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Insurance - Costa Mesa Disposal - 1998-10-01
.'e-r - -- -4.}. :.- 4-ymt,2:-----..rit..tv.1---- tcr'''''''' 11 .r1 cc.-..;-,,- .1.-* '' -'-''?! - --ire:".„7"?.- -'' ' --.'-r.rew''--.4.-.:•-4:---`'S----- Tv- i...... ,s ._,.,7 t.,. ....r. ...,...t Yrtf.,-.1!". A 4 , 5":.1' 4 :-. 4-'% 744 ."14" "' 1^.' .4s.'' ;el":rt.„... 0 44 .r.14. g-SG` ,, a".1.- - .1%-44 4 -,,," te•-.4„ % .r: -4`7. ,: -,..tn--•"--• ',,.:.*-,* -..t. s . ( .../, - eS. see' eat.' ' '''' '4.• " 4 '. 4: • %$,!...51.--!%.- •.- ' ""'s - ';- (j.„,,,:...A•fr.-fitt ,l• .'t c-.:et. '1-,..;e3:' '- i C: - ...m"'-...Th ' - • ' 4-11 .0. v.41....,... „I 0` 44 4 s, ,,. i" .4 44. r ' ""P , `,4'.' • „- mmm ,...... „.- II ft.4:::-.4 ge.., .. .)I- ."4,4 s . ....44%. .;.4,1 ,. „.. . . . ...4 . ..• . .t...4."..a4.4 . .4 "44-:"".5 r 'gg 14 . A . .4 4. ,, „...11. 4„ :Pi"' ,4 A '' .4 S' .. - 4,4.41. :P.a.'BOX 80 7 'SAN ,FRANCIS'CO,CA-94.10V-080T- .1-si 54- - ,r4. 1. if t< 'f‘P;•• ".Y.'":: -,-.. VIC': ", 'COMPENSATION. --8,L1,-,^43"fl..J.J.F,:7:0 --;f4:4 *4-45,2" telt• "•• Sz- _-•/. • :, ...44: "..;`;14-rafE r INSURANCE . -`, 0",1".." - ,...tn=, - -," I. 1/4 •;•••*1/41(4-4• •*ge '. r.... li' 'P'-•' It.;:f.• .-,•'----Cb..it; .•-e--6-3, tc 1- C2-%, , • •' • -,- ere .." 1/4 -• .9(1/4 .1/4•Z • . 41•.1/4,7, • „ • ..!4 47, 4kj, 14; A FUND,,,,ethilttoid-Ali.?6orilAioilkERrecorivititi■isATioiv-iNsimilvANOE'' tfr.:*" ..,tift::.;;;',. ,,e-':-.t, u. ...t.t.-4.:-; , , 4,, ;•,, :„. ...„_, .i., ,.- „, , ...• . r _,....., ■‘. g.: --t, 4 . ,. . POLICY NUMBEIR. -481-88..t.UNIJ.T- 00400138 ,...,_..t'S.,...--, .i: .: ....-a tktit.r., „,;$::""t".' (tttr, et tt, ".t,i-` Et , :24,44.: 0tteg 1. CERTIFICATE EXPIRES 10-0.1-.99.V4. 41;4811- .- r'11... ISSUE•DATE: :10;01=98 .j,t- ,, te "::, ..."."6.1: "rtrt,e„tre%4 ,, ^..,“ ,;,*:, 'r: ' ,:t.t 1• r.' 't ,• •le2i. ',,,, ...-t-% -VI"' " In*.44e,....,p ' I' i•- i .. , U ' „s , ' '' ;:i." „gf•I TY . .r .-4 .C.C. •ry ‘-.1. il^ _- N.- 'OA ,. r4:44.-‘el‘4. ji. e:-.1..s.„ --.*- 4S,..• 3 t & h',";;;- • e.-", 4:',7.. , 1 ...e , 4f,"-IT"-'," 44 %, t d COSTA, lit.SAt.iAt4 I TARY iiI(ST.. .','• 4 "• - -- ...f1/4• e "4-7:,:. ,/,, ili,AtTit ROB I N.,B H AME RSt, ., -....tzt,e' A "74; 1se.. ..hr .A. ••:--- e , ,:t 47 . ,j, 'c l.-Z: 4'..c• c•..‘,..1..