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Home My WebLink AboutSWAYZER CORPORATION (4)MAYOP PRO � C CUNCILMEMBERS D en;waza ek Phan �N IN" X ! ._, Sw-ayzer Corporation 166_5 East Del Amo Blvd Carson_ CA 90746 Attn: Samuel Sw°ayzer CITY OF ANA A UR I IC WORKS AGENCY Re: Extension of Aureernent to Provide Landscape 1a ntenance el -vices. reement No. A-2 119-1 1 Te GEE my 're r IRNE u P _ alho r = — Pursuant to Section 3 ("Term") of the above -referenced Agreement, entered into by Swa_yzer Corporation, and the City of Santa Ana, dated August 2 , 2019, the time period of the Agreement is he ebv extended for an additional two -near period, from August 20, 2 22 through august 19, 202 . Any insurance certificates are required to be extended andior renewed to cover this extension. All ether terms and conditions of the Aureement remain wichanyed and in fall force and effect. Sincerer. t-t Nabil Saba, P.E. Executive Director, Public Works Agency C1T YO F S: NTA ANA Kristine Ridge City Manager :ATTEST Clerk of the Council APPROVED AS TO >E'Oi2M SWAVZER CORPORAT O r tal don Salvatierra Samuel Swayzer DOPLIN City- Attorney President SWA A' C _ _ IC Mazariego, Subject: FW: Internal Notice of Compliance From: CTrax <certificate -request ctrax.Ididata.corn> Date: September 15, 2022 at 9:13:16 AM PDT To: dlaessig2wfcinsurance.com, erCah[7swayland.com, "Bermudez, Jaime" <`bermudez Santa- ana�.or >, rachelleh wfc nsurance.corn Subject: Internal Notice of Compliance CITY STAFF: PRINT THIS PAGE AND 1NICLUELF � AGREEMENT � WITH AIR E fT O THE CLERK O, v[L Contractor Swayzer Corporation Name Project N-2019-192 Number: Project Agreement To Provide On -Call debris Removal And Weed Abatement Name: Services The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are:: TYPE OF INSURANCE POLICY NUMBER EXPIRATION GATE COI DATE FILE NAME AUTOMOBILE LIABILITY BAW56694138 12/01/2022 07/21/2022 Cert of Ins - CITY OF SANTA ANA .PDF GENERAL LIABILITY BLS56694138 08/08/2023 07/21/2022 Cert of Ins - CITY OF SANTA ANA .PDF SCOPE OF WORK & PROFESSIONAL LIABILITY WAIVER 09/14/2023 09/14/2022 INSURANCE FORMS.pdf Swayzer Corporation DBA Swayzer WORKERS COMPENSATION AND FMPLOYERS' LIABILITY SWWC326686 05/16/2023 05/23/2022 Landscapes COI WC ONLY Exp 5-16-23 RMD05262022.pdf Thank you, 1 uigita Iiy SI 1iE01 C) Ht-I 1E �VE ODATE(MM1DDtYYYY) CERTIFICATE OF LIABILITY�6WNCE 11 tit THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONAWi3VItj104#ON TKE CE,]� i ATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFF BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 NAME T Automatic Data Processing Insurance Agency, Inc. Automatic Data Processing Insurance Agency, Inc, PHONE 1-800-524-7024 FAX A{C No Ext : AfC, No E-MAIL ADDRESS: 1 Adp Boulevard INSURER(S) AFFORDING COVERAGE _. NAIC A Roseland NJ 07068 INSURER A: NorGUARD Insurance Company 31470 INSURED Swayzer Corporation '.. INSURER B : INSURER C : INSURER D : DBA: Swayzer Landscapes 1665 E Del Amo Blvd INSURER E: Carson CA 90746 INSURER F :. COVERAGES CERTIFICATE NUMBER: 2465892 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. ILT R L'rR I TYPE OF INSURANCE INSDADDLISUBRI INSD WYD POLICY NUMBER POLICY EFF MM{DDtYI'YY POLICY EXP NIMIDD/YYYY _.. . LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE `OCCUR I e I EACH OCCURRENCE S _.._. -.A, IA -. N ED PREMISES (Ea occurrence) S MED EXP [Any one person) S _... PERSONAL & ADV INJURY S hEI.TL AGGREGATE LN1:fT APPLIES PER: POLICY ❑ LQC JECT OTHER: GENERAL AGGREGATE S _. PRODUCTS - CQIy7P;6P AGG 5 S _. AUTOMOBILE LIABILITY ANY AUTO OWNED I --I SCHEDULED AUTOS ONLY j AUTOS HIRED ! NON-OLhINED AUTOS ONLY AUTOS ONLY j I � - C-MBINED SINGLE LIMIT (Ea accident} S BODILY INJURY (Per person) BODILY INJURY (Per accident) S _.. PROPERTY DAMAGE {Rer accident _.. S UMBRELLA DAB EXCESS LIAR OCCUR , CLAIMS -MADE I __.._ EACH OCCURRENCE S AGGREGATE _....- S I D€D I I RETENTIONS S A WORKERS COMPENSATIONCE7R11 AND EMPLOYERS' LIABILITY ANY PRQPMETORFPARTNER;EXEC4ITIVE �Y l N OFFICERlIi EMBER EXCLUDED7 1 ' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N t o Y SVVWC326686 05116/2022 05/16/2023 I : , _.. E L EACH ACCIDENT S 1,000,000 -- E L,. DISEASE - EA EMPLOYEE 5 1 ,000=6 _ E,L. DISEASE - POLICY LNJIT -- S 1,0005000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101, Additional. Remarks Schedule, may be attached if more space is required) This certificate has a blanket Waiver of Subrogation for the following state(s) :CA CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA, Attn: RISK MANAGEMENT DIVISION 20 CIVIC CENTER PLAZA Santa Ana 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 v CA 92702 Q 1998-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD r.� a REviEwED & APPROVED BY. sa v r; ar a. PiskManagenient Specialist Araiza, Fatima From:City of Santa Ana <certificate-request@ctrax.jdidata.com> Sent:Monday, August 28, 2023 2:40 PM To:Mazariego, Diana; Bermudez, Jaime; Oma, Jaminla; Reyes, Kathia; Zavala, Talisa Subject:Internal Notice of Compliance NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Swayzer Corporation Name: Project A-2019-141-01 Number: Project Extension of Agreement to Provide Landscape Maintenance Services, Name: Agreement No. A-2019-141 The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION COI TYPE OF INSURANCE FILE NAME NUMBER DATE DATE AUTOMOBILE LIABILITY BAW56694138 12/01/2023 11/16/2022 CITY OF SANTA ANA.PDF Cert of Ins - CITY OF SANTA ANA GENERAL LIABILITY BL056694138 08/08/2024 07/24/2023 2.PDF SCOPE OF WORK & INSURANCE PROFESSIONAL LIABILITY WAIVER 09/14/2023 09/14/2022 FORMS.pdf WORKERS COMPENSATION SWWC466561 05/16/2024 05/17/2023 Certificate_SWWC466561_3018773.pdf AND EMPLOYERS' LIABILITY Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 8/28/2023 5:40 PM 1 NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Swayzer Corporation Name: Project A-2019-141-01 Number: Project Extension of Agreement to Provide Landscape Maintenance Services, Name: Agreement No. A-2019-141 The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE CITY OF SANTA ANA-Uploaded to AUTOMOBILE LIABILITY BAW56694138 12/01/2024 11/16/2023 CTrax.PDF GENERAL LIABILITY BL056694138 08/08/2024 07/24/2023 Cert of Ins - CITY OF SANTA ANA 2.PDF SCOPE OF WORK & INSURANCE PROFESSIONAL LIABILITY WAIVER 08/30/2024 08/30/2023 FORMS.pdf WORKERS COMPENSATION AND SWWC466561 05/16/2024 05/17/2023 Certificate_SWWC466561_3018773.pdf EMPLOYERS' LIABILITY Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 11/20/2023 1:05 PM