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STATE COMPENSATION INSURANCE FUND CERTHOLDER COPY SP iQECEIVED P.O. BOX 420807, SAN FRANCISCO,CA 94142.-0807 Try' 01= RIVERSIDE MAR 1 6 2007 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE F<ISK MANAGEMENT ISSUE DATE: 03-13-2007 GROUP: 000044 POLICY NUMBER: 0023497-2006 CERTIFICATE ID: 9 CERTIFICATE EXPIRES: 03-01-2008 03-01-2007/03-01-2008 REDEVELOPMENT DEPARTMENT CITY OF RIVERSIDE ATTN: PAUL SUNDEEN 3900 MAIN ST RIVERSIDE CA 92522-0001 JOB:ALL CALIFORNIA OPERATIONS 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 upon30 days advance written notice to the employer. We will also give you 30 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. tt::- REPRESENT ATI EMPLOYER'S LIABILITY LIMIT ~ PRESIDENT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #1600 - RUBIN CENDEJAS PRES TREAS - EXCLUDED. ENDORSEMENT #1600 - DEBBIE CENDEJAS SECY - EXCLUDED. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03-01-2007 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. AP?ROVBO I4f$ TO FORM . e;' ~~ ~ 04!JiL7cJ.7 II: iMNAG~ EMPLOYER K-MAG CONSTRUCTION, INC 14122 CENTRAL AVE STE B CHINO CA 91710 SP PRINTED [SLC,SP] 03-13-2007 (REV.2-05)