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THE PETERSON GROUP A-2008-305-002 REVIEVVED BY: POLICYHOLDER ... EUNICE OEREDIA (PG 2 OF 9) SP <br />MENESSIMM CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE; 04-11-2015 GROUP: <br />POLICY NUMBER; 9094902-2015 <br />CERTIFICATE Q 3 <br />CERTIFICATE EXPIRE& 04-11-2016 <br />04-11-2015/04-11-2016 <br />CITY OF SANTA ANA SP <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />-This is to certifV that vve- have issued ._a valid Workers' Compensation insurance policy in a form approved by the <br />California 4nGUrance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. <br />We will also give. you 10 days advance notice show1d 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 poiicy, <br />h - <br />t��-- lezl <br />Authorized Representative President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT 41600 - PETERSON JR. , ALAN M, PRES SEC TRES - EXCLUDED, <br />EMPLr-)YER <br />THE PETERSON GROUP INC. DSA, THE PETERSON <br />GROUP, INC. <br />18851 BARDEEN AVENUE, SUITE 225 <br />IRVINE CA 92612 <br />PRINTED : 03--17-2015 <br />fIEV.7-2010 <br />