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ST' T E P.O. BOX 420807. SAN FRANCISCO. <br /> CA <br /> 94142-0807 <br />COMPENSATION <br />INSURANCE <br /> <br />I=U N 13 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> <br />NOVEMBER 5, 2002 POLICY NUMBER: 046-02 UNi'? 0002?47 <br /> CERTIFICATE EXPIRES: ~ -' <br /> <br />CiTY OF RIVERSIDE <br />ATTN EWINA LAU PARK & RECREATION <br />3900 ~IAIN ST <br />R i V E R !.:., I "-,') E CA 92522 <br /> <br />Th s is to certify treat we have issued a vano Workers' Comoensahon insurance policy in a form approved Dy the California <br />Insurance Commissioner to the employer named below for the po,cy Derioc ndlcazed. <br /> 30 <br />This Dohcy ~S not subject to cancellation Dy the Fund exceo[ upon t~f days advance written nooce [o [ne employer. <br /> <br /> 3 o <br />We wm also g ye you ~ da~' advance no~ce should th~s pouc~ De cancelled orlor to ts normal exc raBon. <br /> <br />This certificate of insurance is not ~n insurance pohcy and odes Rot amen~ extend or alter the coverage afforded by the <br />DOhCleS hsted herein. Notwithstanding any requirement, term. or concision of any contract or other document with <br />resoec~ to whi6h tn~s ceruficete of insurance may be issueo or may certain, the insurance afforded by the policies <br />described hereto IS SUOjeC~ to 81 t~e terms, exclusions and conditions of such <br /> <br />AUTH (.'~RIZED BEPR ESENTATIVE <br /> <br />:.M, L_,,LR =, LtABzLI ¥ LIMIT INCLUDING DEFENSE COSTS: $1,.'JOO,uOo PER OCCURRENCE- <br /> <br />ENDORSEMENT i~2065 ENTITLED uERTtF~..A,E HOLDERS'NOTICE EFFECTIVE <br />01/01/02 IS A,~A~H,:-D TO AND FORMS A PART OF TH,_~, RRLICY <br /> <br />APPROVED AS TO FORM <br /> <br /> EMPLOYER <br /> <br />DALKE & SOf-~ CONSTRUCTION INC <br />DBA C D CONSTRtJCTION <br />4585 ALLSTATE DR <br />RIVERSI;QE CA 92501 <br /> <br /> <br />