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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE <br />_ . TIl , <br />PROD'JeER (7i4)939-0800 FAX (714)939-1654 <br />(al-Surance Associates, Inc. <br />. PO Box 7048 <br />333 City Blvd., West, Ste. 400 <br />Orange, CA 92863-7048 <br />INSURED CalPac, LLC; OnSite Fabricators, LLC <br />DBA: Onsite Furniture Service <br />9200 Sorenson Avenue <br />Santa Fe Springs, CA 90670 <br /> <br /> <br />DATE (MMlDDNY) <br />11/21/2001 <br /> <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />INSURER A: <br /> <br />Great Norhern Insurance Co. (Chubb) <br />Federal Insurance Co. (Chubb) <br />State Compensation Insurance Fund <br /> <br />INSURER B: <br /> <br />INSURER c: <br /> <br />INSURER 0: <br /> <br />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. NOlWITHSTAND1NG <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 />11~.p: TYPE OF INSURANCE POLICY NUMBER DATE (MMfDDIYY) DATE (MM/DDIYY) LIMITS <br /> GENERAL L1AalLlTY 35755795 10/01/2001 10/01/2002 EACH OCCURRENCE $ 1,000,000 <br /> f-- <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ Included <br /> __J CLAIMS MADE [Xl OCCUR , MED EXP (Ai11' Ofie J}erson) , 10 , UOO <br /> .-- <br />A PERSONAL & ADV INJURY S 1,000,000 <br /> - 2,000,000 <br /> - GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 <br /> II 'n~RO- n, <br /> POLICY JECT LOC <br /> ~TOMOBILE LIABILITY 73260159 10/01/2001 10/01/2002 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Eaaccident) $ 1,000,00C <br /> -"- <br /> - ALL OWNED AUTOS BODILY INJURY <br /> {Per person) 5 <br /> SCHEDULED AUTOS <br />B - <br /> ~ HIRED AUTOS BODILY INJURY <br /> (Peraccidenl) $ <br /> ~ NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Peracciden1) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 5 <br /> ~ ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE . <br /> b OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION . $ <br /> WORKERS COMPENSATION AND 046016606 01/01/2001 01/01/2002 X I TORyl'MITS I ~- -- <br /> EMPLOYERS' LIABILITY . E.L EACi j AC'::;iDi::NT ., 1,000,000 <br />r <br />'- E.L. DISEASE - EA EMPLOYE $ 1,000,00C <br /> E.L. DISEASE. POLICY LIMIT $ 1,000,OOC <br /> OTHER <br />DESCRIPTION OF OPERATIONS/LOCA TIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL 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 11-5-01** <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 WILL~^~ MAIL <br /> SANTA ANA POLICE DEPARTMENT ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> ATTN, MARY CALDERWOOD-CHIECHI ~K)(~I()(~PIlIIOO@l)(JI)QJlllI~x.JlXX <br /> P.O. BOX 1988 M-30 JI~JlIOilllXX!'I!ll~~JOOm:~XXXXXX <br /> SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE ,# \ ~ <br /> Cra i a Lewi s .1' _;I1/IV<f <br /> i (flOf) FAX: 714 647-6515 f , ,... <br /> <br />( ) <br />