Laserfiche WebLink
Digitally signed by <br />Francine <br />Francine R. Villareal <br />POLICYHDLOER COPY R. VIIIareal 16:33302070055P <br />P.O. BOX 8192, PLEASANTON, CA 94588 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 07-11-2021 GROUP: <br />POLICY NUMBER: 9257170-2021 <br />CERTIFICATE ID: 1 <br />CERTIFICATE EXPIRES: 07-11-2022 <br />07-ii-2021/07-11-2022 <br />CITY OF SANTA ANA SP <br />RISK MANAGEMENT DIVISION <br />20 CIYIC CENTER PL2- <br />SANTA ANA CA 02701-4058 <br />This is to certify that we have Issued a valld 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, Land conditions, of such policy. <br />Authorized Representative President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTSt $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT N2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-11-2020 15 <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />NATI'S HOUSE (A NON PROFIT CORP) NEUTRAL SP <br />GROUND FAMILY SERIVCES <br />1733 VALENCIA ST <br />SANTA ANA CA 92706 <br />tHEV.7-20141 <br />e z lUekMxtmgenoit0ivislsn -� <br />h @ REVIEWED &APPROVIIJ BY: <br />PRINTED 0 �'. <br />'' Ritk M4nagement Malyzt <br />