REACH EMPLOYEE ASSISTANCE 1 -2005

Home Browse Search

SP CERTHOLDER COPY STATE COMPENSATION INS U RAN CE FUND P.O BOX 807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 03-01-2005 ^ ~w(L L - C r(\ J" F\ 'J'" :r- ~. GROUP, POLICY NUMBER: 1555105-2005 CERTIFICATE 10, 11 CERTIFICATE EXPIRES: 03-01-2006 03-01-2005/03-01-2006 CITY OF SANTA ANA BENEFITS OEPT 20 CIVIC CENTER PLAZA SANTA ANA CA 92702 SP This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration. I This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement. term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain. the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. ~ ~~c ~ AUTHORIZED .REPRESENTATIVE PRESIDENT EMPLOVER'S LIABILITV LIMIT INCLUOING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2005 IS ATTACHED TO AND FORMS A PART OF THIS PDLICV. EMPLOYER LEGAL NAME REACH EMPLOYEE ASS I STANCE. I NC 101 E LINCOLN AVE STE 230 ANAHEIM CA 92805 REACH EMPLOYEE ASSISTANCE, INC (REV,3.03) ". . :. . . .