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02-0829_AUSTIN-FOUST ASSOCIATES, INC._Insurance CertificateL.Heme: ouv i --- �1CQRa CERTIFICA-10 OF LIABILITY INSUFONCE 08izs,oz�""' Dealey, Renton & Associates 600 S. Lake Avenue #308 Pasadena, Ca 91106 626-844-3070 INSURED Austin Foust Associates, Inc. 2020 North Tustin Avenue Santa Ana, CA 92705 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. INSURERS AFFORDING COVERAGE INSURER A. St. Paul Fire &Marine 'SURER B; American Motorists Ins. Co. INSURER C: Security Ins. Co. of Hartford MVYGl1NVGJ 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. ITS "—� �POIJCY EFFECTIVE POLICY EXPIRATION LIMITS TYPEOFINSURANCE POLICY NUMBER DATE MM/DW"" DATE (MMIDO/YY1 A GENERAL LIABILITY RP06642703 08/15/02 08/15/03 EACH OCCURRENCE $3 OOO OHO X COM M ERCIAL GENERAL LIAB ILITY FIREDAMAGE(Anyonefire) $50000 - - CLAIMS MADE �. OCCUR MED EXP (Any one person) _ � - $ of PERSONAL B ADV INJURY $3,000, 00 J j GENERALAGGREGATE $5,000,000 — PRODUCTS-COMP/OPAGGc $S�OOO,OOO _ - - GEN'LAGGREGATELIMRAPP_UESPER: POLICY , PRO LOC A AUTOMOBILE LIABILITY RP06642703 08/15/02 08/15/03 COMBINED SINGLE LIMIT$'j 000,000 (Ea eccitlenp ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS + HIRED AUTOS BODILY INJURY X NONOWNED AUTOS --- EPROPERTY DAMAGE - -- -- citlent) GARAGELIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC_ ANYAUTO $ --- - - $ AUTOONLV: AGO EXCESS LIABILITY EACH OCCURRENCE _ $ OCCUR `� CLAIMS MADE AGGREGATE _ $ DEDUCTIBLES- - -- $-- - - --- ! RETENTION $ $ B WORXERSCOMPENSATION AND 7CW21231606 09/01,02 09/01/03 WC STATIT OTH- X TRV LI ITS ER_ - B EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 _ _ E.L. DISEASE -E1 EMPLOVEF- $1,000,000 E.L.DISEASE-POLICY LIMIT $1,000,000 C OTHER Professional AEE0221754 03/25/02 03/25103 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Cn Re: Personal Services Agreement. City of San Juan Capistrano is additional insured on the commerital genal ti liability and the hired and non -owned liability. C_ iTi n, CD o rn p, SHOULD ANYOFTHE ABOVE DESCRIBED POUCIG ECANCELED BE THE EXRRATION City of San Juan Capistrano DATE THEREOF, THE ISSUING INSURER WILL*taeRRn(; MAIL�DAYSWRITTEN Attn: Jill Thomas NOTICE TO THE CERTIFICATE HOLDER NMA ED XCIHE LEFT�71AANA"RKXXX 32400 Paseo AdelantoXRXRR1Wri�IRR1PR9r0fI0ntIN61RIRR1n61R6�MI![RRX San Juan Capistrano, CA 92675 AXR1B6XKXK) J6RX AUTHORIZED REPRESENTATIVE (7/97)1 of 1 #M78054 MAF © ACORD CORPORATION 1938 I111CTI0^11C Ml1011lfl. Jvi, AC) CERTIFICA M OF LIABILITY INSU CE 08/29, Z°""' PRODUCER Dealey, Renton & Associates 600 S. Lake Avenue #306 LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE WDD/YY 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. GENERAL LIABILITY INSURERS AFFORDING COVERAGE Pasadena, Ca 91106 626-644-3070 INSURED OOO _ SE: INUR $t.RAPaul Fire & Marine Austin Foust Associates, Inc. INSURERS: American Motorists Ins. Co. 2020 North Tustin Avenue CLAIMS MADE l� OCCUR INSURER C: Security Ins. Co. of Hartford _ _ Santa Ana, CA 92705 $5,0— - INSURER D: _ __ INSURER E: _ PERSONAL 8 ADV INJURY GENERAL AGGREGATE 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. _ - _ r POLICY EFFECTIVE 'POLICY EXPIRATION- - LIMITS LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE WDD/YY A GENERAL LIABILITY RP06642703 06/15/02 06/15/03 EACH OCCURRENCE j$3000000 OOO _ XCMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any One lira) $50000 CLAIMS MADE l� OCCUR MED EXP (Any one person) _ $5,0— - P_'L PERSONAL 8 ADV INJURY GENERAL AGGREGATE $3,000000 $5,000,000 j (PRODUCTS COMP/OP AGG - $5,00000_ ITAPPR: AGGREGATE LIMLIESPE _7 POLICY PRC- LOC A AUTOMOBILE LIABILITY RP06642703 t08/15102 06/15/03 COMBINED SINGLE LIMIT $2,000,000 ANY AUTO (Ea accident) - ALL OWNED AUTOS BODILY Perperon) �$ (Per person) SCHEDULED AUTOS - X HIRED AUTOS BODILY INJURY $- _X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ - (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EX_ CESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR El CLAIMS MADE $ DEDUCTIBLE $ - - - -- ' RETENTION $ $ B WORKERS COMPENSATION AND 7CW21231606 09/01/02 09/01/03 X WC STATU- OTH- 'T RV -LIMIT I ER B EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 _ E.L. DISEASE - EA EMPLOYEE _ E.L. DISEASE -POLICY LIMIT _$1,000,000 $1,000,000 C OTHER professional AEE0221754 03/25/02 03/25/03 $1,00000 per claim Liability $2,006000 ara = r,A DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESrEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS C C'? Re: Plan Check Services City of San Juan Capistrano is additional insured on the commercial gener 1f abilim n and the hired and non -owned liability. /. M v- N� m x� City of San Juan Capistrano Attn: Alan Oswald 32400 Paseo Adelanto San Juan Capistrano, CA 92675 ACORD 25-S (7/97)1 of 1 SM79054 SHOULD ANYOFTH E ABOVE DESCRIBED POLICIE$AE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30__ DAYSWHITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFMLURE TODOSOSHALL IM POSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURERJTS AGENTS OR MAF © ACORD CORPORATION 1988 Policy Number: RP06642703 Owners Lessees or Contractors (Form 13) ADDIT16NAL INSURED Change(s) Effective: 08/29/02 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance policy under the following: LIABILITY COVERAGE PART: Schedule Name of Person or Organization: City of San Juan Capistrano Attn: Alan Oswald 32400 Paseo Adelanto San Juan Capistrano, CA 92675 SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. Re: Plan Check Services City of San Juan Capistrano is additional insured on the commercial general liability and the hired and non -owned liability . CL/BF 22 40 03 95