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CERTHOLDER COPY <br />SG <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 05 -13 -2008 GROUP: 000238 <br />POLICY NUMBER: 0009520-2008 <br />CERTIFICATE ID: 64 <br />CERTIFICATE EXPIRES: 05 -01 -2009 <br />05 -011- 2008/05 -01 -2009 <br />CITY OF SANTA ANA <br />220 S DAISY AVE M -85 <br />SANTA ANA CA 92703 -4334 <br />SG JOB:ALL OPERATIONS <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 />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. <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 certificate 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 />V <br />THORIZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 05 -08 -2008 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />f.a—S iz. aL <br />EMPLOYER <br />PAULUS ENGINEERING, INC. AND /OR R.F. PAULUS. <br />INC. <br />2871 E CORONADO ST <br />ANAHEIM CA 92806 - [CAD,SCI <br />PRINTED : 05 -13 -2008 <br />(REV.2-05) <br />