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<br />ACORD", CERTIFICATE OF WORKERS' COMPENSATION COVERAGE I DA Tl: IMMiDD.'YYI <br /> 1.2,'2S'lOU(i <br /> THIS CERTIFICATE IS ISSUEO AS MATTER OF INFORMATION ONLY <br />PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />AllianL Insurance Ser\'lccs. Inc. THIS CERTIFICATE DOES NOT AMEND, EXTENO OR ALTER THE <br />The Transalllerica Pyramid COVERAGE AFFOROED BY THE POLICIES BELOW. <br />600 tv'lontgomcry StTeet. 9ll\ FIoO! INSURERS AFFORDING COVERAGE <br />San Francisco. C1\ 94111 <br />Phone: (415) 41n-1400 Fax: 141\) 402,0773 <br />INSURED INSURER A NonProfits' United \'.'orkers' Comnensation Grou!' <br /> INSURER B Safety Natlonal insurance Company <br /> Caliromi:.:t Hispanic CommIssion on Alcohol & Dru~ Abuse. Inc. INSURER C <br /> 210; Capitol Avenue INSURER 0 <br /> Sacramento. CA 95~ 16 <br /> INSURER E <br />COVERAGES TI1I5 Cen>!lcate IS nOI intenoeo \~ specil\' aU enaorsemenlS, coverages, terms, conditioi'15 and exc:usiof1s orille poliCies shown <br />THE POLICIES OF IhJSURtl,NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THe. PO~ICY PERIOD INDICATED NOTVv'ITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDi~ION 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 CONDITIOl~S OF SUCH <br />POLICIES ,....GGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> INSR TYPE OF INSURANCE POLICY NUMBER POLICY POLlCY LIMITS <br /> LTR EFFECTIVE EXPIRATION <br /> DATE (MMlDDNYl DATE lMMIDDNYl <br /> GENERAL LIABILITY EACH OCCURRENCE: , <br /> COMMERCIAL GENERAL LIABILITY FIRE DAMAGE IAnl' one fire) . <br /> -1 C,-AIMS MADE -1 1 OCCUR MED EXPENSE:An\'onepers~r,: S <br /> PERSONAL & ADV INJURY . <br /> GENERAL AGGREGATE . <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS.COMPIOP AGG S <br /> POLlC" 1 I PRO I I <br /> JEeT LOC <br /> Al:TOt>tuIHLE L1AIULlT\ COMBINED SINGLE lI!v'.IT S <br /> ANY AUTO (Eaaeeide:1l} <br /> , <br /> ALL DINNED AUTOS BODILY INJURY S <br /> SCHEDULED AUTOS IPerperson} <br /> S <br /> HIRED AUTOS BODILY' INJURY , <br /> NON.OI'VNEO AUTOS (PEcaeClCienl) <br /> , <br /> PROPERTY DAMAGE S <br /> (PEr aee,jenn <br /> S <br /> GARAGE UABJLlTY AUTO ONL Y-EA ACCIDENT , <br /> I ANY AUTO OTHER THAN I EA ACC . <br /> AUTO ONLY <br /> I I AGG , <br /> EXCESS LIABILITY EACH OCCURRENC $ <br /> OCCUR I I CLAIMS MADE AGGREGATE , <br /> , <br /> DEDUCTIBLE S <br /> RETENTION <br /> WORKERS' COMPENSATION AND I we STAT'. I X I OTH. <br /> EMPLOYERS LIABILITY TORY liMITS ER <br /> NPU-WCGOO-2007 lillG? 1/1/08 EL EACH ACCIDENT '5500,000 <br />A <br /> E_L DISEASE EA EMPLOYEE $ 500.000 <br /> EL DISEASE - POLICY LIMIT ~ :)00,000 <br /> OTHER <br />B Excess Worker's Comp,;;nsillloll SF-l F81-CA 1/1/07 1/1/08 $25,000,000:>-: $500,UOO we <br /> $"iOO.OOO xs $"iOO,OOO EL <br />DESCRIPTION OF OPERATIONSILOCATlONSNEHICLESIEXCLUSIONS ADDEO BY ENDORSEMENTISPECIAUPROVISIONS <br />Evidence of Workers' Compensation Coverage <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE <br /> NPu_CHCADA_OO4 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO <br /> Cay of Santa Ana OBLIGATION OR LIABILITY Oc ANY KIND UPON TrlE INSURER 115 AGE.NTS OR <br /> WorkfoTce Investment Adl11imstration REPRESENTATIVES '-7 J -----. <br /> 1000 E. SantJ ,Lv1a Bouleyard, Suite #200 ^ <br /> Santa Ana, CA 92701 AUTHORIZED REPRES eTIV7~~fJt G V+-.. <br /> - <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />ACORO 25--5 (7/97) <br />TO:\CSG\DOC'Jv\ASTERS\Certificate of Liability Insurance ACORD25-S i <br />