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05-0307_CREST AUTOMATION_Insurance CertificateAh `A AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CORD„ CERTIFICATE OF LIABILITY INSURANCE 03 o�izoo5 PRODUCER Contractors Outpost Insurance Services, Inc. 24338 El Toro Rd 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. POLICY EXPIRATION DATE MM/DDM/ Suite E130 INSURERS AFFORDING COVERAGE Laguna Woods CA 92653 - CL041801351 r - �. `� S �' l f ..., --- ' -' INSURED INSURERA. Evanston Insurance Com an EACH OCCURRENCE $ 1,000,000 Crest Automation and Classic INSURER B: INSURER C' 2913 El Camino Real #119 MAR 1 0 2005 'I - INSURER D'. INSURER E: Tustin CA 92782— UUVCKAUCA 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR T.DATE rypE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE MMIDD/YY POLICY EXPIRATION DATE MM/DDM/ LIMITS x GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR CL041801351 r - �. `� S �' l f ..., --- ' -' 01/26/2005 Il��ll Y.i(((lll!!! { 01/26/2006 / / EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE Myope fire 5 50,000 MED EXP (Any one arson) 4 5,000 PERSONAL B ADV INJURY $ 1.000,000 MAR 1 0 2005 'I - / / GENERAL AGGREGATE 8 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMP/OP AGG B 1x000,000 POLICY JECT 17 LOC AUTOMOBILE LIABILITY ANY AUTO PUBLIC WORKS __ _ _ / _ / / COMBINED SINGLE LIMIT (Ea acAant) $ BODILY INJURY ALL OWNED AUTOS / / / / SCHEDULED AUTOS (Per person) s BODILY INJURY HIRED AUTOS / / / / NON -OWNED AUTOS (Per a=iE np e PROPERTY DAMAGE (Per ao�denp $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 8 OTHER THAN EAACC $ ANY AUTO / / / / AUTO ONLY. AGO $ EXCESS LIABILITY OCCUR F—I CLAIMS MADE / / / / EACH OCCURRENCE e AGGREGATE e B $ DEDUCTIBLE / / / / s RETENTION 3_7­70­T_ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / / / / WC $TATU- OTH- TORY LIMBS ER E.LEACHACCIDENT $ E L. DISEASE -EA EMPLOYEE $ E. L. DISEASE -POLICY LIMIT 8 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSAEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS •30 day notice of Cancellation, except for non-payment of premium which is 10 days. "Proof of Insurance". VA City of San Juan Capistrano 32400 Paseo Adelanto Attn: Michelle Perea San Juan Capistrano CA 926 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESENTATIVE RD 25S (7197) INS025S (991o).o1 ELECTRONIC LASER FORMS, INC. -(800)327-0545 3N 1988 Page 1 of 2 *,, INS026S(9910).01 Papel a2 3/22/200522 PM FROM: 949-786-2300 TO: 493-3955 PAC* OF 002 CREST AUTOMATION �roroRora 2913 EI Camino Real # 119, Tustin, CA 92782 Tel(949)552-6552 Fax(949)786-2300 E Mail: cmotorola@aol.com 3/22/2005. City of San Juan Capistrano l Attention: Theresa Abernathy Fax # 949-493-3955 O0 Paseo Juto Juan Capistrano San CA 92675. ev�Wpe�g� P� Dear Theresa, 2 PAGE FAX (INCLUDES THIS COVER SHEET) Attached please find my Liability Insurance for my Vehicle. I have $1 million dollars in Vehicle Liability Insurance Coverage. I thank you for your assistance. Sincerely SAUL HIRSCHMANN, dba CREST AUTOMATION, MOTOROLA AUTHORIZED SALES AND SERVICE. LICENSED ELECTRICAL CONTRACTORS, LICENSE V 699349. 3/22/20021 PM FROM: 949.786-2300 TO: 493-3955 PAGE02 OF 002 PERSONAL UMBRELLA POLICY 7rARMER5 INSURANCE£XCHANCE DECLARATIONS AMENDED DECLARATIONS EFFECTIVE: 07/28/2004 1. Named •SAUL HIRSCHMANN Insured .23 EELMONTE Address , IRVINE, CA 92720 z. Elfecuve From 07/28/2004 'fn' 07/28/2005 3, Schedule.1 Underlying brsunnce (Flan. in thousands ol'dolhus) CARRIER POLICY NUMBER FIRE INSURANCE EXCHANGE 911460006 FARMERS INSURANCE EXCHANGE 146561719 FARMERS INS. EXCHANGE 146613124 FARMERS ® TRUCK INSURANCE EXCHANGE Prod, Count Prematic Ault No. 97 66 355 015034614 Agan I P.licy Nuotbrr (mol prior to lime applied (or) 12:01 AM. ltandud Tune, as the addrns of dic named .,n d COVERAGE UNDERLYING LIMITS HOMEOWNER 100 AUTO LIABILITY 250/500/100 AUTO LIABILITY 250/500/100 IMPORTANT NOTICE: You have told us war have underlying insunnce policies with liability lirnksInced above, If your undcTlying inuvance policies have lower limits than Ae%n above, you wifl be eopmteaed for the d,ffemaco. Yuu mus, keep the above coverages and limits in efi at to avoid ib.. gaps in your Protection. 