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HISPANIC BUSINESS CONSULTANTS (3)-2010
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HISPANIC BUSINESS CONSULTANTS (3)-2010
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Entry Properties
Last modified
1/3/2012 2:56:12 PM
Creation date
9/23/2010 10:24:42 AM
Metadata
Fields
Template:
Contracts
Company Name
HISPANIC BUSINESS CONSULTANTS
Contract #
A-2010-115
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
7/6/2010
Expiration Date
1/31/2011
Insurance Exp Date
1/3/2011
Destruction Year
2016
Notes
A-2010-025;01
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r - <br />POLICYHOLDER COPY <br />P.O. BOX 424807, SAN FRANCISCO,CA 94142-0807 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 02-01-2010 <br />GROUP: <br />POLICY NUMBER: 1679144-2010 <br />CERTIFICATE ID: 1 <br />CERTIFICATE EXPIRES: 02-01-2011 <br />02-01-2010/02-01-2011 <br />THE CITY OF SANTA ANA, ITS OFFICERS, SP <br />EMPLOYEES AND AGENTS <br />P.O. BOX 1988 <br />SANTA ANA CA 92702 <br /> <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 />UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: <br />THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER; <br />EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING <br />CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS' <br />COMPENSATION LAW. <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />'to <br />9 <br />00 <br />RG? <br />ey <br />J o <br />EMPLOYER ' <br />HISPANIC BUSINESS CONSULTANTS SP <br />2510 N GRAND AVE STE 101 <br />SANTA ANA CA 92705 <br />SP <br />M0409 <br />MEV.2-053 PRINTED : 01-15-2010
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