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NOV-14-2008 13:29 FIRST CLASS INS AGENCY <br />714 550 1043 P.03L_, <br />-ZO!%J-15� <br />BROI—A COPY <br />SP <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 84142-0807 <br />COMION"SATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 11-14-4008 GROUP: <br />POLICV fVUMBCii: 4917085-4009 <br />CERTIFICATE IO: 1 <br />CERTIFICATE EXPIRES: 11-01-2009 <br />11-01-4008//1-01-2009 <br />CITY OF SANTA ANA <br />PO 53X ts8b <br />SANTA ANA CA 92702'1888 <br />SP <br />This Is to certify that we have Issued a valid Workers' Compensation Insurance policy in a form approved by the <br />California Insurance Commissioner to the amPltlyer named below for the policy period indicated. <br />This policy is not subject to eaneoltation by the Fund except upon 10 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 alter the coverage afforded <br />by the Policy listed harem. Notwithstanding any refµdranwnt, term or condition of any contract or other document <br />with respect to which this eertifiosta of Inwrance may be issued Or to which It may pairtaln, the insurance <br />afforded by the policy described herein is subject IO all the <br />tt'errmss,,�exetuslons, and conditions, of such policy. <br />7THORIZEDREPRSS£NTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INOLL93INO DEFENSE COSTS: $1,000.000 PER OCCURRENCE. <br />ENOORSENENT 711800 - BADE, OTTO P,S T - EXCLUDED, <br />EMPLOYER <br />EL COYAR INC. SP <br />13881 NEWPORT Ave N 8 <br />TUSTIN CA 92780 <br />[B1X,SP1 <br />-"" '--- TOTAL P.03 <br />Fax from 1714 650 1843 11/14/08 1445 Pg: 3 <br />