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<br />.~.. '..~'^"'.... <br />Rj~~~~; <br />IN$UflAN <br />PUNO <br /> <br />!J.O. 'BqXA?~807. SAN fRANCISCO, GA~fl1;4?;1Ja07 <br /> <br />. . <br />CERTfFICATE OF WORKERl,.COMPENSATION.INSUAANCE <br /> <br />APRIL 11 2007 <br /> <br />POi.lL;Y Nl JMf.lt'H 624-06 UNlT00(4~00S <br />(.:Ef~lIHCATf.' FXP1RE~. 4-1-08 . <br /> <br />CITY Of S,AHTA. Mf~, <br />PUBL:Ee !,QJHS 'J(GEN~Y .~,. ~,>' '"''':''' <br />~:TTN: Dmn.1.SAi";~~a~~$$Oc..;~, 17~~F~Rfo\~J ~lHN . '. .' ..... ,. ...' <br />.2~ CIVIC.Cllf '1-,.\3:. 'SAW'U 'A1~"t~92702' lOlh ALl.. CAtUORklA O~ERA'fI'ON~. <br />. -.,. ~ . . " 'i_,":,. <br /> <br />, <br />L- <br /> <br />Till:' b tu cer!lty that 'we have is~ued a vallo WOlkers ComI5em"mion :IlSur,H1Cl' ro1iCy II' a torni apprO\lf.:(! by llle O;:liJfcrrik,. <br />Insuranc.c C'Anmi:;;:;;iQI-Ier tq the pmployer named below fot the PQlicy period indicat~d. <br /> <br />TillS oC:,r:, I:; lot !;dbICr.;j:O (; .Uiu.:llnttDn by H..: Funcl cxc'~pt upu!.l,:p ;J,:y'" advanu:l vmtten n >h;e j(j li:t; ':npl(ije, <br /> <br />w.~ wlii aIS01ilIv.t! y(ll, TEN Oi'lys advanGI:! n{)fj~j$hOuld Ihis polir:y b.~ c;;lrlcelind priorto its IIt'tm,,! ~x~:W<ttlorr. <br /> <br />This cb'rtlflcatF. of insurapC6.15 not.;m in~l!rance r.m!lGY nnd does riot nmcmd; extemj of alltH tlie cov,,(age <lffo"_ii~tj by (tIO <br />Dollc:es Ii~ted !l(lfr;in. NQtWilllstandin'g (jny Jl:lqll!Jf:JITIl:lnl.. term or condition pi any (;o",\r;::\I)1 Or other document with <br />'ASPACI to wllletl ti'll" cert'!ic:ate lir 1r15IJrqliC;€ IHay b(~ tsr;lInrJ 01 lllay pert(lin, the .InSilmnr;,:; dfford,~d bytlk J.l'l/tCit:S <br />G(:scrlbed hecein I'; sUhj')'-- to all ttH:1 terms,. f~xr.ll1sions ,tn:i c:o[lrlitiom; ui such 11nJi<;iF$ <br /> <br />.~"l.' nc~r'TI'1 .... <br /> <br /> <br />, ,\j,[;" ,<' IT.". "." ".. v . <br /> <br />- n <br />(5<--'." -.: ) L",,-..ckfCY1 <br /> <br />l r" L-, :!f" -Fi.j I <br /> <br />EltPLOYER'S I.lABILITY1..nnT InCLUDING DEFENSE COS1'SI$l. 000. 000 N::n OCCUfffl'&NCIi:. <br /> <br />. . <br />~~,' <br /> <br />,{ <br /> <br />f MPLOYER <br /> <br />ECOltQ~lnCQNT.I{QL PRODUCTS;.. <Ule, ;.ND/OR <br />ttONOLI1'E TRAFFIC EHC;'lNE:.EnlHG& MA1NTENANCE. lKc. <br />a:l&0E.U,. ~AUtAAygiU.lE.:' , <br />AHAHEIK. CA 92806 <br /> <br />'<2~""'" <br /> <br />THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND selF 10262Ii'lEV. 7-65) <br />