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10/21/2002 12:23 State Com. Ins F~n~ · 91V146~7658~ NO.BB6 ~00~ <br /> <br />CERTIFICATE HOLDER <br /> <br />STATE .~0. Box 4=07, sm FRANCISCO, CA 94142-0807 <br /> <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />OCTOBER 21. 2002 <br /> <br />GROUP:. <br />POLICY NUMBER: <br />CERTIFICATE iD: <br />CERTIFICATE EXPIRE~: 06-0'~-200~ <br /> Q6.01- 2002/0(-0T-20n 3 <br /> <br />ATT~ C~SA~ <br />20 CIVIC <br />· ~NTAANA CA 92702 <br /> <br />B~PLOYE~'5 L[ABILXTY ~IMIT INCLUDXNG DRF~N~R COSTS: $1,000,000 PER ~NCE <br /> <br />ENDOE6[~G4T #2065 ~TITLED CE~TIFZCAT~ HOLDEEg' NOTZCR EFFECTIV~ 06-01-2002 IS <br />ATTACHED TO AND FO~4~ ~ ~A~T OF_THIS POLICY. <br /> <br />~LOBAL DIM~gIONS, ~NC <br /> <br />APPROVED AS TO FORM <br /> <br />~'a-u r a Sheedy <br />Deputy City Attorney <br /> <br /> <br />