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�... ... .5.. [>iwr - wf ISSUE DATE (MM/DD/VV) <br />111104m Um .:ii. _ 0711419.5 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND <br />SIGERSETH INSURANCE ASSOCIATES <br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br />DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br />2710 Gateway Oaks Drive <br />POLICIES BELOW. <br />COMPANIES AFFORDING COVERAGE <br />Suite 115 South <br />Sacramento, CA 95833 <br />COMPANY A TRANSAMERICA INS. GROUP OF MIC <br />LETTER <br />COMPANY B TRANSAMERICA INS. GROUP OF MIC <br />LETTER <br />INSURED <br />COMPANY C GOLDEN EAGLE INSURANCE CO <br />FISCH ENVIRONMENTAL CONSTRUCTION SVCS <br />1040 W. KETTLEMAN LANE <br />LETTER <br />COMPANY D <br />SUITE 1B-156 <br />LODI, CA 95240 <br />LETTER <br />COMPANY E <br />LETTER <br />THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW <br />c.e. <br />HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWUHSTANDING ANY REQUIREMENT, TERM OR CONDITION <br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br />AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN <br />MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POUCYEFFECTPIE <br />DATE (MM/DD/YY) <br />POLICY EXPIRATION <br />DATE (MMMO/YY) <br />LIMITS <br />A <br />GENERAL LIABILITY <br />GENERAL AGGREGATE $ 1,000,000 <br />PRODUCTS-COMP/OP AGO. S 1,000,000 <br />X COMMERCIAL GENERAL LABILITY <br />91444-9403316 <br />03/09/95 <br />03/09/96 <br />CLAIMS MADEFIOCCUR. <br />PERSONAL & ADV. INJURY S 50,000 <br />EACH OCCURRENCE $ 1,000,000 <br />OWNER'S&CONTRACTOR'S PROT. <br />DAMAGE (Any one fire) S 50,000 <br />X MODIFIED OCCURRANFIRE <br />MED.EXPENSE(Anyoneperaon S 1,000 <br />B <br />AUTOMOBILE <br />INABILITY <br />ANY AUTO <br />91444-9403316 <br />03/09/95 <br />03/09/96 <br />COMBINED SINGLE <br />UMIT $ 1,000,000 <br />BODILY INJURY <br />(Per person) S <br />ALLOWNED AUTOS <br />SCHEDULED AUTOS <br />X <br />BODILY INJURY <br />(Pere Idenq S <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />PROPERTY DAMAGE $ <br />GARAGE UABIUTY <br />EXCESS LIABILITY <br />EACH OCCURRENCE E <br />AGGREGATE S <br />UMBRELLA FORM <br />OTHER THAN UMBRELLA FORM <br />C <br />STATUTORY UMRS <br />WORKER'S COMPENSATION <br />12256921—N <br />07/14/95 <br />01/01/96 <br />EACH ACCIDENT S 1,000,000 <br />AND <br />gSEASE—POLICY LIMIT S 1'000,000 <br />EMPLOYERS' LIABILITY <br />gSEASE—EACH EMPLOYEE S 3,000,000 <br />OTHER <br />DESCRIPTION OF OPERATONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br />1 7 1995 <br />ENVIRONMENTAL HEALTH <br />iIRG►'FEI�i�k44,AER ;; ,i.. <br />�AfiiC,A'RAM s= _. ::..:::,, <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO <br />PUBLIC HEALTH SERVICES SAN JOAQUIN <br />MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br />ENVIRONMENTAL HEALTH DIV. <br />LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />445 N. SAN JOAQUIN STREET <br />LABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br />STOCKTON CA 95201-0388 <br />AUTHORIZED EPRESE <br />Cv2� <br />