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Client#- 4,` '48 <br />"*O rrG'1 Cf%G <br />\V 1 LLLVJ <br />ACORD- CERTIFIC�k i "'E OF LIABILITY INSU cNCE <br />°ATE(M""'°°^,YYY, <br />INSRE <br />5/04/2010 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Hub International <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HUB int'I Insurance Serv. Inc. <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />4371 Latham St, Ste #101 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />04/20 /2010 <br />04/20/2011 <br />Riverside, CA 92501 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />TSJ Electrical Communications, Inc. <br />INSURER A: Travelers Property Casualty Co <br />25674 <br />INSURER B: Travelers Indemnity Company of <br />25666 <br />DBA: Masters Electric' <br />INSURER C: <br />GENERAL AGGREGATE <br />7490 Jurupa Avenue <br />INSURER D: <br />PRODUCTS - COMP /OP AGG <br />Riverside, CA 92504 <br />INSURER E: <br />rn�mo w nr-c. <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICfY 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 <br />MAY 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 />LTR <br />INSRE <br />TYPE OF INSURANCE <br />- POLICY NUMBER <br />POLICY EFFECTNE <br />DATE MMIDD <br />POLICY EXPIRATION <br />DATE MM/DD <br />LIMQTS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE 51 OCCUR <br />X PD Ded: $2,500 <br />DTEC09011 PO41 TIL10 - <br />04/20 /2010 <br />04/20/2011 <br />EACH OCCURRENCE <br />$1,000,000 <br />DAMAGE TO RENTED <br />$300 ,000 <br />MED EXP (Any one person) <br />s5.000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />$2,000,000 <br />GENL AGGREGATE LIMIT APPLIES PER: <br />POLICY X JEC7 LOC <br />PRODUCTS - COMP /OP AGG <br />$2,000,000 <br />B <br />AUTOMOBILE <br />X <br />LIABILTfY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />DT8109011 PO41 TCT10 <br />04/20/2010 <br />04/20 /2011 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$1,000,000 <br />BODILY INJURY <br />(Per Person) <br />$ <br />X <br />BODILY INJURY (Per (Per accident) <br />X <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />A <br />GARAGE LIABILITY <br />ANY AUTO <br />EXCESS / UMBRELLA LIABILITY <br />7X OCCUR 0 CLAIMS MADE <br />R DEDUCTIBLE <br />X RETENTION $ 10 000 <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABIUTY <br />ANY PROPRIIETgOER/ PARTNER/EX ECUTIVE <br />WFICE,TM inMNHP EXCLUDED? <br />Lj <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />OTHER <br />DTSMCUP09011 P040T1 <br />APPROVED <br />) <br />Lau <br />A,SSlst <br />04120/2010 <br />AS TO <br />04/20/2011 <br />FORM <br />ey <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTO ONLY: AGG <br />EACH OCCURRENCE <br />$ <br />$ <br />$4,000,000 <br />AGGREGATE <br />s4,000,000 <br />$ <br />$ <br />WC STATU- OTH- <br />$ <br />Witt ShCed <br />City Attor <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT $ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Certificate holder is named as additional insured in regards to the General Liability policy per attached <br />form CGD246 08/05. Insurance is primary/non- contributory per attached form CGD246 08/05. Waiver of <br />subrogation applies to General Liabilty policy per attached form CG240410193. <br />eC0'nCI!1erC unl M=- <br />City of Santa Ana <br />Public Works Agency <br />PO Box 1988, M -21 <br />Santa Ana, CA 92702 <br />ARf1R11 9c /�nneln�� . <br />OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />TE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL A_ DAYS WRITTEN <br />TICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />•OSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />AUTHORIZED REPRESENTATIVE <br />• �• +..�. VJ.7v.71MVO04UC o 1 ars -ZUU9 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD VG41 <br />