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1998-0728_ORTEGA II_Insurance Certificate ACORDY CERTIFICA _ OF LIABILITY INSU `NCE DATE(MM/DD/YY) 07/28/1998 PRODUCER, (949)582-5220 FAX (949)582-3512 THIS CERTIFTCAI E IS ISSUED AS A MATTER OF INFORMAL ION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE S P I B Insurance Agency Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 26441 Crown Valley Pkwy, #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Mission Viejo, CA 92690-9055 COMPANIES AFFORDING COVERAGE COMPANY Reliance Ins. Co./Whitcomb Ins. Service Attn: Kathy Jesser Ext: 207 A INSURED COMPANY Sierra Ins. Grp/California Indemnity Ins. Friess Company Builders Inc B Attn: Dan Friess 31726 Rancho Viejo Rd #219 COMPANY Greenwich Insurance Co./Deans & Homer San Juan Capistrano, CA 92675 _ ---------- COMPANY F L 1,e / 0O. 3o C 9 Li COVERAGES L`�Jl 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 COTYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2000000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 2000000 A CLAIMS MADE X OCCUR SJ 3002935 07/27/1998 07/27/1999 PERSONAL&ADV INJURY $ 2000000 X OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 2000000 FIRE DAMAGE(Any one fire) $ 50000 MED EXP(Any one person) $ excluded AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ VVI.JIAIU- 0a- EMPLOY 111 WORKERS COMPENSATION AND X TORY LIMITS'.. ER EMPLOYERS'LIABILITY ' B N6050749C 07/01/1998 07/01/1999 EL EACH ACCIDENT $ 1,000,000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE 1,000,000 OFFICERS ARE X EXCL EL DISEASE-EA EMPLOYEE $ 1,000,000 OTHER CONTENTS BUSINESS $500 DED/SPECIAL $50,000 C INCOME 2271038 11/03/1997 11/03/1998 $ 1,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS RE: ORTEGA II, SAN JUAN CAPISTRANO, CA CERTIFICATE HOLDERS ARE NAMED AS AN ADDITIONAL INSURED WITH RESPECT TO GL, PER FORM RSR55 ATTACHED. 'EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL CITY OF SAN JUAN CAPISTRANO & 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CAPISTRANO VALLEY WATER DISTRICT & S. ALAN SCHWARTZ & ASSOCIATES BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 32400 PASECO AELANTO OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REPRESENTATIVE . Larry Hines/CKY 'r'"�'� ACORD 25-S(1/95) ©ACORD CORPORATION 1988 s Reliance Policy Number: SJ3002935 Insured: Friess Company Builders,Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSUREDS-CONSTRUCTION CONTRACTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART WHO IS AN INSURED(SECTION II)is amended to include as an insured: A. Any entity with whom you agree in a written contract to name as an insured(referred to below as additional insured)with respect to liability arising out of your work for the additional insured specified in a written contract,including acts or omissions of the additional insured in connection with the general supervision of your work, subject to the following additional exclusions: The insurance provided to the additional insured does not apply to: 1. Bodily injury, property damage, or personal injury occurring after: a. All work on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured at the site of the covered operations has been completed; or b. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than a contractor or subcontractor engaged in performing operations for a principal as part of the same contract. 2. Property damage,to: a. Property owned,used or occupied by or rented to the additional insured; b. Property in the care,custody,or control of the additional insured or over which the additional insured is for any purpose exercising physical control;or c. Your work for the additional insured. 3. Bodily injury,property damage,or personal injury arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services for you, for the additional insured or for others including: a. The preparing,approving or failure to approve maps,drawings,opinions,reports, surveys,change orders, designs,or specifications;and b. Supervisory, inspection or engineering services. 4. Advertising Injury. B. As respects additional insureds as defined above,this insurance also applies to bodily injury and property damage arising out of your negligence when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary insurance.Any other insurance available to these additional insureds shall apply on an excess basis. 