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.. '. This is to certify that we have issued a valid Workers' Compensation insurance policy In is form ap <br />y?;_Jnsurance Commissioner tmthe employer named below for the policy poid6l;i <br />This Policy is not subject to cancellation by the Fund except upon ten dokiavaneq WrI4.6 notice i <br />we7m'll also give you TEN days' advance notice should this policy be cancelled prior to Its hohnal 6 <br />This certificate of Insurance is not an Insurance policy and does not amend, extend or alter the c <br />policies listed herein. Notwithstanding any requirement, term, or condition of any contract.o <br />respect to which this certificate of Insurance may be issued or may pertain, the ffievrance.,a <br />described herein is subject to all the terms, exclusions and conditions of such policli <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS :�; <br />STATE <br />P.O. BOX 420807, SAN FRANCISCO, CA 941142-0897 <br />COMPENSATION <br />INSURANCE <br />FUND <br />3834--.�-..9 <br />CERTIFICATE OF WORKERS' COMPENSATION IN§M <br />3-4"147'.. <br />FEBRUARY 6, <br />1996 <br />A., <br />r. <br />CERTIFICATE S <br />V;kV ARRA BROTHER <br />J <br />EMPLOYER <br />.. '. This is to certify that we have issued a valid Workers' Compensation insurance policy In is form ap <br />y?;_Jnsurance Commissioner tmthe employer named below for the policy poid6l;i <br />This Policy is not subject to cancellation by the Fund except upon ten dokiavaneq WrI4.6 notice i <br />we7m'll also give you TEN days' advance notice should this policy be cancelled prior to Its hohnal 6 <br />This certificate of Insurance is not an Insurance policy and does not amend, extend or alter the c <br />policies listed herein. Notwithstanding any requirement, term, or condition of any contract.o <br />respect to which this certificate of Insurance may be issued or may pertain, the ffievrance.,a <br />described herein is subject to all the terms, exclusions and conditions of such policli <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS :�; <br />1-W <br />2e afforded by th Dr document w <br />Id by the pollcl V. <br />tES16&JT <br />)r000. PER tRtEi <br />POLICY HOLDER'S CC <br />IA <br />3834--.�-..9 <br />3-4"147'.. <br />�%,W.41 <br />A., <br />r. <br />EMPLOYER <br />7 <br />N <br />DIETZ, <br />H. <br />6. AND DIETZ, GRETA <br />DBA: <br />DIE, <br />RP. IGAT CC-?" <br />8617 z.,rCHE'.7ERRY <br />VR <br />TRACY <br />CA <br />95376 <br />1-W <br />2e afforded by th Dr document w <br />Id by the pollcl V. <br />tES16&JT <br />)r000. PER tRtEi <br />POLICY HOLDER'S CC <br />IA <br />3834--.�-..9 <br />3-4"147'.. <br />�%,W.41 <br />"21M <br />1-W <br />2e afforded by th Dr document w <br />Id by the pollcl V. <br />tES16&JT <br />)r000. PER tRtEi <br />POLICY HOLDER'S CC <br />