1982-0202_SIGNAL MAINTENANCE, INC._Agreementi
U
• 0
TRAFFIC SIGN L MAINTENANCE
A G RIE E M E N T
THIS AGREEMENT, made
February, 1982, by and bet
a municipal corporation of
referred to as the "CITY",
hereinafter called and ref
CITY COPY
entered into this 2nd day of
the City of San Juan Capistrano,
State of California, hereinafter
Signal Maintenance, Inc.
d to as the "CONTRACTOR".
W I T N 8 S S E T H:
WHEREAS, the CITY has de
and award to CONTRACTOR a con
NOW, THEREFORE, in consi
and promises of the parties h
and conditions hereinafter se
follows:
FIRST: That the complet
include the following documen
hereby incorporated by refere
as if set out in full herein:
1. This agreement
2. List of intersection
3. Adjusted Labor Rate
4. Equipment Rate Sched
ided to accept CONTRACTOR"S proposal
ract for traffic signal maintenance:
eration of the mutual convenants
reto and upon the express terms
forth, the parties agree as
contract shall consist of and
, all of which shall be and are
e and made a part hereof as fully
le
SECOND: CONTRACTOR agrees to furnish all tools, equipment,
apparatus, facilities, labor, ervices and materials, and perform
all work necessary to maintain traffic signal facilities in accordance
herewith. It is understood an agreed that all said labor, services,
materials and equipment shall e furnished and said work performed
and completed by the CONTRACTO as an independent CONTRACTOR, subject
to the inspection and approval of the CITY, its Director of Public
Works, or inspectors or their epresentative.
• I r
THIRD: CONTRACTOR agrees to inspect, clean and adjust all
controller units one time pJe
month.
FOURTH: CONTRACTOR ags to replace all lamps in all signals,
using an 80% depletion schle, and standard traffic signal lamps,
such as are manufactured byneral Electric Company or Sylvania
Company. In addition, CONTTOR agrees to furnish labor and
equipment for replacement oealed beam units. CITY agrees to
reimburse CONTRACTOR for thost of said units.
FIFTH: CONTRACTOR agrto clean and polish all lenses and
reflectors one time per yea
SIXTH: CONTRACTOR agrto provide service twenty-four
hours per day for the servig of traffic signal controllers and
systems equipment covered bhis agreement.
SEVENTH: CONTRACTOR aes to provide the same service twenty-
four hours per day for the air of other equipment and appurtenances
such as safety lighting, stt name signs, street lighting, pedestrian
signals, flashing beacons and detector devices which the CONTRACTOR
may be called upon from time o time by the CITY to repair, replace,
or refurbish.
EIGHTH: a) For furnishing labor, services, materials, and
equipment under paragraphs Third, Fourth, Fifth, and Sixth,
excepting when such repairs a e necessitated by obsolescence or
accidental damage such as col ision, acts of God and vandalism,
CONTRACTOR shall be entitled o receive and shall be paid by the
CITY the sum of $41.56 per mo th for each signalized intersection.
b) For and in onsideration for furnishing said labor,
services, materials and equip ent under paragraph Seventh when such
repairs are necessitated by obsolescence or accidental damage as
defined above and under paragr ph Eighth, CONTRACTOR shall be entitled
to receive in addition to the onthly sum above, a per call sum based
upon the invoice cost of materials, adjusted cost of labor, and a
reasonable percentage for over ead and profit, not to exceed 25%.
Labor costs will be at CONTRAC OR'S prevailing standard rates for job
classifications when repairs a e made.
c) Any ch In reimbursement to CONTRACTOR may
be negotiated each year fol1 wing the anniversary date of this
agreement; Increases that ar within the Consumer Price Index -
Urban (CPI -U) for the Los An eles-Anaheim-Long Beach area may be
approved by the Director of Public Works.
NINTH: The CONTRACTOR s all carry comprehensive general and
auto liability insurance in a amount of not less than $1,000,000
combines single limit of liability. The CONTRACTOR shall also
maintain during the life of t is contract, Worker' Compensation
Insurance covering all of his employees on the project, in a
company satisfactory to the C TY, and upon request shall furnish
to the CITY certificates issu d by such companies showing that all
of the above mentioned insura ce has been issued and is in full
force and effect prior to com encing work. The cost of insurance
is to be included by the CONT CTOR when determining his bid, and
may be subject to annual nego iation for determination of adequacy.
TENTH: This contract sh 11 extend for a period of five (5)
years from the date hereof an shall automatically terminate on
February 1, 1987. However, either party in its discretion shall
have the right to terminate a any time sooner by giving sixty
(60) days advance written notice.
ELEVENTH: If the CONTRA TOR should neglect to prosecute the
work properly, or fail to per orm any provisions of this contract,
the CITY, after three (3) days written notice to the CONTRACTOR,
may without prejudice to any ther remedy it may have, make good such
deficiencies and may deduct th cost thereof from the payment then
or thereafter due to the CONT CTOR.
TEWLFTH: Except for the anufacturer's factory warranty, the
CONTRACTOR disclaims all warra ties with respect to materials supplied
hereunder, and further disclai s any and all liability for failure
to perform or delay in perform nce hereunder where the same is due
in whole or in part to any cau e beyond CONTRACTOR'S reasonable control,
such as, but not limited to fi e, flood, earthquake, lightning,
strike, or other labor dif£icu ty.
-3-
L]
THIRTEENTH: CONTRACTOR shall not be liable for damages arising
out of injury to person or d mage to property of a customer or any
third party unless the same as due to CONTRACTOR'S fault or neglect.
a) CITY further a rees to idemnify to the extent authorized
by law, and save free and ha mless CONTRACTOR against negligent acts
or omissions caused by CITY, its agents or employees, and any costs
and expenses incurred by the respective parties on account of any
claim therefore. CONTRACTOR agrees to indemnify and save free and
harmless CITY and its authorized representatives and employees
against negligent act or omis ions caused by CONTRACTOR, his agents
or employees, and any cost an expenses incurred by the respective
parties on account of any claim therefore.
b) It is agreed by the parties that this indemnity agreement
is not limited in any way by he extent of any policy of insurance
currently in force and held b either party.
Nothing herein contain d shall be construed as limiting in
any way the extent to which t e company may be held responsible
for payment of damages to per ons or property resulting from his
operations or any operations f any sub -contractors under him.
IN WITNESS WHEREOF, the ity Council of the City of San Juan
Capistrano has caused this ag eement to be subscribed by its Mayor
and City Clerk and said CONT CTOR has executed, or caused this
agreement to be executed by his duly authorized officer.
ATTEST:
MARY ANWHANOVER, CITY CLERK
APPROVED AS TO FORM:
S S. OKAZAKI, TY A
CITY OF SAN JUAN CAPISTRANO
SIGNAL MAINTENANCE I
WILLIAM C.
0
CITY OF SAN
LIST OF
MAINTAINED BY
CAPISTRANO
INTERSECTIONS
MAINTENANCE, INC.
1.. Alipaz Street nd Del Obispo Street
2. Blue Fin Drive and Del Obispo Street
3. Calle Arroyo a d Rancho Viejo Road
4. Calle Aspero a d Del Obispo Street
5. Camino Capistr no and Del Obispo Street
6. Camino Capistr no and La Zanja Street
7. Camino Capistr no and Ortega Highway
8. Camino Del Avi n and Del Obispo Street
9. Del Obispo Str et and Ortega Highway
10. Del Obispo Str et and Paseo Adelanto
11. E1 Camino Real and Ortega Highway
* To be added at 6 later date
October 1, 1981 • ADJUSTlD LABOR SCHEDUL0
SCHEDULE A
Primary duties are as directed by le d man in
assisting field technicians and acco plishing
preventative maintenance procedures s
directed. Traffic signalman assists field
technicians as demand is made and as I
ists with
knockdowns and associated repairs.
TRAFFIC SIdNALMAN - APPRENTICE $18.44/hr. $27.66/hr.
Primary functions are to assist and eceive
training from traffic signalman.
TRAFFIC SIGNAL LABORER $17.11/hr. $25.67/hr.
Primary duties are to assist the sig alman
and crew in knockdown repairs and field
modifications as directed.
STRAIGHT
OVERTIME
'TIME
RATE
OPERATIONS SUPERINTENDENT
$25.66/hr.
$38.49/hr.
'All repair work, both field and lab,
subject
to his approval and direction. Available
for
advice and opinion as covered by sp
cifica-
tions (plan, job inspection, etc.).
ENGINEERING TECHNICIAN
$22.44/hr.
$33.66/hr.
Provides liaison, assists traffic e
gineer
on systems and provides technical d
ta.
LEAD MAN
$20.33/hr.
$30.50/hr.
Primary responsibility to guide and
assist
field technicians and signalmen in
he
designated section area.
TRAFFIC SIGNAL TECHNICIAN - FIELD
and
$19.77/hr.
$29.66/hr.
Primary duties are to field troubleshoot
repair field wiring, cabinet wiring,
controllers, and perform routine du
ies
of preventative maintenance.
TRAFFIC SIGNAL TECHNICIAN - LAB
nce of
$19.92/hr.
$29.88/hr.
Performs complete repair and mainten
all controllers, detectors and assoc'ated
devices
which are brought from the field for
repairs.
t. TRAFFIC SIGNALIU-N
$19.77/hr.
$29.66/hr.
Primary duties are as directed by le d man in
assisting field technicians and acco plishing
preventative maintenance procedures s
directed. Traffic signalman assists field
technicians as demand is made and as I
ists with
knockdowns and associated repairs.
TRAFFIC SIdNALMAN - APPRENTICE $18.44/hr. $27.66/hr.
Primary functions are to assist and eceive
training from traffic signalman.
TRAFFIC SIGNAL LABORER $17.11/hr. $25.67/hr.
Primary duties are to assist the sig alman
and crew in knockdown repairs and field
modifications as directed.
ADJUSTED LABOR SCHEDULE -2- , SCHEDULE A
Most of the work performed under extraordinary maintenance will
be, as has been in the past, performed at traffic signalman rate
And/or traffic signalman app entice.
(These rates for contract cu tomers only.)
