Laserfiche WebLink
STATE OF CALIFORNIA <br /> DEPARTMENT OF GENERAL SERVICES eo OTwwcT NVy\aw <br /> OFFICE OF 1 IF STATE ARCHITECT _ <br /> CERTIFICATE JF- INSURANCE -- <br /> RONw00080 NYM.90 <br /> OSA 1710-2 (lna'( <br /> -wOJ.CT .^Ma OI 1...... <br /> Placer Tractor Service <br /> All California OperationsA..wO's <br /> 7200 Wells Ave, Loomis, <br /> This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. <br /> COM- POLICY LIMITS Or LIABILITY IN THOUSANDS (Nos <br /> PANT Type or POLICY NUMBER EXPIRATION <br /> LETTBR INSURANCE O= <br /> AOOwEDATE <br /> DATE OCCUR <br /> GENERAL LIABILITY <br /> A COMPwE"ENBIvE <br /> FORM <br /> PREMUtG — BODILY INJURY Is a <br /> OPERATIONS <br /> ■EPLOSION AND <br /> K- <br /> COL"POO HAZARD PROPERTY DAMAGS Is a <br /> VND[ROROYMD <br /> PRODUC <br /> 11"JURY <br /> FRODYCTSJCOMPLEY[D <br /> OPNRAYIO S MAEAND <br /> CONTRACTUAL BODILY INJURY AND <br /> INSURANCE PROPERTY DAMAGE <br /> RM <br /> PRO ROAERTY DAMAGE COMBINED a 1,000 a 1,000 <br /> INDEPENDENT CIP 092232008 6-9-89 <br /> CONTRACTORS <br /> PERSONAL PZRSOMA61NJWRY • 1,000 <br /> "Thio Certificate <br /> AUTOMOBILE 3xtendq or alter the Goveragii afforded <br /> LIABILITY y the policy." <br /> OCOMPREMENSIv[ DODILY INJURY <br /> TORY ([ACM PXRSON) Is 100 <br /> NODILY INJURY <br /> 13 ©O"up (EACH OCCURNEMCR) a 300 <br /> C3751686 8-29-89 <br /> PROPERTY DAMAGE a 50 <br /> xi <br /> MINED <br /> BODILY INJURY AND <br /> PROPERTY DAMAGE <br /> ❑NON•OWMND COMBINED <br /> EXCESS LIABILITY <br /> ❑Um BNELLA room BODILY INJURY AND <br /> PROPERTY DAMAGE <br /> COMBINED <br /> VNION THAN <br /> VM w{ FORM Is a <br /> WORKERS' <br /> COMPENSATION Grwrurowr <br /> AND EMPLOYERS' •• ••,(EACH•••, <br /> A LIABILITY 740563877 6-9-89 s ACCIDENT <br /> ADDITIONAL PROVISIONS <br /> The State of California,all officers,employees and servants of the State are included as additional insureds. <br /> This policy insures the Contractor, the State of California,and all officers,employees,and servants of the State,while acting <br /> within the scope of their duties, against all claims, suits, or other actions of any nature brought for or on account of any <br /> Injury,damage,or loss, including any death, arising out of or connected with the work under this contract. <br /> The Insurer shall not cancel or modify this policy without giving thirty (30) days prior written notice to the State Architect, <br /> c/o Contract Management Section, P.O. Box 1079,Sacramento,California 95805. <br /> The State shall not be responsible for any premiums or assessments on the policy. <br /> COMPANIES AFFORDING COVERAGES DATE uaYSO <br /> a A USF&G <br /> Y <br /> B B FIC 11-16-88 <br /> M <br /> r <br /> E AYTMOBIiED w BaENTATiV[ <br /> a C <br /> L <br /> I <br /> D xl/` <br />