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1989-0605_BOTACO, INC._Insurance Certificatea1:1OW. CERTIFICATOF INSURANCEISSUE DATE MM/DD/YY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW BOSWELL INSURANCE AGENCY PO BOX 4648 COMPANIES AFFORDING COVERAGE MISSION VIEJO, CA 92690 COMPANY A CODE SUB -CODE LETTER AMERICAN STATES INSURANCE COMPANY CO INSURED LETTERNY B CALIFORNIA INDEMNITY INSURANCE COMPANY WORKER'S COMPENSATION O STATUTORY B AND P 2243A 1/21/89 1/21/90 $ (EACH ACCIDENT) $ (DISEASE --POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE—EACH EMPLOYE OTHER *EXCEPT IN CASE OF CANCELLATION FOR NONPAYMENT OF PREMIUM, 10 DAYS NOTICE MAY BE GIVEN. DESCRIPTION OF OPERAT(ONS(LOCATIONS/VEHICLES(RESTRICTIONS/SPECIAL ITEMS JOB: ALL OPERATIONS PERFORMED BY THE INSURED ON BEHALF OF THE ADDITIONAL NAMED INSURED. CERTIFICATE HOLDER & ADDITIONAL INSURED CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE SAN JUAN CAPISTRANO REDEVELOPMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL )99KK v)mXX0 AGENCY MAIL 3.0—*_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT. �i}�X�X6pXMACk SXN?NL�t1C2X9iMXOCX%X]pCN8X9G9NCD[ SAN JUAN CAPISTRANO, CA 92675 XXAiB(N1tdCd�}CTd]6�t34�(OtN9COTX##XIXQN9XX1X9C�Ct#t7�biX747PXIERYADEsX AUTHORIZED REPRESENTATIVE JOE A. BOSWELL a r ACORD 25-S 53/88) ---_` 111 CACORD CORPORATION 1986 C �Q®® �� BOTACO, INC. LETTER 32221 CAMINO CAPISTRANO #123 A SAN SAN JUAN CAPISTRANO, CA 92675 COMPANY - LETTER D �\eCi�o CIO E �_ LETTERNY 11 a i 'I �—� COVERAGES r't� THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED QED ABOVE FfYT I ppQQII,,ICV PE D INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOC yfENT WgANJ86gP'1'ClWJHI HIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUB.IEJU.1FONtl4ALL THE T MS, 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 ,BALL LIMITS IN TNOUANDS -TR DATE IMM/OO/YY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OPS AGGREGATE $ 2,000 A CLAIMS MADE X OCCUR, 01—CC-103208-3 3/1/89 3/1/90 PERSONAL& ADVERTISING INJURY $ 1,000 OWNER'S A CONTRACTOR'S PROT, EACH OCCURRENCE $ 1,000 FIRE DAMAGE (Any one lire) $ 50 MEDICAL EXPENSE (Any one person) $ 5 AUTOMOBILE LIABILITY COMBINED SINGX $ 500 ANY AUTO LIM TLE ALL OWNED AUTOS BODILY A NJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS X BODILY XNON -OWNED AUTOS 01 -CC -367664-1 INJURY $ 3/1/89 3/1/90 (Per accident) GARAGE LIABILITY PROPERTY $ DAMAGE EXCESS LIABILITY EACH AGGREGATE OCCURRENCE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION O STATUTORY B AND P 2243A 1/21/89 1/21/90 $ (EACH ACCIDENT) $ (DISEASE --POLICY LIMIT) EMPLOYERS' LIABILITY $ (DISEASE—EACH EMPLOYE OTHER *EXCEPT IN CASE OF CANCELLATION FOR NONPAYMENT OF PREMIUM, 10 DAYS NOTICE MAY BE GIVEN. DESCRIPTION OF OPERAT(ONS(LOCATIONS/VEHICLES(RESTRICTIONS/SPECIAL ITEMS JOB: ALL OPERATIONS PERFORMED BY THE INSURED ON BEHALF OF THE ADDITIONAL NAMED INSURED. CERTIFICATE HOLDER & ADDITIONAL INSURED CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE SAN JUAN CAPISTRANO REDEVELOPMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL )99KK v)mXX0 AGENCY MAIL 3.0—*_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 32400 PASEO ADELANTO LEFT. �i}�X�X6pXMACk SXN?NL�t1C2X9iMXOCX%X]pCN8X9G9NCD[ SAN JUAN CAPISTRANO, CA 92675 XXAiB(N1tdCd�}CTd]6�t34�(OtN9COTX##XIXQN9XX1X9C�Ct#t7�biX747PXIERYADEsX AUTHORIZED REPRESENTATIVE JOE A. BOSWELL a r ACORD 25-S 53/88) ---_` 111 CACORD CORPORATION 1986 1111S ENDORSE CIIANGES THE POLICY. PLEASE READ 1WHULLY. mmdm g�rawusa�s, AUDITIONAL INSURED - OWNERS, LESSEES Ca 20 to it as • OR CONTRACTORS (FORM B) COMMERCIAL GENERAL LIABILITY 01—CC-103208-3 Ibis endosemenl modifies Insurance provided under The following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCIIEDULE Name of Person or Organization! SAN JUAN CAPISTRANO REDEVELOPMENT AGENCY 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (II 110 enlry appears above, information required to complete This endorsement will be shown in the Ueclaralions as applicable to fids einimsenrenl.) WIIU M AN INSURED (Section II) Is amended to Include as an Insured the person or organization shown in The Schedule, bul only with respect to liability arising out of "your work" lot Ibal Insured by or tot you. Coryr101. Insurance Services Onice. tire. 1984 { _ JUN 1989 CITY OF n SAN JUAN CAPISTRANO CALIFORNIA /