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P <br />SP <br />CERTHOLDER COPY <br />STATE P.O. BOX 807, SAN FRANCISCO,CA 94142 -0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE _ UT Y- 013 <br />ISSUE DATE: 03 -01 -2005 GROUP: l;, <br />POLICY NUMBER: 1675790 -2005 <br />CERTIFICATE ID: 3 <br />CERTIFICATE EXPIRES: 03 -01 -2006 <br />03 -01- 2005/03 -01 -2006 <br />CITY OF SANTA ANA SP <br />20 CIVIC CTR PLAZA <br />SANTA ANA CA 92701 <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 />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 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 may be 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 />A_ C . <br />AUTHORIZED REPRESENTATIVE PRESIDENT. <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. <br />EMPLOYER <br />BLIND CHILDRENS LEARNING CENTER <br />18542 VANDERLIP AVE STE B <br />SANTA ANA CA 92705 <br />LEGAL NAME <br />BLIND CHILDRENS LEARNING CENTER <br />