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HomeMy WebLinkAboutSUAREZ, RAYMUNDO 2fCity of Santa Ana Clerk of the Council AGREEMENT TERMINAYION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect.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 Suarez, Raymundo G 200b COTC Office Use Only No N -2005 -101 was completed on 6/30/06 and final payment has been made. (List all amendments. Use space below if needed.) N- 2005 - 101-01, N- 2005 - 101 -02, N- 2005 - 101 -03, Department: PRCSA N- 2005 - 101 -04, N- 2005 - 101 -05, N- 2005 -101 -006 N- 2005 -101 -007 Phone /Ext.: 5254 Signature: a CiAJ lfSl 21 Date: 6/16/14 Revised 08 -23 -10 INSU�ANC2ftN FILE yy0q,t MAY PROCEED UNTIL INSURANCE EXPIRES 7 _ �� - / 2 N- 2005 - 101 -006 CLERK OF. COUNCIL DATE: 4 ZiDr� AMENDMENT TO AGREEMENT pUG 2 THIS AMENDMENT TO RECREATION SERVICES AGREEMENT is made and entered into this 20`h day of June, 201 1 by and between Raymundo Suarez, (hereinafter "Provider "), and the City of Santa Ana, (hereinafter "City "). � RECITALS: d � V 1. The parties entered into Agreement N- 2005 -1 O1, as amended from time to time, H A (hereinafter the "Agreement ") by which Provider has provided recreation and leisure a.y class services in the City's leisure program. O 2. In accordance with the terms and conditions of said Agreement, the parties wish to revise the Scope of Services and extend the term 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 and previous Amendments, except those amended in this Amendment to Recreation Services Agreement, the parties agree as follows: 1 . Section 1, SCOPE OF SERVICES, shall be amended by substitution of a new Exhibit A, attached hereto and incorporated by reference. 2. Section 3, TERM, shall be amended to extend the termination date to June 30, 2012. 3. 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 Recreation Services Agreement on the day and year first set forth above. ATTEST: CITY OF SANTA ANA L %?�] �iv.� � fjii Maria D. Huizar, Clerk f e Council APPROVED AS TO FORM: Jose ° Straka, Interim City ttorney RECOMMENDED FOR APPROV erardo Mouet, Exe. hector PRCSA . WALT S� A ting City Manager PROVIDER ��z_ RA UNDO SUAREZ EXHIBIT A SCOPE OF SERVICES 1) Provider will prepare and instruct students in mart ial arts techniques, with an emphasis on Danzan Ryu Jiu -jitsu for children and adults, 7 and older. 2) Provider will provide and 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 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. Black -belt rated students may warm up beginning students, however, Provider must be present at all times. CLASS SIZE REGISTRATION 1. The minimum number or participants is 5 per class, the maximum is 30. 2. No registration will be accepted after the second week of classes. 3. In the event the minimum number of enrollees is not realized by the second meeting of the class, the class shall be canceled. Provider will be under no obligation to provide services and the City will have no obligations to pay Provider compensation. FEES I . Each participant shall pay a $20.00 class registration fee per monthly session. 2. No refunds will be made to participants after the commencement of a session 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. 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 1/6) of the fees collected 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. Commercial General Liability CG 00 01 12 07 Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (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 notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers 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 enforcement 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 applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance 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 occupied 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 occupied by you with permission of the owner; or (iv) 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 I — Coverage A — Bodily Injury And Property Damage Liability. CG 00 01 12 07 © Iso Properties, Inc. , 2000 Page 11 of 16 Commercial General Liability CG 00 01 12 07 (b) Any other primary insurance available to you covering liability for damages arising 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 defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self- insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described 