KINKLE, RODIGER & SPRIGGS 1A -1979

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~-I . 411fERTHOLDER COPY SK STATE P.O. aox 807, SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FUN D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-2004 GROUP: POLICY NUMBER: 0409627-2004 CERTIFICATE ID: 19 CERTIFICATE EXPIRES: 01-01-2005 01-01-2004/01-01-2005 CITY OF SANTA ANA ATTN CITY ATTORNEY PO BOX 1988 SANTA ANA CA 92702-1988 SK JOSEPH W FLETCHER 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 herejn.Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of ihsurancemay be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. ~ ~~c &L- AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,009.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2004 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ~.~ ^\.)e,l:;',:i EMPLOYER LEGAL NAME KINKLE, RODIGtR 3333 14TH ST # RIVERSIDE CA 92 AND 00 01 SPRIGGS KINKLE, RDDIq~R, AND SPRIGGS (A PROF. CORP.) iW}-