Laserfiche WebLink
LICYHOLDER COPY <br /> , NF <br /> STATE P.O. BOX 420807, SARI FRANCISCO,CA 94142-0807 <br /> COMPENSATION <br /> INSURANCE <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 10-15-2008 GROUP: 000692 <br /> POLICY NUMBER: 0003128-2008 <br /> CERTIFICATE ID: 22 <br /> CERTIFICATE EXPIRES: 10-01-2008 <br /> 10-01-2008/10-01-2008 <br /> INTERNAL USE ONLY NF <br /> 3181 LUYUNG DR <br /> RANCHO CORDOVA CA 95742-6899 <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 10 days advance written notice to the employer. <br /> We will also give you 10 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 /> �THIRIZEDREPRESENTATI PRESIDENT <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br /> ENDORSEMENT #1600 - SEAN M. MURPHY PRES,SEC,TRES - EXCLUDED. <br /> EMPLOYER <br /> TOWN & COUNTRY CONTRACTORS INC NF <br /> 3181 LUYUNG DR STE A <br /> RANCHO CORDOVA CA 95742 <br /> [B16,NF] <br /> (REV.2-05) PRINTED 10-15-2008 <br />