ANN CHRISTOPH LANDSCAPE ARCHITECT ASLA 1A - 2008

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' 'N CERTHOLDER COPY P.O. BOX 420807, SAN FRANCISCO,CA 94142 -0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10 -01 -2009 GROUP: POLICY NUMBER: 1939169 -2009 CERTIFICATE ID: 3 CERTIFICATE EXPIRES: 10 -01 -2010 10- 01- 2009/10 -01 -2010 CITY OF SANTA ANA SG JOB:TIERRA DE LAS PAMPAS EXHIBIT AT THE SANTA ANA ZOO 20 CIVIC CENTER PLZ M36 SANTA ANA CA 92701 -4058 This is to certify that we have issued a valid Workers' Compensation insurance 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 10 days advance written notice to the employer. We will also give you 10 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. tTHORI�ZeD REPRESENTATI PRESIDENT UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' COMPENSATION LAW. I EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS EMPLOYER CHRISTOPH, ANN DBA: ANN CHRISTOPH, LANDSCAPE ARCHITECT, ASLA 31713 COAST HWY LAGUNA BEACH CA 92651 $1,000,000 PER OCCURRENCE. M0408 PRINTED : 10 -23 -2009 (REV.2 -05) SG