Laserfiche WebLink
CERTIFICATE OF INSURANCE <br /> <br />[] STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois <br />[] STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />[] STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario <br />[] STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida <br />[] STATE FARM LLOYDS, Dallas, Texas <br /> <br />insures the following policyholder for the coverages indicated below: <br /> <br /> Name of policyholder ADA CONSTRUCTION SERVICES COMPANY <br /> Address of policyholder 1320 E ST ANDREW PL STE D SANTA AMA, CA 92705 <br /> Location of operations <br /> Description of operations CITY OF SANTA ANA, ITS OFFICERS AGENTS AND EMPLOYEES <br /> <br />The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is <br />subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid <br />claims. <br /> <br /> POLICY PERIOD LIMITS OF LIABILITY <br /> POLICY NUMBER TYPE OF INSURANCE Effective Date ! E. xpiralion Date (at beginning of policy period) <br /> Comprehensive ; BODILY INJURY AND <br /> <br />............................... _B_ _u _s! _n_e_s_s_ _L_ i_a_ b_ il ! _ty_ ............................................... PROPERTY DAMAGE <br /> This insurance includes: [] Products - Completed Operations <br /> [] Contractual Liability <br /> [] Underground Hazard Coverage Each Occurrence $ <br /> [] Personal Injury <br /> [] Advertising Injury General Aggregate $ <br /> [] Explosion Hazard Coverage <br /> [] Collapse Hazard Coverage Products - Completed $ <br /> [] Operations Aggregate <br /> POMCY PERIOD BODILY INJURY AND PROPERTY DAMAGE <br /> EXCESS LIABILITY Effective Date i E.x~iraben Date (Combined Single Limit) <br /> [] Umbrella Each Occurrence $ <br /> [] Other : Aggregate $ <br /> ; Part 1 STATUTORY <br /> Part 2 BODILY INJURY <br /> Workers' Compensation ,, <br /> and Employers Liability : Each Accident $ <br /> : Disease Each Employee $ <br /> , Disease - Policy Limit $ <br /> POUCY PERIOD LIMITS OF LIABILITY <br /> POLICY NUMBER TYPE OF INSURANCE Effective Date i F_.xpira'don Date (at beginning of policy period) <br /> 404 1892-D01-75 NON OWNED/HIRED 10/01/03 : 10/01/04 $1,000,000 <br /> R21 0032-B23 75 AUTO LIABILITY 08/23/03 : 02/23/04 50000/100000/25000 <br /> <br />THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY <br />AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POMCY DESCRIBED HEREIN. <br /> If any of the described policies are canceled before <br /> its expiration date, State Farm will ~mail a <br /> written notice to the certificate holder 30 days before <br /> Name and Address of Certificate Holder cancellation~~ <br />SANTA ANA REGIONAL TRANSPORTATION CENTER <br />1000 E SANTA AMA BLVD ~300 <br /> <br />ATTN: CAROLYN FULLERTON i i,~ ' , 0/28/03 <br /> <br /> AFO Code ~'"-~ ''~ <br />$58-994 a.3 04-1999 Printed in US.A. <br /> <br /> <br />