Insurance - Coastal Traffic Systems Inc. - 2011-03-04 (2) DATE(MMIDDWYYI)
ac CERTIFICATE OF LIABILITY INSURANCE 3p4/2011
CERTIFICATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT' If the certificate holder Is en ADDITIONAL INSURED,the policy(les)must be endorsed. 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 Ilea of such endorsement(s).
CONTACT
PRODUCER NAME: Debbie Kilby _
PHONE (S59)222-7722 IIA&N91:(559)212-1T2a
James G Parker Insurance Associates �NCL.Pe6' - -
License #0554959 AeDRSaebbiaKilbye jgparker corn -_
PRODUCER 00079068
1753 E Fir Ave CUETOMERIOI;
Fresno _ 93720 INSURER(a AFFORD:NO COVERAGE NAIC,
-
INSURED - - ASP i a INSURERA:Praetorian Insurance Compare 1257 ,-itx
At,tircrep INSURERB:TOPA Insurance Co an vi(
Coastal Traffic Systems Inc krgrlrft-gb INaussnc,Travelers Prerty Casualty co '+"25676 XV
1261 Logan Ave INSURER D_
INSURER E. --
Costa Mesa CA 92626 INSURER F.
COVERAGES CERTIFICATE NUMBER;USE 10-11 BA EXEtik TM REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTMTHSTANDING 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR - -7ADDL SUER: -. POLICY EFF ' POIJCYEXP
LTR TYPE OF INSURANCE NSR WVD I POLICY NUMBER I(MMR)n(YYYYI IMIWDDlYWYI LIMIT
GENERAL LIABILITY EACH OCCURRENCE S
- AMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY PREMISES Ice occuTence) r -CLAIMS-MADE In OCCUR MED EXP(Any one Person( .1
PERSONAL 6 ADV INJURY $
GENEAL AGGREGATE S
GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG• S
n POLICY n PROT,, 71 LOC $
C
A la 0'ILE LIABILITYL/ ' COMBINED SINGLE LIMIT $ 1 000 000
OF'' BODILY - -
a BODI INJURV{Per per n) $
■ A ALL OWNED AUTOS CA5010000601 6/1/2010 6/1/2011 -
_ BODILY INJURY IPo ecudent) 5
SC HECULED AUTOS PROPERTY DAMAGE
* Re AUTOS Re accIden11 5
X NON-OWNED AUTOS MBdCel payment, 5 5,000
Un Ivc morons combined $ 1,000,000
X UMBRELLA UAB XI OCCUR EACH OCCURRENCE $ _5,000,000
• EXCESS LIAR _ iC!AIMS MADE AGGREGATE _ $ 5,000,000
DEDUCTIBLE Excess Auto 5
B RETENTION 5 XL6601067 6/1/2010 6/1/201. S
I WORKERS COMPENSATON WOSTATU- I I 0TH
-
MD EMPLOYERS'LIABIUTY I TORY L NUTS, I FR _
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT S_
OFFICER/MEMBER-EXCLUDED' N IA
(Mends cry In NH) E DISEASE EA EMPLOYEE I _,__
II yyea,desvbe uncle
DESCRIPTION OF OPERATIONS bob« .E L.DISEASE POLICY LIMIT' r
t. C Contractor Equipment DT 66050 680 3 8T1L10 6/1/2010 6/1/2011 91,000 deducible Per Schedule
C Rented/reseed Equipment CT6605466a030TZL10 16/1/2010 15/1/2011 $1,000daductlxe $100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(MUCH ACORD 101,Addeo A Remain Sc nodule M mom space Is nquwed)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS.
628 W 19th Street
Costa Mesa, CA 92627 AUTHORIZE)REPRESENTATIVE
J Parker III/DKILBY e2 eee i ®wo ■M
ACORD 25(2009109) C1985-2009 ACORD CORPORATION. All rights reserved.
IN8025/200909) The ACORD name and logo are registered marks of ACORD
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