HomeMy WebLinkAboutONG, ALFRED 1BCity 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Please complete this form when the attached agreement is no longer in effect.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 -5237 if you have any questions.
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No. N -2007- 035 -02 was completed on lx I I l c)
and final payment has been made-
W-2-001-035-
Revised 07 -23 -07
Department: I11 'e � i�', r
Phone /6d.: 5D–S4
Signature: Q,� p Ppw cgg o
Date: /�
~~;,~~r~~~ds1,_ w~~y ~~ ;~~. N-2007-035-02
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` ~ {~ ~~ f ~ ~ ~ ~ ~ ~ -, ~~`~~~ ~ SECOND AMENDMENT TO AGREEMENT
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~U~f'I~19 AND AMENDMENT TO AGREEMENT is made and entered into this 3`d day of
June, 2009 by and between the City of Santa Ana, a charter city and municipal corporation of the
State of California ("City") and Alfred Ong ("Consultant").
RECITALS:
1. City and Consultant entered into Agreement N-2007-035, dated January 1, 2007,
Amendment N-2007-035-01 dated April 24, 2008 hereinafter "said Agreement", by
which Consultant has instructed Chess through the City's leisure class 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 Second Amendment to
Agreement, the parties agree as follows:
Section 3, TERM, shall be amended to extend the term of said Agreement through
June 30, 2010.
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.
ATTEST:
- -~ J
-~ _ /
1sATRICIA E. HEALY
Clerk of the Council
CITY OF SANTA ANA
~~~-~`
GERARDO MOUET
Executive Director o~l'arks,
Recreation and Community Services
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
,~.__
By: ,~ ~. '
Kylee Otto
Assistant City Attorney
CERTIFICATE OF INSURANCE
This certifies that ^ STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
® STATE FARM GENERAL INSURANCE COMPANY, Bloomington, fl6nois
^ STATE FARM FSRE AND CASUALTY COMPANY, Scarborough, Ontario
{] STATE FARM FLORIDA INSURANCE COMPANY, YVinter Haven, Florida
^ STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder for the Coverages indicated below.
POliryholder ONG, A1,FREDO DBA CHESS PALACE
Address of policyholder 12E372 VALLEY VIF'w ST STE 5
Location of operations GARDEN GROVE CA 92895-2518
Description of operations CHESS
The polices listed below have been issued to the policyholder far the polity periods shown. The insurance described in these polices is
subjed to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by anY paid claims.
POLICY NUMBER
TYPE OF INSURANCE POLICY PERIOD
Effective Data ; Date LIMITS Ol= LIABILITY
iat beginning of policy psdod)
92-D9-0508-1 G Comprehensive 6-i-06 CONTINUOUS BODILY INJURY AND
Business Liability PRO?ERTY DAMAGE
This -nsurance indudes• ^ Products -Completed Operations
^ Contractual LiabiCrty
^ Underground Hazard Coverage Each Occurrence $ 1, 000, 000
Q Personal injury
Q Advertising Injury General Aggregate $ 2, 000, 000
^ Explosion Hazard Coverage
^ Cdlapse Hazard Coverage Products -Completed $ 2, 000, 000
^ Operations Aggregate
^
EXCESS LIABILITY POLICY PER10D
Flfective Data ~ Expilalton D~a BODILY INJURY AND PROP>=RTY DAMAGE
(Combined Single limit)
^ Umbrella Each OCCUrrenoe $
D Other Aggregate s
Part 1 STATUTORY
Part 2 BODILY INJURY
NOZrE Workers' Compensation
and Employers Liabr~ity Each Accident $
Disease -Each Employee $
Disease -Policy Limit $
Pi?LICY NUIl1$£R
TYPE OF INSURANCE POLICY PERIOD
Etfecfeve Dam ; ration p~ LIMITS OF LIABILITY
{at beginning of policy periody
THE CERTIFICATE OF IN SURANCE lS NOT A CONTRACT OF INSURANCE AND AiEtTH ER e~FiQUerivs•r v Nora uGC:ernn=i v
AMENDS, EXTENDS OR ALTERS TlfE COVERAC3E APPROVED BY ANY POLICY DESCRIBED
if any of thi
ifs exoir~
blame and Address of Certificate Helder
ADDITIONAL INSURED: --rn
GITY OF SANTA ANA;ZTS OFFICERS, EMPLOYEES, AGENTS,VOLUNTEERS
AND REPRESENTATIVES
2D CIVIC CENTER PLAZA SANTA ANA, CA. 92701 Signature ~
': . SOHN Ff]b
STATE FARM INSURANCE CO' S ~ .Tits
JOHN FUT.WILER INSURANCE AGENCY, INC. .~
f714) 895-7882 ~. AgeRYs
~i~`
G •' v
AFO Code
policies are ra led before
to #e Farm o mail a written
rtifi der 30 days before
If er, we fail to mail such notice,
or liability will be imposed on State
its er representatives.