€7', . ..e.,• ,./ .P-b' .BOX:i 200_,?! t, „N:-.,:„ 5„--...tit-,1 t.,,,...).-,snt-,.41. ,,4e,,...,-;,..,,,,,,, 4. f‘1".1/4' ..4,. 4,(4... fa, .4..4-4.0.4 AI, 4 4.-......t ...., v.".--vil *'?"041:";,..q.‘ -.- ,4- ' 'COSTA MESA `.CA, •92628et z--. ,HT.,, kd r .2.-.• . -ii.'f;'' tre, 4-4''`'"S i'., '.4' •' '4 '• - 4. '. '-7" '4•14'4:',..b..10 4gi. 'ic... ler•••-•-• CC J1 Is el „ 4( , - ••••••7,e, *1/41 '-'rrr. ',I-1/4% '', •P ' Iv iCi . vt7 ss- -. --4' •.0 , 't ts- '4 ' • - s tt, 4 „ -1, •-,...t.t-t.s., .-t:" ,:-.0.-4t; 1;; , ---,.k. .....•:‘ : ; ,.... i- v: 9c. rc..":- ..E, fit 4A, --1 ei• 21",%-i-fr•4.i,, j k4e• -•*:,,,DA!„ , lir-* ,I ‘,4 e ti, ti, ."4)‘‘.;„ AI, ,/,:r...04,014,4, ,.%vs-4 , . , ..44 . . %.-- This ,is,to,cel'il'.1 yLthat twe•bacie•iSsuedt`a-valithWorkers :CompensitiOn.instirahce..policy tinca,form-approyethtby,the- 4". „,..;',.-4, ..414z - ''.,.. -Calif ornii-Insurince„Commissioner to:the employer.namedtheloyvt.f or the pc.2licy period .indicated, -- , . ,. ••• 1* • 4 4.-.-7 -4%4.••t-..4-..--- , ..4%. . ......- :4---44- - t•-........",44/-4.-rt:s.....- •'..ptal,:te;-:' 'T -W.-17,4%,1 "•%,te-: •**me+, „•••••%e,et-4.4.0,t,..''.1=4:-.1,14.ear „,.. i_. Fr-ss..„L„ ---.."' ''''' -- 'Pt' 4.-"z- ti...„ 'I-4 kt4e.-r-- x ■‘; ' •••'-* •'rt .; '''‘ 'Y.:. •• ":*4 el . :4% • •••• '' , -.", This'Polley.:is not-subject to,caricel latiEni bttfithe;*FundleZdejit.updri.10 days advance written notice to.theT,e-riiploYer: :1-: ? 1--i> ' r 1■ ' ' . • f t „ fl::',' ). • 4.t.:r "....”e ' ... '-.". S -1•4"-' -4 le t -1/4 ,74.,1%-se.•4„.-e ,< e. ."-., -' vii • ,(7.-," ^-,"'-4.* • , • 1',"1- ••'• "444 4-”.. -? t4/..11:: .4".. % ..L.I -.C..* :41.. , .1..C,'cc .E.C.:-.`elltv • 1.' lt.t ../-4:01* .:t1"- SC 4....?•4". • 1We.,,tivilll'alSoigive,lyoutio,•ilLays. avanoe%notice ,Shouldt,thiel,poli.cylbe..cancelled. prior%to,its...clorfbelseicpiraftbn.\•,,,..2*-ttitt .. • ,1-.;• 4,, -. t.4, 2,1 4. 4..t,... `'' -“:" 1.4g- 4- "'ix.; ' ;Ci14-4 i' '74:: 1 " et- }•• " ••••'*:4*:•%-• *1/4 '•- %Sr •-•/1/4'• ' *4' e 4 ter" 4 • %5*-- ■ ,-. • / 4-• .;•• ‘'••• tel-pe, .4' ti, ikr7-5 otr; --thee..1--er vet"• ,-- -- -.This•certif'bate,of-.insurance;is -not.an insurance,policyt and;does,not,...arnend. p•xtend,tdr'alteiethepoov-erage,:af forded, -- . k 7± - • it"bjcitie lacilibies Iiitedhe.rein:stNloftrtiithStanding\enji lrecilltir'e'reenC.ferre,°Ort.condition of any contractor•other::eitiEumentt, :y, kt.....t. 1 A/1th..respect to which this certificate Of-insi,francezniay$-be,tssiliecr or rnajr,"pe!rtain,l'Atie;%insurinEeraf f Ordedlt titrah4, ..:,:, ,,,,i's-..