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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />WC 04 00 03 (Ed 7-98) <br />EXTENSION OF INFORMATION PAGE <br />Schedule of Locations <br />ITEM 1 <br />Policy No. MW00017162-01 <br />Location FEIN SIC ENTITY <br />PHONE <br />CODE TypE <br />1 1607 N Sycamore St <br />Santa Ana, CA 92701-2352 952748200 714-836-1211 7389 Nonprofit <br />©1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. <br />From the WCIRB's California Workers' Compensation Insurance Forms Manual ©2001.3 of 28 <br />