NOTE: Straight time rate ap lies for the hours between 8:00 A.M.
to 4:30 P.M. Monday t rough Thursday, and from 8:00 A.M.
to 12:00 Noon Friday.
3
February 2, 1980
PERSONNEL VEHICLE
PICKUP TRUCK
SERVICE TRUCK
SERVICE LADDER TRUCK
BOOM LADDER TRUCK
PAINT RIG TRUCK
TELSTA TRUCK
(Hydraulic Type - Man
AIR COMPRESSOR
WATER TRUCK
BIG CONCRETE SAW
ANY EQUIPMENT ITEMS USED,
WILL BE AT THE LOCAL PREV
SCHEDULE
f SCHEDULE B
$ 9.31 Job/Trip
$ .9.31 Job/Trip
$ 9.31 Job/Trip
$ 9.31 Job/Trip
$ 65.88 Day Rate
$ 65.88 Job/Trip
$ 65.88 Job/Trip
$102.60'Day Rate
.$ 42.12 Job/Trip
$ 42.12 Job/Trip
NOT ON THE ABOVE LIST,
G RATE SCHEDULE.
AGENDA ITEM February 2, 1982
TO: Stephen B. Julian, City Manager
FROM: W. D. Murphy, Director of Public Works
SUBJECT: Approval of Traffic Signal Maintenance Agreement
(SMI)
SITUATION
Staff is requesting City Council approval for a revised agreement
for traffic signal maintenance. The contractor, Signal Maintenance,
Inc., is requesting an adjustment for monthly signal maintenance and
labor schedule, due to inflation. The increase is approximately
8%. The City continues to find Signal Maintenance, Inc. to be the
most qualified and reputable contractor to perform this service.
FINANCIAL CONSIDERATIONS
The 8% increase in signal ma
This increase is budgeted in
ALTERNATE ACTIONS
1. Approve the revised agre
2. Do not approve the agree
3. Refer the matter back to
RECOMMENDATION
ance is estimated at $700 per year.
1981-82 fiscal year.
with Signal Maintenance, Inc.
ff.
r
By motion, approve the revised agreement with Signal Maintenance, Inc.
and authorize the Mayor and Ci y Clerk to execute the agreement on
behalf of the City.
Respectfully submitted,
W. D. Murphy
WDM:ER/rem
Sl
46
December 31, 1986
SI NAL
M INTENANCE
IN .
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, California 92675
Attention: City Clerk
Re: Traffic Signal Maintenance Service
Insurance Ce tificate
Dear Sir:
You will find an insuran e certificate enclosed verifying
our coverage of General iability and Automotive Liability.
You will note, our current policies have been extended to
March 1, 1987, at which ime you will receive a new certificate.
Please associate this ce
signal maintenance file.
Thank you.
Very truly yours,
Barbara A. Schulz
Secretary to Mr. Sondes
/bas
Encl.
Main Office'
2720 E. Regal Park Or, Anaheim, CA 92806
(714)630-4900
icate with your current traffic
Regional Office:
3395 Viso Ct., Santa Clara, CA 95050
(408)988-5541
fl �.71FICATE OF
IIOURANC
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC IISS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDO
•
ISSUE DATE (MM/DDIVV)
011
1 /01 /86
+pCT'Uf.ER
POLICY EFFECTIVE
IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
l
LTR
TYPE OF INSURANCE
RIONTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
Marsh &McLennan, Incorporated
DATE(MMODNY)
END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I AGGREGATE
COMPANIES AFFORDING COVERAGE -`
P. o. Box 38e0
San Francisco, CA 94119
(415) 393.5000
OCCURRENCE
L
MPANY
ER
A NATIONAL UNION FIRE INS. CO. OF PA
LIABILITY
C
L
MPANY
ER
s
INSURED
$
C MPANY
L ITER
`.
Signal Maintenance, Inc. and
Signal Construction Company
C
L
MPANY
ER
D
1710 Gilbreth Road
Burlingame, CA 94010
C
MPANY
ER
E
COVERAGES
THIS 15 TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR T14E 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 POLIC IISS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDO
TIONS OF SUCH POLICIES
CO
POLICY EFFECTIVE
POLICY EXPIRATION
LIABILITY LIMITS IN THOUSANDS
LTR
TYPE OF INSURANCE
POLICY NUMBER
DATE(MM,OONY)
DATE(MMODNY)
I AGGREGATE
OCCURRENCE
GENERAL
LIABILITY
BODILY
S
$
X
COMPREHENSIVE FORM
INJURY
PROPERTY
$
$
X
PREM(SESIOPERAT1(INS
GL 1803165RA
1/01/86
1/01/87
A
OIOUNDERGROUND COLLAPSE HAZARD
DAMAGE
X
PRODUCTSICOMPLETED OPERATIONS
INTRACTUAL
B18 PD
COMBINED
$1,000,
11000,
X
NDEPENDENT CONTRACTORS
X
BROAD FORM PROPERTY DAMAGE
X
PERSONAL INJURY
PERSONAL INJURY
$
1,000,
AUTOMOBILE LIABILITY
OWLY
X
ANY AUTO
WAY
(PER PERSDN)
$
X
ALL OWNED AUTOS (PRIV. PASS)
BODILY
$
A
X
ALL OWNED AUTOB `OTER THAN
BA 9284195RA
1/01/86
1/01/67
�huuRy Nrl
PRIVH. PASS)
X
HIRED AUTOS
PRDKFITY
$
X
NON -OWNED AUTOS
DAMAGE
GARAGE LIABILITY
BI d PO
COMBINED
'51,000,
EXCESS LIABILITY
UMBRELLA FORM
=
$
OTHER THAN UMBRELLA FORM
COMBINED
STATUTORY
WORKERS' COMPENSATION
$ ACCIDENT)
AND
(EACH
$ (GSEAGE ucy LIMIT)
EMPLOYERS' LIABILITY
,$ (DISEASEEMCH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLESISPECIAL ITEMS fAl �j 8b
CERTIFICATE HOLDER
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, California 92675
ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
V DATE THEREOF, THE ISSUING COMPANY WILL
0 DAYS WRITTEN NOTICE TO -W CgRTIFICATE HOLDER NAMED TO THE
January 3, 1986
SI NAL
M INTENANCE
IN .
City of San Juan Capistra o
32400 Paseo Adelanto
San Juan Capistrano, California 92675
Attention: City Clerk
0
RE f, EIV ED
Re: Traffic Signa Maintenance Agreement
Insurance Certificate
Dear Sir:
rr
I`
Please refer to our Tette dated December 24, 1985 and the
Insurance Certificate enc osed with that letter. Inadvertantly
the money amounts were om'tted from that Certificate, the new one
enclosed is complete.
Please return the origina Certificate and associate the corrected
Certificate with your cur ent Traffic Signal Maintenance file.
Thank you.
Very truly yours,
Barbara A. Schulz
Secretary to Mr.
/has
Encl.
Main Office: Regional Office:
2720 E. Regal Park Dr, Anaheim, CA 92806 3395 Viso Ct., Santa Clara, CA 95050
(714)630-4900 (408)988-5541
December 24, 1985
City of San Juan Cap
32400 Paseo Adelanto
San Juan Capistrano,
MAIN I tNANUL RECEIVED
INC.
,iaN 2 II az ►,+�'�4S
CIT I' CLE�Zi�
CL"p �M�atT
I_,
Attention: City Clerk
Re: Traffic Sig
Certificate
Dear Sir:
You will find enclosed a
our coverage of General
This Certificate should 1
Traffic Signal Maintenan
Very truly your ,�
Barbara A. Schulz
Secretary to Mr. Sonderg;
/bas
Encl.
Main Office:
2720 E. Regal Park Dr., Anaheim, CA 92806
(714) 630-4900
92675
Maintenance
Insurance
rtificate of Insurance verifying
bility and Automobile Liability.
associated with your current
file.
Regional Office:
3395 Viso Ct., Santa Clara, CA 95050
(408)988-5541
IFICATE OF ARANC;
MARSH & MCLENNAN, INC.
P. 0. BOX 3880
SAN FRANCISCO, CA 94119
(415) 393-5000
INSURED
SIGNAL MAINTENANCE, INC. AND
JRJ CONSTRUCTION
2720 EAST REGAL PARK DRIVE
ANAHEIM, CA 92806
COVERAGES
0
S CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
A NATIONAL UNION FIRE INSURANCE COMPM
8
EMPLOYERS INSURANCE OF WAUSAU
c _ry F:= _
D
E
THIS IS TO CERTIFY THAT 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 C ONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN M SUBJECT TO ALL THE TERMS. EXCLUSIONS, AND CONDF
TIONS OF SUCH POLICIES,
COTypE
LTA
OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MAODMY)
POLICY EXPIRATION
DATEIMMMY)
LIABILITY LIMITS IN THOUSANDS
OCCUR ENCE
AGGREGATE
GENERAL LIABILITY
BODILY
S
S
A
X
COMPREHENSIVE FORM
GLA 116-81-23
1/01/85
1/01/86
INJURY
DAUND MAGE
:
$
PREMSESAPERATIONS
EXPLOSION01111N S COLLAPSE HAZARD
X
PRODUCTS/COMPLETED OPERATIONS
X
fANTRACTwL
Bn._
$500,
$500,
INDEPENDENT CONTRACTORS
X
BROAD FORM PROPERTY DAMAGE
X
PERSONAL IWURY
PERSONAL INJURY
$500,
A
X
AUTOMOBILE LIABILITY
ANY AU{O
BA 118-29-88
3/01/85
3/01/86
BODILY
iANMYPERBONI
$
X
X
X
X
ALL OWNED AUTOS (PRIV. PASS)
ALL OWNED AUTOS OTHER THAN
R. PASS)
HIRED AUTOS
NDN -OWNED AUTOS
BODILY
INJURY
(PER AQlDENT1
$
PROPERTY
DAMAGE
$
GARAGE LIABILITY
CONSIINNEo
S 500,
EXCESS LIABILITY
B
X
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
5736-00-102420
3/01/85
3/01/86
BIaPO
COMBINED
$500,
$500,
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY
$ (EACH ACCIDENT)
$ (DISEASE -POLICY LIMIT)
$ (DISFASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS
CERTIFICATE HOLDER
CITY OF SAN JUAN CAPISTRANO
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
ANY OF THE ABOVE DESCRIBED
i DATE THEREOF, THE ISSI
a --DAYS WRITTEN NOTICETO
:v ncrnwcn innve \// /
G. Ortgies
CANCELLED BEFORE THE EX -
ANY WILL
GATE HOLDER NAMED TO THE
WRTIFICATE OF 1 URAN
PRODUCER
MARSH & MCLENNAN, INC.
