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SP <br />/� <br />C .HOLOER COPY <br />STATE P.O. BOX 807, SAN FRANCISCO;CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 12-01-2004 GROUP: <br />POLICY NUMBER: 1572168-2004 <br />CERTIFICATE IP.. 2 <br />CERTIFICATE EXPIRES: 12-01-2005 <br />12-01-2004/f2-01-2005 <br />CITY OF SANTA ANA'SP JOB: ALL OPERATIONS <br />COMMUNITY DEVELOPMENT x SLMIGRANT DORIS-TURLEY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA <br />CALIFORNIA 92701 <br />This is to certify that we have issued a valid Workers' Corripehsat oo 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 fo days'. 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 ar,1y re8ltirehlen� 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,eXciusions and conditions of such policies. <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUhING DEFENSE COSTS:; $1,000,000.00 PER OCCURRENCE. <br />EMPLOYER <br />KIDSINGERS <br />3947 E LA PALMA AVE <br />ANAHEIM CA 92807 <br />LEGAL NAME <br />KIOSINGERS <br />(A NON-PROFIT CORP) <br />