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<br /> ~ CERTIFICATE OF INSURANCE \ DATE
<br />MARSH USA INC. 01/03/2008
<br />... ..
<br />:ODUCER A ". ;U;O~-( ;:l.:l. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br /> NO RIGHTS UPON THE CERTLFICA TE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br /> Marsh USA Inc. 'I I' POLICY. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE
<br /> 411 East Wisconsin Avenue " -oj AFFORDED BY THE POLICIES DESCRIBED HERELN,
<br /> Suite 1600 " -0:2- /1M a_at Ratmg
<br /> Milwaukee, Wisconsin 53202-4419 A-~Db-:203 COMPANIES AFFORDING COVERAGE (A. 01 01/0210$)
<br /> Ann: CPU. Phone (414) 290-4912 Fax: (414) 290 4953 *See Below
<br /> CPU _Milwaukee@marsh.com N~cRO\)Y- 00 'i Company ACE American Insurance Company A+XV
<br /> A P.O. Box 41484, Philadelphta. PA 19101
<br />ISURED Company Sentry Insurance A Mutual Co. A+XV
<br /> Johnson Controls, Inc. Ann: Corp. Risk Mgmt. X-92 B 1 BOO 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 /> Cal-Air, Inc. e and for CA. WI and EX WC: ACE A+XV
<br /> GES America, L.L.C. American Insurance Company
<br /> Oplima Batteries. Inc. PO Box 414B4, Philadelohia, PA 19101
<br /> USI Companies, Inc. Company Lexington Insurance Company A+XV
<br /> York International Corporation D 100 Summer Slreet, Boston, MA 02110
<br />:OVEAAGE$. ...... This.eertificateSlJOersedes and reolooe$ sriv oreviQ\islv'lSStJEt<:l Certificate.
<br /> THIS LS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
<br /> NOlWlTHSTANDING ANY REQUIREIoAENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
<br /> PERT AIN, 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 BEEN REDUCED BY PAID CLAIMS
<br />:0 POLICY EFFECTIVE POLICY EXPIRATION
<br />T TYPE OF INSURANCE POLICY NUMBER DATE (MM/OOIYY) DATE (MM/DOIYY) LIMITS
<br />R
<br />~ GENERAL LIABILITY (1) 13) (4) GENERAL AGGREGATE $ 5.000.000
<br /> f-- HDOG2373283A 10-1-2007 10-1-2008
<br /> X COMMERCiAl GENERAL LIABILITY PRODUCTS.COMPIDP AGG $ 5,000.000
<br /> l CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 5,000,000
<br /> OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 5.000.000
<br /> T Contractual FIRE DAMAGE (Anv one fire\ $ 5.000.000
<br /> X x,C,U (Explo~on. CoIIap.... Und0<9rou1d)
<br /> X Addltionallnsured (See B"ow) MED EXP IAn. one oerson) $ 50,000
<br />3 ~OMOB1LE L1ABLlITY (2) (3) (4)
<br /> 90-04606-01 10-1-2007 10-1-2008 COMBINED SINGLE LIMIT $ 5,000,000
<br /> X ANY AUTO
<br /> ..:....:-
<br /> ALL OWNED AUTOS BODilY INJURY
<br /> >--
<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 /> -
<br /> ANY AUTO OTHER THAN AUTO ONLY:
<br /> -
<br /> EACH ACCIDENT
<br /> AGGREGATE
<br />D EXCESS LIABIliTY $ 5,000,000
<br /> 5577735 10-1-2007 10-1-2008 EACH OCCURRENCE
<br /> ~ UMBRELLA FORM AGGREGATE $ 5.000.000
<br /> OTHER THAN UMBRELLA FORM
<br />C WORKERS COMPENSATION AND XlWCSTATU. ; \ 17TH'
<br /> EMPLOYERS' LIABILITY 14) WLRC44473094 - AOS 10-1-2007 10-1-2008 TORY LIMITS ER .'
<br /> WLRC44473136 - CA EL EACH ACCIDENT $ 1.000.000
<br /> THE PROPRIETOR} ~ INCL SCFC44473057 - WI $ 1,000,000
<br /> WCUC4447301A - EX WC EL DISEASE-POLICY LIMIT
<br /> PARTNERS/EXECUTLVE EXCL El DISEASE EACH EMPLOYEE $ 1,000.000
<br /> OFFICERS ARE
<br /> OTHER
<br /> (1) ADDITIONAL INSURED: If requinld by conlract, Includes coverage for Addiliooallnsureds per attached .ndors.menl
<br /> (2) AOOITIONAL INSUREO: If required by contract, includ.s cov.rage for Addillonallfl5ureds and Loss Pay.. as required by contract.
<br /> (3) PRIMARY COVERAGE: Where required by lea.a or contracl, this coverage Is primary and nol .~c... of or contributing with other insurance or self-insurance,
<br /> (4) WAIVER OF SUBROGATION: Insu....d waives subrogation to the extent ....quir.d by conlract.
<br />DESCRIPTION OF OPERA TIONSilOCA TIONSNEHICLESISPECIAL ITEMS JC Contract No. 83737111
<br />Projecl Name: Santa Ana Reg Trans BI Chiller 83737111 Ser
<br />Customer PO Number: SIGNED AGREEMENT 3.73119E+11 CITY OF SANTA ANA
<br />CERnFICATE HOLDEIt ..... . CANCELLATION
<br /> SHOUlD mY OF THE POLICIES DESCRIBED HEREIN BE cANCEUEO 8EfORE THE EXPIRATION OATE THEREOF.
<br /> CITY OF SANTA ANA THE ISSUING COM'ANY Wlll.'''I5-'' "'R To.......L 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOlDER
<br /> NAMED HEREIN, IiiJI6lT ralb.' 'fiCll;;."JQ rUIL. t""11 rJQTI~~ &11Ab.' ",pg-iljl;;. trO 20' tC"T19tl QR U.illfTY Qr "tPl' Krr>IQ
<br /> Mario Ghizzi '..l'PQtJ TI i& Itl~' 'f<1~ . 'TQRl:'ltlC 1i:9' '''R'' s:t., ITt "~~nn;: SR RWA"thHT"'ll' IliIL
<br /> CLERK OF THE CITY COUNCIL MARSH USA INC BY:
<br /> 20 CIVIC CENTER PLAZA M-30 fr /;:;1./7: , _/ AW"~-;7-)
<br /> SANTAANA,CA 91702-1988 ,-7~ .' ;:-,:,,:-.."':';:===:w~.:-=~-=~:;=~.:=::-.;~"t::::~r~=.::=;:::"":o;n::''i::~~=~-:;":J:=~:-:~~-=='::"
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