P. 0. BOX 3880
SAN FRANCISCO, CA 94119
(415) 393-5000
INSURED
SIGNAL MAINTENANCE, INC. AND
JRJ CONSTRUCTION
2720 EAST REGAL PARK DRIVE
ANAHEIM, CA 92806
ES
0
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.
COMPANIES AFFORDING COVERAGE
L •ER, A NATIONAL UNION FIRE INSURANCE COMPANY
COMPANY B
0L TIER EMPLOYERS INSURANCE OF WAUSAU
OMPANV `
C
ITER
D / Y
E
THIS GTO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE
BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TME 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 POLI
IES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDO
TIONS OF SUCH POLICIES.
COTypE
POLICY EFFECTIVE
POLICY EXPIRATION
LIABILITY LIMITS IN THOUSANDS
LTR
OF INSURANCE
POLICY NUMBER
DATE (MMIDATE
(MMW YY)
EACH AGGREGATE
OCCURRENCE
GENERAL
LIABILITY
BODILY
$
$
A
X
COMPREHENSIVE FORM
GLA 116-81-23
1/01/85
1/01/86
IWURY
X
PREMISES /OPERATIONS
PROPERTY
$
$
g
UNDERGROUND
DAMAGE
EXPLOSION 8 COLLAPSE HAZARD
X
PRODUCTS/COMPLETED OPERATIONS
X
CONTRACTUAL
III &RD
$500,
$500,
X
INDEPENDENT CONTRACTORS
OM
COMBINED
C
X
BROAD FORM PROPERTY DAMAGE
X
PERSONAL IWURY
PERSONALINJURY
$ 500,
AUTOMOBILE LIABILITY
BODILY
$
A
X ANY AUTO
BA 118-29-88
3/01/85
3/01/86
(PER PERSON)
X ALL OWNED AUTOS (PRIV. PASS)
BODILY
NIURv
$
X ALL OWNED AUTOS bHIVEP H N
)PER ACCIDENT)
X
HIRED AUTOS
PROPERTY
5
X NON -OWNED AUTOS
DAMAGE
GARAGE LIABILITY
BI 8 RD
$500,
COMBINED
EXCESS LIABILITY
B
X UMBRELLA FORM
5736-00-102420
3/01/85
3/01/86
B16 RD
$500,
COMBINED
$500,
OTHER THAN UMBRELLA FORM
STATUTORY
WORKERS' COMPENSATION
S ACCIDENT)
AND
(EACH
$ (DISEASE -POLICY LIMIT)
EMPLOYERS' LIABILITY
5 (DISEASE -EACH EMPLOYEE)
OTHER
T7
I
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS
CERTIFICATE HOLDER
CITY OF SAN JUAN CAPISTRANO
32400 PASEO ADELANTO
SAN JUAN CAPISTRANO, CA 92675
SHOULD ANY OF THE ABOVE
PIRATION DATE THEREOF,
MAIL10—_DAYS WRTITEN
LEFT
G. Or
IES BE CANCELLED BEFORE THE EX -
COMPANY WILL
ERTIFICATE HOLDER NAMED TO THE
March 1, 1985
City of San Juan Capis
32400 Paseo Adelanto
San Juan Capistrano, C
Attention: City Clerk
ornia 92675
Re: Traffic Signal Maintenance
Dear Sir:
0
You will find enclosed a ertificate of Insurance verifying
our coverage of Automobil Liability and Excess Liability
from March 1, 1985 to Mar h 1, 1986.
This Certificate should b� associated with your current
Traffic Signal Maintenanc file.
Very truly yours,
A",/,"-', l
Barbara A. Schulz
Secretary to Mr.
/bas
Encl.
Main Office: Regional Office.
2720 E. Regal Park Dr, Anaheim, CA 92806 3395 Viso Ct., Santa Clara, CA 95050
(714)630-4900 (408)988-5541
a
i
CERTIFICATE OF I SURAN
E
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDF
ISSUE GATE (MM/DD/VY)
12/01/85
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
POLICY NUMBER
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
MARSH S MCLENNAN, INC.
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
P. 0. BOX 3880
SAN FRANCISCO, CA 94119
GENERAL LIABILITY
COMPREHENSIVE FORM
CLEOTMTERNV
A AMERICAN HOME ASSURANCE COMPANY
(415) 393-5000
BOOILY
INJURY
COMPANY
LETTER
s
INSURED
EOTMTERNY
�.
SIGNAL MAINTENANCE, INC. AND
SIGNAL CONSTRUCTION COMPANY
PROPERTY
DAMAGE
2720 EAST REGAL PARK DRIVE
ANAHEIM, CA 92806
(714) 630-4900
OMERPANY
ET7
OMERNY
E
COVERAGES
TMS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAV BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY NTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDF
TIONS OF SUCH POLICIES.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMCDMY)
POLICY EXPIRATION
DATE(MMCDMY)
LIABILITY LIMITS IN THOUSANDS
OCCUR ENCE
AGGREGATE
GENERAL LIABILITY
COMPREHENSIVE FORM
BOOILY
INJURY
S
S
PREMISES OPERATIONS
COLLAPSE HAZARD
PROPERTY
DAMAGE
:EXPSNXLOIO&
S
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
V & PDD0OUBINEDS
S
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
PERSONAL INJURY
AUTOMOBILE LIABILITY
BODLY
NUURY
,
$
ANY AUTO
(PER PERSON)
ALL OWNED AUTOS (PRIV. PASS)
THAN
ALL OWNED AUTOS PPIV. PASS)
BODILY
INJU(O7HER
(PER A
(PER ACCIpENT)
HIRED AUTOS
NONOWNED AUTOS
PROPERTY
DAMAGE
s
GARAGE LIABILITY
0 S PD
COMBINED
$
EXCESS LIABILITY
UMBRELLA FORM
MITER TITAN UMBRELLA FORM
COAEIIPEO
S
STATUTORY
A
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
WC85-11272
12/01/85
12/01/86
= IFACHACODENT)
SE %ICY L)
= (DSRAam
f (DISFASEiACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS
CERTIFICATE HOLDER CAN ELLATION
SHOULD �A,NY OF THE
�
City of San Juan Capistrano PI E 3U DATEDAYS,
32400 Paseo Adelanto 3U
San Juan Capistrano, California 92675
AL11HORIZED REPRESI
Rolland r. OrLi
BEFORE THE EX -
HOLDER NAMED TO THE
P
November 29, 1985
City of San Juan Cap
32400 Paseo Adelanto
San Juan Capistrano,
Attention: City Clerk
Re: Traffic Si
s
RECEIVED
Nov 21 11 39 AM IS
CITY CLERK
DEPARTMENT
CITY OF SAN
JUAN CAP'STRANO
92675
Maintenance Agreement
Dear Sir:
You will find enclosed a Certificate of Insurance verifying
our coverage of Worker's ompensation Insurance from December
1, 1985 to November 30, 1 86.
This Certificate should b associated with your current
Traffic Signal Maintenanc file.
Very truly yours,
Ov �Gfa�1 GL.
Barbara A. Schulz
Secretary to Mr.
/has
Encl.
Main Office: Regional Office.
2720 E. Regal Park Dr. Anaheim, CA 92806 3395 Viso Ct., Santa Clara, CA 95050
(714)630-4900 (408)988-5541
nrt �1 I I� �)III� iI
oriN- 41GHTS UPON THE CERTIFICATE
PY 1 { i lil lil II f HOLDER
DIED
� . POLICIES � �
NAME AND DDRESS OF AGENCY
EMETT & CHANDLER LOS ANGELES, INC. t 0141111,11)1 4, 4FFORDING COVERAGES
1800 AVE. OF THE STARS, STE. #400 — — — --
LOS ANGELES, CA90067 Ii"' III Protective National Insurance
TEL. NO.: (213) 553-2711 — — — --
""
TELEX NO.: 69-1260 �:� Fireman's Fund Insurance Co.
r e
NAME AND ,DDRESS DF INSURED
C IMF{M l4 1 Argonaut Insurance Co.
Signal Maintenance, Inc. LT,I It 1,1
27'20 East Regal Park Drive -- - - —
Anaheirl, CA 92806 L n`IS? 11.1
This is to a Tify that policies of insurance listed Below have
of any con, as or 0' her document with respec) to which this
terms, ezcl Isions at d conditions of such policios.
