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<br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />IN AEPl Y REFER TO: <br /> <br />OCTOBER 31, 2008 <br /> <br />SANTA ANA POLICE DEPARTMENT <br />LINDA FLORES <br />60 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4060 <br /> <br />11/05/0816:31 RCV[I <br /> <br />i'I'l(petre',.I ~ A - ;:xr.n-J-/3 <br /> <br />CERTIFICATE OF WORKERS' <br /> <br />COMPENSATION INSURANCE <br /> <br />CANCELLATION/CONVERSION NOTICE <br /> <br />RE: CERTIFICATE DATED MAY 21, 2008 <br /> <br />THE WORKERS' COMPENSATION COVERAGE PROVIDED UNDER THE <br /> <br />POLICY LISTED BELOW IS BEING CONVERTED TO A NEW POLICY <br /> <br />EFFECTIVE OCTOBER 1, 2008. <br /> <br />THE NEW POLICY WILL PROVIDE <br /> <br />UNINTERRUPTED COVERAGE. <br /> <br />YOU WILL RECEIVE A NEW CERTIFICATE OF INSURANCE UNDER <br /> <br />THE NEW POLICY NUMBER: 780-0000497-08. <br /> <br />IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT THE CUSTOMER <br /> <br />SERVICES UNIT AT THE NUMBER LISTED BELOW. <br /> <br />EMPLOYER: <br /> <br />ALL CITY MANAGEMENT INC <br />1749 S LA CIENEGA BLVD <br />LOS ANGELES, CA 90035 <br />POLICY 780-0000227-07 <br /> <br />CUSTOMER SERVICES UNIT <br />LOS ANGELES DISTRICT OFFICE <br />(323) 266-5000 <br /> <br />1275 Market Street. San Francisco, CA 94103-1410 <br />Mailing Address: P.O. Box 420807 . San Francisco. CA 94142-0807 <br /> <br />selF 19102 <br />