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Hoang, Julie <br />From: City of Santa Ana <certificate-request@ctrax.jdidata.com> <br />Sent: Wednesday, February 28, 2024 5:17 PM <br />To: sipandpaintqueen@gmail.com; Hoang, Julie; 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 Flor Campos <br />Name: <br />Project TBD (134) <br />Number: <br />Project RECREATION SERVICES AGREEMENT WITH FLOR CAMPOS FOR <br />Name: ADULT PAINTING CLASSES <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 <br />POLICY <br />EXPIRATION <br />COI <br />INSURANCE <br />NUMBER <br />DATE <br />DATE <br />FILE NAME <br />AUTOMOBILE <br />WAIVER <br />02/14/2025 <br />02/29/2024 <br />WAIVER- Auto Liability (Non -Use Agreement) <br />LIABILITY <br />Request_Fillable (1).pdf <br />GENERAL <br />P1027896171 <br />01/02/2025 <br />02/01/2024 <br />BOP_ACORD_CityofSantaAna_01_02_2024_P102789617- <br />LIABILITY <br />1528935768656.pdf <br />WORKERS <br />COMPENSATION <br />AND <br />WAIVER <br />11/24/2024 <br />1I/24/2023 <br />WAIVER -Workers Compensation Exemption Form—Flor <br />EMPLOYERS' <br />Campos.pdf <br />LIABILITY <br />No further action is required <br />at this time. <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />