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STATE P.O. BOX 807, SAN FRANCISCO, CALIFORNIA 9410 <br /> j rt COMPENSATION <br /> 1 NSU R^N C E <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> POLICY NUM8ER* <br /> CERTIFICATE EXPIRES <br /> r <br /> L <br /> This is to certify that we have issued a valid Workers' Compensation insurance policy in a ' lifornia <br /> Insurance Commissioner to the employer named below for the policy period indicated. <br /> 30 <br /> This policy is not subject to cancellation by the Fund except uponxeAi days'advanr oyer. <br /> 3tR'0�1 . <br /> -CF <br /> We will alio give you " days'advance notice should this policy be cancellP on, <br /> This Certificate of insurance is not an insurance policy and does not ,verage afforded by the <br /> policies listed herein. Notwithstanding any requirement, term, or ,x other document with <br /> respect to which this certificate of insurance may be issued .e afforded by the policies <br /> described herein is subject to all the terms, exclusions and Gond' <br /> Z�L <br /> 1 <br /> I <br /> k <br /> } <br /> ff <br /> i <br /> 1 <br /> EMPLOYER <br /> r <br /> L <br /> SCIF 30262(REV.e•e4) - OLD 262A <br />