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HomeMy WebLinkAboutHURLEY, PATRICK A. (3)N-2022-258-01 RANCE NOT ON FILE MAYOR WORK MAY NOT PROCEE Valerie Amezcua CITY CLERK MAYOR PRO TEM DATE: Jessie Lopez COUNCILMEMBERS Phil Became I Johnathan Ryan Hernandez David Penaloza Thai Viet Phan Benjamin Vazquez 0 -. P"s r4(.D) CW,SPYNdUJgt\ A- S_ got; rd III August 30, 2023 Mr. Patrick A. Hurley 14920 Minneola Court Tustin, CA 92780 CITY OF SANTA ANA PARKS, RECREATION, & COMMUNITY SERVICES AGENCY 20 Civic Center Plaza — M25 Santa Ana, California 92702 WwW.santa-ana.orD Re: Extension of Agreement #N-2022-258 for Recreation Class Services Dear Mr. Hurley: CITY MANAGER Kristine Ridge CITY ATTORNEY Sonia R. Carvalho CITY CLERK Jennifer L. Hall Pursuant to Section 3 ("Term") of the Agreement between Patrick A. Hurley ("Provider") and the City of Santa Ana, dated August 29, 2022, the term of the Agreement is hereby extended through June 30, 2024. All other terms and conditions of said Agreement remain unchanged and in fall force and effect. SiLawk ly, Y � cott e Director, Parks, Recreation, & Community Services Agreement CITY OF SANTA ANA y� Ifristne Ridge City Manager APPROVED AS TO FORM Bradd-on Salvatierra Deputy City Attorney ATTEST Jennifer Cit # A I If t v�tauw� PathurleylAu 31,202321:06PDT) By: Pathurfey Title: Guitarteacher. SANTA ANA CITY COUNCIL Valene Ahrzma Jessie Lopez Thai Viet Phan aeap.la Vazquez Phil Be.. Johnaihan Ryan Hernandez DaNd Penaloza Mayor Mayor Pra Tem, Ward S Ward1 Ward Word Ward Ward6 Yamezcuaralsanta-anaom iessdlooez5sanla-anaom bvazauazfalsanta-anaom obarerta®sands-anaom a,h h-,rd,zdds,raa-anaom ecenaloza@sanla-anaom N-2022-258-01 Samantha Digitally signed by Samantha M. Lambert I ® Udie: LUGL.IUU3 AGOREI CERTIFICATE OF LIABILITY I iM .,V1o26:ai-o7-00� DATE (MMIf)OryyYV) Ds/1s/zozz THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 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 poltcypes) 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 BIBERK P.O. BOX 113247 Starn", CT 06911 .NANT T . AVN a 8 - 72-0 7 FNAC la • - - Ao. customerserV Ce 7 BER (.Corn WESSEL INSURER1,91 AFFORDING COVERAGE NAICM _ �._—.._...__ INSURER A: Berkshlre Hathaway Direct Insurance Company ED IPd�.7gtUgOUrlay INSURERS: INSURER C I 14920 Minneola Ct Tustin, CA 927BO INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FDR 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 DESCRBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOFINSURANCE D D SWVD UER POLICY NUMBER POLICY EF POLICY EXP LIMITS COMMERCIALGENERAL LIABILITY CLAIMS -MADE ❑OCCUR EACHOCCURRENCE $ PREN18Ee a • $ Mw EXP(Anyonaporsm) $ PERSONAL R AOV I NJURY S ` GEifL AGGREGATE LIMIT APPLIES PER: POLICYF] j�T DLOC OTHER: OENERALAOOn"ATE $ PRODUCTS-COMP/OPA00 $ $ AInDMOBILELIABILIry ANY AUTO AUTOSONLY UT UOS A)U HIRED NON-OWJEU AUTOS ONLY AUTOSONLY COMDINEDSINGLEuNIT accloo $ BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ PROPERTY PAMAOE 1pft.,werm$ UMBRELLA UAB EXCESS LIAR Lj OCCUR CLAIMS -MAD _E_ EACHCCCURRENCE $ AGGREGATE g DEC) r I RETENTION _ q WORKERS COMPENSATION ANOEMPLOYER&WABILITY YIN ANYPROPRIETOR/PARTNEWEXECLJT1VE OFfICER,MEMBEREXOLUDED7 (Mandatory In NH) DMIZIPTIONThe under D• des ON under LITIO SUelav NIA P��EART, OERH- - E.L. EACH ACCIDENT $ E.L. DIOEASE- EA EMPLOYDE - $ E.L,DISEASE. POLICY LIMIT $ A Professional Liability (Errors (k Omissions): Claims -Made X NOPL738182 ov/Oi/2aa2 ns/oi/ao23 Per Occurrence/ Aggregate $1,000,000/ $1,000,000 DESCRIP IoN OF OPERATIONS I LOOATIONS) VEHICLES (AOORO 101. Additional Remarke Schedule, maybe attached if more spacals required) Clty of Santa Ana Risk Management Division is listed as addglonai Insured as I( pertains to professional liability (see endorsaine nt attached) Sexual Molestatlon limits $250k SHOULD ANY OF THE ABOVE D City of Santa Ana Risk Management Division THE EXPIRATION DATE THE 20 Civic Center Plaza ACCORDANCE WITH THE POLIC Santa Ana, CA 92702 AUTHORREDREFRESENTATNE ,� Auammle8pnau tARerrn F REVIEWEDSMPROAtooll �-"� Risk Manayemen[ SuPernisw I,.,. �II�,�-•-. ©1988.2015 AC ACORD 26 (2016103) The ACORD name and logo are registered marks ofACORD CORPORATION. All rights reserved. NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor Pat Hurley Name: Project N-2022-258-01 Number: Project Extension of Agreement #N-2022-258 for Recreation Class 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: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE General Liability - PROFESSIONAL Pat Hurley COI N9PL761342 09/01/2024 09/14/2023 LIABILITY 2023-24.pdf Pat Hurley COI SAM Liability - PROFESSIONAL LIABILITY N9PL761342 09/01/2024 09/14/2023 2023-24.pdf WORKERS COMPENSATION AND WC_Pat WAIVER 10/30/2024 11/02/2023 EMPLOYERS' LIABILITY Hurley.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 11/2/2023 2:35 PM