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<br />. <br /> <br />. <br /> <br />CERTHOLDER COPY <br /> <br />SC <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />PO BOX 420807, SAN FRANClSCO,CA 94142-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE, 02-23-2006 <br /> <br />GROUP, <br />POLICY NUMBER, 180S82B-2oo5 <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 92701-4080 <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 lr.surance Commissioner to the employer named below for the policy period indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon 30 d.lYs adv.ance 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 expir.tion. <br /> <br />This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded <br />by the policy listed herein. 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 />d::REPRESENTATI <br />EMPLOYER'S LIABILITY LIMIT <br /> <br /> <br />~ <br /> <br />PRESIDENT <br />INCLUDING DEFENSE COSTS, $1,000,000 PER DCCURRENCE. <br /> <br />ENDORSEMENT #1600 - RDNALD FARWELL PRESIDENT - EXCLUDED. <br />ENDORSEMENT #1Boo - BARDN FARWELL SEC,TRES - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2005 IS <br />ATTACHED TD AND FDRMS A PART DF 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 />(REV.2-05l <br /> <br />PRINTED <br /> <br />[B 14 ,SC] <br />02-23-2006 <br />