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HomeMy WebLinkAboutSANTA FE TRAILS ARCHERS 1c-.� C, U01 AGREEMENT TERMINATION ,I Please complete this form when the attached agreement is no longer in effect. 7W ,a a €, Return form to the Deputy Clerk of the Council (M -30). Call 647 -5238 if you have any questions. The agreement with No. D(a—] was completed on 0 13o I oo) and final payment has been made. tea yf Revised 05 -22 -08 Department: ?4Q-2>Pr Signature: !�>A V AM 10t � A,� LV Date: (6 31 H City of Santa Ana Clerk of the Council CLERK OF COUNCIL WORK MAY PROCEED N-2008-087-03 UNi1L INSURANCE EXPIRES /- 15- %,z CLERK OF COUNCIL DATE: 8 -2-a - // AMENDMENT TO AGREEMENT G '. RCS (2) S,l V 1 q THIS AMENDMENT TO PROVIDER AGREEMENT is made and entered into this 17`s day of CvevGJ June, 2011 by and between Santa Fe Trails Archers, a limited liability company, (hereinafter "Provider"), and the City of Santa Ana, (hereinafter "City"). RECITALS: 1. The parties entered into Agreement N-2008-067, dated June 18, 2008, as amended from time to time, (hereinafter the "Agreement") by which Provider has provided archery lessons to children through the City's leisure class programs. 2. In accordance with the terms and conditions of said Agreement, the parties wish to revise the Scope of Services (Exhibit A), and extend the term. 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 Amendment to Provider Agreement, the parties agree as follows: 1. Section 1, SCOPE OF SERVICES, shall be amended by substitution of anew Exhibit A, attached hereto and incorporated by reference. 2. Section 2, COMPENSATION, shall be deleted in its entirety and replaced with the following: "In consideration for the City's administration of the program, Provider agrees to pay the City thirty percent (30%) of all gross revenue received from program participants. Provider shall retain seventy percent (70%) of gross revenue from program participants. City pass through to Provider shall be made within thirty (30) days following completion of each class." 3. Section 3, TERM, shall be amended to extend the termination date to June 30, 2012. 4. 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 Amendment to Provider Agreement on the day and year first set forth above. ATTEST: CITY OF SANTA ANA `_T /) 0 Maria D. Huiar Clerk of the Council <?L t"- i? ? PAUL M. WALT RS Acting City Manager APPROVED AS TO FORM: A L tra Sheedy Assistant City Attorney RECOMMENDED FOR APPROVAL: Gerardo Mouet, Executive Director Parks, Recreation & ommunity Services Agency PROVIDER: D IENNE C. DYKMA President N-2008-067-03 EXHIBIT A SCOPE OF SERVICES 1) Provider will teach Archery at the Santiago Park Archery Range. Children 8 years+, adults and families are welcome to learn the basic shooting techniques for recreational archery. 2) Provider will be responsible for equipment, records, personnel and clean up of the facilities and materials necessary to ensure the safety and effectiveness of said instruction. 3) If Provider allows others to teach his/her class, those teachers must be over 21, have obtained and maintain an instructor rating, and be covered by Providers' insurance. Provider shall provide City with documentation to verify instructor and insurance requirements. CLASS SIZE 1) Each class must have a minimum of 12 paid students and no more than a maximum of 15. 2) No registration will be accepted after the second meeting of class. 3) If the minimum number of enrollees is not realized by the second meeting of the class, the class may be canceled. Provider will be under no obligation to provide services and the City will have no obligations to pay Provider compensation. Alternatively, the parties may agree that Provider will retain eighty percent (80%) of registration fees and continue to provide instruction to registered participants when the minimum is not realized. CLASSFEES 1) Each participant shall pay a $99.00 class registration fee for the first 4 class session. The second and third session will be $75.00 per participant. 2) No refunds will be made to participants after the first week of class unless the class is cancelled by the City. 3) The City shall collect registration fees from each participant during the registration period. Provider shall not collect fees, but shall refer all interested participants to City for registration. 4) Except as set forth above, Provider shall receive seventy per cent (70%) of the total fees collected each month. City and Provider agree that City shall retain thirty per cent (30%) of the fees collected as an administration fee. In the event Provider receives eighty percent (80%), City will retain twenty percent (20%) as an administration fee. 5) Provider agrees that City is entitled to audit Provider's records and classes to insure compliance with this Agreement. 6) Provider may not waive class participation/registration fees. 7) City shall prepare class rosters and provide a copy to Provider. Only registered participants may participate in class. AXIS80001081101 CPRTIFICATGnr INIC11oAAIro -..