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NOTICE OF COMPLIANCE <br />CITY STAFF: PRINT III IS PAGE AND INCLUDE WITH AGREEMENT TO'rHE CLERIC OF PIE COUNCIL <br />Contractor Lightning Youth Running Club <br />Name: <br />Project N-2023-116 <br />Number: <br />Project Recreation Services Agreement With Lightning Youth Academy <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 compliantMcoverae(s) <br />.__..._ <br />P m <br />µ .._....,.._.,_,....' <br />TYPE OF INSURANCE <br />POLICY <br />EXPPIRATIIRATIN <br />ON <br />COI DATE <br />FILE NAM E <br />__ <br />NUMBER <br />____ .__ _._.._ <br />..__....-_ <br />_ __..... <br />..... ___ <br />___.. _. _., <br />Auto Liability_Non_Use <br />AUTOMOBILE LIABILITY <br />WAIVER <br />08/15/2024 <br />08/30/2023 <br />Agreement_Requestfor <br />Waiver_ Lightning_2023.pdf <br />_......_,..___.._..............._....._._.... ......._ _._..._.. <br />------------- _._ _.._._..._..._. <br />.......... .... _ <br />. __...__._.. <br />AAU C01_LightnIng Youth 1 <br />GENERAL LIABILITY <br />S18ML00176221 <br />09/01/2024 <br />08/15/2023 <br />Running Club Lightning <br />Youth <br />Academy _2023_2024_.pdf <br />_._ __. ._______.___... <br />SEXUALABUSE <br />_.._..___.. . ...__..__ <br />S18MLOO176231 <br />-.-._ <br />09/01/2024 <br />__._._...._.._.._..___..._.._. <br />09/05/2023 <br />_..._.._ _._- _...___.7 <br />Lightning Insurance <br />____._.__.....___------__._._------ --- ,----- .-_.___.._.....__------ ---- _...__ <br />... ... _..... _.__.._..............................___....._..---..._---.._____,___._. <br />Renewal2023_2024.pdf <br />WORKERS COMPENSATION EXEMPTION <br />WAIVER <br />08/15/2024 <br />08/15/2023 <br />WC Declaration Rev. j <br />Lightning 2023.pdf <br />d...... ___.....___._._.._.____....._____._._........................._._.............,__......__.___...----------___...___.....___... <br />__.._.._.....__.....------ <br />--..._...._.._....-.__..._....._....__.... ___.__._.._ <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />94-011YII:II:3 f &I W L I <br />