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Client#. ' - '36 FULLMCON3 <br />ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (M03/01/3/01/M/DD/YY) <br />04 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Comml Support - Irvine ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />SullivanCurtisMonroe #0721187 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />2100 Main Street, Suite 350 <br />INSURERS AFFORDING COVERAGE <br />Irvine, CA 92614 <br />-INSURED INSURER A: Peerless Insurance Company <br />Fullmer Contract Furniture INSURER B: Golden Eagle Insurance Company <br />400 N. Tustin Avenue INSURERC: Zenith Insurance Company <br />Santa Ana, CA 92705 INSURER D: Fireman's Fund Insurance Company <br />INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />m-1 --Cn nV vain!"1 AMA -- <br />NSR I <br />LTR TYPE OF INSURANCE POLICY NUMBER <br />POLICY EFFECTIVE POLICY EXPIRATION <br />DATE MM/DD/YY DATE MM/DD/YY <br />LIMITS <br />A I GENERAL LIABILITY I CBP9821629 <br />03/01/04 103/01/05 <br />EACH OCCURRENCE $1 000 000 <br />iCOMM ERCIALGENERAL LIABILITY <br />I <br />FIREOAMAGE(Anyonelire) $SOO,000_ _ <br />_ <br />CLAIMS MADE '` X I OCCUR <br />I <br />M� ED EXP (Any one person) �-$�5OOO - <br />'PERSONAL <br />&AD V INJURY '�, $1 000000 --.. — <br />GENERAL AGGREGATE $21000,000 <br />GEN'LAGGREGATE LIMIT APPLIES PER: ; <br />LLRODUCTS -COMP/OPAGG $2,000,000 <br />PO - <br />1 POLICY .j JE T F-1 LOC <br />A , AUTOMOBILE UABIUTY ICBP9821629 <br />103/01/04 <br />103/01/05 <br />I <br />COMBINED SINGLE LIMIT , $1,000,000 <br />(Ea accident) <br />X ANY AUTO <br />I <br />- ---r------- <br />ALL OWNED AUTOS <br />I <br />BODILY INJURY I $ <br />61 <br />- - <br />person) <br />SCHEDULED AUTOS <br />I <br />I—-- <br />-I------------------ <br />X HIRED AUTOS <br />I <br />I <br />BODILY INJURY b <br />_' <br />I <br />accident) <br />t- <br />X NON -OWNED AUTOS <br />_ <br />L -- -------- - <br />- <br />PROPERTY DAMAGE $ <br />/ <br />(Per accident) <br />GARAGE LIABILITY � <br />I <br />! <br />AUTO ONLY - EA ACCIDENT $ <br />�--------_-- - - <br />ANY AUTO <br />1 <br />OTHER THAN EA ACC i $ <br />AUTO ONLY: AGG I S <br />B LIABILITY CU9822929 <br />03/01/04 <br />103/01/05 <br />LEACH OCCURRENCE_ I$10,000,000 <br />EXCESS _ <br />X OCCUR CLAIMS MADE <br />i <br />I <br />AGGREGATE _ $10 0 00 00 0 _ <br />r$ <br />— - <br />I <br />DEDUCTIBLE <br />--------------i S ----- - - - <br />RETENTION $ <br />C WORKERS COMPENSATION AND 2065461501 <br />01/01/04 <br />I 01/01/05 <br />WC STATU- OTH- <br />TORY LIMITS___ ER <br />EMPLOYERS' LIABILITY <br />' EI_. EACH ACCIDENT S1.,000,OnO <br />E.L- DISEASE_- EA EMPLOYEE_] S1,000,000 <br />j <br />EL DISEASE -POLICY LIMIT , S1,000,000 <br />D OTHER Comm'I Exces XTM00076332626 <br />03/01/04 <br />103/01/05 <br />i <br />$5,000,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />** Supplemental Name ** <br />Fullmer Contract Furniture & Services <br />Contract Furniture Installation Services, LLC <br />(See Attached Descriptions) <br />CERTIFICATE HOLDER j ADD ITIONAL INSURED; INSURER LETTER: Ien LJdy P4011QUV - r <br />— i <br />SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />City of Santa Ana Community DATE THEREOF, THE ISSUING INSURER WILL%)( X)p MAIL 3-0 DAYS WRITTEN <br />Redevelopment Agency NOTICE TOTHE CEhRFICATE HOLDER NAMED TOTHE LEFT, a)(TyQx11RR>tI3)QSQY6&SiDiAd)CXX <br />20 Civic Center Plaza M-21 IV1PC96)C79J�QE9CXiAi)C><-0AAGxDWOXGCXR6C7COCyC71Dt0[JOlC4tDC7CDCOC)lD6%QAROUQl6XVGXlQ7Cx416iX� <br />P.O- Box 1988xxx <br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE J <br />nr-non '3r, -4Z 17ro7% 4 -41) �t,econn _ K <br />D CORPORATION 1988 <br />