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<br /> <br />SP <br /> <br />STATE <br />COMPE;Nl;iAT!O,", <br />INS U R A KC E <br />FUND <br /> <br />'/ <br />P.O. BOX 8P?; SAN FRANCISto,CA 9410 1 ~0807 <br /> <br />rvR. ") '") <br />(."" <br /> <br />CERTIFICATE OFWOR~t:RS'CO"'PENSATldN\INSURANCE <br /> <br /> <br />-':'3/;;& Jo)- <br />ft~S <br /> <br />ISSUE DATE: 04-01-02 <br /> <br />CHY OF SANTA MIA <br />HOUSING OepT ATTN <br />POBOX 198B - ~26 <br />SANTA ANA.tA 92702 <br /> <br />SALOl liAR <br /> <br />.loBe: ENVIRONlolE/llTAL SVCS <br />PRO'" '1218-1 <br /> <br />This is tO,certifY that we have issued a validLWQrkers' Compe.ns.ii*ioninsurttnCf3 policy in' a,formfpproved by the <br />California Insurance Commissioner to the emploVE!lr"named below .for- the policy _.period indicated. <br /> <br />This policy is not subject tocanc,~I_latioh'by i~~-~nd ~:l;Ccept l,Ipon30,days' ~varice<written notic'e- to the employer. <br /> <br />'^ '. " <br />We will also give you ,,30:~if"adv.nce notice~hOuld this ,policy be c~ncelled .prior tPJtsnorntal-~'xpir~tion. <br /> <br />This certif'icateof _ihsJr~ric;~ ,isnof ~_-inS~aneepolicyal)d. does nolarn~nd. ext~;nq,:'oralte~the '~ov~rag/;"_.dforded <br />by the po:lici,es"Ii~ted her~ill.~'No,twithst~ing'anY-',-r,6!Qyiren'lent. term; or ,co[lditiop of....anv contr~t.'Qr.'oth"~ dpCUn'lli!Jnt <br />with resp$:ct-to which this cettlficateofii in$uran<=trM~'f'fje.j~sut:td _or may:pe~I\'Jhelnsur'nee:afford$d::bY:' the.,: " <br />policies de~cribed herein is subject 19 ~I the teim~"MCI~SiTs and,COndlllonsOl;policie:z. ~ <br /> <br /> <br /> <br /> <br />~~IDENT . " , <br />EMPLOYER'S; LIABIL~TY LIMIT INCLUOI~ DEFENSIiCt\STl>: $1.0001.060,00 P$R -PC9U~ENCE. <br />ENoOtlSEME,q#2OBS. E'""1'tL~PC~9n"ICAT$tf>L~.9S''';TIC.' EFFE&rtVE.04JO';;02 I~ AtTACHEO TO A"'D <br />EORNS A PART OF"1'HlS POLlCY. ' ., <br /> <br /> <br />,. ,~,",V <br /> <br /> <br />i\PPRQ:YEP ~S TO FORM <br />~. ...-. .......~.'..;.".'..-.iJ.......pr#7 <br />; ...... .... 1.1- ........ . ....,' ." <br />J'; ura SheedY . . .., '. ..... ..' <br />- Dep\\lY City Attorney. .. '.. <br /> <br />EMPLOYER <br /> <br />LEGAL NAME <br /> <br />DC ENVIRQNMENTA1.. INC. <br />1230 N ~EFFERSON ST S1'. <br />ANAHEIM CA 92807 <br /> <br />GC E"lVIRONMEtlTAL. INC. <br /> <br />03-16-02 <br /> <br />P0408 <br /> <br />THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIf--lO?6::> (REV 201) <br /> <br />PRINTED: <br />