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'• CERTIFICATE `= <br /> OF INSURANCE �'' _ <br /> LIBERTY _� <br /> MUTUAL ` <br /> This is TO Certify that IIMIL1Y MVIVM IMfUNAN F(aMP NYSLI81N11 MUTUAL IMF IX5VPAN(COMPANY•soulON <br /> SCA Services, Inc. <br /> Great-'Western Reclamation Name and <br /> 1800 South Grand Avenue 4i1E address of <br /> Santa Ana, California Insured. <br /> • <br /> J <br /> • <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 /> EXPIRATION - - -- - - - - ------ -- <br /> TYPE OF POLICY DATE POLICY NUMBER LIMITS OF LIABILITY <br /> • <br /> COVERAGE FORLIMIT OF LIABI LITYCOV. B <br /> • <br /> LAW OF FOLLAFOWINGDED STATE(S).UNDERW.C. <br /> WORKERS' <br /> COMPENSATION WC1-612-004135-016 <br /> 1/1/79 WC2-612-004135-046 California $100,000 <br /> IPNOIC AYE L IMI(FOE EACH STATE) <br /> ®coMPFoaMNsrvE BODILY INJURY PROPERTY DAMAGE <br /> ELSCHEDULE FORM EACH EACH <br /> $ OCCURRENCE $ OCCURRENCE <br /> Q ® PRODUCTS COM. <br /> PIECED OPERATIONS $ AGGREGATE $ <br /> ¢ L ❑ AGGREGATE <br /> Z ND�PENDENTcoN. <br /> ¢ 1/1/79 LG1-612-004135-026 $500,000 Single Limit <br /> O L ❑ TORS PRofECTIVE O (Bodily Injury & Property Damage Combined) <br /> alLIA <br /> I:I CONT <br /> BILRACTITYUAL <br /> r ®OWNED <br /> O m O N OWNED $ 500,000 EACH PERSON Single Limit <br /> et a ® 1/1/79 AEI-612-004135-036 Bodily Injury & Property Damage <br /> ® HIRED $ Combined EACH ACCIDENT g EACH ACCIDENT <br /> _ OR OCCURRENCE $ OR OCCURRENCE <br /> et <br /> W <br /> m <br /> f- <br /> O • <br /> LOCATION(S) OF OPERATIONS 8 JOB # (If Applicable) <br /> DESCRIPTION OF OPERATIONS. <br /> ADDITIONAL INSURED: City of Santa Ana <br /> G .,/,3D/// <br /> Id AC <br /> NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF <br /> • <br /> DAYS IS ENTERED BELOW). BEFORE THE STATED EXPIRATION DATE THE COMPANY '''' CERTIFICATE <br /> WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES <br /> PRIOR TO DAYS AFTER NOTICE OF SUCH CANCELLATION OR REDUCTION HAS BEEN <br /> MAILED TO: <br /> F City of Santa Ana 1 <br /> 20 Civic Center Plaza <br /> Santa Ana, California 92701 (x. Ll�i • L l Q[nil <br /> Attn: James Conhey AUTHORIZED REP SENTATIVE <br /> December 7, 1977 Boston, Massachusetts <br /> L J 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 FIRE INSURANCE <br /> COMPANY as respects such insurance as Is afforded by That Company, <br /> BS 234A R7 <br />