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<br />07/08/2001 19:15
<br />
<br />8135504
<br />
<br />CROSSTOWN
<br />Dee 7/6/01 Tunc: 4Z)..}6 PM
<br />
<br />PAGE 02
<br />t'agel.m,
<br />
<br />Fr.l)m: la-ry BI_d.. 9094(i!.1!32 To Te;re1i!1
<br />
<br />AC!J~O_ CERTIFICATE OF LIABILITY INSURANC~oi~l~ I OAn:IIIMtQOf'N)
<br />07/06/01
<br />"""",,,"1\ THIS CERTIFICAlE 191991JED ~ A MATTER OF INFORMAnON
<br />lnaurance Incorporated of 0Nt. Y AND CllHl'ER$ NO IUOIffS UPON THE CERnFICAT!;
<br />So~thQrn Calitorni~ HOLDER. THIS CERTIFICATE DOeS NOT AMEND, EXTEND OR
<br />1199 s, F.irway Dr.., #101 ALTER THE COVERACE AFFORDeD BY THE POLICIES SELOW.
<br />Industry CA 91789 I INSURERS AfFORDING COVERAGE
<br />?hoPQ: 909~468-2233 Tax' 909-468-2232 I
<br />I..SURW ......_-- .-.------_..._...._.~.- -~ ._--- ..
<br /> ~f.~" W~~tch~~~er!i.. In8uranca Co.
<br /> !'~S.~A:8 ~E~~ry_~~u.l tv .~C?~~y_
<br /> Crosstown EIQctr~~ " DaU, :{ 1;;;'J~p.'~ Conat1-tution tnauranog Coll'Danv
<br /> ATT; T~r6E.1a
<br /> 16031 Arro~ H~ ~B t.
<br /> Irw~ndal~ CA 9 7 5 IIN'3VRB'lO
<br /> .--.-----
<br /> lloiSl.JR!!RE
<br />
<br />COVERAGeS
<br />
<br />THe: f'OllCIES O~ ..,1JAANt;E LIST€"0 DHOW HAY! eeEN ISSuED TO TH( IN9UAfD ""NEt> ,A.9()VE a::OR THE fIOuCY PERiOO INDICATED NOTWI'THSTANOI%
<br />ANY RlaUl~~, ~Ofl CONQI1ICN(lf'" Am' CON1"AACTOI\OTHl::RCQCU~l'(fWlTI1 Rf~ TO 'M-\\CM iH'S~~'I'1~TE MAY (If 13S\JEC CIA
<br />oloCAY ~UIN. rI~ I!IISU~ M:FDlfotO "., me POI.ICJ.li::SDE5CJIlII8Il:"O l1C1a!'.IN ~ SUBJECT TO AU Tl-IE T.:,AI.lS I;XClUSlQNS ""I) c..oHDmONS OJ:' SVCIol
<br />CIQlIC'ES A()()R~l~ L!toIIlT~ S"'QW"l MAY .....\It!: "!!EN Rl;.OVCEO ,"'PAlO ClAIMS
<br />~f.' --------- ., : ~ .-. I tiW'~., 'l'fw.DJW"
<br />I. T" TY,r. OF lM61J1tNttl! I"OUC'Y MlM.~ ".n
<br /> QI:MEJitAll....1UTY : i f..'CtiOC'tlJl'lR~~ l'1..000~QO u
<br />A ~""hlt:AOAl~~I...lllltrl I CLS682549 06/03/01 06/03/02 Ftll:J:.OIl.MA~lAn1'o".r...l \ $ 50000
<br /> ~ C;...aIMS~E ~ O<:CVI'l: I I r Mto ~p !^"~ 011. OeflOrl) i So 5,000
<br /> I..!.! Owner/Cont Prot. 1 pt;~No\l '....OVINJl)RY !, 1000000
<br /> X'XCU I I ~ENE:RAl.AGGQEGolTE .~'.1 S 20~2.QQ~~-'.-.
<br /> ~N"~ ~~~TE LIMIT ~"'fS "'iOA 1 I , 1"AOCl)<';'-S.crn,IP/OPAGG, s1000000
<br /> f-'-'-. """". :-'1 ~ff'r I 1'00 I I I
<br /> A4JfOUO&lU:' lIA.""" I COW}lM=J:I',fNG,l F L JMn" 1'1000000
<br />B ~ "'''''H.U'fO ' AC11040980 I 06/03/01 06/03/02 ie'~ll
<br /> ,
<br /> , I. . __pO - .._--~_.._--_-.-
<br /> '"'Ll OWNED -..\.JTOS I ~"""NJVR'f t.
