Insurance - Mike Kilbride LTD 11/02/2015 06:19 9491 102064 STATEFARMINSURANCE PAGE 01/01
CERTIFICATE OF INSURANCE
This certifies that ® STATE FARM FIRE AND CASUALTY COMPANY,Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
Insures the following policyholder for the coverages indicated below:
Name of policyholder MIKE KTLBRTDE LTD DBA COAST WATER & POWER
Address of policyholder P.0. BOX 3341
NEWPORT BEACH, CA. 92659
Location of operations
Description of operations
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions,and conditions of those policies.The limits of liability shown may have been reduced by any paid claims.
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
Effective Date Expiration Date (at beginning of policy period)
Comprehensive I
Business LiabilityIf BODILY INJURY AND
This insurance includes: ❑Products-Completed Operations PROPERTY DAMAGE
Contractual Liability
0 Underground Hazard Coverage Each Occurrence $
❑Personal Injury
❑Advertising Injury General Aggregate
❑Explosion Hazard Coverage Products-Completed
❑Collapse Hazard Coverage Operations Aggregate $
❑General Aggregate Limit applies to each project
EXCESS LIABILITY POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE
Effective Date Expiration Date (Combined Single Limit)
❑ Umbrella
• Other Each Occurrence $
Aggregate $
Part 1 STATUTORY
Workers' Compensation Part 2 BODILY INJURY
and Employers Liability Each Accident $
Disease Each Employee $
Disease-Policy Limit $
POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD LIMITS OF LIABILITY
Effective
P447489A1075 AUTOMOBILE /10/15 x1/10/],6 1, 000, 000 beginning of policy period)
If any of the described policies are canceled before its
expiration date, State Farm will try to mail a written notice to
KELLY RRENNANCPCUAXUCtFC the certificate holder 30 days before cancellation, If,
StateFarm L IC 0678344
C 24800 CHRISANTA DR STE 150 however,we fail to mail such notice,no obligation or liability
C-C�, MISSION OE*.CA mai will to imposed on State Farm or Its agents or
PH(949)7706100 representatives.
FX(049)7702084
Name and Address of Certificate Holder
Costa Mesa Sanitation District
628 W. 19th Street Si n rAot/orized Representative
Costa Mesa, CA 92629
Title /
fr
698.904 a 2.00 Printed In U.S.A. �/f [`
Date