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1998-0917_ORTEGA II_Insurance Certificate %.mn I irIL.R I c ur IfV,Ur[HNI.c gUCH IMSURANCE. Ila RESPECTS THI SEREST OF THE CERTIFICATE HOLDEI .L NOT BE CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DA 'RIOR WRITTEN NOTICE TO THE CERT! FE 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: [ ] STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington. Illinois. or CI 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. — _ Address of Named Insured 31 658 RANCHO VIEJO RD SUITE B SAN JUAN CAPISTRANO, CA 92675-2777 POLIGYNLIMBfR P47 3958-F19-75 P43 8807-D14-75B C99 7185-C25-75 L36 7527-A15-75C EFFECTIVE DATE OFpot.ICY 6/19/98 04/14/96 03/7419A OR/1 c/g$ .- - DESCRIPTION VEHICLE 98 GMC DUMP 89 FORD F250 PU 98 gmc VAN 90 FORD F350 PU VEHICLE LIABILITY COVERAGE [ J YES Q NO Eij YES n NO [g YES Q NO ;F-' YES [] NO LIMITS OF LIABILITY ..- a. Redly Injury • Person Each AccId4nt 1 -4- b. Properly Dealings Each Accident • C. Dodly Wtxy$Ropey Dem‘p Single Levi _ Each Accident 1 , 000, 000 1 . 000.000 1 .O01L O0 1,nnn nnn PHYSICAL DAMAGE n YEg 0 NO Q YES [J NO 0 YES El NO Li YES [I] NO COVERAGES a. Comprehensive $ Deductible $--- Deductible $ Deductible $ - Deduetble [1 ^ l - YES n NO [] YES Q Np Q YE3 n NO (� YE9 L) NO b. Col siool $— DeOuctble S_- - Deductble $ _ Deductible $ Deductible - EMPLOYER'S r-^� NON-OWNERSHIP [' J YES ` , NO [x] YES [ ] NO Cil YES [ ]NO 4 YES n NO COVERAt . HIRED • • • ERAGE n YES n NO [ ] YES r j NO L$'YES [ ] NO Lid YES [ 1 illNO �.—� AGENT 8323 09/17/98_ Signature of Authorized Representative T rile Agent a Code Number Data Name and Address of Certificate Holder _ Name and Address of Agent CITY OF SAN JUAN CAPISTRANO AND I CAPISTRANO VALLEY WATER DISTRICT JOHN H. McMAHAN, AGENT AND S. ALLAN SCHWARTZ & ASSOC. LIC. #0576973 32400 PAS EO ADELANTO STATE FARM INSURANCE COMPANIES SAN JUAN CAPISTRANO, CA 92675 32221 CAMINO CAPISTRANO 8105 SAN JUAN PLAZA 661-0485 L 1.015 1D SAN JUAN CAPISTRANO, CA 92615 11,(D) O ---1-1 01 1+ he � . col c 0), 32400 PASEO ADELANTO MEMBERS OF THE CITY COUNCIL SAN JUAN CAPISTRANO,CA 92675 4 U JOHN GREINER (949)493-1 171 mfAAruAUA WYATT HART (949)493-1053(FAX) IfIAIIISNfI 1961 GILJONES 176 DAVID M.SWERDLIN ik • (16 • CITY MANAGER GEORGE SCARBOROUGH • September 9, 1998 Friess Company Builders, Inc. 31658 Rancho Viejo Road, Suite B San Juan Capistrano, California 92675 Re: Renewal of Automobile Liability Certificate of Insurance (Ortega II-Construction of Water Facilities Burger King/Del Taco) Gentlemen: The Automobile Liability Certificate of Insurance,regarding the above-referenced project,expired on August 30, 1998. In accordance with your agreement, the insurance certificate needs to be renewed for an additional period of one year. Please forward the updated certificate to the City,attention City Clerk's office,by August 18, 1998. If you have any questions, please contact me at (949) 443-6310. Thank you for your cooperation. Very truly yours, /CA1 / Dawn M. Schanderl Deputy City Clerk Cheryl Johnson, City Clerk Craig Harris, Senior Engineering Technician DRUG USE IS di 'A San Juan Capistrano: Preserving the Past to Enhance the Future • Project FRIESS COMPANY BUILDERS, INC. Management General Contracting FAX TRANSMITTAL Liccnse#706656 To: Dawn Schanderl, Deputy City Clerk Company: City of San Juan Capistrano Fax Number: 493-1053 Business Phone: From: Camela Torrance Fax Number: (714) 248-8433 Business Phone: (714) 487 9700 Date And Time: 9/17/98 4:24 PM Pages With Cover: 2 Regarding: Automobile Certificate of Insurance Comments: Following please find the updated certificate of insurance you requested. If you need anything else, don't hesitate to call me directly at (949) 248-1112, ext. 118. Thank you. If you do not receive all of the pages indicated or receive illegible copies, please call us immediately. 31658 Rancho Viejo Road, Suite B • San Juan Capistrano,CA 92675 Tel(714)487-9700 Fax(714) 248-8433