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<br />' F9~'N,P' CERTIF.CATE OF:WORKERS.'CÒ~'P,!N~Atfö~:\INS~ÁÂNC$':,,/' ,.-
<br />ISSU~ DATh 04.01'2~" "'~;' ,L;"'~'2~'r(ì~~~~;(~ii~~~(7~~~~:
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<br />,.' .; ", " ' ":::~":"CER"nFlëA:~ ÐCPIRESfj-'~O"-01-2005'
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<br />POBOX' ,1988,... ';, .;~ ' ,
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<br />This'is to certlfytnat we have issueda \lalid Worker¡¡'CQmpe,;s¡j~fQn, ìn~r,~ê~'polic{Jt1'.á~!órm'~pproved
<br />,Galiforni~,lnsur'nce Corr'lmissíonør to the, emplovernamed belowfpr2.the,p"ç;!icy:periöd )",di~t8d. "'"
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<br />This policy is not subject to cancellation by the, Fund :~xèeptupon3oâ.aY~>¡8...ct\l~~ê. w¡:iUen notic::e to the
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<br />with resp~c::t to wlticn this ,'certificate oEinsuran~e'<m.aý.bê':.issued or l11ày,pe~ln.':thø'lnsúr"Mëafforqed by the .u.'
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<br />AUTHORlZE6REPF.!ËSEÑTATIVE " ,. ~~, 'PRESIDENT".: "." ' ,,' .
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<br />EMPLOYER'SLIQILJTY LIMIT JNCLUDXNG. DEfENSECÔ5T~:i::~'$l. ~O\'~;'Q(J';j~'.ER¡ÓC~RENCÉ.
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<br />!=ND9'RSEMENT.f208a ENTlTL.ED CERT J F ~ CATEttDL-ÒERS' ~t:~Ç,£,:~,¡'¡'EeTìVÉ' 'O~'':91-20ó(1 S,A.-TTÀÇH!D,TO AND
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