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<br />ACORD," CERTIFICATE <... WORKERS' COMPENSATION _ JVERAGE I DATE (MMIOOIYY) <br /> 6/27/2006 <br /> THIS CERTlFICAlE IS ISSUED AS MATTER OF INFORMATION ONLY <br />PRODUCER AND CONFERS NO RIGHTS UPON THE CERTlFICA lE 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 /> . th <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' Compensation Groutl <br /> INSURER B: Insurance Corooration of Hannover <br /> California Hispanic Conunission on Alcohol & Drug Abuse, Inc. INSURER c: <br /> 2101 Capito' Avenue INSURER 0: <br /> Sacramento, CA 95816 <br /> INSURER E: <br />COVERAGES This Certificate is not intended to specify all eodorSemenlS. coverages, lenns, conditions and exclusions of the policies shOwn_ <br />THE POliCIES OF INSURANCE LISTED BELOW HAVE BEEN lSSUED 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 />INSR TYPE OF INSURANCE POLICY NUMBER FOUCY POUCY LIMITS <br />LTR EFFE~E DDIY'Yl EXPIRATtoM <br /> DATE MM/D DATE <br /> GENERAL UABIUTY EACH OCCURRENCE S <br /> COMMERClAl GENERAlllABIUIt FIRE DAMAGE (Any one lire) S <br /> I CLAIMS MAnE I I OCCUR MED EXPENSE (hlyone ~ S <br /> PERSONAL & ADV INJURY S <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-GOMPJOP AGG $ <br /> POLiCY I I ~:g; I IlOC <br /> AUTOMOtULE LIABILITY COMBINED SINGLE LIMIT S <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BQOIL Y INJURY S <br /> SCHEDULED AUTOS (per person) S <br /> HIRED AUTOS BOOIl Y INJURY S <br /> NON-DWNED AUTOS (Perllcddent) $ <br /> PROPERTY DAMAGE S <br /> (Perllccident) $ <br /> GARAGE UABIUTY ~- AUTO ONL Y-EA ACCIDENT $ <br /> I ANY AUTO -7 OTHER THAN I EA ACC $ <br /> AUTO DNL Y~ <br /> I I AGG S <br /> EXCESS UAB'Ul'Y If EACH OCCURRENC $ <br /> OCCUR I I CLAIMS MAOE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE S <br /> RETENTION <br /> WORKERS' COMPENSATION AND I WC STATU- I X I OTH- <br /> EMPLOYERS UABIUTY TORY LIMITS ER <br /> NPU. WCGOO-2006 2/1/2006 1/1/2007 E.L EACH ACCIDENT S 500,000 <br />A <br /> E.L. DISEASE - EA EMPLOYEE . 500,000 <br /> E.L DISEASE POLICY LIMIT , 500,000 <br /> OTHER <br />B Excess Worker's Compensation H35.Q402601 2/1/2006 1/1/2007 S25, 000,000 x S5oo,ooo <br />DESCRIPTION OF OPERATIONSIlOCATk)NS/VEHJCLES/EXClUSK>NS AODED BY ENOORSEMfNTISPECIAl.lPROVISlONS <br />Evidence of Coverage of Workers' Compensation <br />CERTIFICAlE HOLDER 1 ADOrOONA1.INSURfD; INSURER LETTER: CANCELLATION <br /> SHOUlD MY OF THE ABOVE DESCRIBED POlICIES BE CANCELLED BEfORE THE EXPIRATKlN <br /> NPU-CHCADA.(l1O DATE THEREOF. TltE tsSUING iNSURER WILL ENDEAVOR TO MAIl---12- DAYS WRITTEN NOTICE <br />City of Santa Ana - CDBO Palomitas <br />Community Development Agency TO THE CERTIFICATE HOlDER NAMED TO THE LEfT, aUT FAILURE TO 00 SO SHALL IMPOSE NO <br />20 Civic Center Plaza, 6th Floor OBLIGATION OR UABllITV OF />H'i KIND UPON THE INSURER, ITS AGEHTS OR <br />Santa Ana, CA 92702 REPRESEHTATIVES. 1--7 '^ J -... <br />A TIN: Frank Hernandez AUTI-lQR\ZED REPRESij "ATft~ft. ( .Y+ <br />ACORD 25-S (7/97) -- @ACORD CORPORATION 1988 <br /> <br />TO:ICSG\OOC\MASTERSICO':rt.ificat<: Qf Liabi\ity IfflUf'all1:.O': ACORD25-S.1 <br /> <br />e-~. <br />