|
<br />COVERAGES This certificate supersedes a-nd replaces any previously issued certificate for the policy _ perlod noted below. 1
<br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLlCY PERIOD INDICATED.
<br />NOT\",ITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE 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 />---- --- ~- -
<br />co I
<br />LTR \ TYPE OF INSURANCE I POUCY NUMBER
<br />,
<br />
<br />MARSH
<br />
<br />PRODUCER
<br />MARSH USA, INC.
<br />200 CLARENDON STREET
<br />BOSTON, MA 02116
<br />
<br />99713-APCC--08-09
<br />
<br />INSURED
<br />
<br />MGE UPS SYSTEMS, INC.
<br />ATTN: MICHAEL DENNIS
<br />1660 SCENIC AVENUE
<br />COSTA MESA, CA 92626
<br />
<br />A- :2ODI-lgLj
<br />A -:.LODLf-Ol'l
<br />A- ~'1-olq_o I
<br />-0:>'-
<br />-03
<br />
<br />/I
<br />
<br />"
<br />
<br />i'
<br />
<br />"
<br />
<br />GENERAL LIABILITY I
<br />, '
<br />A ~tx COMMERCIAL GENERAL lIABlLlTY ,1,7218693
<br />
<br />f - CLAIMS MADE rx--I OCCUR
<br />! OWNER'S & CONTRAcr;'s PROT I
<br />c'
<br />X IuMM.sIIL _ - 1
<br />1-
<br />
<br />~~OMOBILE liABILITY
<br />
<br />B X ANY AUTO
<br />c-j
<br />IL J .ll.lL OWNED AUTOS
<br />, I SCHEDULED AUTOS
<br />!f- .J HIRED AUTOS
<br />f------.j NON.OWNED AUTOS
<br />L)( PHYSICAL DAMAGE
<br />X COIM~P-&(;OLL$1,OOO--
<br />I GARAGE liABILITY
<br />l-
<br />i _! ANY AUTO
<br />
<br />1-
<br />
<br />EXCESS LIABILITY
<br />
<br />o IX II UMBRELLA FORM
<br />I-
<br />I OTHER THAN UMBRELLA FORM
<br />WORKERS COMPENSATION AND
<br />C I EMPLOYERS'lIAB1l1TY
<br />
<br />B I THE PROPRIETOR'
<br />I PARTNERSlEXECUT1VE
<br />I OFFICERS ARE:
<br />OTHER
<br />
<br />I
<br />T J_CAP_8199A41-4-TIL
<br />\
<br />I
<br />I
<br />I
<br />
<br />1
<br />I
<br />I
<br />
<br />19835472
<br />
<br />,
<br />,
<br />\TC2H-UB-8196A02-A-08- TIA
<br />Ixll'NCLJTRJ-UB-186K259-O-08-TIL
<br />I EXC'
<br />!
<br />1
<br />I
<br />
<br />CERTIFICATE NUMBER
<br />
<br />NYC-002667482-04
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONfERS
<br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br />POLICY, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br />AFFORDED BY THE POLICIES DESCRIBED HEREIN.
<br />
<br />CERTIFICATE OF INSURANCE
<br />
<br />1-
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />--- --- -
<br />
<br />-
<br />
<br />COMPANY
<br />I A AMERICAN HOME ASSURANCE CO.
<br />-I---~ -- ----- --- --
<br />COMPANY
<br />~ B TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
<br />-------- - - -- -
<br />COMPANY
<br />Ie TRAVELERS INDEMNITY COMPANY OF AMERICA
<br />-- -~ - - - - ~-~--
<br />COMPANY
<br />, D NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA
<br />
<br />--\PO~CY EFFECTIVE~OUCY EXPIRATI~J---
<br />DATE (MM/DDNY) , DATE (MM/DDNYI I
<br />
<br />I ~ENERAL AGGREGATE : $
<br />101/01/09 PRODUCTS _ COMPIOP AG~ $
<br />\ ~~ON~ & ADV INJU_RY \ $
<br />I EACH OCCURRENC~ $
<br />\ ~REDAMAGEIAnYOl1efi~ _
<br />MED EXP IAnv one nersol11 1$
<br />, !
<br />I COMBINED SINGLE ',-IMIT i $
<br />
<br />LIMITS
<br />
<br />101/01108
<br />
<br />4,000,Oil,tl
<br />4,000,000
<br />2,000,000
<br />--'--
<br />_ 2,OOO,OO~
<br />1.000,000
<br />-
<br />10,000
<br />1,000,000
<br />
<br />- -
<br />
<br />1
<br />I
<br />I
<br />1
<br />101/01108
<br />I
<br />
<br />101/01109
<br />
<br />I~~DILY IN-JURY-
<br />(Per person)
<br />
<br />~-
<br />$
<br />-1'---
<br />$
<br />I
<br />
<br />1 BODILY INJURY
<br />IPeraccidentl
<br />
<br />,
<br />
<br />I
<br />I
<br />I
<br />I
<br />,
<br />I
<br />101/01109
<br />i
<br />
<br />! PROPERT'r' DAMAGE
<br />
<br />1101101108
<br />
<br />~!JTO. ONL~AACCIDENT \$ . -_--
<br />tOTHER THAN AUTO ONJ:Y..:.- -- _ ---'-----'-.-
<br />f-- EACH ACCIDENT +!- - ----
<br />i AGGREGATE I $
<br />I EACJ:i~CCURRENCE $ 5,000,000
<br />1 'GGREGA~ - f ~- - 5,000,00~
<br />
<br />LX 1_ T~-!ltMI~sl TO~~~-,->~---,-----,_,
<br />,EL EACH ACCIDENT__~ L_2,QOO,OOO
<br />IEL DISEASE-POLICY L1MIT~ L ,----.?,OOO,O~~
<br />EL DISEASE-EACH EMPLOYEE'I $ 2,000,000
<br />
<br />101/01108
<br />01101108
<br />I
<br />I
<br />
<br />I
<br />
<br />101101/09
<br />01101109
<br />I
<br />I
<br />
<br />1
<br />
<br />;
<br />
<br />DESCRIPTION OF OPERATIONSllOCATIONSfVEHICLE5ISPECIAL ITEMS
<br />
<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 />
<br />CERTIFICATE HOLDER
<br />
<br />City of Santa Ana
<br />AUn Clerk of the City Council
<br />Civic Center Plaza, M-30 P.O. Box 1988
<br />Santa Ana, CA 92702
<br />
<br />CANCELLATION
<br />
<br />SHOULD ANY OF THE POLICIES DESCRIBED HEREN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF
<br />THE INSURER ,o.FFORDING COVERAGE INILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTlCE TO THE
<br />CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br />
<br />LIABILITY OF ANY KIND UPON THE INSURER AFFORDi'lG COVERAGE. ITS AGENTS OR REPRESENTATIVES. OR THE
<br />
<br />ISSUER OF THIS CERTIFICATE
<br />MARSH USA INC.
<br />BY: Edward R Ford
<br />MM1(3102)
<br />
<br />~7<'.~
<br />
<br />VAUD AS OF: 12131107
<br />
|