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05-0627_BAKALL, ERGUN_InsuranceJun 27 05 04:28p ERGLOBRKRLL 714 00480 p.l A Ergun Bakall, P.E. Consulting Civil Engineer June 27, 2005 City of San Juan Capistrano 32400 Paseo Adelanto San Juan Capistrano, CA 92675 Attention: Ms. Maria Guevara 14 Bonsall, Irvine, Ca 92602 Tel/Fax : 714 838 0480 VIA FAX 949 493 1053 Subject: Personal services Agreement to Provide 2005 Urban Water Management Plan Update Dear Ms. Guevara: As per our phone conversation this is to notify you that my firm does not employ anyone other than myself as the sole proprietor. Therefore, I have no need for Workers Compensation Insurance since I work alone. As for the Automobile Insurance, I have the coverage's required by the contract and I am including a copy of my policy with the Auto Club. It is a pleasure to be of service to the City of San Juan Capistrano. Should you have any questions regarding this letter, please feel free to call me at any time. Very truly yours, Ergun I3akall, P.E. Principal Jun 27 05 04:28p ERGUIWAKALL 714 10480 p.3 rInterinsurance Exchange of the Automobile Club Automobile Insurance Policy Coverage and Limits Policy Change Declarations — Insurance is in effect only for the vehicles, coverages, and limits of liability shown on this declarations page and as set forth in the insurance policy and endorsements. These declarations, together with the contract and the endorsements in effect, complete your policy. NAMED INSURED (Item 1.) BAKALL, ERGUN AND CHERYL 14 BONSALL IRVINE CA 92602-0950 AUTO POLICY NUMBER G 6395664 POLICY PERIOD (PACIFIC STANDARD TIME) EFFECTIVE DATE 3-13-0512:01 A.M. EXPIRATION DATE 3-13-06 12:01 A.M. SUBJECT OF POLICY CHANGE THIS IS NOT A BILL VEHICLE CHANGE This policy change will decrease your premium by $2468.00 VEHICLES (Actual Cash Value unless otherwise stated, less deductible) t 38 Vehicle t Vehicle 2 Vehicle 3 VEHICLE NUMBER IDENTIFICATION VEHICLE USE GARAGE ZIP CODE ANNUAL MILES LEASED FINANCED ACV NUMBER $500 $500 $500 $500 1 1993 TOYO CAMRY LE JT25K12EOP0157774 COMMUTE 92602 5,001 - 7,500 NO NO 2 1999 BENZ E320 WDBJF65HOXA860178 COMMUTE 92602 15,001 -20,000 NO NO 3 2000 ISUZU RODEO 4S2CK58W5Y4302857 COMMUTE 92602 7,501 - 10,000 NO NO 4 2005 PORS 911 CARRERA S CAB WPOAB29965S740658 PLEASURE 92602 1- 5,OOD NO YES - COVERAGES AND LIMITS ANNUAL PREMIUMS Coverage is not in effect unless a premium or the word "included" is shown _ COVERAGES LIMIT OF LIABILITY Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle Liability Bodily Injury $500,000 each person/ $1,000,000 each occurrence i S 808 ': $ 283 i $ 278 i 258 Property Damage $250,000 each occurrence S 138 's S 137 $ 143 i S 131 Medical NA NA i NA NA Physical Damage (Actual Cash Value unless otherwise stated, less deductible) t 38 Vehicle t Vehicle 2 Vehicle 3 Vehicle 4 Vehicle Comprehensive ACV ACV ACV ACV (Less Deductible) $500 $500 $500 $500 Collision ACV ACV ACV ACV (Less Deductible) $500 $500 $500 $500 Car Rental Expense (Per Day) NA $30 $30 NA Uninsured Motwrst Bodily Injury $30,000 each person/ $60,000 each occurrence Uninsured & Underinsured Vehicles Uninsured Deductible Waiver Total Premium PREMIUM DISCOUNTS Please refer to the enclosed document entitled 'Premium Discounts Applied to your Automobile Policy. i� 41s PROCESS DATE 3-14-05 $ 42 8 70 t 38 $ 321 $ 146 $ 386 ; 6 225 i $ 1285 NA :` $ 35 [ $ 31 NA $ 38 ; S 39 $ 38 S 30 lcluded ;Included :Included :Included $ 672 $ 950 It 753 $ 2025 "NA' indicates coverage not purchased Total Annual Premium' $4400 Net Premium $4400 -1„cludes all applicable disceunL PLEASE ATTACH TO YOUR POLICY (SEE REVERSE) Jun 27 05 04:28p ERGLWAKRLL 