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· May-15-02 04=28P__ <br /> <br />STATE <br /> <br />COMPENSATION <br /> <br />FUND <br /> <br />IS,.ed.,IE DATE: <br /> <br />P,O. BOx 807, SAN FRANCISCO, CA 94101-0~07 <br /> <br /> CERTIFICATE OF .'WORKERS' COMPENSATION INSURANCE <br /> <br /> POLICY NUMBER: 11158~15 - 02 <br />0B-01-O2 CERTIFICATE EXPIRES: 05-Ot-O3 <br /> <br />THE CITY OF SANTA ANA <br />ATTN, KATIE MONTGOMERY <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 <br /> <br />SP <br /> <br />This is tO certify thst we have issued a valid Workers' C[xmpensation insurance policy t~ s form aDProved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br /> <br />This policy is not subject to car~celJation by the Fund except upon 3Od&¥$' advance written n=tice to the employer. <br /> <br />We will also give you 'JO days' advance notice should tl~s Policy be cancelled prior to its normal exp~ratior~, <br /> <br />This certifieat, e Of insurance is not an insurance policy and does not amend, extend or alter Lhe coverage afforded <br />by the pali¢ies lis(~d herein. Notwithsta~l~ng any requirement, term. or condition of any contrac[ or other document <br />with respect to which this ceYtificete of~: i~urance maY be issued or may pertain, the insurance affor¢led by the' <br />policies de, scribed herein ~S subject to all ,1~e [arms, exclt.,',ions and cOnditior~ of such policies. <br /> ~ID~NT <br /> <br />ENPLDY£R'$. LZABZL~TY LZ#ZT ZlCLUOZNG DEFENSE COSTS: $1,000.000,00 PIER.'OCCURR~NCE. <br />'.EI~ORSEMEN~. ~MSS ~rTXTLED CEI~rZF~CATE HOLDERS' NOTICE EFFECTIVE' OS/Ol~/02 IS A?lrACHED TO AND <br /> rOW A PART OF'THXS POLICY- .. <br /> <br />EMPLOYER <br /> <br />T~E',R~¥NOLDS CROUP <br />250 £L CASINO R.EAL:.$TE 20~' <br />TUSTIN CA 92780 <br /> <br />THE I~YNOLDS ~UP (A CDRP. ) <br /> <br />04-17-O'2 P0410 <br /> <br /> <br />