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Swayzer Corporation
1665 East Dei Arno Blvd
Carson, CA 90746
Attn: Sarnuel S ayzer
OF SAN TIA AN
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Extension of Agreement to DebrisRemoval and Weed
AgreementAbatement Sea -vices. o.a
Pursuant to Section 3 (` Te ") of die above -referenced Agreement, entered into by Swayzer
Corporation., and the City of Santa Ana, dated September ?>, 2019, the time period of the Agreement
is hereby extended for an additional two-year period, from September ? 5, 2022 through September 24,
2021- . any insurance certificates are required to be extended and/or renewed to cover this e-xtensiori
All other terms and conditions cif the Agreement remain wicharged and in full force and effect.
Sincerely,
1
I
abil Saba, P.E.
7� Executive Director, Public Works Agency
CITE' OF SANTA ANA ATTEST
pristine Ridge
C tlr Manager ,Clerk ofithe Council
APPROVED AS TO FORM S N�17ER CORPORAT
Ems---
B,mo'dvn Salvatierra Samuel Swalvzer
Deputy City attorney President
Mazariego, Diana
Subject: FW: Internal Notice of Compliance
From: CTrax <certificate-reguest@ctrax.ididata.com>
Date September 1S, 2022 at 9:13:16 AM PDT
To: diaessig2wkinsuranee.com, eliiah swayland.com, "Bermudez, Jaime" <ibermudezl santa-
ana.Orlh>, rachelleh@wfci'nsurance.com
Subject: Internal Notice of Compliance
CITY STA:FF. PRINT THIS PAGE AND INCLUDE WIT I < AGREEMENT TO THE CLERK OF: THE .Of. NCII
Contractor Swayzer Corporation
Name:
Project N-2019-192
Number:
Project Agreement To Provide Can -Cali 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 DATE CQ[ DATE FILE NAME
AUTOMOBILE LIABILITY
BAW56694138
12/01/2022
07/21/2022
Cert of Ins - CITY OF
SANTAANA.PDF
GENERAL LIABILITY
BL556694138
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
FORS.pdf
Swayzer Corporation
DBA Swayzer
WORKERS COMPENSATION AND EMPLOYERS' LIABILITY
SWWC326686
OS/16/2023
05/23/2022
Landscapes COI WC
ONLY Exp 5-16-23
RD05262022.pdf
Thant' you,
1
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor
Swayzer Corporation
Name:
Project
N-2019-192-01
Number:
Project Extension of Agreement to Provide On-Call Debris Removal and Weed
Name: Abatement Services. Agreement No. N-2019-192
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 1:06 PM