--,r-.4Y 'et ,policies5described‘herein iii-Subject,to-all the fir?ris, excibeicinsland.,cohditienSiof such OolibleS7 'v.* ' -,,c ss"?'S LA .4.4rst t.tli 'sta. 4.4 Ty.1 - w4.1,. - 4:r.-r 4". A:- . , .,,,k"-Acti.-• „/..zi. -...• grit,,... ,- 4..-, •-•.-E, , , , :•.-s•--- C... 4r4' '1. IA ... g ,X3 , ''' tge? 0.- . 'S. . ' at - */ •'st. "t'0' ,S. , - ,-- .e, ,' 't vt",,,,,,r ••• 47' - ' ""4 r ..: 4-14,41 ,,...-41 PPESIDENT? -.',4 •,•=J.^;47 4 -ire 441 .4% ..):4-.)•i er *4:-.*e.>••t-4‘.• ri• " ...I. , ?•:--re. 1 i „ •--, ,-44 --A. •.41.1r2;;C1/4 -, f.:- .:”' .../' A 1, MPLOYER'S'.CIABI L ITV";.1.".IMIT INCLUDING DEFENSE COSTS eil,$1 000 000 00 PER OCCURRENCE.,,t.L:„„..,, .;...et.t t . ., 4-• .I..„- ' ttt-' -I "zi -c.,0.... A's.N,..>.,.4.0.,. • -4 "r; 1-i- s .. ,, •4'. ± '0-- -l".`...4.--tivr.= 4‘. of•C - - 4 Ot- •%.4 <it „,--.-...: ..s• -v.„ . v.. tr,.t - .t,, 4 , .. ,-,...,.. , - • Ar..... --,-4, e.,.- . 4s,-..7.,.. s...:„...2. , -;- ,%,., ,. ..-,.: ..,), -,-- , -,,-,., ..sy., .,, ,,,,,?- , - .:, 1, fr- 4 ..-,2: , . , .., -' 't- -'21"; e 442:Z4 ..i.).A '4" e. ‘00 ,. 4,0 4 4" ..T. %.9. • - " ,c. -.1. e. "?..,?..-4-, „......,,-;,et" ± ,4 ••4•;-.. e.„ :T.' I- vi2 • "tr•• •4•4 ••• 14"r *r•'• li--le- :le' -'r-i: A- r 4.5. ,..t,i, ,:,..- a, •,,, -1- --“t. - --,:-.' , -`t, -4\ .ssfils C.?, -t444:14 4,t.44.' it .4.4.44:".• +4" ...."..:` ' 0.z ... 0- - -.4-.0-. .,Tit.`" '''' '4`4414 '4:: A:, ''g' b• '* .--. `t....° l',. r .,*311,-,. .i. ■ .0.," .-rt'. -,t, ?€ -'?' "we'-`•14 '272'''' - 'Li; :-. e., ...., -..„ • ' ,. .. ,, o,.- '1\113, e -€5 'J.. 4.---`,e.t0; tW. ;.; -•-,r1- ,.. -.1'..1- ,i,.,4,:e".?. ,4''"A.T. --Y. tt. ;;;Is-c,ati,a 44. .. atts .44' 74A---:tfiti. .4.4: r 4ei l 4 ''.T#°.-5,,4 1 : • '.f; 0; r. 1v- 1/4-;•?)t7.l- • .t4„".#...,.4.. A r.. 4 -44-r..;,tt.--":",444,.,.. ' -‘*2 •%'1/4 '. . Y..' %Pa.'. "1/4%•,'••i, einCe."-te-fl • 'VC.% 14. ,i... ,"1,1%<- Cli,54„'.4: Ra....'t.s ••••-i:"..V.e ;:tt;$'1' .v."<<•24‘...:- -21? -C." 4r_,,i24.- :41-'IL:t11-rer 7.4. e,.„.. riet --tak ‘... ri..4.- ,t ..ei- .t- 4.' 14r(N.-1. •IS:■‘ --;- -14,..1. .t."4... 11 -,st -. 