Insurance - Sancon - 1997-04-04 : ..
• ACORD 'CERTIFICATE `L A i TY 'INSURANCE.... . .... .. .... ... DATE(MM/DD/YY
04/04/97
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Eastman & Company Ins Brokers HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2550 N Hollywood Way Suite 201 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Burbank,CA 91505-1055 COMPANIES AFFORDING COVERAGE
COMPANY
A Continental Casualty A f XV
INSURED COMPANY
Sancon Engineering Inc. B Transportation Insurance A + XV
5841 Engineer Drive COMPANY
Huntington Beach, CA 92649 C American Casualty Company 4 + XV
COMPANY
JHM D
C4VEA...
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 OFINSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION OMB
LTR DATE(MIWOD/YY) DATE(MNUDD/YY)
A GENERAL UABILITY (96)C129147116 08/01/96 08/01/97 GENERAL AGGREGATE $ 2,000.000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000
.... CLAIMS MADE X OCCUR PERSONAL B ADV INJURY $ 1,000,000
OWNER'S B CONTRACTORS PROT EACH OCCURRENCE $ 1,000.000
FIRE DAMAGE(Any one fire) $ 50,000
MED EXP(Any one person) $ 5,000
B AUTOMOBILE LIABILITY
X ANY AUTO (96)C129144748 08/01/96 08/01/97 COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS BODILY INJURY $
_ SCHEDULED AUTOS (Pe person)
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Pe acc)dent)
PROPERTY DAMAGE $
GARAGEUABILITY AUTO ONLY EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
C EXCESSUABIUTY C136526482 08/01/96 08/01/97 EACH OCCURRENCE $ 4,000,000
X UMBRELLA FORM AGGREGATE $ 4,000,000
OTHER THAN UMBRELLA FORM $
WC
A WORKERS COMPENSATION AND TORY L HITS OFR -
EMPLOYETISCP aITY 96)WCC15599922 10/01/96 10/01/97
EL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR/ INCL EL DISEASE POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE. X EXCL EL DISEASE EA EMPLOYEE $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES'SPECIAL ITEMS
RE. Manhole Rehabilitation Project No.1112100-144.Costa Mesa Sanitary
District,its elective and appointive board,officers,agents and employees
shall be named as additional insured.Policy will not be cancelled or
Cl RIfICAt£HOtp> p .. .. .. . ... . . . ._ -... .:.. .. .- CANClt*ttON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Costa Mesa Sanitary District EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
77 Fair Drive 30 DAYS WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT,
Costa Mesa,CA 92626 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
• ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHOR • ■ •EPRESENTATIVE
A . i N 1988
ACORDSS11795}-_ Oki
CFF 1JFI.CAT-EOFIMSU.N A'N.CE.
INSURED. Sancon Engineering Inc.
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS (Continued):
reduced unless thirty days advance notice is mailed to the district.These
policies are primary insurance and not contributing with any other insurance maintained by the district.
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