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SENT BY:THE COPY CENTER <br />10-31-93 ; 1:14PM ; <br />• <br />STATE P.O.13ox 420807, SAN FRANCISCO. CA 94142-0007 <br />12094640138;# 9/ 9 <br />COM►W&wTION <br />IPA &u RA NC's <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />SEPTEMBER 29, 1993 POUCYNUMaER' 1213305-93 <br />CERTIFICATE EXPIRES: 8_01_94 <br />r OMNI ENVIRONMENTAL <br />40 NINTH STREET. <br />CAYDCUS, CA 93430 <br />ATTN, STEVE MUEi.'LER <br />L <br />This is to certify that we have issued is valid Workers' Compensation insurance policy in a form approved by the California <br />insurance Oommissioner to the employer named below for the policy period indicated. <br />This poticy is not subieci to cancellation by the Fund except upon ten days' advance written notice to the employer. <br />We will also give you TEN 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 nr alter the coverage afforded by the <br />policies listed twain. Notwithstanding any requitement. term, or condition of any contract or other documertt with <br />respect to which this certificate of insurance may be issued or may pertain. the insurance afforded by the policies <br />described herein is subject to all the terms, exclusions and conditions of such politics. <br />r <br />levoiWrT <br />PltES10E1VT <br />1 <br />EMPLOYER <br />r TATYANA L. BUSH <br />DBA: T.L. BUSH <br />P.O. B OX 4184 <br />HAYWARD, CA 94540 <br />