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t~ <br />1 <br />POLICYHOLDER COPY <br />SG <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />IN S U R A N C E <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 04-02-2008 GROUP: <br />~ ((~~(~~( I POLICY NUMBER: 1868433-2008 <br />`r-lJ~/~^ 1 3~- CERTIFICATE EXPIRES: 03-06-2009 <br />03-OB-2008/03-06-2009 <br />CITY OF SANTA ANA SG <br />DEPT OF PUBLIC WORKS <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <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 10 days advance written notice to the employer. <br />We will also give you 10 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 />THORIZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - ANTOINETTE ANDREWS PRES - EXCLUDED. <br />~~~~~ <br />EMPLOYER / <br />CORPORATE TRANSLATIONS INC SG <br />1300 AVIATION BLVD <br />REDONDO BEACH CA 90278 <br />(REV.2-05) <br />PRINTED 04-02-2008 <br />[CMW,CN] <br />