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CERTHOLOER COPY SK STATE COMPENSATION INSUR.ANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 ':-<\:..,~>:iv'ED j Y <"W: ",-:iVEF?SIOE iAN OJ 20GB ISSUE OATE: 01-01-2006 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GROUP: 000229 ,"iSK Ml',NAGEMENT POLICY NUMBER: 0022928-2006 CERTIFICATE 10: 20 CERTiFICATE EXPIRES: 01-01-2007 01-01-2006/01-01-2007 CITY OF RIVERSIOE 3900 MAIN STREET RIVERSIOE CA 92502 SK This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions. and conditions, of such policy. ~ ~~ c!. &L- AUTHORIZED REPRESENT A TIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUOING OEFENSE COSTS: $1,000,000 PER OCCURRENCE. "'P--~' ._.~ . ~ _..~, ,-,.,~," r\ r\-..;.lF~' ~~ 1'\':;; . U r'ur'",jVl f~.~blltHL()6 C'--" .",' .['....".' i....~.i. i,:t-\N. ''-'~'' EMPLOYER F R CONSTRUCTION 2410 RAINBOW GLEN RO FALLBROOK CA 92028 SK M0408 PRINTEO 12-17-2005 iREV.2-05)