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<br />,ERTHQCbER COpy
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<br />F U ~ Ç) CERTIFìcA TE 'ÒF ,:WO~KERS'"COMPENSA TIÒN\í~URANCE
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<br />C t;rÝ OF SANTA ANA
<br />ATTN"ILIDNA DE, ROSA CONTRACT SPEC!
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<br />SANTA ANA CA '2702 ¡, ,.:
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<br />POLICY NUMBER: 12S6302-2D03
<br />CERTIFICATE 10: .' 43
<br />CERTIFICÂTE,éxPIRES: 04-01-2004
<br />04-01-2D03/04-01-2004
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<br />ISSUE DATE:
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<br />04-01-2003
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<br />This is to certify that we have issued a valid Workers'Compensatlon insurance pOlicy in a form approved by the
<br />C.lifornia Insurance Commissioner 10 tho emplo,e; named balow for ~~a policy period indicatod.
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<br />This policy is not $ubjocI 10 cancellation bylho Fund except upon 30 clays' adv_nce _illon notice 10 tho, employer,
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<br />We w;;1 01$0 give you :30 .daYS"a¡j~_n;ce notice should ,this policy be cancelled pri,or to:u~,normalé~Plralion.
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<br />Th;S cartlirc-ta oì"ì~$l"¡"a i$ no; a.~ ins~f.nca policy and does nole~;n( .eXI¡~,¡i or_iter the¿ovéra¡¡'è_fforded
<br />by the p'oliòiosAiståd he""ih. NOf,^,il~st_n'din~ _ny requirement.tarm. or c9ndi,tior o{,any'.:onlract:'QrotlÌar âocumarrt
<br />with res¡;ect,lo Which this' certificate of insurance may"ba"issued or may,pèr\aín./lhelnsútanco,'affordod by the ""..T' ,
<br />policies d~crib~èI herein i$ subjact to al< the terms,".xc¡~sl~ns and condition. ,of such pÔlicies./' ,; r:""
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<br />AUTHORIZi¡Ó'REPRESENTATIVE PRESIDENT':;.."';', ..
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<br />\"', EMP~OYÉ~'S;,LIABILh~ LiMiT INCLUDING[)EFENSE:èO~.T~,: ,~;L"'ô'c)\to,',',9?;OO":,,,,, p'~~¡ioC",,~R, RENe,' .E. ,'.
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<br />\ 'fNDDRSEMENT"N206SENTITLED CERnFI~~TEHDLDERS' ~?T~;CE;,'EFFEcnVE'04~O1"2~0~, IS¡AIT~~~~"i:O~D '
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<br />ßQUTHLAND ,CÞ,R ÇO,UNTERS
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<br />\;,;:,t"i City Attorney
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<br />EMPLOYER
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<br />COMMUNICATIONSI!-, Dþ.TA INC
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<br />PRINTED:"03:i7-2qè)3 PD40B
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