HomeMy WebLinkAboutDELHI CENTER (23)INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
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CITY CLERK
DATE: MAY 16 2023
MAYOR
Valene Amem a
MAYOR PRO TEM
Jessie Lopez
COUNCILMEMBERS
Phil Bacena
Johnalhan Ryan Hernandez
David Penaloza
Thai Viet Phan
Benjamin Vazgiez
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CITY OF SANTA ANA
PARKS, RECREATION, AND COMMUNITY
SERVICES AGENCY
20 Chic Center Plaza a P.O. Box 1988
Santa Ana. Califom:a 92702
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April 19, 2023
Delhi Center
Attn: Patrisia Gonzalez, Director of Operations
505 E. Central Ave.
Santa Ana, CA 92707-3503
A-2022-069-06A
Re: Extension of Agreement IA-2022-069-06t for Use of American Rescue Plan Act
fARPA)Foods
CITY MANAGER
Kristine Ridge
CITYATTORNEY
Sonia R. Carvalho
CITY CLERK
Jennifer L Hall
Pursuant to Section I.B. ("Term of Agreement") of the above -referenced Agreement, entered into by
Delhi Center ("Subrecipient"), and the City of Santa Ana, dated May 3, 2022, the time period of the
Agreement is hereby extended for an additional one-year period through June 30, 2024. Any insurance
certificates are required to be extended and/or renewed to cover this extension. All other terms and
conditions of the Agreement remain unchanged and in full force and effect.
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Finance and Management Services Agency
CITY OF SANTA ANA
lstinK( a Ridge — -
City Manager
APPROVED AS TO FORM
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Deputy City Attorney
SAP, I
ATTEST
nnifer L. H
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SUBRECIPIW
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Title: P66cm4e911'ro- t'
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor Delhi Center
Name:
Project A-2022-069-06
Number:
Project Agreement Between The City Of Santa Ana And Delhi Center
Name: For Use Of American Rescue Plan Act (ARPA) Funds
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
EXPIRATION
COI DATE
FILE NAME
—
— NUMBER
DATE
ACORD Form
AUTOMOBILE LIABILITY
202201376
11/01/2023
09/06/2022
20221025-
132337.pdf
--
l
ACORD Form
GENERAL LIABILITY
202201376
11/01/2023
09/06/2022
20221025-
132337.pdf
UOCIAL SERVICE PROFESSIONAL LIABILITY
ACORD Form
IMPROPER SEXUAL CONDUCT LIABILITY
202201376
11/01/2023
09/06/2022
20221028-
094302.pdf
WORKERS COMPENSATION AND
ACORD Form
EMPLOYERS' LIABILITY
SNUWC0152622
, 11/01/2023
09/06/2022
20221021-
154756.pdf
_...--
—__I__—_
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
10/31/2022 12:49 PM
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor
Delhi Center
Name:
Project
A-2022-069-06A
Number:
Project Agreement Between The City Of Santa Ana And Delhi Center
Name: For Use Of American Rescue Plan Act (ARPA) Funds
The Certificate of Insurance (COI) submitted indicates that the coverages comply
with the insurance requirements.
The compliant coverage(s) are:
POLICY EXPIRATION
TYPE OF INSURANCE COI DATE FILE NAME
NUMBER DATE
ACORD Form
AUTOMOBILE LIABILITY 202301376 11/01/2024 10/17/2023
20231017-174127.pdf
ACORD Form
GENERAL LIABILITY 202301376 11/01/2024 10/17/2023
20231017-174127.pdf
IMPROPER SEXUAL CONDUCT ACORD Form
202301376 11/01/2024 10/17/2023
LIABILITY 20231017-174127.pdf
WORKERS COMPENSATION AND ACORD Form
BNUWC0152622 11/01/2024 10/17/2023
EMPLOYERS' LIABILITY 20231017-174127.pdf
No further action is required at this time.
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
2/23/2024 2:54 PM