1976-0323_BRAEGER ,ART A._Insurance MOSELLE INSURANCkINC.
128 SOUTH LA BREA AVERM CER19CATE OF INSURANCE
LOS ANGELES, CALIFORNIA 90036
Telephone: (Area Code 213) 936-7211
HAS ISSUED TO THE INSURED NAMED HEREIN THE POLICIES OF INSURANCE SHOWN BY NUMBER BELOW, SUBJECT TO ALL THE TERMS OF THE POLICIES
APPLICABLE THERETO. IF THESE POLICIES ARE CANCELLED OR CHANGED IN SUCH A MANNER AS TO AFFECT THIS CERTIFICATE, TEN DAYS ADVANCE
NOTICE WILL BE MAILED TO:
F_ the City of San Juan Capis-
trano, its elected & appointed
TH • City of San Juan Capistrano officials & employees are
� "
32400 Paseo Adelanto hereby named as additional
A; San Juan Capistrano, Calif. 92675 insureds, but only respects
Tthe operations of A. Art
L Draeger.
LOCATION AND DESCRIPTION OF WORK -- DESCRIPTION OF AUTOMOBILE — EQUIPMENT -- ETC.
All California operations unless otherwise excluded from the policy.
X ENTRY INDICATES THAT THE CERTIFICATEHOLDER IS A LOSS PAYEE AS RESPECTS THE DESCRIBED AUTOMOBILE
*33XS1311 4-1-75 to 76 & Renewal Aetna Casualty &Surety
POLICY NO. 33AS 07196 POLICY PERIOD 7-1-75 to 76 Cemparry Aetna Casualty & Surety Co.
COMPREHENSIVE LIABILITY* SPECIFIC LIABILITY
X ENTRY($) INDICATES THAT THIS POLICY AFFORDS, X ENTRYISI INDICATES THE SPECIFIC COVERAGES AND HAZARDS UNDER WHICH THIS POLICY AFFORDS
INSURANCE, AUTO- PREMISES. INDEPENDENT PRODUCTS.
L MOBILES OPERATIONS ELEVATORS CONTRACTORS COMPLETED CONTRACTUAL
BODILY OPERATIONS
A
BODILY INJURY LIABILITY INJURY ��❑ ❑ ❑ ❑ El ❑
LIABILITY
PROPERTY
B X PROPERTY DAMAGE LIABILITY DAMAGE —0 E ❑
I LIABILITY
L ;• AS RESPECTS AUTOMOBILES AND THE FOLLOWING HAZARDS,
REMISES-OPERATIONS, ELEVATORS, INDEPENDENT NTRACTUAL.CONTRACTORS, **1, 000,000 Commercial Umbrella
1 PRODUCTS-COMPLETED OPERATIONS, CONTRACTUAL.
T L BODILY INJURY LIABILITY PROPERTY DAMAGE LIABILITY
y I EACH PERSON EACH ACCIDENT AGGREGATE EACH ACCIDENT AGGREGATE
M 250 ,Iwo
I Automobile Liability $ $ 500 ,OOO APPLIICCABLE : SO 'DUO APPLICABLE
T General Liability APPLICABLE
S 300 ,000 E 300 ,000 S 300 ,000 g 300 ,000
S
WORKMEN'S COMPENSATION B EMPLOYERS' LIABILITY AUTOMOBILE PHYSICAL DAMAGE
POLICY No. 33CK955356 POLICY NO. POLICY PERIOD
POLICY PERIOD 7-1-75 to 7-1-76 X ENTRYISI INDICATES THE COVERAGES UNDER LIMITS OF LIABILITY
WHICH THIS POLICY AFFORDS INSURANCE:
COMPANYAetna Casualty_&_Surety_Cc COMPREHENSIVE ACV OR $ .p
LIMITS OF LIABILITY COLLISION ACV LFLaq S_ tADUCTIBLE
STATUTORY - In conformance with the Com
pensahon law of the �
FIRE—
State Z Z_ �O
State of California. ACV OR �r
THEFT ACV ORi' C� `
E
ACV: ACTUAL CASH VALUE
Name of Insured and Mailing Address
r -I Dared 3-19-76
A. Art Braeger
1334 A North Benson Avenue MOSELLE INSURANCE, INC.
Upland, Calif. 91786 q
L J By
AurHow D w[Pw[a[Hr AT rv[
lv
MOSELLE INSURANCE, INC.
