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FROM` OGISO 5104515771 05-10-98 03:07PM TO 19163545633 x182 P.4/5 <br /> FO1 <br /> STATE P.O. BOX 420807.SAN FRANCISCO,CA 94142-0807 <br /> C09APGN6ATioN <br /> IN$UMA"Cre <br /> FUND CERTIFICATE OF WORKERS!COMPENSATION INSURANCE <br /> APRIL 3, 1998 1341P33 -. 9a <br /> . c�lCr NtLABEq. <br /> C"TIFtcnTE"wtr 5: 4-1-99 <br /> O!(OH, CLEMENT I <br /> OfliBO &NVIRONPIFN'fq� <br /> Ph BOX 61825 <br /> St"YVALE CA 94886 dOEYI PROOF OF INS CERTIFICRTE <br /> L <br /> Thls Is to tRurance c haw iwued a valid Wcrkcra'Compensation insurance ��� Vie Cat <br /> td the employer naroo tWk)w for Cq poli �� In a form <br /> ryperbd Indimted- <br /> TNa Pdky k not eubl"to c collation by the Pund except up0n� - <br /> �n days'advance written notsog b the employer. <br /> We MR alsoMe you, X" <br /> p days'advance notice ahouitl this policy be cancelled prior b its nomui expiration. <br /> TUU certificate of insurance is nag an insurance Policy and does not amend, extend or alter the coverage afforded by the <br /> PdiGea Iittod herein. NOtrithetanding any requirement, term, or condition of any eernraU or otlTar document w+8z <br /> respw to descrlbe0 nereri nhis subject this certificate d insurance may he iasuiid or may pertain, the insurance afforded by the pdicies <br /> trject to ail the farms,exclualore end eonditiOrs of Such pdicies. - <br /> AVTHORI2 F0 RFPgEBENTATIVE <br /> PR[j�Q6NT <br /> EM6'LOYERIS LIABILITY' LIMIT INCLUDIW, DFFFNSE CGSroz si,6e(dreea f R UCCl1RAlNCF.. <br /> ENDORSEMENT {1.065 ENTITLED CERTIFfr.ATE HOLDER,, NOTICI EFFECTIVE <br /> 04/0I/98 1.: ATTAINED TO fLND FORMS A PART Oc THIA POLICV. <br /> EN kJOYER <br /> Ia. .,. <br /> G(OHr CLEXENT I <br /> OBISO ENVIRONMENTAL <br /> PO Box 61025 <br /> St1MNV1iAl f CR 94066 <br />