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<br />CERTHOLOER COPY <br /> <br />SL <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />tJ, ?oD7-00:J- <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 N,:;)DD7-007 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 12-01-2007 <br /> <br />GROUP: <br />POLICY NUMBER: 1414076-2007 <br />CERTIFICATE 10: 92 <br />CERTIFICATE EXPIRES: 12-01-2008 <br />12-01-2007/12-01-2008 <br /> <br />CITY OF SANTA ANA <br />CLERK OF THE CITY COUNCIL <br />20 CIVIC CENTER PLZ M-30 <br />SANTA ANA CA 92701-4058 <br /> <br />SL <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 />tREPRESENTATI <br />EMPLOYER'S LIA8ILITY LIMIT <br /> <br /> <br />~(~~ <br /> <br />PRESIDENT <br />INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> <br />ENDORSEMENT #1600 - GERALD NEWFARMER, PRES CEO SEC - EXCLUDED. <br /> <br />ENDORSEMENT #206S ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-2002 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />MANAGEMENT PARTNERS, INC <br />1730 MADISON RD <br />CINCINNATI DH 45206 <br /> <br />SL <br /> <br />M0408 <br /> <br />PRINTED <br /> <br />11-16-2007 <br /> <br />(REV.2-0'5\ <br />