PROOF OF INSURANCE (2003) CLOSEDcERTIFICATE OF INSURANCE
UNIVERSAL t)NDERWRITERS INSURANCE COMPANY
P
7045 College BuWevard -- pverlapd Park, Kansas 66211
hereby certifies that the following insurance policies have been issued on behalf of'.
Name of Insured lV(`rty ss
Address of insured 1730 W
'uto Inventory Physical Damage, which includes
iarageKecper's Legal Liability
:,,rage gperations and Auto Hazard including
jenerai Liability
Drttbrella
t :ity of F.1 Segundo is named as additional insured on
the above coverage parts, but only as respects the
negligent acts of our Insured.
234765A
234765A
234765A
04101/03 —()4/01104
04/01/03 — 04/01/04
04/01/03 — 04/01/04
UU3308 (9.82)
$500,000
$1000 deductibles Comp
$1000 deductibles Collision
$300,000
$1.000,000
This Certificate of insurance neither affirmatively not negatively amends. extends or alters the coverage aftbrded by the polities liatcd
above which have been issued by this Company. will endeavor to give 30 days
in the event of any material change in. or cancellation of, Said policies, the undersigned company
written notice to the party to whom this certificate is issued.
Certificate of insurance prepared for: Name
This certificate is not valid unless countersigned by an authorized representative of the company.
J /J
Date APr1l W? _Countersigned by Authorized Represeotative
Z101262C City of p Segundo-repair
6
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.•INK . �� , ��;� 4 t 06PM DODSON GROUP
Casualty Reuprocal Exchange(nerem oaued v%@ company)
9201 STATE LINE ROAD
r.l+rr KANSAS CITY, M,SSOURI 64114
"'amed Marcy's 3mw (rra_ty'3 Foreign
�«JO rp 56 _= Td"•CJ. .% eGSGi
NO. 51134 P.
CERTIFICATE OF INSURANCE '. „*
k.
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THIS CERTIFICATE IS IsBURD AS A MATTOR OR INFORMATION ONLY AND
CONKRS NO RIGHTS UPON THE CERTIFICATE HOLLER WE
CERTIFICATE DOES NOT AMEND, V TRNO OR ALLM TI1L COV8RA13�.
AFFORDED BY THE POLICIES BELOW.
THIS IS TO CERTI FY THAT POLICIES OF INSURANCE LIMO BELOW HAVE MEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED
NC7W!TH6TANDIW AN' REQUIREMENT, TERM, OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REBFEOT TO WHICH THIS COVIRICATA MAY M 13aWI1D
Oa UAV PERTAIN 'HE iNSURANOE AFFORDED BY THC POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH
�OuCIQS, ,
MI$CELSN60US INF0FZ,MA'T'10N
C4SCRIP7K -)N OF ON CFAT1ONSrLOCATIONSNEHICLE36k�STRICTION "PECWL ITEMS
-'S �w,; or any, c tef l91 crange Ir', a cancellatiDr, cf bald Pallcles, the company will endsayorto Dtue SO days written notice t0 the party to whom this cartIftate Is
s 6�eC Dui fBnUfb IO Qlve OL {h n0VC0 97911 IMD09A no obligetlon nor liability Upen the cornpany.
- ER'IFICgI E 15 uED T0; Dated, 3/26/03
POUCY
P01.ICY
TYPE OF INSURANCE i
POLICY NUMBER
EFFiCT”
EXPIRATION
ALL 14MIT8 IN THOUSANDS
DATE
DATE
"�
o5t4ERAL J^E urr
CEPrIAALACGF);GATE
PItO9YCTSCOM?0PBAGG"GATIE
_ 00414RCA• 06No+µ WAOILrrr
130140HALApVORTIRINO wURY
_ cu MAD1_ O CL�.R%NCE
EACH OC"ROME
OW%k R6 COMPACTORS PA07VCTIVF
fife DAMAGE wy Oro fn)
MEDICAL EXPENSE (Any One Panan)
A-U10UC6ILE LABIV^
CtL
_ .c:teLULE7 WTOS
BODILY IWURY FMP*NM
�wawNGO nu �i
BODILY INJURY QPaf AWdMQ
G.� RAC,F i lr9l !TV
PROPERTY DAMAGE
CE.EoE.Qy
PMITZ
OCDUCTIOLEi
COMPR9iRN,
_ .,i�T PAVAMti
iFEG CAUSES
�t�ec' I�cESS
COWspN
C+ i SS L'AyLlTv
sACH ocouRfacNCE
A00AiCATd
.1/ORKER'S r,OV9FNSA ^oN
1000 EACHAOOICENT)
kNE
wCP :09344? oa
6/1/02
Q /1 /C]
1000 .
llltli� PCLICYUM
FMR OvER'S LWBtL!TV
1000 011 W E EACH IMPLOYBB)
MI$CELSN60US INF0FZ,MA'T'10N
C4SCRIP7K -)N OF ON CFAT1ONSrLOCATIONSNEHICLE36k�STRICTION "PECWL ITEMS
-'S �w,; or any, c tef l91 crange Ir', a cancellatiDr, cf bald Pallcles, the company will endsayorto Dtue SO days written notice t0 the party to whom this cartIftate Is
s 6�eC Dui fBnUfb IO Qlve OL {h n0VC0 97911 IMD09A no obligetlon nor liability Upen the cornpany.
- ER'IFICgI E 15 uED T0; Dated, 3/26/03
UNIVERSAL UNDERWRITERS R GROUP
1920 Main Street, Suite 950, Irvine,
C 3!a • �is +d S �-q Olga Richards/Dealer Sales Division
F,-Mail Address: oiga.richards@zurichna.com
04-7 q.1 urns Ph 800/435 -8342
47000 F 03
ax 949/838 -0305
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