The URL can be used to link to this page

Home My WebLink AboutDE SANTOS, GUADALUPE 1ACity of Santa Ana Clerk of the Council AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. 7T9 AUG 22 PM G' n4 Return form to the Clerk of the Council Office (M-30). Call 647-5237 if you have any questions. CITY OF SANTA ANA CLERK OF COUNCIL ---------------------------- The agreement with No. CAS—_ C1O was completed on and final payment has been made. Revised 07-23-07 Department: y — Q c S /� Phone/Ext.: qQ m Signature: C4 Date: 5zJI fq 1 a6I9- N-2015-013-001 MAYOR Miguel A. Pulido MAYOR PRO TEM Vincent F. Sarmiento COUNCILMEMBERS Angelica Amezcua P. David Benavides Michele Martinez Roman Reyna Sal Tlnajero `OCT 1 9 2015 Guadalupe De Santos 2030 So. Olive Street Santa Ana, CA 92707 CITY OF SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICE 20 Civic Center Plaza M-23 • P.O. Box 1988 M-23 Santa Ana, California 92702 www.santa-ana.oro September 24, 2015 Re: Recreation Services Agreement "Extension" Dear Ms. De Santos: CITY MANAGER David Cavazos CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Made D. Huizar Pursuant to Section 4 ("Term") of the Agreement No. N-2015-013, entered into by Guadalupe De Santos and the City of Santa Ana, dated January 29, 2015, the time period of said Agreement is hereby extended for one additional (2) year period, from January 1, 2016 to December 31, 2017. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terns and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, Gerardo Monet Executive Director of Parks, Recreation and Community Services Agency APPROVED AS TO FORM: Sonia R. Carvalho City Attorney _66 M. n J M. Funk Assistant City Attorney cc: Clerk of the Council CITY OF SANTA ANA David Cavazos Cit page 1 ATTEST: Maria D. Huizar Clerk of the Council SANTA ANA CITY COUNCIL Miguel A. Pulido Vincent F. Sarmiente, Michele WarGn m Angelica Amezcua P. David Benavdas I Roman Reyna Sal Toole. Mayor Mayor Pro Tem, Ward 1 Ward2 Ward3 Word4 Ward5 • WertlS MPullgala anta-ana om i VSarmlentgal anla-ana era I MMartlnezfalsanta-ana.ora t PAmazcua Aataane ora UaenaWdas(hlsanla-era oro i RRevne sanla-ana om i 3Tinaiero(0san{.gc ana.or EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2015-05 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza P. O. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Guadalupe De Santos TYPE: Zumba 2070 S. Olive Street DATE(S): 01/05/15—12/31/15 Santa Ana, CA 92707 LOCATION: Memorial Center *Liquor Liability Yes ❑ No "Liquor Liability after 12 am ends before 2 am ❑ This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: SEP41017 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2015 EXPIRATION: JANUARY 1, 2016 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE. NONE General Aggregate Limit $ 2,000,000 Products & Completed Operations 1,000,000 SPECIAL CONDITIONS: Personal & Advertising Injury L000,000 The following endorsements attached to Each Occurrence Limit 1,000,000 the Master Policy do not apply to this Damage To Premises Rented To You (Any One Premises) 100,000 Certificate Of Insurance: Medical Payments (Any One Person) 5,000 Liquor Liability (If purchased) 1,000,000 Optional Limits Purchased ❑ $1,000,000/$3,000,000 ❑ $2,000,000/$2,000,000 Damage To Property (If purchased) The limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. OTHER ADDITIONAL INSUREDS CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions, AUTHORIZED REPRESENTATIVE: DATE ISSUED: January 5, 2015 by Briza Morales EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2016-17 CERTIFICATE OF INSURANCE SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance Services 20 Civic Center Plaza 1". 0. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658, License No: OC 36861 NAMED INSURED (EVENT HOLDER):: EVENT INFORMATION: Guadalupe De Santos TYPE: Zumba 2070 S. Olive Street DATE(S): 01/07/16 — 12/31/16 Santa Ana, CA 92707 LOCATION: Memorial Center *Liquor Liability Yes[] NoZ *,*Li2uorLiability after 12 am ends before 2 ant ❑ This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. The insurance described herein is subject to all the tertns, exclusions and conditions of such policy(ies) unless amended as described in Special Conditions. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: SEP41020 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2016 EXPIRATION: JANUARY 1, 2017 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Lirrut $2,000,000 Products & Completed Operations 1,000,000 SPECIAL CONDITIONS Personal & Advertising Injury 1,000,000 The hallowing endorsements attached to Each Occurrence Limit 1,000,000 the Master Policy do not apply to this Darn age To Premises Rented To You (Any One Prern ices) 100,000 Ccrt i ficate Of InSUrauCC: Medical Payments (Any One Pei -son) 5,000 Liquor Liability (If purchased) I poo'000 Optional Limits Purchased F-1 $1,000,0001$3,000,000 El $2,000,00052,000,000 Damage To Property (If purchased) The limits Of insurance apply separately to each event insured by this policy as i f a separate policy insurance has been issued for that event OTHER ADDITIONAL INSUREDS CANCELLATION Should the above described policy be cancelled before the expiration date thereof, notice will be defiVeFed in accordance with the policy provisions. AUTHORIZED REPRESENTATIVE: DATE ISSUED: — January 7. 2016 by Briza Morales