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1986-0905_AL LOWRY PAINTING_Insurance CertificateNULFIHE BY THETPOLICIIES TUPON HNISS."R.,LISTST NAM AND ADDRESS OF AGENCY N GiORMAN :I: (:i E: N 1 0 YIP I I AFFORDING COVERAGES :.'.. OAD JM1 � iN 1 .. a ... .. �.: t:j� X; t:)X ,.�ih t7'p I.r Ev •y iil:::t.1.1..PiN S1 1II:i.c `=:$311..:)itl 111:1":Jt::l, CA. 9 Z59t 7h'iN' _ 1..j 1 7 �') c? 41.131. r E v NAM'. AND ADDRESS OF INSURED N 'tM L.. (:)44F'Y F, A.1 N1:[i>!t -r-�_ 3.i'r:I:tJi� I 11:1:1_,.1(:). t:jr1 17ET T'EP This is to certify that policies of insurance listed belowhave been issuedtc tl, initrd 2r':1 ib vasI - orceatthistime. Notwithstanding of sny contract or other document with respect to which this certificate i 1 i b. s w i I I ay o art i I surance afforded by the policies dE terms, exclusions and conditions of such policies. CIEIANY TIER TYPE OF INSURANCE POLICY NUF r,_7 Limits of List GENERAL LIABILITY N DATE 1 1, 6 qsl 4 T COMPREHENSIVE FORM 414 ♦L'� "} t t�`'"'� 4 L X111111111 PREMISES—OPERATIONS ` II f tli l:: I""� ❑ EXPLOSION AND COLLAPSE ::IS.ia'T' [(:1 IAL.. .l:NSIJI'(t:.11 file; Fttc,f I r:l r f' L:F 11 :' (.ff I! HAZARD BODILY INJURY AND ❑ UNDERGROUND HAZARD,. 1 PROPERTY DAMAGE PRODUCTS/COMPLETED f"ti 1 OPERATIONS HAZARD "LJ CONTRACTUAL INSURANCE BROAD FORM PROPERTY - DAMAGE INDEPENDENT CONTRACTORS Yl PERSONAL INJURY O AUTOMOBILE LIABILITY I1 U t't'!1ZI 1"t' i_. FI t.174.i COMPREHENSIVE FORM I �•f-ri Xl1, N.(3 pn�OWNED HIRED NON OWNED EXCESS LIABILITY ❑ UMBRf LLA FORM ❑ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION and EMPLOYERS' LIABILITY OTHER — -- — -- - - I ,Y Limits of List N DATE 1 1, 6 qsl 4 T BODILY INJURY X111111111 DESC HIPTIONOF /TI OPERANSINSn. H �.. ... IrY ,.iAT PFl=,n� t.�l�I, i.)I I L1 .: '::I: (It i. `: "'r�31`'t LI i.l II f tli l:: I""� PROPERTY DAMAGE ::IS.ia'T' [(:1 IAL.. .l:NSIJI'(t:.11 file; Fttc,f I r:l r f' L:F 11 :' (.ff I! It.) 41t:RF, BODILY INJURY AND PROPERTY DAMAGE COMBINED requirement, term or Conanion bed herein is subject to all the y in Thousands ) EACH AGGREGATE OCCURRENCE PERSONAL INJURY BODILY INJURY $ (EACH PERSON) BODIIV INJURY S (EACH ACCIDENT) PROPERTY DAMAGE b BODILY INJURY AND PROPERTY DAMAGE $ BODILY INJURY AND PROPERTY DAMAGE $ COMBINED STATUTORY 8 1 1, 6 qsl 4 ��■IIIIIII■ X111111111 DESC HIPTIONOF /TI OPERANSINSn. H �.. ... IrY ,.iAT PFl=,n� t.�l�I, i.)I I L1 .: '::I: (It i. `: "'r�31`'t LI i.l II f tli l:: I""� I I.f Int._ Itt-11'11').1 ::IS.ia'T' [(:1 IAL.. .l:NSIJI'(t:.11 file; Fttc,f I r:l r f' L:F 11 :' (.ff I! It.) 41t:RF, Pla l(J(ii'tt:.tl Cancellation: Should any of the above described )olicil : b eE ncE llec )efor • the expiration date thereof, the issuing com- pany will endeavor to mail 30 ( ays v 't1 nr Iotice c : )elow named certificate holder, but failure to mail such notice shall impose no obll gatiol I )r Iia I- ty of n I, Im— J upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER t) / �' 1. 