUN 23 2007 premises location. Expiration Date: JUN 23 2008 Named Insured: Individual Location of Covered Premises: 1186 N TUSTIN AVE ORANGE CA 92867-6006 Your policy is amended JUN 23 2007 ADDL INSURED NAME & ADDRESS ADDED ENDORSEMENT FE-6609 ADDED Coverages & Property Section I A Buildings B Business Personal Property C Loss of Income - 12 Months Limits of Insurance Excluded $ 5 800 $ Actual loss Section II L Business Liability M Medical Payments Products-Completed Operations (PCO) Aggregate General Aggregate (Other Than PCO) I 1,000,000 5,000 2,000,000 2,000,000 Deductibles - Section I $ 500 Basic $ Forms, Options, and Endorsements Special Form 3 *Section II Additional Insured Amendatory Endorsement Debris Removal Endorsement Policy Endorsement Business POlicy Endorsement Glass Deductible - Section I * New Form Attached FP-6143 FE -6609 FE-6205 FE -6451 FE-6506.2 FE-6464 FE-6538.1 In case of loss under this policy, the deductible will be applied to each occurrence and will be deducted from the amount of the loss. Other deductibJes may apply - refer to policy. Endorsement Premium Increase $ 120.00 Discounts Applied:APDD r",;, Renewal Year . >.. 1. hV, AS Ye~rs in Business .,...//J...J. .' .' Claim Record ---~~i.r ,~::/L2/'. ..' j I J.. , ':;1,--'-'~ t. ~j;'::':'l . "A"..;..-.---- Prepared JUL 06 2007 FP-8030.2C A3TN 06/1993 Your policy consists of this page, any endorsements and the policy form. PLEASE KEEP THESE TOGETHER. avo 1 Age nt (o1f2172b) .. SB Policy No. 92-GA-8133-8 FE-6609 SECTION II ADDITIONAL INSURED ENDORSEMENT sun 'AIM A IHIlItANCI << Policy No.: 92-GA-8133-8 Named Insured: GEORGE, MARIE DBA ACT ONE ACADEMY OF DANCE Additional Insured (include address): CITY OF SANTA ANA THEIR OFFICERS & EMPLOYEES 888 W SANTA ANA BLVD STE 200 SANTA ANA, CA 92701-4561 WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to include as an insured the Additional Insured shown above, but only to the extent that liability is imposed on that Additional Insured solely because of your work performed for that Additional Insured shown above. Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a suit brought for damages for which you are provided coverage. The Primary Insurance coverage below applies only when there is an "X" in the box. ~ Primary Insurance. The insurance provided to the Additional Insured shown above shall be primary insurance. Any insurance carried by the Additional Insured shall be noncontributory with respect to coverage provided to you. All other policy provisions apply. c l~~' APPRO'! ,1-> /"~') I;> '-/r"~ . . } L> '-___ V /~___ ---~~-I~:i~,~~;;l,--~-- "~, A,S-::;lsta~-l'~ (~1t~'/ :"-\ T ~ i..; r l-~ FE-6609 Printed in U.SA 08/15/2008 15:05 71452788g8 STATE FARM PAGE 02 CHARLENE HATAKEYAMA. AgBnl UcensB 1/0171272 7841 Vlllley View Sr..el La PelmB, CA 90623 IN......,- (714) 527-81191 FB.; (714) 527-8898 e~m8jl; charleno,hatakeV8ma,wrdOslatelarm.com Fire n.n "A.. A Policy Status AUGUST 15, 2008 GEORGE, MARIE DBA ACT ONE ACADEMY OF DANCE 1186 N TUSTIN AVE ORANGE CA. 92867-6006 B Ph. (714) 625-9356 GENL Policy: 92-GA-8133-8 G Yr issd: 2002 Xref: Location: 1186 N TUSTIN AVE ORANGE CA 92867 Term: CaNT Type: BUSINESS - MISe Coverage information Premium: Renew date: JUN-23-09' 1,209_00 Written date: SEP-06-02 B-BUSN PROP 10000 C-LOSS INC ACT LOSS L-BUSN LIAB GEN AGGREGT PCO AGGREGT M-MED/PERSN 1000000 2000000 2000000 5000 End act 06/23/08 Amount due: Date due: Bill to: SFPP SFPP SFPP Prev premo 1,255 Prev risk: 5,800 SFPP acct:0404-0556-23 Deductibles applied: 500 ALL PER OTHER DED MAY APPLY Messages: Year built: 1951 Zone: 59 Sub zone: 01 Constr: FRAME ~ /.