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is P.Q. BOX 420807. SAN FRANCISCOLA 94142-0807 <br />COMPENSATION <br />FUND CERTIFICATE OF WORKERS` COMPENSATION INSURANCE <br />ISSUE DATE: 04-14-2007 GROUP; 0005157 <br />POLICY NUMBER: 0000772-200e <br />CERTIFICATE 10: f <br />CERTIFICATE EXPIRES: 04-14-2008 <br />04-i4-2007/04-14-2006 <br />CITY OF SANTA ANA SP <br />20 CIVIC CENTER PLAZA <br />SANTA ANNA CA 92702 <br />This is to certify that we have iccuad a valid Workers' Compensation insurance policy in a form approved by the <br />California insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 1O days advance written notice to the 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 after 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 />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />�T40MZEDREPRESENTATI PRESIDENT <br />EPPLOYER'S LIABILITY LIMIT INCLUDIIN(I DEFENSE COSTS: $1,000,000 PER GUMIRRENCE. <br />EMPLOYER <br />GRANO COUNTY CHILDREN'S THERAPEUTC ARTS $P <br />2215 N BROADWAY <br />SANTA ANA CA 92709 <br />;REV.2-05) <br />PRINTED : 03-19-2007 <br />U0409 <br />MA <br />