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<br />Apr 23 08 0834a <br /> <br />Charleen Jones <br /> <br />951 698-5436 <br /> <br />p.2 <br /> <br />, <br /> <br />'. <br /> <br />POLICYHOLDER copy <br /> <br />SK <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> <br />'-' <br /> <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />ISSUE DATE: 02-07-2008 <br /> <br />GROUP: 000238 <br />POLICY NUMBER, 0005845-2007 <br />CERTifiCATE ID: 6 <br />CERTifiCATE EXPIRES, 02-07-2009 <br />02-07-2008/02-07-2009 <br /> <br />CITY OF SANTA ANA <br />PUROlASIN6 <br />20 CIVIC CENTER PLZ PMB 1988 <br />SANTA ANA CA 92701-4058 <br /> <br />SK <br /> <br />This is to certify that we h.ave issued a v.alid Workers' Compensation ~[lsura"ce poliCY in .a form appro'Jed by the <br />California Insurance Comrrissloner to the emplover named below for the policy period indlca'::sd. <br /> <br />This polil:Y is not suoject to ca'1celhilion by the Fund except upon 10 days advance written notice to the employer. <br /> <br />We will also give you 10 days advance notice should this poiicy be cancelled prior to its. normal expiration. <br /> <br />This certificate of insurance is not an insurance policy and does not a1\end. exte.,d or alter the coverage afforded <br />by the policy listed here1n. Notwi~hstanding any re(1uirement, term or condition of any ~ontract or other document <br />with re5pect to wh\ch this. certificate of insurance may be iss.ued or to which ;1 may pertain, the insurance <br />af10rded b'l' the polLe';' desCribed hereLrl is subject to all the terms, excLusions. and conditions, of SUCh poLi~.,.. <br /> <br />'- <br /> <br />6::RE::::a <br /> <br /> <br />EMPLOYER'S LIA8ILITY LIMIT INCLUDING <br /> <br />~~ <br /> <br />PRESIDENT <br />DEFENSE COSTS; $1,000,000 PER OCCURRENCE. <br /> <br />ENDORStMENT #1600 - JONES, EARL DOYLE, PRESIOENT TREASURER - EXCLUDED. <br /> <br />ENDORSEMENT #1600 <br /> <br />dONES, CHARLEEN WREY. SECRETARY - EXCLUDED. <br /> <br />~ <br /> <br />EMPLOYER <br /> <br />PACIFIC SYSTEMS ELECTRIC, INC <br />38330 VIA LA PALOMA <br />MURRIETA CA 92563 <br /> <br />SK <br /> <br />'-" <br /> <br />M0410 <br /> <br />PRINTED , 02-19-2008 <br /> <br />{R'EV.2-051 <br /> <br />1 Hi'" ,,\..) (.\ <br />