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CERTIFICATE OF WORKERS' COMPENSATION <br />COVERAGE <br />oct27 z0D8 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />Nonprofits' United Workers' Compensation Group <br />344 Thomas L. Berkley Way, Shite 340 <br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br />COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Oakland, CA 94612 <br />Phone: (877) 551-6717 <br />INSURERS AFFORDING COVERAGE <br />Fac: (530) 274-9871 <br />INSURED <br />INBURER A: NOnPI0lits' Uni[ed Workers' Compensation Group <br />AIDS Services Foundation of Orange County, Inc. <br />17986 Sky Park Circle, Suite J <br />INSURER 8: Safety National Casualty Corporation <br />INSURER C: <br />Irvine, CA 92618 <br />INSURER D: <br />INSURER E: <br />COVERAGES This Certificate is not intended to specify all endorsements, coverages, terms, conditions and exclusions of the policies, shown. <br />THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE AFFILIATE MEMBER NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />IPOLICY <br />LTR <br />TYPE OF COVERAGE <br />POLICY NUMBER <br />EFFECTNEDATE <br />POLICY <br />EXPIRATION DATE <br />USS <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />COMMERCIAL GENERAL LIABILITY <br />FIRE DAMAGE (Any me lire) <br />$ <br />QAIMS MAGE OCCUR <br />MED EXPENSE (Airy on. Pemm) <br />$ <br />GENERAL AGGREGATE LMR APPLIES PER: <br />PERSONAL #ADV INJURY <br />$ <br />PDUCY PROJECT LOC <br />GENERAL AGGREGATE <br />IF <br />PRDDUCTSCOMPWOPAGG <br />$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE UMT <br />$ <br />ANY AUTO <br />(Each ao ORt) <br />$ <br />ALLCWNEDAUr09 <br />BODILY INJURY <br />$ <br />SCHEOULEDAUTOS <br />Per person) <br />$ <br />HIRE-DAUTOS <br />BODILY INJURY <br />NONOWNED AIAO-S <br />$ <br />?w wddmQ <br />PROPERTYDAMAGE <br />$ <br />(ParacddanV <br />$ <br />A <br />WORKERS'COMPENSATION <br />AND <br />NPU-W CG 00I-2008 <br />1/1/08 <br />1/1/09 <br />WCSTAT <br />LIMITS <br />X <br />OTHER <br />...............": <br />EL. EACHACCIDENT <br />$500,000 <br />E.L. DISEASE-EA EMPLOYEE <br />$500,000 <br />EMPLOYERS LIABILITY <br />E.L. DISEASE-COVERAGE LIMIT <br />$500,000 <br />HER <br />B <br />Excess Worker: Compewation <br />SP-IY94-CA <br />1/1/08 <br />1/1/09 <br />$25,000,0)0 X$500,000WC <br />$1,000,WDX $500,000 EL <br />DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTSPECIALIPROVISIONS <br />Evidence of Workers' Compensation Coverage: 12/06/08 World Aids Candelight Vigil <br />CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: <br />CANCELLATION <br />NPLTWCG-ASTOC 014 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL <br />ENDEAVORTOMAIL 31) DAYS WRITTEN NOTICE TO THE CERTIFICATE <br />HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE <br />City of Santa Ana <br />20 Civic Center Plaza <br />NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS <br />AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESEMATNE <br />Santa Ana, CA 92701 <br />Based on ACORD 25S (71671 <br />