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STATE P.O. BOX420807, SAN FRANCISCO, CA 94142-'0807 <br />COMPENSATION f, <br />INSURANCE <br />FU N D CERTIFICATE OF WORKERS` COMPENSATION INSURANCE y: <br />OCTOBER 25, 2002 POLICY NUMBER 1462781 -,02 <br />CERTIFICATE EXPIRES: .10-1-03 <br />CITY OF'SANTA eANA <br />COMMUNITY,DEVELOPMENT AGENCY <br />:P ,b BOX 1988 M-25 . - <br />SANTA ANA CA 1270<t` <br />L ,...c <br />s <br />This is to certify that we have Issued a valid Workers Compensation insurance policy in a form approved; by the California <br />.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 W days' advance written notice to the employer. <br />We will also give you X�j'clays` 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 or4ter the coverage afforded ;by the <br />.:policies fisted herein. NRfwkhstariding amyre(juirement, 4erm,,or condition'o{,any contract 'or other dncunrent ivdh <br />.respect to,which this certificate'oi insurance may be,Issued'or,may pertain, the, insurance afforded bVAle pollaes <br />and concitions of such policies. <br />v;z <br />f <br />r <br />7I - <br />✓L ' z <br />ENDORSEMENT 02065 ENTITLED CERTIFICATE HOLDERS'NOTICE EFFECTIVE <br />10/25/02;_'IS ATTACHED ;TO AND F0kMS,A,PART OF THIS POLICY. <br />v. <br />