1998-1203_MD CONSTRUCTION GROUP_Insurance Certificate ACORD •
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Aon Risk Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2495 Campus Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Irvine, CA 92612-1583 • COMPANIES AFFORDING COVERAGE
COMPANY
949-476-4300 A United Pacific Ins. Co.
INSURED
COMPANY
Robert Bein, William Frost B Reliance National Indemnity
& Associates COMPANY
PO Box 57057
Irvine, CA 92619-7057 COMPANY
I
CO V
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/DD/YY) DATE(MM/DDNY)
GENERAL LIABILITY GENERAL AGGREGATE $ 2000000
A X COMMERCIAL GENERAL LIABILITY PQ8573175 11/30/98 11/30/99 PRODUCTS-COMP/OPAGG $ 2000000
CLAIMS MADE X OCCUR 0 PERSONAL&ADV INJURY 1000000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE 1000000
FIRE DAMAGE(Any one fire) e 650000
MED EXP(Any one person) $ . 5000
AUTOMOBILE LIABILITY
A X ANY AUTO PQ8573175 11/30/98 11/30/99 COMBINED SINGLE LIMIT $ 1000000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY
X 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 $ 5000000
A X UMBRELLA FORM QU8573175 11/30/98 11/30/99 AGGREGATE $ 5000000
OTHER THAN UMBRELLA FORM $
— — —
WORKERS COMPENSATION AND x WC STATU- 0THB
LIMITS ER
EMPLOYERS'LIABILITY
NWA0147712 7/01/98 7/01/99 EL EACH ACCIDENT $ 1000000
THE PROPRIETOR/ INCL EL DISEASE-POLICY POLICY LIMIT $ 1000000
PARTNERS/EXECUTIVE — CZ?
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE rn 1000000
OTHER
W
IllN.1 rn
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS 65
Re: JN 401408, Mission Hills Reservoir
u: —o
;Yr-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of San Juan Capistrano EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Capistrano Valley Water Dist. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
32450 Paseo Adelanto, PO Box BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
967, San Juan Capistrano, CA OF ANY KIND UPON_THE COMPANY, ITS •G TS OR REPRESENTATIVES.
92693 Attn: Robert W. Clark AUTHORIZED REPREE 111820000
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