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CERTHOLDER COpy s... STATE COMPENSATION INSURANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 01-01-2008 GROUP: POLICY NUMBER: 3004808-2008 CERTIFICATE 10: 156 CERTIFICATE EXPIRES: 01-01-2009 01-01-2008/01-01-2009 CITY OF RIVERSIDE BUILDING INSPECTION DEPT 3900 MAIN ST RIVERSIDE CA 92522-0002 S'" ~. . 4- "'A. t(1; ()~ I ~ () II/ '3 RISk""MANAGL~ 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. O:::-REPRESENTATI EMPLOYER'S LIABILITY LIMIT ~~ PRESIDENT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. EMPLOYER SClJ,NNEO iviAR u '? 2008 f:mance/Aisk M" .. 9nn N.B. CONSTRUCTION, INC. 4780 CHINO AVE STE 0 CHINO CA 91710 s... (REV.2-05) PRINTED M0408 02-08-2008