HomeMy WebLinkAboutCAMBODIAN FAMILY, THE (15)INSURANCE ON FILE
WORK MAY PROCEED
UNTC,;VAN EFPlg1"
CITY CI FRK
MAYOR MAY 18
Valerie Amezcua
MAYOR PRO TEM
Jessie Lopez
COUNCILMEMBERS
Phil Bacerra
Johnathan Ryan Hernandez
David Pension
Thai Viet Phan
Benjamin Vazquez
CITY OF SANTA ANA
PARKS, RECREATION, AND COMMUNITY
SERVICES AGENCY
20 Civic Center Plaza • P.O. Box 1988
Santa Ana, California 92702
www.santa-ana.ora
g:TQ,��()(Av) April 19, 2023
The Cambodian Family
Attn: Vattana Peong, Executive Director
1626 E. Fourth Street
Santa Ana, CA 92701
A-2022-069-17A
Re: Extension of Ap-reement (A-2022-069-17) for Use of American Rescue Plan Act
(ARPA) Funds
CITY MANAGER
Kristine Ridge
CITY ATTORNEY
Sonia R. Carvalho
CITY CLERK
Jennifer L. Hall
Pursuant to Section I.B. ("Term of Agreement") of the above -referenced Agreement, entered into by
The Cambodian Family ("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.
Sin l ,
( Gr
Hawk Scott
rector,
Finance and Management Services Agency
CITY OF SANTA ANA
Kristine Ridge
City Manager
APPROVED AS TO FORM SUBRECIPIENT
on Salvatierra By: Vattana Peong
Deputy City Attorney Title: Executive Director
SANTA ANA CITY COUNCIL
Valero Arri Jess,ewpez Thal Vet Phan Banana. Vazquez Phil Sawn Johnahan Ryan HemarMez Oamd Penabia
Mayor Mayor any Tam W.W3 Ward Ward Ward Ward Ward
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Garcia, Stephanie
From: City of Santa Ana <certificate-request@ctrax.jdidata.com>
Sent: Tuesday, March 14, 2023 12:52 PM
To: Arroyo, Francisco; Garcia, Stephanie
Subject: Internal Notice of Compliance
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREE M ENT TO THE CLERK OF THE COUNCIL
Contractor The Cambodian Family
Name:
Project A-2022-069-17
Number:
Project Agreement Between The City Of Santa Ana And The Cambodian Family
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 NUMBER EXPIRATION C01 DATE FILE NAME
DATE
AUTOMOBILE LIABILITY
PHPK2510614
03/09/2024
02/17/2023
City of Santa
Ana.pdf
City of Santa
Ana, 20 Civic
GENERAL LIABILITY
PHPK2510614
03/09/2024
03/02/2023
Center Plaza,
Santa Ana, CA,
92702.pdf
SEXUAL ABUSE
PHPK2510614
03/09/2025
02/17/2023
City of Santa
Ana.pdf
C01 for City of
WORKERS COMPENSATION AND EMPLOYERS'
906498621
06/30/2023
07/07/2022
Santa Ana 3-9-
LIABILITY
2023 & WC
063023.pdf
Thank you,