128 SOUTH LA BREA AVEIS CEROICATE OF INSURANCE
LOS ANGELES, CALIFORNIA 9 036
Telephone: (Area Code 213) 936-7211
HAS ISSUED TO THE INSURED NAMED HEREIN THE POLICIES OF INSURANCE SHOWN BY NUMBER BELOW, SUBJECT TO ALL THE TERMS OF THE POLICIES
APPLICABLE THERETO. IF THESE POLICIES ARE CANCELLED OR CHANGED IN SUCH A MANNER AS TO AFFECT THIS CERTIFICATE, TEN DAYS ADVANCE
NOTICE WILL BE MAILED TO:
C
F —iPhe City of San Juan Capis-
E trano, its elected & appointed
ao City of San Juan Capistrano officials & employees are
Fp 32400 Paseo Adelanto hereby named as additional
A; San Juan Capistrano, Calif. 92675 insureds , but only respects
Tthe operations of A. Art
E
L Draeger.
LOCATION AND DESCRIPTION OF WORK -- DESCRIPTION OF AUTOMOBILE — EQUIPMENT ETC.
— All California operations unless otherwise excluded from the policy.
X ENTRY INDICATES THAT THE CERTIFICATEHOLDER IS A LOSS PAYEE AS RESPECTS THE DESCRIBED AUTOMOBILE ❑
*33XS1311 4-1-75 to 76 & Renewal Aetna Casualt • &Surety
POLICY NO. 43AtA207196 POLICY PERIOD ?-1-75 to 76 company Aetna Casualty & urety Co.
COMPREHENSIVE LIABILITY* SPECIFIC LIABILITY
X ENTRY(S) INDICATES THAT THIS POLICY AFFORDS, X ENTRY(S) INDICATES THE SPECIFIC COVERAGES AND HAZARDS UNDER WHICH THIS POLICY AFFORDS
INSURANCE, AUTO- PREMISES- INDEPENDENT PRODUCTS-
L MOBILE5 OPERATIONS ELEVATORS CONTRACTORS COMPLETED CONTRACTUAL
BODILY OPERATIONS
A BODILY INJURY LIABILITY INIURY
�❑ ❑ ❑ ❑ ❑ ❑
LIABILITY
URY
PROPERTY
B X PROPERTY DAMAGE LIABILITY LIAMAGBILITM—)E] ❑ ❑ ❑ ❑
" AS RESPECTS AUTOMOBILES AND THE FOLLOWING HAZARDS:
L PREMISES OPERATIONS, ELEVATORS, INDEPENDENT CONTRACTORS,
I PRODUCTS-COMPLETED OPERATIONS, CONTRACTUAL. *$1 , 000 , 000 Commercial Umbrella
T L BODILY INJURY LIABILITY PROPERTY DAMAGE LIABILITY
y I EACH PERSON EACH ACCIDENT AGGREGATE EACH ACCIDENT AGGREGATE
M2 5 0 ,000
1 Automobile Liability $ S 500 '000 APPLIOCABLE E 50 000' APPLICABLE
T General Liability gppNOT S 300 ,Ltoo I 5 300 ,00o g 300 ,Ltoo g 300 1000
5
WORKMEN'S COMPENSATION
rS�ATION & EMPLOYERS' LIABILITY AUTOMOBILE PHYSICAL DAMAGE 'p
POLICY NO.�CZ . afi POLICY NO. POLICY PERIOD `0
POLICY PERIOD 7-1-75 t0 7=1 7F) X ENTRYISI INDICATES THE COVERAGES UNDER �i Mt I LIA IC Y
WHICH THIS POLICY AFFORDS INSURANCE: 1T
COMPANYAetna Casualty & Surety CC COMPREHENSIVE ❑ ACV OR sy f
LIMITS OF LIABILITY ig-
COLLISION ❑ ACV LESS DEDUCTIBLE
STATUTORY – In conformance with the Compensation Law of the ❑ .`�
State of C.1,f.rm.. FI RF ACV OR $
THEFT ❑ ACV OR $
❑ $
AIV: ACTUAL CASH VALUE
Name of Insured and Flailing Address
r -1 Dated 3-19-76
A. Art Braeger
1334 A North Benson Avenue MOSELLE INSURANCE, INC.
Upland, Calif . 91786 By
11 '
•UTROR12 E0 RE PRElERT1TiVH
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