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Vega, Brenda <br />From: City of Santa Ana <certificate-request@ctrax.jdidata.com> <br />Sent: Wednesday, March 1, 2023 10:10 AM <br />To: stacy@lakeins.com, Vega, Brenda <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 The Cambodian Family <br />Name: <br />Project A-2022-092-03 <br />Number: <br />Project Agreement Between The City Of Santa Ana And The Cambodian Family <br />Name: For Use Of Community Development Block 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 />PHPK2510614 03/09/2024 02/17/2023 City of Santa <br />Ana.pdf <br />GENERAL LIABILITY <br />PHPK2510614 03/09/2024 02/17/2023 City of Santa <br />Ana.pdf <br />COI for City of <br />WORKERS COMPENSATION AND <br />906498621 06/30/2023 07/07/2022 Santa Ana 3-9- <br />EMPLOYERS' LIABILITY <br />2023 & WC <br />063023.pdf <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />3/1/2023 1:09 PM <br />1 <br />