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<br /> MARSH CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
<br /> NYC-002667482-04
<br />PRODUCER A- 2Ool-lg'-j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br /> MARSH USA, INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br /> 200 CLARENDON STREET A - ;;).OO'-f-OIGj POLlCY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br /> BOSTON, MA 02116 AFFORDED BY THE POUC1ES DESCRIBED HEREIN.
<br /> A- 2-OO'1-0Iq_o 1 I COMPANIES AFFORDING COVERAGE
<br /> " " -O::L COMPANY
<br />99713-APCC--08-09 " " -03 A AMERICAN HOME ASSURANCE CO.
<br /> - -- I - -
<br />INSURED COMPANY
<br /> MGE UPS SYSTEMS, INC. B TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
<br /> ATTN MICHAEL DENNIS ___.u_.__ - -
<br /> 1660 SCENIC AVENUE , COMPANY
<br /> COST A MESA, CA 92626 C TRAVELERS INDEMNITY COMPANY OF AMERICA
<br /> ..---,.~. -- -
<br /> COMPANY
<br /> D NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA
<br />COVERAGES This certificate superseoesandrepraces any previously lssued certifjcate fo(the policy period noted below. 1
<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 /> NOT\\o'ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF A.NY 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. A.GGREGATE
<br /> LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br /> ---~----- POUCY EXPIRATION 1 -
<br />CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE LIMITS
<br />LTR DATE (MMIDDJYY) DATE (MM/DDNY)
<br /> I GENERAL LIABILITY I GENERAL AGGREGATE !$ 4,000,000
<br />A rx- COMMERCIAL GENERAL LIABILITY 17218693 01101108 '01101109 I PRODUCTS~~~;~OPAGG $ 4,000,000
<br /> ~ CLAIMS MADE ~ OCCUR I ~~Al & ADV INJURY $ 2,000,000
<br /> I I OWNER'S & CONTRACTOR'S PROT I , $ 2,000,000
<br /> icc-i J':Al::1:I OCCURRENCE ~
<br /> ~1t2MM BIR i ~MAGE (Anyone fire) 1,000,000
<br /> , ! ! , MED EXP (Anv one "er.>on\ 1$ 10,000
<br /> f50MOBILE LlAB<UTY ITJ-CAP-8199A41-4-Tll c~..."..._ I: ,~~
<br />B X ANY AUTO 01101108 01101/09
<br /> '- 'ALL OWNED AUTOS BODILY INJURY $
<br /> SCHEDULED AUTOS (Perper.>on)
<br /> - 1
<br /> HIRED AUTOS i BODILY INJURY $
<br /> ~NON-OWNED AUTOS (Per accident)
<br /> --- .------..--
<br /> i X; HYSICAL DAMAGE , PROPERTY DAMAGE $
<br /> I-X--~OMP & COll $1 ,000 I ;
<br /> i GARAGE LIABILITY I I AUTO ONLY - EA ACCIDENT t
<br /> R ANY AUTO ! OTHER THAN AUTO ONLY:
<br /> I~ EACHACQlO,ENTT$~'
<br /> I , .--.-
<br /> AGGREGATE I $
<br /> EXCESS LIABILITY I , I EACH OCCU~RENCE ~,09,~'~.s!~
<br /> I 101101109
<br />D I xl UMBRELLA FORM 9835472 01/01/08 AGGREGATE , I: 5,000,000
<br /> 1---- OTHER THAN UMBRELLA FORM
<br /> WORKERS COMPENSATION AND i ,,:<,,5TATU- I 10J!:'-'
<br /> I EMPLOYERS'L1ABILITY I X I TORY LJMITS ER .
<br />C \TC2H-US-8196A02-A-08- TIA 01101/08 01/01/09 EL EACH ACCIDENT 1$ 2,000,000
<br /> ~ IINeL TRJ-UB-186K259-0-08-Tll .- -f-
<br />B I THE PROPRIETORl 01101/08 01/01/09 EL DISEASE-POLICY LIMIT ~$ 2,000,000
<br /> : PARTNERS/EXECUTIVE ,~~~~ASE"EACH EMPLOYEE! $ 2,000,000
<br /> OFFICERS ARE: I EXCL
<br /> 10TH..
<br /> !
<br />DESCRIPTION OF OPERAT10NSfLOCATlONSNEHICLESrSPEC1ALITEMS
<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 />CERTIFICATE HOlDER CANCELLATION
<br /> SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
<br /> THE INSURER AFFORDING COVERAGE 'MLL ENDE!.vOR TO MAIL ----3D DAYS WRITTEN NOTICE TO THE
<br /> City of Santa Ana CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br /> Attn_ Clerk of the City Council
<br /> Civic Center Plaza, M-30 P 0, Box 1988 LIABILITY OF ANY KIND UPON THE INSlJRER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES. OR THE
<br /> Santa Ana, CA 92702 ISSUER OF THIS CERTiFICATE
<br /> MARSH USA INC, ~7?~
<br /> BY, Edward R Ford
<br /> MM1(31021 VAUD AS OF: 12/31/07
<br />
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