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11. R CERTIFICATE OF LIABILITY INSURANCE
<br />`/
<br />D06/0312020 Y)
<br />06/03/2020
<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 poliey(ies) must be endorsed. If SUBROGATION IS WANED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsements).
<br />PRODUCER LICENSE NO.0637431
<br />PATRICK MCRAE INSURANCE SERVICES
<br />1265 N. MANASSERO ST. SUITE 303
<br />ANAHEIM HILLS, CA 92807
<br />NAMEA PATRICK MCRAE
<br />PHONE (714) 779-6999 N„ (714) 779 6903
<br />� nE p.mcrae@sbcglobal.net
<br />INSUR S AFFORDING COVERAGE
<br />NAIC6
<br />INSURERA: CRUM & FORSTER SPECIALTY INSURANCE
<br />44520
<br />INSURED
<br />INSURERB: INSURANCE COMPANY OF THE WEST
<br />27847
<br />CROSSTOWN ELECTRICAL & DATA, INC. /
<br />5454 DIAZ STREET
<br />IRWINDALE CA 91706
<br />INSURERC: INTEGON NATIONAL INSURANCE COMPAN
<br />_
<br />29742
<br />wsuaeao: ATLANTIC SPECIALTY INSURANCE COMPAIN
<br />27154
<br />INSURERE: GREAT AMERICAN INSURANCE CO.
<br />16691
<br />INSURER F:
<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 HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />LN
<br />TYPEOFINSURANCE
<br />POLICYNUMBER
<br />M LICY EFF
<br />MNLICY FJ� IDDyyyyI
<br />UNITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />ClA1MSf.1ADE 1XI OCCUR ✓
<br />XCU
<br />X
<br />X
<br />GL0065967
<br />DEDUCTIBLE $5,000 PER
<br />OCCURENCE
<br />06/03/202006/03/2021:.
<br />i ,/
<br />✓
<br />EACH OCCURRENCE
<br />s 1,000,000
<br />PDAMAGE TO RENTED
<br />REMISE Eao¢urerK:
<br />S 100,000
<br />X
<br />MEDEXP1An .Person)
<br />s 5,000
<br />X
<br />OCP
<br />PERSONAL & ADV INJURY
<br />S 1,000,000
<br />GEML AGGREGATE LIMIT APPLIES PER.
<br />POLICY ❑X JECOT L_! LOC
<br />GENERALAGGREGATE
<br />S 2,000,000
<br />�
<br />PRODUCTS - COMPlOPAGG
<br />f 2,000,000
<br />C
<br />OTHER
<br />AUTOMOBILE LIABILITY ✓
<br />X ANY AUTO
<br />ALL OWNED X SCHEDULED
<br />AUTOS AUTOS
<br />X HIRED AUTOS X AUNO-0WNED
<br />X
<br />X
<br />2005675448
<br />11/051201911/05/20-
<br />I
<br />IEBL
<br />MBw IN LE LIMIT
<br />a iN nt
<br />s 1,000,000
<br />S 1,000,000
<br />BODILY INJURY (Per Person)
<br />S _
<br />BODILY INJURY (Per eccMera/
<br />S -
<br />PROPERTY DAMAGE
<br />Per aociEenl
<br />3 -
<br />s
<br />E
<br />B
<br />D
<br />X
<br />UMBRELLA LIAR
<br />EXCESSMA9
<br />XIDDCUR
<br />i
<br />I CLANS -MADE
<br />NIA
<br />x
<br />TUE 257205202
<br />UNDERLYING LIMITS:
<br />GL; AL; EL POLICIES
<br />WVE 5030354-05
<br />710039414
<br />$1,000 DEDUCTIBLE
<br />COV. INCL. THEFT
<br />06/03/202006/03/2021
<br />06/03120200
<br />�/
<br />05/10/202006MWO21
<br />03/2i -
<br />V
<br />EACH OCCURRENCE
<br />S 10,000,000
<br />AGGREGATE
<br />s 10,000;000
<br />X DED RETENTIONS 0
<br />WORKERS COMPENSATION �
<br />ANDEMPLOYERS'UABILRY TIN
<br />OFF CERRAEMBER EXCLUDED' ECUTIVEFN
<br />(MaMrtory In NXI
<br />K yee, 1PTION uOF O
<br />DESCRIPTION OF OPERATIONS Mbx
<br />PROPERTY &
<br />CONTRACTORS
<br />EQUIPMENT
<br />STAT T ORH-
<br />S -
<br />E. L EACH ACCIDENT
<br />s 1,000,QQQ
<br />E.L DISEASE - EA EMPLOYE
<br />S 1,000,000
<br />EL DISEASE -POLICY LIMIT S 1,000,000
<br />n
<br />$s 418.60Pr�alPrerr..a
<br />1s3D0oo010°e0`e`nseaBPP
<br />DESCRIPTIONOF OPERATIONS I LOCATIONS !VEHICLES ACORD 1eI,AWRIenal Remarks BCMduIe, may MenacMd Irmorea ceb neeReR)
<br />THE CITY OF SANTA ANA, ALONG WITH THEIR Or ICERS, OFFICIALS. AGENTS, EMPLOYEES AND VOLUN PEERS ARE NAMED AS ADDITIONAL INSURED WITH
<br />RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENTIS). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED
<br />WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS, WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. ✓
<br />'SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. A 30 DAY WRITTEN NOTICE WILL BE ISSUED. ✓
<br />RE: Agreement #A-2017-172
<br />CTWN: 3196
<br />CPUTICNIATC Unl neo
<br />City of Santa Ana �/ Y I
<br />20 Civic Center Plaza I' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />JU 19 1f(cE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Santa Ana, CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />ANqiE ACEI ediLIPRIZE0REPRESENTPNVE
<br />© 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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