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•.... .r. I11 VJJ IJ V <br />-- --,- ---- ._. 714-54 746 <br />Oct 01 07 01158P OC 7th Commission <br />• poL'ZCYMLDER COPY <br />I <br />STATE F.0. 13OX 420807, SAN FRANCISCO.CA 94142-0807 <br />Try gL <br />RANCa <br />FUND c.ITIFICATZ OF WOMMS' CoWaii16ATM wsuRAKCE <br />ISSUE DATE, 00-01-2007 pouav MOM 184H999-200rf <br />CER71P1CAT E !M 1 <br />CERTIFICATE CXPIAES: os -01-2008 <br />og-of-2oo7lo9-dt-2009 <br />P -W vWTj45 ` <br />7011TH QXMEL SP <br />C"OOR 1iIE\701 AW ALVD 217 <br />L <br />SSWrA M4a W AA 92701-4561 <br />T9a is 10 certify that wa have Ism d a valid Workwe GemPenauOn cI li a (orm �proyad i2Y die <br />Cagtorala lnswarrce Caarniaatomv W the employer AVAad below for thePolicya P�� indieatad <br />This Polley Is not subleet to cehcallatien by the Fund exeopt upon 10 deye advanoe written nOtiee to the employer. <br />We will also give you 10 drys advance <br />notice should this poney be uncalled prior to its normal exPiradom <br />This certiftpts Of inswa�os is not an inauranes Policy and does not NOW4 °Mud or atter the coverage afforded <br />nt term or eonfton of arty comraet or u1bor d the ecumM <br />by, the Poky tistad herein NofwPhst OV any regriretw� Issued or m w oh h tnev Peu1a71t <br />with respaet to which Jbis r.*Mfkgw of a+raranee <br />ujW afforded by the Policy desermed herein is subjeet to all the tams. OYCIUMOM and cor"i"lo , of such po cy. <br />IZEP REpRESENTATI <br />PRESIDENT <br />SpLoyEY'S LIABILITY IMI INCL'=NX MFENSE COSTS: 57,000,000 PER OCCDRRE?9'.4• <br />EMPLOYER <br />amellIls t'XtlmTy Iroulk7 COMRSSWR jA y0 v=f13i <br />IS5p g Smm ST STE 2RA7ION) <br />i SANTA ANA G 82705 <br />77ev.2-as7 <br />�� r <br />pRIMEO t 07-77-2007 <br />SP <br />7@402 <br />