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Reyes, Kathia <br />From: City of Santa Ana < certificate- request@ctrax.jdidata.com> <br />Sent: Wednesday, January 31, 2024 4:36 PM <br />To: ConstructionContracts; Mazariego, Diana; Castillo, Jose Gilbert; Burrola, Melissa; <br />office@teroberts.com; Castaneda, Ruben; troberts@teroberts.com; wateradmin <br />Subject: Internal Notice of Compliance <br />Follow Up Flag: Follow up <br />Flag Status: Completed <br />NOTICE OF COMPLIANCE <br />CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL <br />Contractor T.E. Roberts, Inc. <br />Name: <br />Project A-2019-142-03A <br />Number: <br />Project Extension of Agreement To Provide On -Call Emergency Water And Sewer <br />Name: System Repair Services <br />The Certificate of Insurance (COI) submitted indicates that the coverages comply with the <br />insurance requirements. <br />The compliant coverage(s) are: <br />TYPE OF INSURANCE POLICY NUMBER EXPIRATION COI DATE FILE NAME <br />DATE <br />AUTOMOBILE LIABILITY <br />BAP302554101 <br />09/01/2024 <br />08/30/2023 <br />#5866 COI exp <br />090124.pdf <br />GENERAL LIABILITY <br />GL0302554201 <br />09/01/2024 <br />08/30/2023 <br />#5866 COI exp <br />090124.pdf <br />23-24 Master - <br />PROFESSIONAL LIABILITY <br />PECO05263605 <br />09/01/2024 <br />01/29/2024 <br />City of Santa <br />Ana.pdf <br />WORKERS COMPENSATION <br />AND EMPLOYERS' WC302554401 <br />09/01/2024 <br />08/30/2023 <br />#5866 COI exp <br />LIABILITY <br />090124.pdf <br />No further action is required at this time. <br />Thank you, <br />