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<br />MARSH
<br />
<br />CERTIFICATE OF INSURANCE
<br />
<br />CERTIFICATE NUMBeR
<br />
<br />NYC-002667482-01
<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 POUC1ES DESCRIBED HEREIN.
<br />
<br />PRODUCER
<br />. MARSH USA INC.
<br />200 CLARENDON STREET
<br />BOSTON, MA 02116
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />--- -
<br />
<br />99713-APCC--07/07
<br />--.'--
<br />INSURED
<br />
<br />COMPANY
<br />A VIGILANT INSURANCE COMPANY
<br />
<br />MGE UPS SYSTEMS, INC.
<br />1660 SCENIC AVENUE
<br />COSTA MESA, CA 92626
<br />
<br />COMPANY
<br />B GREAT NORTHERN INSURANCE COMPANY
<br />
<br />COMPANY
<br />C WAUSAU BUSINESS INSURANCE COMPANY
<br />
<br />-,-
<br />
<br />COMPANY
<br />D NATIONAL UNION FIRE INS. CO, OF PITTSBURGH, PA
<br />
<br />COVERAGES This certificate supersedes and replaces any previOusly issued certificate for th~poHcy. period noted below ~ 1
<br />THIS 15 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 DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES 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 />~' TYPE OF 'NSURANCE I------::'Cy NUMBER
<br />
<br />I GENERAL UABlLITY I
<br />A [Xl C~MMERCIALGENERAL_~IABILlTY 13531-48-45
<br />
<br />= CLAIMS MADE [] OCCUR
<br />,-_' OWNER'S & CONTRACTOR'S PROT i
<br />~ $2MMSIR . _I
<br />
<br />I' POLICY EFFECTIVE POLICY EXPIRATION
<br />I DATE (MMIDDJYV) DATE (MMJDDIYY)
<br />
<br />06/01/07
<br />
<br />I
<br />107/01/07
<br />
<br />AUTOMOBILE L1ABfUTY
<br />
<br />,
<br />107/01/07
<br />
<br />B ~,ANYAUTO
<br />~ ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />1. HIRED AUTOS
<br />NON.OWNED AUTOS
<br />X PHYSICAL DAMAGE
<br />X OMP. & COLL $1 ,000
<br />GARAGE LIABILITY
<br />
<br />7320-34-35
<br />
<br />06/01/07
<br />
<br />-"!
<br />
<br />R' ANY AUTO
<br />
<br />r--
<br />
<br />~CESS LIABILITY
<br />
<br />o ~ UMBRELLA FORM
<br />I OTHER THAN UMBRELLA FORM
<br />I WORKERS COMPENSATION AND
<br />! EMPLOYERS' LIABILITY
<br />I'>
<br />THE PROPRIETORJ IXlINCL
<br />PARTNERSJEXECUTIVE I":'=---j
<br />I OFFICERS ARE: ' EXCL
<br />o,HO.
<br />
<br />4485537
<br />
<br />06/01107
<br />
<br />07101/07
<br />
<br />10/01/06
<br />
<br />10/01/07
<br />
<br />WCK-Z91-439161-016
<br />
<br />LIMITS
<br />
<br />t:NERAL AGGREGATE
<br />, PR~QUCTS-CO~~OPAGG
<br />PERSONAl & ADV INJURY
<br />
<br />~
<br />, $
<br />$
<br />
<br />-
<br />
<br />4,000,000
<br />4,000,000
<br />,----'----
<br />2,000,000
<br />2,000,000
<br />1,000,000
<br />'--'---
<br />10,000
<br />1,000,000
<br />
<br />._~
<br />
<br />5,000,000
<br />5,000,000
<br />
<br />---~
<br />1,000,000
<br />1,000,000
<br />1,OOe,Ooo
<br />
<br />DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLESISPECIAL 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 />CANCELlATION
<br />
<br />~q~_OCCURRENCE i $
<br />
<br />FIRE g!'MAGE (Anyone fire) $
<br />MED EXP IAnv one Derson\ $
<br />
<br />COMBINED SINGLE lIMIT__L-_.
<br />
<br />BODIL'( INJURY i $
<br />(Per person) j $
<br />80DIL Y INJURY
<br />(Per accident) +---
<br />
<br />PROPERTY D~MAGE -. I $
<br />
<br />AUTOONLY_EAACCIDENT $
<br />
<br />~~ THAN AUTO ONLY'
<br />EACH ACCIDENT $
<br />AGGREGATE ~ $
<br />EACH OCCURRENCE ' $
<br />,$
<br />$
<br />
<br />AGGREGATE
<br />
<br />X TOR~~~I~S i I UE~-
<br />EL EACH ACCIDENT 1$
<br />EL DISEASE.POLlCY LIMIT $
<br />EL DISEA;:;E-EACH EMPlOYEE: $
<br />
<br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLEO BEFORE THE EXPIRATION DATE THEREOF
<br />THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL --3Q DAYS IIVftITTEN NOTICE TO THE
<br />CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALL MPOSE NO OBLIGATION OR
<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 />liABILITY OF ANY KIND UPON THE INSURER AFFORDNG COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
<br />
<br />ISSUER OFTHIS CERTIFICATE
<br />MARSH USA INC.
<br />BY: Edward R Ford
<br />MM1 (3/02)
<br />
<br />~7?~
<br />
<br />VAUD AS OF: 06/27/07
<br />
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