HomeMy WebLinkAboutCOI - Empowering Our Community for Success - ExpiresSTATE
COMPENSATION.
I'N'SURANCE
FUND
NOVEMBER 14, 2023
CITY OF GILROY
7351 ROSANNA ST
GILROY CA 95020-6141
IN REPLY REFER TO:
CERTIFICATE OF WORKERS'
COMPENSATION INSURANCE
CANCELLATION WITHDRAWAL NOTICE
RE: CERTIFICATE DATED SEPTEMBER 20, 2023
THE CANCELLATION HAS BEEN WITHDRAWN FOR THE WORKERS' COMPENSATION
INSURANCE POLICY FOR THE EMPLOYER NAMED BELOW. THIS LETTER SUPERSEDES
THE NOTICE OF CANCELLATION SENT TO YOU ON OCTOBER 27, 2023.
THIS EMPLOYER'S WORKERS' COMPENSATION INSURANCE COVERAGE CONTINUED
UNINTERRUPTED.
EMPLOYER:
EMPOWERING OUR COMMUNITY FOR SUCCE
1711 WARBURTON AVE APT 5
SANTA CLARA, CA 95050
POLICY 9261123-23
'CUSTOMER SERVICE REPRESENTATIVE
CUSTOMER SERVICE CENTER
(888) 782-8338
5860 Owens Dr Pleasanton, CA 94588-3900
Mailing Address: P.O. Box 8192 • Pleasanton, CA 94588-96$2
SCIF 19102