COMPANY TYI E01 NSURANCF
LETTER
GENE RAL LIABILITY
C1UNDEI
COMP 'ERENSIVE FORM
CFREW ,ES -OPERATIONS
A [E%PLC AON AND COLLAPSE
C HAZ IRD
GROUND HAZARD
C IM'IM
L I'lll'
III
issued to the insLi a T d bt •
d rI, a.Ic' i I - Irce at this time. Notwithstanding any requirement. term or condition
canificate may be ue i o r y I E RH n 11 11- urance afforded by the policies described herein Is subject to all the
- Y Liability in housan s )
FOLICY NUM HEL - - � I U P T 1 1 'ATE Limits of EACH
OCCURRENCE AGGREGATE
[ PRODI CTS/COMPLETED CGL 347 24 29
OPE DATIONS HAZARD
CY/
�
J CONTI ACTUAL INSURANCE
[ DRONE FORM PROPERTY
C(( DAN AGE
yyP INDEP NDFNT CONTRACTORS
CQPERSC IAL INJURY
Cp;p''COMP 'EHENSIVE FORM
Cp; OWNE
B C_p? HIRED
C? NON{ NNED
❑ UMBRELLA FORM
CJ OTHEFTHAN UMBRELLA
FORM
C Iand
EMPLOYERS' LIABILITY
275AB80001907
WC 20 425 11027
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
BODILY INJURY I s I s
PROPERTY DAMAGE b S
.1-1-85
_ BODILY INJURY AND
PROPERTY DAMAGE b $
COMBINED 500, 500,
PERSONAL INJURY E 500,
BODILY INJURY 5
(EACH PERSON)
BODILY INJURY $
(EACH ACCIDENT)
PROPERTY DAMAGE $
-85 BODILY INJURY AND
PROPERTY DAMAGE E 500,
BODILY INJURY AND
PROPERTY DAMAGE SOD , s500,
COMBINED
STATUTORY
1%-1-8 It z,uuu,ui
LK,
01,�tL �d
a(o�°,r4r-/
Cancellation:: Should any of the above described policies be cant el led he11 re the expiration date thereof. the issuing com-
pany will Kr)pX*XKfpXrRai l --34— days wriIiten no ice to th Mow named certificate holder, b)(JXj3X%rXXtX XX
rnRk f19 R92lFX"RMIRLk'k)F&RR !(0'ikVtXTY)f%IX'R91' R@X0P3ffRr)'XX
NAME AND ADDRESS OF CERTIFICATE HOLDER:
City of San Juan Capistrano it
32400 Paseo Adelanto
San Juan Capistrano, CA 926 5
March 12, 1984 (Revised)
NK l
April 6, 1984
NTENANCE
Ju, r��r_
Office of the City Cler
City of San Juan Captano
32400 Paseo Adelanto
San Juan Capistrano, Ca. 92675
Attn: City Clerk
RE: CERTIFICATE OF INSURANCE
Enclosed please find cop of the REVISED Certificate of
Insurance verifying our coverage to March 1, 1985.
Please file this certifi ate in your file associated
with traffic signal main enance agreement we have with
the city.
Very truly yours,
Rose Schriever,
Secretary to Mr. Sonde
/rms
Enclosure
Main Office: Regional Office:
2720 E. Regal Park Or, Anaheim, CA 92806 3395 Viso CL, Santa Clara, CA 95050
(714)630-4900 (408)968-5541
rtifI S I II!II I I i t 16 I
i r 1 jyli�l 111
TIFICATE DOES NOT AMEND, EXTEF
�•"1 ill ': `i�I
NAME AND tMC4MANDLER LOS ANGELES, INC. I C YIP I,
1800 AVE. OF THE STARS, STE. #400 - - -
LOS ANGELES, CA 90067 DR, ^N )
TEL. NO.: (213) 553.2711 R
TELEX NO.: 69.1260 ' I TINT ER T R ,i
NAME AND AUURESJ OF INSUHtU
Signal Maintenance, Inc.
2720 East Regal Park Drive
Anaheim, CA 92806
of any contract or other document with respect to which
terms, exclusions and conditions of such policies.
COMPANY
LETTER
TYPE OF INSURANCE
'OLICY NUI
GENERAL LIABILITY
Protective National Insurance C
COMPREHENSIVE FORM
A
PREMISES—OPERATIONS
Argonaut Insurance Co.
EXPLOSION AND COLLAPSE
HAZARD
Dice at this time. Notwithstanding. any requirement, term or condition
UNDERGROUND HAZARD
Limits of Liability in Thousands ( )
CGL 347 2 4 2
;Y
N DATE
PRODUCTS/COMPLETED
OPERATIONS HAZARD
$
b
CONTRACTUAL INSURANCE
PROPERTY DAMAGE
BROAD FORM PROPERTY
$
DAMAGE
INDEPENDENT CONTRACTORS
FY'T
PERSONAL INJURY
u
PROPERTY DAMAGE
LIABILITY
E
((�YAUTOMOBILE
COMBINED
500,
IJ COMPREHENSIVE FORM
®
$500,
OWNED
PERSONAL INJURY
B
® HIRED
BODILY INJURY
®NON
275AB8000190
OWNED
EXCESS LIABILITY
BODILY INJURY
f
® UMBRELLA FORM
D
❑ OTHER THAN UMBRELLA
MN032191
PROPERTY DAMAGE
FORM
WORKERS' COMPENSATION
INJURY D
C
and
WC 20 425 11
PROPERTY DAMAGEBODILY
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
T =P
1 Jh 1\N (•I
T ER
IN I\N-
T ER
t mins rtd En;d.b'YaEi ( I
r a, ba lw( d u n ay Dan m u(
IER L` �
7 3-1
3-1
)270 12 -
IBM I ■ gills m11m 1111111 1
Cancellation: Should any of the above described FcIici to cal Dal lei bml( r? the expiration date thereof, the issuing com-
n� C(4f�lt7hXIK9GTJpii9F'9(d(CC)Q�Xdfl �$-X�1i'XX(�M4P)X�(DXi9C4(91'Xy)QX�4l9Ni(7(�(T�IPK')F7E'k9C�1C9(IX°,�t�X�'1Pk3@l�9trR1i°(X
lJ0 X'R":ilyF�,f'R9E'RX',�'R�'X')PRiI�X'RR�IYIk?1"�('1°Jclk"�'KiX'X',��"1(�X{SlXR9t'��X'ff'�Z`k'X
NAME AND ADDRESS OF CERTIFICATE HOLDER
"ity of San Juan Capist,ano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
March 1, 1984
1 : ISSUED:
A H RIZED REPRESENTATIVE rp
AFFORDING COVERAGES
Protective National Insurance C
Fireman's Fund Insurance Co.
Argonaut Insurance Co.
Mission National Insurance Company
Dice at this time. Notwithstanding. any requirement, term or condition
surance afforded by the policies described herein is subject to all the
Limits of Liability in Thousands ( )
;Y
N DATE
EACH AGGREGATE
OCCURRENCE
BODILY INJURY
$
b
PROPERTY DAMAGE
$
$
-84
BODILY INJURY AND
PROPERTY DAMAGE
$
E
COMBINED
500,
500,
$500,
PERSONAL INJURY
BODILY INJURY
$
(EACH PERSON)
BODILY INJURY
f
(EACH ACCIDENT)
PROPERTY DAMAGE
$
O
INJURY D
-85
PROPERTY DAMAGEBODILY
$ 500,
COMBINED
BODILY INJURY AND
PROPERTY DAMAGE
$ 500,
S 500.
—85
COMBINED
—jM=
STATUTORY
1-84
UUU
,
,
,E PCCIDENi1
Cancellation: Should any of the above described FcIici to cal Dal lei bml( r? the expiration date thereof, the issuing com-
n� C(4f�lt7hXIK9GTJpii9F'9(d(CC)Q�Xdfl �$-X�1i'XX(�M4P)X�(DXi9C4(91'Xy)QX�4l9Ni(7(�(T�IPK')F7E'k9C�1C9(IX°,�t�X�'1Pk3@l�9trR1i°(X
lJ0 X'R":ilyF�,f'R9E'RX',�'R�'X')PRiI�X'RR�IYIk?1"�('1°Jclk"�'KiX'X',��"1(�X{SlXR9t'��X'ff'�Z`k'X
NAME AND ADDRESS OF CERTIFICATE HOLDER
"ity of San Juan Capist,ano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
March 1, 1984
1 : ISSUED:
A H RIZED REPRESENTATIVE rp
March 9, 1984
Office of the City Cle k
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, Ca. 92675
Attn: City Clerk
RE: CERTIFICATE OF INSURANCE
P
rEOFIVED
MIR 12 t 1 ?7 WTq
CIT
Enclosed please find our Certificate of Insurance verifying
our Automobile and Excess Liability to March 1, 1985.
This certificate should be filed in your current file associated
with our contract for traffic signal maintenance services.
I apologize for a data Orocessing error in the Cancellation
Clause of the Accord fo m. It is understood and agreed that
this clause should read as follows:
Should any of thebove described policies be
cancelled before t e expiration date thereof, the
issuing company wi1 mail 30 days written notice to
the below named ce tificate holder.
If a new certificate islnecessary, please contact the under-
signed at area code 714V630-4900 or 213/223-1146.
Very truly yours,
Rose Schriever,
Secretary to Mr. Sonder
/rms
Enclosure
Main Office:
2720 E. Regal Park Dr., Anaheim, CA 92806
(714)630-4900
rd
Regional Office:
3395 Viso Ct., Santa Clara, CA 95050
(408)988-5541
Cancellation:,,S,h,pyt any of the above described policies e cancelled bet xE the expiration date thereof, the issuing com-
4,6JA1iXX""Xo mail _1f) days wri ten notice to t -e I elow named certificate holderXj rV1i)KgA J
*"I)60(dhX%%*XK*1Xr)0KC* K(X(h1Q"!XrX Ik4Ph(tXMen IXl"k'k'itfP7i1Q'kmm.
NAME AND ADDRESS OF CERTIFICATE HOLDER: DECEMBER 19, 1983
City of San Juan Capistrano IATE ISSUED:
32400 Paseo Adelanto
San Juan Capistrano, CA 9 675 In
ACORD 25
'�
HOLDER
;��9� ki��r�l11 �i 1i .
o rr . . , .•
�• r. a ..T , •. .•BELOWW
,
NAt AND 1DDRESS OF AGENCY
l EMETT 8L CHANDLER LOS ANGELES, INC,
f 0111111 it !i AFFORDING COVERAGES
I SW AVE. OF THE STARS, STE #400
--`—_....-PITO=I V E NATIONAL INSURANCE CI
LOS ANGELES, CA 90067
W"N I ��
TEL. NO.: (213) 553-2711
T _T .:...._ _.
TELIX NO.-
!rte
ONPnN" E
NAME AND DDRESS OF INSURED
Signal Maintenance, Inc.
�_
LT11:i �.r ✓
2720 East Regal Park Drive `
-- —
Anaheim, CA 92806
fr":N
C MPI,NY--
LnI:B
namsd.rN)"ard L, xceatthistime. Notwithstanding any requirement term or condition
This isto cwifytha- policies of insurance listed below have been issued to the insure
of any con Tact or c Cher document with respect to which this certificate maybe is:
Rd or IT it, Llrtal i, t e r :urance afforded by the policies described herein is subject to all the
terms, etc usions a conditions of such polices.
