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04/09/2009 15:50 <br />NO.649 P002 <br />CERTHOLDER COPY <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE. <br />ISSUE DATE: 08-01-2007 �p� GROUP. <br />POLICY NUMBER: 1543445-2007 <br />�. CERTIFICATE ID: 1 <br />_h CERTIFICATE EXPIRES: 06-01-2008 <br />08-01-2007/08-01-2008 <br />CITY OF SANTA A" SP JOB:ALL OPERATIONS <br />PURCHASING DIVISION ATTN: BILL O'CONNOR <br />P. 0. BOX Igoe <br />SANTA ANA <br />CALIFORNIA 52702 <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 ruined below for the policy period Indicated. <br />This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to die employer. <br />We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy 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 />i <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />Ck} <br />tTHORI�ZFD :REMWITZI jQ PRESIDENT <br />E14PLOYERIS LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />I <br />EMPLOYER <br />�I <br />HYDROBLAST SP <br />726 W ANGUS AVE STE G <br />ORANGE CA 22808 <br />iJTM,CN1 <br />ntEV.rosl PRINTED 04-09-2008 <br />Sp <br />