714 V#0480 p,4 Interinsurance Exchange of the Automobile Club Automobile Insurance Policy Coverage and Limits Changes to Declarations (continued) AUTO POLICY NUMBER G 6395664 EFFECTIVE DATE: 3-13-05 DRIVERS (UNLESS LISTED AS EXCLUDED) DRIVING RECORD RATED DRIVER NUMBER OF FIPST DRIVERYEAR NAME VEHICLE I GENDER MARITAL STATUS MINOR LICENSED NUMBER NUMBER 1 PRIMARY 2 1 RAKALL, ERGUN MALE MARRIED fit 2 BAKALL,CHERYL FEMALE MARRIED 68 3 AKAY, ENIS E MALE SINGLE 96 ENDORSEMENTS AND CERTIFICATES NUMBER I TITLE 2231 GUARANTEED RENEWAL 2052 LOSS PAYABLE - NOTICE TO LIENHOLDER EQUIPMENT' SOUND EOUIPMENT' Ynl cAYPFAI. orNEN jjIQA Ta u RAOp OTHBi 1 2 3 4 -Coverage is indicated by a "Yes" in the appropriate equipment column. Coverage limitations apply unless coverage was purchased specifically for certain equipment. ANY PHYSICAL DAMAGE LOSS MAY BE MADE PAYABLE TO YOU AND ANY INTEREST LISTED BELOW: VEH NO. 4 ORANGE COUNTY TEACHERS FCU P O BOX 11547 SANTA ANA CA 92711 DRIVING RECORD RATED DRIVER NUMBER OF NUMBER OF TRAFFIC CONVICTIONS DRIVER STATUS VEHICLE I NUMBER F."IALLY AT FAUL_T_ACCIDEtRS MINOR SERIOUS MAJOR SEVERE SUSPENSIONS NUMBER 1 PRIMARY 2 2 PRIMARY 3 PRIMARY 1 3 ENDORSEMENTS AND CERTIFICATES NUMBER I TITLE 2231 GUARANTEED RENEWAL 2052 LOSS PAYABLE - NOTICE TO LIENHOLDER EQUIPMENT' SOUND EOUIPMENT' Ynl cAYPFAI. orNEN jjIQA Ta u RAOp OTHBi 1 2 3 4 -Coverage is indicated by a "Yes" in the appropriate equipment column. Coverage limitations apply unless coverage was purchased specifically for certain equipment. ANY PHYSICAL DAMAGE LOSS MAY BE MADE PAYABLE TO YOU AND ANY INTEREST LISTED BELOW: VEH NO. 4 ORANGE COUNTY TEACHERS FCU P O BOX 11547 SANTA ANA CA 92711 Jun 27 05 04:29p ERGt)WAKALL 714 0480 p.5 r• t/r Interinsurance Exchange of the Automobile Club Premium Discounts Applied to Your Automobile Policy Auto Policy Number: G 6395664 The following show all automobile premium discounts offered by the Interinsurance Exchange for qualifying drivers and/or vehicles. Discounts that currently apply to your policy premium are indicated with a "Yes-" Multi-PolicyI Select Prof. & Claims Cost Multi -Vehicle Groups Persistency Reduction Homeowners condominium Renters Watercraft YES YES _. _ Driver Improvement Certificate Driver Good Good (valid 3 years) New Number Name Driver Student' Driver Mature Driver Driving Course 1 BAKALL, ERGUN YES 2 BAKALL,CHERYL YES 3 AKAY. ENIS E YES *Good Student - Full-time high school, college, or university study (minimum of 12 units per term) with less than nine years driving experionce who. have attained a current or cumulative grade paint average of at least 3.0. VEHICLE DISCOUNTS _ Anti -Theft Device••' Vehicle Year Make I Model Air Bags'* Garage Elecroic Other Number Lo Parking 1 1993 TOYO CAMRY LE YES NO NO YES 2 1999 BENZ E320 YES NO YES YES 3 2000 ISUZU RODEO YES NO YES YES 4 2005 POPS 911 CARRERA S CAB YES NO YES YES -Air Bags - Discount applies if Medical Payments and Uninsured Motorist Bodily Injury coverage Is purchased (refer to page one of the declarations). '•' Anti -Theft Device - Discount applies if Comprehensive coverage is purchased. If you need additional information about any of the above discounts, please refer to the Available Automobile Premium Discounts booklet included with your renewal offer (or the insert provided with your application). If you have any additional questions about premium discounts or your auto policy, please call us at 1-877-422-2100. ffWMA s 12 Jun 27 05 04:29p ERGLIWRKRLL 714 V#0480 p.6 This policy provides at least the minimum anrounls of liability Insurance required by the CA VEH CODE SECTION 160M for the specified vehicles and named insureds and