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POLICYHOLDER COPY <br /> NF <br /> STATE <br /> P 0 BOX 8192, PLEASANTON, CA 94588 <br /> FUND <br /> CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> ISSUE DATE: 11-29-2019 GROUP. <br /> POLICY NUMBER: 9053901-2019 <br /> CERTIFICATE ID: 4 <br /> CERTIFICATE EXPIRES: 11-29-2020 <br /> 11-29-2019/11-29-2020 <br /> CALIFORNIA DEPARTMENT OF MOTOR VEHICLES NF CA#: 954267 <br /> MOTOR CARRIER PERMIT BRANCH INCEPTION DATE:11-29-2019 <br /> PO BOX 932370 DO:NF <br /> SACRAMENTO CA 94232-3700 <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 /> Authorized Representative President and CEO <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 41,000,000 PER OCCURRENCE. <br /> GEO-EX SUBSURFACE EXPLORATION NF <br /> 1510 MADERA DR <br /> DIXON CA 95620 <br /> ,UtU.NF1 <br /> PRINTED : 12-05-2019 <br />