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1989-0509_BOTACO, INC._Insurance CertificateCERTIFICAT F INSURANCE ISSUE DATE (MMIDD/YY) . 5/9/89 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 su0-coDE LETTER AMERICAN STATES INSURANCE COMPANY INSURED COMPRNY B CALIFORNIA INDEMNITY INSURANCE COMPANY BOTACO, INC. LENTERNY C 32221 CAMINO CAPISTRANO #123 COMPANY SAN JUAN CAPISTRANO, CA 92675 LETTER D 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 ANI' REQUIREMENT, TFRM 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 ALL LIMITS IN THOUSANDS .TR - DATE (MMIDD/YY) DATE (MM/DD/YY) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONSISPECIAL ITEMS CERTIFICATE HOLDER THE CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 ACORD 25-S (3188) ..,, CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1.0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,, • ,, ' JOE A. BOSWELL ®ACORD CORPORATION 1988 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 A 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) $ r 5 AUTOMOBILE LIABILITY COMBINED $ 500 x ANY AUTO LIMIGTLE ALL OWNED AUTOS BODILY r A INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS x BODILY INJURY $ x NON GINNED AUTOS 01—CC-367664—i 3/1/89 3/1/90 (Per accidenp GARAGE LIABILITY PROPERTY DAMAGE S EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY B AND P 2243A 1/21/89 1/21/90 E (EACH ACCIDENT) $ (DISEASE—POLICY LIMtTI EMPLOYERS' LIABILITY $ (DISEASE—EACH EMPLOYEE OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONSISPECIAL ITEMS CERTIFICATE HOLDER THE CITY OF SAN JUAN CAPISTRANO 32400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 ACORD 25-S (3188) ..,, CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1.0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,, • ,, ' JOE A. BOSWELL ®ACORD CORPORATION 1988