CARD METERING SYSTEMS 1 - Laserfiche WebLink

Home Browse Search

CERTHQLDER COPY Su STATE COMPENSATION INSURANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFiCATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-01-2007 GROUP: 000560 POLICY NUMBER: 0000371 -2007 CERTIFICATE 10: 20 CERTIFICATE EXPIRES: 10-01-2008 10-01-2007/10-01-2008 CITY OF SANTA ANA CLE~ OF THE CITY COUNCIL 20 CIVIC CENTER PLAZA (M-30) SANT A N4A CA 127~ S,", This IS to certlfv thllt we hllve Issued a valid Workers' Compensation Insurance policy In a form approved by the ClIl,fornl. Insurllnce CommiSSioner to the employer named below for the policy period indicated. ThiS poilCV IS not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We Woll .Iso 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 poliEy 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. ~ ~(~~-~ ~THORIZEO REPRESENT A TI EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: PRESIDENT $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2005 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER CARD METER SYSTEMS INC DBA: C M S INC S.J 1104 N ANITA AVE TUCSON AZ 85705 M0408 PRINTED 09-17-2007 (REV.2-05)