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<br />ACORD,' CERTIFICATE OF LIABILITY INSURANCE D;;;;~~D;~~) <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />C VER D I <br />INSURERS AFFORDING COVERAGE <br /> <br />COVERAGES IMSEOl F2 <br />THE POLICIES OF IN URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDrTlONS OF SUCH <br />POLICIES. AGGRE E LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR POLICY EFFECTIVE <br />l TR POlICY NUMBER DATE MMlDD1YY <br /> <br />, <br /> <br />Locklon In~rance Brokers, Inc. <br />PRODUCER 725 S. Fig 'eroa Street, 35th FI. <br /> <br />CA Ucens #0714705 <br />Los Angele CA 90017 <br />(213) 689 5 <br /> <br />mSURED t <br />Kimstaff H <br />1018997 17872 Co nAve. <br />Irvine CA 614 <br /> <br /> <br />~ ....-"- <br /> <br />INSURERA: SelfInsured <br /> <br />INSURER B : <br /> <br /> <br /> <br /> <br /> <br />NOT APPLICABLE <br /> <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG S <br /> <br />LOC <br /> <br />NOT APPLICABLE <br /> <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br /> <br />BDDll Y INJURY <br />(Per person) <br /> <br />BODll Y INJURY <br />(Per acciden') <br /> <br /> <br />PROPERTY DAMAGE <br />(Per accident) <br /> <br />AUTO ONLY - EAACCIDENT S <br /> <br />ANY AUTO <br /> <br />NOT APPLICABLE <br /> <br />OTHER THAN <br />AUTO ONLY: <br /> <br />EA ACC S <br />AGG S <br /> <br />S <br /> <br />EXCESS lIABIUTY ! <br />OCCUR 0 CLAIMS MADE <br /> <br />NOT APPLICABLE <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br /> <br />A <br />A <br /> <br /> <br />04/0112003 <br />04/01/2003 <br /> <br />CERTIFICATE NO. 2279 (KIMC <br />CERT. NO. 2279-A (KIMSTAFF) <br /> <br />E.L EACH ACCIDENT <br />E.L DISEASE - EA EMPLOYEE S <br /> <br />, <br />I <br />, <br />I <br />I <br />. OTHER <br />¡ <br /> <br />El. DISEASE. POLICY LIMIT S <br /> <br /> <br />lIMITS <br /> <br />xxxxxxx <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br /> <br />xxxxxxx <br /> <br />xxxxxxx <br /> <br />xxxxxxx <br /> <br />xxxxxxx <br /> <br />xxxxxxx <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br />XXXXXXX <br /> <br />xxxxxxx <br />XXXXXXX <br />XXXXXXX <br /> <br />DESCRIPTION OF OPERA IONSIlOCA TIONSNEHlClESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br />Rc: Employees of Ca ada Environmental Services, Inc. <br /> <br /> <br /> <br />ADDITIONAL INSURED' INSURER LETTER: <br /> <br />CA <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EJ(PIRA TION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBUGATION OR LIABIlITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br />I\CORD 25-5 (7/97) <br /> <br />FOt questions r8vanling this certificate. c.ontaÇ1 the numlMr list'" in the "Produc"" ~tion abow and specify the etienl cod. 'KI EO", <br /> <br />