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<br /> CERTIFICATE OF INSURANCE 1 DATE
<br />MARSH USA INC. 10/27/2008
<br />PRODUCER THIS CERTIFICATE 1$ ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br /> NO RIGHTS UPON THE CERTIFICATE HOlDER OTHER THAN THOSE PROVIDED IN THE
<br /> Marsh USA Inc. 10838SE POLlCY THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br /> AFFORDED BY THE POLICIES DESCRIBED HEREIN.
<br /> 411 East Wisconsin Avenue AM B..tFbtil'lg
<br /> Suite 1600 COMPANIES AFFORDING COVERAGE I". aI otlO1tO&)
<br /> Milwaukee, Wisconsin 53202-4419 *See Below
<br /> Attn: CPU, Phone (414) 290-4912 Fax (414) 29Q..4953 Company ACE American Insurance Company
<br /> CPU_Milwaukee@marsh.com A P.o Box 41484. Philadelphia, PA 19101 A+XV
<br />INSURED Company Sentry Insurance A Mutual Co. A+XV
<br /> Johnson Controls, Inc. Attn: Corp. Risk Mgmt. X-92 B 1800 North Point Onve, Stevens Point, WI 54481
<br /> Johnson Controls Battery Group, Inc. P.O. Box 591 Company Indemnity Insurance Company of North America
<br /> Johnson Controls Interiors, L.L.G. Milwaukee, WI 53201
<br /> JCIM US LLC C and for CA, WI and EX WC: ACE A+XV
<br /> Gal-Air, Inc. American Insurance Company
<br /> GES America, L.L.G. P,O Box 41484 Phil~"'hia. PA 19101
<br /> Metro Mechanical Inc. Company
<br /> Optima Batteries, Inc. 0 ACE Property & Casualty Insurance Company A+XV
<br /> USI Companies, Inc 436 Walnut street, Ph;ladelph~, PA 19106
<br /> York International Cornnration
<br />COVERAGES This certificate suoersedes and reolaces any oreviouslv issued certificate.
<br /> THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLlCY PERIOD INDICATED.
<br /> NOT'NITHSTANDING 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 BEEN REDUCED BY PAID CLAIMS.
<br />eo POLICY EFFECTlVE POLICY ~RATlON
<br />LT TYPE OF INSURANCE POLICY NUMBER DATE (MMlDONY) DATE (MMlD01YY) LIMITS
<br />R
<br />A GENERAL LIABILITY {1} (3) (4) GENERAl AGGREGATE $ 5,000,000
<br /> 'X COMMERCIAL GENERAL LIABILITY HDOG23746396 10-1-2006 10-1-2009 PRODUCTS..cOMP/OP AGG $ 5,000,000
<br /> l CLAIMS MADE ~ OCCUR PERSONAl & ADV INJURY $ 5,000,000
<br /> 'X OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 5,000,000
<br /> Contractual FIRE DAMAGE IAnv onefire\ $ 5,000,000
<br /> X x.c.u (Explosion. Collapse, Underground)
<br /> X AdcIillonallnsured-OwnerlLe.....esor MED EXP (Anv one person) $ 50,000
<br /> Conln.ctore See Below
<br />B ~TOMOB1LE LIABILITY (2) (3) (4)
<br /> 90-04606-01 10-1-2006 10-1-2009 COMBINED SINGLE LIMIT $ 5,000,000
<br /> ~ ANY AUTO M
<br /> _ ALL OWNED AUTOS BODILY INJURY
<br /> ex SCHEDULED AUTOS {Per person)
<br /> HIRED AUTOS 'fJJu P ~! I! L; BODILY INJURY
<br /> -jf NON-OWNED AUTOS (peracc:ident)
<br /> c"-
<br /> . PROPERTY DAMAGE
<br /> GARAGE LIABILITY ') AUTO QNLY-EAACCIDENT
<br /> RANYAUTO OTHER THAN AUTO ONLY:
<br /> EACH ACCIDENT
<br />D EXCESS LIABILITY $ 5,000,000
<br /> XOO G23665014 10-1-2008 10-1-2009 EACH OCCURRENCE
<br /> ~ ~MBRELLA FORM $ 5,000,000
<br /> AGGREGATE
<br /> OTHER THAN UMBRELLA FORM
<br />C WORKERS COMPENSATION AND WLRC42650565 - AOS 10-1-2008 10-1-2009 X IfCSTATU- 5\ WTH-
<br /> EMPLOYERS' LIABILITY (4) WLRC42650573 - CA TORY LIMITS ER
<br /> SCFC42650615 - WI EL EACH ACCIDENT $ 1,000,000
<br /> THE PROPRIETORI . ~ INeL WCUC42650627 - EX WC $ 1,000,000
<br /> EL DISEASE.POLlCY LIMIT
<br /> 6~~~e:~:iCUTIVE EXCL EL DISEASE-EACH EMPLOYEE $ 1,000,000
<br /> OTHER
<br /> (1) AOOlTlONAL INSURED: If required by contract,.lnctudetl coverage for Additional Insureds per endorwment attached.
<br /> (2) ADDITIONAL INSURED: tf required by contract, Includes coverage for Addtttonallnsuredl and Lo" Payees as required by contract.
<br /> l~t ,PRIMARY COVERAGE: Where required by lease or contract,. this c~~~~ ~I,:ry and not excess of or contributing with other Insurance or self.lnsurance.
<br /> .. WAIVER OF SUBROGATION: Insured waives s to the exwnt ulred contract.
<br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESfSPECIAL ITEMS JCIContractNo.
<br />Project Nama: All WOl'X performed by above insured
<br />Customer PO Number.
<br />CERllFICA TE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE POUCIES DESCRIBED HERBN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.
<br /> City of Santa Ana THE ISSUlNGCOMP!\NY WILL E;''''(".' .~n T~ MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
<br /> Building Maintenance M-ll NAMED HEREIN. O"T~' . n~ T~'" - - ...-_._~ - ... ._~~~ . _ ~~. _._~. ~n' ._ ~. _~ ..n'~"~
<br /> 20 Civic Center Plaza . ",'I-..r ..._.~_~ .r~~~_' _ ___~._~ ._~ ._r.~_ ~~~_'"'""'(~_"_'T"-'~
<br /> Basement MARSH USA INC. BY: I /liY~ 7'
<br /> Santa Ana, CA 92701 ~ // /;1t/;'" -;c> ........ 8H.t...uftO' or...""...... pWIId...for I-....ao& purpoIl..ontyand.._-, upOlll~ """...,..,t...-"rOIflBplV........-.lI USAlnc:. DII",_$8l1Onll h.... _~to.ud1I'11l1ng11o. ...h USA Inc.'""lIt,.lIlI_h..... no
<br />IHpoMlIIIIll:)Oor CIlIIlpIOI'1to.lllfonn.' ....otc:l*floldIr 01'",,,,- NIyIIoQ UpoI'I thlIl..~or.., w...-In...a. ..... a.trMlltp~"",,"""clI- """" USA IIIc. ........ no.lIIIlIly_ ....pKlto....~orfWlun ablII1rlO INlY
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