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In•ZJ. ZUUb 4:IaPM NO-11H P. ZiZ <br />STATE CERTHOLDER COPY —.W. <br />`�+ ■ ATE P.O. BOX 420907, SAN FRANCISCO,CA 94142-0807 <br />1COMP61iSAT10H <br />INSUftq HCE <br />�LJN ® CERTIFICATE OF WORKERS' COMPENgA'noN INSURANCE <br />ISSUE PATE. 08 -23 -2005 GROUP 000488 <br />PQUCY NIMA3M 0000982 -2005 <br />CFRTIMATE ID: 7 <br />CERT114CATE EXPIRES: 09 -01 -2000 <br />09- 01- 2009108 -01 -2008 <br />This rD to certify that Cewe have I tcedth valid Workers' COmpQlaation In6U`mQ0 Policy In a form approved by the <br />California insurance a employer harried below for the policy period utdicated. <br />This policy is not subject to cancellation by the Hand except UPOn 10 days advance written notice to the employer <br />We will also give YOU 10 days advance notice shOUld this policy be cancelled prior to Its normal expiradon <br />This certificate of insurance is not an Ihzwerce policy and does not amend, extend or alter the Coverage afforded <br />with the Policy listed herein. Notyvithstanding aty rec�rdnem, term or eomklo- of my contract or other documem <br />with respect to which this; crtH /icste of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described heroin Is spbject to all the terms, exciuslOns, and eora&OOns, of such policy.. <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLMINQ pEFENSE CASTS: $1,000,000 PER OCLLARREiCE. <br />LAURA'S HOUSE SQ <br />27129 CALLE ARROYO STE 1922 <br />SAN JUAN CAPISTRANO CA 92675 <br />1916,HOj <br />r2 -osi PRINTED : 08 -23 -2009 <br />