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POLICYHOLDER COPY SK <br />P.O. BOX 8192, PLEASANTON, CA 94588 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 07-01-2016 <br />SANTA ANA POLICE DEPARTMENT SK <br />FISCAL DEPARTMENT DIVISION M-97 <br />60 CIVIC CENTER PU <br />SANTA ANA CA 92701-4060 <br />GROUP <br />POLICY NUMBER: 9017352-2016 <br />CERTIFICATE ID: 5 <br />CERTIFICATE EXPIRES: 07-01-2017 <br />07-01-2019/07-01-2017 <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 80 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 polli�c��cyy 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 INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-2012 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />ADLERHORST INTERNATIONAL, INC. DBA: ADLERHORST <br />POLICE K-9 KENNEL <br />3951 VERNON AVE <br />RIVERSIDE CA 92509 <br />M0410 <br />(REV.7.20141 PRINTED : 06-18-2016 <br />