PACIFIC SYSTEMS ELECTRIC 2B - 2010

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.," 2001.-w�-o( R� CERTIFICATE OF LIABILITY INSURANCE "OP ID Ji rTE(MM CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 10/113/13/1Y) 0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poi cy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: PHONE (A C, No, Ext): (AIC, No): Roger Stone Insurance Agency ADDRESS: 5015 Birch Street Newport Beach CA 92660 CUSTOMERID#: PACI-12 Phone:949-757-0270 Fax:949-757-0375 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: Scottsdale Ins. Co. Pacific S Stems Electric, Inc. 32670 Dowling Court INSURERB: Mercury Casualty Co 11908 INSURERC: Winchester CA 92596 INSURER D CLAIMS -MADE �' OCCUR INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TC WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE INSR WV POLICY NUMBER (MMI fYYYY) (MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CPS1111583 02/02/10 02/02/11 PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE �' OCCUR MED EXP (Any one person) $ 5,000 X Owner/Cont Prot. X PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMP/OP AGS $ 2,000,000 Poucv X PEcr L7LCC I Emp Ben. $ None B AUTOMOBILE X LIABILITY ANY AUTO CCA0006663 02/01/10 02/01/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 iBODILY INJURY (Per person) $ AL- OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE $ (Per accident) NCN-OWNED AUTOS $ A UMBRELLA LIAB OCCUR XBS0006443 02/02/10 02/02/11 EACH OCCURRENCE s4,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE s4,000,000 DEDUCTIBLE $ X RETEN-ION $ N/A $ WORK S COMPENSATION- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFCER/MEMBER EXCLUDED? j� A,P1 NIA ,rom (� �� - -r �Y -� - - .TORY LIMITS I ER E �. EACH ACCIDENT $ E . DISEASE- EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below - E DISEASE- POLICY LIMIT $ ty A ttorney DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) RE: Electrical services for the City of Santa Ana CA. The City of Santa Ana its officers, employees, agents and representatives are named Additional insured with primary and non-contributory per form CG20100704 attached. *10 day notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Attn: Building Maintenance Div P.O. Box 1988 20 Civic Center Drive Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYSA9 I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. XXXXXXXXXXXX ©1988-2009 ACORD CORPORATION_ All rinhts racarvarl ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD