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<br />'-' <br /> <br />....." <br /> <br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />P.O. BOX 420807, SAN FRANCISCO, CA 94142.Q807 <br /> <br />CERTIFICATE OF <br /> <br /> <br />OCTOBER 1 2001 <br /> <br />- 01 <br /> <br />r- <br />CITY OF SANTA <br />ATTi~ LYDIA <br />P 0 HUX 198B <br />EAI,T A AW, C,; <br /> <br />L <br /> <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the Caiifornia <br />'Tiisurance Comrllissionerto the erllp10yer nametlbelow1or1ne-poIIc;rperloulr,uiGalea':- <br />30 <br />This policy is not subject to cancellation by the Fund except upon l!l(1 days' advance written notice to the employer. <br />30 <br />We will also give you l~N days' advance notice should this policy be cancelled prior to its normal expiration. <br /> <br />This certificate of insurance is not an insurance <br />policies listed herein. any <br />respect to which this certificate <br />described herein issqbj~ to all <br /> <br /> <br />and does not amend, extend or alter the coverage afforded by the <br />or condition any contract or other document with <br />insurancl! affordeq"by the policies <br /> <br />~""--"L..- <br />AUTHORIZED <br /> <br /> <br />K~ <br /> <br /> <br /> <br />PRESIDENT <br /> <br />EMF'LOYER'S U <br /> <br /> <br />,OO() PER OCCUHRHICf. <br /> <br />HmORSEMENT 112065 ENTITL.ED CERTIFICATE HOLDERS' NOTICE EFFECTIVE <br />10/01/01 IS ATTACHED TO AND FORMS A PART OF THIS POL.ICY. <br /> <br />EMPLOYER <br /> <br /> <br />r- <br /> <br />SHEPPARD CONSTRUCTION INC <br />2681 DOW AVE STT B <br />Tl~TIN CA 92780 <br /> <br />THIS DOCUMENT HAS A BL.UE PATTERNED BACKGROUND SOIF 10262 'REV 3 9S} <br /> <br />.~'" <br />