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Master Contract No. 902012 <br />Procurement Contract No. 24823 <br />LOCAL AUTHORITY WORKERS COMPENSATION EXCESS JOINT POWERS AUTHORITY EXCESS <br />WORKERS' COMPENSATION PROGRAM LIMIT OF COVERAGE <br />CERTIFICATE OF COVERAGE <br />TH IS CERTI FI ES THAT THE COVE RAGE <br />Oityof$anLea ndro <br />DESCRIBED HEREIN HAS BEEN ISSUED TO: <br />DATES(S) OF A{TI Vn'Y; <br />buly 1, 2023 to June 30, 2024 <br />LOCATIO N 0 F A CTI VrrY; <br />Within City of San Leandro boundaries <br />San Leandro, CA 94577 <br />DESCRIPTION Or ACTIVITY: <br />First Amendrnent to Agreement dated October 1 , <br />2022: Homeless Coordinating and Financing Council <br />(HCFC) for the Homeless Housing, Assistance and <br />Prevention (HHAP) Program to address immediate <br />homelessness challenges; Master Contract No. <br />902012, Procurement Contract No_ 24823 <br />ENTITY PROVIDING COVERAGE <br />COVERAGE LIMITS <br />CERTIFICATE <br />EXPIRATION DATE <br />City of San Leandro <br />835 East 14th Street <br />$250,000 <br />Juno 30, 2024 <br />San Leandro, CA 94,577 <br />The following coverage is in effect and is provided through participation in a risk sharingJoint Powers <br />Authority_ The City of San Leandro is self -insured for $250,DD0 with excess coverage of $45,000,000 <br />through Local Agency Workers' Compensation Excess J PA (LAWCX). <br />October 23, 2023 <br />DATE <br />r o?-w B_ <br />A U1 HOR 1ZP DSIG rqJf7U <br />Leticia Naranjo, frisk Management Analyst <br />NAME AND TITLE <br />Exhibit C <br />Page 3of3 <br />