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ALLIBUI-01
<br />AL C7R0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY)
<br />10/1612019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer ri hts to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # OC32169 CONTACT
<br />ME:
<br />Rancho Mesa Insurance Services, Inc. PHONE FAX
<br />No).61$ .937-0168
<br />250 Riverview Parkway WC. No, ExtL{612) 937-0164 �, ( _( �
<br />E-
<br />Santee, CA 92071 ; pnnF�E
<br />MA L
<br />ss; _ _ -
<br />INSURER(S} AFFORDING COVERAGE
<br />INSURERA:Valley Forge Insurance Co
<br />(NSURER a Transportation Insurance Co
<br />INSURER C: Continental Insurance Company
<br />INSURER D: Insurance Comps of the West
<br />INSURER E: Arch Specially Ins Company
<br />INSURER F :
<br />INSURED
<br />Alliance Electrical Systems Inc.
<br />Lighting Efficiency & Design
<br />12520 High Bluff Drive Ste 345
<br />San Diego, CA 92130
<br />847
<br />199
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />1t15R TYPE OF INSURANCEINSSUBR WVOIPOLICY NUMBER POLICY EFF POLICY EXP YYILIMITS
<br />A
<br />X
<br />_
<br />i COMMERCIAL GENERAL LIABILITY I
<br />CLAIMS -MADE X OCCUR 6076240904 4/1/2019
<br />X X
<br />4/1/2020
<br />EACH OCCURRENCE
<br />DAMAGE TO RENTED
<br />PREMISES (Ea wcilrrengQ)—..
<br />$ 2,000,000
<br />100,QOQ
<br />$
<br />$ 15,000
<br />MED EXP (Any one person)
<br />$ 2,000,000
<br />_
<br />PERSONAL &ADV INJURY
<br />$ 4,000,000
<br />_
<br />GEN'L
<br />AGGOGATIE LIMIT APPLIES PER:
<br />POLICY rX I JECT LOC
<br />GENERAL AGGREGATE
<br />PRODUCTS - COMP/OP AGO
<br />$ 4,000,000
<br />OTHER.
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COM6INEDSiNGLE.UMIT
<br />tEa aelden[j
<br />1,000,00-
<br />$
<br />X
<br />ANY AUTO
<br />6076240899
<br />4/1/2019
<br />4/1/2020
<br />BODILY INJURY (Per person)
<br />$_ _
<br />_
<br />OWNED SCHEDULED
<br />AUUTNOSSW�Ep
<br />AUTOS ONLY Ix
<br />AU SONLY AUTOS ONLY
<br />BODILY INJURY (Per accident)
<br />..�aacr tl rnpAMAGE
<br />COMP/COLL
<br />$
<br />_ —
<br />C
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />s 15,OO7
<br />EXCESS LIAB
<br />F
<br />CLAIMS-MADE
<br />-6076240885
<br />4/1/2019
<br />4/1/2020
<br />AGGREGATE
<br />$ 15,000,000
<br />DED X I RETENTION $ 10,000
<br />is
<br />D WORKERS COMPENSATION I
<br />AND EMPLOYERS' LIABILITY Y f N X WSD502021907 12/31/2018 12/31/2019
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? 111 A
<br />(Mandatory In NH)
<br />X STAT�rE EER7H-
<br />1,000,000
<br />E.L. EACH ACCIDENT $
<br />E.L. DISEASE - EA EMPLOYE s 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E Professional iPDCPP0010803 1/20/2019 1/20/2020
<br />1
<br />1,000,000
<br />E.L DISEASE - POLICY LIMIT $
<br />Limit 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required
<br />RE: CITY OF SANTA ANA, ROSITA PARK, 706 N NEW HOPE ST., SANTA ANA, CA 92703. CITY OF SANTA ANA, IT'S OFFICERS, EMPLOYEE'S, AGENTS AND
<br />REPRESENTATIVE ARE INCLUDED AS ADDITIONAL INSURED PER FORM CNA75079XX (10-16)ATTACHED. PRIMARY
<br />AND NON-CONTRIBUTORY WORDING
<br />APPLIES.
<br />REVIEWED & APPROVED
<br />By RISK MANA EMENT DIVISION
<br />CITY OF SANTA ANA
<br />ATTN: RISK MANAGEMENT
<br />20 CIVIC CENTER PLAZA
<br />SANTA ANA, CA 92701
<br />ACORD 25 (2016/03)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />EXPIRATION DATE TIIERf_OF-, NOTICE WILL BE DELIVERED IN
<br />R. VILLAR ORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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