__.__.. AXIS 8000(08170) CERTIFICATE OF INSURANCE 04/26/2011 PRODUCER THIS CERTIFICATE 15 ISSUED AS A LATTER OF INFOMIXTIONOMV AIIO CONIFERS 110 American Specialty Insurance & Risk Services Inc RIGHTS UPON THE CERTIFICATE MOLDER. THIS CERTIFICATE DOES NOT w RRIAATIIELY T , 142 North Main Street OR NEW WELY AI.IEND, EXTEND, OR ALTER THE COVERAGE AFFMOED BY THE POLICIES "F LOW. THISCERIFI TEOFHSUM411MOMS14OTCA14STOUTEACONTRACT Roanoke, Indiana 46783 BETWEENTHEISSUINGINSURER(S) AUTHORREDREPRESENTATWEORPNGDUCIR APD THE CERTIFICATE HOLDER. INSURED The Natio l A h A i t INSURERS AFFORDING COVERAGE na rc ery ssoc a ion of the U S One Ol m ic Plaza INS. A: AXIS Insurance Company y p Colorado Springs CO 60909 INS. B: . 03 2008 087 N INS. C: - - - SANTA FE TRAIL ARCHERS 11339 MULHALL STREET EL MONTE. CA 91732 CERT NUMBER: 1000953549 COVERAGES THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT WITHSTA14DING ANY REQUIREMENT, TERM OR 001401 TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAedS INS LTR POLICY TYPE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS General Aggregate 5,000,000 GL AXGL03100381-11 01115/2011 0111512012 Products-Coro leled Operations Aggregate 2,000,000 A 12 01 Personal and Advertising InIu 11000,000 : a m 12:01 am Each Occurrence 1,000,000 Damage t Premises Rented 1 You An One Preml es 300,000 Medical Expense Llmll An One Person Excluded DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - The canificateholder shall be an additional Insured. but only with respect in the operations of the Named Insured, and subject to (lie provisions and limitations of Form CO 2026 - Addilional Insured - Designated Person or Organization. but only with respect to PARKS AND RECREATION PROGRAM AT SANTIAGO PARK ARCHERY RANGE from April 22. 2011 through January 14 2012 AS FO FORM ?_.? La'lrb Rr.6[ Spec y ?•..?nts.n 1. City Attorney S,FCFC I IrluA PARKS, RECRATION AND COMMUNITY SERVICES AGENCY 20 CIVIC CENTER DRIVE SANTA ANA. CA 92703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED M ACCORDANCE WITH THE POLICY PROVISIONS t0, _ Insurance & Risk as ADBncv In the slate POLICY NUMBER: AXGL03100381.11 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE The City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 to Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- A. In the performance of your ongoing operations; or B. In connection with your premises owned by or CG 20 26 07 04 C ISO Properties, Inc , 2004 Page 1 of 1 ? b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no. tice of the claim or "suit- as soon as practica- ble. c. You and any other involved insured must: (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, In the en- forcement of any right against any person or. organization which may be liable to the in- sured because of Injury or damage to which this insurance may also apply. d. No Insured will, except at that Insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us Into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless ail of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are In excess of the ap- plicable limit of Insurance. An agreed settlement means a settlement and release of liability signed by us, the Insured and the claimant or the claim- ant's legal representative. 4. Otherlnsurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method de- scribed in c. below. b. Excess Insurance This insurance is excess over: (1) Any of the other Insurance, whether pri- mary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That Is Insurance purchased by you to cover your liability as a tenant for "prop- erty damage" to premises rented to you or temporarily occupied, by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section 1 - Coverage A - Bodily Injury And Property Damage Liability. (2) Any other primary insurance available to you covering liability for damages arising out of the premises or operations for which you have been added as an additional in- sured by attachment of an endorsement. CG 00 01 1001 0 ISO Properties, Inc., 2000 Pagel 1 of 16 O 32082 ACORO® CERTIFICATE OF LIABILITY INSURANCE DAT 0 2 If ? 1 1/26/2012 1/26/2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Andrea Wright- Wells Fargo Insurance NAME Commercial Lines - (719) 592-1177 PHONE 800-332-9256 FAX 877 405 0932 - - AC No: Wells Fargo Insurance Services USA, Inc. wn andrea hl@wellsfar o oom AD g . g . DRESS. 5755 Mark Dabling Blvd., Suite 300 INSURERS AFFORDING COVERAGE NAIC # Colorado Springs, CO 80919-2228 INSURERA i Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B' National Archery Association dba USA Archery INSURER C : 711 N. Tejon Street N INSURER D: s t?j 'a ?