1994-0525_C.B. ELECTRIC_Insurance Certificate 05/25/94
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
R W 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
LETTER
COMPANY B
INSURED LETTER FINANCIAL INDEMNITY
C B Electric COMPANY C 3
114 Avenida Sierra LETTER <
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COMPANY �-y A Cn
San Clemente CA 9267 LETTER D rn
(714 ) 492-3013 COMPANYosn — rn
LETTER
�T x ✓ Tt
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI- POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT O WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TfL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO POLICY TR TYPE OF INSURANCE POUCY NUMBER DATE(MM/DDT/YY)IVE PDATE(OUCY MM/DD/YY)
UMITS
GENERAL LIABIUTY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABIUTY PRODUCTS-CAMP/OP AGG. S
CLAIMS MADE OCCUR / / / / PERSONAL&ADV.INJURY S
OWNER'S&CONTRACTORS PROT. EACH OCCURRENCE $
FIRE DAMAGE(Any one tire) $
MED.EXPENSE(Anyoneperson) $
B AUTOMOBILE UABIUTY COMBINED SINGLE
ANY AUTO UMIT
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Per person) 2 5 0, 000
HIRED AUTOS C3822874 05/23/94 11/23/94 BODILY INJURY
NON-OWNED AUTOS (Per accident) $500, 000
GARAGE LIABILITY
PROPERTY DAMAGE s100, 000
EXCESS LIABILITY EACH OCCURRENCE _ S
UMBRELLA FORM / / / / AGGREGATE S
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION / EACH ACCIDENT $
AND
DISEASE-POLICY UMIT $
EMPLOYERS'LIABIUTY
DISEASE-EACH EMPLOYEE $
OTHER
/ / /
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICL Es/SPECIAL ITEMS
ALL OPERATIONS OF THE NAMED INSURED
............ . .............
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
3 2450 PASEO ADELANTO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
pAN JUAN CAPISTRANO, CA. 92675 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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