HomeMy WebLinkAboutON THE DOT (AKA DIEDRA POWELL-WILLIAMS) 1ACity of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Clerk of the Council Office (M-30).
Call 647-6520 if you have any questions.
The agreement with
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INSURANCE ON FILE
WORK MAY PROCEED
UN7ILINSURANCE EXPIRES
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COUNCIL
FIRST AMENDMENT TO
N-2007-152-01
CLERK OF CONSULTANT AGREEMENT
DATE: i yyg - v `~
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~o^ ~I"„s THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is made and entered
into this 12~h day of December, 2008 by and between Diedra Powell-Williams, a sole
proprietor doing business as ON THE DOT (hereinafter "Consultant"), and the City of
Santa Ana, a charter city and municipal corporation of the State of California ("City").
RECITALS:
The parties entered into Agreement N-2007-152, dated November 7, 2007,
(hereinafter "said Agreement") by which Consultant has conducted state
notary public instruction classes in the City's leisure program.
2. In accordance with the terms and conditions of said Agreement, the parties
wish to renew said Agreement for an additional one-year period.
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 Consultant Agreement, the parties agree as follows:
Section 3, TERM, shall be amended to extend the termination date from
January 1, 2009 to December 31, 2009.
2. Except as herein amended, all terms and conditions of said Agreement shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the day and year first set forth above.
APPROVED AS TO FORM:
JOSEPH W.FLETC R
City Attorney
CITY OF SANTA ANA
,.c...~Lf~ -
GERARDO MOUET
Executive Director - arks, Recreation
and Community Services Agency
EVANSTON INSURANCE COMPANY
CERTIFICATE NO.: 2008-09
CERTIFICATE OF INSURANCE
EXCLUDES COVERAGE FOR NOMIN CIAL EVENT LIABILITY pgpGPR4MATIONS FOR NOMINEE EVEiv'fS.
City of Santa Ana
Inc. in conjunction
Apex Insurance Services
P. O. Box 645D
Newport Beach, CA 92658
(949)660-8135
Deidra Powell-Williams
PO Boa 351
Fair Oaks, CA 95628
OLDER):
/~,p -1he ~o}
20 Civic Center rtaza
Santa Ana, CA 92701
TYPE: ~,_,_.~, o..titc,. t-nurse
DATE(S): March 2008 -December 2008
LOCATION: _Various City Locations
•Liquor Liability Yes ^ No
srr :~.,~. r iah;lity after 12 amends before 2 am_
This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period
indicated. Notwithstanding any regnuernents, temu or conditions of any contract or other docurrlerlt with respect to which this
certificate maybe issued o: may pertain, the insurance afforded by the policies described herein is subject to all 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: 04SEP1000001-4
MASTER POLICY DATES: EFFECTIVE: IANUARY 1, 2008 EXPI1tATION: JANUARY 1, 2009
COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIDLE: NONE
General Aggcgate limit S 2,000,000
000,000
1
.
Products & Completed Operations
000
000
1
,
.
Personal & Advertising Injury
l 000,000
Each tkcrurence limit
000
50
,
Fire Darnege (Any Onc Fire)
5
000
,
Medical Payments (Any One Perton)
000
000
1
,
,
Liquor Liability (Tf purchased)
The limits of insurance apply separately to each event insured by this Policy ab if a separate pancy of mawmrw ,ea .....,• •~...-- •-• --- - ~ ----
"Who is insurcA" is amended [o include, as an iruured, the poison w organization shown in this schedule, but only with respect to liability arising out of the
ownership, maintenance or use of the premises rued by the namod insured (event holder). This insurance does not apply ta: Any "occuaence" which takes Dlace
after the event holder ceases to be
(.GJC/
J
CANCF t-AT10N: Should the above described policy to cancelled beforo the expiration date thereof, the issuing company will mail 30 days written notice to the
holder and additional insureds listed.
~~~
AUTHORIZED REPRESENTATIVE:
DATE IssuEn: 3 t w