My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
GORDON & WILLIAMS, INC. 1A - 2005
Clerk
>
Contracts / Agreements
>
_PENDING FOLDER
>
READY TO DESTROY IN 2018
>
GORDON & WILLIAMS, INC. 1A - 2005
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/3/2012 2:54:09 PM
Creation date
9/23/2005 2:52:52 PM
Metadata
Fields
Template:
Contracts
Company Name
Gordon & Williams Inc
Contract #
A-2005-162
Agency
Public Works
Council Approval Date
6/20/2005
Expiration Date
11/1/2006
Insurance Exp Date
6/27/2008
Destruction Year
2012
Notes
A-2002-144A; 1ST AMENDMENT; TERM SLIP 08/22/07
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
109
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
<br />~... <br /> <br />CERTHOLDER COPY <br /> <br />STATE <br />COMPENSATION <br />IN SURANCE <br />FUND <br /> <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 09-30-2005 <br /> <br />CITY OF SANTA ANA <br /> <br />2 FARADAY <br />IRVINE CA 92618 <br /> <br />SC <br /> <br />GROUP: <br />POLICY NUMBER: 1717797-2004 <br />CERTIFICATE 10: 376 <br />CERTIFICATE EXPIRES: 11-01-2005 <br />11-01-2004/11-01-2005 <br />THIS CERTIFICATE SUPERSEDES AND CDRRECTS <br />CERTIFICATE 8 305 DATED 12-23-2004 <br />~06:NDRTHWEST CORNER OF SANTA ANA 6LVD <br />& ROSS ST., SANTA ANA, CA <br />(FILE NO. 18811) <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 that will expire or did <br />expire as indicated above. <br /> <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy 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 to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions. and conditions, of such policy. <br /> <br />~ <br /> <br />~~~ <br /> <br />~ <br /> <br />AUTHORIZED REPRESENT A TIVE PRESIDENT <br />EMPLOYER'S LIA6ILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT 81600 - EDWARD F HILL PRESIDENT SECRETARY - EXCLUDED. <br />ENDORSEMENT 81800 - MICHAEL SAVAGE VICE PRESIDENT TREASURER - EXCLUDED. <br />ENDDRSEMENT 82065 ENTITLED CERTIFICATE HOLDERS' NDTICE EFFECTIVE 11-01-2003 IS <br />ATTACHED TO AND FDRMS A PART OF THIS POLICY. <br />ENDORSEMENT 82570 ENTITLED WAIVER DF SUBROGATION EFFECTIVE 2005-09-30 IS <br />_ ATTACHED TD AND FORMS A PART OF THIS POLICY. THIRD PARTY NAME: <br />CITY OF SANTA ANA <br /> <br />RECEIVED <br /> <br />EMPLOYER <br /> <br />GEDTECHNOLDGIES INC <br />439 WESTERN AVE <br />GLENDALE CA 91201 <br /> <br />SC <br /> <br />on Ii 5 }U1I5 <br />GOI1IJON & WILLIAMS <br /> <br /> <br />'--L-,' <br /> <br />if) <br /> <br /> <br />(REV.2-0S) <br /> <br />'---~~CdY ------- <br /> <br />Assistant City Atlorn\.~\ <br /> <br />[B19.SC] <br />PRINTED 09-30-2005 <br />
The URL can be used to link to this page
Your browser does not support the video tag.