Laserfiche WebLink
<br />CITY S R - PUBLIC WORK Fax:714-647-5823 <br />O~jOTf02 a; QB FAI' un '1l22~21 PH. Ins ST08 Inc <br />,- <br />~----- <br /> <br />ACO~.Q. CERTIFICATE OF LIABILITY INSURANCE Oiio1n~ <br />'rn1S llml11'1 I P <br />ONLY AND CONFllUI NO UPON lHI l:QT\FIt;A'Il! <br />1I0LDill. 'filII CEJmFlc;,o.fE !lOg NOT AIIIfID. ilCIIf(O Olt <br />T'l1'Il'HE ~ "'I'JPONltiD IY TNIi POI.lCIU IIl!LOW. <br />III$U"PI ""j;QRDltG C:0ViRAQ~ <br />CPelll _r Ciln Ins. ~JI)I <br /> <br />~iI <br /> <br />T.. 'OI.JCfU O. IN~V,,^N"" LlO'!tO DE,OW Hl,VI: a~!N !i/lU&)TO THE ~ /lAM&/) AlOV= FOR n<e PCLICY -.00 tlDlC4T11l. N i\'IDlNQ <br />.......v llB>.,....MEHr. TENoI "" CDNOI'l1ON OF ANT CONTIlACT 01\ OTMIR COO\IMENT W1llt ItElI'ECTTO 'MIlCH lHlI ~'lIF'c:ATIi.""'Y .I"IIED OR <br />IMY ~ERTAlN. THi 1N6UlWlCi_OllOeo IV THE l'OI.1C.5 Dev<rRIIIlID _IN II.UBJECTTO....... THe 'lEllMI.IIl\CLUlllD1l8ANC IXINDIT1DIIll (]P IIUO>l <br />POWEll, AGGRBOATE LNlT5 GHOV\IN.....y....VS IISl' ll~ IlVPAlO ClAIMS. <br /> <br />TYR. or: III-.nu,,.ca !"GLRr I"I-..M UIII'q <br /> <br />...OIW.UAlIlltY N;j75S1U05 CoI.OMcc",,- . <br /> <br />X o"""""ow. c;lIIIW. UUll1TV .... -loOoot... n . <br /> <br />l:LAlM!~ (!J OCCIm ._ '"' . <br /> <br />A ~1.l_....,1t'/ . <br /> <br />n; . <br /> <br />MOtllIm._.....1\M . <br /> <br />....PIlClll R 79 -105. Fill( C42li) II -2 U <br />FU. Insuran&e. Sc:rvi~l lnl'. <br />.9 S....th Ulk. "'\1M..... lUOO <br />P.I.dtna. CA .1101 <br /> <br />IIrIILlIUm <br /> <br /> <br /> <br />LaO <br /> <br />ilCJ7iJlliO. <br /> <br />A X <br />X <br /> <br />-el.M8J1m' <br />1tNI),IITD <br /> <br />^ <br /> <br /> <br />_l.IA8ILITY <br />DCCUA 0 ~IW'I <br /> <br />DliilllJC'tllLf. <br />.~fON I <br /> <br />:'="~t'WE <br />A } <br /> <br />'\ . <br />on. Eaura Sheedy <br />Deputy City <br /> <br /> <br /> <br />Jan 8 2002 11 '04 <br /> <br />'-- <br /> <br />P.02 <br />Ollflfll <br /> <br /> <br />. <br />. <br />. <br />. <br /> <br />I <br />I lIlIO II <br /> <br />"KU....A'" <br />1rlaJ~~~ <br />lNIUR!1\ c: <br />11_" <br />""tollER;: <br /> <br /> <br />08/0112001 0'/0112 <br /> <br />CiQM"...~ AINILI UMIT I <br />~-) <br />I!!!ODLV IIIJURY' . <br />CP"_IIl <br />to~'L'''''''''' , <br />rI"tr..~ <br /> <br />""O'''"~~7IONII\IINllj:"UI!I._ I~_ . <br />1fh rlSpects II., ,lIln..OI. The CIty 0 antll Ill, U V,c ~""e. PlUiI, laMa Ana CA 'nOI. iu <br />ff1urs, 1!'lIlIl10y.... .,enta, v91IM..... al\lI .BJll'lIlllllllati.... are n._ u allditionll1 111511''''1, at the;l' <br />'IIt.rut ..y appeal', p.,. EJdI1bit J lInuhed, <br /> <br />/)1 <br /> <br />~=.r""" · <br /> <br />OIffllOHl.Y.&.\ NI/l', <br />IloAOC . <br />;!114 I <br /> <br />~ <br /> <br />-. <br />_rr <br /> <br />. <br /> <br /> <br />h~~ t." (10) .l'~ notice of ~aneel'.'Ua" fOl' -"lIY_r 01 premUlll. <br /> <br />CEI\'llJIIc.+.nHOLOI" A..'''.'''''''-...._:__ CANol!l..lAnoN <br />IHCM.D '-rf'fep' 'Tl1INMWI DlJIl~ l'Oua... CIJIIRLiD iiJGI:CA,.;l1C <br />-nIHM'.--._a_"'_WILl.""""""11lWllL . <br />..!M..1llYJ__ T11T1ll1_-.""WlMu.u............. <br />t...._TIlIWl......_f<W.I._""__...UAII."., <br />O/'.wfillflll ne__.n1l . <br />.ou1JOO " <br /> <br />Ci~ of Stlntll Ana <br />At'Cn 'oJa _non <br />20 Civic Cornte,. "'1lZAt <br />Strlt<< ""., CA .nOl <br /> <br />'.4X: (714)147-5n5 <br /> <br /> <br /> <br />.... ' <br /> <br />'''' <br />