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POLICYHOLDER COPY <br /> NG <br /> STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 <br /> COMPENSATION <br /> IN SUPtA NCR <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> GROIR: <br /> aSSUE DATE: 03-07-2008 POLICY NUVIl 1&05459-2005 <br /> CERTIFICATE IR 25 <br /> CERTIFICATE EXPIRES:02-25-2009 <br /> 02-28-2000/02-25-2009 <br /> THIS CERTIFICATE SUPERSEDES AND CORRECTS <br /> CERTIFICATE # 27 DATED 03-07-2008 <br /> MIN4 ► COMPANY INSURANCE BROKERS <br /> N0 <br /> 321 5TH ST <br /> HOLLISTER CA 1111023-3932 <br /> I <br /> This Is to certify that we have Issued a valid Waters' 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 policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the Nnployer. <br /> We will Yso gin you 30 days advance notice should this policy be cancelled prior to its normal expiration, <br /> i <br /> This cwtifkau of Insurance is not an Ilnswwce policy and does not amend, extend or sltw the coverage afforded <br /> by the policy listed herein. NotwlthstandlnaQ any me <br /> requirent, term or condition of any contract or other document <br /> with respect to which this cwtlflcate of Vaca may be Issued or to which it may pertelm the insurance <br /> afforded by the policy described herein Is subject to all the <br /> terms. exclusions, and conditions, of such policy. <br /> V <br /> t:QZED REPRESENTArI PRESIDFM t <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 511000,000 PER OCCURRENCE. <br /> i <br /> ENDORSEMENT #1500 - ANGELO PARADISO PRES - EXCLUDED. <br /> 1 <br /> ENDORSCMlNT #1500 - CYNTHIA PARADISO TRCS - EXCLUDED. <br /> ENDORSEMENT #1500 - PAUL PARADISO SEC TREAS - EXCLUDED. <br /> ENDORSEMENT <br /> AND FORMS A <br /> ENT # ENTITLED <br /> CERTIFICATE POHOLDERS' NOTICE EFFECTIVE 02-28-2008 IS <br /> EMPLOYER <br /> I <br /> PARADISO MECHANICAL, INC NG <br /> 2000 WILLIAMS ST <br /> SAN LEANDRO CA 94577 <br /> JB14,NG) <br /> PRINTED 03-07-2009 <br /> WSv.a•csl <br />