EL PUENTE KIDWORKS 1-2004 - Laserfiche WebLink

Home Browse Search

SP CERTHOLDER COpy STATE COMPENSATION INSURANCE FUND P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE THE CLERK OF THE CITY COUNCIL SP CITY OF SANTA ANA 20 CIVIC CENTER PLAZA(M-30) PO BOX 1988 SANTA ANA CA 92702-6956 GROUP: POLICY NUMBER: 1776218-2005 CERTIFICATE ID: 1 CERTIFICATE EXPIRES: 02-01-2006 02-01-2005/02-01-2006 JOB: WEED AND SEED GRANT ISSUE DATE: 02-01-2005 It -~y -a-iJO 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 policies listed herein, Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance maybe issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. ~ ~~t. ~ AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUOING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. ENODRSEMENT #2065 ENTITLEO CERTIFICATE HOLDERS' NOTICE EFFECTIVE 02-01-2005 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME KIDWORKS 2002 S GRAND AVE STE A SANTA ANA CA 92705 EL PUENTE COMMUNITY DEVELOPMENT CORPORAT (REV.3-03) PR'NTED: 01/19/2005 P0408 THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10""