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<br />CERTHOLDER Cf""'Y <br /> <br />RECEIVED MAR 0 1 ~Wl6 <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 03-01-2006 <br /> <br />GROUP: <br />POLICY NUMBER: 1332857-2006 <br />CERTIFICATE 10: 3 <br />CERTIFICATE EXPIRES: 03-01-2007 <br />03-01-2006/03-01-2007 <br /> <br />CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br /> <br />SG <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 expiration. <br /> <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 /> <br />a:::- REPRESENTAll <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: <br /> <br /> <br />~ <br /> <br />PRESIDENT <br />$1,000,000 PER OCCURRENCE. <br /> <br />EMPLOYER <br /> <br />HOTLINE OF SOUTHERN CALIFORNIA (A NON-PROFIT <br />CORP. ) <br />PO BOX 32 <br />LOS ALAMITOS CA 90720 <br /> <br />(REV.2-0S) <br /> <br />M0408 <br /> <br />PRINTED <br /> <br />02-18-2006 <br />