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g�6UTM CERTIFICATE OF LIABILITY INSURANCE-RODU°"'�" °° <br />Brow ER (Brown Of Cal FAX (714)939-1654 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION <br />Brown &Brown of California, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />PO Sox 6999 HOLDER. THIS CERTIFICATE DOES NOT AMENO, EXTEND OR <br />College Blvd., Ste 1300 <br />500 N. State Coll ALTER THE Cov GE AFFORDED BY THE POLICIES BELOW. <br />Orange, CA 92868 INSURERS AFFORDING COVERAGE NAIL # <br />V911RE0 New AngramLL ; d: n-$ to teSerV, INSURER A: $t. Paul <br />dbaOn-SiteFabricators;dba:IngegratedWorkplace INSURERB: State Fund <br />Tangraminteriors;TangraMPabricators,Inc. INSURER C: <br />9200 Sorensen Avenue INSURER D; <br />Santa Fe Springs,CA 90670 <br />A <br />X <br />COMMERCIAL GENERAL LIABILM <br />CLAIMS MADE a OCCUR <br />_-, __, ,,-., <br />,,. 1. .,,,,,, . <br />DA GE TO NTEb <br />MED EXP (qRy onE penes) <br />B <br />S <br />$ <br />PERSONAL S ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />S <br />GEN'L <br />AGGREGATE LIMrc APPLIES PER: <br />POLICY JFE� LOC <br />PRODUCTS-COMP/Op AGG <br />S <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />CK06103D51 <br />11/01/2003 <br />11/01/2004 <br />(WMB�IN1DISW0LE LIMIT <br />S <br />X <br />ALL OWNED AUTOS <br />X <br />ePeppILYIWURY <br />S <br />A <br />SCHEDULED AUTOS <br />HIREO gUTOS�) <br />X <br />NON-0WNE0 AUTOS <br />Owned Phys Dmg <br />I�BLV�INJURY <br />$ <br />X <br />X Hired Phys Dmg <br />(PPReOP=.YIDAMAGE <br />E <br />GARAGE LIABILTlY <br />ANY AUTO <br />AUTO ONLY -EA ACCIOENT <br />$ <br />OTHERTHAN EAACC <br />AUTO ONLY; AGG <br />EACH OCCURRGNCE <br />$ <br />S <br />$ <br />EXCESSNMaRELLA LIABILITY <br />X OCCUR a CLAIMS MgpE <br />06103051 <br />11/01/2003 <br />11/01 004 <br />A <br />AGGREGATE <br />$ <br />X OEOUCTIBLE <br />S <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />B ANY PROPRIETORAPARTNER,SXECUTN <br />OFFICERIMEMBER EXCLUDED? <br />operty at <br />tallations I l 1 <br />"UDAUSUSl11/01/2003 11/O <br />l/2004/2004 Limit: 400,000/Ded: <br />ATTACHED. <br />certificate issued 5/6/04) <br />City of Santa Ana <br />Lydia Moran <br />P.O. Box 1988 <br />Santa -Ana, CA 92702 <br />jxo,O 'hn1 <br />ACORD 25 (2001/08) FAX: (7 <br />LIABILITY PER ENDORSEMENT <br />$MOULD ANY OP TMe ABOVE OEECmaeO POLICIES BE GANCELLEO BEFORE THE <br />EXPIRATION DATE THEREOF, THE m$UIMG INSURER WILLIt{M MAIL <br />30 DAYS WRITTEN NOTICE To THE CERTIR"TE HOLDER NAMED TO THE LEFT, <br />"CORD CORPORATION i98a <br />10 'd 'ON Xdd Wd 0VO [Nd GOOd-H-A W #V'' <br />