6/ 0 i IR r ISSUED: C:C'1"Y (]f' SANJUAN(;(dl'ta A t Til : (vlf: NCY 32.¢00 F'r=ttl:(:) rfifll::a...r`r('�LC) d��fGI-.CJ ?1�11`J JUAN t„fJl l"'.L �:r t i'i; fi l'�t.l; I. lryi AUTHORIZED REPRESENTATIVE ACORP 25 (1 79) — - — ----� --- 0 • MEMORANDUM February 13, 1986 TO: Ray Becerra, Planning FROM: John Shaw, City Attorn(� SUBJECT: Los Rios Bid Package We received a call from the insurance agent of the one and only bidder on the Los Rios paint program indicating that they couldn't understand why we would require a Labor & Materials Bond when the contractor will not be using any subcontractors. After review of the situation, I believe it would be appropriate to waive the Labor & Materials Bond given these circumstances, including the fact that there is only one bidder. Therefore, I have advised the insurance agent that the bidder should submit a letter to the City requesting a waiver. The bidder will, how- ever, produce a Bid Bond and a Performance Bond. If you should have any questions, please advise. JRS:ef cc: City Clerk TH:S CERTIFICATE IS ISSUED �, •1 T� ) CERTIFICATE EOAMEND EXTEf I II II �i l�'Ifi �'E r •, NAME AND ADDRESS OF AGENCY !' I'F'V 379138 DAN (30R`iAN INS. AGENCY ' '� IOtPa, AFFORDING COVERAGES 27001. 1_A FA ROAM Js ,N O„ DOX 36,79 r;: ,' (IMFRTCAN SIATE :q M:I:SSION V:LE..JOZ CA., 92691. )N'.N tADDRESrhN-UA1f 1 r;l —.--..._._. NAME AND ADDRESS OF INSURED PRODUCTS/COMPLETED C AL.. LOWRY F'A1N'T':I:NI:3 IN ' N• TI 2-17345 i'f:&ILL-A )1V N BROAD FORM PROPERTY DAMAGE T1 TI' A2 2 This is to certify that policies of insurance listed below have been issued 1 in , + 11 G v , a i >rce this time. Nothe any contract or other document with respect to which this certificate , e I , b uc I r - ry a rt: I.. „ ;urance afforded by the policies d c policies l to terms, exclusions and conditions of such policies. ❑ COMPANY LETTER TYPE OF INSURANCE POLICY NUN GENERAL LIABILITY — rl I'F'V 379138 $ COMPREHENSIVE FORM PROPERTY DAMAGE PREMISES—OPERATIONS Cl EXPLOSION AND COLLAPSE HAZARD UNDERGROUND HAZARD PRODUCTS/COMPLETED OPERATIONS HAZARD CONTRACTUAL INSURANCE BROAD FORM PROPERTY DAMAGE INDEPENDENT CONTRACTORS PERSONAL INJURY AUTOMOBILE LIABILITY ❑ COMPREHENSIVE FORM ❑ OWNED ❑ HIRED ❑ NONOWNED EXCESS LIABILITY ❑ UMBRELLA FORM ❑ OTHER THAN UMBRELLA FORM WORKERS'COMPENSATION and EMPLOYERS' LIABILITY OTHER is subject to all the .v Limits of Liabil ty in Thousands ) � N DATE OCCURRENCEEACH AGGREGATE BODILY INJURY $ 8 PROPERTY DAMAGE $ $ BODILY INJURY AND PROPERTY DAMAGE $ $ COMBINEDJl �' .. V/ .JtU/ PERSONAL INJURY I $ BODILY INJURY $ (EACH PERSON) BODILY INJURY $ (EACH ACCIDENT) PROPERTY DAMAGE $ BODILY INJURY AND PROPERTY DAMAGE $ BODILY INJURY AND PROPERTY DAMAGE $ $ COMBINED STATUTORY 1 loll 0 1111 lioi11111111 DESCRIPTION OF