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POLICYHOLDER COPY NE <br /> STATE PC) BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> COMPENSATION <br /> 114131-l"ANGO <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE! 06-02-2009 GROUP: 000641 <br /> POLICY NUMBER: 0000199-2009 <br /> CERTIFICATE 10: 1a <br /> CERTIFICATE EXrIRE6:06-01-2007 <br /> 05-01-2009/05-01-2007 <br /> ARTHUR J. 911LLAGWR NE <br /> 7910 N INQlUl AVE STE 201 <br /> FRESNO CA 09711-6899 <br /> This Is 10 certify that we have iaSued a valid Workers' Compensation insurance policy in a form approved by the <br /> Celifornla Insurance Commissioner to the employer rained below far the policy period ;".&led <br /> This policy Is not subbed to cancellation by the FUnrl except u ona0 days aWance wrltlat notice to the employer. <br /> We will also Ove you s,0 days advance notice should this, pollcy be cancelled prior to its normal expiration. <br /> TMs certificate of insurance is not an Insurance policy and does nut amend, extend or alter the coverage afforded <br /> by the policy listed herein. Ninhivithstanding my requirement, term or condition of any contract or Other document <br /> with respect to width this cerbhcato of insurance may be Issued or to vv icn it may pertain, me Insurance <br /> afforded by the policy described herein Is subject to all the terms, exclusions, and conditions, of such policy. <br /> t,11CRIZEO REPRESENTATI PRES <br /> E]PLO►ERrS LIMILITY LIRIT INCLIIDINR DEFENI COSTS: 91,000,000 PER OCCURRENCE. <br /> EIDORSEMENT /1000 - CARRIE PODPLE6 PRESIDENT - EkpUDLD. <br /> ENDMENENT !1000 - Q9lIS PEOPLES CFO SECRETARY - ERCLUOEO. <br /> --OCORSERENT /20M ENTITLED CERTIFICATE MLflOMI NOTICE EFFECTIVE 07-01-2006 I0 <br /> ATTACHED TO AND FUM A PMT Or THIS POLICY. <br /> EMPLOYER <br /> REMEDIATION RISK INC 11lA: TRITON <br /> CONSTRUCTION <br /> 2890 SO9UEL AVE STE 202 <br /> SANTA CRUZ CA 90082 <br /> 17 <br /> wsv.:•oe1 PRI11T[D 05-00-2-03-2009 <br />