Laserfiche WebLink
<br />CERTHOLDER COPY SC <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />I N S U R A N C E <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 01-01-2009 GROUP: <br />POLICY NUMBER: 1696984-2009 <br />CERTIFICATE ID: 36 <br />CERTIFICATE EXPIRES: 01-01-2010 <br />01-01-2009/01-01-2010 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLZ M-26 <br />SANTA ANA CA 92701-4058 <br />SC <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 employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 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 herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />~~7~ <br />THORIZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 51,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - STEVEN DENZLER, PRES,SEC,TRE - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2004 IS <br />~~ ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />®~ <br />d <br />~F <br />EMPLOYER <br />LEAD TECH ENVIRONMENTAL <br />605 S PACIFIC AVE STE 202 <br />SAN PEDRO CA 90731 <br />I (REV.2-05) <br />5~~~~ 0~~2`~ <br />P$~`S~a <br />SC <br />SANTA; ~~~~ I~rl ' ~,=3 <br />NEIGHBOI3H0C?P f)-.; ° ~)P#~EN7 <br />DEC 2 ~, zao~ <br />~~c~iw~E <br />M0408 <br />PRINTED 12-20-2008 <br />