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• <br /> "REVISED CERTIFICATE" r <br /> CERTIFICATE <br /> OF INSURANCE LIBERTYts, ='I <br /> MUTUAL - ATtp <br /> This Is to Certify that LIBERTY MUTUAL INSURANCE COMPANY•LIBERTY MUTUAL FIRE INSURANCE COMPANY•ROSTON <br /> SCA SERVICES INC, and 1 Name and <br /> Great Western Reclamation Co flpany address of <br /> P. O. Box 2337 Insured. <br /> Santa Ana, California 92707 J <br /> is. at the date of this certificate. insured by the Company for the types of insurance and in accordance with the limits of liability. <br /> exclusions, conditions, and other terms of the policies hereinafter described. This certificate of insurance neither affirmatively or neg- <br /> atively amends, extends or alters the coverage afforded by the policies listed below. <br /> TYPE OF POLICY EXPIRATION DATE POLICY NUMBER LIMITS OF LIABILITY <br /> COVERAGE AFFORDED UNDER W C. LAW OF LIMIT OF LIABILITY COT,' B <br /> FOLLOWING STATES (Indicate Limit for erica state? <br /> WORKERS' 1-1-80 W02=612-004135-049 * CALIFORNIA * $500,000 <br /> COMPENSATION 1-1 -80 **'WC1-612-004135-01 9 ** MA,SSACH'iJSETTS arta $100,000 <br /> 1-1-80 so-*W02-612-001+135-069 3t;f ALL OTHER STATES <br /> MARITIME COVERAGE FOLLOWING STATES LIN.D OF LIABILITY MARITIME COsEEADEI <br /> BODILY INJURY PROPERTY DAMAGE <br /> Rl COMPREHENSIVE _� <br /> LYJ FORM •.ee. ♦�,� '.. <br /> ❑SCHEDULE FORM $ ? " $ c ime'.. ! <br /> J PRODUCTS COM- <br /> IQ HI PLETED OPERATIONS •$ TS&RiBE 1S7C $ � Tgtl <br /> r:eL ❑ <br /> w _ 1-1-80 LG1-612-004135-029 3.1. & P,D. COPT3INE)7 5T.J,GLE LIMIT <br /> wm <br /> Q INDEPENDENT CON- <br /> CD -1 ❑ TTORST PPRO I ERNEAr. <br /> $500,000 I <br /> I <br /> CONTRACTUAL <br /> LJ LI <br /> Iti ®OWNED -- ---- EACH PERSON <br /> n 1-1=30 AF1-612 004135-039 $ <br /> '— NON•OWNtD p EACH ACCIDENT FACE ACCIDENT <br /> D Q Q 1-1-30 .AMI-61 2-0041 3 5-`059 $ .— OR OCCURRENCE R OR OCCURRENCE <br /> ® HIRED $ 5� �� EACH ACCIDENT-SINGLE LIMIT.BT AND P.D_COMEWEDI <br /> -cc I <br /> in <br /> r <br /> I LOCATION(S` OF OPERATIONS a JOB # (If Applicable) DESCRIPTION OF OPERATIONS. . 1 <br /> City officers, agents and employees are named as additional insureds. <br /> NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF "wised Certificate" <br /> DAYS IS ENTERED BELOW). BEFORE THE STATED EXPIRATION DATE THE COMPANY <br /> WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES <br /> PRIOR TO 30 _DAYS AFTER NOTICE OF SUCH CANCELLATION OR REDUCTION HAS BEEN <br /> MAILED TO: r <br /> \ --,—;-- <br /> .„),;„---.—.D : <br /> . <br /> City of Santa Ana, City Attorney's Tide r_ <br /> 26 Civic Center Plaza AUTHORIZED REPRE'��TATIVE <br /> Santa Ana, California 92701 Jan,. 17, 1979 Boston' Massachusetts <br /> L Att: James L. Conkey DATED OFFICE <br /> This certificate is executed by LIBERTY MUTUAL INSURANCE COMPANY as respects such Insurance as Is afforded by That Company,It Is executed by LIBERTY MUTUAL EIRE INSURANCE <br /> COMPANY as respects such Insurance as is afforded by That Company. B5 234A RA <br />