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APR-26-2004 14:39 FRON:ENPROB 5305892230 7^'12099480621 P.3 <br /> POLICYHOLDER COPY <br /> STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 <br /> COMPENSATION <br /> INSURANCE <br /> FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE <br /> APRIL 16, 2004 GROUP: 000713 <br /> POLICY NUMBER: 7363-2003 <br /> CERTIFICATE ID: 84 <br /> CERTIFICATE EXPIRES: 10-01-2004 <br /> 10-01-2003/10-01-2004 <br /> KLEINFELDER INC <br /> 2825 EAST MYRTLE STREET <br /> STOCKTON CA 95205-4794 <br /> This Is to certify that we have issued a valid Worker's 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 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 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 hereln Is subject to all the terms,exclusions,and conditions, of such policies. <br /> y4A-1- Al� <br /> AUTHORIZED REPRESENTATIVE PRESIDENT <br /> EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE <br /> EMPLOYER <br /> SILIG0, DONALD BURTON AND OTT, DENNIS JAMES <br /> PO BOX 6093 P.O.Box 9093 <br /> OROVILLE CA 95966 OroyIII9,CA <br /> 86D80 <br /> SCIF 10262E rEPF-UI:BO 1 <br /> 04/26/2004 KION 15:39 [TX/RX NO 99491 0 003 <br />