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1991-0625_BOTACO, INC._Insurance Certificatey PRODUCER SEA COAST INSURANCE 34197 PCH 11202 DANA POINT, CA 92629 INSURED BOTACO, INC. 31921 CAMINO CAPISTRANO 11401 SAN JUAN CAPISTRANO, CA 92675 ISSUE DATE (MM/DD/YY) 6-25-91 CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COMPANIES AFFORDING COVERAGE COMPANY LETTER A AMERICAN STATES INS. CO. COMPANY B LETTER COMPANY LETTER C COMPANY D LETTER COMPANY E LETTER COVERAGES ,- ,. N, tF._-•,i' "'x: ,'i e..'.�:':. , 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 LTR DATE (MM/DD/YY) DATE (MMIDD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S I,UVU,VUU. i X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 1,000,000. CLAIMS MADE X OCCUR. 01—CC-79441-1 10— 13-90 10-13-91 PERSONAL 8 ADV. INJURY S 19000,000. A OWNER'S 6 CONTRACTOR'S PROT, EACH OCCURRENCE S 1,000,000. FIRE DAMAGE (Any one lire) S 50,000, MED. EXPENSE (Any one person) S 5,000. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS A X SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY COMBINED SINGLE s 1,000,000. LIMIT BODILY INJURY $ 01—CC-519448-1 10-13-90 10-13-91 (Per person) BODILY INJURY $ (Per accident) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS LANDSCAPE MAINTENANCE, VARIOUS LOCATIONS CERTIFICATE HOLDER CANCELLATION 10 DAY NON—PAY ADDITIONAL INSURED[ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN CAPISTRANO & COMMUNITY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO REDEVELORAWr AGENCY, ITS ELECTED OR APPOINTED MAIL30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE OFFICERS, OFFICIALS, R4WYEES & VOLUNTEERS LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR j 32400 PASED ADELANTO LIABI TY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I SAN JUAN CAPISTRANO, CA 92675 AUTHO ED REPRESENTATIVE ATTN: DAWN SHANDERL ACORO 25-S (7190) CACORO CORPORATION 19901 PROPERTY DAMAGE S I EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM STATUTORY LIMITS j WORKER'S COMPENSATION EACH ACCIDENT $ AND DISEASE—POLICY LIMIT S EMPLOYERS' LIABILITY DISEASE—EACH EMPLOYEE 8 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS LANDSCAPE MAINTENANCE, VARIOUS LOCATIONS CERTIFICATE HOLDER CANCELLATION 10 DAY NON—PAY ADDITIONAL INSURED[ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF SAN JUAN CAPISTRANO & COMMUNITY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO REDEVELORAWr AGENCY, ITS ELECTED OR APPOINTED MAIL30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE OFFICERS, OFFICIALS, R4WYEES & VOLUNTEERS LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR j 32400 PASED ADELANTO LIABI TY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I SAN JUAN CAPISTRANO, CA 92675 AUTHO ED REPRESENTATIVE ATTN: DAWN SHANDERL ACORO 25-S (7190) CACORO CORPORATION 19901 • LIABILITY ENDORSEMEN CITY OF SAN JUAN CAPISTRO COMMUNITY REDEVELOPMENT AGENCY 32400 Paseo Adelanto San Juan Capistrano, California 92673 ATTN: ern c Lana s oFFics A. POLICY INFORMATION Endorsement !/ 1 I. Insurance Company AMERICAN SLAM INS. CO. ; Policy Number 01 -OC -79441-1 2. Policy Term (From)I 13-90 To Iola-. I�;Endorsement Effective Date 10-13-90 3. Named Insured BUMOD INC. 4. Address of Named Insured CAPISLRAM #401, SAN JUAN CAM r& QIX17� 5. Limit of Liability Any One -occurrence/Aggregate 5 1.000.000. ag, General Liability Aggregate (check one:) Applies "per location/project" XX Is twice the occurrence limit 6. Deductible or Self -Insured Retention (Nil unless otherwise specifiedr $ 7. Coverage is equivalent to: Comprehensive General Liability form GL0002 (Ed 1/73) xic Commercial General Liability "claims -made" form CG0002 S. Bodily Injury'and Property Damage Coverage is: "claims-made" "occurrence" It claims -made, the retroactive date is B. POLICY AMENDMENTS This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent statement in the policy to which this endorsement is attached or any other endorsement attached thereto, it is agreed as follows; 1. INSURED. The City and the Community Redevelopment Agency, .its elected or appointee officers, officials, employees and volunteers are included as insureds with regard to damages and defense of claims arising from: (a) activities performed by or on behalf of the Namec Insured, (b) products and completed operations of the Named Insured, or (c) premises owned. leased or used by the Named Insured. 2. CONTRIBUTION NOT REQUIRED. As respects: (a) work performed by the Named Insure( for or on behalf of the City; or (b) products sold by the Named Insured to the City, or (c premises leased by the Named Insured from the City, the insurance afforded by this policy shall be primary insurance as respects the City, its elected or appointed officers, officials employees or volunteers; or stand in an unbroken chain of coverage excess of the Namet Insured's scheduled underlying primary coverage. In either event, any other insurance maintained by the City, its elected or apppointed officers, officials, employees or volunteer shall Se in excess of this insurance and sfiall not contribute with it. (OVER) 3. SCOPE: OF COVOGE. This policy, if primary, affo,coverage at least as broad as: (1) Insurance Services Office form number GL 0002 (Ed. 1/73)0 Comprehensive General, Liability Insurance and Insurance Services Office form number GL 0404 Broad Forma comprehensive General Liability endorsement; or (2) Insurance Services Office Commercial General Liability Coverage, "occurrencefl form CG 0001 or "claims -made" form CG 0002; or (3) If excess, affords coverage which is at least as broad as the primary insurance:; forms referenced in the preceding sections (1) and (2). 4. SEVERABILITY OF INTEREST. The insurance afforded by this policy applies separately o'� each Insured who is seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. S. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS. Any, failure to comply with reporting provisions of the policy shall not affect coverage providect to the City and the Community Redevelopment Agency, its elected or appointed officers, officials, employees or volunteers. 6. CANCELLATION NOTICE. The insurance afforded by this policy shall not be suspended,: voided, cancelled, reduced In coverage or In limits except after thirty (30) days' prior written, notice by certified mail return receipt requested has been given to the City. Such notice shall be addressed as shown in the heading of this endorsement. r C. INCIDENT AND CLAIM REPORTING PROCEDURE Incidents and claims are to be reported to the Insurer at: ATTN: Title Department SEA OOAST INSURANCE AGOCY Company 34197 PCH #202 Street Address DANA POINT, CA 92629 City State Zip c—'R7e 714) 489-1574 p. Telephone D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER ' it JAMES E. PAUL (print/type name), warrant that I have authority to bind the below listed insurance company and by my si ure hereon do so bind t is company. SIGN URE OF ACTH IZED ESENTATIVE (origganal s>, ature required on endorsement furnished to the City3 CWMIZATICN: SFA COAST INSURANCE AGENCY, INC TITLE: PwsmEff ppMS; 34197 PCH #202, DANA POINT, CA 92629 'i'Fi2FrEM: (714 ) 69q-IS7(