~. ~tvt~ hV~-;J.-3-CK! .;. .,:t ,,?: -.:,...'07 ~ ~jA~ tJ - ;)OC(g .- ()GO - 02- ~':; :'~: '.";.~ 07/28/2009 16:31 71A5278898 STATE 1=AF2M PACaE 02 pECLARATIpN5 PAGE covERAGE suAAMARY , Policy Number JUL 2d 2009 82-t~A 8i33-8 STATE FAaM GENERAL INSURANCE COMPANY ""`" 900 OLD RIVER RD. BAKERSFtELD CA 93311.6044 ASTOCK COMPANY Wli'H HOME OFFICES IN BLOOMINGTON, ILLINOIS Named Insured and Meiting23d8d82f F790 S QEOFiQE, MARIE D8A ACT ONE ACADEMY Of DANCE 1186 N TUSTIN AVE ORANGE CA 92867-6006 ~2 00l - OGO, ~/t 0,2~ - C~ 3 Cov A -Inflation Coveragge Index: NIA . BU91NE95 POLICY - SPECIAL PORM S Cov B - Consumer Pricelndex: 220.0 AUT4MATtC RENEWAI. - If the POLICY P1=R O~~fl Is showwnn as i2 ~nba~N~o~I! S, th s o 1 will be renewed aufomatical~Y s b ect to the remtoms, ruled and fa rnwri~te ~notlcerln comS~i~@ce Iwmt the p~lia~ pro~is(onspo°rla r qu~rlej~~y~awe w tl g~v~ you and tie [wortgapee~IL~enhatde P Policy Period:, 12 Months em~sesYocat onbegtns and ends at 121 am standard time attlte Effective Date. JUN z3 2009 P Expiration Date: JUN 23 2010 Named Insured: (ndiv uet Requested i3y: Actd$fonel Insured Location of Covered Premis®a: 11$6 N TIJSTiN AVE ORANGE GA 92867.6008 Coverages & Properly Section l A Buildings H Business Personal Property C LOSS Of lnoorrr9 - 12 MOrtthS Seotion If L 8uslness Ltabllily M Medical Payments Products-Completed Operetians (PCO) Aggregate General Aqgg regate (Other 7nan PCi:?~) Limits of Insaranoe Ex~Olu300 Actual doss 1,D0~~~~~ 2,000, 2,000,OOQ Forms options, and Endorsementg Sp®cia~ Form 3 FP-6143 Amendatory Endorsemr~nt FE-8205 Debris Removal Endorsement FE-6451 Policy Endorsement FE-6508.2 Business Policy Endorsement FE-64fi4 glass Deductible - S9ctfon [ FE-6638.1 Terrorism Insurance Cov Notice i=E-6999.1 Deductibles - 9eotioe r 600 Basic In case of toss under this policy the deductible will be applied to each occurrenoe and will be deducted from the amount of the Ioes. Outer deduotlbies may apply -refer to policy Premium Discounts ApAlted: Renewal Year Years in Business Cfalrtl Reoord Continued en Reverse Side of Page i Prepared OTHER LIMITS AtdO 1:xCLi1810NS MAY APPLY- RHEA JUL 20ggpp2008 Count atgned 0~8~93.2C CU7Q BY Your afroy eonststs of this page,any ehdorsemanta CHARLENE HATAKEYAi ahd the papcy torm. Pi.tcASfi KEEP THE.4E TOGIETNICR. (714) 827-8897 ,09D.0 p0~ .~0 /~ ,~ ~_ Aaent (0112 t7Rb} 07/28/2009 15:31 7145278898 STATE FARM PAGE 03 CORD POI[Cy NO,: 92-GA $133-8 FE- eeo9 .,.,,.. SECTION tl ADDITIONAL INSURED ENDORSEMENT Policy No.: 92-OA 8133-8 Named Insured: DEOROE, MARfE 013A: ACT ONE ACADEMY OF DANCE Additional Insured include address}: CITY OF SANTA ANA THEIR 4FFICER8 & EMPLOYEES 886 W SANTA ANA BLVD STE 200 SANTA ANA CA 92701-4561 WW© IS AN INSURED, under SECTION it DESlONATION OF INSURED, is amended to include as an insured the Additional insured shown above, but only to the extent that Hasbiifty Is imposed on that Additlonasl Insured solely because of your work ~rformed for that Addltional Insured shown above. Any Insurance provided to the Additional Insured shall oniy apply with respect to a claim made or a suit brought for damages for vrhioh you are provided coverage. The Primary insurance coverage below applies oniy when there is an "X" In the box. Primary insurance. The insurance provided to the Additional Insured shown above shall be primary insurance. Any Insurance Carried by the Additional Insured shall be noncontributory with respect to Coverage provided to you. All other potlcy provisions apply. FE-0609 Pdnled In tl,5.A,