1990-0125_BOTACO, INC._Insurance CertificateA040Itioe CERTIFICAT -OF INSURANCE 1-225-905-90
ISSUE DATE (
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
SEA COAST INSURANCE EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
31726 RANCHO VIEJO RD 11213 FtECEIVED
SAN JUAN CAPISTRANO, CA 92675 F /1��
fAN 29 1 06 40mlly A
LETTER
CODE SUB -CODE CiT'Y CLERK
OEPARTMENFETTER B
INSURED ETTER
CITY OF SAN
BOTACO CORP. JUAN Cb('ISTRA PANy
LETTER C
27455 ORTEGA HWY
SAN JUAN CAPISTRANO, CA 92675 COMPANY
LETTER D
COMPANY E
LETTER
COMPANIES AFFORDING COVERAGE
U.S.F.&G.
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
LTR DATE (MM/DDNY) DATE IMM/DDIVY)
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
�A AND 11 TO BE ASSIGNED 1-21-90
EMPLOYERS' LIABILITY
OTHER
I
DESCRIPTION OF OPERATIONS/LOCATIONSNENICLES/RESTRICTIONS/SPECIAL ITEMS
VARIOUS PARK & LANDSCAPE MAINTENANCE PROJECTS
GENERAL AGGREGATE It
PRODUCT&COMP/OPS AGGREGATE $
PERSONAL S ADVERTISING INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Any one lire) $
MEDICAL EXPENSE (Any one person) It
COMBINED
SINGLE $
LIMIT
BODILY
INJURY
$
(Per person)
BODILY
NJURY
$
Per accident)
PROPERTY
$
DAMAGE
EACH _ AGGREGATE
OCCURRENCE
$ S
STATUTORY
1-21-91 $ 100,
$ 500,
$ 100,
(EACH ACCIDENT)
(DISEASE—POLICY LIMIT)
(DISEASE—EACH EMPLOYED
I
CERTIFICATE HOLDER CANCELLATION 10 DAY NON PAY
CITY OF SAN JUAN CAPISTRANO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ATTN: CITY CLERKS DEPT. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
32400 PASEO ADELANTO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
SAN JUAN CAPISTRANO, CA 92675 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UP HE COMPANY, ITS AGENTS OR REPRESENTATIVES.
REP
. 5i801
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AQ4_RP,25..i91®ACORD
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