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06/06/2003 16:25 0000000000 PACE 02/02 <br /> STATE P.O. BOX 420807,SAN FRANCISCO,CA 94142-0807 <br /> COMPENSATION <br /> 1NSURANCE <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> JLTNE 9, 2003 POLICYNUMBER: 238-02 UNIT 0000625 <br /> CERTIFICATE EXPIRES: <br /> r <br /> SAN JQAoIN COUNTY <br /> ENVIRONMENTAL HEALTH <br /> 304 E WEBER AVE THIRD FLOOR <br /> STOCKTON CA 95202 <br /> This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California <br /> 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 ten daysadvance 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 or alter the coverage afforded by the <br /> policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with <br /> respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies <br /> described heroin is subject to all the terms, exclusions and conditions of such policies. <br /> AUTHORizeD R6PRE8ENTATNE PRESIDENT <br /> MIPLOYER"S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> EMPLOYER <br /> r <br /> D & S DRAGLINE SERVICE INC <br /> PO BOR 705 <br /> LOS BANOS CA 93835 <br /> 5CIF 10M2 <br />