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oUL. 0-6.2009 01:33 707$6479-66 STATE COMP INSir <br /> RAJ r F _ . 0G2 !CO2 <br /> . M <br /> CERTHOLDER COPY <br /> STATE <br /> P.O. BOX 40$07, SAN FRANGSCO,CA 94942-0807 NK <br /> COMPENSATION <br /> I N S U R A N C E <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 07-08-2009 GROUP_ 400730 <br /> POLICY NUMBER; 0000138-2008 <br /> CERTIFICATI= 10: 120 <br /> CERTIFICATE EXPIRES! 10-01-2009 <br /> 10-01-2008/10-01-2009 <br /> OAKLAND FIRE DEPARTMENT NK <br /> FIRE PREVENTION SURrAU <br /> 250 FRANK H OGAWA PLZ STE 3341 <br /> OAKLAND CA 94812-2075 <br /> This is to certify th5T 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 <br /> ndicatedThis policy is not subject to cancellation by the Fund except upon 30 days advance wrRten notice to the employer. <br /> We wilt also give you 3o days advance notice shoutd this policy be cancelled prior to its normal expiration, <br /> This certificate of insurance is not an "nsurance policy and does not amend, extend or alter the coverage affordad <br /> by the policy listed heroin. Notwiihstandinq any requirement, terns or condition of any contract or other document <br /> wrth respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br /> affordad by the policy de9cribed herein is subject to all the terms, cxclusions, and conditions, of such policy, <br /> Q/� Af,� ��� <br /> 4)tTHORIZED REPRI:5ENTATI PRESIDENT <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> ENDORSEMENT #1600 - .JOHN LYNCH P S T - EXCLUDED. <br /> ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-1997 IS <br /> ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> EMPLOYER <br /> WRIC4 T ENVIRONMENTAL SERVICES, INC. NK <br /> 2395 E PESCADERO AVE <br /> TRACY CA 95304 <br /> [PAF,CNI <br /> IREV.2-06) PRINTED 07-08.-2009 <br />