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<br />STATE
<br />C:OMPE!H,SA1'IQN
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<br />FUND
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<br />po. BOX 807,
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<br />^ ,', ' . ~RTHOLDER COpy
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<br />SAN FRANClsc~e~0;~4 r~~07
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<br />ISSUE DATE:
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<br />CERTIFICATE OF; WORKERS' CQMPl!NSATlOl\llNSUJiA:NcE
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<br />04-0t-2o<l3 GROuP:
<br />, POLlCY NUMBER: 1443685-2003
<br />,.CEflTIFICA TE ,10: '.. 4
<br />CERTIFICATE .EXPlRES, 04-01-2004
<br />04-01-2003104-01-2004.
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<br />C (TV OF SANTA ANA Sf> c'
<br />AnN: 'JEFF St~VEtIS. RI$XANAGEIU.MT lJfV1SI.ON
<br />20 C I VI C CENT~R Pl:AZA.:' ROO/'l."llT28
<br />SANTA ANA CA,~2702
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<br />JOB; uOB; bTY OF SANTA ANA
<br />, 'AUDIO 'TESTING,
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<br />This is to certtfy that we ",ave ,issued a valid W!'rkers' Co~en$ation insurance poliCY in a ',form ~prov~d by the
<br />California" msuianc:e Commissiorrer---to'.'tfore employ. -named" bl,tfOw--tor,:the"-pct!cy-pcriod incficlJ1:ed.-
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<br />This poliCY is not subject to cano"Jlatlbn by tha' FUMo- except upon 10 days' advance written notice to the employer.
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<br />We will also give YOY"-'0 days'- 'adva'r'lce notice should this poHt:y be cancelled -prior to 'its 'no1rr\al" flxpiratioh.
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<br />This certifjcate<'of, insurance" is _ not ,an in$Urance, pOlicy'-'
<br />by the policies listed here,,,.lII01Wlthstandi/lg atir ,r.eM
<br />with respect to which this certificate 6f insurAlrlee nDj!
<br />policies ~scribed herein is subject'to all :,the \t$triS},~
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<br />P:~s not arilet1<l. e><.tend' or alter llie CQverage 'afforded
<br />fJ;ti.t~,t9rm.- or cQrid.tiOF\ 9f'any comr.ct-br other document
<br />, . $Oed -or may'-:.per.Ulin/ the insurance afforded by the-:,' " "
<br />ns and condit!-ori~ of 'sueh policies. ~ '
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<br />AUTHORIZED REPReSENTA rive
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<br />PRESIDENT
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<br />EMPLOVER'S LIABILITY LIMIT INCLUDING DEFENSE (:os"'$; $i,Ooo,cioo.oo PER~OcctiRRENCE.
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<br />EMPLOYER
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<br />LEqAL'MAME
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<br />'JOliN G ALEVllO~.. riO. ItIC
<br />8~' N .rUST! NAVE STE A
<br />SANTA ANACA 92705 ,
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<br />;"m<<Gl' ~E\iIZGS ,DO, INC NID
<br />"TUSTIN-IRVINE MEOICAL ~. tIC
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