Laserfiche WebLink
<br />SP <br /> <br />CERTHOLDER COpy <br /> <br />ST"ATEi <br />COMPENSATION <br />INSURp..Nc;E <br />FUND <br /> <br />P.O. sox ~O7. SAN FRAOCISCO,CA.$4142-0~P7 <br /> <br />C~TIPlCA.,", OF WOR~ERS'COMPENSA.TION \INSURANCE <br /> <br />ISSUE DATE: <br /> <br />06-01-2004 <br /> <br />CITY OF SANTA ANA <br />ATTN: KIll PFEIFFER <br />20 CIVIC CENTER PLAZA <br />SANTA ANA .CA 92701 <br /> <br />SP <br /> <br />GROUP: 000048 <br />POLICY NUMBER: oot~5-2ooÌl <br />CERTIFICATE 10:48 . <br />CERTIFICATE .ExPIJ:!Es: 06-01-2005 <br />06-0h2oo4/08-01-2oo5 <br /> <br />JOB: ALLOP:9ATIONS <br /> <br />This is to certi:fy that we have issued a valid Workers' Compensation insur~ce þolicy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon 30 days' advance written notic. to the employer. <br /> <br />We wHl also giVe. YOU'30days'~dvance notice should this, policy be cancelled prior to its nOrmal expiration. <br /> <br />This certificate<of ,insurancf:t. is f10tan insurance policy and does not amend. extend or alter thecbverage' afforded <br />by the p~lic:ies li~ted harein;,Notwithstandi"Q any ,requir~ment term, or cOfldi~iop of any contractor other docur,-,".r:1t <br />with resp..,ct to ,which this"c'ertificate, °1' ir'l$ural1ce,.~..be "issued or maypert,in, ,..the insurance ~fforded by the <br />policies 'described herein is subject to all the t~rms, eXêllJsiQnsand conditions of such policies. <br /> <br />~ <br /> <br />~~(!. <br /> <br />&£.- <br /> <br />AUTHORIZED .REPRESENT A TIVE <br /> <br />PRESIDENT <br /> <br />~LOYE!I'S LIABILITY LIMIT INcLUOIfIG DEFEII$E CdST.S: <br /> <br />$1,000,000.00 PER OCCURRENCE. <br /> <br />ENoo'RSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTIÇlE EFFECTIVE 06-01-2004 IS ATTACHEOTO AND <br />FORMS A PART QF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />LEGAL "NAME, <br /> <br />r~ <br />~ <br />f <br />. <br />I'" <br /> <br />ORANGE COUNTY CONSERVATION- CORPS <br />lOON VAHEY ST STE <br />ANAH£III CA 92801 <br /> <br />ORANGE. COU"ITYi CONSERVATION CORP. <br />(A NON PROFIT CORP. <br /> <br />