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CERTHO~OER COPY S.J STATE COMPENSATION INSURANCE FUND P.O, BOX 420807, SAN FRANCISCQ,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-01-2005 GROUP: 000560 POLICY NUMBER: 0000371-2005 CERTIFICATE ID: 20 CERTIFICATE EXPIRES: 10-01-2006 10-01-2005/10-01-2006 CITY OF SANTA ANA CLERK OF THE CITY COUNCIL 20 CIVIC CENTER PLAZA (M-30) SANTA ANA CA 92704 S.J This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement. term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms. exclusions, and conditions. of such policy. ~ ~~c. ~ AUTHORIZED REPRESENTATIVE EMPLOYER'S LIABI~ITY LIMIT INCLUDING DEFENSE COSTS: PRESIDENT $1,000,000 PER OCCURRENCE. ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2005 IS ATTACHED TO AND FORMS A PART OF THIS PD~ICY. EMPLOYER CARD METER SYSTEMS INC DBA: C M S INC S.J 1104 N ANITA AVE TUCSON AZ 85705 M0408 PRINTED 09-17-2005 (AEV.2.051