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<br />I ACORD,"
<br />
<br />! PRODUCER 714-779-6999
<br />I MCRAE & ASSOCIATES A -,;)/){)5- .:L3'f -Q r
<br />PATRICK MCRAE INSURANCE SrRVICES
<br />, 1290 N HANCOCK ST STE 210
<br />L ANAHEIM HILLS CA 92807
<br />IINSURED
<br />I CROSSTOWN ELECTRICAL & DATA, INC,
<br />5463 DIAZ STREET
<br />IRWINDALE, CA 91706
<br />,
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />DATE (MMIDDIYVVY)
<br />07/09/2008
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />I
<br />
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />- -- --~-
<br />INSURERA LIBERTY SURPLUS INSURAN~ J 10725___
<br />'INSURER., UNITED NATIONAL INSURANCE CO . 11445 _
<br />~NSUR, ERC AMERIC,AN ZURICH INSURA, NCE C,O--+ __~01iL
<br />INSURERD COMMERCE WEST __ _ 13161_
<br />INSURERE
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
<br />ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUeD OR
<br />I MAY PERTAIN, THE, I'NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL,THE TERMS, EXCL, USIQNS AND CONDITIONS OF SUCH
<br />. POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . .. .
<br />
<br />I~~: ADD' . POLICY NUMBER . POL.ICYEFFECTIVE' POLICY EXPIRATION LIMITS
<br />
<br />
<br />IA
<br />I
<br />I
<br />
<br />GENERAL. LIABILITY
<br />I X COMMERCIAL. GENERAL LIABILITY
<br />f::Z:jxd~LAIMSMADE l~ OCCuR I
<br />
<br />X OCP
<br />
<br />DGL-SF-184783-036
<br />
<br />06/0312008
<br />
<br />06/0312009
<br />
<br />EACH OCCURRENCE $ 1.000,000
<br />~~~~~i~~E~~~~~r~nce)___ : $- _~9,000-
<br />MED E'(P(Any one person) I S EXCLUDED._
<br />,PER,~NAL&ADVINJUR~Y $ ,___ 1,000,000
<br />._GENERA~.AGGREGATE $. 2,000,000
<br />PRODUCTS ,COMP/OPAGG , S ~,OOO,QOO
<br />
<br />
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />- -, POLICY IX PRO> LaC
<br />AUTOMOBIL.E LIABILITY
<br />
<br />g ANY AUTO
<br />AL.LOWNED AUTOS
<br />~ SCHEDULED AUTOS
<br />X HIRED AUTOS
<br />~L NON,OWNEDAUTOS
<br />
<br />I
<br />
<br />$5,000 DEDUCTIBLE
<br />
<br />FCX0005465
<br />
<br /> COMBINEDSINGL.E LIMIT
<br />02/02/2008 0210212009 (Eaaccident)
<br /> I BODIL. Y INJURY
<br /> (Per person)
<br /> - -
<br /> BODIL'( INJURY
<br /> IPeraccidenl)
<br /> PROPERTY DAMAGE
<br /> {Per accident)
<br /> AUTO ONL. Y ,EA ACCIDENT
<br /> OTHER THAN EAACC
<br /> AUTO ONLY AGG
<br /> , EACH OCCURRENCE
<br />06/03/2008 0610312009 Ag5>REGATE
<br /> IJROD'~ICT~ > G:)PM Inp
<br />
<br />$ 1,000,000
<br />
<br />CV A0388720
<br />
<br />t--
<br />
<br />
<br />B
<br />
<br />~ESSlUMBRELL.A LIABILITY
<br />1_1U OCCUR -~ CLAIMS MADE
<br />
<br />$
<br />$ 2,000.000 ~
<br />$ 2,000.000
<br />, _~OOO,OOO
<br />$
<br />
<br />
<br />DEDUCTIBLE
<br />RETENTION
<br />WORKERS COMPENSATION AND
<br />C EMPL.OYERS' L.IABILlTY
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />I OFFICER/MEMBER EXCLUDED?
<br />I If yes, desCflbe under
<br />, SPECIAL PROVISIONS below
<br />I OTHER
<br />
<br />WC0283135400
<br />
<br />06/0312008
<br />
<br />06103/2009
<br />
<br />
<br />OTH>
<br />ER
<br />
<br />1,000,000
<br />1000,01)(L
<br />1.000,000
<br />
<br />DESCRIPTION OF OPERATIONS ILOCATlONSJVEH1CL.ES/EXCL.USIONSADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />I CITY OF SANTA ANA, ITS AFFILIATES, REPRESENTATIVES, ASSIGNS, OFFICERS, DIRECTORS, EMPLOYEES, AND VOLUNTEERS
<br />"SERVANTS" ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO PROJECT' MASTER AGREEMENT
<br />, CROSSTOWN JOB NO 1695
<br />'10 DAY NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM
<br />!
<br />
<br />CERTIFICATE HOLDER CANCELLATION
<br />
<br />,
<br />.'
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WIL.L.~~X:~:MAIL. 30* DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOL.DER NAMED TO THE LEFT7B6~~~~n.
<br />.~l.\~~,H;j{~M~?\~~
<br />~XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
<br />AUTHORIZED REPRESENTATIVE ., ,)
<br />PATRICK MCRAE iJl!J1C
<br />
<br />CITY OF SANTA ANA
<br />POBOX 1988/ M-4'3^ ' r~' J
<br />SANTA ANA, CA 92702._~...cJ1jf'
<br />
<br />;Iv
<br />
<br />ACORD 25 (2001108)
<br />
<br />
<br />'ACORD CORPORA TION 1988
<br />
<br />"
<br />
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