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ITATI: or c:ALXrOIUfXA I • <br />DEPARTMENT or INDOSTR:lAL RELATIONS <br />orrlCI: or 'l'RI: DZUC'I'O" <br />MOHIIR 2559 <br />CERTIFICATE OF CONSENT '1'0 SELF-INSURE. <br />THIS II TO CIlRTZry, <br />ha. complied wi~h the requlrements of the Direc~or of<br /> <br />provi.lon. of S.ctlon. 3100 to 310&, inclu.lv., of ~h.<br /> <br />\ California and 11 h.r.by 9rant.d thil Ctrtlficate of Con.lnt <br />Thls certiflcat. may b. revoked at any time for 900d <br />3702. ' <br />IlrrIC'1'%W MaEcb 1, 1"3 <br />DEPARTMENT or INDUSTRIAL RELATIONS <br />or THt ST~Tt or C~LlrORNIA <br />~ ?v.(2.J2.z <br />DJP.tCTOR ( <br />,'G'I.CIDI' CI.rl'lcarl 10. ,-lJU.. <br />That <br />. <br />cau •• pursuant to Labor Cod. S.ction <br />lndu.~rlal Relatlont und.r the <br />Labor Cod. of ~h. Stat. of . , <br />to a.lf-In.ur•. <br />\If A';.';loA-tN:Y. i/U, This cet-Uficate only covers employees. not volunteers/agents <br />of the Univel'sity of California <br />DocuSign Envelope ID: 80AD863D-11A5-4B60-BE8F-02FD677D8AEC