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NOV 10 '92 16:40 SCIF WOODLAND HILLS P.2/2 <br />6% TAT E P.O. BOX 420807, SAN FRANCISCO, CA 94142.0807 <br />COMPaNSATION <br />I N64JR AN C Z <br />Emu U 2 soft <br />Im FMLJ CERTIFICATE OF WORKERS'COMPENSATION INSURANCE <br />NOVEMBER 100 1992 POLICYNumBFA. 446w92 UNIT 0000166 <br />CERTIFICATE EXPIFUS! 1-1-93 <br />Fbi <br />PUBLIC HEALTH SERVIC2S I SAN 40AQUIN COUNTY <br />ATTN: CAROL OZ I ENVIRONMENTAL -HEALTH DIV, <br />443 SAN JOAQUIN <br />STOCKTON CA.952,01 <br />L <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by t I he California <br />Insurance Commissioner to the emplovO named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon ton days' advance written notice to the employer. <br />We will also give you TEN 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 by the <br />policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with <br />respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies <br />described herein is subject to all the Terms, exclusions and conditions of such Policies, <br />PRESIDENT <br />1-19111 <br />IPL* it <br />io 101992 -M <br />EMPLOYER <br />T & L PEARCE <br />P. 3* BOX 4076 <br />SUNLAND CA 91040 R FAX <br />L <br />%V if. I 4111h � I k E V 10.061 <br />