1991-1017_BOTACO, INC._Insurance CertificateK ACORD. C r' IC -1 7 S OF MSU A CE ! SSUE DATE i 7 -9 D 1 w
I
PRODUCER THIS CERTIFICATE IS ISSUED AS AFFMATTER OF INFORMATION ONLY AND
CONFERS NO SEA COAST INSURANCE AGENCY, INC.
DOES NOT MEIND,TS UPON THE EXTEND OR ALR'ER'VERAGE AFFORDED
IBY THE
FICATE
34197 PCH 11202
DANA POINT, CA 92629
COMPANY A CIT;' :LERK
LETTER AMERICAN STOflHI.BiMMTCO.
E
(;TTY OF N
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NY
COMPAJUAN CAIS ANA
B
INSURED
LETTER
BOTACO, INC.
COMPANY`.
LETTER
31921 CAMINO CAPISTRANO, CA 11401
COMPANY
SAN JUAN CAPISTRANO, CA 92675
LETTER
COMPANY E
LETTER
COVERAGES
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
LTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MMIDDIYY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE S 1,000,000.
X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMPIOP AGG. $ 1,000,000.
CLAIMS MADE X OCCUR. 01 -CC -79441-2
10-13-9 1 10-13-92 PERSONAL & ADV. INJURY $ 1,000,000.
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE S 1,000,000.
A
FIRE DAMAGE (Any one fire) S 50,000.
MED. EXPENSE (Any one person) $ 51000.
AUTOMOBILE LIABILITY
COMBINED SINGLE
$ I , Do, COO .
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY
$
A X SCHEDULED AUTOS
(Per person)
01 -CC -519448-2
10-13-91 10-13-92
X HIRED AUTOS
BODILY INJURY
X NON -OWNED AUTOS
$
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY
EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION
EACH ACCIDENT S
AND
DISEASE—POLICY LIMIT $
EMPLOYERS' LIABILITY
DISEASE—EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VENICLES/SPECIAL ITEMS
LANDSCAPE MAINTENANCE, VARIOUS LOCATIONS
CERTIFICATE HOLDER
CANCELLATION 10 DAY NON -PAY
ADD'L INSURED: CITY OF SAN JUAN CAPISTRANO &
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I
CM4jNITY REDEVELOPFMEM AGENCY, ITSEXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
ELECTED OR APPOINTED OFFICERS,
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
OFFICIALS, EMPLOYEES & VOLUNTEERS
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
32400 PASEO ADLANTO
LIABILITY 9F ANY 5W UPOgTHE COMPANY, ITS AGENTS OR REPRESENTATIVES.
SAN JUAN CAPISTRANO; CA 92675
AUTHORIZE RESENTATIVE
ATTN: DAWN SHNDERL
ACORD 25•S 7/90
ORD CORPORATI.