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CERTHOLDER COPY STATE COMPENSATION INSURANCE FUND P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 ISSUE DATE: 03-10-2010 QQ G')--\ z-< ~O GROUP: 000571 ~ .,., POLICY NUMBER: 0006143-2009 ~;t, . CERTIFICA TE ID: 3034 .< 8 CERTIFICATE EXPIRES: 10-01-2010 ,3 ~ 10-01-2009/10-01-2010 :z 0 ~O :::00 ~Q --t ~-< CERTIFICATE OF WORKERS' COMPENSATION INSURANCE CITY OF REDWOOD CITY ENGINEERING AND CONSTRUCTION PO BOX 391 REDWOOD CITY CA 94064-0391 NG ~OB:#5873 SITE DEMOLITION 1402 MAPLE STREET REDWOOD CITY CA This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend. extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is' subject to all the terms. exclusions, and conditions, of such policy. G=REPRESENTATI ~E~ EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-2003 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #2001 ASBESTOS CERTIFICATION EFFECTIVE 10-01-2002 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER FERMA CORPORATION 1265 MONTECITO AVE STE 200 MOUNTAIN VIEW CA 94043 NG [LM6,CN] (REV.2-05) PRINTED 03-10-2010 NG J::-. - ~ [= f 3 J> :;0 ~ ,').> f- I C N' r-:;., C~' '--. ct: