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POLICYHOLDER COPY <br />STATE P.D. BOX 420807, SAN FRANCISCD,CA 94142--0807 <br />COMPENSATION <br />IN Sun A14CE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 08 -23 -2809 GROUP: 000481 <br />POLICY NUMBER; 0000413 -2005 <br />CERTIFICATE ID: 41 <br />CERTIFICATE EXPIRES: 09-23 -2007 <br />08- 23- 2008/oa -23 -2907 <br />CITY Of SANTA ANA SP <br />DEPARTMENT OF PUBLIC MARKS <br />20 CIVIC CENTER PLAZA kM -11 <br />SANTA ANA CA 92702 <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 employor. <br />We will also give you 30 days advance notico should this policy be cancelled prior to its normal expiration. <br />This certlfloate of insurance is not an Insurance policy and does not amend, extend or alter the coverage afforded <br />by the geliey 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 />THORI7FD REPRESENTATi <br />PRESIDENT <br />EMPLOYER'S LIA9ILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT 02065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08 -23 -2008 IS <br />ATTACKED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />CURASIDE, INC SP <br />1180 N ARMANDO ST <br />ANA14EIM CA 92806 <br />IREV.2 -051 PRINTED : 07 -18 -2006 <br />N0410 <br />SP <br />