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SEP, 30. 2003 1:17PM CERTHOLD~RC¢~O. 682~ P, 1/' <br /> <br />8TA <br /> <br />SANT~ <br /> <br />This Ls to <br />Irmumn~ <br /> <br />This poll <br /> <br />We will <br /> <br />This cee <br />policle~ <br /> <br />describe <br /> <br />(PART <br />( PAR'~ <br /> <br />1840; <br /> <br />F'E P.O. BOx 420~07, SAN FRANCISCO, CA 94142.0807 <br /> <br />J D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />T'~ 09-30-2003 <br /> <br />: CTR P.~ZA {H-301 P O ]BOX 19aa <br />IA CA 92702 <br /> <br />GROUP: : <br />POLICY NUMBER: 53~SSS-20o} <br />CERTIFICATE ID: aS <br />CERTIFICATE EXPIRES: 08-03.-2o0~ <br /> 0e-01-~003/0e-ol - 2eo~i <br /> <br /> rtlfy that we have isauecl a valid Wod<er's Compensation insurance policy In a fon'n soflroved by the Celifornia <br /> ommia~ior~- to the emp~yer named below for the policy ~edo<l inclmMed. <br /> <br />Is nc4 sul~e~ ~o cence~lalion by the Fund except upon 30 day~ ~ivance written notice to ~he employer. ' <br />) give you 30 ,~a~/s at, vance notice ~houk:l'thls po!icy be c~oelied ,pdor to its normal expiration. <br />ate of Insurance iS ~ an insurance policy and does not amend= extend or a~ter the coverage afforded by ~e <br />)d.hlrel~. NMWII{ .l~t~ .lng ilny requirement, tetTn or cl~ctltlor~ o~ .aa.~ ¢~tract o~ other ~oeument w~th <br />~hi~ t~' .~. i~C~ .vt, ul'ml ce may be is~,ue(~ or may p~dain, the insurance.afforded by the policies <br />=m~n = ~bjec~ ~o.all the terms, exc~usioce, and con~litions, of such polioiel. <br /> <br />!ER' S LIABILITY LIMIT INCLUDING DEI~I~NSR COSTS: $1,000,000 p~.R OCCURRENCE. <br /> <br />;~MSi~ ~2065 ~i~D ~RTIFI~TE '~S' ~TIC~: ~F~IVE 08-01-1991 IS <br />t~ ~ ~ F~s A P~T O~ THIS ,~LZ.~. · <br /> <br />%~R PLANING & DEVELOPMENT /~D SERVICES INC. <br /> AND 1~ A, IRWIN OF CALIFORNIA INC <br /> · ~ND LAVA~I~ CONSIJLTFaNT$ 'INC. (PARTN[~) <br /> GROUp . . · ' <br /> <br /> <br />