The URL can be used to link to this page

Home My WebLink AboutWELDY, SCOTT DR., DBA SERRANO ANIMAL & BIRD HOSPITALCity of Santa Qna Clerk of the Cou:._il AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes _ No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. i The agreement with COTC Office Use Only City of Santa Ana t;1e 02 2021 Clerk of the Council No. A—ao iLl—tO`Z—C.c; was completed on op/L721 12M� and final payment has been made. (List all amendments. Use space below if needed.) A—DD I L{--LD 9 A----ac I Y t0 �-'- 01 pt--a01W-- I &-0 :�L Revised: 10-18-16 Department: M--BA Phone/Ext.: Signature:fldw Date: ISO MAYOR Miguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Senavides Vicente Sarmiento Jose Soiorio Sal Tinalero Juan Villegas Uj �i t_u LC31 ua IC�7 N ei s,ua 7 a 0 rL ILu "a yi �Z tx.: OFFICE OF THE CITY ATTORNEY 20 Civic Center PSaza, M29 * P.O. Box 1988 Santa Ana, California 92702 714-647-5201 r Fax 714-647-6815 wwW,santa-ana.pfQ co j �: P � A Scott Weldy, DVM Serrano Animal & Bird Hospital 21771 Lake Forest Drive, Suite 111 Lake Forest, CA 92630 June 6, 2017 Re: Two-Honth Extension of Agreement for Veterinary Services (Agreement No. A-2014-1081 Dear Dr. Weldy: I ACTING CITY MANAGER Gerardo ivlouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL Marla D. Huizar Agreement No. A-2014-108 ("said Agreement"), entered into by Dr. Scott Weldy, DVM dba Serrano Animal & Bird Hospital and the City of Santa Ana, dated July 1, 2014 for the provision of veterinary services will expire on June 30, 2017. In order for the City to issue a Request for Proposals ("RFP") for such veterinary services, the City Council approved a two mouth extension of said Agreement for a final two (2) month period, from July 1, 2017 through August 31, 2017• Compensation during the 2-month extension shall not exceed Sixteen Thousand Dollars ($16,000). The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Sincerely, Gerardo Mouet Executive Director of Parks, Recreation and Community Services Agency APPROVED AS TO FORM: Sonia R. Carvalho City Attorney - .4 r- ,,- Lisa Storck Assistant City Attorney CI Y OF SANTA A CYNTHIkKURTZ INTERIM CITY MANAGER ATTEST: Maria D. Huizar Clerk of the Council SANTA ANA CITY COUNCIL L iguei A. flulido fykheie Martinez Vicente 5arrnienfo Juse Soloria P. David Bewsvide6 Juan Villegas Sat Tinuiaro t layttr Mayor Pro Tam, Ward 2 Ward 1 Wxd 3 Ward 41 Ward 5 Ward 6 rrrrse:bric,Fusdnla-ana.ora m nartirtez.c"'�csantit•7na.orn v5am�ienfn:a rar�ia„ina.or I®rignn Banta ana-org dbendvidesrsanfa-,ana.org Mileefas4sarga-�na00 5Undrflro mta-ana. oN SERAN-1 OP 10:1 r CERTIFICATE OF LIABILITY INSURANCE 07I0712018 THIS CERTIFICATE IS ISBtJP:D A9 A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S UPON 7111E CERTIFICATE HOLDER. THIS 09RTIVICATE 0043 NOT AFFIRMATIVELY OR NEGATIVELY AMIaND, EXTEND OR ALTER THE COVORAGE AFFORDED BY THE POLICIES BELOW, THIS CgRTIP"TE OF INSURANCE DOSS NOT Cr MSMUTE A CONTRACT BETWEEN THE ISSUM ENSURER{a), AUTHORIZED REPR98ENTATIVB OR PROOUCIR AND THE CERTIFICATE HOLDER, INfpoRUNY. 