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<br />SP <br /> <br />. .- <br /> <br />...... <br /> <br />'.....; <br /> <br />STATE <br />COMPENSATION <br />INSURANcE <br />FUND <br /> <br />P.O. BOX 807, SAN FRANCISCO,CA 94101-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 09-30-02 <br /> <br />POLICY NUMBER: 1354969 - 02 <br />CERTIFICATE EXPIRES: 09-30-03 <br /> <br />CITY OF SANTA ANA <br />COMMUNITY REDEVELOPMENT AGENCY <br />P.O. BOX 1988 <br />SANTA ANA, CA 92]02 <br /> <br />uOB: ALL OPERATIONS <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 upon 10 days' advance written notice to the employer. <br /> <br />We will also give you 10 days'advance notice should this policy be cancelled prior to its normal expirortion. <br /> <br />This certificate:of.insurance is not an i~surance policy and does not amend, extend or alter the coverage afforded <br />by the policies. listed herein. Notwithstanding any requirf3:rTlent, term, or condition of any contract or other documeflt <br />with respect to which this certificate at insurance may be -issued or may pertain, the insurance afforded by the <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br /> <br />~IDE~ <br /> <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000,00 PER OCCURRENCE. <br /> <br />Al'PROVED AS TO FORM <br /> <br />~-YVY cC:; <br />;lc;[tura'":i.Jhccdy .. <br />Dr,puty City Attorney <br /> <br />EMPLOYER <br /> <br />LEGAL NAME <br /> <br />NEIGHBORHOOO HOUSING SERVICES NEIGHBORHOOO HOUSING SERVICES OF 0 C INC <br />OF O. C. , INC, INC <br />198 W LINCOLN AVE FL 2 (A NON-PROFIT CORP,) <br />ANAHEIM CA 92805 <br /> 08~19-02 <br /> PRINTED: PO 408 <br /> <br />, ,THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND . selF '0265 (REV 2.") <br />