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NOTICE OF COMPLIANCE <br />CITY I„„ . "A ,AFF. II111RINTI'Ill I111"i I1111AGE ,CLE INC'LLEE CI I T'Ill1 , GREE OIEL I" O 1111E CLERK CIF 1111E C OLLC'I➢L <br />Contractor Jorge B Melgoza <br />Name: <br />Project N-2022-027 <br />Number: <br />Project Agreement With Jorge Melgoza, DBA Ardent Ergonomics, To <br />Name: Provide Preventative Ergonomics Assessments <br />The Certificate of Insurance (COI) submitted indicates that the coverages are in <br />compliance with the insurance requirements. No further action is required at this time. <br />The compliant coverage(s) are: <br />TYPE OF INSURANCE <br />POLICY <br />EXPIRATION <br />COI DATE <br />FILE NAME <br />NUMBER <br />DATE <br />Jorge B Melgoza <br />dba Ardent <br />AUTOMOBILE LIABILITY <br />5837885DI555 <br />10/15/2022 <br />09/20/2022 <br />Ergonomics COI <br />Exp 10-15-22 <br />RMD02012022.pdf <br />Jorge B Melgoza <br />dba Ardent <br />GENERAL LIABILITY <br />90E3K8745 <br />10/15/2022 <br />01/20/2022 <br />Ergonomics COI <br />Exp 10-15-22 <br />RMD02012022.pdf <br />Jorge B Melgoza <br />dba Ardent <br />WORKERS COMPENSATION AND <br />WAIVER <br />01/17/2023 <br />09/20/2022 <br />Ergonomics COI <br />EMPLOYERS' LIABILITY <br />Exp 10-15-22 <br />RMD02012022.pdf <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />9/20/2022 12:36 PM <br />