may provide cgw"o for other persons and other vehicles as provided by the insurance policy. PROOF OF INSURANCE Interinsurance Exchange of the 0 Automobile Club Named Insured Policy Number G 6395664 i BAKALL, ERGUN AND CHERYL o Effective Date: 03/13/05 Expiration Date 03/13/06 This policy prwldes at least the minimum amounts of liability Insurance required by the CA VEH CODE SECTION 16056 for the spxl8ed vehicles and named insureds and may provide coverage for other Persons and other vehicles as provided by the insuranre policy. VEHICLES ON POLICY YEAR HAKE VEH I.D. 0 1993 TOYO JTZSKIZEUPOIS7774 1999 BENZ WDBJF65HOXA860178 20DO ISUZU 4S2CKSBWSY4302857 2005 PORS WPGAB2996SS74065B DRIVERS ON POLICY BAKALL. ERGUN SAKALL.CHERYL AKAY. ENIS E Place the Proof of Insurance in each vehicle insured under your policy. In addition, we suggest that each listed PROOF OF INSURANCE PROOF OF INSURANCE Irlteninsurance Exchange of the VEHWAJ S ON POLICY Autonrobile Club 1993 NAIa eel I.D. 1999 BOYO JrZSK1WDBJF2EOP0157774 1999 BENZ BS017 2000 4S2CKS VftT43WB57 z PORS WPOA8 996SS706S 2005 PORS WPOAB299655740658 nelned Insured Policy Number G 6395664 i BAKALL, ERGUN AND CHERYL 9 DRIVERS ON POLICY BAKALL. ERGUN Effective Date: 03/13/05 Expiration Date: 03/13/06 BAKALL. CHERYL AKAY, ENIS E This policy provides at least the minimum anrounls of liability Insurance required by the CA VEH CODE SECTION 160M for the specified vehicles and named insureds and may provide cgw"o for other persons and other vehicles as provided by the insurance policy. PROOF OF INSURANCE Interinsurance Exchange of the 0 Automobile Club Named Insured Policy Number G 6395664 i BAKALL, ERGUN AND CHERYL o Effective Date: 03/13/05 Expiration Date 03/13/06 This policy prwldes at least the minimum amounts of liability Insurance required by the CA VEH CODE SECTION 16056 for the spxl8ed vehicles and named insureds and may provide coverage for other Persons and other vehicles as provided by the insuranre policy. VEHICLES ON POLICY YEAR HAKE VEH I.D. 0 1993 TOYO JTZSKIZEUPOIS7774 1999 BENZ WDBJF65HOXA860178 20DO ISUZU 4S2CKSBWSY4302857 2005 PORS WPGAB2996SS74065B DRIVERS ON POLICY BAKALL. ERGUN SAKALL.CHERYL AKAY. ENIS E Place the Proof of Insurance in each vehicle insured under your policy. In addition, we suggest that each listed Jun 27 05 04:28p JO�OpBI(f�lG (a AAA oe= yFRN CA���` ERGLOBRKRLL 714 VV0480 Interinsurance Exchange of the Automobile Club P.O. Box 25001, Santa Ana, CA 92799-5001 www.aaa-calif.com 1-877-422-2100 BAKALL, ERGUN AND CHERYL 14 BONSALL IRVINE CA 92602-0950 Automobile Policy: G 6396664 Dear Valued Member, MARCH 14, 2005 The enclosed declarations page reflects a recent change to your policy. A description of the change appears on the back of this letter. Please take a moment to review this document. The policy charge you have made has resulted in a credit of $2468.00 for the remainder of this policy period. A new set of Proof of Insurance cards is included. You will need to destroy your previous set of Proof of Insurance cards, which are no longer valid, and replace them with the new set. We are pleased to have the opportunity to be of service to you, and look forward to providing you with dependable, high quality service for years to come. If you have any questions, call us toll-free, Monday through Friday from 8 a.m. to 7 p.m. or Saturday from 9 a.m. to 2 p.m. at 1-877-422-2100. Sincerely, Greg L. Backley Group Manager Policy Management Group Enclosures tl ddscription zif your pglf}r a harj$e;8plears ijn ihe:tidck of thls 1e11er iTs .. Insurance provided to qualified Auto Club members by the Interinsurance Exchange of the Automobile Club EI 4w p.2