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<br />CERTHOLDER COPY <br /> <br />SC <br /> <br />STATE <br />COMPIiNSATION <br />IN SURANCE <br />FUND <br /> <br />PO BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 02-23-2008 <br /> <br />GROUP, <br />POLICY NUMBER, 1805826-2005 <br />CERTIFICATE ID: 169 <br />CERTIFICATE EXPIRES: 10-01-2006 <br />10-01-2005/10-01-2006 <br /> <br />THE CITY OF SANTA ANA <br />60 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4060 <br /> <br />SC <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 indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon30 days advance written notice to the employer. <br /> <br />We will also give you 30 days advance notice should this policy be cancelled prior to its normal expirOltion. <br /> <br />This certificate of insurance is not .an insurance policy and does not amend, extend or alter the cover.age afforded <br />by the policy listed, nerein. Notwithstanding any requirement. term or condition of .any contract or other document <br />with respect to which this certific.ate 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 />O::-REPRESENTATI <br />EMPLOYER'S LIABILITY LIMIT <br /> <br /> <br />~ <br /> <br />PRESIDENT <br />INCLUDING DEFENSE COSTS, $1,000,000 PER OCCURRENCE. <br /> <br />ENDORSEMENT #1600 - RONALD FARWELL PRESIDENT - EXCLUDED, <br />ENDORSEMENT #1600 - BARON FARWELL SEC,TRES - EXCLUDED. <br />ENDORSEMENT 62065 ENTITLEO CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2005 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />ALL CITY MANAGEMENT INC <br />1749 S LA CIENEGA BLVD <br />LOS ANGELES CA 90035 <br /> <br />SC <br /> <br />IREV,2-051 <br /> <br />PRINTED <br /> <br />[B14,SC) <br />02-23-2006 <br />