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<br />_1t:;...~.A~:iiililiii:ii ..i.ii." CEaT'E,~~~~qf'I~$.tJ~~~~il DATE
<br /> C...,-L-,-.:...... LX...:.X. ..: 09/24/2006
<br />PROOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DNL Y AND CONFERS
<br /> NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br /> Marsh USA Inc. 4831SE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br /> 411 East Wisconsin Avenue AFFORDED BY THE POLICIES DESCRIBED HEREIN.
<br /> AM Best Rating
<br /> Suite 1600 COMPANIES AFFORDING COVERAGE lAsoI09/26i05)
<br /> Milwaukee, Wisconsin 53202-4419 *See Below
<br /> Attn: CPU, Phone (414) 290-4912 Fax (414) 290-4953 Company Union Insurance Company
<br /> CPU _ Milwaukee@marsh.com Illinois A+XV
<br /> A P.O. Box 41484. Philadelphia, PA 19101
<br />INSURED Company Sentry Insurance A Mutual Co.
<br /> Johnson Controls, Inc. A+XV
<br /> Attn: Corp. Risk Mgmt. X-92 B 1800 North Point Drive, Stevens Point, WI 54481
<br /> Johnson Controls Battery Group, Inc. P.O. Box 591
<br /> Johnson Controls Interiors, l.L.C. Milwaukee, WI 53201 Company Indemnity Insurance Company of North America
<br /> Johnson Controls of Puerto Rico, Inc. e and for CA: ACE American Insurance Company A+XV
<br /> Cal-Air, Inc. P.O. Box 41484, Philadelnhia, PA 19101
<br /> GES America, l.L.C. A -;)Oc4>- :/0 :3 Company
<br /> Optima Batteries, Inc. D Lexington Insurance Company
<br /> Pro-Tel, Inc. USI A+XV
<br /> USI Companies, Inc. 100 Summer Street. Boston, MA 0211 0
<br /> York International Cornoration
<br />COIIERAGES thl$:!lllIliIHlillll'$U""'r'$.ijdes~d .,/j"I~:~Ii!.""$\tI""'$I"J$$usd.c/ji:tilicat/j,: ..!.iU.<f.. .......!::..:.i.-:
<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 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, LIMITS SHOWN
<br /> MAY HAVE ElEEN REDUc"=n BY PAID CLAIMS.
<br />CO POLICY EFFECTIVE POLICY EXPIRATION
<br />LT TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDfYY) DATE (MMJDDfYY) LIMITS
<br />R
<br />A GENERAL LIABILITY (1) (2) (3) GENERAL AGGREGATE $ 5,000,000
<br /> )( COMMERCIAL GENERAL LIABILITY HDOG23719290 1 0-1 ~2006 10~1~2007 $ 5,000,000
<br /> PRODUCTS-COMP/OP AGG
<br /> I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 5,000,000
<br /> OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 5,000,000
<br /> X Contractual FIRE DAMAGE (Anv one fire\ $ 5,000,000
<br /> X X,C,U(ExpJosion, Collaps.a, Und..rground)
<br /> X Addrtionallnsored-Ov,nersL..SS8..sor MED EXP IAn" one nerson\ $ 50,000
<br /> ContraGtors See Below
<br />B ~TOMOBllE LIABILITY (1) (2) (3)
<br /> 90-04606-01 1 0-1-2006 1 O~ 1 ~2007 COMBINED SINGLE LIMIT $ 4,000,000
<br /> ><-- ANY AUTO
<br /> - ALL OWNED AUTOS BODILY INJURY
<br /> - SCHEDULED AUTOS (Per person)
<br /> ><-- HIRED AUTOS BODILY INJURY
<br /> ><-- NON-OWNED AUTOS (Per accident)
<br /> PROPERTY DAMAGE
<br /> GARAGE LIABILITY AUTO ONLY EA ACCIDENT
<br /> ~ ANY AUTO OTHER THAN AUTO ONLY I....:!.:i. ..>
<br /> EACH ACCIDENT
<br />D EXCESS L1ABILlTY $ 5,000,000
<br /> 5577492 10~1~2006 10-1-2007 EACH OCCURRENCE
<br /> q :'MBRELLA FORM AGGREGATE $ 5,000,000
<br /> OTHER THAN UMBRELLA FORM
<br />C WORKERS COMPENSATION AND WLRC44441135 1 O~ 1 ~2006 1 0-1 ~2007 X1WCSTATU-) I I~TH- <i..
<br /> EMPLOYERS' LlABILlTY (3) WLRC44441111 CA TORY LlMITS ER [ i...>......
<br /> -
<br /> EL EACH ACCIDENT $ 1,000,000
<br /> THE PROPRIETOR! H The Indemnity Insurance Company 01 North
<br /> INCL America program applies to aU JCI enUties in aU EL DISEASE-POLlCY LIMIT $ 1,000,000
<br /> PARTNERS/EXECUTIVE states except for the self-insured entities and the
<br /> OFFICERS ARE: EXCL monopOlistic states. EL DISEASE-EACH EMPLOYEE $ 1,000,000
<br /> OTHER
<br /> (1) ADDITIONAL INSURED: If required by contract, Includes coverage for Additional Insureds & loss Payees as required by lease or contract.
<br /> (2) PRIMARY COVERAGE: Where required by lease or contract, this coverage is primary and not excess of or contributing with other insurance or self-insurance.
<br /> (3) WAIVER OF SUBROGATION: Insured waives subrogation to the extent required by contract,
<br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS JCI Contract No.
<br />ProjeclName:
<br />Customer PO Number:
<br />CERTIFICATE HOLDER .. .............. i> .. ............. CiANCiELLATlON .... ...... <
<br /> SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.
<br /> Clerk of the City Council THE ISSUING COMPANY WILL ~"~[. 9'1T'G'MAIL Clerkoflhe Cijv Council OAYS WRITTEN NOTICE TO THE
<br /> City of Santa Ana CERTIFICATE HOLDER NAMEO HEREIN. n ~ ~ .'1 "'IE 1'9 rl.IL~' 'C"" .'?T'o;"E CII.LL IrlP~~~' :- 9~ ~.TI?tI2F1
<br /> 20 Civic Center Plaza (M-30) ( MJ ' ..~, ~'?r 't ntiS' P~" T, r,. C' '~IO:R 'IT9~~' ~ ':'? r~.Gt;:,ITS .GnIT~-:;MM::-M"rEGE;:tIT.TI ES
<br /> P.O. Box 1988 1I51A n,~ j jTf;H USA INC. BY' j;llY;r?:'
<br /> Santa Ana, CA 92702-1988 j:;?;f./Jrf'U97 ~,_~~:;~~.r~~of",su"~'.~.~9VkI~~;f<<;~~P\l~_.onJy~~;:~~-~,!~cttosuc,~.t~k1u...~.II~~...to.Manl)~{n:c::.~:m-..~..Set~:~~~.r...~,~.~~~'~~:If:~.~~'
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<br /> to.tlM .(lrrutur., to' :~:ciNIn .oUlw,lftSui'_.-.. ni.~,whk:b:bav.,IHIIlId:""'l,""lI1l11ce 1c:I"Nhl"n~~__ ,.,__.,--:____----..---.-:.,. --.-:":--'-',, '__"'-"''---'''-.':--'-' ....;..... '. :"'-'.--'-"'-"--:.'"",,.'/.:'--:;::C::"
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