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CERTHOLDER COPY ISSUE DATE: 01-01-2010 THE CITY OF RIVERSIDE 8095 LINCOLN AVE RIVERSIDE CA 92504 P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE RECEIVED CITY OF RIVERSIDE JAN 2 0 2010 SK RISK MANAGEMENT GROUP: 000238 POLICY NUMBER: 0013364-2009 CERTIFICATE ID: 8 CERTIFICATE EXPIRES: 01-01-2011 01-01-2010/01-01-2011 JOB:CANYON FIRESTATION #9 REMODEL 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 policv 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. tTHORIZED REPRESENTATI PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. EMPLOYER C A CONSTRUCTION 981 IOWA AVE STE A RIVERSIDE CA 92507 SK PRINTED : 01-13-2010 SK M0408 (REV.2-05)