HomeMy WebLinkAboutECONOLITE CONTROL - INSURANCE CERTIFICATECERTHOLDER COPY
SP
STATE P O BOX 420807 SAN FRANCISCO CA 94142-0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS COMPENSATION INSURANCE
ISSUE DATE 04-01-2008 GROUP 000824
POLICY NUMBER 0001005-2007
CERTIFICATE ID 78
CERTIFICATE EXPIRES O4-01-2009
04-01-2008/04-01-2009
CITY OF FORT COLLINS
P 0 BOX 580
FORT COLLINS CO 80522
SP JOB ALL CALIFORNIA OPERATIONS
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 10 days advance written notice to the employer
We will also give you 10 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
tTHORIDZEaD REPRESENTATI PRESIDENT
EMPLOYERS LIABILITY LIMIT INCLUDING DEFENSE COSTS $1 000 000 PER OCCURRENCE
EMPLOYER
ECONOLITE GROUP INC
PRODUCTS INC
3360 E LA PALMA AVE
ANAHEIM CA 92808
DBA ECONOLITE CONTROL
M0408
(REV 2 05) PRINTED 03-18-2008