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<br />I 17- ;2 C,lf);;; ~ ;; I ~
<br /> ACORD m CERTIFIC.E OF LlAB I~ITY INSU.\NCE DArE IMMIDOIYY)
<br /> 2/21/2003
<br /> PRODUC"R The Master Insurance Agency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> 18053 VALLEY BLVD ONLY AND CONFERS NO RIGHrS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> CITY OF INDUSTRY CA 91744 INSURERS AFFORDING COVERAGE
<br /> (626) 854.9541
<br /> INSURED INSURER A Everest National Insurance Company
<br /> SOFTMASTER INC. INSURER B
<br /> 20640 OAK CREST DR. INSURER C ,~
<br /> DIAMOND BAR, CA91765 INSUR,R 0
<br /> INSURER'
<br /> COVERAGES
<br /> ¡~~ ~~g3:~~~:~~,S~E,,:~g~ ~~~EciiTig~o01 ~~~~~~~~~~ug~ Ò~:~~ 6~~UJ ED NAMED ABOVE FOR THE POLICY PERIOD INDICATED- NOTWITHSTANDING
<br /> ENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE I IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA '.S.
<br /> ,~.¡': TYPE OFiNSURANCE ! . POLICY NUMBER LlCY EFFECTly,E I. POLICY EXPI,,{,..'1°N _LIMITS
<br /> ATEIMMIDDIYY) DATEIMMIDDIYY)
<br /> ~NERAL LIABILITY I EACH OCCURR'NCE S
<br /> COMMERCIAL G'NERAL LIABILITY i FIRE DAMAGE (Aoyo", ""I ,
<br /> ==:J CLAIMS MADE 0 OCCUR liMED EX~;;; 000 pa"ool ,
<br /> I PERSONAL &ADVINJURY ' ,,-
<br /> GENERAL AGGR'GA TE S
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG ,
<br /> =:J 0 PRO- 0
<br /> POLICY JECT LaC
<br /> c""TOMOBILE LIABILITY COMBINED SINGLE LIMIT .
<br /> ANY AUTO (" ",ldoo')
<br /> ~ --
<br /> ~ ALLOWN'DAUTOS BODILY INJURY
<br /> SCHEDULED AUTOS (P" ""00) .
<br /> ~
<br /> ~ HIRED AUTOS BOOILY INJURY
<br /> NON-OWN'D AUTOS (P" ""idool) .
<br /> c----
<br /> ~ Lì) \. ,0 !OR]\) PROPERTY DAMAGE $
<br /> (P,,'co,d.ol)
<br /> ~RAGE LIABILITY ~<.Þ.2LW" - AUTO ONLY.. EAACCIDENT S
<br /> ANY AUTO ........~--- I--- OTHER THAN EAACC '
<br /> ; " ,."".." AUTO ONLY' AGG $
<br /> EXCESS LIABILITY ; -'-'I"" EACH OCCURR'NCE S
<br /> :::J OCCUR D CLAIMS MADE AGGREGATE $
<br /> $
<br /> 1 DEDUCTIBLE $
<br /> RET'NTION $ S
<br /> WORKERS COMPENSATION ANO X I T~2J[~Ws I 10JIt
<br /> EMPLOYERS' LIABILITY I, 1,000,000
<br /> A 3900037744021 10/27/2003 I 10/27/2004 EL 'ACH ACCIDENT
<br /> 'L DISEASE - 'A EMPLOYEE $ 1,000,000
<br /> I E.L. DISEASE - POLICY LIMIT I $ 1,000,000
<br /> OTHER
<br /> DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESlEXCLUSIONS ADDED BY ENDORSEMEN /SPECIAL PROVISIONS
<br /> SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSI ONS, INSURED FOR THE LOCATION AT:
<br /> 2512 CHAMBERS RD.,
<br /> TUSTIN, CA 92780
<br /> "3O DAYS NOTICE SHOULD THE POLICY CANCEL FOR NO "I.PAYMENT
<br /> CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER; CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORE THE EXPIRATiON
<br /> CITY OF SANTA ANA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..1Q.. DAYS WRITTEN
<br /> ITS OFFICERS, AGENTS AND EMPLOYEES NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
<br /> 20 CIVIC CENTER PLAZA IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br /> P.O. BOX 1988.M12 REPRESENTATIVES- ~~
<br /> SANTA ANA CA 92702 AUTHOR"ED REPRESENTATIVE Ko
<br /> ACORD 25-5 (7/97) @ ACORD CORPORATION 1988
<br /> LM LPW ,196 00 2121/°' -1548 by U,",N'm6 LP LPW 1980021211O3-15A8byU,.,",,- "".D.'
<br />
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