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Garcia, Stephanie <br />From: City of Santa Ana <certificate-request@ctraxjdidata.com> <br />Sent: Monday, November 6, 2023 10:37 AM <br />To: Baird, Sarah; Acosta, Carmen; Garcia, Stephanie <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 Fabian Grassini <br />Name: <br />Project TBD (010) <br />Number: <br />Project Recreation Services Agreement With Fabian Grassini DBA Royalty Hills <br />Name: For Tennis And Pickle Ball Classes <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 NUMBER EXPIRATION COI DATE FILE NAME <br />DATE <br />City of Santa Ana <br />- Fabian Grassini <br />GENERAL LIABILITY <br />18LB4968 01/01/2024 <br />10/17/2023 <br />DBA Royalty Hills <br />Inc -Tennis <br />Instruction- END <br />WOS.pdf <br />Royalty Hills Inc - <br />SEXUALABUSE <br />18LB4968 01/01/2024 <br />11/06/2023 <br />Fabian Grassini <br />Ins 100123.pdf <br />WORKERS COMPENSATION AND EMPLOYERS' <br />WAIVER 08/15/2024 <br />11/06/2023 <br />Santa Ana Forms <br />LIABILITY <br />-1.pdf <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />1 <br />