Insurance - C & R Drains - 2006-04-11 r.. .. .. •
•ACORD
CERTIFICATE. OF LIABILITY' INSURANCE DATE IMM/ODYVI
04/11/06
PRODUCER R EC E i \T VS(CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
OOLDER. D CONFERS NO RIGHTS UPON THE CERTIFICATE
FEDERATED MUTUAL INSURANCE COMPANY gpH�OLLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5701 W Talavi Boulevard APR 2 C 2Y69ER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Glendale, AZ 85306 COMPANIES AFFORDING COVERAGE
Phone: 1-888-333-4949 COSTA nitil AR 9 I ICT FEDERATED MUTUAL INSURANCE COMPANY OR
Home Office: Owatonna, MN 55060 FEDERATED SERVICE INSURANCE COMPANY
INSURED 310-410-6
C & R DRAINS INC COMPANY
1525 WEST MACARTHUR BLVD #11 B
COSTA MESA CA 92626 COMPANY
C
COMPANY
D
COVERAGES .. . - - . - ...... ..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION
lTq POLICY NUMBER DATE IMM/DD/YVI GATE IMM/DD/YYI UMITS
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG $ 2,000,000
A CLAIMS MADE X OCCUR 9339895 09/17/05 09/17/06 PERSONAL&ADV INJURY $ 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE Any o e 0 el $ 100,000
MED EXP(Any one per n) 9
AUTOMOBILE LIABILITY
X ANY AUTO COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $
A SCHEDULED AUTOS 9339895 09/17/05 09/17/06 IPe per n)
X HIRED AUTOS
X NON-OWNED AUTOS BODILY INJURY $
IPe ode tl
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO AUTO ONLY EA ACCIDENT $
OTHER THAN AUTO ONLY- _
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
$
WORKERS COMPENSATION AND WC STATU- OTH-
EMPLOYERS'LIABILITY TORY LIMITS ER
EL EACH ACCIDENT 9
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE EL DISEASE POLICY LIMIT $
OFFICERS ARE: EXCL EL DISEASE EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
CERT1FICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE
CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
FOR GENERAL LIABILITY.
CERTIFICATE HOLDER' . - .... .._`...., . . . . . ..
al31041% . ... ..LL'ATION. - ..
COSTA MESA SANITATION DISTRICT 219 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE,CANCELLED BEFORE THE
77 FAIR DRIVE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
COSTA MESA CA 92627 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMP , ITS AGE TS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE//
ACORD.26-S.(7/961- _.. . . PRg$l T
sACORp:Ct3RPORATiON 1988