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<br />JAMES H MYERS
<br />4620 ARLINGTON AVE
<br />RIVERSIDE, CA 92504
<br />
<br />REVISED CERTI~ICATE
<br />
<br />CERTIFICA TIWlF INSURANCE . ISSUE DATE (MMID~
<br />. .... 4/18/91 "-
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND I
<br />CONFERS NO RIGHTS UPON THE CEIiITlFICATE HOLDER. THIS CERTIFICATE i
<br />DOES NOT AMEND, EXTEND OR AL Tt!A THE COVERAGE AFFORDED BY THE (
<br />POLICIES BELOW. ,
<br />--1
<br />
<br />I
<br />
<br />I
<br />
<br />
<br />A....lllt.
<br />
<br />1
<br />
<br />PRODUCER
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />~~i'i~~NY A
<br />
<br />FIREMANS FUND INS CO
<br />
<br />, INSURED
<br />
<br />~~T~~~NY B
<br />
<br />KINKLE, RODIGER & SPRIGGS
<br />3801 UNIVERSITY AVE., SUITE 700
<br />RIVERSIDE, CA 92501
<br />
<br />~~~~NY C
<br />
<br />~~i'i~~NY D
<br />
<br />E~T~~~NY E
<br />
<br />:-COV'ERAGES-'-- ----.
<br />
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />
<br />I
<br />I~T~ TYPE OF INSURANCE
<br />_~_~__'__'__"".''''_'____'r'-_
<br />GENERAL LIABILITY
<br />
<br />POLICY NUMBER
<br />
<br />POLICY EFFECTIVE POLICY EXPIRATION
<br />DATE (MMIDDfYY) DATE (MM/DDfYY)
<br />
<br />LIMITS
<br />
<br />i
<br />'A
<br />I
<br />I
<br />I
<br />
<br />L_..______P'__'_ _.
<br />
<br />CLAIMS MADE
<br />
<br />X OCCUR.
<br />
<br />293ABC80356153
<br />
<br />GENERAL AGGREGATE $ 1, 000, 000
<br />PRODUCTS-COM PlOP AGG. $ 1, 000, 000
<br />PERSONAL & ADV. INJURY $ 1, 000, 000
<br />EACH OCCURRENCE $ 1, 000, 000
<br />FIRE DAMAGE (Anyone fire) $ 50,000
<br />. .__.~_,.o~_~______..__.~_",._.__.,,~,.__.__~:..~~~~person) ~.,~_,~__,2' 000
<br />
<br />1/28/91
<br />
<br />1/28/92
<br />
<br />X COMMERCIAL GENERAL LIABILITY
<br />
<br />OWNER'S & CONTRACTOR'S PROTo
<br />
<br />A
<br />
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />X HIRED AUTOS
<br />X NON~OWNED AUTOS
<br />GARAGE LIABILITY
<br />
<br />COMBINED SINGLE
<br />LIMIT
<br />
<br />$1,000,000
<br />
<br />293ABC80356153
<br />
<br />1/28/91
<br />
<br />1/28/92
<br />
<br />BQDlL Y INJURY
<br />(Per person)
<br />
<br />$
<br />
<br />BODilY INJURY
<br />(Per accident)
<br />
<br />$
<br />
<br />PROPERTY DAMAGE $
<br />
<br />!. "--~~_._-'._._.. .---,.--.-- ~
<br />
<br />i
<br />IA
<br />I
<br />
<br />EXCESS LIABILITY
<br />X UMBRELLA FORM
<br />OTHER THAN UMBRELLA FORM
<br />
<br />"-'-~___'__"____.~~"~__._,_~_,_."__"__'_W"_~____,~''''A''__'._~__._''"
<br />
<br />XEK2079241
<br />
<br />1/28/91
<br />
<br />1/28/92
<br />
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />
<br />$ 20,000,000
<br />$ 20,000,000
<br />
<br />il WORKER'S COMPENSATION
<br />AND
<br />EMPLOYERS' LIABILITY
<br />i___~__.___~___._...___" __.____.__.,
<br />OTHER
<br />
<br />STATUTORY LIMITS
<br />
<br />EACH ACCIDENT
<br />
<br />$
<br />$
<br />DISEASE-EACH EMPLOYEE $
<br />
<br />DISEASE-POLICY LIMIT
<br />
<br />l-iiEsCRIPTlONOFoPiiRAT'O"NSiLoCAiiOiis;;;EHICLEs,sPeci;;';:-iTEMS'--" ----. ----,--
<br />i LAW OFFICES - LOCATION - 837 NORTH ,ROSS ST., SANTA ANA, CA 92701
<br />, CITY OF SANTA ANA IS NAMED AS ~AITIONAL INSURED AS RESPECTS POLICY #293ABC80356153.
<br />
<br />'CERTIFICATE HOLDER
<br />
<br />__.~.. _ __. "~______...e" ._._..,~
<br />CANCELLATION
<br />
<br />CITY OF SANTA ANA
<br />POBOX 1988
<br />SANTA ANA, CA 92702
<br />ATTN: EDWARD J COOPER
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO
<br />MAil ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br />lEFT, BUT FAilURE TO M SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR
<br />LIABILITY OF ANY KIND U N THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
<br />
<br />ACORD 25-5 (7/90)
<br />
<br />
<br />JAMES H
<br />
<br />
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