|
<br /> ONLY AND CONFE.R8 NU K.:~':-: I::; UI"UN Inc; \.I¡:;;nI Il".'-'''''''' I
<br />~Woods , Grooms, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />1529 Washin~ton Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />IColumbus I. 41201
<br />Fone ~12-~7~-4435 Fax: 812-373-4445 INSURERS AFFORDING COVERAGE NAIC#
<br /> .
<br />INSURED INSURER A: Zurich America IneuranC8 Co. 0212
<br /> INSUR.ER B. Zurich ~rica Xn~ur.nca Cø~ 0212
<br />ì cummins Cal Pacific LLC ~E_RC:
<br />! 1939 Deere Avenue ----
<br />Irvine CA 92606 INSURER D:
<br /> INSURER E.
<br />
<br />[,^W,,""'.
<br />
<br />COVERAGES
<br />:H~ PC~;C!ES OF 1~URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTlMTHSTANDING
<br />:,~"/ ~~,::t.:¡¡=;=M!õ.Nr. l'ERM OR CONDITION OF ANY cONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />:.'.\y ?ËRTAIN, "!';~J:: INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI!'1 JS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDmONS OF SUCH
<br />pO'~IC\~. AGGREGAl'E LIMITS SHO\NN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />
<br />L Tft NSRIJ. TYPE OF INSURANCE
<br />,
<br />GENER,o\L LIABILITY
<br />:.X! COMMI:õRCIAL GENERAL LIABILITY
<br />enl -, CLAIMS MADE [JC] OCCUR
<br />l~; BrC?_~~- Form Liab
<br />~~icontractual Liab
<br />; GEN'L AGGREGAl'E LIMIT APPLIES pER
<br />X POLICY II jr8.; ¡ LOC
<br />
<br />I
<br />B:X
<br />I
<br />
<br />:3
<br />3'
<br />,
<br />
<br />i :?
<br />
<br />x
<br />
<br />, A.UTOM03lLE LI~BIL1TY
<br />:-.~
<br />}~ 'AN'( AJTO
<br />
<br />\' B rl ;"'-'- OWNED A.UTOS
<br />Çl SCHEDULED AUTOS
<br />I ;~ H\REO AUTOS
<br />B L~j NON-OWNED AUTOS
<br />B' f-xjAU1:<'3hys Dzunage
<br />, .
<br />t--t--.J:- GA~GE LIABILITY
<br />\ B i X !xl ,"V AUTO
<br />r-
<br />
<br />; EXCESSIUMBREllA LIABILITY
<br />:x--: OCCUR f1 '::-AlMS MADE
<br />
<br />;A
<br />
<br />i DEDUCT!BLE
<br />RETENTION
<br />
<br />
<br />.10 000
<br />
<br />WORKERS COMPENSATION AND
<br />, EMPLOYERS' UA81UTY
<br />¡ B ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />i OFï=ICERlMEMBER EXCLUDED?
<br />Ifyes.ðe9Crlt-eu~
<br />I SPECIJ,L PROV\SIONS helow
<br />OTHER
<br />
<br />A I Property Insurance
<br />
<br />POLICY NUMBER
<br />
<br />DATE aiM/DO
<br />
<br />DATE MMIDD
<br />
<br />LIMITS
<br />'1,000,000
<br />. Included
<br />. 5,000
<br />PIe.RSON..6.L&AOVINJURY $1,000,000
<br />GENERAL AGGREGATE $ 1,000, OO~--
<br />PRODUCTS-COMP/OPAGG $1 000,000
<br />
<br />GL0373102200
<br />
<br />03/01/04
<br />
<br />03/01/05
<br />
<br />EACH occuRRENce
<br />PREMISES Ea occurence
<br />MEO EXP (Anyone person)
<br />
<br />I
<br />,
<br />!
<br />I
<br />I BAP373102100
<br />
<br />\
<br />
<br />!
<br />I BAP373102100
<br />
<br />COMB1NED SINGLE LIMIT
<br />(EaacciOe¡\1)
<br />
<br />.1,000,000
<br />
<br />BODILY INJURY
<br />(Per person)
<br />
<br />'.
<br />
<br />03/01/05
<br />
<br />03/01/04
<br />
<br />BODILY INJURY
<br />{Per accident)
<br />
<br />.
<br />
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />
<br />.
<br />
<br />AUTO ONLY. EA ACCIOENT
<br />
<br />01 000,000
<br />0
<br />.
<br />.5 000,000
<br />'5,000,000
<br />'.
<br />
<br />03/01/05
<br />
<br />OTHER THAN
<br />AUTO ONLY:
<br />
<br />EAACC
<br />AGG
<br />
<br />03/01/04
<br />
<br />I
<br />I UMB373B80400
<br />,
<br />I
<br />I
<br />
<br />I EACH OCCURRENCE
<br />03/01/05 AGGREGATE
<br />
<br />03/01/04
<br />
<br />.
<br />.
<br />
<br />
<br />WC373102300
<br />
<br />03/01/04
<br />
<br />03/01/05
<br />
<br />.1000000
<br />.1000000
<br />$1000000
<br />
<br />--'
<br />
<br />E.L. DISEASE - EA EMPLOYE
<br />E.L. DISEASE - POLICY LIMIT
<br />I
<br />03/01/05
<br />
<br />I cpo3738B0300
<br />
<br />A
<br />
<br />03/01/04
<br />
<br />Spec Form
<br />RC
<br />
<br />!]ESCR~?TION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />! :' :-"':~91 ~ngine .sales and service. The City of Santa Ana, its officers,
<br />?~~?~oyees. agents, volunteers, and representatives are added as additional
<br />¡insureds for work performed, but only as respects to eummins Ca1 Pacific,
<br />¡LLC'S sole negligence. fax 714-647-6944 fax 949-253-60BO
<br />
<br />CERTIFICATE HOLDER
<br />
<br />DEPOTSA
<br />
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE ÐCPIRATION
<br />DATETHEREOF,THEISSUlNGINSURERWllbilill. ,rTOMAlL ~ DAY5WRmEN
<br />
<br />The Depot as Santa Ana
<br />carolyn Fu~lerton
<br />1000 East Santa Ana Blvd. #10B
<br />santa Ana CA 92701
<br />
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH'f LEFT, ilI:!Tr"n--¡-q~'" A- ""'A' I
<br />NM/oQU~"'" .....~, ,- ~-(ttl -R t 'Av1' -. -;~ "¡r' nfllil"--'I Till nl8"R-"'~ ITt] - -,'- ......
<br />
<br />ACORD 25 (2001108)
<br />
<br />2'd
<br />
<br />
<br />APPROVED AS T
<br />')
<br />
<br />w,.#~J
<br />@ ACORD CORPORATION 1988
<br />
<br />/
<br />
<br />¡ ~e ¡ Ll
<br />
<br />e~~:60 SO 02 uer
<br />
|