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<br />CERTIFICATE OF WORKERS' COMPENSATION COVERAGE \ DATE <br /> Dee 19,2007 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY <br /> AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, <br />NonProfits' United Workers' Compensation Group THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />344 Thomas L Berkley Way, Suite 340 COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Oakland, CA 94612 <br /> Phone: \877) 55[-6717 INSURERS AFFORDING COVERAGE <br /> Fax: (53U) 274-9871 <br />INSURED A -;;).007- )Cj'f INSURER A: NonProfits' United Workers' Compensation Group <br />Orange County Conservation Corps N-\qqq-I1?1 INSURER B: Safety National Casualty Corporation <br />1853 North Raymond Avenue <br />Anaheim, CA 92801-1117 N -.:2000-015 INSURER c: <br /> N - ?-Do I -000 <br /> INSURER 0: <br /> A-;2.00b-;)37- INSURER E: <br />COVERAGES This Certificate is not intended to snecifv all endorsements, coveranes, terms, conditions and exclusions of the nolicies shown. <br />THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED lOTHE AFFUATE MEMER NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE <br />COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS <br />SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF COVERAGE POLICY NUMBER POLICY POLICY l.IMITS <br />LT" EFFECTIVE DATE EXPIRATION DATE <br /> GENERAl. liABIliTY EACH OCCURRENCE $ <br /> -I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ <br /> 1 CLAIMS MADE I - I OCCUR MED EXPENSE (Ally one person) $ <br /> GENERAL AGGREGATE LIMIT APPLIES PER: PERSONAL & ADV INJURY $ <br /> -1 POLICY T I PROJECT I IlOC GENERAL AGGREGATE $ <br /> PRODUCTS-COMPiOP AGG $ <br /> AUTOMOBIl.E LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Each accident) $ <br /> All OWNED AUTOS BODilY INJURY $ <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS BODilY INJURY $ <br /> NON-OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE $ <br /> (Per accident) $ <br /> I WCSTAT I X I OTHER <br /> WORKERS' COMPENSATION LIMITS <br />A AND NPU- WCG 00l-2OOS 1/1/08 111/09 E.l. EACH ACCIDENT $ 500,000 <br /> EMPLOYERS LIABILITY E L DISEASE - EA EMPLOYEE $ 500,000 <br /> E l DISEASE - COVERAGE LIMIT $ 500,000 <br /> OTHER <br />B Exc~ss Workers' Compensation SP-l Y94-C A 111/08 1/1/09 $25,QOO.000 x $500,000 WG r - <br /> $1,000,000 x $500,000 EL <br />DESCRIPTION OF OPERATIONSJLOCATIONSNEHICLESfEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAUPROVISIONS <br />Evidence of\\iorkers' Compensation Coverag~: <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER lETTER: CANCELLATION <br /> NP~W(,G-OC(,(,-08 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER IMLL <br /> ENDEAVOR TO MAIL 30 DAYS WlITTEN NOTICE TO THE CERTIFICATE <br /> HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE <br /> City of Santa Ana NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER. ITS <br /> AGENTS OR REPRESENTATIVES. <br /> 20 Civic Center Plaza <br /> Santa Ana. CA 92701 AUTHORIZED REPRESENTATIVE <br /> ATTN: Michael Lopez <br /> /~~:r <br /> <br />Based on ACORD 25-S (7/97) <br />