1P the urtiHoata holdar 15 an ADDITIONAL INSURED, the poll roes) trust ba endomotl, If SUBROGATION IS WAIVE➢, aubjact to the tem s and onndIUOne of the Panay, certain p011e1ss may require an endorsement. A statement On this certificate deea not canter rights to the 001100to holder In Ile1j of such andarnarnenuai CO, ISO M Hp INSUNWO Serrana Animal daatt H. Weldy, DVM ° 4 " 10 � 21771 LalksForest Drive #111 A-2 14k--t0g-- C)I Lake Fame% CA 02030 THIS IS TO CERTIFY THAT THE P[]L1CIE$ OF INDICATED. NOT"TH$TANDINO ANY REQUI CERTIFICATE MAY BE ISSUED OR MAY POR EXCLUSIONS AND CONDITIONS OF SGCH PAL _ T'rI�M OP 3l1SUNANCN I A I COMMaltelAL, 94KII 4L WAIK4tTrr ul ela cleuw'Mug r! "Clio I X PQLIQr C de` Lx J Lac R rxER Auro000" L"UTV A ANYAU70 _ e AU70SI} k�A11IG ULFO MifyEUAtIiS�9 t j AU109NlH6n rw1ww"uwa accuN uv uu A ,. - r ,-w ar_. y nnec mccm =uw [tA me tMuRtia NAMED ABOVIA FOR THE POLICY PEA10I1 NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE (POLICIES DESCRIBEO HEREIN I$ SUWECT TO ALL THE TERMS, LIMITS 8NOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, sort � o7l�trxal$ � ®7f0112g17 s C$fjyI1804 QTA)112016 0710112017 softy INJURY IPre pw%wo 4 400ILY INJURY pF w *=,Wq S rAl [MP61044me 1 SIM1201sl 47101=17 a4ID&t4RTadM 4r' OPtBtATtprla I LQeieTlQit1 tY4NiGLaa trrewtao sar. Aaeina� tlu�,aAa ��tw ar al�cMdllr ma+f, s4oa iR irquh�0j �� Clt d#Samar 11ata, lto offlcaral N9ertia, erflptoyeea and a �epfealydaetatIV" are by. Inc uded as addt mil Irdlutalaia, f 10 IDiys 1140"0 DOYS NOC for tiaaa-payment � AhLrr City of Santa A" Fin A Met Seca Agency Patrctrul"a illy, 30 Civta Caritas PN1aaal M44 ML4 MR aF "M AROVE DEscttt81=.I1 POLICIES Be BANCeLLF.DI OUCRE UM E0411tAwn tlrAN TWERO(F. HOM TALL ae nawma as ACCORDAIM Wilk THE "Llay PROYMONS. r w 1"w-M4 fmonu�VRP IORATN7N. All rlgft moried. ACORD 23 City 41M) The ACORD name and logo are M21*11errad Madta of A=RD Additional Insured -- Owners, Lessees or Contractors w AB 90 67 12 93 Policy Amendment Section 11 1 s r d Serrano Animal & Bird Hospital 'a rU_N%mbcr AZC80911904 }'inducer Veterinary Ins Scrvlum Ca 9M90v_0_1_)AW 071111116 Schedule Name of pemon(a) or Qrganixatiott(s) City of Santa Area, Its officer v, agents and employees 26 Civic Center Plata Santo Ana, CA 9 701 City of Santa Ana, Its officers, agents, employees representatives are included ar additional insureds, "The insurance provided header dais policy is primary and with amy father inxurance 9vull4ble tea the arldltianal Insured. This insurance applies separatet'y to each lnsufed 49ahut wlaome claim iv made or sarr't Is brought except with respect to tits companies limit e f liability. The lorlusion Of rtr{y person or organization as an insuredshall not erect any right which such ,person Of Organization would have a s a claimant if root so included. " 30 Days Notice of Cancellationito mays Notice of Cancellation for Nonpayment or Premium (If no entry appears above, infartmiion required to complete this EtadorsemGnt will be shown 1n the Mclarations as applicable to this Endorsement) The following is Added to Part 1- WHO 1S AN IN. SUR ED in the Business Liability Section of this policy 5. 'no person or organization shown in the Schedule is also an insured. but only with respects to liability arising out oryaur work for that insured by or ttr YOU, All other terms and conditions of the policy apply. This form must be attached 10 Chanaiic li ndciruotent wham jWAd aft T the p1►tie v is %vritten, One of the Firematn's Fund tnsuraRc* Campania as n4md in the poti;a, AOhfimd A49067 1 ]-93 Cxif{M OWYdAled Mmatal tarlwvawa Samos raiAas, fah. 141t t�resident -� Reviewed -by: E V Al Ethan Fisher PRCSA/Zoo