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POLICYHOLDER COPY SK <br />STATE P.O. BOX 420607, SAN FRANCISCO,CA 94142-OB07 <br />FSU N D <br />CERTIFICATE OF WORKERS' COMPFASSATION INSURANCE <br />GRDLJP= 000238 <br />ISSUE DATE: 02-o7-2008 POLICY NUMBER, ooCS94S-2007 <br />CERTIFICATE ID: 02_07_2009 <br />CERTIFICATE EXPIRES: <br />02-07-2008102-07-2009 <br />SK <br />CITY OF SANTA ANA <br />PURCKASXM <br />20 CIVIC CENTER PLZ PMH 1988 <br />SANTA ANA CA 927D1-4058 <br />in a form approved by the <br />that we have issued a valid Workers' Coelow for the pdiey period indicated. <br />the employer eased b <br />this is to certify mperasuon insurance PO" <br />•cY <br />California Insurance COmrrissioner t0 <br />This pclicy Is not sunject to cancellation by the Fund except upon 1p days advance written "once to the employer. <br />We will also give you 10 days advance notice should ths policy be cancelled prior to its normal expiration. <br />tic and does not amend, extend or alter thorcotheragdocumeded <br />rs uir0ment, term or condition Of env a� the other <br />ranee <br />This certificate of insurance o not to insuraanynce q be issued or to which -t may per <br />by the policy <br />listed herein Notwithstanding sur s <br />with respect to which this cer lificate of insurance may <br />afforded by the phlchloy described herein is subject to all the <br />Nterms. <br />-exetusiorz, and conditions' of such Policy <br />V <br />PRESIDENT <br />HORIZED AEPRESENTATI <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE <br />S COSTS; $1,000,000 <br />1 ,000 000 PEREOCCURRENCE <br />SURER <br />ENDORSEMENT #1600 - JONES. EARL DOYLE, <br />ENDORSEMENT #1600 - JONES, CHARLEEN MREY, SECRETARY - EXCLUDED. <br />EMPLOYER <br />PACIFIC <br />SYSTEMS ELECTRIC, INC <br />SK <br />A LA <br />OMA <br />MIR2RIETA CA 92563 <br />PRINTED :02-19-2008 <br />!aEV.2-051 <br />T l I` <br />M0410 <br />