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Vega, Brenda <br />From: City of Santa Ana <certificate-request@ctraxjdidata.com> <br />Sent: Friday, November 18, 2022 1:40 PM <br />To: agomez@chioc.org; Vega, Brenda; certs@paychex.com; <br />jeremy@thecomprehensiveinsurance.com <br />Subject: Internal Notice of Compliance <br />NOTICE OF COMPLIANCE <br />CITISTAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO TIIE CLERK OF THE COUNCIL <br />Contractor Community Health Initiative of Orange County <br />Name: <br />Project A-2022-092-18 <br />Number: <br />Project Agreement Between The City Of Santa Ana And Community Health <br />Name: Initiative Of Orange County For Use Of Community Development Block <br />Grant Funds <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 POLICY EXPIRATION COI DATE FILE NAME <br />NUMBER DATE <br />AUTOMOBILE LIABILITY <br />202244927 10/15/2023 09/14/2022 COI Certificate <br />101523.pdf <br />ACORD Form <br />GENERAL LIABILITY <br />202244927 10/15/2023 11/03/2022 20221103- <br />085512.pdf <br />Cormnunity <br />WORKERS COMPENSATION AND <br />Health Initiative <br />EMPLOYERS' LIABILITY <br />9289091 1 t/05/2023 11/14/2022 <br />of Orange <br />County.pd£ <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />