Laserfiche WebLink
CERTIFICATE of COVERAGE <br />Workers' Compensation <br />Nevada Retail Network Self Insured Group & <br />Safety National Casualty Corporation - AM Best Rated A++ <br />NAIC #15105 <br />575 S. Saliman Road <br />Carson City, NV 89701-5000 <br />Phone: (775) 887-2480 Fax: (775) 887-2481 <br />MEMBER COMPANY <br />Fleet Solutions LLC dba USA Fleet Solutions <br />Policy No : NRN17807-2025-01 <br />169 Cadillac Place <br />Reno, NV 89509 <br />Dates of Coverage: APPROVED 1 <br />12:01 AM on 01/01 /2025 to 12:01 AM on 01/01/2026 I By Tu Tran Nguyen at 4:09 pm, Sep 02, 2025 <br />This document certifies that the named Member Company has secured coverage for their workers' <br />compensation obligations pursuant to the Nevada Workers' Compensation Act by qualifying as a <br />member of the Self -Insured Group. The Self -Insured Group is an Association of Self -Insured Private <br />Employers authorized by the Nevada Division of Insurance to provide Workers' Compensation benefits <br />to employees of member companies under Chapter 616 and 617 of the Nevada Revised Statutes. <br />CERTIFICATE HOLDER: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />JOB DESCRIPTIONS: <br />All Nevada Jobs <br />LIMITS OF LIABILITY: WORKERS COMPENSATION STATUTORY <br />OPERATIONS COVERED: NEVADA <br />EXCESS WORKERS COMP INSURANCE: Safety National Casualty <br />EMPLOYER'S LIABILITY LIMIT: $1,000,000/$1,000,000/$1,000,000 <br />This certificate is issued for information purposes only. Should the member company's enrollment in the <br />Self -Insured Group be terminated before the date of expiration, the Self -Insured Group and Safety <br />National Casualty Corporation will mail 30-days written notice to the Certificate Holder. However, failure <br />to mail such notice shall impose no obligation or liability upon the Self -Insured Group, Safety National <br />Casualty Corporation, the Association Administrator, or any Party acting as a Trustee, Officer, Agent, or <br />Appointee of the Self -Insured Group or Safety National Casualty Corporation. The Self -Insured Group is <br />under no obligation to provide notice to the Certificate Holder should the member company elect to <br />terminate coverage prior to the stated expiration date. <br />NOTICE: An extension of coverage, or the addition of another "insured," must be by written <br />endorsement only and cannot be extended by the member under this certificate. <br />Dated At <br />Carson City, <br />Nevada : August 20, 2025 By. Title: Director - Underwriting <br />and Government Relations <br />