2. We waive any right of recovery we may have against these additional insureds because of payments we make for injury or damage arising out of your work done under a written contract with the additional insured. 3. The term `insured' is used separately and not collectively,but the inclusion of more than one insured shall not increase the limits or coverage provided by this insurance. RSR 55 ACORD CERTIFIC1', : E OF LIABILITY INSI ANCE DATE(MM/DD/YY) 07/28/1998 PRODUCER (949)582-5220 FAX (949)582-3512 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5 P I B Insurance Agency NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9 Y Inc.. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26441 Crown Valley Pkwy, #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Mission Viejo, CA 92690-9055 COMPANIES AFFORDING COVERAGE COMPANY Reliance Ins. Co./Whitcomb Ins. Service Attn: Kathy Jesser Ext: 207 A INSURED COMPANY Sierra Ins. Grp/California Indemnity Ins. Friess Company Builders Inc B Attn: Dan Friess 31726 Rancho Viejo Rd #219 COMPANY Greenwich Insurance Co./Deans & Homer San Juan Capistrano, CA 92675 COMPANY D 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 LIMITS LTR DATE(MM/DDNY) DATE(MM/DD/YY) GENERAL LIABILITY -. GENERAL AGGREGATE $ 2000000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG ';$ 2000000 CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $ 2000000 A SJ3002935 07/27/1998 07/27/1999 X OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ Z000000 FIRE DAMAGE(Any one fire) $ 50000 MED EXP(Anyone person) I $ excluded AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND X TORY LIMITS EIR EMPLOYERS'LIABILITY B N6050749C 07/01/1998 07/01/1999 EL EACH ACCIDENT . $ 1,000,000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE OFFICERS ARE. X EXCL EL DISEASE-EA EMPLOYEE $ 1,000,000 OTHER CONTENTS BUSINESS $500 DED/SPECIAL $50,000 C INCOME 2271038 11/03/1997 11/03/1998 $ 1,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS RE: ORTEGA II, SAN JUAN CAPISTRANO, CA CERTIFICATE HOLDERS ARE NAMED AS AN ADDITIONAL INSURED WITH RESPECT TO GL, PER FORM RSR55 ATTACHED. *EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL CITY OF SAN JUAN CAPISTRANO & 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CAPISTRANO VALLEY WATER DISTRICT & S. ALAN SCHWARTZ & ASSOCIATES BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 32400 PASECO AELANTO OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. SAN JUAN CAPISTRANO, CA 92675 AUTHORIZED REPRESENTATIVE ���eerV /0 Larry Hines/CKY ACORD 25-S(1/95) ©ACORD CORPORATION 1988 Reliance Policy Number: SJ3002935 Insured: Friess Company Builders,Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSUREDS-CONSTRUCTION CONTRACTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART WHO IS AN INSURED(SECTION II)is amended to include as an insured: A. Any entity with whom you agree in a written contract to name as an insured(referred to below as additional insured)with respect to liability arising out of your work for the additional insured specified in a written contract,including acts or omissions of the additional insured in connection with the general supervision of your work,subject to the following additional exclusions: The insurance provided to the additional insured does not apply to: 1. Bodily injury, property damage,or personal injury occurring after: a. All work on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured at the site of the covered operations has been completed;or b. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than a contractor or subcontractor engaged in performing operations for a principal as part of the same contract. 2. Property damage,to: a. Property owned, used or occupied by or rented to the additional insured; b. Property in the care,custody,or control of the additional insured or over which the additional insured is for any purpose exercising physical control;or c. Your work for the additional insured. 