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G 2 CONSTRUCTION INC
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Last modified
2/1/2010 3:23:36 PM
Creation date
1/29/2010 10:45:06 AM
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General
General - Type
Insurance
General 2 - Date
1/29/2010
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CERTHOLDER COPY <br />ISSUE DATE: 02-01-2010 <br />CITY OF RIVERSIDE <br />3900 MAIN ST <br />RIVERSIDE CA 92522-0002 <br />°14ECEIVED ry <br />P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />1A ,2 t 9010 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCE RISK MANAGEMENT <br />GROUP: 000238 <br />POLICY NUMBER: 0008852-2009 <br />CERTIFICATE ID: 47 <br />CERTIFICATE EXPIRES: 02-01-2011 <br />02-01-2010/02-01-2011 <br />SK <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 30 days advance written notice to the employer. <br />We will also give you 30 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 />tTHORI~ZED REPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - JOHN ALVARADO, PRES TRES - EXCLUDED. <br />ENDORSEMENT #1600 - LYDIA ALVARADO_ VP SEC - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 02-01-2009 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />G 2 CONSTRUCTION INC. SK <br />13331 GARDEN GROVE BLVD STE H <br />GARDEN GROVE CA 92843 <br />SK <br />M0408 <br />PRINTED : 01-15-2010 <br />(REV.2-05) <br />
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