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<br /> <br />NOTICE OF COMPLIANCE <br /> <br />CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL <br />Contractor <br /> <br />Backhaus Dance <br />Name: <br />Project <br /> <br />N-2021-250-02 <br />Number: <br />Second Amendment To Agreement With Jennifer Backhaus <br />Project <br /> <br />DBA Backhaus Dance For Provision Of Ballet And Creative <br />Name: <br />Movement Classes <br /> <br />The Certificate of Insurance (COI) submitted indicates that the coverages are in <br />compliance with the insurance requirements. No further action is required at this time. <br /> <br />The compliant coverage(s) are: <br />POLICY EXPIRATION <br />TYPE OF INSURANCE COI DATE FILE NAME <br />NUMBER DATE <br />ABUSE & MOLESTATION GLP3961460 06/03/2024 05/03/2023 Backhaus- Santa Ana.pdf <br />Auto Liability (Non-Use Agreement) <br />AUTOMOBILE LIABILITY WAIVER 05/31/2024 06/02/2023 <br />Request for Waiver_Fillable (2).pdf <br />GENERAL LIABILITY GLP3961460 06/03/2024 05/03/2023 Backhaus- Santa Ana.pdf <br />WORKERS <br />COMPENSATION AND WC8094601 09/07/2023 05/31/2023 Certificate_WC8094601_3041136.pdf <br />EMPLOYERS' LIABILITY <br /> <br />Thank you, <br /> <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />6/2/2023 5:38 PM <br /> <br />