C.T.

MALE ASSOCIATES CTMSpec

WESTMERE FIRE DISTRICT Overhead Door Replacement

SECTIO& 00$2 $ % CERTIFICATE OF I&S'RA&CE FORM ATTAC(ME&T )A*E

. A.

I&S'RA&CE RE+'IREME&TS The ,-cce,,.-l /0dder ,hall prov0de1 pa2 .or1 and ma0nta0n ,-ch 0n,-rance a, 30ll protect the We,tmere F0re D0,tr0ct and the ,-cce,,.-l /0dder .rom cla0m, -nder Wor4er, Compen,at0on Act, and amendment, thereto. The ,-cce,,.-l /0dder ,hall pa2 ,alar0e, and e5pen,e, o. 0t, emplo2ee, and ,hall per.orm all o/l06at0on, and d0,char6e all l0a/0l0t0e, 0mpo,ed -pon emplo2er, -nder ta51 la/or1 3a6e ho-r1 3or4er, compen,at0on and 0n,-rance1 ,oc0al ,ec-r0t21 and an2 and all .ederal1 ,tate1 co-nt21 and local la3, and re6-lat0on,. The ,-cce,,.-l /0dder1 at h0, e5pen,e1 ,hall at all t0me, carr2 l0a/0l0t2 0n,-rance 0n,-r0n6 h0m,el. and the F0re D0,tr0ct 30th l0m0t, a, .ollo3,7 . Wor4er, Compen,at0on In,-rance7 a. Stat-tor2 /ene.0t, /. Emplo2er8, L0a/0l0t2 9 at lea,t :2#01000.00 2. Commerc0al *eneral L0a/0l0t2 ;0ncl-d0n6 Contract-al and )er,onal In<-r2 L0a/0l0t2=7 a. : 10001000 Each Occ-rrence :210001000 A66re6ate /. L0a/0l0t2 covera6e 0n the amo-nt o. at lea,t :2#01000 .or each occ-rrence1 cover0n6 a d0rect lo,, o. propert2 or mone2 o. a cl0ent ca-,ed /2 d0,hone,t act, o. the ,-cce,,.-l B0dder>, a6ent or emplo2ee, .or 3h0ch the ,-cce,,.-l B0dder 0, le6all2 l0a/le. !. Commerc0al A-tomo/0le L0a/0l0t2 ;0ncl-d0n6 o3ned1 non%o3ned and h0red veh0cle,= a. : 10001000 Com/0ned S0n6le L0m0t ?. 'm/rella E5ce,, L0a/0l0t2 a. :#10001000 Each Occ-rrence /. :#10001000 A66re6ate The pol0c0e, ,hall name the We,tmere F0re D0,tr0ct1 0t, emplo2ee,1 and 0t, Board o. F0re Comm0,,0oner,1 and the Arch0tect1 C.T. Male A,,oc0ate, En60neer0n61 S-rve20n61 Arch0tect-re @ Land,cape Arch0tect-re1 ).C.1 a, add0t0onal 0n,-red,1 30th no re,pon,0/0l0t2 .or pa2ment o. prem0-m,. W0th the /0d propo,al1 the ,-cce,,.-l /0dder ,hall .-rn0,h to the We,tmere F0re D0,tr0ct cert0.0cate, o. 0n,-rance .rom an 0n,-rance compan2 a-thor0Aed to do /-,0ne,, 0n the State o. &e3 Bor41 and rated CAC or /etter /2 AM Be,t. The cert0.0cate ,hall prov0de a th0rt2 ;!0= da2 3r0tten not0ce o. cancellat0on o. ,-ch 0n,-rance.

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E&D OF SECTIO& 00$2 $

Attach 0n,-rance cert0.0cate, here.

DECEMBER 20 ! 00$2 $ %

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