FAIR HOUSING COUNCIL OF ORANGE COUNTY 2006-07

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STATE COMPENSATION INSURANCE FUND . CERTHOLDEWPY P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 05-30-2006 GROUP: POLICY NUMBER: 0355209-2006 CERTIFICATE ID: 117 CERTIFICATE EXPIRES: 05-30-2007 05-30-2006/05-30-2007 CITY DF SANTA ANA ATTN CARLA THOMPKINS PO BOX 19B8 M-25 SANTA ANA CA 92702 SP This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions. of such policy. 6::-REPRESENTATI EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: ~ PRESIDENT $1,000,000 PER DCCURRENCE, ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 05-30-1990 IS ATTACHED TO AND FORMS A PART OF THIS POLICY, EMPLOYER \/LU AS TO FORM -~ ;h~/ c:Jty Attorney ORANGE COUNTY FAIR HOUSING COUNCIL (A SP NON-PROFIT CORP,) 201 S BROADWAY SANTA ANA CA 92701 (REV.2-05) e,,t . PRINTED 04-18-2006 SP M0408