Stamp
558-9fl4 p.4 11-12-2002 Arinled ei U.SA
...c::; l1: 11 ll~:ii°52089 STATE FARM INSUP.ANCF °AGE 92/02
gt)R COl ~~~ G>gN~It,l~Y..tAl3I1.~'£X PC~~.~+CX'
Iu~tza~~ce Comp~Y ~~~ ~~
x`his a~tment t~todi£ea sucb- inxuta~e as ~ affua'ded by the previsions of Policy
.~+~ ~ $'a !- ~atiag to tha fulloaiag:
~ . 'Che City o!' Santa ,Ab,a, and tba City o£ 3a>1ta ,Axe, located at 24 Civic
Center klaaa, Sanxa Arra, cali~oaa 927ai; and tlt+~ir regpcctive officers, em~layGes,
agents, ~~alunteers and represeutatiwcs are ~aatncd as additional insureds (°additional
- vrr:,tle ~) v~^it~a i agard fo liability mid dai'e~,-a o£ sadte arieiuug franc Llie operations grad
tomes nen•:ormad by ox an beksalf o£tlae named insured.
;~.. Wirb. rospcxt to claims stisirr$ out o£tl~ opeza~tious and. users perfa~mea by
or an behalf of the uatged in.~ntd, such insurartoo as! is affor+dod Uy tbis policy is pxistxtar;+
and i~ twt additional to ox corrtx~ibutiaog with auy other itasut~e carriod by ar far the
~.c~.t of tha a~3.clitxoz+~al ~~•
This insurance applies sQp>~Lcly to sash insru~od against whom cLtim. xs
~~-
lnade Or 8t#it ~ krrongbt P.~tCCpt wiCh res~sect to the c0~lap8><!y'S limits of liability, The
~clusion of arty pessan ar vrgenization as as insured shall not a~'xt ~y right which sw:h
parson cr argauization wouM have as a claimant of trot sa istcluSled~,
t~. With respect to the additional iastsrrds, this insurance shall not ba
cancelled, or u~ateriatly reduced iu coverage ax lituite ~caelrt atleir #hirty (30} days ~avxittEn
aotica izaa bang given to th$ Community ~edeve]op~t ,A,gezrcy of tl>,e City of Sarnta
+~n~ 2Q ('ir'is L'.~rtx Plasta (~-25), Santa ~ Califox~a 927t?l.
~~,or.~.pl~~ticra ak the following, including oauatersignaturt. is required to make this
~dersea~•etzt ei~E`ective.)
Effa^ti~~ f ~' ~' G "~ ~ thin andars~ent form as a o!
?sswxl t~
~% ~9bd EOZvLG94TL 65~bL iB@Z/9Z/E0
Jotsrisr zru~twlrcr~i~aura~e~ganrF-rnr~...__.
Scats Farm rnsoranc~ Co's
t27~2 Vagcy 4'ictiv St. Ste. ~
Gar~9en Gra.c,Cw. 92845
(714) 895-7892 (800) 8G3-! ! 22