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<br />~C~RD CRT' 'CAT OF LIABILITY lNSURANd# W'Jl.v~I~O~')
<br />_____N 05/17/2001
<br />p",," (714)939-0800 FAX (714)939.1654 -- I"IITS"CEI\TTFICATEl'OISSUtOlrJliS',l("liI)\"Tre,;;-uF NFOIl1\IIATIO,.----
<br />ea' -Suranee A~5ociates, ~nc, ONLY AND CONFERS NO RIGHTS UPON HiE CERTIFICATE
<br />~ HOLDER, THIS CERTlnCATE DOES NOT AMEND, EXTEND OR
<br />PO lIox 7048 ALTER TflE COVERAGE AfFORDED I>YfHE POLICIES IlELOW.
<br />H3 City Blvd" West, Ste. 400 ----;;;~R~R$A~~ORtlIN~COVE;-~~-..-'-.-
<br />Orange, CA ~2IG}-7041
<br />l~u~lPac, L~OnSite -Fabricatorg';--o:C--'
<br />DBA! nsit Furniture Service
<br />9200 orenson Avenue
<br />Santa Fe Springs, CA 90610
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<br />IN';ul~--Greilt 'filii-her;;' rnsu;a~roCo:'-(Chubb)'--
<br />iNOuiitii'"~ae;:ar-il'-sur"iice Co.-' ((hublif'----..,-.--
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<br />TH POLICI.S OF INSURANC L15T.0 ow HA SEEN IS5UEb '1'0 THE INSURED NAMED ABOVE FeR Tl m ,,1i[,CY PcHIOD '''JlcATED Noii'ii'r,1S .ANDiNO
<br />AN< R"OUIREM!:NT. TERM OR CONDITIoN OF ANV OONTRACT on OTHER UOCUMCNr WITIl RE~PECT TO WHICH TH.>; CERTIFICATE MAY [t:i IE,SUEI) W
<br />MAY PERTIIIN, Tl1E INSVRANCE AFFORC[D BV T"~ PQLICI(S DE3CRi~ED H.R.IN IS S'JBJ~CTTO At L THE T.oMS. EXCLUSIONS AN\) CONDITIONS 0, sUCH
<br />POLICIES, AGGREGATE L1MI1'S SHOWN M^V HAV" ~E.N REOUC'" UV PAID CUlIMS,
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<br />I. R TlPEOI=IN!iUftANCE I"Q\,I~YNlIMis&;R bATE:(MPNOONYl O^lE,IMM1DD.l!.'H
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<br />OENEM"'AOI"'Y 5755795 -- 10/01/2000 10/01/2001
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<br />X COMM6~IALGENER"L LA6r..ITY
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<br />1'1 t}; rJ#l.M/l,CE (An' oVlh n(~l $ 100 000
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<br />N: r-:sON....L 3. f.J.'N INJlltlY li 1 000.00
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<br />AUTOMD"L~ L1AOIllTY 73260159
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<br />ALL OWNtD AUTO:;
<br />S.CHliDUlCO ",UTOS
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<br />, 10/01/2000
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<br />10/01/2001
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<br />RETENTION S
<br />WQRI<<i.AS toMPItNSATION AND
<br />EMPLOYERS'UA61U1V
<br />
<br />46016606
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<br />01/01/2001 -'ill/Ol/20028::G.'O~y'tiUN~~C!Dr1II ====-=
<br />f"t. EACH,\CC10C:.NI', $ L 000,00
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<br />cJCCUJ\ 0 CLAIMS fAAOO
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<br />IIEPRESENTATIVES ARE NAMED AS ADDITIONAL INSUREll'PPK l~
<br />
<br />'.SUPERCEDES CERTIFICATE DATED 4-20-01'''' .Ji1~ J).. ~....
<br />Michael VigliDtla ,
<br />ADDtrlONAL IN.SURCDj IN$UfU:R 1.e.1 TF:R ,D;pu ty ($JIJI'(ClRL~T~.....-
<br />8HOULO ^NY OF 'nIl: ^\3OV~ Cl!stRlP,[;.D ro'UClbS Ill!: CAttCilLtCl f.\t:;tORt THIe.
<br />r;;~IRAtION DAU "tHiRtDf, lHE I:sSUINO '::OMPI\N'l WiLl~ MAr\.
<br />j.O~_ DA"'$W~ITT~N ~OTlc.E 'ro 1t-tG. CI!Rllj.:ICA fe HOlOtH I'IA\1t" 1"0 me t,rr-'f!
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<br />
<br />SANTA ANA POLICE OEPARTMENT
<br />ATTN, BETTY DANG, ClER~ OF COUNCIl.
<br />P.O. BOX 1988 M-iO
<br />SANTA ANA, CA 92702
<br />
<br />@AI.>--o
<br />
<br />F~;" (714)641-6515
<br />
<br />GalLO 'd
<br />
<br />'ON Xli.:!
<br />
<br />Wd 80:10 nHl 100G-LI-AliW
<br />
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