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CERTHOLDER COPY <br />NF <br />STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br />COMPENSATION <br />I N S U R A N CE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />ISSUE DATE: 10-01-2009 GROUP: 000592 <br />POLICY NUMBER: 0003128-2009 <br />CERTIFICATE ID: 22 <br />CERTIFICATE EXPIRES: 10-01-2010 <br />10-01-2009/10-01-2010 <br />INTERNAL USE ONLY NF <br />3181 LUYUNG DR <br />RANCHO CORDOVA CA 95742-6899 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />�THORIZEDREPRESENTATI PRESIDENT <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #1600 - SEAN M. MURPHY, PRES,SEC,TRES - EXCLUDED. <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2009 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />EMPLOYER <br />TOWN & COUNTRY CONTRACTORS INC NF <br />3181 LUYUNG DR STE A <br />RANCHO CORDOVA CA 95742 <br />[816,NF] <br />tREV.2-05i PRINTED : 02-18-2010 <br />