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<br />CERTHOLDER COPY <br /> <br />SG <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 />CITY OF SANTA ANA <br />CLERK OF CITY COUNCIL <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br /> <br />k;2.0DS-/;;;).-7 <br /> <br />A- 2q)3-17::2-~ <br />rt t( _0 :2- <br />SG <br /> <br />GROUP: <br />POLICY NUMBER: 0539588-2008 <br />CERTIFICATE 10: 199 <br />CERTIFICATE EXPIRES: 08-01-2009 <br />08-01-2008/08-01-2009 <br /> <br />ISSUE DATE: 08-01-2008 <br /> <br />~OB:I2-1055 <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 30 days advance written notice to the employer. <br /> <br />We will also give you 30 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:::- REPRESENTATI <br />EMPLOYER'S LIABILITY LIMIT <br /> <br /> <br />~~ <br /> <br />PRESIDENT <br />INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE OB-01-1991 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />BEINHAKER PLANNING & DEVELOPMENT AND SERVICES <br />INC. (PARTNER) AND NEAL A. IRWIN OF CALIFORNIA <br />INC (PARTNER) AND LAVALLE CONSULTANTS INC. <br />(PARTNERS) DBA: IBI GROUP <br />18401 VON KARMAN AVE STE 110 <br />IRVINE CA 92612 <br /> <br />M0408 <br /> <br />(AEV.2-05) <br /> <br />PRINTED <br /> <br />07-17-2008 <br />