3. Bodily injury,property damage,or personal injury arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services for you, for the additional insured or for others including: a. The preparing, approving or failure to approve maps,drawings, opinions,reports, surveys,change orders, designs,or specifications; and b. Supervisory, inspection or engineering services. 4. Advertising Injury. B. As respects additional insureds as defined above,this insurance also applies to bodily injury and property damage arising out of your negligence when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to these additional insureds shall apply on an excess basis. 2. We waive any right of recovery we may have against these additional insureds because of payments we make for injury or damage arising out of your work done under a written contract with the additional insured. 3. The term `insured' is used separately and not collectively,but the inclusion of more than one insured shall not increase the limits or coverage provided by this insurance. RSR 55 CERTIFICATE OF INSURANCE SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: P< STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois, or [ I STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois has coverage in force for the following Named Insured as shown below: Named Insured FRIESS COMPANY BUILDERS INC_ 31658 RANCHO VIEJO RD SUITE B Address of Named Insured SAN JUAN CAPISTRANO, CA 92675-2777 POUCY NUMBER P47 3958-F19-75 P43 8807-D14-75R C99 7185-r25-75 L-16 727_41 _7Sc EFFECTIVE DATE OF POUCY 06/19/98 04/14/98 03/25/98, 06/15/98 DESCRIPTION OF VEHICLE 98 GMC DUMP 89 Ford F250 PU 98 GMC VAN 90 Ford F350 PU UABILITY COVERAGE IX I YES [ I NO [1 YES I I NO n YES n NO I x I YES 0 NO UMITS OF UABIUTY a. Bodily Injury Each Person Each Accident b. Property Damage Each Accident c. Bodily Injury&Property Damage Single Limit 1 , 000, 000 1 000 000 1 , 000 , 000 1 000 000 Each Accident r r r r PHYSICAL DAMAGE In YES n NO n YES n NO Q YES n NO n YES I—I NO COVERAGES a. Comprehensive $ Deductible $ Deductible $ Deductible $ Deductible I—I YES I I NO n YES n NO [ I YES [ I NO I I YES 0 NO b. Collision $ Deductible $ Deductible $ Deductible $ Deductible EMPLOYER'S NON-OWNERSHIP [-I YES 0 NO I I YES n NO I-I YES I—I NO I-[ YES n NO COVERAGE HI•ED CAR COVERAGE I A YES n NO YES 0 NO I i YES [ I NO Ix I YES 0 NO LOL, AGENT 8323 07/30/93 Signature of Authorized Representative Title Agent's Code Number Date Name and Address of Certificate Holder Name and Address of Agent ECITY OFSAN JUAN CAPISTRANO AND 7 f JOHN R. McMAHAN, AGENT CAPISTRANO VALLEY WATER DISTRICT LIC. #0576973 AND S . ALLAN SCHWARTZ & assoc . STATE FARM INSURANCE COMPANIES 32400 Paseo Adelanto 32221 CAMINO CAPISTRANO 8105 San Juan Capistrano, Ca 92675 SAN JUAN PLAZA 661-0485 SAN JUAN CAPISTRANO, CA 92675 L J b J letti I 'Num I t Ur II'bUtiANL t "SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER WILL NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY ANY POLICY DESCRIBED BELOW. This certifies that: n STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois,or I STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois has coverage in force for the following Named Insured as shown below: Named Insured Address of Named Insured SAN JUAN CAPISTRANO, CA 92675-2777 POUCY NUMBER P43 8807-D14- , EFFECTIVE DATE OF POUCY ' 11 '1 /98 r1/ /771'1,;, DESCRIPTION OF VEHICLE - UABIUTY COVERAGE n YES In NO n YES n NO n YES n NO n YES I I NO UMITS OF LIABIUTY a. Bodily Injury Each Person Each Accident b. Property Damage Each Accident c. Bodily Injury&Property Damage Single Limit Each Accident PHYSICAL DAMAGE in YES in NO in YES in NO n YES in NO in YES in NO COVERAGES a. Comprehensive $ Deductible $ Deductible $ Deductible $ Deductible in YES in NO n YES I I NO in YES I I NO in YES I I NO b. Collision $_ Deductible $ Deductible $ Deductible $ Deductible EMPLOYER'S NON-OWNERSHIP in YES I I NO n YES I I NO in YES n NO n YES n NO COVERAGE HIRED CAR COVERAGE El YES I I NO in YES I I NO in YES in NO n YES I I NO Signature of Authorized Representative Title Agent's Code Number Date Name and Address of Certificate Holder Name and Address of Agent ECITY OFSAV JU,JA. CAPISTRANO ANIT CAPISTRANO VALLEY WATER DISTRIC.i AND S. ALLAN SCHWARTZ & assoc. 32400 Paseo Adolanto San Juan Capistrano, Ca 9267,5 L • J L J