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<br />04/15/2004 08:32
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<br />626-795-9157
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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 />PRODUCER This cartif!ca,te is ieeued as a matter of infolTl'l8tiOn only and t:ol1fers no righ1s
<br /> MARSH USA INC. upon 1tre Certificate Holder. Thie Certifica1e does not amend, flxtend Qralter the
<br /> coverage afforded by the policies below.
<br /> ONE srATE STREET .,-
<br /> HARTFORD, CT 061034187 COMPANIES AFFORDING COVEFl.I\ClE
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<br /> Company Hartford Fir. Insurance Co
<br /> A
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<br />INSURED Company In. Co of ltl. Sla'" of PA
<br /> OTIS ELEVATDR COMPANY B
<br /> ONE PARM SPRINGS ROAD -
<br /> FARMINGToN, or 06032 C<lmpany American Home Assuranea Co
<br /> C
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<br /> ComJ)lny New Hampe,hire lneurance Co
<br /> 0
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<br /> Company National Union Fir$ 'n$ Co Pa
<br /> E
<br />COVERAGES Thia eertific:ate supersedes and feplac8a any previouefy issued cerdflca1e for the IXIliey j:leriod note~ l)etlow.
<br />This Is to certify that the policies of Insurance described nel'ein tlave been Issued to the Insursd namad herein for the policy period Inl: IC'Jlmd. ~standing
<br />any requIrement, term or condition of contract or other document with rHpElct to whir;h this certtftcate may be Issu@d or may pertain.III~1 insurance afforded by
<br />the poliCies described herein Is subject: to aJlthe terms. conditIons and exclualona of $ueh poliOies. Um;ts shown may have been re~ll~ by pa]d claims.
<br />co TYPE OF IN$URANCE POllCV NUM8EA EFFECT1VE EXPIRATION UMrTS OF lABILITY
<br />IT --
<br />A GENERAL UABILlTY 02CSET1Q004 0410112004 0410112005 EACH OCCURRENCE $ 1.000.000
<br /> I&J ComMQl'C!sl General LlablII1y FIRE DAMAGE. S 300.000
<br /> Ll OIsJm!!, Made iii Ooeul'rMCa $2,000,000 general aggregare per ME.OICAl. ExPENSE S I 5.000
<br /> o Ownera' and Contnu:tcr~ Protection
<br /> 0 Ioce.liorvprojaet ~A9ONAI., & AOV INJUAY $ 1,000,000
<br /> .- 2.000.000
<br /> 0 o.ENEFlAl.AMPlE<.\An .,- $
<br /> General AggregBle Umlt applle!!. per. $10,000,000 ~licy gener'al aggr&g8te PRODUCTS. CQMPIOP AGG. $ 2.000,000
<br /> o Policy 0 P'Ojeel DLocttion . -
<br />A AUTOMOBILE UABILITY 02CS!1l'1000Q (AIO) 04101/2004 04/01/200. COME!jNEO S1NGt.E UMlT $ 1.000.000
<br /> IX! Any Automobile OaCSE!"'OOO3 (TX) BOolLY INJURY fF'9rperscnl
<br /> o All Owned AulomOOiIe$ -
<br /> HAflford Cuualty Ins Co BOO1L,( INJURY (Ptr accldel'lll
<br /> o S<:hElduled Automotllles 02C8ETlOOO2 (MAl -
<br /> o Hlllld Automoblle3 PROPERTY OAMAGE:
<br /> Hartford Ace & 100 Ins Co -
<br /> o NonoOwr'led Automobiles 02CSETlOO19 (HI) COMPR!;;HEN$IVE -
<br /> 0 HartfOrd Underwriters Ins COLUSlON
<br />. WORKERS' COMPENSATION 1NC5212397 (OtMr' States) 0410112004 0410112006 we...""",,,,,,, xl""", I I-
<br />e AND EMPLOYERS' UABIUTY WC$212J96 (CA) 1401(NJ) el. EACH .-.c::ClCENT $ 1,000,000
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<br />c W~1~4lKl(N"(,WI) EL. DISEASE (E~ OIl"CI~) $ 1 ,000.000
<br />E WCS~1240~ (ex~ CT). ,-
<br /> ~L DISEASE; (POIiI;y l.iTIll) S 1.000.000
<br /> , 1\'05212300 (ME,MS.NV,OR,RI,tJT)'
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<br /> "NationQ,1 UniOn Fire Ins Co Pa
<br /> EXCESS L1ABILlTY Ii, .',.' EACM OCCUFlFlENCEi
<br /> o OCCvrlttnce DClalms Made /) AGGREGA.TE
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<br /> f{~()' 2f/-vu t -
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<br />Cky of Santa AM Pollee and HoldlnQ FIiICUIty, Santa MA, CA 92702
<br />TI'1e CIty of Santa Ana, liS offIctfS. aga-nts. volunteers. and erll~oye&s are acldltlonallnaured on the above CommerCial General Uablllty ilB N:<lulred by (:(<:'t!nl.cl The liability
<br />coverage atfol'ded ~ prin-wy and non-COnlriblJfOrj'. oorttrelct number: SAN sMl8
<br />CE!RTlFICATl! HOLDER -
<br /> S~UL.O ANY OF THE ABOVE CE!SCFlIB~ POl.lCJES BE CANCEll.!:rl Br;:FOAE THE
<br /> EXPIRATION OATE!THeF4cO~. THE INSUR~R W11.,1. MAIl. 30 DAYS ~."F\ITTEN NOTICE TO 'n41!!
<br /> CeFlTIFICATE: HOt.OEA NAMED TO THE LeFT.
<br /> City of Santa Ma MARSH USA INO (/-- -r.- f(7)Bi
<br /> 20 Civic Cenlor Plaza (M.29). PO ~I! 19a5 BY.
<br /> Santa Ana, CA ~O<:
<br /> Cef!lfi~8IC " RFF-oSK2
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