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1994-1103_CAPITAL & COUNTIES USA_Insurance Certificate SENT SY;SULLPAN & CURTIS UV. ; 4- 5-95 ; 1:571'M ; 714)1ShIn'" U-4uoiuo;l;I, zr o AC M I1, IF . INSURANCE IssUE DATE(MM/ODJYY) 11/0.i/94 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED OY THE SUM ivan 8 Curtis Ins. Brokers POLIGIE2BELOW 2100 Main Street; #1350 COMPANIES AFFORDING COVERAGE Irvine, CA 9271 ¢ COMPANY A LETTER CHURN ORANGE COMPANY c INSURED LEITER COMPANY Capital & Counties U9R, Inc , LETIER G 101 California St. , # 252 GQMPANr Sale Francisco Cit 94111 LETTER COMPANY E LETTER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST U)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 RE ISSUED OFt 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 PAlO CLAIMS, CO TYPEOF MIV SUNANCE POUCY NuMNER POL/CY EFFECTIVE POLICY B7[PIRALQN TLawsLTR DATE(MMtM[NYY) DATE(MMIDPlYYI GENERAL LIACILITY 35307721 1.1/O:t/94 11/01/95 GENERA.AGGREGATE : 2000000 X GOMME DIAL OE/ERA'.LtAAILTIY PRODUCT3GOMINCP ACO. 3 2000000 CLAIMS&UDE X OCCUR, PERSONALaADV.INJURY 5 1000000 CIwNER'S a CONTRACTOR'S PROT. EACH OCCUNRENCE $ 1000000 FINE CARTAGE(Any one firm) R .5'0000 MED,EXPENSE(A+7 orn Pent $ 5 0 0 0 AUTOMOBILE LIABiITY COMBINED SINGLE AMY AIYtl7 UNIT ALL OWNED AUTOS 807ILY INJURY $ SCHEDULED AUTOS (P* Pm ) HIRED AUTOS BODILY INJURY NG*-QWNEL)AUTOS (kr ecgklenT) GARAGE LABILITY PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURRENCE 1 UMBRELLA FORM At I3REGAT£ 011101 THAN UMBRELLA FORM wORXER S cO NSATHQII STATtJLORY LIMITS EACH ACCIDENT S AND DISEASE—POLICY t IUIT i EMPLOYERS'LIAINLiT"1' otsEASE—EACH EmPLGYEE $ OTHER DESCRIPTION OF OPERATIONS LOCAT ONSNE7UCLEWBPECWL Imo RE: LICEINSE AGREEMENT, LOT 216, TRACT 12954 SEE T1TTPCHED CG20I0 FOR ADDITIONAL. INSURED INFORiMATIONi CERTIFICATE HOLDER CANCEk LAT14N • SHOULD ANY OF THE ABOVE DESCRIBER POLICIES CE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 3Eibilakiatopa CITY IIF SAN U A N! CPPISTRANO MAIL_.3 0 DAYS WRITTEN NOTICE TP THE CERTIFICATE HOLDER NAMED TO THE DEFT . OF ENG . & BLDG. LEFT, . a.. ->< < r_•.• - - - . •'c' Iii 32400 PASEG AULLRNTU zaxagromeg *,. • e litniceilrtrfflin5RPAYPRW SANT JUAN CAP1STRANO, CA 92675 _LL AUTHORIZED ESENTATIVE b SO ACORD 2s-$ POH .�� . OA I RATION 1990 2 - 76 SENT liT SULL l VAIN & (Tiff I S 110. ; 4 5 95 ; 1 57M ; 714)'8.529762- 9--4931Q53;# 3/ 3 . POLICY NUMBER: 0-, A. .OMMERC AL GENERAL LIASIUW THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM R) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART, SCHEDULE Name of Parson or OrmeisatIosi CITY OF SAN JUAN C 1PISTRANNO (U no entry appears above.information required to cGxnplete this endorsement ent will be shaven in the Declarations as applicable to this endorsement.) WHO IS AN INSURED(Section II)eat amendad to it tach as an imwrsd the person or organizabon shown in the Schedule, but only with respect to liability arising out of..your work"for that insured by or for you. CG 20101185 Copyright. Insurance Services Office, Inc., 19114 L SENT BY:SULLIVAN & CURTIS IRV. ; 4- 5-95 ; 1:56PM ; 714)11,5V.:i762-' i-4J011100;* 1/ i • SuuivAN&CURrIS i N S U k A N C E IIPOKERS •IRVINE TELEC.OP/ER OUT CVNG ME$ AGE COMER PAGE •PASADENA •LAS ANEJELE,$ •HONOLQLU •EEAT171; FAX # 714-493-1053 DATE: APRIL 5, 1995 FIRM: CITY OF SAN JUAN CAPISTRANO FRO}i: LORRAINE DOPP TO: KATHLEEN DU COING OFFICE: IRVINE, CA RE: CERTIFICATE OF INSURANCE FOR # OF PAGES: 3 CAPITAL & COUNTIES USA, INC. **********************************************yr**************tit e****Ir* SEE ATTACHED * Pasadena FAX: 1-818-792-6111 * Honolulu FAX: 1-808-522-5919 * Irvine FAX: 1-714-852-9762 * Santa Barbara FAX: 1-805-687-8851 * Los Angeles FAX: 1-213-628-8852 * South Carolina FAX:1-803-738-9797 art**, ***************************************************************** This mage is intended only for the use of the Individual or entity to which it is uldriamed and may contain information that is privi- le ged,confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,or the noiployee or agent responsible for delivering the message to the 1n.unet recipient,you are hereby notified that any dI se, Ination, dstrlbetian or copying,of this ctumnuniealian is strictly peoldbited. fT,Y,ua have received this communication'if.error,please notify us Immediately by telephone and reON11 the arigMLut merge to us at the above address via the U.S.Postal Service_ Thank you. 111) MO WAN Kravxr MINE.CA 92714. 7f17 FAS 7141652-9WSg