|
9 4
<br /> 71
<br /> • St; IT
<br /> --ATE'"i 1 (/_ 4tie•i 5,.\i•1Y 1,4 1 .4) •'lK t MMIDD:A.. )•d
<br /> '•IssuE
<br /> .rnvtxa;.r '4 '•::�'1'Cts�.�: ir.,.,��-.^k;.'cr �s. .,� t� �tt: ,Q�+� ,'pf,Kiut $,6'R, '2't.Kbk4r'1„", t,.`'( rl :•• ,,,: y OAT MID
<br /> �•, E(M p/YYI
<br /> PRODUCER
<br /> e: ct.i'^.1��!}'f•3.'1:?.«.... s ,,,x/F':;:���e t.'1 t7 / tt
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
<br /> DICK •HARRIS INS . AGY , , A CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
<br /> AFFILIATE OF GRAM I'C E INS DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br /> P-0- BOX 660178
<br /> POGCIES'BELOW:' s
<br /> SACRAMEP•11'0, CA.
<br /> COMPANIES AFFORDING COVERAGE
<br /> 95866
<br /> 916-973-0772 ! COMPANY
<br /> • i LETTER �A
<br /> T-0 PA
<br /> COMPANY B
<br /> INSURED .......-.�_......._.-___.._..._.
<br /> LETTER
<br /> ARONSON EVIG I NEER J.i'10-• 1 rlC (aP,lD COMPANY
<br /> LETTER
<br /> MICHAEL J. 4RONS0I.I ,. .I11D ------ - L- ST-STATED-ARE----"
<br /> j COMPANY .—
<br /> 6804 MC COMBER S I'i�f=[ T LETTER D
<br /> ____._.._._._r.._.._......._ AT POLICY INCEPTION_--.
<br /> SACRAMENTO, CA 958^c8 i COMPANY --
<br /> LETTER E. c
<br /> 7LNDA
<br /> �a��.:�.+�:�•'�.�'+�<�'��Ia6L'✓.;.•.t�S/.d:�w..}.I�w�w!:..i:.4,ws .r�11�1h, iy�.. �s�,?Y
<br /> IS
<br /> ERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED
<br /> 'NAMED ABOVE FOR THE POLtCYr�V
<br /> NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> E MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br /> j
<br /> S AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY.PAID CLAIMS.
<br /> —
<br /> cc L .__ ___ ___.. —.
<br /> LTR' TYPE OF INSURANCE ! POLICY NUMBER 'POLICY EFFECTIVE!POLICY EXPIRATION!
<br /> DATE(MM/DDNY) i DATE(MM/OD/YY) LIMITS
<br /> I GENERAL LIABILITY
<br /> 'I
<br /> ! ! I IGENERAL AGGRE7�R
<br /> S I
<br /> 1 ICOMMEACIALGENERALLIABILITY ^ r --- Gfrt(1CUo-0--
<br /> A a
<br /> CCP' 21 55 09 { + " -
<br /> I ":Y a1 ;CLAIMS MADEi OCCUR.! 0c O6/93 02/0 6/44'PRODUCTS.COMPS
<br /> __�: t
<br /> OWNER'S b CONTRACTOR'S PROT.! ! l _ �`,C,(,�0$1 , 000PROPLI:'1'1PERSONAL S
<br /> DAMAGE EACH OCCURRENCEVS�U
<br /> _
<br /> DEDUCT .U C 1 !FIRE DAMAGE(Any one fire) i S I
<br /> f nTIA
<br /> AUTOMOBILE LIABILITY MED.EXPENSE(Any Ong person);S SOC)
<br /> ANY AUTO ;COMBINED SINGLE E
<br /> [LX X TALL OWNED AUTOS t j ? 'LIMIT S
<br /> A�SCHEDULED AUTOS :BODILY INJURY —
<br /> 1 CCP 21 55 09
<br /> ; (Per person)AUTOS 02/fb/q� 02/06/�4 .
<br /> NON-OWNED AUTOS
<br /> -Js
<br /> _._.._"_...''_—. — —•
<br /> `10 DAY N0110E OF I ': BODILY INJURY
<br /> GARAGE LIABILITY ! j (Per accident) !S
<br /> CANCEIJA71ONAPPl1ES
<br /> I l
<br /> FOR ItlON•PAYMENTOF i l PROPERTY DAMAGE — _ —
<br /> EXCESS LIABILITY is I
<br /> 4�UMBRELLA FORM EACH OCCURRENCE i S
<br /> OTHER THAN UMBRELLA FORM c AGGREGATE S f
<br /> !
<br /> OR - �l. tea n9 4.;..,
<br /> I" • 'WORKER'S COMPENSATION
<br /> A
<br /> I
<br /> AND , t lJ !STATUTORY LIMITS I:
<br /> 1 '.14/31_'. 931 04/30/941 EACH ACCIDENT ~
<br /> EMPLOYERS'LIABILITY
<br /> 1 DISEASE—POLICY LIMIT S
<br /> --—
<br /> OTHER - i---_LOS�t�C�O_0
<br /> DISE _
<br /> , ; ASE—EACH EMPLOYEE
<br /> is
<br /> SCttl (lt
<br /> n
<br /> Al. INSTALLATION CPi
<br /> CP215509 j
<br /> 'COVERAGE 10'/2u/93i 02/06/94 $61_) �-
<br /> l ,000 PER JOBSITE
<br /> 00 $60,000 PER DISASTER
<br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS P N T I.1-' 1 n j('
<br /> TFM ''•
<br /> ADDITIONAL INSURED AS RESPECT GENERAL_ LIAHILII'Y PER GECG840 ATI LOCATION
<br /> 871—DIUI #82
<br /> RE:FUEL TANK UPGRADE 65080•. ' ACHED
<br /> AD1D IdAI�T>JRT
<br /> ;CERTIFICATE:HOLDER OT' S JRROGAT.IOAT PER
<br /> ,.,;_ _. ;,1.:-,.. ;:r;i.�.t"a:. ' 'y��ICANCELLATiON, '' ,, .a• r, �;t;-,:,.,;.
<br /> SHOULD ADESCRIBED POLICIES BE CANCELLED BEFORE-THE
<br /> t REGENTS NY.OF THE OF THE UI•d i' V OF CALIF & �,;" ABOVE ri
<br /> °••LAWRENCE LIVERMORE.' FIAT LAB �a EXPIRATION..DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO }
<br /> -U-S- -DEPT OF 'ENERGY MAIL 210 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br /> P'O' .-SOX 5502 G LEFT,•BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br /> °$ ,
<br /> �17
<br /> LIABILITY OF ANY KIND UPON THE COMPANY•ITS AGENTS OR REPRESENTATIVES.
<br /> LIVERMORE, CA . .gL1551 ORIZED REPRESENTA IV NDA HAMPT�/ J J!
<br /> ;AC D 51S7 __T. r
<br /> �. 'tK' "^ t+•,,wirwr., v/nrt !•rv.c..l'� .r,..�,.� .,
<br /> C CA II\ i h.� 't•' b -.'•V �'.7•TT^V f�VSV
<br /> f J 1.>r..7 '.r �'J;: �t� .)...? 1 i.J.1 )'r�.'`1'rt'r'S •yr f.- Y,._.._.... .. _r..........._..--_..«..,.,r.�._
<br /> Q7ACORD...
<br /> CORPOR..ATION 1990
<br />
|