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A-2018-211-02 <br />Ho, Josephine <br />From: City of Santa Ana <certificate-request@ctraxjdidata.com> <br />Sent: Wednesday, January 11, 2023 10:02 AM <br />To: kchambers@adminsure.com; Lambert, Samantha; Acevedo, Angie; HR@adminsure.com; <br />Ho, Josephine; Lambert, Samantha <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 AdminSure, Inc. <br />Name: <br />Project A-2018-211-01 <br />Number: <br />Project Professional Services Agreement for Third Party Workers' Compensation <br />Name: Claims Administration <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 />AUTOMOBILE LIABILITY <br />[4111113TIV <br />CYBER LIABILITY <br />CYBER LIABILITY <br />GENERAL LIABILITY <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />Thank you, <br />POLICY EXPIRATION <br />NUMBER DATE <br />703 63 73 744 1 01/01/2024 <br />6260392656 01/01/2024 <br />H23NGP221562 01/01/2024 <br />H23NGP221562 01/01/2024 <br />7036373730 <br />7036374814 <br />01/01/2024 <br />01/01/2024 <br />COI DATE FILE NAME <br />01/04/2023 <br />ADMSU- <br />199994.pdf <br />01/09/2023 <br />ADMSU- <br />199994.pdf <br />01/04/2023 <br />ADMSU- <br />199994.pdf <br />01/04/2023 <br />ADMSU- <br />199994.pdf <br />01/10/2023 <br />ADMSU- <br />199994.pdf <br />01/04/2023 <br />ADMSU- <br />199994.pdf <br />1 <br />