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ACORD", GERTIFICATE OF WORKERS' COMPENSATION COVERAGE I DATE (MMlDDIYY) 8/22/2006 THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Driver Alliant Insurance Services, Inc. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE The Transamerica Pyramid COVERAGE AFFORDED BY THE POLICIES BELOW. 600 Montgomery Street, 9'" Floor INSURERS AFFORDING COVERAGE San Francisco, CA 94111 Phone: (415) 403-1400 Fax: (415) 402-0773 INSURED INSURER A- NonProfits' United Workers' Comocnsation Grouo INSURER B Insurance Comoration of Hannover Orange County Conservation Corps INSURER C 1853 N. Raymond Ave Anaheim, CA 92801-1117 INSURER 0 INSURER E COVERAGES This CertifiC<lle is not intended to specify all endorsements, coverages, terms. conditions and exclusions of the policies shown THE POLICIES OF INSURANCE LISTED BElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lNSR TYPE OF INSURANCE POLICY NUMBER POLlCY POLICY LIMITS LTR EFFECTIVE EXPIRATION DA no: /MMJDDIYYI DATE-iMMIDOIYY\ GENERAL LIABILITY EACH OCCURRENCE I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) I I CLAIMS MAOE I I OCCUR MED EXPENSE IMy 01)3 p€i'S(IIll I --------- PERSONAL & ADV INJURY I ---------- ---------------- GENERAL AGGREGATE I GEN'L AGGREGATE LIMn APPLIES PER PRODUCTS.COMP/OP AGG I I I PRO I I LOC - POLICY JECT AUTOMOBILE LlAB1LlTY 11>-'2> 'tV COMBINED SINGLE lIMIT I ANY AUTO (Ea accident) I ;<~ ~\) ------/ All OWNED AUTOS BOOll Y INJURY I SCHEDULED AUTOS ~~ '- (Per person) $ :\0\' .~'i\:" 'I HIRED AUTOS ~ S \ BODILY INJURY I NON-OWNED AUTOS \)Sf>. \ 'C\\~ f' ) (Peraccidenl) I ~\S\'O\'\ _ /l. -- r "[70" , PROPERTY DAMAGE I (Peracodent) I GARAGE LIABILITY '-- AUTO ONt Y EA ACCIDENT I I ANY AUTO OTHER THAN I EA ACC I AUTO ONLY I I AGG I EXCESS LIABILITY EACH OCCURRENC I OCCUR I I CLAIMS MADE AGGREGATE I $ DEDUCTlBLF I RETENTION WORKERS' COMPENSA nON AND I we STATU. I X I OTH- EMPLOYERS LIABILITY TORY LIMITS ER NPU-WCGOO-200G 1/1/2006 1/i/2007 EL EACH ACCIDENT S 500,000 A EL DISEASE - EA EMPLOYEE $ 500,000 EL DISEASE - POLICY LIMIT $ 500,000 OTHER B Excess Worker- s Compensation H35-0402601 1/1/2006 Ul12007 $25,000,000 x 5500,000 DESCRIPTION OF OPERA TIONSfLOCA TIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECiAl/PROVISIONS Evidence of Coverage of Workers' Compensation CERTIFICATE HOLDER t I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NPU-OCCC-059 DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAIL ....J"- DAYS WRITTEN NOTICE City of Santa Ana TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAll IMPOSE NO Workforce Investment Board OBliGATION OR UABlliTY Of ANY KINO UPON THE INSURER, ITS AGENTS OR P. O. Box 1988 M-7J, REPRESENTATMS I.-, - I ____ Santa Ana, CA 92702 AUTHORIZED REPRES "ATlVE)~~1-\1 , V--/-_ ACORD 2!;-S (7/97) .- @ACORDCORPORATION 1988 rO:CSGDOC\MASTERSLenificate (If I ,iabiJily Insuian;:e ACORD2S-S_1