1998-0401_HOLLAND-LOWE CONSTRUCTION, INC._Insurance Certificate r ' i DATE(MM/DIVVY)
ACORD
PRODUCER (714)582-5220 FAX (714)582-3512 THIS CERTIFICATE C JED AS A MAT I ER OF INFORMA1 ION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5 P I B Insurance Agency Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26441 Crown Valley Pkwy, #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Mission Viejo, CA 92690-9055 COMPANIES AFFORDING COVERAGE
COMPANY Safeco Insurance Company
Attn: Kathy lesser Ext: 207 Aap
INSURED DO
Jezowski & Markel Contractors, Inc. COMPANY
Michael Barth .�� 73
COMPANY 4 n Trl
C)
748 N. Poplar C
m
Orange, CA 92868
COMPANY
D qtr z Co
cavl�Ra;cl=s
..............
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIPERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI I i 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.
COTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DIVVY) DATE(MM/DIVVY)
GENERAL LIABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $
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 $
WORKERS COMPENSATION AND X TORY LIMITS ER
EMPLOYERS'LIABILITY .. .... . :.. . :`':.''`` ` '` :':..
A WC 2199693 04/01/1998 06/041011110kEL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR/ INCL RL DISEASE-POLICY LIMIT $
1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE: X EXCL EL DISEASE-EA EMPLOYEE $ 1,000,00 0
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL
SUBCONTR. #1016C-5, JOB #1016C TZZEVENTATIVE ST. MAINT. 1996-97;IA CALIFORNIA/CAMINO LAS RAMBLAS
4VENIDA AEROPUERTO, MISSION HILLS & CAPISTRANO VILLAS SPEED BUMPS
EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL XI M)0(tp MAIL
3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
CITY OF SAN JUAN CAPISTRANO R 7P1i-1QTVF,Mh NI N/04aPfi<40X$440 M RclteKVPVOWSQ9ml9C+ (X4A(314-XIXX
32400 PASEO ADELANTOf35CWint'iNPxMP92NR XANAI)RA4cENMSR9IRERT4M€XITATNX XXXX XXX
SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REPRESENTATIVE
Larry Hines/CKY
fJACO:RfI COR'ORAT:ION 198$