03-0326_AUSTIN-FOUST ASSOCIATES, INC._Insurance Certificate (2)DATE (MMID
ACORQ CERTIFICAT60F LIABILITY INSURAVCE 03/26/03MYI
dRGDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
199 S Los Robles Ave Ste 540 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pasadena, CA 91101 RECEIVED
626 844-3070 INSURERS AFFORDING COVERAGE
INSURED INSURER A: United States Fidelity & Guaranty
Austin Foust Associates P Jim INSURER APR . a �' 21 INSURER B: American Motorists Ins. Co.*"
2020 North Tustin Avenu INSURER C: Security Ins. Co. of Hartford_- _
Santa Ana, CA 92705 Cil l ,f CLERK 'INSURER D: _
JUAN CAPISTRAN NSURERE:
aTaTtt: x•Ts»
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 rypE OF INSURANCE
LTR
POLICY NUMBER
POUCY EFFECTIVE 'POLICY MIMMDEXPIRATON
DATE MM/DD/YY DATE M/DD/YY
LIMITS
A IIG�GENERALLIABILITY
BKO1261229
06/15/02
06/15/03
E�OCCURRENCE
$3000,000
X COMMERCIALGENERALLIABILITY
General Liability
FIRE DAMAGE (Anyone fire)
$300000 _
J CLAIMS MADE 1XI OCCUR
excludes claims
MED EXP (Any one person)
$ 000_ _ _ -
arlsing out Of
PERSONAL BADV INJURY
$3,000,000
_
the performance
GENERAL AGGREGATE
$5,000,000
hLG1AGGREGATELIMITAPPLIES PER:
of professional
PRODUCTS -COMP/OP AGG
-
$5 000,000POLICY
PEO -
LOC ServIC@B.
I
A AUTOMOBILE
LIABILITY
BKO1261229 08/15/02
08/15/03
COMBINED SINGLE LIMIT
$'J,000,000
AUTO
(Ea accident)) _
LiANY
ALL OWNED AUTOS
BODILY INJURY
',$
SCHEDULED AUTOS
(Per person)
-
-
BODILY INJURY
X
HIRED AUTOS
$
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
$
EXCESS LIABILITY
EACH OCCURRENCE
$
_ _ _
OCCUR F -] CLAIMS$ CLAIMS MADE
�
_
DEDUCTIBLE
$
_. _ _
_
RETENTION $
$
B
ON AND
WORKERS COMPENSATION
7CW21231606
09/61/62
09/01/63
STAN- OTH-
X T RY IMI_T ER
[E, EACHACCID_E_N_
_
$1,000,000
EMPLOYERS'LIABILIry
E.L. DISEASE -EAEMPLOYEE1
$1,000,000 _
E.L. DISEASE -POLICY LIMIT
1$1,000,000
C
OTHER Professional
AEE0229522 03/25/03
03/25/04
$1,000,000 per claim
Liability
$2,000,000 annl aggr.
DESCRIPTION OF OPERAnONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
** The insurer's payment obligations are backed by a Cut Through Agreement to National
Indemnity Company, an A++ rated Berkshire Hathaway subsidiary. A summary of the Cut
Through Agreement is attached.
Re: Plan Check Services
(See Attached Descriptions)
SHOULD ANYOFTHE ABOVE DESCRIBED POLX:IESBE CAW CELLED BEFORE THE EXPIRATION
City of San Juan Capistrano DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3D - DAYS WRITTEN
Attn: City Clerk's Office NOTICETOTHE CERTIFICATE HOLDERNAIMEDTOTHELEFT, BUTFAILURE TODOSOSHALL
32400 Paseo Adelanto IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
San Juan Capistrano, CA 92675 REPRESENTATIVES.
ACORD 25-S (7/97)1 of 2 #M85519 IF M JMV O ACORD CORPORATION 1988
(Continued from
City of San Juan Capistrano is additional insured on the commercial
general liability and the hired and non -owned liability.
AMS 25.3 (07/971 2
11
Policy Number: 3KO1261229
Owners Lessees or Contractors (Form B)
ADDITIbNAL INSURED
Change(s) Effective: 03/26/03
El
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: City Clerk's Office
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
�� trosur� encs Gom�p�inlas
Kemper/National Indemnity
Cut Throwh Summary
In the event Kemper receives an order to cease policy payments or is deemed insolvent by a court or
regulatory order:
• For policies where the notice is provided at the policy inception date, National Indemnity
Company (NICO) will pay on behalf of Kemper 100% of policy payment obligations not
previously paid by Kemper.
• For policies where the notice is provided effective mid-term, NICO will pay on behalf of
Kemper 100% of policy payment obligations not previously paid by Kemper for any claim where
damages, loss or offense commences on or after the date on which the notice was provided.
• Claim payments to insureds and claimants, including payments to mortgagees and assignees are
covered, as are legally declared payable dividends, retro premium adjustments and return
premiums
• Third party liability payments will be made upon either legal judgement, approval by Kemper
prior to any order, or NICO approval after such order
• An insured does not have to notify NICO of any claims or suits unless they have received actual
notice of an order issued by a court or regulator
• All policy payment obligations of the original policy continue to apply
• NICO will bear 100% of all reasonable defense costs
• There is no sunset provision on the payment obligation by NICO
• NICO is the lead member of the Berkshire Hathaway Croup of insurance companies and is
`A++' rated by A.M. Best and AAA by Standard & Poor's
Disclaimer- This is not intended to be a legal interpretation. The actual wording of the notice will always govern the
application of this cut -through notice.