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STATE OF CALIFORNIA Edmund G. Brown Jr., Governor <br />DEPARTMENT OF INDUSTRIAL RELATIONS <br />OFFICE OF SELF-INSURANCE PLANS <br />11050 Olson Drive, Suite 23Q <br />Rancho Cordova,CA 95670 <br />Phone No. (916) 464-7000 <br />FAX (916) 464-7007 <br />CERTIFICATION OF SELF-INSURANCE OF WORKERS' COMPENSATION <br />TO WHOM IT MAY CONCERN: <br />This certifies that Certificate of Consent to Self -Insure No. 7431 was issued by the Director of Industrial Relations to: <br />Orange County Fire Authority <br />under the provisions of Section 3700, Labor Code of California with an effective date of March 1, 1995. The certificate is <br />currently in full force and effective. <br />Dated at Sacramento, California <br />This day the 15th of March 2017 <br />Lyn Asio Benz, Chief <br />ORIG: Rhonda Haynes <br />Human Resources, We Program Manager <br />Orange County Fire Authority <br />I Fire Authority Rd. Building I a <br />Irvine, Ca 92602-0125 <br />