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<br />. <br /> <br />'-" <br /> <br />o <br /> <br />STAT,S P.o.. So.X 420807, SAN FRANCISCO., CA94142:0eb7 <br />COMPENSATION <br />INSURANCE <br />FUN D CERTIFICATE O~ WORKERS'COMPENSATION INSURANCE <br /> <br />,1UL Y 8, 2002 <br /> <br />POLICY NUMBER, <br />CERTIFICATE EXPIRES, <br /> <br />1638989 - 02 <br />7-1-03 <br /> <br />,- <br />CITY Of SANTA ANA <br />ATTN COMMUNIfy'DEVELOPMENT AGENCY M-25 <br />POBOX 1988 <br />SANTA ANA CA 92702 <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 California <br />Insurance Commissioner to the employer named below for the policy period..indicated. <br /> <br />This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. <br /> <br />We will also give you TEt'idayt' advanc? notice should this policy be cancelled prior to its normal expiration. <br /> <br />This certific?te otinsuranc8,is not-an insutance policy and does not amend, e:xtend or 'alter thecoverage afforded by the <br />policies li~ted herein. NotV"it~~t~nding any Iequir~llJt?nht~rm, or condition of ,Bny contract or other document,wittl <br />respect to,-,whiCh,:this certificate of insur~nce m&y be,iss'~ed or may pertain",:th~- insurance afforded bydhe poliCIes <br />described herein IS subject to all the terms; exclusions and cO[ldltions of suchpqllcies. <br /> <br />;7~~~ <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />I{~ <br /> <br />PRESIDENT <br /> <br />EMPLOYER'S LIABILITY tIMIT INCLUDING DEFENS~ Gn~TS: $1,000,000 PER00CCURRENCE. <br /> <br />EMPLOYER <br /> <br />I <br /> <br />FEEDBAtKFOUI\1PAtl0N INC <br />i~oo N KNOLLWOOD ClRCLE <br />ANAHEIM CA 92801 <br /> <br />ll~ln <br /> <br />