MANAGEMENT PARTNERS, INC. (2007 Council Retreat)

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CERTHOLDER COPY SL STATE COMPENSATION INSURANCE FUND N' -;)Otf7 ~ 0 0::2- P.o. BOX 420807, SAN FRANCISCO,CA 94142-0807 N ,;). DD 7 - 00 7 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 12-01-2007 GROUP: POLICY NUMBER: 1414076-2007 CERTIFICATE 10: 92 CERTIFICATE EXPIRES: 12-01-2008 12-01-2007/12-01-2008 CITY OF SANTA ANA CLERK OF THE CITY COUNCIL 20 CIVIC CENTER PLZ M-30 SANTA ANA CA 92701-4058 SL This is to certify that we have issued a valid Workers' Compensation insurilnce policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. ~ ~(~~- \.JTHORIZED REPRESENT A TI PRESIDENT EMPLOYER'S LIA8ILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - GERALD NEWFARMER, PRES CEO SEC - EXCLUOED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 12-01-2002 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER MANAGEMENT PARTNERS, INC 1730 MADISON RD CINCINNATI OH 45206 SL M0408 PRINTED 11-16-2007 IREV.2-051