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Commercial Certificate of Insurance FARM E R S <br />.Agency . KIRK MILLER INSURANCE AOENCY <br />Name . 6048 CORNERSTONE CT W #El Issue Date (MM/DD/YY) 04/29±10 <br />& , SAN DIEGO, CA 92121 l <br />Address This certificate is Issued as a matter of infornpHon only and confers no rights <br /> upon the certificate holder. This certificate does not amend, extend or alter the <br />St. 99 Dist. 36 Agent 72 coverage afforded by the policies shown below. <br /> Companies Providing Coverage: <br />Insured Company A Truck Insurance B.echange <br />. CAPE EXPRESS teurr <br />Name . Dba: George Caban & AncaCaban company B Farmers Insurance Exchange <br />& • 1000 E. SANTA ANA BLVD. Company C Mid-Century Insurance Company <br />Address • SANTA ANA, CA 92701 teuer <br />D <br /> Company <br />Letter _ _ <br />Coverages <br />This is to certify that the policies of insurance listed below have been Issued to the insured named above for the policy period Indicated, Notwithstanding <br />any requirement, term or condition of any contract or other document with inspect to which this certificate may be issued or may pertain, the Insurance <br />afforded by the policies described herein Is subject to all t he terns, excluslons and conditions of such policies. Limits shown may have been reduced by <br />paid claims. _ <br />Co. <br />Ur. <br />Type of Insurance <br />Policy Number Policy Effective <br />Date (mh4iDnmi Policy Expiration <br />Date (MMMI)IM <br />Policy Limits <br /> General Aggregate t <br />0 <br />B General tlability 604734217 04/29110 04129/11 <br />Products-Cnmp/OPS ' 4,0 <br />0,000 <br /> X Commercial General <br />Agegate <br />$2,000,000 <br /> Liability Personal & <br /> X - Occurrence Version Advertising Injury $ 2,000,000 <br /> Contractual - incidental Each Occurrence S 21000,000 <br /> Only Fire Damage <br /> (Any one Orel $250,000 <br /> Owners & Contractors Prot. Medical Expense <br /> (Any one pason) I S 5,000 <br /> Automobile Liability APPROV ,LD AS '1:10 FORM Combined 314e <br /> <br />All Owned Commercial <br />Autos <br /> <br />-- <br /> <br />Q <br />` <br />-t ..: <.? <br /> <br />' • <br />? <br />Limit <br />Bodily 41n ury <br />P S <br /> Scheduled Autos -_ -_ _ --- 1,2t _ 4, <br />I i ltltt _ ...._._ <br />y ( <br />er per <br /> Hired Autos <br />Non•OwnedAutos <br />Assist <br />' nt. City Attor <br />ney Bodily I ury <br />(Perabc ot, $ <br /> Garage Liability j Property Damage S <br /> Garage Aggregate g <br /> Umbrella liability Limit <br />-- <br /> Workers' Compensation Statutory t <br />Each Accident $ <br /> and Disease . Each Emproyft $ <br /> Employers' Liability Disease - Policy Limit g <br />Description of OperatlonsNehieles/Restrietions/Special Items: <br />PERSONAL PROPER'L'Y COVERAGE $100,000 <br />Certificate Holder Cancellation <br />CITY OF SANTA ANA Should any of the above described polities be cancelled before the expiration date <br />Name ATTN: CAROLYN FULLERTON thereof. the issuing company will. endeavor to mail 30 days written notice to the <br />& 1000 E. SANTA ANA BLVD. certificate holder named to the left, but failure to mail such notice shall Impose no <br />Address SANTA ANA, CA 92701 obligation or liability of any kind upon the company. Its agents or representatim <br /> KIRK MILLER <br /> Authorized Representative <br />66-2492 +-94 copy Vistributton: Service center l;opy ana Agenrs t;opy „w.