COMPANY
(11 Y
Limits of LEablll in Thousan s (000)
LETTER
TY' E OF INSURANCE
POLICY NUM BFR
E+I,ir II:i DATE
EACH AGGREGATE
OCCURRENCE
GENERAL LIABILITY
-'� --- --
-----
BODILY INJURY
$ f
COMFREHENSIVE FORM
PREMSES—OPERATIONS
PROPERTY DAMAGE
E f
EXPLOSION AND COLLAPSE
HAZARD
A
HAZARD
PROD, COMPLETED
PROD ICT
CGL 347 24 20
1-1-85
I
OPl RATIONS HAZARD
!
BODILY INJURY AND
p
¢00,
CONTf?ACTUAL INSURANCE
I
PROPERTY DAMAGE
s500,
BROAU FORM PROPERTY
COMBINED
DAMAGE
INDEPENDENT CONTRACTORS
PERSONAL INJURY
r
PERSONAL INJURY
BODILY INJURY
,5009
$
AUTOMOBILE LIABILITY
(EACH PERSON)
COMPREHENSIVE FORM
BODILY INJURY
$
OWNED
(EACH ACCIDENT)
HIREC
$
PROPERTY DAMAGE
BODILY INJURY AND
NON OWNED
PROPERTY DAMAGE
$
COMBINED
EXCESS LIABILITY
C� UMBRFLLA FORM
BODILY INJURY AND
$ $
OTHEHTHAN UMBRELLA
PROPERTY DAMAGE
1
COMBINED
FORM
STATUTORY
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITYs
(eaaraccmrn
OTHER
FIRE LEGAL
CGL 347 24 29;
1-1-85
$25,000
A
LIABILITY
MEESE
mm ■1
DESCRIPTION
OF OPERATIONS/LOCATIONSNEHICLES
r, .A
Cancellation:,,S,h,pyt any of the above described policies e cancelled bet xE the expiration date thereof, the issuing com-
4,6JA1iXX""Xo mail _1f) days wri ten notice to t -e I elow named certificate holderXj rV1i)KgA J
*"I)60(dhX%%*XK*1Xr)0KC* K(X(h1Q"!XrX Ik4Ph(tXMen IXl"k'k'itfP7i1Q'kmm.
NAME AND ADDRESS OF CERTIFICATE HOLDER: DECEMBER 19, 1983
City of San Juan Capistrano IATE ISSUED:
32400 Paseo Adelanto
San Juan Capistrano, CA 9 675 In
ACORD 25
December 29, 1983
Office of the City Clerk
City of San Juan Capistr no
32400 Paseo Adelanto
San Juan Capistrano, Ca. 92675
Attention: City Clerk
RE: CERTIFICATE OFIINSURANCE
n
LJ
I`.'ED
aI o 4"'8a
Y CLE; fK
i,
Enclosed please find our Certificate of Insurance verifying
our General Liability co erage with Protective National
Insurance Company effectve 1-1-84 to 1-1-85, Policy
Number CGL 347 24 29.
This certificate should �e filed with your current contract
for traffic signal maint nance services we have with the
city.
Very truly yours,
Rose Schriever,
Secretary to Mr. Sonde
/rms
Enclosure
Main Office: Regional Office:
2720 E. Regal Park Dr., Anaheim, CA 92806 3395 Viso Ct., Santa Clara, CA 95050
(714)630-4900 (408)988-5541
NAME AND ADDRESS OF CERTIFICATE HOLDER:
I
City of Son Juan Capistra o
32400 Pas o Adelanto
San Juan apistrano, CA 9 675
ACORD 25
DATE SSUED,
December 1, 1983
NMI
THIS CERTIFICATE IS ISSUED A� A MATTER
aw.
t
THIS CERTIFICATE DOES NOT
HOLDERGIFTS UPON THE CERTIFICATE
AMEND EXTEP
�ORDED By THE POLICIES LISTED BELOW
NAME AND ADDR S OF AGENCY
ZMETT & CHANDLER LOS ANGELES, INC. 0OR,
11:!' WORDING COVERAGES
1800 AVENUE OF THE STARS, SUITE 4 0
n,,N1
LOS ANGELES, CA 90067 I
��
'_aCONAT" TNSIMANCE CONRANY
(213) 553-2711 TLX. 69-1260
TT I'
NAME AND ADDRESS OF INSURED
' L
Signal Maintenance, Ince TM f NY
_ _
2720 East Regal Park Drive -A
M NY
Anahesip, CA 92806
MI ANY
% ITT F
This isto certify that poll ies��f insurance listed below havebeenissuedto helnsu E1 n urs bo ., ar:=r
iIrceatthistime. Notwitlistand'mg any requirement, term or condition
of any contract or other dodument with respect to which this certificate r �Ey be i : Ie > y Erta r
,e n urance afforded by the policies described herein is subject to all the
terms, exclusions and conditions of such policies.
_
_
Limits of Uabilit in Thousan s
COMPANY
LETTER
TYPE OF INSURANCE
POLICY
E:
F,T'IV
',Lil DATE
EACH
AGGREGATE
OCCURRENCE
GENERAL LIABILITY
'
BODILY INJURY
$
b
❑ COMPREHENSIVE FORM
❑ PREMISES—OPERATIONS
PROPERTY DAMAGE
$
$
❑ EXPLOSION AND COLLAPSE
r
HAZARD
❑
UNDERGROUND HAZARD
j
❑ PRODUCTS/COMPLETED
OPERATIONS HAZARD
❑ CONTRACTUAL
BODILY INJURY AND
INSURANCE
❑ BROAD FORM PROPERTY
PROPERTY DAMAGE
COMBINED
$
$
DAMAGE
❑
INDEPENDENT CONTRACTORS
❑ PERSONAL INJURY
PERSONAL INJURY
$
--__�_---------
AUTOMOBILE LIABILITY
BODILY INJURY
$
❑ FORMBODILY
'
(EACH PERSON)
COMPREHENSIVE
$
V
(EACH ACCIDENCiDEN T)
OWNED
❑ HIRED
PROPERTY DAMAGE
$
❑NON
BODILY INJURY AND
-OWNED'
PROPERTY DAMAGE
$
COMBINED
EXCESS LIABILITY
❑ UMBRELLA FORM
BODILY INJURY AND
PROPERTY DAMAGE
$ $
❑ OTHER THAN UMBRELLA
COMBINED
FORM
WORKERS' COMPENSATION
STATUTORY
A
and
WC 20 425 110270 1
12-1-34
EMPLOYERS' LIABILITY
¢
.__
_
_
_
Z 000 000 reecH Accocry
OTHER
0011
11■ III
=I INII
MEMO
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLE
i
v
Cancellation: Shouldpove desc ibed policies I
e ca n ;gilled Ilr
tore. the expiration date thereof, the issuing com-
pany wil� mail er d<-ys wr t
e ) v Lice to
he b glow named certificate holder,MOtMl11i'X1lP
NAME AND ADDRESS OF CERTIFICATE HOLDER:
I
City of Son Juan Capistra o
32400 Pas o Adelanto
San Juan apistrano, CA 9 675
ACORD 25
DATE SSUED,
December 1, 1983
NMI
December 10, 1983
0
I"�"""� RECvIVED
N .
City of San Juan Capist ano
32400 Paseo Adelanto
San Juan Capistrano, Ca 92675
Attention: City Clerk
RE: CERTIFICATE Op INSURANCE
Enclosed please find out Certificate of Insurance verifying
our Workers' Compensatin coverage with Argonaut Insurance
Company effective 12-1-;3 to 12-1-84, Policy #WC 20 425 110270.
This certificate shouldlbe filed with your current contract
for traffic signal main)enance services we have with the
city.
Very truly yours,
i
Rose Schriever,
Secretary to Mr. Sonde
/rms
Enclosure
IF YOU SHOULD H
THIS CERTIFICATE
PLEASE CONTACT
AT EMETT & CH
1800 AVENUE
LOS ANGELES,
Main Office:
2720 E. Regal Park or, Anaheim, CA 92806
(714)630-4900
4Y QUESTIONS REGARDING
INSURANCE OR CORRESPONDENCE,
ROBIN PARKER
DLER, (213) 553-2711. THANK YOU.
THE STARS, SUITE 400
kLIFORNIA 90067
Regional Office:
3395 Viso Ct., Santa Clara, CA 95050
(408)988-5541
�1
NAM AND IDDRESS OF AGENCY
EMETT & CRANIMER
1800 Avenue oE the Stars
Ins Angeles, A 90067
(273) 553-2nl
NAME AND ADDRESS OF INSURED
SIGNAL MAINTENMCE, INC.
2.720 Fast Regal Park Drive
Anaheim, CA 92806
of any con' ract or a her document with respec to which this certificate may be
terms, excl esions In d conditions of such poliq{ es.
COMPANY
LETTER
TYI E OF INSURANCE
PILICY NUMBER
GENEIAL LIABILITY
BODILY INJURY AND
PROPERTY DAMAGE
s500,
Ar� COMP'EHENSIVE FORM
COMBINED
E� PREMI ES—OPERATIONS
�] EXPLO TION AND COLLAPSE
en
$500,
yy HAZ fRD
a
E� UNDEE GROUND HAZARD
(EACH PERSON)
PRODL CTS/COMPLETED
A
OPE iAT10NS HAZARD
0r CONTI ACTUAL INSURANCE
CGL 347 24 29
3-1-84
BROAE FORM PROPERTY
E�
rr'77 DAMAGE
/(J INDEPI NOENT CONTRACTORS
PROPERTY DAMAGE
$
PERSO JAL INJURY
BODILY INJURY AND
; WTOM )BILE LIABILITY
I-COMPI
COMBINED
EHENSIVE FORM
B
jilowrlif
275AB67510547HIRED
3.1. 84
PROPERTY DAMAGE
EI,000,
a7 -,0l70,
COMBINED
J NON-0YNED
J
Dj UMBRI LLA FORM I M 022953
IPL 1 OTHER THAN UMBRELLA
FORM
C and SOM1024027
EMPLOYERS' LIABILITY
OTHER
A Hire Legal Liab. CGL 347 24 29
OF
CONPI IIII !, III FORDING COVERAGES
C JN H fN
L 'r-I.J I`I ---
_ _---- .... Tjj,?.raer.n�R wTnmTrvr>\r TnTermrwv+c nnMnrTYas
C)MI AN- III
L T`111?
