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it--'a Rrrrs..f a p' Jr-tgt�.. . <br /> fi F c Zl! �u +gat': )� <br /> r c+ taw ;11:1 <br /> 7( ARGONAUT INSURANCE CC ANY, i rV SEP $ ; I, 1 <br /> r, O Nq HOME OFrICE: MENLO PARK, CALIFORNIA [I sI1tR I I! j <br /> / ❑ ARGONAUT'-MIDWEST INSURANCE COMPANY <br /> P/ �-� CERTIFICATE HOME OFFICE: CHICAGO, ILLINOIS <br /> •n OF 0 <br /> HOME ARGONAUT—NORTHWESTDC C-: BOISE, DAHO INSURANCE COMPANY <br /> A1/4;:4-,_4,-74'r �� INSURANCE • <br /> ❑ ARGONAUT—SOUWIVVEST INSURANCE COMPANY <br /> Q R P.� HOME OFFICE: METAIRIE, LOUISIANA <br /> This is to certify that the COMPANY designated above has issued to the named Insured the policy(s) enumerated below, subject to all the terms of such policy(s). <br /> This Certificate of Insurance neither affirmatively or negatively amends, extends or alters the coverage afforded by such policy(s). In the event of any material <br /> change in or cancellation of the policy(s),the COMPANY will make every effort to notify the certificate holder, but undertakes no responsibility of failure to do so. <br /> CERTIFICATE HOLDER AND ADDRESS NAMED INSURED AND ADDRESS <br /> • CITY OE SANTA ANA • GREAT WESTERN RECLAMATION, INC. <br /> City Hall .'' '' Post Office Box 2337 <br /> Santa Ana, California Santa Ana, California 92707 <br /> Attn: Mrs. West ' <br /> fyr <br /> If certificate holder is a loss payee with respect to the described auto,check here CI <br /> III POLICY NUMBER KIND OF INSURANCE AND COVERAGES LIMITS EXPIRATION <br /> CC20 291 084 101WORKMEN'S COMPENSATION Statutory <br /> 10/1/72 <br /> EMPLOYER'S LIABILITY $ 2,000,000 ,000 each accident 10/1/73 <br /> BODILY INJURY LIABILITY $ ,000 each person <br /> — EXCEPT AUTOMOBILE * $ ,000 each accident <br /> $ ,000 each occurrence <br /> $ ,000 aggregate products <br /> PROPERTY DAMAGE LIABILITY $ ,000 each accident <br /> — EXCEPT AUTOMOBILE * $ ,000 each occurrence <br /> $ ,000 aggregate operations <br /> $ ,000 aggregate protective <br /> $ ,000 aggregate products <br /> $ - ,000 aggregate contractual <br /> BODILY INJURY LIABILITY $ ,000 each person <br /> -- AUTOMOBILE 0, $ ,000 each accident <br /> — $ ,000 each occurrence <br /> j PROPERTY DAMAGE LIABILITY <br /> $ ,000 each accident <br /> — AUTOMOBILE ** $ ,000 each occurrence <br /> MEDICAL PAYMENTS — AUTOMOBILE $ each person <br /> PHYSICAL DAMAGE—AUTOMOBILE—ACTUAL CASH.VALUE UNLESS OTHERWISE STATED <br /> COMPREHENSIVE <br /> l <br /> COLLISION OR UPSET LESS $ deductible <br /> FIRE AND THEFT $ <br /> * IF COMPREHENSIVE LIABILITY, CHECK HERE <br /> Description of Operations, Locations, or Automobiles Covered; or Additional Coverages;or Special Condition. <br /> Rubbish hauling <br /> I � <br /> PRODUCER AND ADDRESS ARGONAUT INSURANCE COMPANY IAF <br /> _ ARGONAUT—MIDWEST INSURANCE COMPANY <br /> • Lee Smith and Company, Ing.- ARGONAUT—NORTHWEST INSURANCE COMPANY <br /> Post Office Box 504 ARGONAUT—SOUTHWEST INSURANCE COMPANY <br /> Santa Ana, California 92702 15 <br /> /j 72.074_,A, <br /> /I/� '' ,/, <br /> t, Ai c112 <br /> G D G1- , PRESIDENT SECRETARY <br /> ill 3' I I1-.' V ' <br /> Santana California September 26 72 <br /> DATED AT __=__._ ON __._ _, 19 <br /> UND-618 <br />