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POLICYHOLDER COPY NA <br /> - • P.O. BOX 8192, PLEASANTON, CA 94588 <br /> � <br /> CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 07-01-2013 GROUP: <br /> POLICY NUMBER: 1548613-2013 <br /> CERTIFICATE ID: 61 <br /> CERTIFICATE EXPIRES: 07-01-2014 <br /> 07-01-2013/07-01-2014 <br /> CITY OF REDWOOD CITY NA JOB:ALCOHOL AND OTHER DRUG GRANT <br /> RC 2020: CITY MANAGERS DEPT <br /> 1017 MIDDLEFIELD RD <br /> REDWOOD CITY CA 94063-1993 <br /> This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br /> California lnsurance Commissioner to the employer named below for the policy period indicated. <br /> This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br /> We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. <br /> This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br /> by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br /> with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br /> afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br /> ���� � �� <br /> Authorized Representative President and CEO <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> ENDORSEMENT 112065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2001 IS <br /> ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> EMPLOYER <br /> PENINSULA CONFLICT RESOLUTION CENTER (A NA <br /> NON-PROFIT CORP. ) <br /> 1660 S AMPHLETT BLVD STE 219 <br /> SAN MATEO CA 94402 <br /> M0410 <br /> (REV.1-2012) PRINTED : 06-17-2013 <br />