|
9e:::AWAtic?Witer 4,1
<br /> NWAti
<br /> r r � s R'RA 3' - ,+Ta a t � z ifi 3 g i e � � �� " _ �.- �'ri
<br /> K
<br /> 64 a —rcav:xc. 3 1 . ° T'',taE : :" l a :.ga E,�u z. c I.1�&sol at k .. lJ Yv 4:-. A�
<br /> c'.4
<br /> NAME AND ADDRESS OF AGENCY
<br /> t�far
<br /> Emar Associates, Inc. COMPANIES AFFORDING COVERAGES
<br /> 141 So, Harrison St . COMPANY ,
<br />.'f.: : East Orange, N. J . 07018 LETTER ' tMission Insurance Co. - -t
<br /> - ,.<'4
<br /> A'. COMPANY �R '"42�'
<br /> LETTER �} a « "
<br />.--14 NAME AND ADDRESS OF INSURED �` gk,"
<br /> F x COMPANY e 44,,l
<br />'$)$$$ LETTER 4
<br /> ;s SCA Services, Inc. and
<br /> COMPANY
<br /> Great Western Reclamation Company LETTER
<br /> r- P. 0. Box 2337 — _._((�� COMPANYE
<br /> i.,;;;;
<br /> kEeee,, Santa Ana, California 9277 LETTER
<br /> This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. y' .;
<br /> JAI -- -- — -- Limits of Liability in Yh ®sands(OM) °'A
<br /> - COMPANY TYPE PE OF INSURANCE POLICY NUMBER POLICY EACH g:
<br /> LETTER EXPIRATION DATE AGGREGATE
<br /> OCCURRENCE A" al
<br />' GENERAL LIABILITY -- no N
<br /> BODILY INJURY $ $
<br /> El COMPREHENSIVE FORM
<br /> V
<br /> 111LOOR PROPERTY DAMAGE $ $ FI
<br /> ❑EXPSIONANDCOLLAPSE HAZARD '"
<br /> ❑ UNDERGROUND HAZARD
<br /> xi 1
<br /> `' 1
<br /> ❑ PROPUCTS/COMHLETED ;
<br /> OPERATIONS HAZARD BODILY INJURY AND 2;,
<br /> X�' ❑CONTRACTUAL INSURANCE PROPERTY DAMAGE $ $ +
<br /> ,
<br /> f g
<br /> ❑ BROAD FORM PROPERTY COMBINED
<br /> DAMAGE
<br />� ❑ INDEPENDENT CONTRACTORS _t - i
<br /> ❑ PERSONAL INJURY '-
<br /> PERSONAL INJURY $ pm
<br /> _-- �$
<br /> "= AUTOMOBILE LIABILITY BODILY INJURY $ r r '.„,,, ,'•
<br /> (EACH PERSON) , ,
<br /> 4 r ❑ COMPREHENSIVE FORM BODILY INJURY $ -3'T 14 s m,
<br /> ❑ OWNED (EACH ACCIDENT) t Y- s,� ), c.
<br /> -
<br /> ❑ HIRED PROPERTY DAMAGE $ 2ti� ^#{ {"f �
<br /> '. ❑ NON-OWNED BODILY INJURY AND $ )4 4� �;
<br /> S. PROPERTYDAMAGE -44*,�"
<br /> . COMBINED �'/ v74 ,yE:ate' ,_
<br /> c/d4 EXCESS LIABILITY
<br /> C o BODILY INJURY AND `St'
<br /> $''' A ® UMBRELLA FORM M838070 1/1/80 PROPERTY DAMAGE $ 1,000 $ 1,000 $k
<br /> .1. ❑ OTHERTHAN UMBRELLA ;.
<br /> FORM COMBINED
<br /> y41 WORKERS'COMPENSATION STATUTORY -)' &'Arca € .:-it
<br /> and K-�^„"p' - rv . fu�.re:. .-_ ,.P ff�r t .
<br /> EMPLOYERS'LIABILFrY . - ,m '�i,, $
<br /> -_ .� __._.�_ x„,yzfi.a-, R3;z$,.;J ,,, _ _ IEFCNALCIDENT) 47-
<br />„ozoi OTHER
<br /> itLy
<br /> VA
<br /> I '' s"SvavE. _-cn. T,"'„ 'l—,,_ __ / __ _-) $ .-.,?_ �.$,T .,r$.43 $/�.: .':`--• ', ' "_3.: .s ,.:?5...xu$ "1:
<br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES -
<br />`1E,A1 01
<br /> City officers, agents and employees are named as additional iiiN
<br /> Nil
<br /> I Cancellatlori Should any of the above desc ibed policies be cancelled before the expiration date thereof, the issuing cor -- ,
<br />€ '', pany wills mail 40 days written notice to the below named certificate holder Krormo4tt
<br /> eu,aa- k }DbethiRWAMC/W0614 IAVu44 •Tm• 4e4$'4.5 , ..4..3 R PU 440€I 1.4.1.0" . �r�
<br /> Sa ..' — -------- -- "• - SED CER FTCATE" 4
<br /> ; NAME AND ADDRESS OF CERTIFICATE HOLDER:
<br /> w� t DATE I ' ED J• uary I / 1979
<br />/ City of Santa Ana, City Attorney's Office J
<br /> IPA 26 Civic Center Plaza /F / % `'
<br /> ITN Santa Ana, California 92701 �L , t2°,�--t'"7( '
<br /> .' AU'HORIZED REPRESENTATIVE
<br /> 44 Att: James L. Conkey v
<br /> a ACORD 25 (Cd 77 77)
<br /> tt:
<br /> ;,,T.mi 5, *. - : p ,,,� 'yi.' ' 9 itN 6,P Ira qmx 4 1> ,s�e rj- Arm e' GA; ,R ,° .tia ;l
<br /> x . . ? ,.... -1. _... , .. a, -...,,, ...-I s 1.,'a.._,..-�___.a:'t t„ .,3n ' 1 .," ,r .-.,.,a .$
<br />
|