KINKLE, RODIGER & SPRIGGS 1B -1985

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. 411fERTHOLDER COPY SK STATE COMPENSATION INSURANCE FUND P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 . ~.....~, CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-2004 GROUP: POLICY NUMBER: 0409627 -2004 CERTIFICATE 10: 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 herein~.. Notwithstanding any requir~rTlent, term, or condition of any contract or other document with respect to which this certificate of insuraocemay be issued or maypertain,the insurance afforded by the policies described herein is subject to all the terms. exclusions and conditions of such policies. ~ A~t! ~ AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE CDSTS: $1,000,000.00 PER OCCURRENCE. ENDDRSEMENT #2065 ENTITLED CERtIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2004 IS ATTACHED TD AND FORMS A PART DF THIS PDLICY. ~ ~.~...d-1J f1~~; <'/', , <d.:': EMPLOYER LEGAL NAME KINKLE, RODIGER, AND SPRIGGS 3333 14TH ST # 200 RIVERSIDE CA 92501 KINKLE, RDOIGER, AND SPRIGGS (A PROF. CORP.) fI'W }-