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<br />ACORD' CERT,FICA TE OF LIABILITY INSURANCE DATE {MMIDDIYY) <br />_', -..,-'... Tlol . ' 05/17/2001 <br />PRODUCER (714)939-0800 FAX (714)939-1654 ONLY AND 'CONFE'~~ NO RIGHTS UPO~ ~~~ CERTIFICATE <br />Cal-Surance Associates, Inc. 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; OnSite 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 />sa~:.:Re SP~ CA 90670 INSURER 0: <br />~ 'J''': ~--"D) INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING <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 />LTR TYPE OF INSURANCE POLICY NUMBER DATE IMMIDDrrl)E DATE (MMlDDrVY) LIMITS <br /> GENERAL LIABILITY 35755795 10/01/2000 10/01/2001 EACH OCCURRENCE $ 1,000,001 <br /> >x COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100 , OO( <br /> I CLA.IMS MADE [K] OCCUR MED EXP (Anyone person) $ 1O,00( <br />A PERSONAL & ADV INJURY $ l,OOO,OO( <br />- <br /> GENERAL AGGREGATE $ 2,OOO,00( <br /> - <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 <br /> I ,nPRO. n <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY 73260159 10/01/2000 10/01/2001 COMBINED SINGLE LIMIT <br /> f-=- (Eaaccident) $ <br /> X ANY AUTO 1,000,000 <br /> I-"- <br /> ALL OWNED AUTOS BODILY INJURY <br /> f- $ <br /> SCHEDULED AUTOS (Per person) <br />B X <br /> HIRED AUTOS BODILY INJURY <br /> X $ <br /> NON-OWNED AUTOS (Per accident} <br /> -'..:. <br /> PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> GARAGE LIABILITY AUTO ONLY. EA ACCIDENT S <br /> ~ ANY AUTO OTHER THAN EA ACC S <br /> AUTO aNL Y: AGG S <br /> EXCESS LIABILITY EACH OCCURRENCE S <br /> ~ -OCCUR 0 CLAIMS MADE AGGREGATE S <br /> S <br /> ~ ~EDUCTIBLE S <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND 046016606 01/01/2001 01/01/2002 X I TORY L1~''fS I TI,\" <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 <br />C EL DISEASE. EA EMPLOYEE $ 1,000,000 <br /> E.L. DISEASE. POLICY LIMIT $ 1,000,00C <br /> OTHER <br />DESCRIPTION OF OPERATIONSJLOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDQRSEMENTfSPECIAL PROVISIONS <br />SANTA ANA POLICE DEPARTMENT, CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS & <br />REPRESENTATIVES ARE NAMED AS ADDITIONAL INSURED <br />*SUPERCEDES CERTIFICATE DATED 4-20-01** <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY W1LL~ MAIL <br /> SANTA ANA POLICE DEPARTMENT ~ DAYS WRiTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> ATTN: BETTY DANG, CLERK OF COUNCIL IllXIll*J{)(~K)(I'JI.9OO(9l~M!lXl){J1Jl)lllll(~J{JOO( <br /> P.O. BOX 1988 M-30 Jl";:~ ~9Ill0llfJ(IOOOlllJro()()(XXXXX <br /> SANTA ANA, CA 92702 AUTHORIZED REP <br /> Crain Lewis <br /> J -':::1-;) lll~fJ , """...... I ,....u... <br /> - <br /> <br />FAX. (714)647 6515 <br />