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POLICVFpLDER COPY SC <br />STATE <br /> P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPCNSATI ON <br />I <br />NSURANC:E <br />r <br />r U N ~ ' <br /> CERTIFICATE OF WORKERS <br />COMPENSATION INSURANCE <br />I55UE GATE: 10-01- 2008 GROUP: 000780 <br /> POLICY NUMBER: 0000227-2008 <br /> CERTIFICATE ID: 138 <br /> CLiiT~iCA'tE EXPIRES 10-01-2009 <br /> 10-01-2008/10-01-2008 <br />THE CITY Of SANTA ANA SC <br />60 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-1~0 <br />This is to certify tMt we have issued a valid Workers' Compensat;on insurance pelicy in a form approved 6y the <br />California Insurance Commtsaoner to the empbyar named below for the policy period indicaUd <br />This policy is not subject to cancellation by Na Fund except upon 30 drys advance written notice b the employer. <br />We will also give you 30 days advance notice should this polity 6e cancelled prior to its normN expiration <br />This certiticrte of insurance rs not an msurance policy and does nol amend, extantl or alter the covuage afforded <br />by the poi~cy listed herein NalwiWtanding any requtremen4 term or condi0on of any contra[ a other doeummt <br />wdh respect to which this tartdlca[e of insurance nay 6s issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the larms, exclusiotro, and conditlons, Of such policy. <br />V <br />ORIZED REPRESENfATi PRESIDENT <br />ENPLOYER~S LIABILITY LIMIT INCLUDIND DEFENSE COSTS: 11,000,000 PER OCCURRENCE. <br />ENDORSCEENT N2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2007 IS <br />ATTACNEO TO AND FORNS A PART OF THIS POLICY. <br />Z ~*Yn <br />EMPLOYER <br />ALL CITY NIWAGEMEM INC SC <br />178 5 LA CIlNEDA BLYO <br />LOS ANGELES CA 80036 <br />n <br />~~ Y <br />/ ~. <br />N0410 <br />IMEV.Y'O$1 PRINTED 09-1T-2008 <br />