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JMtI Ca '90 12:59 T_ HRH- IrJc� H3E1,t_ !0 P. 02 I CATS OFI NSURA 0 i / TAKEHARA & ASSOCIATES INS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, GERALD TAKEHARA EXTEND OR ALTER THE COVERASE AFFORDED BY THE POLICIES BELOW. 1 ------------- ---------- --------- --- ---- ----- 1 UPLANDS WAY SUITE B ;-----�----___ __-------_-_ _-.. -- ; CITRUS HI+ TGHTSa LSA 95610- COMPANIES AFFORDING COVERAGE 1 PHONE916-966-0704; +------------------------------------------------------ -__. - --__.----------------------------- ---- - - 1 INSURED ; COMPANY LETTER A Maryland Casualty ; ----------------------------------------------------------------------- --1' 1 Herbst Engineering Inc. 1 COMPANY LETTER B Emp 1 ayes± rBene+ i t s Assoc i at i on 1 Ed a n d Maryy 1 yy n He r s t,----------------------------------------------------------r-------____--._ P.O. Bax 225(34 COMPANY LETTER C ! 1 Sacramento, CA ;--------------- --------------------.__ ..---------------_---_ --_-__-__--_1 95822 1 COMPANY LETTER D ! ------------------------------------------------------------I-----------! COMPANY LETTERE1> COVERAGES 1 ! THIS IS TO CERTIFY THAT POLICIES OF INSURANCELISTEDBELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 1 PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO ; 1 WHICH THIS CERTIFICATE MAY K ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO , ! ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES, L[IIt1i5�39MWN SAY HAVE MUNRBH[t(11E RPY PAID CLAIMS. 1 -_------^__.--- ---- '-P-NUMHR - __;-+---; --1 ALL LIMITS INTHOUSANDS --------'^ 1"Oil TYPE OF INSURANCEOLICY POLICYEFF POLICY EXP ! 1LTR: 1 ! DATE ; DATE 1 +-_1-----_--_--.r_rr-----------------1---r_-------r._--_-_.-r---_--1--------_--e__4l______-_-r_________.r ....__ ' J` 1 1 ! GENERAL LIABILITY 1 1 1 ! GENERAL A66REGATE 11400 1 ,- -_------------------'---------- 7C ` A ICOMMERCIAL GEN LIABILITY [EPA06724091 0'7/ 14/e9 07/ 14/90 ; PRODS-COMP!OPS AGS, 2000 1 '--------------------- 1-,•------••__' 1 1 CX 3 I ) CLAIMS MADE 00 OCC. ! 1 ! PERS. k ADVG. INJURY! 1 000 11 --------------------- ----------- I 13 OWNER'S I CONTRACTORS ; ! 1 1 EACH OCCURRENCE 1000 I ! PROTECTIVE ; ,---------------------+---------- + ! 1 1 FIRE DAMAGE 1 1 1 1 C 3 1i (ANY ONE FIRE) 50 1 --------------------- ----------- 1 ! { ) 1 t 1 MEDICAL EXPENSE ! 1 (ANY ONE PERSON) :5 --------------------------~ --------------------------'-------------'-------------- '-------------------- '--------- ' - 1 AUTOMOBILE L IAP ! ' I CSL ^ :600 ! '-------------------- '------__ , 1 ; C 3 ANY AUTO 11 s1 1 BODILY INJURY �1 11 1 Al CX I ALL OWNED AUTOS WAA82737248 09/ 14/89 0'7/ 14/90 1 (PER PERSON) 1 I C 3 SCHEDULED AUTO'S --------__ -----! ! CX) HIRED AUTOS 11 1{ 1 BODILY INJURY _-_i, -_-- - 1 1 (X) NON -OWNED AUTOS 1 1 1 (PER ACCIDENT) ! 1 1 1 ( 3 6ARAEE LIABILITY) ! --------------------- ----------- , 1 ! E 3 ! 1 PROPERTY EXCESS- - LIABILITY -�------ _______..___,.._------- ' _..-..__--_-__-..'--------------'; _-_----1-EACH OCC 1 +A66RE6ATE ~-1 ' ' ( 3 UMBRELLA FORM I ' ' C 3 OTHER THAN UMBRELLA FORM 1 1 ! -I-' 1-' - ----------------------- ' rr - -+ ' - 1 ! 1 STATUTORY 1 1 >B1 WORKERS' COMP ; 33 11 51 11/17/B9 at/17/90:2000 EACH ACC 1 1 AND 1 12000 DISEASE -POLICY LIMIT 1 ° EMPLOYERS' LIAR 1 1 1 12000 DISEASE -EACH EMPLOYEE! !--'-------------------------------- l-------------------------- -------------- l-------------- 1----------------------- -___-.__-`1 It 1 OTHER 1 1 Li/ 1 DESCRIPTION OF OPERATIONSILOCATiONS/VEHICLEri!SPECIAt ITEMS 1 2 1990 JAN 1 , 1 ENV1RUNi\AENTAL HEALTH 1 !1) CERTIFICATE HOLDERCANCELLATIOt( <=- �� -Kia=======�M�,�_-_�_��_:M=_==1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX - San Joaquin County, P)RATION DATE THEREOF, THE ISSUIN6 COMPANY WILL ENDEAVOR TO MAIL 30 ! 1 Publ is Health Services DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 1 1 P.0- Sox 2009 s FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLI697ION OR LIABILITY OF ! 1 Stockton. CA = ANY MIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ! 95201 ----�------------------------------------�------------- AUTHORIZED�-1 I REPRESENTATIVE F