|
<br />,
<br />
<br />07//8/2005
<br />
<br />15:47
<br />
<br />3103702474
<br />
<br />SENT BY: VAN DUlER INSURANCE;
<br />
<br />3104762818;
<br />
<br />HYGIENE TECH
<br />JUN.2.05 10,12AM;
<br />
<br />PAGE 02
<br />PAGE 3/8
<br />
<br />, H.~ .........,. "if,:li;;~;':j~i~;M.\~~"";;.l;.:;q:1.\l"uili;.:M,,jli~~e-.::"n"n'::'"';.;;i1':'i,e,::(i,:!,!'"'i',;;,;"i:,;~u~'iii''''' ~~';'u;~""" ""
<br />:,:: ~~~.~:~".,~~.:,1"':f:t~~~.t!:~~:~~i.~~~~.Ji~~~n.~::~,~~~~::~~~ff~:1"i~;~~;~;i~},A{?dzI:~/::~ttF~~}1~jls~~,h~:tt~f:i" 0 6 / 0 2 / 2 0 0 5
<br />';':ODI.lCflt . .. . "".,,... .. .... ,.. THI:i'CE~nnCAn I' 15'S'~'';D''''A~ A. MATTE,,"OF' "NFO~MATIO'" oNLy ~ND
<br />CON~EFlS NO ~tQ"TI UPON TH~ C6RTlFfCATE HDL.DER. n4IS CE...nF'ICAlE
<br />ooEs NOT AMENP, E~TEND 011 ALTE/I THE COH/lAQ~ AFI'O/lOm BY THE
<br />"OllCIES BELOW.
<br />
<br />Dick Van Duzer & Assoc., Inc.
<br />P. O. Box 49894
<br />LOB AngeleB, CA 90049-0894
<br />(310) 476.6561 Fax 476-2818
<br />
<br />COMPANIES AFFORDING COVEAAOE
<br />
<br />HYGIENE TECHNOLOGIES INTER.
<br />3625 P~L AHO BLVD. #180
<br />TORRANCE, CA 90503
<br />A - "Jf)Oj - 0/3
<br />f0 ' ).f.)O)..- l~;;'
<br />
<br />r.nM"""'. A HARTFORD INSURANCE
<br />_'"'.
<br />C:OlU.rAIoIY B
<br />I,l:l It...
<br />C~o.N'l' C
<br />lm'll
<br />CO/04a^~i' D
<br />lCm:11
<br />tOMl"...N1 E
<br />urnfl
<br />
<br />'"tvwllO
<br />
<br />
<br />-n.m IS TO CEf1TlFY hr"l ll.le: POUC~ES OF INSU""'t.lCr. l,lSr(C) BELOW ~,l'VE BE~N I!;:;UG) 'fa TIle tN9UFtf:D NAME.D AI10Yt' rOA TIt( POllC'f PERI(J[J
<br />INUI(;AllLJ, NQ'T',,""Tt1STANDlp.,IG AN., "F.OVI~(Mo.n. n~M Of:! COtiDITION UI A~V CON'rRAr.r nn nTHFn I)OCI)MUJT WITH IlESPECT TO IAIHI(:H fillS
<br />r.E.~IJ:IC^'TE MAY f1F I$SLJEU OK tJ,A'1 rEATAI"', n-lF tNSUAANC(; AfI'OMOEO 8'1' THF rOUCIEA OtSt.:MtULD H'E"[IN IS SUAJfCl ro ~LL till ml;MS.
<br />!:J({;tUSION! A~ CO":l.~I.TI~IIIS u~ ::lLJ{;1'11101lt;rl.:~, ..l.l~',I,~~, SI1O'NN "'..... ~~VE O(LN ~EUVCED fill' P~IO CI,AtMS.
<br />
<br />.allC' 1D'r:1ClJVr: roue," ED'I.....no..
<br />PAn f"""'tOCIl'l'Y) Ol\.fallo1"""-"l,...f)
<br />
<br />C.
<br />LT.,
<br />
<br />N.... 0,," t""U""'~Cl
<br />
<br />roucY w".lt..
