1989-0706_BOTACO, INC._Insurance CertificateAck,eitip. CERTIFICAT L.; OF INSURANCE ISSUE DATE (MM/DD/YY)
7/6/89
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
BOSWELL INSURANCE AGENCY EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
PO BOX 4648 COMPANIES AFFORDING COVERAGE
MISSION VIEJO, CA 92690
CODE
[INSURED
SUB -CODE
BOTACO, INC.
32221 CANINO CAPISTRANO #123
SAN JUAN CAPISTRANO, CA 92675
COMPANY
LETTER A CALIFORNIA INDEMNITY INSURANCE COMPANY
COMPANY B
LETTER
COMPANY
LETTER l
COMPANY D
LEITER
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 POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS
TR DATE (MM/DDNY) DATE (MM/DDNY)
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
OWNER'S 8 CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
GENERAL AGGREGATE $
PRODUCTS-COMP/OPS AGGREGATE $
PERSONAL 8 ADVERTISING INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Any one tire) $
MEDICAL EXPENSE (Any one person) $
COMBINED
SINGLE $
LIMIT
BODILY
NJURY
$
Per person)
BODILY
INJURY
$
(Per eooidenl)
PROPERTY
$
DAMAGE
EXCESS LIABILITY EACH AGGREGATE
OCCURRENCE
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY
A AND $ (EACH ACCIDENT)
$ (DISEASE—POLICY LIMIT)
EMPLOYERS' LIABILITY P 2243A 1/21/89 1/21/90 $ (DISEASE—EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
CERTIFICATE HOLDER CANCELLATION
CITY OF SAN JUAN CAPISTRANO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
32400 PASAN UELANTO EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
SAN JUAN CAPISTRANO, CA 92675 MAIL --I()- 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 a
JOB A. BOSWELLa-v-
ACOR6
1'
25-S (3/88) CACORD CORPORATION 1888