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HomeMy WebLinkAboutQUEENS PUBLIC LIBRARY (3) - 2017p City of Santa Ana f'19� Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect.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 No. was completed on (List all amendments. Use space below if needed.) A- a-t) 20V FEB -6 .PII IR CITY pF OTC Office Use Only CEf?N n r%,., ., and final payment has been made. Department: i4 j byQn•I�c Phone/Ext.:S� Signature:Q''�tt� Date: �7/� INSURANCE NOT ON FILE A-2015-006-02 'CORK MAY NOT PROCEED CLERK OF COUNCIL DATE, DEC 1 D 2017 90 A (`) FIRST AMENDMENT _TG_CONSULTANT AGREEMENT WITH QUEENS BOROUGH S< ivia LIBRARY FOR INSTITUTE OF MUSEUM AND LIBj2ARY SERVICES GRANT "MEMORIES OF MIGRATION" PROJECT THIS FIRST AMENDMENT effective as of 2"d day of November, 2017, by and between Queens Borough Public Library (hereinafter "Queens") and the City of Santa Ana ("City"), a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California. RECITALS A. The City is a recipient and grantee of the 2014 Federal Institute of Museum and Library Services (IMLS) National Leadership Grant Program for its project "Memories of Migration" (hereinafter `the project"). As part of the grant, City as the Grant administrator has entered into Agreements for services related to the project with several government entities including Queens. B. On December 1, 2014, City and Queens entered into an Agreement #A-2015-006 for Queens to conduct a series of community memory events along with related web site services in connection with the project. As part of the Agreement, Queens agreed to abide by the General Terms and Conditions for IMLS Discretionary Awards. C. On or about August 30, 2017, City and Queens mutually agreed to extend the term of the Agreement for one year until September 30, 2018. D. In the original Grant application, the City and the sub -recipients including Queens, were going to utilize a company specializing in robotics to assist in the project. However, that company has gone out of business. City, with the approval of the grantor, will purchase the robotic equipment and provide it to all participants in the project. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set firth, the parties agree as follows: 1. Subsection d, will be added to Section2, Compensation, to read as follows: d. The original grant from IMLS for the project included robotic equipment to be purchased by the City and utilized by all agencies participating in the project. However, the vendor of the robotic equipment is no longer in business. City agrees to purchase robotic and/or STEM (Science, Technology, Engineering, and Math) equipment as outlined in the original grant for the project and to provide that equipment to Queens for use on the project. Queens agrees to maintain the equipment and should it be requested, return the equipment to the grantor IMLS as outlined in the general terms and conditions for IMLS Discretionary Awards, provided that such equipment has not been expended or exhausted for the purpose provided for herein. 2. Except as modified by this First Amendment, the terms and conditions of the Agreement remain unchanged and in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to the Agreement the date and year first written above. ATTEST: <%s- Maria D. Hu'zar Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Bv:' -A wll� Laura A. Rossini Senior Assistant City Attorney RECOMMENDED FOR APPROVAL: 'k -. 6- iqdzt' Gerardo Mouet Executive Director, Parks, Recreation and Conwiunity Services Agency CITY OF SANTA ANA Raul Godinez It iji✓ City Manager QUEENS BOROUGH PUBLIC LIBRARY By: aer\nis M. til�koi Title: Ct:b •lam QLIEEBOR-02 CERTIFICATE OF LIABILITY INSURANCE $1212017 THIS CERTIFICATE IS ISSUED ASA MAI TER OFINFORMATION 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 -I SSUINGJNSURER(S),AUTHOR17.EQ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policyHos) must have ADDI ]'TONAL INSURED provisions or be ofldorsod If SUBROGATION IS WAIVED, Subject to the'totals and conditions of the policy, certain policies may require an codorsernent, A stitoonanton this carNficata does not confer Ngot5 to the certificate holder in Ileo ol such errdojsement(s), PROIIl,C'c P. CON FACI NANE 'Arthro' J. Gallagher Risk Management Services, INC, P"ONErAX one joncro Plaza suits '100 (A'C 4., E,,, (5 16) 745.0800 rr c' N,(516)745 -0082 Jericho, NY 11753 A' MAIL LRSSS INSURERal AFNOROCC COVERAGE NAIC 4 rN3IA&O A, Fede ral III C cimpany 20281 ITISUPIED ers,,RER a Great Northern Insurance Company 20303 Cascara Borough Public Library MSURFR c: 69-11 Merrick Blvd. III D, Jamaica, NY 11452 INSURER E: INSURER P COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: H q3 IS TO CERT IF Y THAT 'FHE POLICIES Or INSIJR,4INCF LISTED ED BELOW HAVE SEEN ISSUED 1'0 THE IPC.3URED NAMED ABOVE FOR P HE POLICY PERIOD INDICATED NOT V'jI I'HS I ANDING ANI RIE'JOIREMEN I` rERM OR GONDI 1 ION OF ANY CON liRArT 0RorPER DOCUMEN I vI TH RESPECT TO 0I I'Ji rIc C - AfFORCED ' -ERIII-ICAIC MAY BE 13SUEL, OF MA'S PEHrAIN r, -IF 4,13URANCE ,,Y THE POLICIES DESCRIBED HCREINIS SUBJECT rOALL-PIETE:RNIS EXCLU,Sn)NS AND CONDI LIONS CJP SUCK POI OCIES I-ItAir8SHODYliN MAY HAVE BEEN REDUCGJ fat LAID CLa1lNi5 Ifl,R AOOL 5U9IR POLICY EFF POLICY EXP LrFt TYPE OF INSURANCE _tlPOLCYNUMBE. LIMITS A X comSieA<eALGeNEAA1LUAdnLor( X GL --99.496992 0610112017 0610112018 X .. .... FICIIAPLI An P)MORILe LIAEOLITY X UMBRELLA LIAR j, -p EXCESS LIAR . - A, A- 't WORKSIS COMPFNSATION ANN EMPLOYERSYLIASOLITY Y.N NIA rQjI "N -l'.L "L 1110 P.daya OFSCRIPTION OF OPERA nONS LOCAf IONS; VEHIQ- 65 ADDITIONAL INSURED PER FORM 980�02-2367 05-07 I.The City of Seats Ana, its officers, employees. agents, and representative are included as Additional Insured$ . ' — CERTIFICATE HO! )ER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NONCE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH ME POLICY PROVISIONS, Attry PRCSA 20 Civic (,enter Plaza -Ross Annex - ----- Santa Ana, CA 92701 All TI ORIZU) REPRC'n.14 NIPVC ACORD 27120'14/031 9,1938-2015 ACORD CORPORATION. All rights fasorved The ACORD Name SOOT logo are registered marks of ACORD CERTIFICATE OF EXCESS INSURANCE CONTRACT FOR SELF -INSURER STATE NATIONAL INSURANCE COMPANY INC Name of Excess Insurance Carrier CIO US SPECIALTY UNDERWRITERS 6140 PARKLAND BLVD SUITE 300 MAYFIELD HEIGHTS. OH 44124 Address, City, Stale, Zip THIS IS TO CERTIFY that a Workers' Compensation Excess Insurance Contract has been Issued by this Company as follows: The Excess Insurance Contract is now in force and the Company will give the Chair, Workers' Compensation Board, Attention: Office of Self -Insurance, 328 State Street, 3i' Floor, Schenectady, NY 12305 not less than thirty (30) days written notice of cancellation or of any change to be made by the Company in said Contract. Such notice shall be sent by registered or certified mail or delivered by personal service as required in the Contract. Name Self -Insurer Queens Borough Public Library Address 89-11 Merrick Blvd., Jamaica, NY 11432 Contract Number NDE -0864177-16 Contract Effective 07101/2016 until canceled. Company's Limits of Liability Statutory each occurrence. Self -Insurer's Retention $500,000 each occurrence. Dated this 21st day of June 20 16 STATE NATIONAL INSURANCE COMPANY INC Name of Excess Insurance Company Authorized Representative' DEAN M. WILLIAMS, PRESIDENT Print Name of Representative 440-605-5100 Phone Number including Area Code Attach evidence of authority �ed'ay e SI -21 (04-05)e�� ADDITIONAL INSURED ENDORSEMENT Insurance company Federal Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # 00-02-2367 (5-07) relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; it officers, employees, agents and representative are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional Insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, Is required to make this endorsement effective.) Effective 6/01/2017 this endorsement form as part of Policy# 9949-69-92 LIQ Issued to Queens Borough Public Library Name Insured Countersigned by J � - Insurance Agent Signature tOlm e L ag \ GSN Pd qtr P '`� � CERTIFICATE Q'LIABILI'fY INSURANCE DATE'lM8 IYYYY) �- 9118/2018 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 _ -^EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. :APORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or 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 Arthur J. Gallagher Risk Management Services, Inc. One Jericho Plaza Suite 200 Jericho NY 11753 A NAME: PHONE Fax bac N. €E.t) 516-745-0800 A/c No): 516-745-0082 ADID ESS: INSURER S)AFFORUINQ COVE RAGE NAIC# 7/1/2019 INSURER A: Federal Insurance CompEmV 20281 INSURED QUEEBOR-02 Queens Borough Public Library 89-11 Merrick Blvd INSURER B: Great Northern Insurance Company 20303 INSURER C: INSURER D: PREMISES Ef EA occurrence) Jamaica, NY 11432 INSURER E: $10,000 INSURER F: COVERAGES - CERTIFICATE NUMBER: 968494588 REVISION NUMBER: 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. INSR TYPE OF LT AUDI. BR V POLICY NUMBER POLICYEFF l IYYYY POLICY C•XP MMI DIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 99496992 7/1/2018 7/1/2019 EACHOCCURRENCE $1,000,000 CLAIMS -MADE OCCUR PREMISES Ef EA occurrence) $1,000,000 MED EXP (Any one person) $10,000 ' PERSONAL &ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L POLICY ❑ PROJECT LOC PRODUCTS - COMP/OP AGG $Included $ OTHER: AUTOMOBILE LIABILITY 73598196 7/1/2018 7/1/2019 COMBINED SINGLE LIMIT Ea acc'den0 $1,OW,000 _ BODILY INJURY (Per person) $ -' X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ 4;2 PROPERTY DAMAGE Peraccident $� $ — _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ '0 AGGREGATE It CI'.J EXCESS LIAB CLAIMS -MADE DED RETENTION $'� WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIUQFVPARTNER/EXECUTIVE PER 0TH- STATUTE ER o--�- ['r": E.L. EACH ACCIDENT __ $ OFFICER/MEMBEREXCLUDED4 (Mandatory in NH) N/A E.L. DISEASE- EA EMPLOYE 4-^^ $ E.L. DISEASE -POLICY LIMIT "^ $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached H more space is required) ADDITIONAL INSURED PER FORM #80-02-2367 05-07 The City of Santa Ana, its officers, employees, agents, and representative are included as Additional Insureds . City of Santa Ana Attn: PRGSA 20 Civic Center Plaza -Ross Annex Santa Ana CA 92701 USA ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD The AGORD name and logo are registered marks Of ACORD reserved.