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03-0918_AUSTIN-FOUST ASSOCIATES, INC._Insurance Certificate (2)CERTIFI PRODUCER Dealey, Renton & Associates 199 S Los Robles Ave Ste 540 Pasadena, CA 91101 626 844-3070 Austin Foust Associates, Inc. W'C' -,rte e 2020 North Tustin Avenue Santa Ana, CA 92705 COVERAGES OF LIABILITY INSUIONCE 1 09/18//0 D"Y' 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 United States Fidelity & Guaranty- INS & RERS St. Paul Fire Marine Ins. Co. - -- INSURER C: Security Ins. Co. of Hartford _ - - INSURER a. INSURER E: _ _ 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. NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MM/OM/Y DATE MM/DD/YY A GENERAL LIABILITY BKQ1261229 08/15/03 08/15/04 EACH OCCURRENCE 11$3,000,000 X IGOMMERCIALGENERALLIABILITY General Liability FIRE DAMAGE (Any onefire) $300,000 CLAIMS MADE 1XI OCCUR I @XCIUdes CIa1m5 MED EXP (Any one person)+$5QOOarising OUt Of the PERSONALE ADV INJURY3,000,000_ performance of GENERAL AGGREGATE $5,000,000 GEN'L AGGREGATE LIM ITAPPL IES PER: professional PRODUCTS-COMP/OP AGO $5,000,000 -- POLICY - PEP LOC services. _- A AUTOMOBILE LIABILITY BKO1261229 1 06/15/03 1108/15/04 COMBINED SINGLE LIMIT $JrQQQ QQQ ANY AUTO (Ea accident) BODILY INJURY ALL OWNED AUTOSl -. $ _ 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 $ LIABILITY EACH OCCURRENCE is--- � OCCUR F�j CLAIMS MADE - AGGREGATE $— �EXCESS DEDUCTIBLE T$ - -- RETENTION $ $ B WORKERS COMPENSATION AND WVA7726345 09/01/03 09/01/04 X WC STATU- OTH- T LIMITS ER_ TORY - +- - --- ---- _ E.L. EACH ACCIDENT — EMPLOYERS'LIABIUTY _$1,000,000 �E.LDISEASE-EAEMPLOYEE _$1,000,000 _ I E.L. DISEASE - POLICY LIMIT $1,000,000 C OTHER Professional AEE0229522 03/25/03 03/25/04 $1,000,000 per claim Liability 1 $2,000,000 annl aggr. DESCRIPTION OF OPERAnONSILOCAnONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Personal Services Agreement. City of San Juan Capistrano is additional insured on the commercial general liability and the hired and non -owned liability. City of San Juan Capistrano Attn: Jill Thomas 32400 Paseo Adelanto San Juan Capistrano, CA 92675 1 of 1 flMQ9SR'. SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL%,ItRFAiDDii MAIL 3a__ DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDER NAM ED TOTHE LEFT, BYAl1eUt lIx"NA:RAKII AUTHORIZED LMIV © ACORD CORPORATION 1998 Policy Number: BKO1261229 Owners Lessees or Contractors (Form B) ADDITIbNAL INSURED Change(s) Effective: 09/18/03 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: Jill Thomas 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: Personal Services Agreement. 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