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Service Center <br />PO 13OX 33015 <br />SAN ANTONIO TX 78265 <br />(866) 467-8730 <br />Fax: (877) 905-0457 <br />001799 <br />City of Santa Ana <br />Parks, Recreation, & Community Services <br />P•a. Box 1988 M-23 <br />Santa Ana, CA 92702 <br />Insured Name: MATTHEW WESTFALL <br />Policy Number: 658BMNW4998 <br />Effective Date: 06/01/09 <br />Expiration Date: 06/01/10 <br />To whom it may concern: <br />�/- 02 004-QS3 <br />THE19f <br />HARTFORD <br />09/07/09 <br />Our records indicate that a certificate of Insurance was issued, providing proof of insurance, <br />on behalf of the above named insured. <br />This is to inform you that effective 08/29/09, all coverage shown on the certificate for the <br />above policy number is cancelled. <br />Should you have any questions, please do not hesitate to contact our office <br />Sincerely, <br />Your Customer Service Team <br />at The Hartford <br />