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<br /> <br />NOTICE OF COMPLIANCE <br /> <br />CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL <br />Contractor <br /> Tom Bystry <br />Name: <br />Project <br /> A-2020-257-03 <br />Number: <br />Project Agreement To Provide Video Production Services For The City Of Santa <br /> <br />Name: Ana <br /> <br />The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the <br />insurance requirements. No further action is required at this time. <br /> <br />The compliant coverage(s) are: <br />EXPIRATION <br />TYPE OF INSURANCE POLICY NUMBER COI DATE FILE NAME <br />DATE <br />AUTOMOBILE LIABILITY 2006521219 05/21/2023 12/06/2022 <br />Cert of Ins - City of <br />GENERAL LIABILITY MP000400900796406 02/01/2024 01/25/2023 <br />Santa Ana.PDF <br />T Bystry Waive Pro <br />PROFESSIONAL LIABILITY WAIVER 12/13/2023 12/15/2022 <br />Ins.pdf <br />WC <br />Declaration_Thomas <br />WORKERS COMPENSATION AND <br />WAIVER 12/05/2023 12/05/2022 E Bystry dba Video <br />EMPLOYERS' LIABILITY <br />Engineering <br />Services.pdf <br /> <br />Thank you, <br /> <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />1/31/2023 4:32 PM <br /> <br />