4, 1Le iinumnce afforded is indicated by the sp v:ific limit and premium charge or charges. LIMITS OF LIABILITY S 1 .000.0110 Each Occurrence S 250 Retained limit Promium Limits ofLiabilit s 313.00 $I Million $2 Million S3 - 55 Million 313.00 Total Premium <:ash RccuivJ 299.10 Balance Due U on RrYd .t' Refund Anv -To Al balance' m.rade Ivss ilrtn SIAM will ki e1 pb,J n. vont ... ..o'. am Jn upon aq�t .. Monnir„I v, hi:h 111 old>.Il 0111111, vohid n wrhomn. nwert..rlo..InJ L.. ro.J u.national .rhirlo�� Expo. Quantity Ower+ -occupied residenau 1 M.Ion"ed vrhida 2 UM/UIM (wberc availably) Yaull,l.l Driver (+"likened recra-ationol vchide Sailboat Powe'b"a' Rental Dwelling On po-nuns 011icv Ull P¢Inina 011 ire I u..... I .rs.ur I m dour'. Ib.c bcr liabilitt Witt. Cor coral Punklinuvr lradmr I;vbiliry Witbnw Cngmul Pumsh nmto Inkidknod 16ummg (wml aco') Ca'.mn land Oncd mn-.1 Rrnn Lind (lm.rl .a n>) Tann laud Iva d u. Utbar. ('waf h+ %kid, 56,1 I N'f)111R1.%IIA I'S.11T11("%I%l1 7O'11 IIS 1911 R'. Y. (It M.'whh Ki'."t 10021 or 100251.. 0', C..orw,.ipw-d 07/08/2004 03/07/2005 10:20 949786-2300 0 PERSONAL UMBRELLA POLICY []FARMEPS INSURANCE EXCHANGE DECLARATIONS AMENDED DECLARATIONS EFFECTIVE: 07/28/2004 1. N.uned • SAUL HIRSCHMANN Insured .23 BELMONTE Address IRVINE,CA 92720 2, Effeetivr From; 07/28/2004 Tb: 07/28/2005 3. Schedule of Underlying Insurance (Entnes in thousands of dollars) CARRIER POLICY NUMBER FIRE INSURANCE EXCHANGE 911460006 FARMERS INSURANCE EXCHANGE 146561719 FARMERS INS. EXCHANGE 146613124 • ® TRUCK INSURANCE FXCHANCF. PAGE 3/3 FARMERS' Prod. Count Prematic Acd N'o. 97 66 355 015034614 .Agan Iodwy lumber (not prior to lime applied for) 1291 A.M. Suuulutd lung at the address of the named inmired. COVERAGE UNDERLYING LIMITS HOMEOWNER 100 AUTO LIABILITY 250/500/100 AUTO LIABILITY 250/500/100 IMPORTANT NOTICE: You have told us you have underlving insurance policies with liability limits listed above 11 Your underlying insurance policies have lower limits than drown above, you will be unprotected for the difference. You must keep the above eovmages and limbs m effect to avoid these gaps -ill 'your Protection. 4. The insurance afforded is indicated by the specific limit and premium charge or charges. LIMITS OF LIABILITY $ 1 .000'100 Each Occurrence $ 250 Retained Limn Premium Limits of Liability S 313.00 $1 Million $2 Million S3 - $5 Million 313.00 Total Premium Caall Received 299.10 Halmte Due Leon Reed u' Refund 'ft, '10IT I. b.Ibn.r.1111111 Ice. t11un$].00 .ill br:gydlld n vmun.n bdwzo e,Le—,$7.W nr Anon.u.Ju., uy.1 qp ' Ma1.rmJ.chid, lndud...11l a , u«ks, n +orLnvv.. nw1 n+.i.'G •nJ hi.'u..'al 1'. n'aIInllal n'I.Itl..�u L Exposure Qoantity Owner-ocarpial residetur I Motorized vehicle'* 2 CM/111M (oh, re available) Youthful Driver Cidwensed recreational vehicle 5eilloit Pnwerhoal Kemal Dvvelhup. On P .... um s (liner Oil Prcn.iwe Office lusurwl as.o Log4,,w, 7iacher liabilhy Will. Cor wood Punishount T"'be, Iobilily Will Cngmrd 1 41.nunt Incidental Inning (toad atter) V.uao land (loud arae) bean Lod Dotal etc..) Fano Lod h.ur'11 to Other. (o.d .0 res) Child (:.,. (- 1 blldna...m.l lar) b-1 M.i/b+ Y' d I NI1(Ht11 A11.A"IS API+I ICA611- 10-1111A II(111C1'-Ill Muolbl. P.Iv. ,, 10022 ,, 10025 u1 Oilgun) Cuatnersiguol 07/08/2004 n X11 .u. Aoa...�v..l G."... •..�n.