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sun rwa <br />CERTIFICATE OF INSURANCE <br />InsntpKr <br />SUM .I_ , RANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE <br />CAMbE? OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID 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 />a..... ,...,.,.,...,...? :.. fY..V.e 6,? +i,n fnllnwinn IUflmarl If1C11PP(i ac Si1AWn t]EI01Ar <br />IIcto W7ri1 wd 111 -- - - .w..v.... .., ..?....-.. -- -- ---- '"_' <br />NAMED INSURED: COAST SURVEYING, INC. <br /> <br />ADDRESS OF NAMED INSURED: 15031 PARKWAY LOOP, SUITE B, TUSTIN, CA 92780 <br />POLICY NUMBER 059 5449-D19-75B C90 5581-F10-75G <br />EFFECTIVE DATE <br />OF POLICY 08/15/08-02/15/09 08/15/08-02/15/09 <br /> 1999 DODGE 1989 JEEP <br />DESCRIPTION OF DURANGO CHEROKEE <br />VEHICLE (including VIN) 1B4HR28Z8XF605847 1J4FJ78L1KL595564 <br />LIABILITY COVERAGE ® YES ? NO ® YES ? NO ? YES ? NO ? YES ? NO <br />LIMITS OF LIABILITY <br />a. Bodily inory <br />Each Person 1,000,000 1,000,000 <br /> <br />Each Accident 1,000,000 1,000,000 <br />b. Property Damage J1, <br /> <br />E <br />`?'? <br />CK <br />Dey <br />Each Accident 1,000,000 1,000,000 . r <br />c. Bodily Injury & S?Stan{ <br />Property Damage <br />Single Limit <br />Each Accident <br />PHYSICAL DAMAGE <br />® YES ? NO <br />® YES <br />? NO <br />? YES <br />? NO <br />? YES <br />? NO <br />COVERAGES <br />a. Comprehensive $ 1000 Deducible $ 1000 Deductible $ Deducfibie $ Deductible <br /> ® YES ? NO ® YES ? NO ? YES ? NO ? YES ? NO <br />b. Collision $ 1000 Deductible $ 1000 Deductible $ Deductible $ Deductible <br />EMPLOYERS NON-OWNED <br />® YES ? NO <br />® YES <br />? NO <br />? YES <br />? NO <br />? YES <br />? NO <br />COVERAGE <br />HIRED CAR LIABILITY <br />YES [I NO <br />® YES <br />? NO <br />El YES <br />? NO <br />[I YES <br />? NO <br />COVERAGE <br />FLEET - COVERAGE FOR <br />E <br />? YES ® NO <br />El YES <br />® NO <br />[I YES <br />[I NO <br />? YES <br />[I NO <br />MOTOR VEHICLES <br />MOTOR <br />/ AGENT 8126 07/16/08 <br />Title <br />Name and Add of Ceditate Holder 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 STMT WASH TOBOVWERSOX,Apnt <br />ANA, ITS OFFICERS, EMPLOYEES, AGENTS License ill'M135. <br />VOLUNTEERS AND REPRESENTATIVES ARE ADDITIONAL NO Pic Coast H"., S• 204 <br />INSURED AS RESPECTS TO GENERAL LIABILITY AS tasuaASac Dana Polnt, CA OM9 <br />REQUIRED BY WRITTEN CONTRACT COVERAGE AFFORDED So:(90)eel-= <br />THE ADDITIONAL INSURED IS PRIMARY & NON- Fax(90)661-4119 <br />CONTRIBUTORY.WAIVER OF SUBROGATION INCLUDED IN <br />WORK COMP