Laserfiche WebLink
CERTIFICATE of COVERAGE <br /> Workers' Compensation <br /> Nevada Retail Network Self Insured Group & <br /> Safety National Casualty Corporation -AM Best Rated A++ <br /> NA1C #15105 <br /> 575 S. Saliman Road <br /> Carson City, NV 89701-5000 <br /> Phone: (775)887-2480 Fax: (775)887-2481 <br /> MEMBER COMPANY <br /> Fleet Solutions LLC dba USA Fleet Solutions <br /> Policy No: NRN17807-2025-01 <br /> 169 Cadillac Place <br /> Reno,NV 89509 <br /> Dates of Coverage: APPROVED <br /> 12:01 AM on 01101/2025 to 12:01 AM on 01/01/2026 By To Tran Nguyen ai4 09 pm,Sep 02x 2025 <br /> This document certifies that the named Member Company has secured coverage for their workers' <br /> compensation obligations pursuant to the Nevada Workers' Compensation Act by qualifying as a <br /> member of the Self-Insured Group. The Self-Insured Group is an Association of Self-Insured Private <br /> Employers authorized by the Nevada Division of Insurance to provide Workers'Compensation benefits <br /> to employees of member companies under Chapter 616 and 617 of the Nevada Revised Statutes. <br /> CERTIFICATE HOLDER: JOB DESCRIPTIONS: <br /> City of Santa Ana All Nevada Jobs <br /> 20 Civic Center Plaza <br /> Santa Ana,CA 92702 <br /> LIMITS OF LIABILITY: WORKERS COMPENSATION STATUTORY <br /> OPERATIONS COVERED : NEVADA <br /> EXCESS WORKERS COMP INSURANCE : Safety National Casualty <br /> EMPLOYER'S LIABILITY LIMIT: $1,000,0001$1,000,0a01$1,000,000 <br /> This certificate is issued for information purposes only. Should the member company's enrollment in the <br /> Self-Insured Group be terminated before the date of expiration, the Self-Insured Group and Safety <br /> National Casualty Corporation will mail 30-days written notice to the Certificate Holder. However,failure <br /> to mail such notice shall impose no obligation or liability upon the Self-Insured Group, Safety National <br /> Casualty Corporation, the Association Administrator, or any Party acting as a Trustee, Officer,Agent, or <br /> Appointee of the Self-Insured Group or Safety National Casualty Corporation.The Self-Insured Group is <br /> under no obligation to provide notice to the Certificate Holder should the member company elect to <br /> terminate coverage prior to the stated expiration date. <br /> NOTICE:An extension of coverage, or the addition of another"Insured," must be by written <br /> endorsement only and cannot be extended by the member under this certificate. <br /> Dated At <br /> Carson City, <br /> Nevada : August 20,2025 By: } Title: Director- Underwriting <br /> �/ ��� and Government Relations <br />