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ZS-L.:K."52%0-C'$'11/4.4[4-1;:':re•-•2-01 le i.t.st: ....,. .i.f.4. 0.,,..4i.,04 4.•-'4,4,-"."..0414ttsr..... 4:lc 71g -Yt1/4`2%- 9•52-:4 4 .-t• , :4;:. ::,,,A.r*„, ,,,-,..1„, ;5: -,-,.tit.r< Ai 'L 4.- 0, ,,tA 7,.,..11-; '7" •%** ':/1/4fer•'1/4' .5. :MI'S.% LEGAL,NAME '-re: 14, 'es. -•""1 %.I.FP174-4:4, ‘-',..yri1/2• A.EMPLOYER% •- -A -5-4.irr -'''ti 14.-- .152-4..r4U f•-?-er ' t, Si; - , "It,eze,- e--4 ,I ei.,,,‘•?: ... ,''i St' -a- -bt4.4 .tia ottC.0 41 aig'it , • -•-• 471%-lt“ •••10"b ••44•-•-• kt4...44.-ete":.J - 4,:leV1-.4. .8.:-". t " ,„. .. 0.10. .,,,,..y ,....tet- :- I' ;It - .....te ' -- ie ;Ie.:- -4,r, 4:kr r .": ..;--, ,: , `,..•r •Ik-:-''‘2- p. r.-"'-',' .,.., .... y , 7- ,ties-il,rt. .4.. ,, ..t.-/ .4,d." 94" .4, ' •.0 ...t. ,:..; 4,.4.., ,,,, '1,e..f. -*-.. .472,e) e -et, •4 -..;$ -.T"re i.y? 'ery„ .:),. Lt.- l'..f"-; „tt.r.;„...."-$r„ „L.A. /It "....„:Ay,. ,.../ r, ri5. •... r.",11W .-„,. -.0.V. "4". f-144.44 4 4"',4„ .4:?,4.4.1.11. ,/.."4g"?.),t -A - Sr 4; .4;4,:Y• Arill:;1/4. 1 ..." :•.:COSTAP,MESK-1511SPOSALr' INC--- -i,:ee, - ,-? 'tea' i• Zr- '0.4•. r.:COSTA.MESCDI SPOSAL:4 NC tc-i- . gtr$74::r -''''''''.) -''S‘ tt''' .7.':-2-051 .13L:ACEITrItt'fAV,I . --T-'" i"4.." -*- --'-' .(:,-4tern- A, ''''F. '77.F.At '24( ti'f“ . 4'1'11;44.41; "4‘ace...r.alit's-a' ."ks--it-%- "sr.,110 tc, „t„t a '' ....4 tV-gtitt--,t-L, ,,,..:r --01. -..-""-e•Sic<1..:04?-^.:,• _,, I:4-11-,S4--%,1% i.-essart.7.. A do§TA fo'lE SA1 diZt.9-26 2'7 0t4 4". .‘„1,...4 . • ,:._„:„}A, 4,0,,c, 4.- rya- a44744....t.- 1".4.?!.. .T.- 14 7.44:1-,,,--1.-re-..:. ,-- -..e. --,,,;.::" , - ... -er . .i.f6A. .Ca. 1.4 . . '1,4 1-: sias s;t--4,421:41-1.> 4;4 itta--..r S:•.1‘..t. F .•fr--- 4-'.-4‘,;-: P. rtEr--:5-<?" rt: , .--.e7:L'I-11,-5: tat (7-. --€. e‘ce,.... r. , r",,,c-* *". I ...,?"'reef- , t, •- ,"."--.. ., 1 "'Any, fra,14:gtt .4.it's --iikt--*: -,t'''nCt-tc".'i .2. s. : .e.ta..4.7. Ag.:tr s.,4„ „"gm ejn C"- ; '''' cc ;II'S' a tk.'"?' %--ss. .1" ....4ft'-f.14-A.At.4 '-'1-'-'2. 1.i; .02-4. • i:...-.1 ca.,' 4S, C ..r".,S -• eg ,0:5'_ 11/41;•*%%‘: -1/4*•:'r."-4-**%*a" Pe,t %."7-1/4a•- 'SPRINTED ,.t•-• kl re..4.‘,,,--4,1r4....,09-18798. a _,_ • . -, : • • T_ HIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND , - sciF 10265(REV.2-9S) • -'‘f . -.4---4.-,-4- Sa.-..“_._ ... --.. --