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POLICYHOLDER COPY NE <br /> STATE <br /> P.Q. BOX 8192, PLEASANTON, CA 94588 <br /> FUND <br /> CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 11-01-2017 GROUP: <br /> POLICY NUMBER: 1308371-2017 <br /> CERTIFICATE ID: 173 <br /> CERTIFICATE EXPIRES: 11-01-2018 <br /> 11-01-2017/11-01-2018 <br /> CONTRACTORS STATE LICENSE BOARD NE LIC PERMIT#: 804904 <br /> INCEPTION DATE:11-01-2017 <br /> PO BOX 26000 DONE <br /> SACRAMENTO CA 958260026 <br /> This is to certify that 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 policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br /> We will also give you 30 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 <br /> by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br /> with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br /> afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br /> Authorized Representative President and CEO <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 11-01-2016 IS <br /> ATTACHED TO AND FORMS A PART OF THIS POLICY. <br /> EMPLOYER <br /> CONFIDENCE UST SERVICES INC. NE <br /> 16250 MEACHAM RD <br /> BAKERSFIELD CA 93314 <br /> M0409 <br /> PRINTED 10-17-2017 <br /> (REV.7-2014) <br />