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CERTHOLDER COp`r <br />S'T'ATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 10-01-2005 GROUP: <br />POLICY NUMBER: 1462781-2005 <br />CERTIFICATE ID: ~ 3 <br />CERTIFICATE EXPIRES: 10-01-2006 <br />10-01-2005/10-01-2006 <br />CITY OF SANTA ANA SG <br />COMMUNITY DEVELOPMENT AGENCY <br />P 0 BOX 1988 M-25 <br />SANTA ANA CA 92702 <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 SO 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 />~, c . <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 31,000,000 PER OCCURRENCE. <br />ENDORSEMENT !{2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2003 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />WOMEN HELPING WOMEN (A NON-PROFIT PUBLIC SG <br />BENEFIT CORP.) <br />711 W 17TH ST STE A10 <br />COSTA MESA CA 92627 <br />SG <br />M0408 <br />IREN.2-05) PRINTED 09-17-2005 <br />