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~~~/ <br />POtICI-I•gLDER COPY SQ <br />S'TAT~ P.p. BOX 420807, SAN FRANCISCO,CA 94142-pa07 <br />COMPEPlSATYON <br />IN5U144NCE <br />~~ N D c>EAr~FIGATE of WORK1tR5' COMPEStiISATION INSt~iANCE <br />ISSUE DATE: Ot-01-2009 GROiJP: <br />POLICY NUIiABEFb 1675325-2001! <br />CERTIFICATE 10: t t <br />CERTIFICATE tJfPIRES: 07-01-20t0 <br />04 -Ot -200!1/01-Ot -2010 <br />CITY OF SAfiTA M!A 56 <br />Q4DG INSPECTION DEPT <br />40 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />This is to certity that. we. have issued a vai}d Workers' Gompenaatian insuritCe policy in s farm approved by the <br />California Insurance Come-+StiOner to the err:ployer tamed beltmr fur the policy period indicated, <br />This policy is nos subject tb Cancellation by tho Furid exceisf open ~ days advance written notice to the entpbYer. <br />We will also give you ~ days advance notice should this policy be cancelled ixior to its nomwl e~p}ratipn. <br />This certificate of insurance is not an Insurance policy end dues rrot a-nettd, extend or alter the cpversge afiordrd <br />by the policy listed tlereHl. Notwithstanding any requirement terfi Or condition o} xry CCnMact Or other dacur*tent <br />with respect to which this certificate pi insurance may be issued or to which it may pertain. the insuanee <br />afforded by the pol~cY described here}n is subject to all the terms, exclusions, and conditions, of wch policy. <br />c y <br />4RIIfD REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABIRITY LIMIT INCLUDING DEFEALSE CASTS: 51,000,000 PER OOGURRENCE. <br />£la01tSEMEPiT /h 600 -DONALD RHDDES, PRESIDENT -EXCLUDED. <br />ENDORSEMENT X 1600 - .1UL I E RFADES , V . P . - EXCWDED <br />ENDORSEMENT ~Y2065 ENTITLED CERTIFICATE FIDLEIERS' NQTICE EFFECTIVE 01-01-4008 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />_ C " <br />~~ <br />i ~ ~ `' ~/ <br />1:MPL0~'ER <br /> <br />I HATER INC. SG <br />18 WDODYEAR STt: 100 <br />IRVINE CA 92818 <br />IRFV.4-05~ <br />Z001Z00 d SBb4tt <br />PRINTED 12-~O-Z008 <br />LS bl 600ZIS0/l0 <br />