1994-0720_C.B. ELECTRIC_Insurance Certificate :; ::.• ISSUE DATE(MM/DD/YY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
R Ti BURNS INSURANCE BROKERAGE CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
34071 LA PLAZA SUITE 210 POLICIES BELOW.
DANA POINT CA 92629 COMPANIES AFFORDING COVERAGE
( 714 ) 240-8350 COMPANY A
7142401436 FAX LETTER SAFECO INSURANCE COMPANY
COMPANY B
INSURED LETTER FINANCIAL INDEMNITY COMPANY
C B Electric COMPANY C
114 Avenida Sierra LETTER 5611. 2 11
COMPANY D yy
San Clemente CA 9267 LETTER
(714 ) 492-3013 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)
A GENERAL LIABILITY GENERAL AGGREGATE $1,000, 000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $1,000 r 000
CLAIMS MADE OCCUR. SL 2285548 07/23/94 07/23/95 PERSONAL&ADV.INJURY $1, 000000
OWNERS&CONTRACTORS PROT. EACH OCCURRENCE $1, 000, 000
FIRE DAMAGE(Any one fire) $ 50, 000
MED.EXPENSE(Anyoneperson) $ 5, 000
B AUTOMOBILE LIABILITY COMBINED SINGLE
ANY AUTO LIMIT $
ALL OWNED AUTOS
BODILY INJURY
X SCHEDULED AUTOS (Per person) $2 5 0, 0 0 0
HIRED AUTOS C 3822874 05/23/94 11/23/94 BODILY INJURY
NON-OWNED AUTOS (Per accident) $5 0 0, 000
GARAGE LIABILITY
PROPERTY DAMAGE $100 000
•
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM / / / / AGGREGATE $
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION / EACH ACCIDENT $
AND
DISEASE--POLICY LIMIT $
EMPLOYERS'LIABILITY --
DISEASE--EACH EMPLOYEE $
OTHER
/ / / /
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
ALL OPERATIONS OF THE NAMED INSURED
ADDITIONAL INSURED: SEE PAGE TWO (2 ) ATTACHED TO THIS DOCUMENT
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF SAN JUAN CAPISTRANO M EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
32450 PASEO ADELANTO Ni MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
SAN JUAN CAPISTRANO, CA. 92675 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY,p;a.AGENTS OR REPRESENTATIVES.
ATTN: RON S I E VE RS AUTHORIZED REPRESENTA IVE
AC tF ......................,.0.004#0,0001i
Pg 2
JULY 20, 1994
CHARLES D BROWN DBA C. B. ELECTRIC
CERTIFICATE TO CITY FOR SAN JUAN ET AL
ADDITIONAL INSUREDS:
The City and the Community Redevelopment Agency, its elected
or appointed officers, officials, employees and volunteers
are included as insureds with gard to damages.