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 contributes equal amounts until it has paid its applicable 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 Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance 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 computation, 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 accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; 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 insured 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 expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. CG 00 01 12 07 © ISO Properties, Inc. , 2000 Page 12 of 16 POLICY CHANGE DOCUMENT POLICY NO. CHANGE # 2 CHANGE EFFECTIVE: 07/23/2011 PHPK751 184 -000 Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. NAMED INSURED MAILING ADDRESS Raymundo Suarez 610 S. Townsend St. Santa Ana, CA 92703- POLICY PERIOD: FROM 07/23/2011 TO 07/23/2012 at 12:01 A.M. Standard Time at your mailing address shown above. DESCRIPTION _ In consideration of the premium reflected, the policy is amended as indicated below: Amended: Additional Insured City of Santa Ana, its officers, agents, and employees Form CG2026- Additional Insured Designated Person or Organization applies Total Annual Additional /Return Premium Total Annual Add itiona I /Return Tax/Surcharge /Fee COUNTERSIGNED Total Prorate $0.00 Additional /Return Premium $0:00 Total Prorate Additional /Return $0.00 Tax/Surcharge /Fee $0.00 BY (Date) (Authorized Representative) Page 1 of 1 POLICY NUMBER: PHPK751184 -000 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 Organizations) City of Santa Ana, its officers, agents, and employees Santa Ana CA 92703 -2821 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 persons) or organi- zations) 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 pertormance 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 O .aco moo° Maguire Insurance Agency, toc. 2J101 Puerto Real Suite 200 Mission Vief O, CA 92691 - (8JJ)638 -J459 INSURED aaymundo s.,are� 610 5. TOwns¢ntl St. Santa Ana, CA 92J03- IrA \/ F R A!�' F C DATE (MM /DDM CERTIFICATE OF LIABILITY INSURANCE DJI /D2/2D31 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURER C: 18058 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 CERIFICATION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR AOD'L INSRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM /DD /WYYI POLICY E %PIRATION GATE MM /OO /YYYYI LIMITS A X GENERAL LIABWTY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR X PROFESSIONAL LIABILITY GEN'L AGGREGATE LIMIT APPLIES PER' X POLICY PROJECT LOC PHPKJ5 1184 -000 OJ/23/2011 OJ/23/2012 EACH OCCURENCE $1,000,000 PREMISES Ea occurrence 5300,000 ME° EXP (Any one person( $2,5°0 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE 53,000,000 PRODUCTS— COMP /OP AGG 53,000,000 �I ���� ��II � AUTOMOBILE LIABILITY ANV AUTO ALL OWNED AUTOS SCH FOULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (EA attitlenS) BODILY INJURY (Per person( BODILY INJURY (Per accitlen t( PROPERTY DAMAGE (Per accideni7 GARAGE LIABILITY ANV AUTO AUTO ONLY — EA ACCIDENT OTH ER THAN EA ACC AUTO ONLY: qGG EXCESS /UMBRELLA LIABILITY OCCUR � CLAIMS MA°E DEDUCTIBLE RETENTION EACH OCCURENCE AGGREGATE EMPLOYERS' LIABILITY Y N ANV PROPRIETOR PARTNER /E %ECUTIVE OFFICER /MEMBER %CLUOEDJ (Mantlatpry In NH) If yes describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE — EA AM PLOVEE E.L. DISEASE — POLICY LIMIT OTNE0. DESCRIVTION OF OPERATIONS /LOCATIONS/ VEHICLE$ / E %CLUSIONS ADOEO BY ENDORSEMENT /SPECIAL PROVISIONS I[ is und¢rstood ana agrees chat me following entity is addetl as an atltlitional insur¢d but only with respects) to th¢ operations Of the named insuretl ¢acept [hat liability r¢sulting from the atldi[ional insured's sole negligence. APPROVED .AS TO FOB =.: I.CRIIT'II.AIC r1VLUCR L l L..AIV\..CLLAlIV1V - °�" " -' -'- - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of Santa Ana, its officers, agents, antl employees LaLISB liL Shaedv THEREOF, THE ISSUING INSURE0. WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE 1825 W Civic Center Dr Clt At C ". ; CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR Santa Ana, CA 92J03 -2821 ,ASST SLBIIL Y O r LIABILITY OF ANY KING UPON THE IN9UREp, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESEMATIVE �I ���� ��II � ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01)