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<br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />AUGUST 1, 2005 <br /> <br />/t-11tf5-(SI <br /> <br />;4-;ZCJ(ff- C!7J- DB <br />A- ~:;{oo5 - in <br /> <br />IN REPLY REFER TO: <br /> <br />CITY BG <br /> <br />POBOX 1988 <br />SANTA ANA CA 92707 <br /> <br />CERTIFICATE OF WORKERS' <br /> <br />COMPENSATION INSURANCE <br /> <br />CANCELLATION WITHDRAWAL NOTICE <br /> <br />RE: CERTIFICATE DATED NOVEMBER 1, 2004 <br /> <br />THE CANCELLATION HAS BEEN WITHDRAWN FOR THE WORKERS' COMPENSATION <br /> <br />INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW. THIS LETTER SUPERSEDES <br /> <br />THE NOTICE OF CANCELLATION SENT TO YOU ON JULY 27, 2005. <br /> <br />THIS EMPLOYER'S WORKERS' COMPENSATION INSURANCE COVERAGE CONTINUED <br /> <br />UNINTERRUPTED. <br /> <br />EMPLOYER: <br /> <br />DELHI CENTER <br />505 E CENTRAL AVE <br />SANTA ANA, CA 92707 <br />POLICY 1528709-04 <br /> <br />CUSTOMER SERVICE REPRESENTATIVE <br />CUSTOMER SERVICE CENTER <br />(877) 405-4545 <br /> <br />1275 Market Street. San Francisco. CA 94103-1410 <br />Mailing Address: P.O. Box 420807 . San Francisco. CA 94142 -0807 <br /> <br />selF 19102 <br />