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JOHNSON FRANK & ASSOCIATES 2 - 2005
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JOHNSON FRANK & ASSOCIATES 2 - 2005
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Last modified
1/3/2012 2:52:04 PM
Creation date
3/29/2005 10:01:16 AM
Metadata
Fields
Template:
Contracts
Company Name
Johnson Frank & Associates, Inc.
Contract #
A-2005-027
Agency
Public Works
Council Approval Date
2/7/2005
Insurance Exp Date
12/1/2010
Notes
Amended by A-2005-027-01, workers' comp. ins. exp. 1-01-2010
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<br />12-28-07;08:36AM; <br />;7147771641 <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 01-01-2008 GROUP: <br />POLICY NUMBER: 0803915-2008 <br />CERTIFICATE ID: 92 <br />CERTIFICATE EXPIRES: 01-01-2008 <br />01-01-2008/01-01-2008 <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 82701 <br />SG <br />74, <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 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, and conditions, of such policy. <br />THORIZEO REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILM LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT MOO - ROGER FRANK, PRES - EXCLUDED. <br />ENDORSEMENT #1600 - ALAN FRANK, S,T - EXCLUDED. <br />ENDORSEMENT,#2065 ENTITLED CERTIFICATE HOLDERS" NOTICE EFFECTIVE 01-01-2002 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> <br />EMPLOYER <br />JOHNSON-FRANK & ASSOCIATES (A CORP) AND/ SG <br />OBA:JOHNSON-FRANK & ASSOCIATES <br />5150 E HUNTER AVE <br />ANAHEIM CA 02807 <br /># 2/ 3 <br />M0410 <br />(FlEV.2-1151 PRINTED : 12-15-2007
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