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Dec 22 09 02:29F Animal Control 714 2456550 P•2 <br />POLICYHOLDER COPY <br />STATE P,O- 90X 420607, SAN FRANCISCO,CA 94142 -0807 <br />INSURANICE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />GROUP: <br />ISSUE ^DATES 07-01 -2008 POLICY NUMi 00355891 -2008 <br />CERTIFICATE 16: <br />LERTIF1C 7 - 19 0� U1 <br />000-.0 py0 2010 <br />SAM }� ANA POLICE DEPARTMENT <br />SK <br />FISCAL DEPARTMENT DIVISION 14-97 <br />eo CIVIC CENTER PLI <br />SANTA ANA CA 02701-4080 <br />in a form approved by the <br />indicated. <br />This �a to eertifY thn we have issued a valid Workers' Compensation Insurance policy <br />CalifOrma Insurance Commissioner to the employer named below for the policy period <br />This policy is net sub last to cancellation by the Fund except upon 30 days advance written notice t0 the employer. <br />We will else 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 doss not amend. extend or alter the coverage afforded <br />wish respect ee which this certifieats of insurance may be issued or to which it may pertain, the Insurance <br />by the policy Ilsied heroin. Notwithsisnali q any requirement, term er condition of any contract or other document <br />with Watl by the policy ch his t bed her ain. is subject 10 all the [arms. exclusions, end conditions, Ot such polity <br />PRESIDENT <br />T TNDRIZED AEPRESENTATI <br />EsIPLOr ER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />EO FORMS CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07 -01 -1989 IS <br />ATTACHED TO AN <br />r <br />i <br />EMPLOYER <br />ADLERNORST INTERNATIONAL, INC. Dl ADLERNDRST <br />POLICE K -9 KENNEL <br />3951 VERNON AVE <br />RIVERSIDE CA 92609 <br />L <br />[RRC,CNI <br />SK <br />