--- ----- .... p.IA,ra- "�F 9F7f� }�16FT?ZA�T13s 4�k�A�Y
C )MFf N\ IIII
C)MF t N\ ilr�
OWE
------- MnST8t3-
C.)W4 NY Iv
LITTEI
m el�beaeen a�1-ii mceatthistima. Notwithstanding any requirement, term or condition
or mny purbivi P ri) evince afforded by the policies described herein is subject to all the
Limits of Liabille in Thousands
1)'.1 I ) I DATE EACH AGGREGATE
OCCURRENCE
BODILY INJURY a s
PROPERTY DAMAGE a - a
f�
i
1-1-84
BODILY INJURY AND
PROPERTY DAMAGE
s500,
s500,
COMBINED
PERSONAL INJURY
en
$500,
BODILY INJURY
a
(EACH PERSON)
BODILY INJURY
$
3-1-84
(EACH ACCIDENT)
-
PROPERTY DAMAGE
$
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
BODILY INJURY AND
3.1. 84
PROPERTY DAMAGE
EI,000,
a7 -,0l70,
COMBINED
J
STATUTORY
12-1-83
a
525,000
LcecH Accml
1=1-84
0*-.
,Cancellation: Should a ove desc3rlbed policies a cancelled befo-c :he expiration date thereof, the issuing com-
pany will o mail U_ da s wri ten notice to the helow named certificate holderZ15il,{0G{Pi't�€I o
I
I
NAME AND ADDRESS OF CERTI ICATE HOLDER: `
OV TE ISSUED: `'
City of SM Juan Capistrano
32400 Pase4i Pdelanto
San Juan pistrano, CA 9267
—� AUTHORIZED REPRESENTATIVE
ACORD 25 (149)
H
k ,
0
SIGNAL MAI
2720 E. REGAL PARK DR.,
3395 V ISO CT., SANTA
8841 PRODUCTION AVE.,
March 14, 1983
0
ITENANCE INC.
OFFICE:
%HEIM, CA 92806 • (714) 630-4900
4L OFFICES:
RA, CA 95050 • (4081988-5541
DIEGO, CA 92121 • (714) 578-7961
RECEIVED
MAR 15 1 D11183
CITY C�
OEPART�I,
CITY OF SA..
"AH CAPISTF?AK,
City of San Juan Capistran
32400 Paseo Adelanto
San Juan Capistrano, Ca. 9 675
Attn: City Clerk
Enclosed please find our I surance Certificate verifying
our Automobile and Excess iability coverage to March 1,
1984.
This certificate should be filed in your current file
associated with the traffi signal maintenance contract
we have with the city.
Very truly yours,
Rose Schriever,
Secretary to Mr. Sondergar
Enclosure
a
c) Any change in reimbursement to CONTRACTOR may
be negotiated each year followin the anniversary date of this
agreement; Increases that are wi hin the Consumer Price Index -
Urban (CPI -U) for the Los Angele -Anaheim-Long Beach area may be
approved by the Director of Publ"c Works.
NINTH: The CONTRACTOR shat carry comprehensive general and
auto liability insurance in an a ount of not less than $1,000,000
combines single limit of liabili y. The CONTRACTOR shall also
maintain during the life of this contract, Worker' Compensation
Insurance covering all of his em loyees on the project, in a
company satisfactory to the CITY, and upon request shall furnish
to the CITY certificates issued y such companies showing that all
of the above mentioned insurance has been issued and is in full
force and effect prior to comme ing work. The cost of insurance
is to be included by the CONTRA OR when determining his bid, and
may be subject to annual negoti tion for determination of adequacy.
TENTH: This contract shal extend for a period of five (5)
years from the date hereof and shall automatically terminate on
February 1, 1987. However, either party in its discretion shall
have the right to terminate at any time sooner by giving sixty
(60) days advance written notice.
ELEVENTH: If the CONTRACT R should neglect to prosecute the
work properly, or fail to perfo m any provisions of this contract,
the CITY, after three (3) days ritten notice to the CONTRACTOR,
may without prejudice to any of er remedy it may have, make good such
deficiencies and may deduct the cost thereof from the payment then
or thereafter due to the CONTRA TOR.
TEWLFTH: Except for the m nufacturer's factory warranty, the
CONTRACTOR disclaims all warran ies with respect to materials supplied
hereunder, and further disclaim any and all liability for failure
to perform or delay in performa ce hereunder where the same is due
in whole or in part to any caus beyond CONTRACTOR'S reasonable control,
such as, but not limited to fir , flood, earthquake, lightning,
strike, or other labor di££icul y.
3-
r - alfaOellla7 -
11 I i 111 IIiF '
NAME AND 1DDRESS OF AGENCY
COMPA ^III E 4FFORDING COVERAGES
1800 Avet'Xle o the .Stars
COMPANY I
Los; Angeles, -A 90067
f
LITTER wimAL INSURANCE 00WANY
_zz=ivE
COMFANY
Il'I
(213) 553-2711
LETTER ';IMF ATIS PTINM ZNSURAAtrT CGMPANY
`
NAME AND /DDRESS JF INSURED
COMPANY Int
Signal Malnteminc+e, Inc•
LtTTER _rA IlISSIO"T SAYRF & [06C'
COMPANY
2720 East Regal Park Drive
Anaheim, CA 92806
U TER
COMPANY
LETTER C.
above an, .)it nfrceettnistime. Notwithstanding any requirement, term or condition
This is to a rdfy that policies of insurance listed elm have been issued to the insu
named
of any contact or o her document with respect to which this c rtificate maybe is
Lied or
may pertair , : Iurine afforded by the policies described herein is subject to all the
terms, exclusions ar d conditions of such polldA s.
COMLimits
yE
of L a i l
n ousan s
LETTER
TYF`.OFWSURANCE
PI LACY NUMBER
E)�'r�0 ATE
EACH AGGREGATE
.... _.. _
OCCURRENCE
GENE IAL LIABILITY
BODILY INJURY
E E
yy
COMPS EHENSIVE FORM
yLy''JI
1LJ PREM)'.
ES—OPERATIONS
�] EXPLO' ION AND COLLAPSE
PROPERTY DAMAGE
$ $
$$ HAZ. RD
UNDER ;ROUND HAZARD
PRODU ]TS/COMPLETED
A
OPEI'ATIONS HAZARD
L�CONTR ICTUAL INSURANCE
CGL 347 24 29
1-1-84
BODILY INJURY AND
BROAD FORM PROPERTY
PROPERTY DAMAGE
COMBINED
E500, s500,
gg DAM IGE
INDEPE (DENT CONTRACTORS
PERSOI: AL INJURY
PERSONAL INJURY
$500
BODILY INJURY
AUTOMOBILE LIABILITY
C
(EACH PERSON)
COMPF'_HENSIVE FORM
BODILY INJURY(EACH
RCAH$RED
AF3 184 70`77
3-]-83C�ATHIRED
ACCIDENT)
j$50
PIIOPERTY DAMAGEMNON-01
BODILY INJURY ANDO
INEO
PROPERTY DAMAGE
,
COMBINED
EXCE•iS LIABILITY
C
L7 UMBRE LA FORM
MN 00 27 34
3-1-33
BODILY ND
AGE
$500, s500,
El OTHER HAN UMBRELLA
TY DA
PROPEREY DAMAGE
COMBINED
FORM
WORKERS COMPENSATION
sraruroRY
and
EMPLOY ERS' LIABILITY
$
(EM:e nCCIDEN
JTHER
A Fire Legal Liab. CGI. 347 24 29
1-1-34 $25,000.
■■
DESCRIPTION O= OPERA110NS/LOCATIONSNEHICLE$
Cancellation: Should af ve described policies a cancelled before the expiration date thereof, th J�,
pany will
mail 5e days wri en notice to the below named certificate holder)4 t'
NAME AND ADDRESS OF CERTIF(ATEHOLDER:
City of San Jan Capistrano DA E ISSUED:_ January 25, 1923
Fn
32400 Paseo Pelanto '
San Juan Cape trano,} C.A 92675 a
Attn: Mx. Bill Murphy AUTHORIZED REP SEN A
25
I
SIGNAL M
2720 E. REGAL PARK DR.,
3395 V ISO CT., SANTA
8841 PRODUCTION AVE.,
January 27, 1983
ITENANCE INC. RECEIVED
HEIM, CA 92806 • (714) 630-4900 SAN 26 ( 25 PM '83
%L OFFICES: "ITY
RA, CA 95050 • (408) 988.5541 "'t l -hi E h T.
DIEGO, CA 92121•(714) 578-7961 SAH
J'' TnANO
Office of the City Clerk
City of San Juan Capistra o
32400 Paseo Adelanto
San Juan Capistrano, CA. 92675
Attn: City Clerk
Enclosed please find revi4ed copy of the Insurance
Certificate verifying our General, Automobile, Excess
and Workers' Compensation liability coverage.
This certificate should b$ filed in your current
file associated with the 4raffic signal maintenance
contract we have with the city.
Very truly yours,
Rose Schriever,
Secretary to Mr. Sonder;
Enclosure
IF YOU SHOULD H VE ANY QUESTIONS REGARDING
THIS CERTIFICATE OF INSURANCE OR CORRESPONDENCE,
PLEASE CONTACT OBIN PARKER
AT EMETT & CHA DLER, (213) 553-2711. THANK YOU.
1800 AVENUE OF THE STARS, SUITE 400 w
LOS ANGELES, LIFORNIA 90067 812
VAME AND 1DDRESS OF AGENCY
Cancellation Should any of th above described policies ae
pany will mail —'40— days wri to
(1-]9)
Ck.---
cancelled before the expiration date thereof, the {ssuin com-
T notice to the below named certificate holder.
