HomeMy WebLinkAboutROBLES, DENISE (4)INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
GTRAX
CITY CL K
DATE: VV 0 6 2023
p; eat sALqf) MAYOR
Valerie Amezcua
(W •Sgnd�va(�zRS MAYOR PRO TEM
Jamie Lopez
COUNCILMEMBERS
Phil Bacarra
Johnathan Ryan Hernandez
David Penaloza
Thai Viet Phan
Benjamin Vazquez
August 29, 2023
Ms. Denise Robles
1664 Cindy Lane, Apt. D
Anaheim, CA 92803
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CITY OF SANTA ANA -
PARKS, RECREATION, & COMMUNITY
SERVICES AGENCY
20 Civic Center Plaza — M25
Santa Ana, California 92702
YlMy. sanla-ana.ora
N-2022-274-01
Re: Extension of Agreement #N-2022-274 for Recreation Class Services
Dear Ms. Robles:
CITY MANAGER
Kristine Ridge
CITY ATTORNEY
Sonia R. Carvalho
CITY CLERK
Jmnitar L. Hall
Pursuant to Section 3 ("Term") of the Agreement between Denise Robles ("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 full force and effect.
Sincerely,
Hawk Scott
Executive Director,
Parks. Recreation, & Community Services Agreement
CITY OF SANTA ANA
Steven A. Mendoza
Acting City Manager
APPROVED AS TO FORM
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`Bandon Salvatierra
Deputy City Attorney
ATTEST
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P,fVIDER
By:
Title:
SANTA ANA CITY COUNCIL
-. ia-sue-,__ � _ .—e_y. � -..i „-r.:,� r—+ -- r :_... __•� _� „� ;_: ____
Garcia, Stephanie
From: City of Santa Ana <certificate-request@ctrax.jdidata.com>
Sent: Wednesday, June 7, 2023 12:34 PM
To: Garcia, Stephanie
Subject: Internal Notice of Compliance
Follow Up Flag: Follow up
Flag Status: Completed
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor Denise Robles
Name:
Project N-2022-274
Number:
Project Recreation Services Agreement
Name:
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
GENERAL LIABILITY
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
POLICY NUMBER EXPIRATION COI DATE
DATE
100000DOCC2000000AGG 01/01/2024 05/30/2023
WAIVER 08/29/2023 09/14/2022
FILE NAME
City of Santa Ana
- Denise Robles -
Latin Zumba and
Ae robics. pdf
Denise
Robles insurance
Waivers.pdf
NOTICE OF COMPLIANCE
CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL
Contractor
Denise Robles
Name:
Project
N-2022-274
Number:
Project
Recreation Services Agreement
Name:
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:
EXPIRATION
TYPE OF INSURANCE POLICY NUMBER COI DATE FILE NAME
DATE
City of Santa
Ana - Denise
Robles -
GENERAL LIABILITY 1000000OCC2000000AGG 01/01/2024 05/30/2023
Latin Zumba
and
Aerobics.pdf
WORKERS COMPENSATION AND denise
WAIVER 08/22/2024 08/25/2023
EMPLOYERS' LIABILITY robles.pdf
Thank you,
City of Santa Ana
Risk Management Division
in partnership with
CTrax Plus Services Team
8/28/2023 5:15 PM