1997-1016_CALIFORNIA TRAFFIC MAINTENANCE_Insurance Certificate �'Iorn,e TIFICKI(:1Ww OF'INSURANCE DATE�MM�Dm,
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Contractors & Manufacturers Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. 0. Box 7817 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING CO ERAGE
Northridge CA 91327-7817 PANY / 99. //VG-
(818) 368-3561 A
MPANY ss/a�"+'GOLDEN EAGLE INSURANCE CO. //
INSURED /,/0)//as .i )
C
California Traffic Maintenance B C/0 APPLEBY & STERLING
1731 N California COMPANY
C NAVIGATORS INSURANCE CMPANY
Burbank CA 91505- COMPANY
(818) 95418772 D GENERALI INSURANCE COMPANY...USA At
•COVERAGE ::::<::>:;;:..::
............
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.
COI POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER uHTE(WiF1iDD/YY) DA 1E(MM/DIVYY) LIMITS
C GENERAL LIABILITY GENERAL AGGREGATE $2000000
X COMMERCIAL GENERAL LIABILITY 97G2167 07/08/97 07/08/98 PRODUCTS-COMP/OP AGG $1000000
CLAIMS MADE LX I OCCUR PERSONAL&ADV INJURY $1000000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1000000
FIRE DAMAGE(Any one fire)_ $50000
MED EXP(Any one person) $5000
D AUTOMOBILE LIABILITY
COMBINED SINGLE UMIT $
ANY AUTO GA10300023 07/08/97 07/08/98 1000000
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X 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 X STATUTORY LIMITS
EMPLOYERS'LIABILITY NWC 480336 02/05/97 02/05/98 EACH ACCIDENT $1000000
THE PROPRIETOR/ INCL DISEASE-POLICY LIMIT $1000000
PARTNERS/EXECUTIVE
OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $0=1:110000
OTHER
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DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
ALL OPERATIONS OF THE NAMED INSURED ON JOB NO. ANNUAL CONTRACT TEN DAY CANCELLATION FOR NON PAYMENT OF PREMf ' N C7
AS RESPECTS GENERAL LIABILITY, THE CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL tel:
INSURED RESPECTING AS PER ATTACHED CG 00 10 11 85 ENDORSEMENT.
_��w�y� +may �iyy ,` �+�* �!y�1�yf,t :;:
F�'k 1. L4:Nk�l~ ��T�1;'1:. ��i � � �. I;A�G7..4.!•l�a IWI♦� 5 ii:::i:iii
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
Att: Deputy City Clerk 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Ddawn Schanderi BUT FAILURE TO MAIL SUCH NOTICE-SHALL IMPOSE NO OBLIGATION OR LIABILITY
32400 Paseo Edelanto OF ANY KIND UPON THE CO„P• , ITS AGENTS OR REPRESENTATIVES.
San Juan Capistrano CA 92675 AUTH•• ZE1; PRESENTATIV
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