Laserfiche WebLink
iipr'*07 08 04:19p <br />ISTATE <br />COMPENSATION <br />INSURANCE <br />WISEPlace <br />17145423653 <br />POLICYHOLDER COPY <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />r�U N ILMF CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 08-15-2007 GROUP: 000488 <br />POLICY NUMBER: 0000678-2007 <br />CERTIFICATE 10: 1 <br />CERTIFICATE EXPIRES: 08-15-2008 <br />08-13-2007/08-15-2008 <br />CITY OF SANTA ANA <br />MOUSING DEPARTMENT - 1426 <br />20 CIVIC CENTER PLAZA <br />SANTA ANA CA 92702 <br />SP <br />This is to cortify 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 th@-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 advanco notice should this policy be cancelled prior to its normal expiration <br />This Certificate of insurance Is not an insurance policy and does not amond, 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 insurancs <br />afforded by tho policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />tORIZE0 REPRESENTATI • (� PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />EMPLOYER <br />WISEPLACE. A CA CORP <br />1411 N BROADWAY <br />SANTA INA CA 82706 <br />SP <br />P-2 <br />W409 <br />tAEv.2-05) PRINTED : 07-17-2007 <br />SP <br />