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POLICYHOLDER COPY SP STATE PO. BOX 420807, SAN FRANCISCO,CA 94142-0807 COMPENSATION IN S URANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 07-16-2008 GROUP: POLICY NUMBER: 1339472-2008 CERTIFICATE ID: 540 CERTIFICATE EXPIRES: 01-01-2009 01-01-2008/01-01-2009 CITY OF SANTA ANA SP JOB:788-003 CITY OF SANTA ANA CEQA PANEL PO BOX 1988 SANTA ANA CA 92702-1988 This Is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain. the insurance afforded by the policy described herein is subject to all the terms. exclusions. and conditions, of such policy tORI�ZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - F.JAMES GRECO,PRES. - EXCLUDED. ENDORSEMENT #1600 - GEOFFREY SCOTT,SEC. - EXCLUDED. ENDORSEMENT N1600 - BARRY BURNELL,VP - EXCLUDED. ENDORSEMENT #1600 - RUSSELL GARCIA,VP. - EXCLUDED. ENDORSEMENT N1600 - JOEL MORSE,TREAS. - EXCLUDED. ENDORSEMENT N1800 - FIROUZ GHABOUSSI,VP. - EXCLUDED. ENDORSEMENT N2065 ENTITLED CERTIFICATE HOLDERS` NOTICE EFFECTIVE 01-01-1995 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER T & B PLANNING CONSULTANTS, INC SP 17542 17TH ST STE 100 TUSTIN CA 92780 [P t W.SPI tREv.2-05t PRINTED : 07-16-2008