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01/29/2007 15:47 FAX 3237820130 FDS Sou7hlBnd <br /> <br />®ooz <br />POLICYHOLDER COPY ~ <br />STATE PO BOX 420807, SAN FRANCISCO,CA 94 1 42-0 807 ~ _,2005'~~y <br />COMPENSATION <br />INSURANCe <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE A- o2OQ5 - ~~'y-O~ <br />ISSUE DATE: 01-22-2007 GROUP. <br />POLICV NUMBEq; 1BB02BB-4006 <br />CERTIFICATE ID' 6 <br />CERTIFICATE EXPIRES 0+-01-2007 <br />oa-ot-41106/oe-of-2007 <br />CI7T OF SANTA MIA PUBLIC IAIRXS AGENCY SC dOB:ALL CALIFORNIA OPERATIONS <br />ATTN: SNAHIR G06RAN <br />20 CIVIC CENTER PL2 N-a3 <br />SwNTw ANA CA 82701-4058 <br />. ihl;_.ls to certify that we hwe Issued . valid Workers' Compensation Insurance policy in a form approved by the <br />California Insurance Commissioner to the employer nametl below far she policy period Indlcaud. <br />This policy rs not subject to cancellebon Dv the Fund except upon 10 tlayz advance wriHen notice to ilia employer. <br />Ws wdl also glue you to days advance nonce should this policy De cancelled prior to ps normal expuanon. <br />This certificate of Usunnce is nor an Insurance policy and does not amend, extend or alter the cavarage affordetl <br />by the policy listed herein. Notwlthstndin9 my rsqurromenL [arm or contll0on of ym contract or other document <br />with respect to which this cer[lfiu[e of Insurance may be Issued or to which It mN Pertain, the lnsunnce <br />alfor de0 by ilia Dollcy described herein is wblect to dl the terms, exclusions, and contlitlons, of such policy. <br />THORIZEO REPRESENTATI PRES~~ <br />EMPLOYERrS LIABILITY LIMIT INCLUDING DEFENSE COSTS: 51,000,000 PER OCCl1RRENCE. <br />ENDORSEMENT M1600 - ABRAWW TASMNMI PRES. - EXCLUDED. <br />ENDORSEMENT M16oo - MICHAEL GLITZ CFO SEC. - EXCLUDED. <br />VLr) A~ 'r~ F rJ]'.Nl <br />AprRO <br />ps tsg nt ~;ity Attormey <br />EMPLOYER <br />FIELD DATA SERVICES CORPORATION <br />eJ70 MILSHIRE BLVD STE 208 <br />BEVERLY HILLS CA 80217 <br />IME~A'a51 <br />SC <br />[ESI,SPJ <br />PRIMED of-24-4007 <br />