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' 06/29/2006 14:22 714-567-7474 QC HUMAN RELATIONS <br />CERTHOLOER cOav <br />$-TATE P.O. BOX 420807, SAIV FRAIVcISCO.CA 9414?,-0807 <br />COMPENSATION <br />INSUNANC6 . <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />xssuc OATC: aa-za-SD08 ~ GROUP. <br />POLICY NUAABER 1375278-2009 <br />CCitTIF.IGATE IR 27 <br />CERTIFICATE EXPIRES: to-01-2008 <br />10-07-2006/i0-O t'-2008 <br />CITY OF SMfIA ANA <br />20 CIVIC CENTER PLZ M-26 <br />SANTA ANA CA 92701-4099 <br />SP J06:BRIDGES PROGRAM <br />Thk is to certify that we have le:wed a valid Workers' CpmpMSation Msurance policy in s fpm approved by the <br />Galifwnia Insurance Commissioner to the employes named below for the policy period irldicaterL <br />This p011cy Is not wbjact to cartCeilation by the Fund except upon 10 days advance written notice to the employer <br />Wa will also gNa yp, tOdays achrsnce notice should this policy be cancelled prior to. its normal expiration. <br />This certificate Of irmuranea Is nct an insuratrco policy and does net aittend, axtervi a alter the coverage afforded <br />by the policy listed hsreln, Notwithstandnp any nqulremartt, term m condition of amr contract or other document <br />wkh respect to which this certificate of ktsuranes may be i99ued Or t0 which k may pertain, the insurance <br />afforded by the policy described herein Is sub)ect to all tho term9, exclusions, and conditlorta, of such policy. <br />FOXED REPRENG~) ~ I~L~JC^' `~' <br />ERPLOYRR'8 LIAGILITY UNIT INCLUDING DEFENSE COSTS: <br />EMPLOYER <br />ORAN[0: COIiMTY FNNAN RELATIONS COl1NCIl (A 6B <br />NON-PROFIT CORPORATial) C/O COUNCIL <br />1300 S 6YtAND AVE STE B <br />SANTA ANA CA a2706 <br />f 7,000,000 PER OCCURRENCE. <br />F'AGE 02 <br />~;ty ..- or::ec <br />SP <br />ILYF,CNJ <br />IRav.x•osl PRINTED OB-28-2006 <br />