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NOTICE OF COMPLIANCE <br />CIT1 STAFF: PRI,A'I-THIS P1GL AAD IV IF DL NCITH AGRLIL,AI LAT 10"1 HL CLERK OFTIIF. COLM H <br />Contractor CAP Architecture <br />Name: <br />Project TBD (093) <br />Number: <br />Project Extension to Agreement (#A-2020-230-09) to Provide On -Call <br />Name: Space Planning and Architectural Consulting Services <br />The Certificate of Insurance (COI) submitted indicates that the coverages comply <br />with the insurance requirements. <br />The compliant coverage(s) are: <br />TYPE OF INSURANCE <br />POLICY <br />EXPIRATION <br />COI DATE <br />FILE NAME <br />NUMBER <br />DATE <br />ACORD Form <br />AUTOMOBILE LIABILITY <br />5094175320 <br />05/18/2024 <br />12/07/2023 <br />20231207- <br />093756.pdf <br />ACORD Form <br />GENERAL LIABILITY <br />5094175320 <br />05/18/2024 <br />12/07/2023 <br />20231207- <br />093756.pdf <br />PROFESSIONAL LIABILITY CLAIMS <br />ACORD Form <br />RDP0050717 <br />05/18/2024 <br />12/07/2023 <br />20231207- <br />MADE <br />093756.pdf <br />WORKERS COMPENSATION AND <br />ACORD Form <br />EMPLOYERS' LIABILITY <br />5094854715 <br />05/18/2024 <br />12/07/2023 <br />20231207- <br />093756.pdf <br />No further action is required at this time. <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership uvith <br />CTrax Plus Services Team <br />2/9/2024 2:02 PM <br />