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, , CERTIFICATE OF INSURANCE/SELF INSURANCE ISSUE DATE 07/21/99 PRODUCER/ADMINISTRATOR: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAl KEENAN & ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 180 GRAND AVE., SUITE 1380 THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE OAKLAND,CA 94612 COVERAGES AFFORDED BY POLICIES/MEMORANDUMS BELOW. INSURED/COVERED MEMBER: ENTITIES AFFORDING COVERAGE SAN MATEO COUNTY SCHOOLS INSURANCE GROUP and ENTITY A REDWOOD CITY ELEMENTARY SCHOOL DISTRICT UNICARE INSURANCE COMPANY I 2317 BROADWAY I REDWOOD CITY, CA 94063 I i I I COVERAGES...THIS IS TO CERTIFY THAT THE COVERAGES USTED BELOW HAVE BEEN ISSUED TO THE INSURED/COVERED MEMBER NAMED ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TF-RMo OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CfRTIFICATE MAY BE ISSUED OR rv'^y 'PERTAIN. THE INSURANCE/MEMORANDUM AFFORDED HEREIN IS SUBJECT TO All THE TERMS. CONDITIONS OF SUCH POUCIES/MEMORANDUMS. ENT TYPE OF COVERAGE I POLICY/ EFFIEXP SIR/DED ALL LIMITS IN THOUSANDS ! LTR MEMO # DATE I I I i ! i I , WORKERS' COMPENSATION IAI A I AND NWA014778000 7/1/99-7/1/00 COVERAGE A: STATUTORY I ! EMPLOYERS' LIABILITY 181 COVERAGE B: $1,000 ; DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS: I I AS RESPECTS HEALTHY START NETWORK CONTRACT THRU JULY 1. 2000. i , I CERTIFICATE HOLDER: CANCEllATION '...... SHOULD ANY OF THE ABOVE DESCRIBED POUCIES/MEMORANDUMS BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY/JPA WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MA1L SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE COMPANY/JPA, ITS AGENTS OR REPRESENTATIVES. ALCOHOL & DRUG SERVICES ~ 7 400 HARBOR BLVD. ~-L- /" ~ ::::::~; , .. ¿---~-~/~"'-ì BELMONT, CA 94002 -,_.'_._-".".....- ,/ /' ..,..-c- ATTN: ESTHER LUCAS AUTHORIZED REPRESENT A TIVE K&A..P/L..07/99".26