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<br />.~ct .,04 U1 111 1 "'" <br /> <br />ban'Ca Nna LaO <br /> <br />fJ."T,;:I...J.;:)t..,........J. <br /> <br />,..~ <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />IN Rr/"L Y ReFeR TQ: <br /> <br />APRIL 16, 2007 <br /> <br />CITY OF SANTA ANA <br /> <br />1801 E CHESTNUT AVE <br />SANTA ANA CA 92701-5001 <br /> <br />CERTIFICATE OF WORKERS' <br /> <br />--------~-------------- <br /> <br />COMPENSATION INSURANCE <br /> <br />-------~----------~--- <br /> <br />C~NCELLATION/CONVERSION NOTICE <br /> <br />RE: CERTIFICATE DATED APRIL 11, 2006 <br /> <br />THE WORKERS' COMPENSATION COVERAGE PROVIDED UNDER THE <br />POLICY LISTED BELOW IS BEING CONVERTED TO A NEW POLICY <br /> <br />EFFECTIVE APRIL 1, 2007. <br /> <br />THE NEW POLICY WILL PROVIDE <br /> <br />UNINTERRUPTED COVERAGE. <br /> <br />YOU WILL RECEIVE A NEW CERTIFICATE OF INSURANCE UNDER <br />THE NEW POLICY NUMBER: 541-0000424-06. <br /> <br />IF YOU ~~VE ANY QUESTIONS, PLEASE CONTACT THE CUST~~ER <br /> <br />SERvICE CENTER AT THE NUMBER LISTED BELOW. <br /> <br />EMPLOYER: <br /> <br />DIAGNOSTIC VETERINARY LABRTRS, INC <br />1401 E SOUTH ST <br />LONG BEACH, CA 90805 <br />POLICY 1845779-06 <br /> <br />CUSTOMER SERVICE REPRESENTATIVE <br />CUSTOMER SERVICE CENTER <br />(877) 405-4545 <br /> <br />1275 Mark.et SLreet w San Francisco. CA 94103- 1410 <br />Mailing Address; P.O. Box 42080', . San Francisco. CA 94142-0807 <br /> <br />5C:IF 1:1l0Z <br /> <br />" <br />