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POLICYHOLDER COPY SG <br />qI?- -ZED 5.0?3 `7 <br />COMPENSATION STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 ry - ?? 7 / <br />INSURANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE / T <br />ISSUE DATE: 01-01-2009 GROUP: 000092 <br />POLICY NUMBER: 0000678-2008 <br />CERTIFICATE ID: 16 <br />CERTIFICATE EXPIRES: 01-01-2010 <br />01-01-2009/01-01-2010 <br />CITY OF SANTA ANA SG <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92701 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />tTHORWIZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE <br />ENDORSEMENT #1600 - ROGER FRANK, PRES - EXCLUDED. <br />ENDORSEMENT #1600 - ALAN FRANK, S,T - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 01-01-2008 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />JOHNSON-FRANK & ASSOCIATES (A CORP) AND/ SG <br />OBA:JOHNSON-FRANC & ASSOCIATES <br />5150 E HUNTER AVE <br />ANAHEIM CA 92807 <br />M0410 <br />IREV.2-05i PRINTED : 12-20-2008