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Ju4r2e--06",40:44a Hotline of So. Calif. 562 594-7417 p.2 <br />I , <br />POLICYHOLDER COPY Sc <br />COMPENSATIOONN STATE P.O. Ei0X 807 SAN FRANCISCO,CA 941:42-0807 <br />FUNp _ <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 03-01-2oos - <br />GROUP; <br />- POLICY NUMBER 1332857-2005 -- <br />CERTIFICATE ID., 3 <br />CERTiFIGATE EXPIRES: 03-01-2008 <br />03-01-2005/03-Ot-2006 <br />CITY OF.SANTA ANA SG <br />COMMUNITYDEVELOPMENT,. JOB: <br />20 CIVIC CENTER PLAZA - <br />SANTA ANA CA 92702 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form California Insurance Commissioner to the employer named below for the Policy Period indicated approved by the <br />This Policy is not subject to cancellation by the Fund except upon 10days' advance written notice to the employer. <br />We will also give you 10 days' advance notice should this Policy be cancelled prior to its normal expiration. <br />This a POIirate of insurance is not n inswnce Policy and dogs not amend; extend or alter the coverage afforded <br />by the policies listed herein Notwithstanding. any requiremerrL term, or condition of airy contract or other document <br />with es des ib 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 />AUTHORIZED FtEPRESENTATIVE - <br />_ PRESIDENT .. <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $11000,000.00 PER OCCURRENCE. <br />APPROVEL) AS TO WitM <br />As,lstant City Ali, ..:v <br />EMPLOYER <br />HOTLINE OF SOUTHERN CALIFORNIA <br />PO BOX 32 <br />LOS ALAMITOS CA 9072D <br />APPROVE)) AS TO FORM <br />s SULt Shecdy <br />Qty Attorney <br />9 <br />LEGAL NAME <br />HOTLINE OF SOUTHERN CALIFORNIA <br />(A NON-PROFIT CORP.) <br />02/17/2005 <br />