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~ ~ SP <br />C CERTHOLDER COPV <br />STATE P.O BOX $07, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS° COMPENSATION_ INSURANCE <br />ISSUE DATE: 07-01-2005 GROUP: <br />POLICY NUMBER: 1480453-2005 <br />CERTIFICATE ID: 7 <br />CERTIFICATE EXPIRES: 07-07-2008 <br />07-01-2005/07-01-2008 <br />CITY OF SANTA ANA, SANTA ANA CITY JAIL <br />ATTN CHRIS LAUGENAUR <br />62 CIVICS CENTER'PLA2A <br />SANTA ANA CA 92702 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a farm approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 10 days' advance written notice to the employer. <br />We will also give you 10 .days' advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amehd,extend or alter the coverage'. afforded <br />by the policies listed herein. NOtwithstandingany requirement, term, or condition of any contract or other document <br />with respect 'to which this certificate of insurance may tie issued or may pertain; the insurance afforded py khe <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br />~~ ~ c . <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000_00 PER OCCURRENCE. <br />~PPROV~U ~~ l f3 E'`Ji~:.= <br />~r ,~ <br />~ 3~ _ _ <br />L'+trt Stitt SLecdy <br />' Aasitta rtt l`ity !I 'r ~'-` <br />EMPLOYER <br />,...LEGAL NAME <br />CORRECTCONAL MANAGED CARE.. coRRECTiONAL MANAGED. CARE MEDICAL CORP. <br />MEDICAL CORP <br />4211 E LA PALMA AVE <br />ANAHEIM CA 92807 <br />laev.3-oat PRINTED: 06/17/2005 Pnann <br />