<br /> .... I
<br /> .~-J So-<E.O\JlEO.wTf)S \,",-,~j
<br /> ~H.lRf"DAJ.ll"OS I ~"flNJuRY .
<br /> ~, ~WN"n AUT'J~ (Per~l)
<br /> i I .....---
<br /> _...1. "_.n_ - I i ~rY~ .
<br /> , I (Per'~.-.ll
<br /> C..uu~LIAIIU.l"'r I I A~T..?}l~~~CCIOE~t .
<br /> ~.NY...IJTO I
<br /> I I OTlo4l!.ClTf'WIl Lo....cc ,
<br /> -- --
<br /> "!JTOON~'Y "(;0' S
<br /> !)CC!S1 l~llm' i I EACti occv~NCf . 2000,000
<br /> UC:l.t.lNJS,Wl()E; -- ...-...... -
<br />c~ DC"",, TBD , 06/22/01 06/03/02 ~GA'E 12000000
<br /> I l .
<br /> .lIJEOOCTIe<.E I - ---. ._-.
<br /> .
<br /> I'\E~"""IUN . I .
<br /> W()fl:KfRS COtlnNVt~ A*, , I I TGR_Y~I~S~_~!
<br /> I afPl.OY5;Al'llA8lllT"r a:A""l~A:n 10 ... latuto , I ~:,~H~~___. ~
<br /> I lilI CARlUliR. , I iiI.. Dl5EASE'fAEW"l~ -.
<br /> .
<br /> , --_.-
<br /> I UOtIE.A$l:;-IIO\.ICVl"'IT ,
<br /> .".,.
<br />B Phyei.cal ACll040980 06/03/01 06/03/021 COlllp 500
<br /> : ColI 500
<br />Di5QU"TlOf4 OF OPlAATIO~SA..QtA.nQJqNeHIr;t.E&.g,ClU1OlOHS ~ S'f E~M.~~'''Ifi'E-C;lAl PROYIIIIOMS--
<br />'10 day notice of eanc..l1ation 'fill be pr01l'idGd fOl; non payaQtlt of praJlliiwa .
<br />All operation. of the named ~n8ured as cov.red by these pol1c:ies, The <;:i.ty
<br />of Sanb Ana, ~t<s officers, ""'Ploy... agent.. and reprel!lantativilifB are named
<br />a. aad-j, tionea.l ~nBur.d..Cov.raq. 1. PriJlUlry ,
<br />
<br />CERTifiCATe HOLOf~
<br />
<br />I Y "'p;l0I~ 1N8VIlfCO; llldiL/lllIE" ll!TTVl
<br />
<br />CANCELLATION
<br />
<br />City of San~ Ana
<br />Public Woz:Jt. Aget\ey
<br />Attn: Trar~lC En91neeri~q
<br />20 Civio Center Plaza
<br />Santa Ana CA. 92'702
<br />
<br />SAN'l'AAN SMOIJl.D AN'\' Of: TlI~ &8OYE DUCltllllEO 1"Ol.K;IU.If. C4NCli:Ll.EO IIlF'OAE lN1 e~nQ
<br />OAT!!; Tt1:8ACOF. 'rifE ll-IiUWl) INSU~ WIll MAlt. -!J.O. ""'va """lTT(N
<br />""'1lCt: m lWf' cu'''JACATt I<<JlDl!. MAMeO TO TKt: Uf!. ell, - .-- -- .sw.t.l
<br />IMPOSIE fIIIO OtIUGA'tIOW OR UAlltI.(ry ()liO: M4Y ItlNO uPON 'Tl4E J~1tER. ITS '-GENTS OR
<br />1E1'M.SEHl'4D~
<br />'~icr...nve
<br />
<br />ACORD 2505 (7117)
<br />
<br />APPROVED AS TO FORM
<br />
<br />CACORll CORPORATION 1918
<br />
<br />. /. '/ L/
<br />A, ,-,--"~-L-lL-"_.' .,\.,;.,
<br />La ~ra Sheedy -- ,.
<br />Deputy City Attorney
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