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Polezhaev, Katerina <br />From: City of Santa Ana < certificate- request@ctrax.jdidata.com> <br />Sent: Tuesday, May 2, 2023 12:08 PM <br />To: info@cosmoseventrentals.com; ajinsurance@live.com; Polezhaev, Katerina; Reyes, <br />Kathia; Sepulveda, Maria; Le, Ngoc Long Do <br />Subject: Internal Notice of Compliance <br />NOTICE OF COMPLIANCE <br />CI IN STAFF: PRINT THIS PAGE AND INCLUDE N1'ITII AGREENIE_N IF TY) 1 HE CLERK OE THE ( OC:NCIL <br />Contractor Cosmos Event Rentals <br />Name: <br />Project N-2022-255 <br />Number: <br />Project Agreement Roberto Zavala DBA Cosmos Event Rentals To Provide Event <br />Name: Equipment Rental Services For The City Of Santa Ana <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 />GENERAL LIABILITY <br />VEHICLE LIABILITY <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />POLICY <br />EXPIRATION <br />COI DATE <br />FILE NAME <br />NUMBER <br />DATE <br />SA Liability <br />Insurance <br />MP0004014001196 <br />01/14/2024 <br />01/30/2023 <br />Document <br />2023.pdf <br />COI for 1994 <br />GMC for City of <br />195779IF1275D <br />12/12/2023 <br />12/13/2022 <br />Santa Ana 2022- <br />2023.pdf <br />WC Declaration <br />WAIVER <br />01/19/2024 <br />01/30/2023 <br />Rev.2019.pdf <br />