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Victoria, Arnet <br />From: City of Santa Ana < certificate- request@ctrax.jdidata.com > <br />Sent: Monday, May 8, 2023 2:59 PM <br />To: pocha@pocharte.com; Arts and Culture; eddie.quillares.rtwt@statefarm.com <br />Subject: Internal Notice of Compliance <br />NOTICE OF COMPLIANCE <br />CITY STAFF: PRINT IDIS PAGE. AND INCI. 'OF t%ITH AGREF_M ENT TO THE CLERK OF THE COM II <br />Contractor Sandra Pena Sarmiento <br />Name: <br />Project TBD (022) <br />Number: <br />Project American Rescue Plan Act Compliance - Sandra Pena Sarmiento <br />Name: <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 <br />GENERAL LIABILITY <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership it ah <br />CTrax Plus Services Team <br />5/812023 5'.58 PM <br />POLICY <br />EXPIRATION <br />NUMBER <br />DATE COI DATE <br />FILE NAME <br />92KJQ2552 <br />03/012024 03.092023 <br />COSA COI <br />2023.pdf <br />WAIVER <br />08:04 2023 0302 2023 <br />Workers Comp <br />Declaration.pdf <br />