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<br />SK <br /> <br />. <br /> <br />CERTHOLDEFI COPY <br /> <br />STATE P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FU N 0 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 01-01-2005 <br /> <br />GROUP: <br />POLICY NUMBER: 0409627-2005 <br />CERTIFICATE ID: 19 <br />CERTIFICATE EXPIRES: 01-01-2006 <br />01-01-2005/01-01-2006 <br /> <br />CITY OF SANTA ANA <br />ATTN CITY ATTORNEY <br />PO BOX 1988 <br />SANTA ANA CA 92702-1988 <br /> <br />SK <br />JOSEPH W FLETCHER <br /> <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. <br /> <br />We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration. <br /> <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policies listed herein, Notwithstanding any requirement, term, or condition of any contract or other document <br />with respect to which this certificate of insurance maybe issued or may pertain, the insurance afforded by the <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br /> <br />~ <br /> <br />jj~c <br /> <br />~ <br /> <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br /> <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. <br /> <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2005 IS ATTACHED TO AND <br />FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />LEGAL NAME <br /> <br />KINKLE, ROOIGER, AND SPRIGGS <br />3333 14TH ST STE 200 <br />RIVERSIDE CA 92501 <br /> <br />KINKLE, RODI.GE , AND SPIUGGS <br />(A PROF. CORP. <br /> <br />lREV.3.03) <br /> <br />PRINTED: 12/17/2004 P0408 <br /> <br /> <br />.. <br /> <br />: <br /> <br />t :. <br /> <br />- . . <br /> <br />. . <br /> <br />