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POLICYHOLDER COPY n <br />^ <br />E `&_-" i9 <br />P.O. BOX 8192, PLEASANTON, CA 94588 DEC 19 2017 <br />CERTIFICATE OF WORKERS' COMPENSATION INSURANCRIVIRONMENTAL HEALTH <br />ISSUE DATE: 11-01-2017 GROUP: F)F ARTMENT <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 DO:NE <br />SACRAMENTO CA 95826-0026 <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 S0 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 <br />dbby, the <br />ppoolliiic/cyy�described <br />7 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 #2085 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 />(RE V.7-2014) PRINTED : 10-17-2017 <br />