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COAST COMPOSITES, INC. 1 -2012
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COAST COMPOSITES, INC. 1 -2012
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Last modified
10/21/2013 11:35:39 AM
Creation date
7/16/2012 2:58:16 PM
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Contracts
Company Name
COAST COMPOSITES, INC.
Contract #
N-2012-082
Agency
COMMUNITY DEVELOPMENT
Expiration Date
11/2/2012
Insurance Exp Date
3/31/2013
Destruction Year
2017
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Jam{?ice>?_ s?-Z _,?-?. <br />Cllont#: 2b392 <br />HAMPIND <br />DATE (l.IhV DOJYYYY) <br />sACOR®r., CERTIFICATE ®? LIABILITY INSURANCE <br />0 5/3 012 0 1 2 <br />7HlS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOE R. THIS <br />CERTI FfCATE bOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLSCIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 1SSUINO INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PROPVCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: I( 11\a cerNlloale holder Is an ADDITIONAL INSURED, the policy(les) must bo endorsed. It SUBROGATION IS WAIV Eb, SLIbJecl to <br />the term3 end con dltlons of the polloy, certain policies may require an endorsement. A statement on Ihls cerlillcate does not confor rlph(s to the <br />certiticele holder In lieu of such ondorsomenl(s). <br />PRODUCER CT <br />€ <br /> <br />Wlllls of Now Jers ay, Ino, ? <br />? <br />o <br /> , . <br />ac No, <br />> )`- <br />360 Mt. Kemble Avenue E-hl u. <br /> O° <br />P.O.Box 7989 -?- <br /> IN9URER 9 AFFORDING COVERAGE NAIC tl <br />Morristown, NJ 07882 INSVAERAr TwIrT Clty Flre Ins. Co. 29459 <br />INSUAe° iNSVAER arAm071Can Zurich hTSUrance Co. d0i 42 <br />Coast Composites Inc, INSDAERC: Zurich Arnerican Ins Co 70535 <br />5/7 Burrough <br />- <br /> n+sunEROJ <br />Irvine, CA 92018 <br /> INSURER E <br /> INSURER F ! <br />COVERAO ES CERTIFICATE NUfABER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO\Y HAVE BEEN ISSUED TO THE INSURED NA/.SED ABOVE FOR THE' POLICY PERIOD <br />INDICATED. NOTWI7HSTANOIHO ANY REOUIREA{ENT. TERA1 Oft CONDITION OF ANY CONTRAOT OR OTHER DOCUh1ENT VJITH RESPECT TO WHICH THIS <br />CERTIFICATE AfAY BE ISSVED OR I.(AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN !S SUBJECT TO ALL THE TERhI S, <br />E <br />XCLUSIONS AND CONDITIONS OP SUCH POLICIES. LIA{ITS SI(OWN h1AY HAVE BEEN RED VCED BY PAID CLAIhSS. <br />?J? <br />g <br />LTR TYPE OF O+$URAHCE O L BR pOLICY NU M.BER lAMIDD E MA fOD E P LIMITS <br />A eEN ERA! LIA91LITY i3CESOA902i 3l3i/2072 03/3il2013 E <br />A <br />C <br />1 <br />10 <br />00 <br />UR <br />RENCE $i 000 000 <br /> <br />X <br />C0/.1111ERCIAL GENERAL L,A9ILITY E <br />A,L <br />11 <br />AA <br />UU <br />TT <br />R <br />Pli?l./ ES EaE arEirence _ <br />5300 OUD <br /> CLAN.13•LrAOE OX OCCUR LrED exP?Any orle person) $i 0 000 <br /> X B)/PD Doll: 5,000 PERSONALBADYINJUAY $1 OOO OOO <br /> _ GENERALAGOREOATE $2 OOO OOO <br /> GEN'L AGGREGATE LII.IR APPLIES PER: PROD VCTS-C0/.1PlOA AGO $2 OOO OOO <br /> POLICY FE00 LOC $ <br />C AUT OMOaILEL1Aa1LITY BAP509588200 3/31/2012 03/31!201 _c hIBINEpe1N LELIV 1 000000 <br /> X ANY AUTO 90DILV INIUAY (Per persai) $ <br /> ALL OYlNEO <br />AU70S SCIfEOULEO <br />AVTOS BODILY INJURY (Pef accident) $ <br /> X HIRED AUTOS X NON-O\VNEO <br />AUTOS PROPERTY Ar,rAGE <br />Per ac Ida 1 $ <br /> $ <br /> <br />VAIBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />- <br />_ ___ <br />5 _ <br /> EXCESS LlAa CLAILI S-l.rADE ? - _ <br />AGGREGATE <br />^ S <br /> <br />OEO RETENTIO:J __ <br />$ <br />B \VORKE RS COMPENSATION <br />ANO EMPLOYERS`LIA91L1TY WC609688i OO 3/3112012 03137!2013 X WC 9TATU- OTK• <br /> Y/r! <br />ANy Pff??OppgqlEErrooRPARTNEILEXECVT/VE <br />? <br /> <br />N! <br />EL EACH ACCIDENT <br />$1 OOO OOO <br /> OFFICERR.IEI.IBERE ED <br />(eA <br />andalory In NK) A <br />E.L. Df$EASE-EA El.IPLOVEE <br />1 009009 <br /> )) <br />?ESCR<PTION OF OPERATIONS bN.ow E.L. DISEASE-POLICY LILIIT $1 ?D9 <br />Q <br />9 <br /> yy <br />?'??, <br />qq <br />Y!t?=`1`J J. <br />DESCnIPT10fl OF OPERATIONS/LOCATlON9lVEIIICCE9(Atlech ACORD 101, Adtlilional Remarks 9chedula, ll more space is requhed) ? ? _ i? <br />EVIDENCE OF COVERAGE, ?j'??L? <br />g-CpRCK J! <br />?1SA ?• ,ty pitorneY <br />Assistant. C <br />CERTIFICATE HOLDER CANCELLATION <br /> <br />city of Santa Aria THE V EXPIRATIONH DATE V TH EREO(BE NOOf CIEI WIBLL aBE CDEL VE REDO R; <br />Flnanoe & Mgmt Serviaea Agency ACC ORDAr(CE WITH THE POLICY PROVISIONS. <br />Purchaefng DWlsfon <br />20 ClYlc Cantor Plaza M-16 AVYHORIZED REPRE$eHTATIVE <br />P.O. Box 1988 r <br />, <br /> n 19RR.?M R ?Cr]R <br />QORPOR ATION. All rlnhls reserved- <br />ACORb 25 2010!06 7 of 1 TIIO ACORO Hama and logo aro registered marks of ACORD <br />#521 717/M 11386 H2:6 <br />Exhibit C
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