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<br />'. <br /> <br />STATE <br />COMPENSATION <br />INSUFlANCE <br />FUND <br /> <br />IN REPLY REFER TO: <br /> <br />NOVEMBER 29, 2005 <br /> <br />CITY OF SANTA ANA <br /> <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br /> <br />CERTIFICATE OF WORKERS' <br /> <br />COMPENSATION INSURANCE <br /> <br />CANCELLATION NOTICE <br /> <br />RE: CERTIFICATE DATED NOVEMBER 13, 2005 <br /> <br />THE WORKERS' COMPENSATION INSURANCE POLICY FOR THE EMPLOYER <br /> <br />12:01 A.M. <br /> <br />NAMED BELOW HAS BEEN CANCELLED EFFECTIVE NOVEMBER 13, 2005 AT <br /> <br />IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE <br />CONTACT THE EMPLOYER NAMED BELOW <br /> <br />EMPLOYER: <br /> <br />ADVANCED AUTOMATED SYSTEMS INC <br />23691 VIA DEL RIO <br />YORBA LINDA, CA 92887 <br />POLICY 713-0008864-05 <br /> <br />CUSTOMER SERVICES UNIT <br />LOS ANGELES DISTRICT OFFICE <br />(323) 266-5000 <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 /> <br />"" <br />e::~ <br />c:;:;:, <br /><..n <br />c::> <br />~,~ <br />c-; <br />, <br />C"> <br /> <br />..,..c <br /> <br /> <br />~ <br />-. <br />_'.,~ <br /> <br />'2 <br />..,.. <br />CJ <br />