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