NI ME AND ADDRESS OF CERTI 'CATE HOLDER:
City of Sa Juan Capistrano
32400 Pase Adelanto
San Juan C pistrano, CA 92,575
DATE
ar y 3, 19
COMPP NIES AI FORDIN ; COVERAGES
EM TT & CHADID
ER
—
1800 Avenue of
the Stars
COMPANY A
A
Los Angeles,
90067
LETTER
PR-YVPfTnM NATTONAL IMIM&M =ANY
(213) 553-2713
COMPANY B
LETTER
NAME AND .ADDRESS OF INSURED
A
COMPANY ■ -
Signal Mainterprice, Inc.
LETTER V
—
COMPANY n
2720 East Pegal Park Drive
LETTER
Anaheim, M 92806
f
COMPANY
LETTER L
This is to o!rtify that policies of insurance listed Jelow have heel issued to the insun
d named above an I are in ton a at this tim e. Notwithstanding any requirement, term or condition
of any con ract or c :her document with respec' to which this certificate maybe is
ued or may pert& t the insu,once afford d by the policies describer herein is subject to all the
terms, exc usions at d conditions of such No es.
Llrflits07-Llablll 1P Thousands
COMPANY--
LETTER
TYI E OF INSURANCE
F RICV NUMBER
PCLICv
E, PIRATION I ATE
EACH AG(.REGATE
OC'URRENCE
GENERAL LIABILITY
_
BODILY INJURY
E
E
PC
COMP tEHENSIVE FORM
fLfLE(Ci�
CJ
PREMI iES—OPERATIONS
'ROPERTY DAMAGE
E
E
]
EXPLC BION AND COLLAPSE
RR�
HAI ARD
UNDEI GROUND HAZARD
PROM ICTS/COMPLETED
A
�Ls�I
OPE RATIONS HAZARDBODILY
CSI 347 24 29
1-1-84
INJURY AND
L^J
CONTI'ACTUAL INSURANCE
'ROPERTY DAMAGE
ESOO,
tSOO,
BROAI FORM PROPERTY
COMBINED
pp�
[K�
DAN AGE
MDEP -NDENT CONTRACTORS
K
PERSCNAL INJURY
PERSONAL INJURY
E500,
AUTOMOBILE LIABILITY
BODILY INJURY
E
(EACH PERSON)
El COMP 1EHENSIVE FORM
BODILY INJURY
E
(EACH ACCIDENT)
OWNEI
PROPERTY DAMAGE
HIRED
E
BODILY INJURY AND
NON -C WNED
ROPERTY DAMAGE
E
COMBINED
EXCISS LIABILITY
El UMBR LLA FORM
BODILY INJURY AND
"ROPERTY DAMAGE
E E
❑ OTHEI THAN UMBRELLA
COMBINED
FORM
STATUTORY
WORKER!' COMPENSATION
and
EMPLOYERS'LIABILITY
E
IESGb ACLIDf �
OTHER
A
Fixe Legal Tdab.
CGL 347 24 29
1-1-84-
$25,000.
Cancellation Should any of th above described policies ae
pany will mail —'40— days wri to
(1-]9)
Ck.---
cancelled before the expiration date thereof, the {ssuin com-
T notice to the below named certificate holder.
NI ME AND ADDRESS OF CERTI 'CATE HOLDER:
City of Sa Juan Capistrano
32400 Pase Adelanto
San Juan C pistrano, CA 92,575
DATE
ar y 3, 19
•
SIGNAL MAI TENANCE INC. RECEIVED
N OFFICE:
2720 E. REGAL PARK DR. INAHEIM, CA 92806 • (714) 630-4900 �)1N I Is PM 'B3
REGI NAL OFFICES: C!"'y CLERK
3395 VISO CT., SANTA ARA, CA 95050 • (408) 988.5541 OEPART;gENi
8841 PRODUCTION AVE., S N DIEGO, CA 92121 • (714) 578-7961 CITE,
JUAN clPISTr4Nn
January 13, 1983
Office of the City Clerk
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, Ca. 92675
Attn: City Clerk
Enclosed please find Certificate of Insurance
verifying our General Liability coverage to
January 1, 1984.
This certificate sh*ld be filed in your current
file associated withthe traffic signal maintenance
contract we have wit the city.
Thank you.
Very truly yours,
Rose Schriever,
Secretary to Mr. Son ergard
Enclosure
IF YOU SHOULD HAVE
THIS CERTIFICATE OF
PLEASE. CONTACT
AT EMETT h CH.
1800 AVENUE I
LOS ANGELES,
QUESTIONS REGARDING
iANCE OR CORRESPONDENCE,
�1'TW
3) 553-2711. THANK YOU.
i, SUITE 400 n
90067 e
'S 0..0 sp��- Ir 9'J, a. 1 eA _. �• t,�ly ,N µ1P11 '77Ei1 �.
Nit- I
WORLDWIDE FACILITIES, INC.
3435 WILSHIRE BLVD.
'- LOS ANGELES, CALIFORNIA 90010
�j NAMI AND ADIWI'hi N IBI❑
SIGNAL MAINTENANCE, INC.
2720 EAST REGAL PARK DRIVE
ANAHEIM, CALIFORNIA 92806
j
9 i Ic tdyOFFu if to 'nv.t$c u IIn'Pc
he y conn rio s ott ,_ O enl r re. pc, t to of c� F I5 cert F ah m y t
ten exclusions a,d crr-dmons of Sian po4rles
c nAn N;JIT IF NS. PY N,f EOLIevNUMPtR
LI T'tH
GENERAL LIABILITY
'1 IX1'oMPPIPIr,,LJI I, "M
�[X, rHE�+II r. Fl eA nuN. F
Exru,.I,�N Ar.n rl, .LI,I
A XII AGL 00 13 08
.. X NIH v4 :01 Nn mlARI,
! i1'RtlII If' i.l: l-, nr"
X' OI'tP+16N` H^;^IfI,
[XI
CONna,r rUAL INse,RANl f
BROAD IOPM PROFI Rr'I
X
DAMAGE
(INIt(F
N`kNI LONTRN:TORS
��
P Er+SON^I INJURY
7 AUTOMOBILE LIABILITY
Ll
C_ L
,IN I'YR.I I `
UMBRELLA IORM
❑ O TITER THAN UMBRELLA
FORM
and
EMPLOYERS' LIABILITY
__ OTHER__--.
A FIRE LEGAL LIABILITY AGL 00 13 08
DESCRIPTION Of OPERA ITU NSTI)CAnri"I VEHIQIs
a
L L fr -i
COMPANIES AFFORDING COVERAGES
A AMBASSADOR INSURANCE COMPANY
L MP,N, f3
I Tr E + 1
LMr, IN, ■
Lr1E+ C
.i 1.IF nN+
rI fR
Tr�ER
namedlb)rd1a inforce t tsbne N>tv rh a.. nE my re: L.em nt, h!rmo corolaon �'
ed or ^ ryrerlan L e In urarca a:f> , r � by ih(?P0I1LCs described herein Is sub,ect to a:l the bbbY
Limits of Liability in Thousands (O00) _
FxI'6 ArioN WE —fI A('IT I[Nt lnl[
1'lRk w:F I
Hul"tI IF, I0" 8 E 44
P
ruoPFR1Y DmmIGE b b I
IT
1/1/83 -- - —i -- ------IT
BnI`I: Y w gum ANn � G
FROPf R+Y DAMAGF E 500, E 500,
CUMeINED s
t
PtNSUNAI INJURv
a 500,
IT)LILY IN IURY g
Lf.M H Pf f _ONI
eUDI:Y IN Ftp+ $
IROI IITf AI1AL1E b
iC
IIAY INJI RY lco
fHOPERrY❑ArAAGE E _
BODILY INJURY AND
PHOFERIv DAMAGt E E
COMBINE.0
STATUTORY
1/1/83 $25,000. k'
Cancellation: Should am nl Ih,' .ibove described polici" be cancelled before the expiration date thereof, the IssuinP, conl-
pany will Y\Y=tc) mail _30._ days E ntV:n notice to the helow named certificate holder.Yiii3 XXXY`dJit7G
NAMI AND ADDRESS OF CERTIFICATE HOLDER
CITY
OLDERCITY OF SAN JUAN CAPISTRANO DATE ISSUED TIF('FMRER zit og8(/2/�
32400 AN CA ADELISTRANTO ALL
SAN JUAN CAPISTRANO, CALIFORNI 92675
AUTHORIZED REPRESENTATIVE
ACORD 25 IT 79)
SIGNALMAINTENANCE INC. RECEIVES R
2720 E. REGAL PARK DRM OFFICE:
EI M, CA 92806 • (714) 630-4900 fEB ' 23
REGtT .� ��'
I NAL OFFICES: C
3395 V ISO CT., SANTA LARA, CA 95050 • (408) 988-5541 1
8841 PRODUCTION AVE., N DIEGO, CA 92121•(714) 578-7961 SAN II,,AN
CAP(ST�k��
February 22, 1982
City of San Juan Capistrano
o
32400 PaseAdelanto
San Juan Capistrano, Ca, 2675
Attn: City Clerk
Enclosed is Certificate of Insurance verifying our
Primary coverage to Janua y 1, 1983.
This certificate should b� filed in your current
file associated with you traffic signal maintenance
contract we have with the City of San Juan Capistrano.
Very truly yours,
Rose Schriever,
Secretary to Mr.
/rms
Enclosure IF YOU SHOULD HAVE ANY QUESTIONS REGARDING
HIS CERTIFICATE OF INSURANCE OR CORRESPONDENCE,
LEASE CONTACT ROBIN PARKER
EMETT • CHANDLER, (213) 553-2711. THANK YOU.
1800 AVENUE OF THE STARS, SUITE 400
LOS ANGELES, CALIFORNIA 90067
NAME AND 1DORESS OF AGENCY
EMETT & CHANDLER
1800 Avenue of the Stars
Los Angeles, CA 90067
(213) 553-2711
NAME AND ,.DDRESS OF INSURED
'Internaticnal Air Service Can
1710 Gilbreth Road, Suite 100
Burlingame, CA 94010
This is to a Ttity that policies of insurance listed xlow have beer issued to the i
of any con ract or oiler document with respec` to which this certificate may
terms, exc pions at If conditions of such polici as.
