1996-0210_ORANGE COUNTY TRANSPORTATION AUTHORITY_Insurance Certificates (2) A1;111:11., CERTIFICA'. ISSUE DATE(MM/DD/YY)OF INSURANCE 11/01/95
PRODUCER THIS CERTIFIeATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
RODES—ROPER—LOVE INS. AGENCY, INC. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
P. 0. BOX 700 POLICIES BELOW.
MELBOURNE, FL 32902-0700 COMPANIES AFFORDING COVERAGE
amM,NY A UNITED PACIFIC INSURANCE CO.
COMPANY B LEXINGTON INSURANCE CO.
INSURED
COMPANY. __ __... .. . .
DAVE MANAGEMENT, INC. LETTER C &6V• SO
DAVE TRANSPORTATION SERVICES, INC.
COMPANY D
VAN TRAN OF TUCSON, INC. LETTER
DAVE FLEET MANAGEMENT
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY p p GENERAL AGGREGATE $ 2,500,000
A X'COMMERCIAL GENERAL LIABILITY SJ2828222 11/01/95 11/01/96 PRODUCTS-COMP/OP AGG. $ 2,500,000
CLAIMS MADE X OCCUR. PERSONAL&ADV.INJURY $ 2,500,000
OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 2,500,000
FIRE DAMAGE(Any one fire) $ 50,000
MED.EXPENSE(Any one person) $ 5,000
AUTOMOBILE LIABILITY COMBINED SINGLE
LIMIT $
A XANY AUTO SH2673939 11/01/95 11/01/96 2,500,000
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS BODILY INJURY
w _ —
$
X (Per accident),NON-OWNED AUTOS
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE $ 2,500,000
B X UMBRELLA FORM 5108822 11/01/95 11/01/96 AGGREGATE $
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY LIMITS
EACH ACCIDENT I$
AND
DISEASE—POLICY LIMIT $
EMPLOYERS'LIABILITY
DISEASE—EACH EMPLOYEE $
OTHER
$10,000. DED. COMP.
A PHYSICAL DAMAGE SH2673939 11/01/95 11/01/96 $10,000. DED. CD.LL.
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CITY OF SAN JUAN CAPISTRANO, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ^ "'
SHOWN AS AN ADDITIONAL INSURED AS RESPECTS TO THE
OPERATIONS OF THE NAMED INSURED ONLY = Y �' - `7
,flOilkONOIXIER CANCELLATION Si i. r 4. r*T
SHOULD ANY OF THE ABOVE DESCRIBED POLICIE6t CANCEL . BEFORE THE
CITY OF SAN JUAN CAPISTRANO EXPIRATION DATE THEREOF, THE ISSUING COI4PANY WILL +rA4AV7e�♦
ATTN: DAWN SCHANDERLMAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDEAMED TO THE
RECORDS COORDINATOR LEFT, 1Ql1..1'1g?f. *14?A.M.4.A.SA.lftA.1+7.4',1,4V.A,10;,t.'.`4T!.►A4:A♦
32400 PASEO ADELANTO CITY HALLlA1t•t1?”A1A*A?1011!•t. `t+,1,!.1141!,11?mci!+tfT1.111t1A1”
SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REPRESE TATIVE
a:• 25.8(7190)
x tt "L"'N b ..\, b �, �\ g N ,n"`s� `fity
ADDITIONAL INSURED ENDORSEMENT
Attached to and forming a part of the Certificate of Insurance dated
11/01/95
Policy: #5108822
Issued to: CITY OF SAN JUAN CAPISTRANO
ITS OFFICERS, AGENTS AND EMPLOYEES
The Certificate Holder named above is shown as an Additional Insured as
respects to the operations of the named insured only to the extent of
liability assumed by the Named Insured under the contract between the
Certificate Holder and the Named Insured pursuant to which this
certificate is issued, subject to the policy terms and conditions.
Richard P. Love, Jr.
Authorized Representative
Lexington Insurance Co.
............................
Albeit!). CERTIFIC 'E OF INSURANCE DATE(MM/DD/YY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Averbeck Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3270 Inland Empire Blvd $#100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Ontario, CA 91764 COMPANIES AFFORDING COVERAGE
COMPANY
AGreat States Ins . Co.
INSURED COMPANY
Dave Transportation Services, BFireman' s Fund Insurance Company
Inc .
26111 Antonio Parkway COMPANY 6 C C, 50
Rancho Santa Margarita, CA 92688
COMPANY
COVERAGES 1 C�%r i/� / �`J� L-e 71 C C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE B N SSUED TO THE INSURED NAMED ABOVE FO HE POLI PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO ICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO $
CLAIMS MADE OCCUR PERSONAL&ADV INJURY $
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $
FIRE DAMAGE(Any one fire)$
MED EXP(Any one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
A WORKERS COMPENSATION AND GWN1010 3 3 9 6 01/01/96 01/01/97 STATUTORY LIMITS
EMPLOYERS'LIABILITY EACH ACCIDENT $1, 000, 000
THE PROPRIETOR/ X INCL DISEASE-POLICY LIMIT $1, 0 0 0, 0 0 0
PARTNERS/EXECUTIVE -OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE $1, 0 0 0 , 0 00
B OTHER Blanket MXX80635951 12/31/95 12/31/96 $120 , 000 Limit .
Employee $1 , 000 Deductible .
Dishonesty
Coverage
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Verification of Insurance . *10 Day Notice of Cancellation applies for
Non Payment of Premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of San Juan Capistrano EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn. Linda Evans *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
32400 Paseo Adelanto/ City Hall BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
San Juan Capistrano, CA 92675 OF ANY KIND'UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED EPRESENTAT E
ACORD 25-S(3/93)1 of 1 #S39366/M39317 K 0ACORO CORPORATION 1993