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<br /> MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
<br /> NYC-002667462-04
<br />PRODUCER A- :2ODI-Igy THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br /> MARSH USA, INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br /> 200 CLARENDON STREET A -:;l.OOY-Ol'l POLICY THIS CERTIFICATE DOES Nor AMEND, EXTEND OR ALTER THE COVERAGE
<br /> BOSTON, MA 02116 AFFORDED BY THE POUCIES DESCRIBED HEREIN.
<br /> A - 2-00'1-01'9_ 0 f ,------ COMPANIES AFFORDING COVERAGE
<br /> - -
<br /> /I " -0::>'- COMPANY
<br />, 99713-APCC--06-09 " " -03 A AMERICAN HOME ASSURANCE CO.
<br /> ------ -- - ------ -
<br />INSURED I COMPANY
<br /> MGE UPS SYSTEMS, INC. B TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
<br /> ATTN: MICHAEL DENNIS ---- -
<br /> 1660 SCENIC AVENUE COMPANY
<br /> COSTA MESA, CA 92626 i----.c:_ TRAVELERS IN[JEMNITY COMPANY OF AMERICA
<br /> 1- COMPANY
<br /> D NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA
<br />COVERAGES This certifICate supersedes and replaces any previously issued certificate for the policy peliOd noted. below. 1
<br /> THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DeSCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
<br /> NOTVv'ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF A.NY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CER.TIFICATE MAY BE ISSUED OR MAY
<br /> PERTAIN. THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
<br /> liMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />f-- - POUCY EFFECTIVE I POU~~ EXPIRATION I _...
<br />CO TYPE OF INSURANCE POLICY NUMBER LIMITS
<br />LTR i DATE (MMIDDJ'r'Y) , DATE (MMlDDfYYj
<br /> I GENERAL UABlLlTY GENERAL AGGREGATE 1$ 4,000,000
<br /> , 101101/08 --~RO-9UCTS - CCl.~~I~~
<br />A ~MMERCIAL GENERAL ~IA8ILlTY 7216693 01/01/09 4,000,000
<br /> ~ CLAIMS MADE IX] OCCUR \ I pERSONAL & ADY INJURY , $ 2,000,000
<br /> CWNER'S & CONTRACTOR'S PROT ~ACH OC-;;-URRENCE 1$ 2,000,000
<br /> ? FIRED~MA~EIAnYOnefire) 1$ 1,000,000
<br /> --"-fl2MM.S.IR--
<br /> , i MED EXP lAnv one nerson) $ 10,000'
<br /> , AUTOMOBILE LIABILITY 101101/08 $ 1 ,000,000
<br /> - ' COMBINED SINGLE LIMIT
<br />B X I ANY AUTO T J-CAP-8199A41-4- TI l 01/01/09
<br /> ~ AU OWNED AUTOS I I -- 1$ - -
<br /> BODILY INJURY
<br /> i I SCHEDULED A.UTOS I (Per person I
<br /> i _J HIRED AUTOS ~ODIL Y INJURY 1$
<br /> - NON.OWNED AUTOS (~er<lcCidentl ,,_
<br /> i~ jPHYSICAl DAMAGE I PROPERTY DM1AGE 1$
<br /> X COMP & COll $1 ,000
<br /> ! GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
<br /> R ANY AUTO -- ~r-
<br /> tHER THA~ AUTO ONL Y,-_'__ ~-
<br /> i EACH ACCIDENT $
<br /> - -- ! 1 A~~REGATE I $ -
<br /> EXCESS LIABILITY I !_,~ACH OCCURRENCE 1$ 5,000,0ClQ.
<br />D h<l UMBRELLA FORM '9835472 101/01/08 01/01/09 AGGREGATE Ii 5,000,000
<br /> ,- - --
<br /> , OTHER THAN UMBRELLA FORM $
<br /> I WORKERS COMPENSATION AND 101101/08 . '-"Y,",?iATU- j I UJIi'
<br /> EMPLOYERS' LIABILITY X i TORY LIMITS , -,~
<br />C TC2H-UB-8196A02-A-08- TIA 01101/09 EL EACH ACCIDENT $ 2,000,000
<br /> I, THE PROPRIETORl I X-I'NCL - --
<br />B TRJ-UB-186K259-O-08-Tll ,01/01/08 01101/09 EL DISEASE.POLlCY LIMIT _.~ 2,000,000
<br /> PARTNERSJEXECUTIVE -
<br /> OFFICERS ARE' EXCL I EL DISEASE-EACH EMPLOYEE $ 2,000,000
<br /> 10'He" I
<br /> 1
<br /> i
<br />DESCRIPTION OF OPERATlONSILOCATIONSIVEHICLESlSPECIAL ITEMS
<br />RE. MGE field engineers performing work on MGE equipment.
<br />The City of Santa Ana. 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and representatives are included as
<br />additional insured (except Workers Compensation) where required by written contract and allowed by law.
<br />CERTIFICATE HOLDER CANCELLATION
<br /> Sl10ULO ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF
<br /> THE INSURER AFFORDING COVERAGE WLL ENDEAVOR TO MAIL --3Q DAYS \NRITTEN NonCE TO THE
<br /> City of Santa Ana CERTIFICATE HOLDER NAMED HEREIN BUT FAIWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br /> Attn: Clerk of the City Council
<br /> Civic Center Plaza, M-30 P.O. Box 1988 LIABILITY OF ANY KINO UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
<br /> Santa Ana, CA 92702 ISSUER OF THIS CERTIFICATE
<br /> MARSH USA INC. ~~~
<br /> BY: Edward R Ford
<br /> MM1 (31021 VAUD AS OF: 12/31/07
<br />
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