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• T1s � F t <br /> f x <br /> STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 <br /> COMPENSATION II M; l i HEALTH I N S U R A N C E 'y' itF t di"i:_iY I HEI.LTH <br /> FUNDI,,r_,,,,,R,r S r ,.;r; F <br /> CERTIFICATE OF WORKERS' COMPENSATION INSURAN=CFI ' ` <br /> APRIL 19, 1994 POtll'aIVAlI Is83 <br /> CERTIFICATE EXPIRES: 9-01-94 <br /> 1" SAN JOAQUIN COUNTY <br /> DEPT. OF ENVIRONMENTAL HEALTH <br /> P.O. BOX 388 <br /> STOCKTON, CA 945201 <br /> ATTN: MICHAEL COLLINS <br /> L <br /> This is to certify that we have issued a valid Workers'Compensation insurance policy in a form approved by the California <br /> 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 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. X VO" <br /> PRESIDENT <br /> EMPLOYER <br /> r <br /> J. QUARLE & ASSOCIATES, INC. <br /> P.O. BOX 2215 <br /> SAN LEANDRO, CA 94577 <br /> i <br /> L <br /> SCIF 10262(REV. 10.86) <br />