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Le, Tram <br />From: CTrax < certificate- request@ctraxjdidata.com> <br />Sent: Tuesday, October 4, 2022 9:43 AM <br />To: Jayline.Mejia.Vadtod@statefarm.com; Arts and Culture; Cramer, Gabriela; <br />upliftingsoulart@gmail.com <br />Subject: Internal Notice of Compliance <br />NOTICE OF COMPLIANCE <br />CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL <br />Contractor Yenny Bernal dba Uplifting Soul Art Events <br />Name: <br />Project Uplifting Soul Art <br />Number: <br />Project Uplifting Soul Art Events <br />Name: <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 />The compliant coverage(s) are: <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />EXPIRATION <br />DATE <br />GENERAL LIABILITY <br />92EXK5128 05/06/2023 <br />WORKERS COMPENSATION AND EMPLOYERS' <br />LIABILITY <br />WAIVER 08/02/2023 <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />10/4/2022 12:42 PM <br />COI DATE FILE NAME <br />Yenny Bernal <br />08/16/2022 Uplifting Soul Art <br />Events - CERT <br />16AUG22.pdf <br />10/04/2022 Worker's Comp <br />Declaration.pdf <br />1 <br />