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Ruvalcaba, Anqelica <br />From: City of Santa Ana <certificate-request@ctraxjdidata.com> <br />Sent: Wednesday, May 24, 2023 11:02 AM <br />To: Ruvalcaba, Angelica; Reyes, Erendida; Castro, Jose; lisa@socalinsurance.com; Furjanic, <br />Suzi; Rodriguez, Teresa; vidosam@yahoo.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 Vido Samarzich, Inc. <br />Name: <br />Project 23-6476 <br />Number: <br />Project Glenwood Place Water Main Improvements <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 />EXPIRATION <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />COI DATE <br />DATE <br />AUTOMOBILE LIABILITY <br />5164139EO975E <br />11/09/2024 <br />05/08/2023 <br />GENERAL LIABILITY <br />VCGP028763 <br />12/23/2023 <br />05/02/2023 <br />PROFESSIONAL LIABILITY <br />WAIVER <br />05/18/2024 <br />05/24/2023 <br />WORKERS COMPENSATION AND EMPLOYERS' WSD507134900 <br />LIABILITY <br />05/22/2024 05/23/2023 <br />FILE NAME <br />23-6476 COI G L <br />UL WC_EXP 12- <br />23-23_ AL _EXP <br />11-09-23.pdf <br />COI - GL Santa <br />Ana On Call.pdf <br />Professional <br />Liability <br />Letter.pdf <br />COI -Gland <br />Workers Comp <br />Glenwood <br />Updated 5-23- <br />2023. pdf <br />1 <br />