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POLICYHOLDER COPY <br />SP <br />P.O. BOX 8192, PLEASANTON, CA 94588 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 03-27-2020 <br />CITY OF SANTA ANA SP <br />BENEFITS DEPARTMENT <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />GROUP: <br />POLICY NUMBER: 1555105-2020 <br />CERTIFICATE 10: 32 <br />CERTIFICATE EXPIRES: 03-01-2021 <br />03-01-2020/03-01-2021 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance 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 30days 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 <br />dbbyythe <br />policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />Authorized Representative/ President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT X2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2000 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />ENDORSEMENT #1651 - LETICIA A. DAYHOFF SEC.TRES - EXCLUDED. <br />ENDORSEMENT #1651 - MARCUS D. DAYHOFF PRESIDENT - EXCLUDED. <br />EMPLOYER <br />REACH EMPLOYEE ASSISTANCE INC SP <br />650 N ROSE DR <br />PLACENTIA CA 92870 <br />[JCJ,CN] <br />(REV.]-2014) PRINTED : 03-27-2020 <br />