OPERATIONS/LGCATIONSNEHICLES CJE:RT` FICII HOLIER 'TC) 1Ei: NII Af `§?IT.T )!I 1:N:; lftE::I1 AS RE:E)f'Ii::C'T'S OFA R:A'f.1.0NS OF TME= TNSURFIJ TO WORK PIEREORINIFETI Cancellation: Should any of the above described f c tic s bf : JI L:e led t Eton: the expiration date thereof, the issuing com- pany will endeavor to mail 1.0 d I i Y,i:t( r r.ti(e to the I elow named certificate holder, but failure to mail such notice shall impose no obll) ; l ioi E r) n )i i'y �i any Ieiro I upon the company. (::f.TY OF* SAN .JUAN C:AF'O 2400 PASt::O ADE::I_ANTO SAN ..JUAN CAP1:S7'RANOZ CF) ACORD 25 IT 79) DAG F REPRESENTATIVE rtif I F I " D �a . • .MyO THIS CERTIFICATE DOES NOT AMEN �ORDED BY THE POLICIES LISTED BELOW. NAME AND ADDRESS OF AGENCY DAN GORMAN INS. AGENCY C I P I I AFFORDING COVERAGES 27001 L.A PAZ ROAD P. O. BOX 3659 r :N AMERICAN STATES INS« MISSION VIEJO, CA. 92691 Nn N. (714)768--4181 T ' NAME AND ADDRESS OF INSURED Al_ I_OWRY PAINTING = 27345 PAUILLA MISSION VIE.JO, CA )N N T 92691 )N N` T' This is to certify that policies of insurance listed below have been issued to : e in a d e Ib� + a I arse at this time. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate i n b+ s w i r r ey L •rt i - I suranee afforded by the policies described herein Is subject to all the term& exclusions and conditions of such policies. Limits of Liability in Thousands COMPANY TYPE OF INSURANCE POLICY NUE=. t NY DATE EACH AGGREGATE --- - — - - - OCCURRENCE GENERAL LIABILITY — BODILY INJURY $ 8 A 1E]PP037988 0 i ;-. ).5/86 LJ COMPREHENSIVE FORM PREMISES—OPERATIONS PROPERTY DAMAGE $ $ ❑ EXPLOSION AND COLLAPSE HAZARD ❑ UNDERGROUND HAZARD 10 PRODUCTS/COMPLETED OPERATIONS HAZARD ILI BODILY INJURY AND CONTRACTUAL INSURANCE FORM IEI PROPERTY DAMAGE $ $ COMBINED 500, 500, BROAD PROPERTY DAMAGE ILI INDEPENDENT CONTRACTORS PERSONAL INJURY PERSONAL INJURY $ AUTOMOBILE LIABILITY BODILY INJURY $ ❑ (EACH PERSON) COMPREHENSIVE FORM BODILY INJURY $ ❑ OWNED (EACH ACCIDENT) ❑ HIRED PROPERTY DAMAGE $ ❑ NON-OWNED BODILY INJURY AND PROPERTY DAMAGE $ _ COMBINED EXCESS LIABILITY ❑ BODILY INJURY AND UMBRELLA FORM PROPERTY DAMAGE $ $ ❑ OTHER THAN UMBRELLA COMBINED FORM WORKERS' COMPENSATION STATUTORY and EMPLOYERS' LIABILITY E IEACN ACCIIEO OTHER 1111 ! 11■ 111 I IIB II II DESCRIPTION OF OPERATIONS/LOCATIONBNEHICLES Cancellation: Should any of the above desgqribed r ) )Iic (e b a z c IIElC Six, ;)P" the expiration date thereof, the issuing com- pany will endeavor to mail 10 ( c ys v l iti =r I tji ie: (� A +: )elow named certificate holder, but failure to mail such notice shall impose no obli z atier )r ie b I ty of I ry ;In 1 101 the company. tl7 NAME AND ADDRESS OF CERT I FICATE HOLDER: 02/11/86 CITY OF SAN JUAN j r,'• �IssueD: CAPISTRANO 32400 PASEO ADEL.ANTO F�C2�cafi�GLvC__� SAN ,JUAN CAPISTRANO, CA ".'�.''. 17:'. AUTHORIZED REPRESENTATIVE 25 (I -Z9)