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CERTIFICATE
<br />CERTIFICATE
<br />OF INSURANCE .RANCCERTIFICATE NUMBER
<br />[�I s7 \ I G 648068
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
<br />PRODUCER
<br />RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY.
<br />THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br />POLICIES DESCRIBED HEREIN.
<br />Marsh, Inc.
<br />1166 Avenue of the Americas
<br />COMPANIES AFFORDING COVERAGE
<br />COMPANY A: Al South Insurance Co.
<br />New York, NY 10036
<br />Telephone (212) 345-5000
<br />COMPANY B: Commerce & Industry Ins Co
<br />COMPANY C: Fireman's Fund Insurance Company
<br />INSURED
<br />COMPANY D: Illinois National Insurance Co.
<br />SimplexGrinnell, LP
<br />CO1VIPANY E: Insurance Company of the State of PA
<br />COMPANY F: Nat'l Union Fire Ins Co of Pittsburgh, PA
<br />1701 WEST SEQUOIA AVE
<br />COMPANY G: New Hampshire Ins. Co.
<br />ORANGE, CA 92868
<br />United States kiooi jo6-
<br />COVERAGES
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY REOUIRMENTS, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
<br />AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY
<br />PAID CLAIMS.
<br />CO
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY
<br />LIMITS
<br />LTR
<br />DATE (MMIDD/YY)
<br />EXPIRATION
<br />G
<br />GENERAL
<br />LIABILITY
<br />GL 090-73-63 (Primary GL)
<br />10/1/2009
<br />10/1/2010
<br />GENERAL AGGREGATE $2,000,000.00
<br />PRODUCTS - COMP/OP AGG $2,000,000.00
<br />X
<br />COMMERCIAL GENERAL
<br />CLAIMS MADE K OCCU
<br />PERSONAL & ADV INJURY $1,000000.00
<br />EACH OCCURRENCE $1,000,000.00
<br />OWNER'S & CONTRACTOR'S
<br />FIRE DAMAGE (Anyone fire) $1,000,000,00
<br />MED EXP (Any one person) $10,000.00
<br />F
<br />AUTOMOBILE LIABILITY
<br />CA 091-93-98(MA)
<br />10/1/2009
<br />10/1/2010
<br />COMBINED SINGLE LIMIT $1,000,000.00
<br />F
<br />X ANY AUTO
<br />CA 091-93-97 (VA)
<br />10/1/2009
<br />10/1/2010
<br />F
<br />X HIRED AUTOS
<br />CA 091-93-96 (AOS)
<br />10/1/2009
<br />10/1/2010
<br />X NON-OWNED AUTOS
<br />A
<br />WORKERS COMPENSATION AND
<br />WC 060-16-8747 (CT,GA,PA,SC)
<br />10/1/2009
<br />10/1/2010
<br />X I WC STATUTORY oTHE
<br />LIMITS R
<br />B
<br />D
<br />E
<br />EMPLOYERS' LIABILITY
<br />THE PROPRIETOR/
<br />PARTNERS/EXECUTIVE
<br />WC 060-16-8741 (FL)
<br />WC 060-16-8744 (MI)
<br />WC 060-16-8745 (AR,MA,VA)
<br />10/1/2009
<br />10/1/2009
<br />10/1/2009
<br />10/1/2010
<br />10/1/2010
<br />10/1/2010
<br />EL EACH ACCIDENT $2,000,000.00
<br />EL DISEASE-POLICY LIMIT $2,000,000.00
<br />EL DISEASE-EACH $2,000,000.00
<br />F
<br />F
<br />OFFICERS ARE:
<br />WC 060-16-8742 (OR)
<br />WC 060-16-8740 (CA)
<br />10/1/2009
<br />10/1/2009
<br />10/1/2010
<br />10/1/2010
<br />G
<br />G
<br />WC 060-16-8748 (AOS)
<br />WC 060-16-8743 (TX)
<br />10/1/2009
<br />10/1/2009
<br />10/1/2010
<br />10/1/2010
<br />G
<br />WC 060168746 (ND,NY,OH,WA,WI,WY)
<br />10/1/2009
<br />10/1/2010
<br />EXCESS LIABILITY
<br />GENERAL AGGREGATE
<br />PRODUCTS - COMP/OP AGG
<br />OTHER THAN UMBRELLA FORM
<br />*!AS T
<br />FORM
<br />EACH OCCURRENCE
<br />UMBRELLA FORM
<br />14flq
<br />PROPERTY
<br />Dep City
<br />uAgiftcomey
<br />OTHER
<br />C
<br />C
<br />Builder's Risk/installation/Contract Works
<br />Rental Equipment/Contractor's Equipment
<br />OC 9112860
<br />OC 9112860
<br />5/1/2009
<br />5/1/2009
<br />5/1/2010
<br />5/1/2010
<br />USD $1,000,000.00 per Jobsite
<br />USD $1,000,000.00 per jobsite
<br />C
<br />I Blanket Transit
<br />OC 9112860
<br />5/1/2009
<br />5/1/2010
<br />USD $1,000,000.00 per conveyance
<br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
<br />SANTA ANA POLICE DEPARTMENT is named as Additional Insured subject to the conditions of the written contract between the Named Insured and SANTA ANA
<br />POLICE DEPARTMENT.
<br />Waiver of Subrogation applies per the conditions of the written contract between Named Insured and SANTA ANA POLICE DEPARTMENT.
<br />Coverage indicated above shall be primary and non-contributory to other similar insurance per conditions of the written contract between the Named
<br />Insured and SANTA ANA POLICE DEPARTMENT.
<br />Project: ACCESS CONTROL SYSTEM AT SANTA ANA POLICE DEPARTMENT
<br />Other Additional Insureds: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />.SANTA ANA POLICE DEPARTMENT
<br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
<br />INSURER AFFORDING COVERAGE WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN.
<br />60 CIVIC CENTER PLAZA
<br />SANTA ANA, 92710
<br />United States
<br />MARSH USA INC, BY: Franklin Hallock, Global Marine
<br />David Kong, Casualty Program Transit Program
<br />\/ALLD AS OF: 9127/2009'
<br />For questions regarding this certificate contact: M Beck (Email: danbeck®simplexgrinnell.com Phone: 714-870-1010 x770)
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