COMPANY TYI EOE INSURANCE P XICY NUMBER
LETTER
GENERAL LIABILITY
(� COMP 1EHENSIVE FORM
PREMI ;ES—OPERATIONS
[] E%PLC;ION AND COLLAPSE
HA2kRD
L UNDEI GROUND HAZARD
C PROD( CTS/COMPLETED
OPE 2ATIONS HAZARD
C CONTE ACTUAL INSURANCE
C� BROAI FORM PROPERTY
DAN AGE
CJ INDEP NDENT CONTRACTORS
C7 PERSC NAL INJURY
WTOM BILE LIABILITY
CJ COMP'.EHENSIVE FORM
CJ OwNI,
C7 HIRED
C7 NON -CANED
C�
UMBR, LLA FORM
CJ OTHEF THANUMBRELLA
FORM
A Iand 80WC1024027
EMPLOYERS' LIABILITY
OTHER
B Worker's Comp. fo 24WC1723914
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLE5 : Abed Insured
AVIASCO: Arita Sales Co., Inc.: Wine Valley
CONIPt Illi !; AFFORDING COVERAGES
7 UAP1N'�
c mP.w•' I:'
— TGLENS FAT" ID
C IN PI.N)
L T1IIt I'.J
C)N PnN'
L RCR
111 IT 4
,arr A.lblwoaxl ui, xeatthisbme. Notwithstanding
Jo nay lwrta n -I l ir wrance afforded by the policies et
E L ah
I` I-•Pn il.a
BODILY INJURY E
ppC7�LyyE��R.I(
BODILY INJURY AND
PROPERTY DAMAGE E
COMBINED
PERSONAL INJURY
BODILY INJURY
E
(EACH PERSON)
BODILY INJURY
E
,EACH ACCIDENT)
I ROPERTY DAMAGE
E
PODILY INJURY AND
✓HOPERTY DAMAGE
E
COMBINED
BODILY INJURY AND
„ROPERTY DAMAGE
E
COMBINED
STATUTORY
12-1-83
12-1-83 E
111 tl
Signal Maintenance, Inc.,
International Jet Leasing Co.
Ilremem, Term or cononlorl
herein is subject to all the
AGGREGATE
f
E
E
E
E
. ..yy ,
Cancellation: Should any of the above described policies e cancelled bet( re the expiration date thereof, the issuin com-
pan will �STall —� days writ en notice to th t Blow name r rfi to holder, b `If�e�4
a �
Na ME AND ADDRESS OF CERTIF ICATE HOLDER. December 1 1982
D •TI : ISSUED.
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675 Ama;
Attn: Mr. Bill Murphy AUTHORIZED REPRESENTATIVE
99
W
1
SIGNAL MAINTENANCE INC.
AIN OFFICE:
2720 E. REGAL PARK OR, ANAHEIM, CA 92806 • (714) 630.4900
REGIONAL OFFICES:
3395 VISO CT., SANTA CLARA, CA 95050. (408) 988.5541
8841 PRODUCTION AVE., SAN DIEGO, CA 92121 • (7141578-7961
December 7, 1982
This certificate shou�d be filed in your current
file associated with he traffic signal maintenance
contract we have with the city.
Thank you.
Very truly yours,
Rose Schriever,
Secretary to Mr. S
Enclosure
rgard
IF YOU SHOULD HAVE ANY QUESTIONS REGARDING
THIS CERTIFICATE OF INSURANCE OR CORRESPONDENCE,
PLEASE CONTACT
ROBIN PARKER
AT EMETT 3 CHANDLER, (213) 553-2711. THANK YOU.
1800 AVENUE OF THE STARS, SUITE 400
LOS ANGELES, CALIFORNIA 90067
0
City of San Juan Capi
trano
s o
ca
32400 Paseo Adelanto
San Juan Capistrano,
A 92675
no
N
m_
Attn: City Clerk
cp
Enclosed please find
ertificate of
Insurance
N
verifying our Workers
Compensation
coverage
to December 1, 1983.
This certificate shou�d be filed in your current
file associated with he traffic signal maintenance
contract we have with the city.
Thank you.
Very truly yours,
Rose Schriever,
Secretary to Mr. S
Enclosure
rgard
IF YOU SHOULD HAVE ANY QUESTIONS REGARDING
THIS CERTIFICATE OF INSURANCE OR CORRESPONDENCE,
PLEASE CONTACT
ROBIN PARKER
AT EMETT 3 CHANDLER, (213) 553-2711. THANK YOU.
1800 AVENUE OF THE STARS, SUITE 400
LOS ANGELES, CALIFORNIA 90067
0
RF@. IVFP
.r
G:
S"igna"l Maintenance
2720 East Regie Poch PRace
Anaheim, Cati6. 92806
RE: Ambamadon Tndw(ance
PoCi.cy Number. AGL 001
Cancettation Notice
Genteemen:
Pteaze accept .tki.6 t
cancettati.on notice dated
Coverage w"iU expuce
upon.
cc: City o San Juan Car
32400 Aazeo AdeXanto
San Juan Capistrano,
0
L
September. 20, 1982
o6 notice ob xe6cindi"ng
"t 27, 1982.
2y 1, 1983 as agreed
92675
Regards,
E&wAd . Kon"ieczny,
Vice-Phes"i"dent
4 n�
2029 VILLAGE LANE, P.O. BOX 678. SOLVANG. CALIFORNIA3463, (805) 688-4995. TELEX 65-8428, TELECOPIER (805) 688-2668
BRANCH OFFICE 310 SOUTH MICHIGAN AVENUE. CHICAGO. ILLINOIS 60604 (312) 346-1027 TFLEX 20 6331 TEL FCOPIEP (312) 346-7739
F � r
eaesrnbio.
EMETT & CHANDLER
Corporate Insurance Brokers
1800 AVENUE OF THE STARS, SUITE 400
LOS ANGELES, CALIFORNIA 90067
PHONE 553-2711
f. NSr; L r — —
International Air Service
Signal Maintenance, Inc.,
1710 Gilbreth Road, Suite
Burlingame, CA 94010
T` s S ro ¢rtdy Tha; Go
sit ins vance Ivsted belov l ^e b Nen issued tithe Ins
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Terms, exclusions and co,icitens of sUch policies.
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seed or may pertain, the insurance afforded by the policies descnoed herein Is sub,ect to a'a the
nFiRAI .N CAT[ �IAR. NrE LGf:Ff GATT
BODILY INJURY I S I S
PROPERTY DAMAFE I $ I S
BODILY INJURY AND
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COMBINED
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COMPANIES
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9pCILY INJIJP♦ I s
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nFiRAI .N CAT[ �IAR. NrE LGf:Ff GATT
BODILY INJURY I S I S
PROPERTY DAMAFE I $ I S
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Lc`_. I-T'N DI I "AT ,N� :,./ ONI,VEH::LC5_��.............. ..�.....,,. ..,.... ..,...,.r s.,R ,. .o_........_w........www. �wn...........a..^...�
,_ �nY of TEL, r, :^A= descr.ced nohcl s be co a Iled bef Yre t' exroi" n date thereof. the ss,I n,P Com-
.'.:Iu XXXXXXX 'Hall —3A_ _ayS r,l nonce m the b_lovr named certificate holuer.XXXXXXXXX
. XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
City of San Juan Capistrano
?;gid 32400 Paseo Adelanto
San Juan Capistrano, CA 92675
y. March 1, 1982
_1H ISSUED _
i
oRX�.CItlTy RP
J
PEPSONAL INJURY
S '
9pCILY INJIJP♦ I s
!EACH PEkSONI
D]LY 'IjEJRy � 5
3-1-83
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LY NIURY AN C ;moi
PPJrERTY tA/P S 500, �Ny.
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SODr_Y INJURY AND
=PJPERTY DAMAGE S
COMBINED
Lc`_. I-T'N DI I "AT ,N� :,./ ONI,VEH::LC5_��.............. ..�.....,,. ..,.... ..,...,.r s.,R ,. .o_........_w........www. �wn...........a..^...�
,_ �nY of TEL, r, :^A= descr.ced nohcl s be co a Iled bef Yre t' exroi" n date thereof. the ss,I n,P Com-
.'.:Iu XXXXXXX 'Hall —3A_ _ayS r,l nonce m the b_lovr named certificate holuer.XXXXXXXXX
. XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX
City of San Juan Capistrano
?;gid 32400 Paseo Adelanto
San Juan Capistrano, CA 92675
y. March 1, 1982
_1H ISSUED _
i
oRX�.CItlTy RP
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0
U
SIGNAL MA NTENANCE INC. RECEIVED
AIN OFFICE: y
2720 E. REGAL PARK DR. ANAHEIM, CA 92806 • (714) 630-4900 16x'(1 I I 23 �y U 10
L
REG ONAL OFFICES:
3395 VISO CT., SANTA CLARA, CA 95050 • (408) 988-5541C T .{ Ii G
8841 PRODUCTION AVE., AN DIEGO, CA 92121 • (714) 578-7961 ,
SAN UMI
March 18, 1982
City of San Juan Capistrano
32400 Paseo Adelanto
San Juan Capistrano, CA 92675
Attn: City Clerk
Enclosed is Certificate of
coverage to March 1, 1983.
This certificate should be filed
your traffic signal maintenance
Very truly yours,
A—
Rose Schriever,
Secretary to Mr. Sondergard
/rms
Enclosure
verifying our Automobile Liability
your current file associated with
ract we have with the city.
t 6
j `32400 r
SAN JUAN CAI
d
Signal Maintenance, Inc.
2720 E. Regal Park Drive
Anaheim, California 92806
Gentlemen:
r ,t
.0 ADECANTO
4NO, CALIFORNIA 92675
E 493j' 17 }
USLUE
Re: Traffic SignallMaintenance
n
U
Enclosed is a copy f the Agreement relating to the
traffic signal maintenance be ween your company and the City
of San Juan Capistrano. The greement was approved by the
City Council at their meeting of February 2, 1982, and is for
a five-year period of time en ing February 1, 1987.
Thank you for your cooperation.
Very truly yours,
MARY ANN / OVER, CMC
City Clerk
MAH/na
Enclosure
cc: Director of Public Works