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<br />CERTIFICATE NUMBER
<br />SEA-000501470-06
<br />
<br />
<br />PRODUCEr~
<br />r-n.ARSH RI\3K & INSURANCE SERVICES
<br />P. O. BOX 193880
<br />SAN FRANCISCO, CA 94119-3880
<br />CALIFORNIA LICENSE NO. 0437153
<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 />
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<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />MISC .UNITE-W/PRO- un CA J .I-
<br />INSURED Me. ~ 4'7-
<br />UNITED INSPECTION & TESTING INC (I \; U-.. -'
<br />22620 GOLDENCREST DRIVE, SUITE 1 4
<br />MORENO VALLEY. CA 92553 A _ 1"0[,(; . 0 CJJ L( - D I
<br />
<br />A-dO(j() -Noll
<br />
<br />COMPANY
<br />A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA.
<br />
<br />COMPANY
<br />8 AMERICAN HOME ASSURANCE CO
<br />
<br />COMPANY
<br />C AMERICAN INTERNATIONAL SPECIALTY LINES INS. CO.
<br />
<br />COMPANY
<br />o INSURANCE CO. OFTHE STATE OF PA
<br />
<br />
<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 />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEtH WITH RESPECT TO WHICH THE CERTIFICATE MAYBE ISSUEDOA
<br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN is SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />
<br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
<br />LTR DATE (MMfDDIYY) DATE (MMfDDIYY)
<br />A GENERAL LIABILITY GL933-3116 04101104 04/01/05 GEf~ERAL AGGREGRATE 5 2,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COM PlOP AGG $ 2,000,000
<br /> CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000
<br /> OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
<br /> FIRE DAMAGE (Anyone fire) 5 1,000,000
<br /> MED EXP (Any OM person) S 5,000
<br />A AUTOMOBILE LIABILITY 826-1679 AOS 04/01104 04/01/05
<br />B X COMBINED SINGLE LIMIT $ 1,000,000
<br />ANY AVTO 826-1680 MA 04/01104 04/01/05
<br />A ALL OWNED AVTOS 826-1681 TX 04/01104 04/01 /05 BODIL Y INJURY
<br /> SCHEDULED AUTOS (Per person) 5
<br /> X HIRED AVTOS BODIL Y INJURY
<br /> $
<br /> X NON-OWNED AUTOS (peraccidanl)
<br /> PROPERTY DAMAGE $
<br /> GARAGE LIABILITY AUTO ONL Y- EA ACCIDENT S
<br /> ANY AVTO OTHER THAN AVTO ONL V:
<br /> EACH ACCIDENT $
<br /> AGGREGATE 5
<br />C EXCESS LIABILITY 819-4168 04101104 04101/05 EACH OCCURRENCE $ $1,000,000
<br /> X UMBRELLA FORM AGGREGATE $ $1,000,000
<br /> OTHER THAN UMBRELLA FORM $
<br />A WORKERS COMPENSATION AND 7155121 (CA) 01101105 01101106 X OTH-
<br /> EMPLOYERS' LIABILITY ER
<br />0 7155122 (AOS) 01101/05 01/01106 5 1,000,000
<br />0 THE PROPRiETORI X INCL 7155118 EXGLUD.CA,AOS,GA 01/01/05 01/01/06 EL DISEASE. POLICY LIMIT $ 1,000,000
<br /> PARTNERS/EXECVTIVE
<br />E OFFICERS ARE: EXCL 7155119 (GA) 01101/05 01/01/06 EL DISEASE-EACH EMPLOYEE $ 1 000,000
<br /> OTHER
<br />C PROF. LIABILITY (E&O) 819-4168 04101104 04/01/05 EACH CLA:~vl ...~ ,...,...,... "........
<br /> '1> 1 ,""",vv....
<br /> CLAIMS MADE FORM AGGREGATE $1,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
<br /> ,
<br /> Q1' <-
<br /> Laura Stitt Sheet-
<br /> Assistant City A~ ..,;\
<br />
<br />
<br />
<br />
<br />CITY OF SANTA ANA
<br />PUBLIC WORKS AGENCY
<br />CONSTRUCTION ENGINEERING
<br />P.O. BOX 1988/M-22
<br />SANTA ANA, CA 92702
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<br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL KN~ MAIL 30 DAYS
<br />WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN,)e01XUI(XI16e(ROOM:~lloeUON
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<br />MARSH USA INC
<br />BY: Michlo Nekota
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