ARCHIVED REPORTS XR0012610 - Laserfiche WebLink

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,'rte'. - �'wl{ 1 T- EFK d t:`Il�-]l t�:F:X 7 F+ ' 'iF �[. C�iist'. �l�t li �= mart=: ril/o9/a9 ...........-.................-------------- ---------------------------------------- - --. ..._._...___....._-..__ _-._----- i PEODUCfR I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS E I NO RIGHT UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, I OW COLUSA COUNTY IHS. 5`lCS. INC. I EXTEND OR ALTER THE COVERAGE AFFOR4EO BY THE POLICIES k ----COMPANIES AFFORDING COVERAGE----------------------- --------- I 4!1 MRJH 5T., FAX 4!&-45D 5843 r-' '-'--""-_ "--- - ....F.D. Bax 99a ! ) :OLUSR CA 954320988 I------•---------•--- - ------------- ------------- .---•------------------I 1918! 4�G-8B3i ! COMPANY A USF S G I I I LETTER ` ------- -- ----------------------- -- ----- ........ ---------------------------------------- ! COMPANY B I INSURED I I I LETTER --------- !------------------------------------------------------------- ---I 1 UESTERN 6E0-EN61H£ERS, IHC. I CDM:ANY C i 1 P.O. BOT 54 1 LETTER -- ------ --- ---- --- -I I CDLIISA, CA 95932 I--- ---------------------------------------------- I I COMPANY D I I LETTER ._:__-_. ICOMPANY E .i i - --- ----------------- ------------------------------ i t LEITER COVERAGES r:ez:*nz�rrr=nxrzo:::..c.c:xzeoc:q:.:r::::. xtenaznssccccxzax:::::.mex::::: :e:.-.-.cra..o.o.azs.xxn�::.:a. I I 1418 I5 TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I INDICATED. HGlU1iN51A.'ID1H0 ANY REQUIREMENT TEAM OR CONDITION OF ANY CONTRACT OR OTHER DDCUMENT WITH RESPECT TO WHICH THIS I I CERTIFICATE MAY BE ISSUED OR HAY i'ERTAIN TIE IN5URANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, i I EXCLUSIONS, AHI* CONDITIONS OF 56CH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ------------- ------ -------•-----------_-_ ......------... ------------------- ----- - --------------------------------------------- { 1 POLICY I POLICY ! ICO I I IEFFECTIVE IEXPIRATIO!! ILIH! TYPE OF INSURANCE I POLICY NUMBER I DATE I DATE I ALL LIMITS !N iNra15AHD5 ! l---l--------- --------------------------i.._. I ---1 I 1 GENERAL AGGREGATE i I { 1 GENERAL LIAHILIlY I { I PRODUCTS-COMPIDPS ABGIEGATE t t i I I I COMISCIAL GENERAL LIABILITY E ! ! I PERSOIIAL h AOVERTISIN'J INJURY f I I 1 [ I [ J CLAIMS MA9E I I OCCURRENCE I I I EACH OCCURRENCE ; I ! I I I OWNER'S & CONTRACIOR5 PROIECTIVEI I I I IE I I I FIRE DArAGE (ANY ONE FIRE) i ! I J I I I 1 MEDICAL EXPENSEIAHY ONE PER54N)i 1 --------------- -------- -------------I----------I----------I---------------•----------------------------I I i AUTONOBILC LIABILITY ik ! k I CSL I i iI ] ANY AUTO I I ! I---------------'1----____...-.-! i 1 [ I ALL OWNED AUTOS I ! 1 I BODILY ]R]llRY I I ! I 1 E J SCHEDULED AUTDS i ! I ! IPER PERSON! ! S I I I I I I HIRED AJToS I I I----------------)"".-----».---"I ! ! 1 [ I HON-OWNED AUIOSI ! I I BODILY INJURY I I i I I I I GARAGE LIABILITY t i I 1 IPER ACCIDENT) I i I I -'- --T- - - : _ k I l----------------I--------------I r 1 PROPERTY I I I I I I DAMAGE I t ! E i---------------- - -i- _-_._.--i-........_I i I---l-------------------------------------- I ERCH OCCURRENCE ! 45SHESAIE I I EXCESS LIABILITY T ! - I----------------- i 1 [ T UbDRELLA FORM 1 _I ____._.E i 1 1 ! [ I OTHER THAN UMBRELLA ------------------------------ ----------------- ................. --- -------..... 1----------k--�--------I------------------ ---I--------------"`•-' I r ! I STATUTORY I T A I WORKERS' CDMP€NSAIION 1744323588 10414!18@ i 04101184 i--"'.'s'"'» Y1044 - {EACH ACCIDENT) I EMPLOYERSAND 1' LIABILITY I 1 I I I f 1400 (DISEASE-POLICY LIMIT) 1 ! 1 I I r f 1000 (DISEASE-EACH! OTHEREMPLOYEE)i --- ------- .___.,. .-- i . . ................i----------i-___.._._-i---------------- I I I i I I I I I I1 I I I ----------- -------- •-------------------I---- - k-----_- -_--- i DESCRXPIIOH OF OPERATIONSILUCATIOHSIVEHICLESISPECIAL ITEMS i I I I ! i ! ! CANCELLAIION CERTIFICATE HOLDER I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T 1 I PIRATIQU DATE THEREOF, THE ISSUING COMPANY DILL xxxxxYxxxYK MAIL I CITY OF 5TOCK70H I 34 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER MANED TO THE I R19K MANADEMENT DIVISION 1 LEFT. xYXX%kKxYkYYYYYYXKKx XxxxXXxxXyxxxYxxxxY%%XxXxXMxxXx Yximix- Y m 1 CITY HALL l xYYXxYxxX%xxxXxxxxxKXxxkxkxxxxxxxxxxxxYxYxYX%Xx%xYxxKxxKxxXXYxxXxxYxxY+-i I STUCKTON, CA 95202 ---------------------^---------------- ! I AUTHORIZED REPRESENTATIVE - ! I ------------------ I -------------------------------------------------------------------------- ----------- ---------- - ----