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<br />CERTHOLDER COPY <br /> <br />NF <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />PO. BOX 420807, SAN FRANCISCO,CA 94142.-0807 <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 03-19-2007 <br /> <br />GROUP: 000626 <br />POLICY NUMBER: 0000259 -2006 <br />CERTIFICATE 10: 24 <br />CERTIFICATE EXPIRES: 12-31-2007 <br />12-31-2006/12-31-2007 <br /> <br />CITY OF SANTA ANA <br />CITY MANAGER'S OEPT <br />PO 60X 1988 <br />SANTA ANA CA 92702-1988 <br /> <br />NF <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 upon30 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 />d:::-REPRESENTATI <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE <br /> <br /> <br />~ <br /> <br />PRESIDENT <br />COSTS: $1,000.000 PER OCCURRENCE. <br /> <br />ENOORSEMENT #1600 - ~AMES N MOORE - EXCLUDED. <br /> <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-31-1998 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br /> <br />/~ <br /> <br />~. MOORE METHODS, INC. <br />1127 11TH ST STE 1050 <br />SACRAMENTO CA 85814 <br /> <br />NF <br /> <br />(REV.2.05) <br /> <br />PRINTED <br /> <br />[CAD,eN] <br />03-19-2007 <br />