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<br />Feb 21 O? 05:23p <br /> <br />Delhi Center AccountingHR <br /> <br />(?141481-9698 <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />POLICYHOLDER COPY _ <br /> <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />ISSUE DATE: 11-01-2008 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />CITY OF SANTA ANA <br />CO.....ITY DEVELOPMENT AGENCY <br />20 CIVIC CENTER PLAZA M-21 <br />SANTA ANA CA 82702 <br /> <br />SP <br /> <br />GROUP: <br />POLICY NUMBER: 1528709-2006 <br />CERTIFICATE 10: 34 <br />CERTIFICATE EXPIRES, 11-01-2007 <br />11-01-2006/11-01-2007 <br /> <br />4- d-oO~ - 09;;.. - 015 <br />/1.-- ;).fJof.r; - / t& <br /> <br />This is to certify that we have issued .. v~ld Work.ers' Compensation insur8'tCe policy in .. 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 ~ce notice should this policy be cancelled prior to its normal expiration. <br /> <br />This certificate of insurance is not WI insurance policy and does not .-nend, extend or alter the coverage afforded <br />by tne policy listed herein. Notwithsl-.ding any requirement. term or condition of any contract or other document <br />with respect to which this certificate of fnsurlnce may be Issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject 10 all ltIe terms, exclusions. and conditions. of such policy. <br /> <br />d:::REP~ <br /> <br />EMPLOYER'S LIABILITY LIMIT INCLUOING DEFENSE COSTS: <br /> <br />EMPLOYER <br /> <br />DELHI CENTER (NON-PROFET CORPORATION) SP <br />505 E CENTRAL AVE <br />SANTA ANA CA 112707 <br /> <br />(REV.2-oS1 <br /> <br />~ <br /> <br />PRES IDENT <br />$1,000,000 PER OCCURRENCE. <br /> <br />.-"J, <br />.....;t <br /> <br />j~J <br /> <br />A~'I i r~) <br /> <br />-10 <br /> <br />~J;',:Ci. <br /> <br />'L..:':" <br /> <br />/;',,~:~f;;" Ie .2ily At[()~ <br /> <br />PRINTED <br /> <br />10-17-2006 <br /> <br /> <br />f .2 <br /> <br />M041 '.I <br /> <br />e ..Y <br /> <br />SP <br /> <br />I <br /> <br />. <br />