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? - aoo g - cA4 - oa- <br />'`??OR°? CERTIFICATE OF LIABILITY INSURANCE DAT <br />/1s o 0 <br />9 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />_ _ <br />Marsh USA Inc. <br />20t'? SEP 29 PM I= I ? ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />411 East Wisconsin Avenue <br />Suite 161X) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Milwaukee, wl 53202-4419 //++ f-, -_- - ,1 /? <br />Attn: CPU <br />Phones (414) 290912 Fax (414) 290-4953{ <br />r ? T Y U ? (? A ? <br />? 'SEE REVERSE FOR AM BEST RATING <br />N <br />I <br />, <br />. <br />CPU MilwaukeefNmarsM1.com tv - <br />?? I <br />INSURERS AFFORDING COVERAGE A <br />C # <br />sEE REVERSE <br />INSURED ?? ? ? <br />Johnson Controls, Inc. Attn: Corp Risk Mgmt. X-92 INSURER A: SEE REVERSE SIDE FOR INFORMATION <br />JohnSOn Controls Battery Group, Inc. P.O. Box 591 <br /> <br />Johnson Controls Interiors, L.L.C. Milwaukee, WI 53201 INSURER B: SEE REVERSE SIDE FOR INFORMATION <br />JCIM US LLC <br />Cal-Air, Inc. INSURER C: SEE REVERSE SIDE FOR INFORMATION <br />GES America, L.L.C. <br />Metro Mechanical Inc. <br />Optima Batteries, Inc. INSURER D: SEE REVERSE SIDE FOR INFORMATION <br />USI Real Estate Brokerage Services Inc. <br />York International Cor oration INSURER E: <br />:OVE <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 MAY <br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSR OD'L POLICY POLICY <br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS <br /> DATE LATE <br /> MM/DD MM/DD/W <br /> <br />A GENERAL LIABILITY (1) (3) (4) <br />H D OG 25521 390 <br />1 O/ 1 /201 O <br />1 O/1 /201 1 EACH OCC UR ENCE $ S,000,OOO <br /> ® COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED $ rj 000 <br />000 <br /> PREMISES Ea occurrence , <br /> OO CLAIMS MADE ® OCCUR ? <br /> MED EXP (Any one person) $ <br />j0,000 <br /> ® Contractual <br /> <br />® PERSONAL 8 ADV INJURY $ $,000,000 <br /> x,c,u <br /> <br /> <br />' <br />P <br />GENERAL AGGREGATE $ 5.000.000 <br /> GEN <br />PLIES PER: <br />L AGGREGATE LIMIT A <br />PRODUCTS -COMP/OP AGG <br />$ S,000,OOO <br /> POLICY PROJECT LOC <br /> <br />B AUTOMOBILE LIABILITY (2) (3) (4) <br />90-04606-O1 <br />10/1/2010 <br />10/1/2011 COMBINED SINGLE LIMIT <br />000 <br />000 <br />$5 <br /> ® ANY AUTO (Eagccitl¢nt) . <br />, <br /> O ALL OWNED AUTOS BODILY INJURY <br /> <br />Q SCHEDULED AUTOS <br />(Per person) $ <br /> ® HIRED AUTOS BODILY INJURY $ <br /> (Per accitlen[) <br /> ® NON-OWNED AUTOS PROPERTY DAMAGE $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> O ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: qGG $ <br />D EXCESS/UMBRELLA LIABILITY XOO G2682785r 1U/1 /2D1U 1U/1/2011 EACH OCCURRENCE $ 6,000,000 <br /> ® OCCUR O CLAIMS MADE J AGGREGATE $ S,000,OOO <br /> $ <br /> Q DEDUCTIBLE <br /> $ <br /> Q RETENTION $ <br /> <br /> WORKERS COMPENSATION AND W LRC4614014A - AOS ® WC sTATU- O OTH- <br />C EMPLOYERS' LIABILITY (4) W LRC4614O126 - CA 1 O/1 /201 O 1 O/1 /201 1 TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/E%ECVTIVE SCFC46140151 - WI EL EACH ACCIDENT $ 1,000,000 <br /> OFFICEWMEMBER EXCL UDF.O? Q Y/N <br />M <br />tl <br />t <br />I <br />NH WCUC4614O17S - EX WC E.L. DISEASE- EA EMPLOYEE $ 1,000,000 <br /> ( <br />an <br />a <br />ory <br />n <br />) WCUC46140163 - EX WC FL <br /> If yes, describe under E-L. DISEASE -POLICY LIMIT $ 1,000,000 <br /> OTHER <br /> (1) ADDITIONAL INSURED: If requir¢d by contract, includes coverage for Additional Insureds per attest M1ed endorsement. <br /> (2) ADDITIONAL INSURED: If req ufretl by contract, Includes coverage for Additional Insureds and Loss Payees as requlretl by contract <br /> (3) PRIMARY COVERAGE: WM1ara raqul red by lease o ontract, [M1ls c raga Is primary and no[ ¢xcass of or contributing wl[M1 otM1¢r insurances or sell-Insurance <br />c <br /> 4 WAIVER OF SUBROGATION: Insured waives subro <br />atlon [o [M1e extant r ulrad b ontract <br />DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / E%CLDSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />JCI Contract No. JCI Projac[ Nama:All work performed by abov¢ insur¢d Customer PO Number: <br />CERTIFICATE HOLDER A UAT2 (IV F.T7 A R 'TO FORM CANCELLATION <br />City of Santa Ana /? SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />Building Maintenance M-11 C EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL GND6.4?VGiiZC <br />20 CIVIC Center Pala MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, RYi <br />Basemen[ / <br />I' S <br />L Sheedy <br />Santa Ana, CA 92701- aura <br /> <br /> A SS1Sta IIt 1Cy AttOrlley gUTHORIZED REPRESENTATIVE <br /> <br /> Ot MARSH USA INC. <br />ACORD 25 (2009/01) ©ACORD CORPORATION 1988