<br />
<br />lla..rwl
<br />
<br />A GIl;HIlU.L UUlurt
<br />X COlJl.lE.CI~ iJEI'O['1A(, ~I"""" w
<br />, Cl.J\l"'~ ""'Ofi X OCClJA
<br />,,:,:,,:.,
<br />
<br />ow""'cr~ . c~n,l,C'(UA'lI jo'IotO!,
<br />
<br />09/15/05
<br />
<br />09/15/06
<br />
<br />CCNCIVol. AGrArC",TF J, 4 ~ 0 OO~ 000
<br />PAODUcr~C()I,t'tOr.-.aa ,s EXCLUDED
<br />f'l'Il$OIll....A Iocv tN~tICl., 'J 2,000,000
<br />U.C~ crecul'!"'''1'''O( I '2"; (fO'6 ~ '666
<br />rl~ QIMAQE (An. ",.A "I..) I 30.0 . '00 a'
<br />; "'(0 ilC/"''''SC {In, o~, IMI'JIII~)il l'O.','cl"t>o
<br />
<br />11 S8A L05514
<br />
<br />, A..,'rOMOllll1lA,lun
<br />A ,t,"YJU.JlO
<br />: ~l O.,.NfllIlVIQs
<br />: ~CHH)\)\.~O "'UTO'
<br />X : ,",fI.l~.u AU!()~
<br />X I 1otI0H.0,""",,[0 ~VlOJ
<br />"I\IlMil:lIMUT'l'
<br />
<br />72 5." lase'..
<br />
<br />: COI,(QINrj} $lN(jlE
<br />LIaIIIT
<br />
<br />.2,000,000
<br />
<br />09/15/05
<br />
<br />09/151 06.1I001lY INJUn\"
<br />,,,., .,."'o~)
<br />
<br />1'0011.." I"~IJ""
<br />It'll .cc....~11
<br />
<br />PflOF~~ I)JM'G~ ..
<br />
<br />,rAccn LI...a'l"
<br />
<br />U~~l lj. ~OA~
<br />
<br />APPR()V~D AS TO FOR~1
<br />
<br />'(",etl OCCUHltt:lYCt
<br />JlC.C;t1l;.C^T~
<br />
<br />OT~H ~.I\'" \!~LL1\ rO",l.l
<br />
<br />.N.
<br />
<br />
<br />!;,^Turon"lIJ04lr.;
<br />: EACH ACC'IM...,
<br />Clsr~( POllClll"",r
<br />0'''''<;', he.. 1.....10""'.
<br />
<br />......:."
<br />
<br />.a".II::III.' (D...."..flOllI
<br />
<br />CMJ'\o.m7 lM,8!Un'
<br />
<br />, tl'lMV!.
<br />
<br />llUl:_PTIOIil o~ OP('''TIOfW''I-QC..'nQPllalli.ULl:IlIf'ICIAL ll'fM1
<br />THE CITY OF S~TA ANA, ITS OFFICERS. EMPLOYEES, AGENTS AND
<br />REPRESENTATIVES ARE NAMED AS ADDXTIONAL INSUR&P NON OWNED AUTOMOBILE
<br />IS A SYHBOL 9.
<br />
<br />::CII! nil: :IS
<br />
<br />CITY OF SANTA AN~
<br />ATTN, RISK MANAO~ENT DIVISION
<br />PO BOX 1968 M-28
<br />SANTA ANA CA 92702
<br />
<br />SHOll!.!) ANY m lH~ AuOllt: OUCFlIDro POl..lC1E9 QE CANCEuro llFf'Oltl: Hit
<br />[/lVIWAIION DAft: TrIEAEOF. T1"I{ '9SUlr-.lG COMPAtJl' WILL tt'I)'~"-'l .~
<br />"""It --I.Q. DAYS WqlmN ....OTIC~ TO TrolE C(MIIf'IC...T(. HOl.DER IIJAMm TO JJ.lE
<br />LEFT,
<br />
<br />:iltcil'o' .~i", '(11DOj," ..
<br />
<br />:~;;i':;i;~~}
<br />
<br />
<br />'7:~iilii'l:'i\ijiiiCD"~,"~1lO~ HNO:.
<br />
<br />,""
<br />~,;':AUniOIUftO aCPIlUOIT",TlYf
<br />
<br />~ ,';W".;.;;..,
<br />
<br />..>,.,.,....,.,......
<br />.....,.."..,.,...
<br />i...~..,..,.,.,,:' ~.,,'
<br />
<br />; : i'''~;::('.::'>~:' \~::~~. ::.'
<br />
<br />".~":;;:f:~~~,::'::f :';;i~;j!: i:i;? ,; {::.~? :~,;
<br />
|