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A-2008-305-002 <br />CERTHOLDER COPY <br />SP <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 06-30-2014 <br />CITY OF SANTA ANA SP <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />GROUP: <br />POLICY NUMBER: S094902-2014 <br />CERTIFICATE lf) 3 <br />CERTIFICATE EXPIRES: 04-11-2015 <br />04-111-2014/04-li-205 <br />ThW is to certify that we have Issued a valid Workers' Compensatlon 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 10 days advance written notice to the employer, <br />We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration, <br />This certificate of insurance is riot an insurance policy and does not arriond, 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 4 may pertain, the insurance <br />afforded by the policy described herein is subject to all! the terms, exclusions, and conditions, of such pokey, <br />Authorized Representative President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - PETERSON JR. , ALAN M PRES SEC TRES - EXCLUDED. <br />6 <br />THE PETERSON GROUP: A�RE NT # A-2008-305-002 <br />REVIEWED BY: EUNICE HEREMA (pg. 1 of 1) <br />—05-7- <br />EMPLOYER <br />THE PETERSON GROUP INC. OISA: THE PETERSON <br />GROUP, INC. <br />18851 BARDEEN AVENUE <br />IRVINE CA 92612 <br />[VM5,CS] <br />lR Ev, 1 -20 12) PRINTED : 06-30-2014 <br />