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N <br />O <br />N <br />O <br />cm <br />CD <br />2 <br />MAYOR <br />Vicente Sanniento <br />MAYOR PRO TEM <br />David Penaloza <br />COUNCILMEMBERS <br />Phil Bacema <br />Johnathan Ryan Hernandez <br />Jessie Lopez <br />Nelida Mendoza <br />Thai Viet Phan <br />INSURANCE ON FILE <br />WORK MAY PROCEED <br />UNTIL INSURWrr' r" PIPFs <br />OI_{ 01 I LoZf— <br />CLERK OF COUNCIL <br />DATE r <br />August 17, 2021 <br />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />20 Civic Center Plaza, M-36 . P.O. Box 1988 <br />Santa Ana, California 92702 <br />W W W.santa-ana.orc <br />Adminsure, Inc. <br />Attention: Alithia Vargas -Flores <br />3380 Shelby Street <br />Ontario, California 91764 <br />A-2018-210-01 <br />CITY MANAGER <br />Kristine Ridge <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Daisy Gomez <br />Re: _Extension of Workers Comnensation Claims Administration Agreement <br />No. A-2018-210. <br />Dear Ms. Vargas -Flores: <br />Pursuant to Section 1 ("Term") of Agreement No. A-2018-210, entered into by Adminsure Inc. <br />and the City of Santa Ana, dated September 4, 2018, as amended, the time period of said <br />Agreement is hereby extended for an additional two (2) year period from September 1, 2021 to <br />August 31, 2023. The insurance certificates are required to be extended and/or renewed to cover <br />this time extension. All other terms and conditions of said Agreement, as amended, remain <br />unchanged and in full force and effect. <br />Sincerely, <br />Jason Motsick <br />Executive Director, Human Resources Agency <br />CITY OF SANTA ANA <br />lJ 1.— N_ W �-- L r <br />Kristine Ridge <br />City Manager <br />[Signatures continue on the next page] <br />ATTEST <br />nvw, <br />Daisy Gomez <br />Clerk of the Council <br />SANTA ANA CITY COUNCIL <br />Vicente Samoans. David Penalaza Thai Viet Phan Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Nelida Mendom <br />Mayor Mayor Pro Tem, Wadi 2 Ward 1 Ward 3 Ward 4 Ward 5 <br />VsarRli011fe®santa2na Ol0 do.n.1ma0a.ma-ana am torsm s.nta-ana ma assidanisidivanta-ana inq ohaeenaOsanta-ana.Om h d � t _ Waltlfi <br />�g ementlozara t - <br />