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CERTIFICA7E NO. 155UE DATE(MM/DD/YYYY) <br /> wc-2s CERTIFICATE OF COVERAGE o6.1.B. - Page 10 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO <br /> RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY <br /> Excess I ns u ran ce OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS <br /> Authority CERTIFICATE OF COVERAGE DOES NOT CONSTITiTUE A CONTRACT BETWEEN THE <br /> ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE <br /> CERTIFICATE HOLDER <br /> C/O ALLIANT INSURANCE SERVICES, INC. <br /> PO BOX 6450 IMPORTANT:If the certificate holder is requesting a WAIVER OF SUBROGATION,the <br /> NEWPORT BEACH CA 92658-6450 Memorandums of Coverage must be endorsed.A statement on this certificate does not confer <br /> � rights to the certificate holder in lieu of such endorsement(s). <br /> PHONE(949)756-0271/FAX(619)699-0901 COVERAGE <br /> LICENSE#OC36861 AFFORDED BY: A-See attached schedule of insurers <br /> Member: COVERAGE <br /> CITY OF REDWOOD CITY AFFORDED BY: B <br /> ATTN:CAROLYN MCLAURIN <br /> 1017 MIDDLEFIELD RD. COVERAGE <br /> REDWOOD CITY,CA 94063 AFFORDED BY: C <br /> COVERAGE <br /> AFFORDED BY: D <br /> Coverages <br /> THIS iS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE AND POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER <br /> NAMED ABOVE FOR THE PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR <br /> OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED <br /> BY THE MEMORANDUMS AND POIICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDITIONS OF <br /> SUCH MEMORANDUMS AND POLICIES. <br /> CO TYPE OF COVERAGE MEMORANDUM/ COVERAGE EFFECTIVE COVERAGE EXPIRATION �IABILITY LIMITS <br /> LTR POL►CY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) <br /> q EXCESS WORKERS' See attached 07/01/2012 07/01/2013 WORKERS'COMPENSATION: <br /> COMPENSATION 8 Schedule of Difference between <br /> EMPLOYER'S LIABILITY Insurers for policy Statutory and Members <br /> nurrlbe�s $350,000 Retention <br /> EMPLOYERS'LIABILITY: <br /> Difference between <br /> $5.000,000 and Members <br /> $350,000 Retention <br /> LIMITS APPLY PER OCCURRENCE FOR ALL PROGRAM MEMBERS COMBINED. <br /> Description of Operations/Locations/Vehicles/Special Items: <br /> AS RESPECTS EVIDENCE OF COVERAGE FOR MAINTENANCE TO BE DONE ON GARFIELD FIELD. <br /> Certificate Holder Cancellation <br /> SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGE/POLICIES <br /> SAN MATEO COUNTY BE CANCELLED BEFORE THE EXPIRATION THEREOF,NOTICE WILL BE DELIVERED IN <br /> DEPARTMENT OF PUBLIC WORKS ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE/POLICIES PROVISIONS. <br /> 555 COUNTY CENTER,5TH FLOOR <br /> REDWOOD CITY,CA 94063 AUTHORRED REPRESENTATIVE <br /> �� <br /> CSAC EXCESS INSURANCE AUTHORITY <br /> ATTY/AGR/2012.160/GARFIELD MAINTENANCE AGR Page 1 of 2 <br /> REV:09-27-12 JS <br />