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<br />CERTIFICATE OF LIABILITY INSURANCE DATE jKlumomy)
<br />0412412017
<br />THISCERTIFICATE IS ISSUED A I
<br />*RT S A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />ERT�F'ICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: 11 the ce M-cato holder is an ADDITIONAL INSURED, the Policy(ies) must have ADDITIONAL INSURED provisions or be endorsed,
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an ondorsentaft A Statement oil
<br />this Certificate does - ------- 5 --ht$ 10 the certificate holder In lieu of such endorsement(s),
<br />PRODUCE:Z THIS
<br />CONTACT
<br />REPRESENTATIVE
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<br />IMPORTANT:
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<br />TEC BOWERSOX, AGENT949-661 3100 �Ax -rJ49 6&1
<br />34085 PACIFIC CCAST H%W, #204 .......
<br />DANA POINT, CA 92629
<br />INSURER A: Slata Farm Mutual Automobile Insurance Compary 251 -7-6-'
<br />INSURED —
<br />COAS- . SURVEYING, INC. ------ - - ---- . .... ..
<br />15031 PARKWAY LOOP, S7E- -3
<br />TUSTIN CA 92760 JNSURER D: -- ----- —
<br />INSURER —P
<br />COVFRATZ.P�,
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE HAVE BEEN ISSUED
<br />INDICATED NOT',MTHS7AN DING ANY REQJIREMENT,
<br />-CW TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />TERM OR CCNDITICN OF ANY
<br />CERT :KATE IVA' BE ISSUED OR MAY
<br />EXCLUSIONS
<br />CONTRACT OR OTHER DOCUMENT 01ITH RESPECT TO WHICH THIS
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCR13ED HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />AND CONDITIONS OF SUCH PO (CIES LIMITS SHOVA MAY HAVE BEEN REDUCED BY PAID C
<br />P -O, BOX 1988 M-35
<br />-AIMS,
<br />-POLICY
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<br />7RTYPE OPINSURA4CE
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<br />POLICY NUMBER LIMIT'.%
<br />COMMERCIAL GENERAL LIABILITY
<br />_JjMMJDI)ryyyy
<br />II I.LAC.,I- a xJRRENCE
<br />ACORD 2512016/03)
<br />The ACORD name and logo are registered marks of AGORi)
<br />10')1145 132VA�'.12
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<br />-FN'I.AGREGAr-= LMT APPLIES PER
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<br />GENERA.AqC S
<br />POLIC( J-cCT LCC
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<br />C0111`101 AGO S
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<br />AUTOMOBILE LIABILITY
<br />290-30413-1315-75
<br />f�.;5 ONLY AJTCS
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<br />059-5449-815-75 �021'512015'G8i1512,CI8 3001 LY 1'4� URY :Per persar) S 1,OCIO,OOC
<br />800ILY 14LUAY!Peracc aei!) S 1,000.C,00
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<br />AUTOS ONLY Au -CS C -4L-
<br />066-7143-1315-75 02/'5/2017 0211512018 !--- -- - --------
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<br />UMBRELLA UAB(CUR
<br />EXCESS UAS CLAMIS-VADE
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<br />'AND EJV1PLOYCRS'LIABILrrY YIN
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<br />(Mandatory lo NH) —1
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<br />CISEASE - EA EWR-OYE�� 5
<br />------------------------------------------------ E.- C! EA SE - POLICY uM r 1 s
<br />OF 5CRIPTION OF OPERATIONS (LOCATIONS TIONS I VEHICLES IACORO 741, Additional R,ki Schedule, may IrMOM SPAMISMC;uIred)
<br />ADCITICNAL INSURED: THE CITY OFSANTA AN-\, ITS OFFICERS, EMPLOYEES AND REPPESENTATIVES
<br />REF: AL.- OPERATIONS REF: A -2D14-101
<br />THIS INSLI.RANCE IS PRIMARY A�JD NON-CONTRIBUTORYWITH
<br />V�"HICLFS. CAN CIFILATION 30DAV110
<br />RESPECT TO CLAIPAS ARISING CUT OF -I-E OPERATION C- THE DESCROED
<br />FOR NC3NPAYMENT
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<br />rREVU��F D Y EUNiCE HEREDIA (PG
<br />r*PQTIC1e'A'rC Uni
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />=
<br />"Ir EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
<br />CITY OF SAN7A ANA
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P -O, BOX 1988 M-35
<br />SANTAANA, CA 92702
<br />AUTHORVED REPRESENTr,-7""^.
<br />, C . ..... .... . .
<br />(D ISM2015 ACORD CORPORATION, All rights reserved.
<br />ACORD 2512016/03)
<br />The ACORD name and logo are registered marks of AGORi)
<br />10')1145 132VA�'.12
<br />
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