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COAST SURVEYING, INC. 1-2008
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COAST SURVEYING, INC. 1-2008
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Last modified
10/21/2013 11:35:42 AM
Creation date
5/8/2008 4:22:17 PM
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Contracts
Company Name
COAST SURVEYING, INC.
Contract #
A-2008-096
Agency
Public Works
Council Approval Date
4/7/2008
Expiration Date
4/1/2010
Insurance Exp Date
9/18/2011
Destruction Year
2014
Notes
Prof Liab exp 9/18/11 / W/C exp 9/18/11
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fTAT. FARM <br />y M CERTIFICATE OF INSURANCE <br />CHMS RANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE <br />OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR ' WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VAUD MORE THAN 30 DAYS FROM <br />THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY <br />ANY POLICY DESCRIBED BELOW. <br />This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois <br />? STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois <br />? STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas <br />? STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or <br />? STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois <br />has coverage in force for the followinq Named Insured as shown below: <br />NAMED INSURED: COAST SURVEYING, INC. <br />ADDRESS OF NAMED INSURED: 15031 PARKWAY LOOP, SUITE B, TUSTIN, CA 92780 <br />POLICY NUMBER 130 9131-E25-75B 288 1781-A16-75 066 7143-B20-75B 290 3043-B15-75 <br />EFFECTIVE DATE <br />OF POLICY 08/15/08-02/15/09 08/15/08-02/15/09 08/15/08- 02/15/09 08/15/08-02/15/09 <br />DESCRIPTION OF 2008 GMC SAVANA 2008 GMC SAVANA 2002 DODGE B2500 2000 DODGE DAKOTA <br /> <br />VEHICLE (inducting VIN) VAN <br /> <br />1GTGG25K681165430 VAN <br /> <br />1GTGG25K881167132 <br />VAN <br />2B7JB21Y92K140676 <br />TRUCK <br />1B7GG22N4YS639142 <br />LIABILITY COVERAGE ® YES ? NO ® YES ? NO ® YES ? NO ® YES ? NO <br />LIMITS OF LIABILITY <br />a_ Bodily Injury <br />Each Person 1,000,000 1,000,000 1,000,000 1,000,000 <br />Each Accident 1,000,000 1,000,000 1,0 1,000,000 <br />b. Property Damage //••\\ <br />??O <br />Each Accident 1,000,000 1,000,000 5 <br />11 i <br />1, 11000,000 <br />c. Bodily Injury & <br />Property Damage <br />,?pQg? <br />rel <br />Single Limit <br />P ? <br />?y P <br />. <br />Each Accident ?5 ? <br />PHYSICAL DAMAGE g'? <br />COVERAGES ® YES ? NO ®Y [J ® YES ? NO ® YES ? NO <br />a. Comprehensive $ 1000 Deductible $ 1000 Deductible $ 1000 Deductible $ 1000 Deductible <br /> ® YES ? NO ® YES ? NO ® YES ? NO ® YES ? NO <br />b. Collision $ 1000 Deductible $ 1000 Deductible $ 1000 Deductible $ 1000 Deductible <br />EMPLOYERS LIABILITY O-OWNGE ® YES ? NO ® YES ? NO ® YES ? NO ® YES ? NO <br />HIRED CAR LIABILITY <br />COVERAGE <br />® YES <br />? NO <br />® YES ? NO <br />® YES <br />? NO <br />® YES <br />? NO <br />FLEET - COVERAGE FOR <br />ALL OWNED AND LICENSED <br />MOTOR <br />? YES <br />® NO <br />? YES ® NO <br />? YES <br />® NO <br />? YES <br />® NO <br />AGENT <br />8126 <br />07/17/08 <br />JRJIIalule VI ^YPIL M-eu rcepresernauve ride Agent's Code Number Date <br />Name and Address of Certificate older Name and Address of Agent <br />ADDITIONAL INSURED: CITY OF SANTA ANA <br />ATTN:DAVID IP P.O.BOX 1988,SANTA ANA, CA 92702 <br />DESCRIPTION OF OPERATIONS:RE:ALL OPERATIONS AS <br />PERTAINS TO NAMED INSURED. THE CITY OF SANTA srx:? s: aw TED BO11*RSOX, Agent <br />ANA, ITS OFFICERS, EMPLOYEES, AGENTS LI0eM>91M135. <br />VOLUNTEERS AND REPRESENTATIVES ARE ADDITIONAL 34M Patty Coast ?,,? <br />INSURED AS RESPECTS TO GENERAL LIABILITY AS croso pcR Dana PO nt cA 9=9?5 204 <br />REQUIRED BY WRITTEN CONTRACT COVERAGE AFFORDED" Bits: (° 661-3200 <br />THE ADDITIONAL INSURED IS PRIMARY & NON- Fax* (949) 661-4119 <br />CONTRIBUTORY.WAIVER OF SUBROGATION INCLUDED IN <br />WORK
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