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<br />04/15/2004 08:32
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<br />626-796-9157
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<br />OTIS ELEVATOR
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<br />PAGE 02/02
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<br /> MARSH CERTIFICATE OF INSURANCE ISSUE CATE
<br /> 03l2e12004
<br />PRODUOER This certiflce.te i8 ieeU$d as a matter of informatiOn only and {:Cil1ferD no rights
<br /> MARSH USA INC. "pon the OerlfiCBle Holder. Thie c.rIfi""te doea not.mend. extend or oller tile
<br /> ONE srATE STREOT coverage afforded by the poIlc1e. below. .,-
<br /> HARTFORD, CT 06103-3187 COMPANIES AFFORDING COVEA.IIIlE
<br /> .,-
<br /> Company Hartford Fir. Insurance Co
<br /> A
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<br />INSURED Company In. 00 of the Slate of PA
<br /> OTIS ELEVATOR COMPANY B
<br /> ONE FARM SPRINGS ROAD -
<br /> FAAMINGTON, CT tle032 Company American Home Ascuranco Co
<br /> C
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<br /> Compeny New Hampehire lneurance Co
<br /> 0
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<br /> Company National Union Fir. Ine Co PI.
<br /> E
<br />COVERAGES Th'. cort;fio;ote '"persede. and replaco. any Previo"ol\' _ certlflCBle for tho poliCy Period noted 1,.low.
<br />Thls 1& to certify that the pQlicies of Insurance described nerein neve been Issued to the Insured named "erein for the polley period Inl: Ic:atlld. Notwi1t'IBlInding
<br />any requirement, tenn or conditiOn of c:ontract or other document lNith rapGct to whid1 this certificate may be Issued or mey pertain, tht'llnsurance afforded by
<br />the poliCies described herein Is subject tel all ttle terms. conditions and Qxcluslona of $ueh poliCies. Umits shown may Ilave been reG'll!;lKt by paid claIms.
<br />co TVPl! OF INSURANCE POLICV NUM8eR EFFECTIVE EXPIRATION UMITS OF lABILITY
<br />LT ..-
<br />A GENERAL L1ABIUTV 02C5ET100Q4 04101!.l004 0410112005 EACH OOCURRENC; - $ 1.000.000
<br /> iii Commotdel Genenll UablItty FIRE DAMAGE $ 300.000
<br /> D Claims Made iii OCCUl'r'er'le8 $2,000.000 general aggreg&18 per MEDlCAL.lExPEN&& $ I 5.000
<br /> o Ownera' and Contn!ctor$' ProtectIOn _'On/projoct ~SO"'Al," AfJl/l~URY $ 1,000,000
<br /> Cl .- $ 2.000.000
<br /> Cl GI!N!F1AL AGSAEGATEi ..-
<br /> General Aggregate Umtt applle!. per: $lD,OOO,WQ POliey genn aggrogete fl'f'!OI;)UOTS . CQMIi'IOP AGG. $ 2,000.000
<br /> Cl Polloy CJ Projoot ClLocation --
<br />A AUTOMOBILE UABILITY ""CS0l'10000 (ilIO) 04101/2004 04101/2005 COMElINEO SlNGI.! UMIT S 1,000.000
<br /> I!IA"IA_ne o:lCSOl'l0003 (TXI BOcl'ILY INJURY l'P8rpersOl't)
<br /> o All Owned AulomObiIeG HIrI10rd Ga&ualty Ins Co BClDILV INJUFlY CP\lracclclenU
<br /> o Schecll.lledAuromocues 02CSETlOOO2 (MA) -
<br /> o HlllId AutomobIles PROPERTY DAM^<OE
<br /> Hattfad Ace & 100 Ins Co -
<br /> o NonoCwr'led Automobiles COMPREHENSIVE
<br /> Cl 02CSET'OO19 (HI) COlUSlQIol
<br /> Hartfotd Undllrwrft8ra Ins
<br />. WOfIKERS' OOMPENSA nON WC5212397 (Other states) 041011.1004 0410112005 we ",,,,,,,,,,...,,, I. I""" It
<br />C AN D EMPLOYERS' LIABILITY WCS212398 (CAJ 1401(NJ) 1I1.I:AOHAOCl~ S 1,000,000
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<br />0 W052124OC1 (NY,WI) EL.DISl!ASE (E~t1_I_) $ 1,000.000
<br />E WC5212402 (excess CT)- iL DISEASE (POlIr::v Umlt) .-
<br /> $ 1.000.000
<br /> ,. WC521:l399 (ME,MS,NV,OR.RI.l1T)'
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<br /> "National Union Fire Ins Co Pa
<br /> EXCESS L1ABIUTV 10,I'!':,; \;. EAC,IoI C:CCWU!!I!Nel!!
<br /> CI OCCurrence DClalma Made ,-
<br /> /J AGGREGATE
<br /> r\ -
<br /> feV -'. ' nk.2fJ^JU.t -
<br /> J t.yl/ , --
<br /> - -
<br /> ~"., .. I
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<br />Olty of Santa Ana pone:a Ilnd HoldIng FacUlty, santa AnI, GA 92702
<br />TI'IIl City of Santa AnIll, Its ofPIcers, agents, volunteer!. and llImplOYl8$ 1,(6 eddltlcnsllnsursd an the.e.bove Comm&r'C1B1 General UabUItv IUI reqUlI'ed by C"..(.1tI'ilcl. The l1eblllly
<br />caverago afforded ~ primary and nan-contrlb\Jtclry. oontract number: SAN 5208
<br />CERTlFlCATJ! HOLDER -
<br /> SHOULO NlY OF THE ABOVE DESOF4IB~O POI.ICIES BE CANCELL!:f) BEFOFlE' THE
<br /> EXPIRATION OATETHEFt~F. THE INSURER W1l.1. '-"01\11.. 30 DAVa WFlITTEN NOTICE< TO n.lI;
<br /> CERTIFIOATE HOL05R NAMED TO THE LEFT',
<br /> City of Santa 1v'l8 MARSH USA INO (j- or. #7)~
<br /> 20 Civic Center Plaza (M-29). PO ~x 1988 BY:
<br /> Santa Ana, CA 927~
<br /> Cer!!!!* I . RFF-o
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