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P ~ C <br />COMPENSATION ?.O. BOX EWAN FRANCISCO, CALIFORNIA 94101-08A <br />CO <br />IN 91 URANCE <br />FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br />OCTO:,ER 27, 19„7 POLICY NUMBER: <br />CERTIFICATE EXPIRES: <br />r <br />MARLOwE PROoEP.T£FS <br />-Ox 211 <br />SA% aA'4=L <br />�A v4o1 <br />570-97 U%,T 00C2310, <br />10-1-65 <br />J05: 4636-A EAST sATEgL0C RI)A,� <br />L 4p4C—A E=,T 'WATERLOO o^,AD <br />4^4{,_12-4 EAST WATSRLCC <br />This is to certify that we have issued a valid Workers' Compensation insurance olic 4648 E M u T R L C O S T O C ,c T 7 `) <br />Insurance Commissioner to the employer named below for the Policy P Y in a form approved by the California <br />P y period indicated. <br />This policy is not subject to cancellation by the Fund except upon ten 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 />/01 V-� <br />PRESIDENT <br />EMPLOYER <br />r <br />p. C. 8.,X 1.,24 <br />WEST SACRA%-FNTC <br />L CA 95041 <br />SCIF 10262 (REV. 10-86) COPY FOR INSURED'S FILE <br />OLD 262A <br />