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<br /> MARS H CERTIFICATE OF INSURANCE ISSUE DATE <br /> 03/19/2005 <br />PRODUCER This certificate is issued as a matter of information only and confers no rights <br /> MARSH USA INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the <br /> ONE STATE STREET coverage afforded by the policies below. <br /> HARTFORD, CT 06103-3187 COMPANIES AFFORDING COVERAGE <br /> Company Hartford Fire Insurance Co <br /> A <br />INSURED A. - 2003 CJ.&g Company Ins Co of the State of PA <br /> OTIS ELEVATOR COMPANY B <br /> ONE FARM SPRINGS ROAD Company <br /> FARMINGTON, CT 06032 A -;>'003 ,,Jld-Ol American International South Ins Co <br /> C <br /> 4. - -;tiXyf- ).3v Company New Hampshire Insurance Co <br /> D <br /> Company National Union Fire Ins Co Pa <br /> E <br />COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below. <br />This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding <br />any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by <br />the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. <br />co TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS OF LIABILITY <br />LT <br />A GENERAL LIABILITY 02CSET10004 04/01/2005 04/01/2006 EACH OCCURRENCE $ 1 .000.000 <br /> [R] Commercial General liability FIRE DAMAGE $ 300.000 <br /> o Claims Made [R] Occurrence $2,000,000 general aggregate per MEDICAL EXPENSE $ 5.000 <br /> o Owners' and Contractors' Protection location/project $ 1 .000.000 <br /> D PERSONAL & ADV INJURY <br /> D GENERAL AGGREGATE $ 2.000,000 <br /> General Aggregate Limit applies per: $10,000,000 policy general aggregate PRODUCTS COMPIOP AGG. $ 2.000.000 <br /> o Polley 0 Project 0 Location <br />A AUTOMOBILE LIABILITY 02CSET10000 (AiO) 04/01/2005 04/01/2006 COMBINED SINGLE LIMIT $ 1 .000.000 <br /> [R] Any Automobile 02CSET10003 (TX) BODILY INJURY (Per person) <br /> o All Owned Automobiles Hartford Ins Co of Midwest BODILY INJURY (Per accident) <br /> o Scheduled Automobiles 02CSET10019 (HI) <br /> o Hired Automobiles PROPERTY DAMAGE <br /> o Non-owned Automobiles Hartford Underwriters Ins COMPREHENSIVE <br /> D COLLISION <br />B WORKERS' COMPENSATION WC5899613 04/01/2005 04/01/2006 WC Statutory Limit I X I Other I I <br />C AND EMPLOYERS' LIABILITY WC5899610 EL EACH ACCIDENT $ 1.000,000 <br />0 WC5899609/611/612 EL DISEASE (Each employee) $ 1 .000.000 <br />E WC5899614 (excess CT)" EL DISEASE (Polley Limit) $ 1 .000.000 <br /> .. SI R $2,500,000 <br /> EXCESS LIABILITY EACH OCCURRENCE <br /> o Occurrence 0 Claims Made ,\PPROVEl AS AGGREGATE <br /> TO FORM <br /> " . ~. :', ,,- b <br /> ---.~ , <br /> IdLJra Erill She'ed) <br /> ~ '-;Sl,qa 11 I City "-Horr e, <br />City of Santa Ana Police and Holding Facility. Santa Ana. CA 92702 <br />The City of Santa Ana, its officers, agents, volunteers, and employees are additional insured on the above Commercial General Liability as required by contract. The liability <br />coverage afforded is primary and non-contributory. contract number: SAN 5208 <br />CERTIFICATE HOLDER <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE INSURER WILL MAIL 30 DAYS WRITTEN NOTICE TO THE <br /> CERTIFICATE HOLDER NAMED TO THE LEFT <br /> City of Santa Ana MARSH USA INC (j.-.J-? -r. 117JRr <br /> 20 Civic Center Plaza (M-29), PO Box 1988 BY: <br /> Santa Ana, CA 92702 <br /> Certificate 10: A1 K7.6YQ <br />