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SrAMW W IaAVA <br />09�M1 M1@!f M 1 p fOi iR IR E9 <br />A Public Service Agency <br />This is to certify that: <br />CERTIFICATE OF SELF-INSURANCE <br />The Salvation Army <br />NAME OF SEI RINSURER <br />30840 Hawthorne Boulevard, Rancho Palos Verde, California 90275 <br />ADDRESS. GT ,, STATE, ZIP <br />has been approved as a Self -Insurer under the California Compulsory Financial Responsibility <br />Law and assigned Self -Insurance # 202 pursuant to Section 16053 of the California <br />Vehicle Code for the period August 19, 2021 through August 18, 2022 <br />MAN ER <br />Financial Responsibility Unit <br />Department of Motor Vehicles <br />SR 27 (REV. IQW) UH <br />_ ""per. WekMnrgetlpttDMY°n <br />-� REVIEWED&APPRovWBY: <br />�' Risk Management Analyst <br />