Laserfiche WebLink
POLICYNOLDEP COPY <br />P.O. SOX B192, PLEASANTON, OA 94588 <br />CER' WICATE OR WORKERS' COMPENSATION lNSURANCE <br />ISSUE DATE: 07-01-2014 <br />SANTA ANA POLICE DEPARTMENT <br />FISCAL DEPARTMENT DIVISION M-97 <br />60 CIVIC CENTER PLL <br />SANTA ANA CA 92701-4050 <br />Rs <br />GROUP: <br />POLICY NUMBER: 0017552-2014 <br />CERTIFICATE ID: 5 <br />CER'T'IFICATE EXPIRE <br />• 07-01-2016 <br />07-01-204/07-01-2015 <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.,z,0 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 <br />/described herein is subject to all the terms,/exclusions, and conditions, of such policy. <br />Authorized Representative President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDINQ DEFENSE COSTS: $4,000,000 PER OCCURRENCE. <br />ENDORSEMENT X2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2012 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />ADLERHORST INTERNATIONAL <br />POLICE K-9 KENNEL <br />3951 VERNON AVE <br />RIVERSIDE CA 92509 <br />A ROVED AS TO FORM <br />Laura A. Rossini <br />istant City Attorney <br />INC, DEA: ADLERHORST <br />PRINTED : 06-17-2014 <br />(RE V:1-2012) e - e <br />SK <br />