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04302024-1200 S. Anaheim Blvd., Suite 217 Anaheim, CA 92805 714) 765-5166 • fax (714) 765-4105 www.anaheim.net Request for Public Records Page 1 of2CityofAnaheim Office of the City Clerk STEP 1:COMPLETE all fields on this form. This form is to facilitate and expedite the processing of your public records request. Describe identifiable records in the possession of the City; your request must be sufficiently focused and specific to allow the City to locate the requested record(s). STEP 2:SUBMIT completed form by mail, fax, email or in person to Custodian of Records, Office of the City Clerk, 200 S. Anaheim Blvd., Suite217, Anaheim, CA 92805; tbass@anaheim.net fax: (714) 765-4105 STEP 3:WAIT to receive a response from the City. The City shall determine within 10-days from receipt of a public records request, whether the request, in whole or in part, seeks copies of discloseable public records in possession of the City GC 7927.535(a)]. Please note that if you are requesting the opportunity to inspect records, you will be requested to make an appointment to return at a later date/time to view the documents. Charges for the direct cost of duplication will apply . Documents will not be copied until payment has been received. If payment is not received within 20 days after invoice is sent, you may be required to submit a new request. Please see backside for additional information. REQUESTER INFORMATION Full Name:Date: Company Name: Mailing) Address: City/State/Zip Code: Phone number: Email: Preferred method of contact in the event of questions: Julia Saul 4/30/24 7:48 AM The Claims Center 55447 com866- Email DESCRIPTION OF REQUESTED RECORD(S): (Describe the specific public record(s) e.g., date, type, time period covering documents requested etc) I am working on behalf of South California Gas Company to obtain a copy of the Certificate of Liability Insurance for the company HSU Management that covers the date 9.18.21. (Preferably for that date, but if not available, we are happy to work with whatever you may have on file.) Does the City of Anaheim have a record of liability insurance for this company, perhaps in connection with a municipal contract, or for licensing, permitting or registration? This is my second request as my first one was submitted 4.16.24 but I have not received a response. The information entered to request for public records is continued on succeeding page(s) I understand that I will be contacted once documents have been identified. If production of records is requested, an estimated cost will be provided to me and I agree that I will be required to submit payment for duplication costs (and mailing) prior to the production of the requested documents. Please note that information contained in any PRA request is a public record and may be subject to public inspection pursuant to the California Public Records Act. I wish to inspect City records Will Pick-Up Records Electronically Signed/Submitted 4/30/24 7:48 AM SIGNATURE OF REQUESTER X Please Mail 200 S. Anaheim Blvd., Suite 217 Anaheim, CA 92805 714) 765-5166 • fax (714) 765-4105 www.anaheim.net Request for Public Records Page 2 of2CityofAnaheim Office of the City Clerk DESCRIPTION OF REQUESTED RECORD(S)-Continuation Thank you for any assistance or direction you may have for us to locate the appropriate liability insurance.