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O.C. HUMAN RELATIONS-COMMON GROUND 4 - 2007
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O.C. HUMAN RELATIONS-COMMON GROUND 4 - 2007
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Entry Properties
Last modified
12/29/2016 8:57:57 AM
Creation date
10/9/2007 12:58:29 PM
Metadata
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Template:
Contracts
Company Name
ORANGE COUNTY HUMAN RELATIONS-COMMON GROUND
Contract #
A-2007-105-030
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
4/16/2007
Expiration Date
6/30/2008
Insurance Exp Date
4/26/2008
Destruction Year
2016
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<br />~ <br /> <br />CERTHOLDER COpv <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />I SSUE DATE: 10-01-2006 <br /> <br />GROUP: <br />POLICY NUMBER: 1375218-2006 <br />CERTIFICATE ID: 27 <br />CERTIFICATE EXPIRES: 10-01-2007 <br />10-01-2006/10-01-2007 <br /> <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZ M-25 <br />SANTA ANA CA 92701-4058 <br /> <br />SP <br /> <br />~06:BRIDGES PROGRAM <br /> <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. <br /> <br />We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. <br /> <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain. the insurance <br />afforded by the policy described herein is subject to all the terms. exclusions. and conditions, of such policy. <br /> <br />Q:::-RB>RESENTATI <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: <br /> <br />~ <br /> <br /> <br />PRESIDENT <br />$1,000,000 PER OCCURRENCE. <br /> <br />'-#--'.... <br /> <br />_._'~ :"'~". . i" ~':~';.,... J ...... <br />J. .._~.. ~ <br /> <br /> <br />-- ~ c.- <br /> <br />,- o..;.I..J <br />t- ~ . ..: l! -.. '" <br /> <br />EMPLOYER <br /> <br />ORANGE COUNTY HUMAN RELATIONS COUNCIL (A SP <br />NON-PROFIT CORPORATION) C/O COUNCIL <br />1300 S GRAND AVE STE B <br />SANTA ANA CA 92705 <br /> <br />(REV.2-051 <br /> <br />PRINTED <br /> <br />09-17-2006 <br /> <br />I~-J :{.;.': <br /> <br />/ ( .:)/; <br /> <br />./- .,J r V(,p <br />SP <br /> <br />M0408 <br /> <br />c.p <br />
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