IBI GROUP 3 - 2003 - Laserfiche WebLink

Home Browse Search

SG POLICYHOLDER COPY STATE COMPENSATION INSURANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 11-01-2005 GROUP: POLICY NUMBER: 0539588-2005 CERTIFICATE ID: 199 CERTIFICATE EXPIRES,08-01-200B 08-01-2oo5/08-01-200B CITY OF SANTA ANA CLERK OF CITY COUNCIL 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 SG ~oB:I2-1055 This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstandin~ any requirement, term or condition of any contract or other document with respect to which this certificate of Insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ~ A~t ~ AUTHORIZEO REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #20B5 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-01-1991 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER 8EINHAKER PLANNING & DEVELOPMENT AND SERVICES INC. (PARTNER) AND NEAL A, IRWIN OF CALIFORNIA INC (PARTNER) AND LAVALLE CONSULTANTS INC. (PARTNERS) DBA: IBI GROUP 18401 VON KARMAN AVE STE 110 IRVINE CA 92B12 lREV.2-05J PRINTED IRLI,CN] 11-01-2005