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ACC:' be" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDIYYYY)
<br />`---''
<br />06/07/2010
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER LICENSE NO, 0637431
<br />CONT C
<br />NAME: T PATRICK MCRAE
<br />PATRICK MCRAE INSURANCE SERVICES
<br />PHONE//714 779-6999 jA.,Noi:-(714} 779 6903
<br />(AJC No Exq:_ (
<br />1290 N. HANCOCK ST., SUITE 210
<br />E-MAIL
<br />AWREss_P•Mcrae @sbc lobal.net
<br />ANAHEIM HILLS, CA 92807
<br />PRODUCER CTE2.... S
<br />CUSTQM_ ER Iq #:
<br />- --
<br />INSURER(S),AFFORDING COVERAGE NAIC #
<br />INSURED
<br />_ _
<br />INSURER A: SCOTTSDALE INSURANCE COMPANY 41297
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />INSURER B: AMERICAN ZURICH INSURANCE COMPANY 40143
<br />5463 DIAZ STREET
<br />INSURERc: REDWOOD FIRE & CASUALTY INS 11673
<br />A-2008-308
<br />INSURER D: PEERLESS INSURANCE COMPANY 24198
<br />IRWINDALE CA 91706
<br />_ -- _
<br />1,000,000
<br />INSURER E: ' -
<br />-
<br />INSURER F: -
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
<br />PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
<br />THE TERMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR __- -'AOOL UBR--''---�—POLICY EFF--- POLICY EXP
<br />LTR TYPE OF INSURANCENSR WVD POLICY NUMBER MMJDD/YYYY MMIDDIYYYY LIMITS
<br />A GENERAL unelurY BCS0022281 06/03/2010 06/03/2011 EACH OCCURRENCE $
<br />1,000,000
<br />$5,000 PER OCC DED. DAMAGE TO RENTED ----""-"
<br />X COMMERCIAL GENERAL LIABILITY PRE MISES_(Ea
<br />-
<br />100,000
<br />occunence� _$
<br />CLAIMS X
<br />-MADE OCCUR
<br />MED EXP (Any ane person) $_--
<br />X XCU
<br />__--
<br />PERSONAL 8 ADV INJURY
<br />X OCP _ -- Y $
<br />'
<br />1,000,000
<br />._- ---.....---------.".-_ -------!GENERAL AGGREGATE $
<br />2,000,000
<br />„GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG j $
<br />... r._ ..
<br />2,000,000
<br />POLIPRO-
<br />CY X LOC EBL EA CLAIM/ACG $
<br />1,000,000
<br />C AUTOMOBILE LIABILITY CAA100505 11/05/200911/05/2010.. COMBINEDSINGLELIMIT
<br />$
<br />X ANY AUTO
<br />PF'RO�Ei� —
<br />COMPREHENSIVE DELI ' AS TO �L (
<br />J RY Per.
<br />1,000,000
<br />person) $
<br />ALL OWNED AUTOS - !
<br />$1'000';
<br />-
<br />BODILY INJURY (Per accident)' $
<br />X SCHEDULED AUTOS
<br />COLLISION DED. E?t-r 7
<br />_
<br />,,._ PROPERTY DAMAGE
<br />X HIRED AUTOS $
<br />I. � 0
<br />$1,00'-
<br />_
<br />X NON -OWNED AUTOS Laura Stitt Sheedt
<br />$
<br />X HIRED PHYS $300,000 LIMIT I 4ssistan`( City Altorrret� - - — —_
<br />- $
<br />- -
<br />A UMBRELLA UAB X OCCUR XLS0067479 06/03/201006/03/20111 EACH
<br />OCCURRENCE $
<br />X EXCESS LIAB CLAIMS -MADE! - --"-- "--
<br />5,000,000
<br />- - - AGGREGATE S
<br />X
<br />5,000,000
<br />DEDUCTIBLE
<br />RETENTION S 0
<br />�
<br />13 WORKERS COMPENSATION WCO283135402 06/0312010106/03/2011 ! VVC STATU- .0TH- $
<br />AND EMPLOYERS' LIABILITY X
<br />Y 1 N I . TS2R�LI1v117$
<br />ANY PROPRIETORJPARTNER/EXECUTI`JE
<br />OFFICE MBER EXCLUDED? � N / A E L. EACH ACCIDENT $
<br />1 ,000,000
<br />(Mandatory in
<br />If yes. under '.
<br />and E.L DISEASE - EA EMPLOYEE $
<br />1,000,000
<br />,
<br />__-- --_
<br />DESCRIPTION
<br />DESCRIPTION OF OPERATIONS below �! E.L. DISEASE -POLICY LIMIT $
<br />° BUSINESS OWNERS & cBPBsa192o
<br />`.._
<br />11000,000
<br />$752,760 BUILDING
<br />CONTRACTORS EQUIPMENT $1,000 DEDUCTIBLE $367,200 BPP - $300,000 BI WI EE
<br />COV. INCL. THEFT 04/10/2010,04 10 oi1
<br />$116,316 SCHEDULED EQ,
<br />DESCRIPTION OF OPERATIONS / LOCATIONS t VEHICLES (Attach ACORD 101 Additional Remarks Schedule if more space is required)
<br />THE CTY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFdRNIA 92701, ALONG WITH IYS ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYERS AND VOLUNTEERS
<br />LISTED AS ADDITIONAL
<br />ARE
<br />INSURED AS REQUIRED PER WRITTEN AGREEMENT. INSURANCE BY THE AFFORDED BY THE GENERAL LIABILITY POLICY FOR THE BENEFIT OF THE
<br />ADDITIONAL INSURED IS PRIMARY INSURANCE AS RESPECTS ANY CLAIM, LOSS OR LIABILITY CAUSED
<br />IN WHOLE OR IN PART BY THE NAMED INSURED(S) OPERATIONS,
<br />OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED IS EXCESS AND NON- CONTRIBUTORY. '30
<br />AND ANY
<br />DAY NOTICE OF CANCELLATION IN ANY EVENT.
<br />PROJECT DESCRIPTION: CITY OF SANTA ANA/ TRAFFIC ENGINEERING (CT 1695)
<br />CFRTIFI1'ATF un! nco
<br />CITY OF SANTA ANA
<br />TRAFFIC ENGINEERING
<br />20 CIVIC CENTER PLAZA (M-43)
<br />P.O. BOX 1988
<br />SANTA ANA, CA 92702
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />v I V00-1cuuty 14%,UKU k UKl`UKA i IVN. All rights reserved.
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
<br />
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