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C HOLDER COPY <br />SG <br />STATE P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 10-01-2004 GROUP: <br />POLICY NUMBER: 1462781-2004 <br />CERTIFICATE ID: 3 <br />CERTIFICATE EXPIRES: 10-01-2005 <br />10-01-2004/10-01-2005 <br />CITY OF SANTA ANA SG <br />COMMUNITY DEVELOPMENT AGENCY <br />P 0 BOX 1988 M-25 <br />SANTA ANA CA 92702 <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 30days' 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 notan insurance policy and does not amend, extend or alter the coverage afforded <br />by the policies 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 may pertain, the insurance afforded by the <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br />AUTHORIZED REPRESENTATIVE <br />PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1-,,000,000.00 PER OCCURRENCE. <br />ENDORSEMENT #206S ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2004 IS ATTACHED TO AND <br />FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />WOMEN HELPING WOMEN <br />711 W 17TH ST STE AID <br />COSTA MESA CA 92627 <br />LEGAL NAME <br />WOMEN. HELPING WOMEN <br />(A NON-PROFIT PUBLIC BENEFIT CORP.) <br />.00: <br />THIS DOCUMENT HAS A 917UE PATTERNED BACKGROUND PRINTED: SCF 102C_ <br />