OMEGA GROUP, THE 2 - 2003 - Laserfiche WebLink

Home Browse Search

. . CERTHOLDER COPY so STATE P.O. BOX 807, SAN FRANCISCO,CA !;!4142-0807 COMPENSATION INS U RAN C Ii; FU NO CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-01-2004 GROUP: POLICY NUMBER: 1302649"2004. CERTIFICATE 10: 29 CERTIFICATE EXPIRES: 10-01-2005 10-01-2004/10-01-2005 SANTA ANA POLICE DEPARTMENT ATTN BRIAN SHELOON 60 CIVIC CENTER PLAZA SANTA ANA CA 92]02-6956 SO 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 30days'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, extender alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term. or condition of any contract orother dopument with respect to which this certificate of insurance maybe. issued or maypertain,the insurance afforded by the policies described herein is subject to all the terms, eXclusions and conditions of such policies. ~ ~~c ~ AUTHORIZED REPRESENT A TIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000.000.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. SEP29'0415:59 RCVO EMPLOYER ~ LEGAL NAME THE OMEGA GROUP, I NC 5160 CARROll CANYON RO Fl 1 SAN DIEGO CA 92121 T~E OMEGA GROUP, INC IIREV.3-031 PRINTED: 09/17/2004 PD408 .:lh....I.IIl.J1'JI:::lI~..:'.~.......:J.II=-:l....::I:I~1::I'.:f'ltf~ni:{'JlI~I' selF 1026"