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<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 '
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<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,
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<br /> G D G1- , PRESIDENT SECRETARY
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<br /> Santana California September 26 72
<br /> DATED AT __=__._ ON __._ _, 19
<br /> UND-618
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