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q, I b- i -� <br />SPECIFIC EXCESS WORKERS COMPENSATION AND <br />b EMPLOYERS LIABILITY INDEMNITY POLICY <br />EMPLOYERS REINSURANCE CORPORATION <br />No. 0553087 <br />SCHEDULE <br />1. Insured: City of Redwood City <br />2. Mailing address: 1017 Middlefield Road <br />Redwood City, Califomia 94063 <br />3. Named states: Califomia <br />4. Excluded states: None <br />5. Police 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 />6. Retention: <br />(a) Each accident: $350,000 <br />(b) Each emplovee for disease: 5350,000 <br />7. Limit each accident: <br />(a) Policy Part One, Workers Compensation: Statutory <br />(b) Policy Part Two, Employers Liability: 51,000,000 <br />8. Limit each employee for disease: <br />(a) Policy Part One, Workers Compensation: Statutory <br />(b) Policy Part Two, Employers Liability: 51,000,000 <br />9. Premium: <br />(a) Payroll divided by 5100 multiplied by: .0824 <br />(b) Minimum: $28,150.00 <br />O (c) Deposit: $31,280.00 <br />ERC -2120 I <br />