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<br />. <br /> <br />. <br /> <br />. <br /> <br />SPECIFIC EXCESS WORKERS COMPENSA nON AND <br />EMPLOYERS LIABILITY INDEMNITY POLICY <br /> <br />EMPLOYERS REINSURANCE CORPORATION <br /> <br />No. 0553087 <br /> <br />SCHEDULE <br /> <br />1. <br /> <br />Insured: <br /> <br />City of Redwood City <br /> <br />2. <br /> <br />Mailing address: 1017 Middlefield Road <br />Redwood City, California 94063 <br /> <br />3. <br /> <br />Named states: <br /> <br />California <br /> <br />4. <br /> <br />Excluded states: None <br /> <br />5. <br /> <br />Policy Period: <br />(a) From: October 1,2000 <br />(b) To: October 1,2001 <br />Both days at 12:01 A.M. standard time at the <br />Insured's address shown in Item 2 of this Schedule <br /> <br />6. <br /> <br />Retention: <br />(a) Each accident: <br />(b) Each employee for disease: <br /> <br />$350,000 <br />$350,000 <br /> <br />7. <br /> <br />Limit each accident: <br />(a) Policy Part One, Workers Compensation: <br />(b) Policy Part Two, Employers Liability: <br /> <br />8. <br /> <br />Limit each employee for disease: <br />(a) Policy Part One, Workers Compensation: <br />(b) Policy Part Two, Employers Liability: <br /> <br />9. <br /> <br />Premium: <br />(a) Payroll divided by $100 multiplied by: <br />(b) Minimum: $28,150.00 <br />(c) Deposit: $31,280.00 <br /> <br />ERC-2no I <br /> <br />Statutory <br />$1,000,000 <br /> <br />Statutory <br />$1,000,000 <br /> <br />.0824 <br />