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<br />08/82/2886 89:41
<br />
<br />7687838292
<br />
<br />COAST CITIES INS
<br />
<br />PAGE 82
<br />
<br />! Icommerci~1 Ce;tificat; of In;ura~ce
<br />
<br />Agent)' . Ol1l:liel C Inskeep 11 CPCU CLU ChFC
<br />NillfflC 1295 En,ftim1!S Blvd
<br />& Bncinitas, CA 92024
<br />A.ddr!S~ 760-7R300229 fax 760-783-OH2
<br />
<br />--_.---~-FARME~J
<br />
<br />
<br />1o.u. Dol' (MMlDDIYYJ bml2~6-_.J
<br />
<br />Agent, 3:16
<br />
<br />This certlncate is IJSued 8S II matter or in!(I1'm8tlon only imd ((loftn no rights
<br />IJpotl tht r:ertif\tate hQ1der. This certlfiCllle do~ not itmern:t. exrend or al~er the
<br />cO"o'tt"aJltllfforded by rl\@ polltitJ ~hawn btlow
<br />
<br />I
<br />I
<br />-J
<br />
<br />St. 99
<br />
<br />Din, ,83
<br />
<br />Compilnitll Providing CoveJ:agt::
<br />A Truck :r.I'I$ur/lncC! f'..xcl:1~-,,~
<br />
<br />..lln'u,,~
<br />
<br />
<br />I
<br />
<br />N.me
<br />"
<br />Addresi
<br />
<br />, OCCUPATIONAL SERVICES INC
<br />. 6~97 NANCY RIDGE DR #8
<br />, SAN DIEGO,C A 9212\
<br />
<br />t;:l1mlMlny
<br />1..1:1....
<br />Comp."" B Faf1Tlcn ImutOl.nce [Kchal"lRe
<br />lAl1l1 .
<br />Comp'ny C MId-Century 100unmr.~ Company
<br />""'"
<br />Com~ 0
<br />LtlltT
<br />
<br />Coiie-rages
<br />ThLJillo tt.rtlfy that rJ\e policies of 11lS\,lra.nCfo listad htlnwhlve Men iS5Ucd to lhe insured aimed lOOR for Inf' policy periOfllndiclited. NDtWithsu.ndlng
<br />any requirement, lerm llf condltiort or ony oontrlct or other docummt with respKt to wtlich this certifiatt may ~ is$ued or mil)' ~f1llin, the in$uranet
<br />i.tTorded by the I'Oliclr.s delulbe(l heretn Q subjtct to illl tt1e turns. cxtlusiom Irld clllld\tion$ or luth (Xlllcles. Ull'll~ mown may h,WC been re<lul;r.d by
<br />~~ r e1'~:r:-:;-;:;;.n:~ - Polloy Num""r - t~~ ~~;:,"ri ~~:? =i;'~d, I . -;:;;;~'mlt' _~
<br />
<br />II General li~bility General AgRrept! S
<br />I 'Producn-Cflmp/OPS
<br />Ccmml!!rci~l Gener,1 AllDI'lIlrIIte 1
<br />Ulbility 1IEl''"t>'"
<br />Personal &
<br />I "Occurrence Vl!:T'lIIOl1 Adverlisin" Injury
<br />C'm~rar.tual.lncldentll I!:arh OcCUrrtnce
<br />Only F~re Dlm~
<br />(Anyone "I')
<br />MldlalEJlpt'JlSe
<br />(AnY,onepeflon) ,
<br />Comb1ntd SlncJe
<br />Umit
<br />
<br />I
<br />I
<br />
<br />OWners & CO'l'I!rRr.ton Prot,
<br />
<br />Automobilf Liall'ilit~-
<br />Ail Owned Commrrtial
<br />Alltos
<br />X SthtdulcdAuto)
<br />""tired Auto,
<br />Ncn-Ownca Autos
<br />_~Il"Li'b'llty
<br />
<br />~.~.lIal"billty
<br />
<br />A ~workm' cnmpensatitlj:
<br />; A2010-21-50
<br />Employe~' liability
<br />- ,.,--_." ,.... -
<br />Dc~crlptiot\ of OpeTilliooslVehltles/Re$lr'"lctlonvSptdalttem:i:
<br />
<br />+---
<br />
<br />s 1,000,000
<br />
<br />A
<br />
<br />60262-83-62
<br />
<br />12/1112005
<br />
<br />1211112006
<br />
<br />Bodilyll1.iul'Y
<br />(PP.I' prnonl
<br />BodllylJ\i\lry
<br />(Pr.ratdd!ntl
<br />~ropt.rty Dilmagt'
<br />Cira~@Agsreglh:
<br />
<br />L1mlr
<br />
<br />1
<br />I
<br />
<br />~-~
<br />
<br />_.
<br />
<br />QSIO 1/2006
<br />
<br />OSI01l2007
<br />
<br />StaMory
<br />Each Acdthmt
<br />Disea~.ElcII'E",fllclylIe
<br />Dlse;l1e' Policy Limi~
<br />
<br />I 1,000,000
<br />1 1,000.000
<br />1..1,_000,000
<br />
<br />
<br />CITY OF SANA T ANA,IT'S OFF1CERS,AGENTS,EMPLOYEES,REPRESENTA TlVF-S,&VOLUNTEERS
<br />ARE NAMED ADDITIONAL INSUR,F.D PER COMPANY FORM
<br />RB:SANTAANA ZOO
<br />
<br />Cenificate Holder
<br />CITY OF SANTA ANA. PARx.np-CREA.1'!ON&
<br />COMMUNtTY SERVlCBS ACiBNCY
<br />
<br />Name
<br />"'
<br />Addfe~"
<br />
<br />PO BOX 1988.M.21
<br />SANTA ANA. CA 92702
<br />
<br />Canc~latiOl1
<br />Should 'fiY or the abo~ dtstribed pollcJt,~ be Clr\l::elted briOI"fl tne l!Hp1r.ttlon da.te
<br />tl'l,,",or. ~he tssuinG('"mpmy wi.ll cndelwor to milil30 days.WTithm notice to the
<br />cen:ltlcate holder n;mlld lei the left. bLlt rallure tu mail suc:n notice snillllmPOse~o
<br />6bltg 011 tlllbilityoflr\yk\nd the pilny.\tsagenbor~entatlves.
<br />
<br />Au rl d j.Y1l.\tt1btlve
<br />Copy Distribution: Service-Cent" Copy and Agent'1 Copy H."
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