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<br /> A,- b(Hi -n. . <br />..~90RQ. .CERTIFICATE OF LtABILlTY INSURANCE DATE (MMIDDIYY) <br /> 04/20/2001 <br />PROOllCER (714)939-0800 FAX (714)939-1654 . , THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Cal-Surance A~sociates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />PO Box 7048 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />333 City Blvd., West, Ste. 400 INSURERS AFFORDING COVERAGE <br />Orange, CA 92863-7048 <br />INSURED CalPac, LLC; OnS,te Fabricators, LLC INSURER A: Great Norhern Insurance Co. (Chubb) <br /> DBA: Onsite Furniture Service INSURER B: Federal Insurance Co. (Chubb) <br /> 9200 Sorenson Avenue INSURER c: State Compensation Insurance Fund <br /> Santa Fe Springs, CA 90670 INSURER 0: <br /> I ~'n.,....l1 L< 1'7'~ . - ~ INSURER E: <br />COVERAGES fI U <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 />POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR TYPE OF INSURANCE POLICY NUMBER P~k.li~.~f.~6~ POLICY EXPIRATION LIMITS <br />LTR <br /> ~NERAL LIABILITY 35755795 10/01/2000 10/01/2001 EACH OCCURRENCE S 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,000 <br /> I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 10 . 000 <br />A PERSONAL & ADV INJURY $ 1,000,000 <br /> - 2,000,000 <br /> - GENERAL AGGREGATE $ <br /> ~.~ AGG~EnE ~L1MIT APr~~t IPER: PRODUCTS - ceMP/OP AGG $ 2,000,000 <br /> POLICY ~:gi LOC <br /> ~OMOBILE LIABILITY 73260159 10/01/2000 10/01/2001 COMBINED SINGLE LIMIT <br /> ~ ANY AUTO (ElIsccidenl) $ 1,000 000 <br /> - ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEOULED AUTOS (Per person) <br />B X <br /> HIRED AUTOS BODILY INJURY <br /> X (Peraccidenl) $ <br /> - NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> R^GE UABILITY AUTO ONLY. EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS UABIUTY EACH OCCURRENCE $ <br /> P.OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND 46016606 01/01/2001 01/01/2002 X I To*-i'm.1N. I IOJIt <br /> EMPLOYERS' LIABILITY EL EACH ACCiDENT $ 1,000,001 <br />C l,Ooo.OO( <br /> E.L. DISEASE. EA EMPLOYE $ <br /> EL DISEASE. POLICY LIMIT $ 1 000 001 <br /> OTHER <br />DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONSADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />SANTA ANA POLICE DEPARTTolENT, CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS .. <br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED PER FORM 80022305 ATTACHED. <br /> APPROVE') AS TO i~,--",l"'" <br />*10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM ~ ~ , <br /> { - <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LEnER: CANCELLATION M C ael V jullOwJ <br /> SHOULD ANY OF T~'" ~IESlQftGt.JQBI BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> SANTA ANA POLICE DEPARTTolENT 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> A1TN: BETTY DANG, CLERK OF COUNCIL BUT FAILURE TO MAIL SUCH NOTICE SHALl-IMPOSE NO OBLIGATION OR LIABILITY <br /> P.O. BOX 1988 M-30 OF AllY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE ~~" L:? <br /> Crain Lewis ' <br />ACORD 25-5 (7197) FAX: (714)647-6515 ~ /' CORPORATION 1988 <br />