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Ilk CERTHOLDER COPY <br />STATE 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 -2007 GROUP: 000044 <br />„ POLICY NUMBER: 0020381-2007 <br />`1 3W CERTIFICATE ID: 21 <br />CERTIFICATE EXPIRES: 10 -01 -2008 <br />10 -01- 2007/10 -01 -2008 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZ M36 <br />SANTA ANA CA 92701 -4058 <br />SG JOB:TIERRA DE LAS PAMPAS EXHIBIT AT THE <br />SANTA ANA ZOO <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 30 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 />THORIZED REPRESENTATI <br />PRESIDENT <br />UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: <br />THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; <br />EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING <br />CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' <br />COMPENSATION LAW. <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10 -01 -1998 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />CHRISTOPH, ANN DBA: ANN CHRISTOPH, LANDSCAPE <br />ARCHITECT, ASLA <br />31713 COAST HWY <br />LAGUNA BEACH CA 92651 <br />(REV.2 -05) <br />SG <br />e;TA--;:; Fu ND WIG IWdAaA )CC- <br />.Doeb ITT NOD CAO A PP(Zov-A L <br />M0408 <br />PRINTED : 09 -17 -2007 <br />