/c INSURER E: Colorado Springs CO 80903 INSURER F : COVERAGES CERTIFICATE NUMBER: 3862498 REVISION NIIMRFR- Q.. Lot,.,., 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 REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 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. INTR R TYPE OF INSURANCE AD L UBR POLICY NUMBER MMI OYEFF MMIDDffYY LIMITS A GENERAL LIABILITY pHPK814663 1/15/2012 1/15/2013 EACHOCCURRENCE $ 1000000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100000 F?17 CLAIMS-MADE OCCUR MEO EXP(Any one person) S EXd PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE S 3000000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG S 3000000 POLICY X PRO LOG lPr.T F7 S AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT E. accident ANY AUTO BODILY INJURY (Par person) S ALL OWNED AUTOS SCHEDULED AUTOS .t F%.9 3? `? ty/)•?1? ) - jC?1??L BODILY INJURY (Per eCpitlanl) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccidant $ $ UMBRELLA LIAR H OCCUR _ r. - - EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE J_,HI]Id `,( AGGREGATE ' $ v IIV '"?lr L n?.;'C' DED RETENTIONS . 151fla g `-[ WORKERS COMPENSATION WC STATU- OTH- ANDEMPLOYERS'LIABILITY 3 YIN ANY PROPRIETOR/PARTNENEXECUTIVE 7-7 OFFICERM M NIA E.L. EACH ACCIDENT S -' - E BEREXCLUDED? (Mandator, In NH) E .L. DISEASE- EA EMPLOYE $ t If yes, deecnbe under DESCRIPTION OF OPERATIONS MI. E. L. DISEASE - POLICY LIMIT $ " r_ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AHach ACORD 101, Additional Remarks Schedule, if more apace is mquimd) - Named Insured Includes Santa Fe Trail Archers The certificate holder is only an additional insured with respect to liability caused by the negligence of the Named Insured as per Philadelphia Indemnity form PI-AM-002 Additional Insured-Certifcate holders Coverage applies to the above with respect to sanctioned events, club practices, club fundraisers and meetings City of Santa Ana, its officers, agents, employees, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE and volunteers THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Parks, RED, 8 Community Services Agency 20 Civic Center Drive AUTHORIZED REPRESENTATIVE Santa Ana, CA 92703 ge-441, The ACORD name and logo are registered marks of ACORD @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) POLICY NUMBER: PHPK814663 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Santa Ana, its officers, agents employees, and volunteers Parks, Rec, & Community Services Agency 20 Civic Center Drive Santa Ana, CA 92703 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II - Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ? (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- ble. c. You and any other involved insured must (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit", and (4) Assist us, upon our request, in the en- forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the ap- plicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claim- ant's legal representative. 4. Otherlnsurance If other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Para- graph b. below applies. If this insurance is pri- mary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insur- ance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occu- pied by you with permission of the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occu- pied by you with permission of the owner; or (iv) If the loss arises out of the mainte- nance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I - Coverage A - Bodily Injury And Property Dam- age Liability. (b) Any other primary insurance available to you covering liability for damages aris- ing out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer de- fends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. CG 00 01 12 07 © ISO Properties, Inc., 2006 Page 11 of 116 ? (3) When this insurance is excess over other c. We have issued this policy in reliance upon insurance, we will pay only our share of the your representations. amount of the loss, if any, that exceeds the 7, Separation Of Insureds sum of: (a) The total amount that all such other Except with respect to the Limits of Insurance, and insurance would pay for the loss in the any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this in- absence of this insurance; and surance applies: (b) The total of all deductible and self- a. As if each Named Insured were the only insured amounts under all that other in- Named Insured; and surance, (4) We will share the remaining loss, if any, with any other insurance that is not de- scribed in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer con- tributes equal amounts until it has paid its ap- plicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; b. Those statements are based upon representa- tions you made to us; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The in- sured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V - DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific mar- ket segments about your goods, products or ser- vices for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web-sites, only that part of a web- site that is about your goods, products or ser- vices for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equip- ment". Page 12 of 16 © ISO Properties, Inc., 2006 CG 00 01 12 07 ?