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City of Santa Ana /% CORE 360'
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<br /> Excess Workers' Compensation
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<br /> Carrier Response Indemnity Company of California
<br /> A.M. Best Rating A-X
<br /> Admitted/Non-Admitted Admitted
<br /> Payment Plan In Full
<br /> Payment Method Agency Bill
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<br /> Premium $327,547.00
<br /> Exposure/TIV $142,743,924-Total Payroll
<br /> Rate 0.2295
<br /> TRIA Included
<br /> Minimum Type Minimum And Deposit Premium
<br /> Minimum Amount/Description $327,547
<br /> Estimated Cost $327,547.00
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<br /> States Covered: CA
<br /> States Excluded: OH, ND, WA, WY
<br /> Extraterritorial Jurisdictions:
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<br /> Coverage A-Workers'Compensation Statutory
<br /> Per Occurrence, Each Accident: Per Person,
<br /> Each Occupational Disease or Cumulative $500,000
<br /> Trauma
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<br /> $750,000 xs$1,250,000 Premium : $475,721
<br /> $1,000,000 xs$1,000,000 Premium :.$735,719
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<br /> Retention-Workers Compensation-Limit&
<br /> Retention per occurrence, each Accident: per
<br /> person, each Occupational Disease or $1,500,000
<br /> Cumulative Trauma
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<br /> Policy form-FSIR 000
<br /> Subject to Audit: At Expiration
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