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<br />. ... I ~ . <br /> <br />STATE P.O. 80X 420'07. SAN fRANCISCO, C'" 84,.:a-oa07 <br />c:eJlllPIN.AT'O,.. <br />'''''''''_''Nca <br />FUN D CERTIFICATE OF WORKERS' COWENSATION INSURANCE <br />, <br /> <br />D~CLlUln 1:1, 2003 <br /> <br />lillOVI'; <br />PCl.IGY HUMlIIiR; 17son..z.03 <br />CEIIlTlFICA T1! 10: U <br />CERT1F1CAT1!ElCPI~S; .......00. <br />07~01-aoal/o'.Ol~20Q. <br /> <br />'fIt1 <:JTV QF SAll"rA A.IU. <br />~os Q.Q't' FCOTH S'!'lU:E':, 201 <br />$'-Itrll ANA eJo 12701 <br /> <br />N. ~_ Cl.IAII , ._SUIII: \lUK <br />'.ilVlCI. .1.'1' TItlE DIIIJO'! AT SNI'I'A NQ <br />'000 E. IAHrA _"YD. __ folIA. <br />a.. <br /> <br />TN. i. .. ...Ailjllllll_ htv81".IO . VIP. Wo",.r. Com......uon In~UIIIl<I Policy III. /omItpprov., by III. Cluromio <br />I.......... CotiInIts_ '0 ... '''''''1* "'__lor'" polO., p~"" indlctItcl. <br /> <br />TNo polICy IOllOIsuDJtelIO __II\' lilt """" -t1__ 20 dl7"'_ wn- noli.. 10 lilt _I.~r. <br /> <br />w. ""''''0 ... yov 10 ctayo _.... ....... '"""" UN oolley be ....._ ptIot to lis _ .........n. <br /> <br />Th'" oon;l'oc". 01 iNlIIilnce 10 not.., ,,,,._c. pallor and do.. nOl _no. ..,.1lG .t .K.r lilt 101/eIOQ' III....., by Ill. <br />...nc:loo bled h.roln. NoIwI......nding ""1......-... _ or conGlIlon .. .ny CO"".oI.. Olh.r _ Willi <br />..specr ro wnIch "'Is _.re or 10._ ""'" be I.IIIICI or may Ilel\lln. lilt in....... .~OIlItd by Ill. pol;o;,. <br />desc;riDed hero;"'" '"~ 10 eltho Ie..... e_. tnd concli_ 01..... Polio'". <br /> <br />~ <br /> <br />AIJ~.'lfio"''''!S(''TATNt <br /> <br />..d~ t. ~ <br /> <br />1Nl!$IDClllr <br /> <br />rMPLOYER'. LlAlILITY LIMIT INCLUDIWC orPIN.s COSTS. ,.,OOQ,OOO ~Ea OCCOR~cr <br />ElIIlOR5SMSIIT .20", INTITLED enTlrlClln IlOL<lI:U' MO'I'Ice I:FFEC'UVE 0"0,-'003 IS <br />"tv.<:K1lD '0 NOD FOItHS A PAI''I' OF ':IIXS poue~. <br /> <br />laUU)Y\;;A <br /> <br />TSCH CORP <br />11111 GOT~ 51 ST~ 10' <br />HUNTINCTN BCH CA 92648 <br /> <br />CC" '0'''.11 <br /> <br />rlifllF_UI: ,., <br />TOTRL P.04 <br /> <br />,~',.': ~;', <br /> <br />',JYi <br /> <br />~~ck v/v~_. <br />.7, ""~2 <br /> <br />TOTAL P.0S <br />