Project 132 - Insurance - Grbavac - 1994-02-04 .. ... .. ..... .. - .. ISSUE DATE(MMmOnY)
CERTIFICATE F'IN.S.URANCE.
11 .2/4/94
AROOUCER THIS CERTIFICATE IS ISSUED AS A' ER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CCRJIFICATT HOLDER.THIS CERTIFICATE
DOES .40'AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
o I Ime 30, W
The Ru_ Company Inc
COMPANIES AFFORDING COVERAGE
P 0 BoX 7072
COMPANY
LETTER A CNA/TRANSCONT'NE:TTAL
Pasadena CA 91_09 .
COMPANY
B CNA/
INSURED - LETTER TRANSPORT.ATION
COMPANY
Crgo Cordon C:bavac LETTER C CHUBB GROUP OF INS CO
Cans. JC' on Ca nC COMPANY D '
401 W _ongde Ave L_'TER
Arcad.a Ca 91007 COMP IY C
L- it L
...
COVoS nGcJ .. ..
-HIS IS CCRTIFV HA THE POLICIES OF INSURANCC LIS'ID BELOW HAVE BEN ISSUED TO 'HE INSURED NAMe. ADC' -CR THE POLICY ERIOD I
NOICATED. NOT VITHS-ANOING ANY RECUIREMENT TERM CR CONOITICN OF ANY CONTRACT OR 0-HER OOCUMENT KITH RESPE"T-O WHICH 'PHIS
-RTIFICA NAY BE ISSUED OR MAY PERTAIN THE INSURANCE FORDED BY HE POLICIES DESCRIBED HER IS SUBJECT-O AL_THE TERMS.
-XC.USIC.NS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HA EN EDUCED BY AID AS. 1
'.I TYPE OF NSUR POLICY NUMBER I POLICY - " I POLIO :XP ( LIMITS
LRI CA R M/CONY)0AT'(MM/00/ Y7
A I FRAL LIABILITY 120925559 _0/16/93 _0/'a/94 IERAL ACCR ..A 2000000 �
I X COMM. GENERA LABILITY PROD- MP/OP AGO. 100000G
IC).AI AS MACE( X !OCC. RS. S AOV INJURY _000000
X IC'WNER-S 3 'R.,, PRO I -CH CURR NCI 200000
I 1 In- , OE,.. _ AI '0000
!—J I
A_O :xa fore n 5000
3 I AU' AOBII_ L. slur- 120926a _0/ 0/93 .0/10/ 4 CD'IOINED SINOL_ 1000000
PINY AUTO It-
I IA.... OW ED AUTO$ ]COIL (JURY
I '(SCHEDULED AU-Oe IP. n)
C IIHIR[0 AUTOS BODILY IJUR
I ,( INC'•OWNE AUTOS (P. afdent)
I ICAR GE LIABILITY
PnOPER'Y 0A AAOEE
C 1 -XC_SS _IAOILITY 79690146 L./0./9 .0/10/91 3000000
_ICH GCC'JRRCNCI
I;( 'IWMOREL_A rORM ACOR C. T-
(OTHER N UMOREL LA PCs," -t 1
STATUTORY LIMITS __. I
WORKER'S COMPF,9SATION ACM ACCIDENT I 1
ANO OISEASE•POLICY LIMIT i
PLOVERS' LIABILITY
• CE ^H EMP I
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS 1
NOORSEMENT C17157A ATTACHED COSTA MESA PROJECT 1112100-132
SANITARY DISTRICT. ITS ELECT^1E BOARD, OFFICERS AGENTS S EMPLOYEES
A, ADDITTONA., NSUREDS COVERAGE IS PRIMARY S NON CONTRIBUT-NG.
CERTIFICATE HOLDER .. - CANCELLATION•
SHOULD NY OF THE ABOVE DESCRIBED POLICIES DE NCELLEO BEFORE''HE
EXPIRA-ION DATE THEREOF THE ISSUI.IC CO.IPANY IL—_`..
MAIL JO DAYS WRITTEt NOTICE TO CERTIFIC, HOLDER NAMED TO-HE
LEFT "_ _• .,,, n.�... ....� ___ _
COSTA ME A SAN-T,ARY DISTRICT • - . - - - -- -
P 0 DO'‹ 1.200 $/
IAUT 10..11 - 60
A�I__
COST aA CA 9'_629-1:00
1- S /
ACCRm S I '9C)
. : A C
~Ali Ca v]l��
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
BLANKET I ADDITIONAL INSURED ENDORSEMENT
This endcrser.en• modifies insurance prvided under the following:
COMMERCIAL GEN_.RAL LIABILITY COVERAGE PART
'r -C IS AN INSURED (Secoon It) is amended to incude as an insured any person or cryaniz2tion (called
ae.ditcnai insured) whom you are recoired to add as an additional insured on this policy under a virile-en
ant, or agreemen• c.:rrentty in effect or teeming effe=.tie during the term of this policy prvided that a
=r•`_to of insurance `.owing that per-.,..dr. o: crcanioaden as an addMcnal insured has been issued.
The insurance ;-waled the add. :cnal insured is limited as rclIcws:
That pencil cr c rgani_atcn is cniy an addi!icnal ins- ' with respect to Ilaciiity arising cut of
z. P-enises you own lease cr ccr y or
b. 'Your ware for 'ha: adci';cnai insured by cr for you.
-._ limi's C. insurance a_c cabie :- ate additional insured are 'hose specified in• he written contract c
en' or in he CeC;a.a::C.:s cr "is polio/ wn:cnever are less. These timiis cf insurance are inc:_s:
of and nct in act, :sr, to iin.• c: insurance sncwn in 'he Dec:ara;ions.
The :r.:.. ice - a- i - _ '. - — a
The ra.^.Ce _`/ __ ._ _ d__. :Cn3. s.., __ _...es .C' .,71y _.,Ct1`I .l�rf r _co;�, da... -_ ...
a�a
acver:s:nS •-/' an—n.; c o ar ni,__: s eng•nee• s. sur e.vcrs enderng of or ,Apure
renter an o.ess;cnal ser.ices Inc::c, .g:
t. T,_ pre-.. , .y, a;:roving, C.' �a;ii^.^ pre:ar_ ate ove ,1a:s. crawings. ccnions. -erar:S. sur/e./_
cnange C.ce. des:gns scec:ficaucn
S: and
2. Su:e Jisor J insC__::cn Cr _^.;:n__ring services.
COSTA :ESA SANITARY D.STRICT COSTA MPS_ SANTTARY DISTRICT ITS ELECTIVE
P 0 BOX 1200 BOARD Or`CERS AGENTS & EMPLOYEES ARE
COSTA MESA CA 92528-1200 ADDITIONAL INSUREDS COVERAGE IS PRIMARY
& NON CONTRIBUTING
5 PROJECT 1112100-132
T-=s ENDORSEMENT IS A PAST OF YOUR POLICY AND TAKES EFFECT i ON T'ric EFFECTIV_ CAM OF YCL.
POLICY UNLESS ANC i r!ER E=`CTIVEE DATE IS SHOWN BELOW
POLICY CHANGE NO EFFECTIVE DATE CF THIS POLICY CHANGE
.2-1-94
CUNiERSIGNED DA—E AUT:-i PTFR=SENTATlVE
2-1-94 /yp
C 5
(ED C2JS2)