Laserfiche WebLink
CERTHOLDER CV-- <br />SP <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 08-15-2010 <br />CITY OF SANTA ANA COMMUNITY SP <br />DEVELOPMENT AGENCY M-25 <br />P.O. BOX 1988 <br />SANTA ANA, CA 92702-1988 <br />GROUP: 000488 <br />POLICY NUMBER: 0000679-2010 <br />CERTIFICATE ID: 2 <br />CERTIFICATE EXPIRES: 08-15-201 1 <br />08-15-2010/08-15-2011 <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 />tr,.ed Representative Interim President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-15-2005 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />WISEPLACE, A CA CORP SP <br />1411 N BROADWAY <br />SANTA ANA CA 92706 <br />M0408 <br />PRINTED : 07-16-2010 <br />(REV.1-201W <br />