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Insurance - Nikola - 2007-04-06
: ACORD DATE(M CERTIFICATE OF LIABILITY INSURANCE MIDDAYYY)04/06/2007 PRODUCER (714)524-4949 FAX (714)524-4940 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Commercial Associates Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4226E La Palma Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Anaheim, CA 92807 INSURERS AFFORDING COVERAGE NAIC It INSURED Ni kola Construction Corporat • - - INSURER Fu Netherlands Insurance Company 18012 Cowan 8290 APR 9 2007 INSURER B. - Irvine, CA 92614 INSURERC INSURER 13 COSTA MESA SANITARY DISTRICT INSURER E: COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. BIDR�A� TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS O7 ' : I .,P,u1 : I . uPAJAI GENERAL LIABILITY EACH OCCURRENCE $ I ■ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED . $ ■■ CLAIMS MADE I OCCUR MED EXP(Any o person) $ ■ PERSONAL$ADV INJURY $ ill GENERAL AGGREGATE $ GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ ■ POLICY ■ jE� ■ LOC AUTOMOBILE LIABILITY 8A8096362 12/19/2006 12/19/2007 COMBINED SINGLE LIMIT■ ANY AUTO (Es accident) $ 1, 00,000 I ■ ALL OWNED AUTOS BODILY INJURY © SCHEDULED AUTOS THIS CERTIFI ATE SUPERS DES (Per person) $ © HIRED AUTOS ALL PREVIO S CERTIFIC'T�$ BODILY INJURY © NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Peremdenl) OTHER" AUTO ONLY THAN EA ACCI�DA G $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ I. OCCUR CLAIMS MADE AGGREGATE $ $ I ■ DEDUCTIBLE $ . RETENTION $ �.(�^�.(� 7]$$�� $ IWORKERS COMPENSATOR AND I■i7sg77mlj�ll,l EMPLOYERS'LIABILITY E L EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' E L.DISEASE-EA EMPLOYE: $ It yes,describe under SPECIAL PROVISIONS below E L.DISEASE POLICY LIMIT $ I OTHER -- DESCRIPITON OF OPERATORS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 'e Operations usual to the named insured -10 days notice may be given in the event of non-payment of premium. Iktillalea El MILNAM■111111•111■1■1M1IINANNA EN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL KIM( MAIL Costa Mesa Sanitary District 30* DAYS WRITTEN NOTICE TO THECERTFICATE HOLDER NAMED TO THE LEFT, Joan Revak, Board Secretary/Program Manager/ Clerk of the District 628 W 19th Street ;j.a : . . .,.,. :. .,,. X Costa Mesa, CA 92627 liirlrill ACORD 25(2001!08) / . OACORD CORPORATION 1988 I4 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED subject to the terms and conditions of the policy certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2001/08)