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, rr� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (M
<br />ll-ii
<br />2010YYY)
<br />10/3/2010
<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
<br />NAME:
<br />Marsh, Inc.
<br />PHONE FAX
<br />1166 Avenue of the Americas
<br />A/C No Ext: 212 345 -5000 A/C No:
<br />_
<br />E -MAIL
<br />New York, NY 10036
<br />ADDRESS:
<br />PRODUCER
<br />$1,000,000.00
<br />MED EXP (Any one person)
<br />CUSTOMER ID #:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURED
<br />INSURER A: AGCS Marine Insurance Company (Allianz)
<br />SimplexGrinnell, LP
<br />INSURER B: CHARTIS CASUALTY COMPANY
<br />1701 WEST SEQUOIA AVE
<br />INSURER C: Commerce & Industry Ins Co.
<br />GENERAL AGGREGATE
<br />ORANGE, CA 92868
<br />INSURER D: Illinois National Insurance Co.
<br />United States
<br />INSURER E: Nat'l Union Fire Ins Co. of Pittsburgh, PA
<br />INSURER F: New Hampshire Ins. Co.
<br />PRODUCTS - COMP /OP AGG
<br />COVERAGES CERTIFICATE NUMBER: 760166 - A REVISION NLIMRFR-
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR TYPE OF INSURANCE
<br />LTR
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM /DD/YYYY
<br />POLICY EXP
<br />MM /DD /YYYY
<br />LIMITS
<br />F
<br />:' GENERAL LIABILITY
<br />X COMMERCIAL GENERA
<br />L LIABILITY
<br />CLAIMS -MADE il, OCCUR
<br />GL 4360884 (Primary GL)
<br />10/1/2010
<br />10/1/2011
<br />EACH OCCURRENCE
<br />$1,000,000.00
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$1,000,000.00
<br />MED EXP (Any one person)
<br />$10,000.00
<br />PERSONAL & ADV INJURY
<br />$1,000,000.00
<br />OWNER'S & CONTRACTOR'S
<br />GENERAL AGGREGATE
<br />$2,000,000.00
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP /OP AGG
<br />$2,000,000.00
<br />� X POLICY PRO -
<br />T 7 LOC
<br />E
<br />AUTOMOBILE
<br />LIABILITY
<br />CA 3976576 (VA)
<br />10/1/2010
<br />10/1/2011
<br />COMBINED SINGLE LIMIT
<br />$1,000,000.00
<br />E
<br />E
<br />X
<br />ANY AUTO
<br />CA 3976575
<br />CA 3976577 ROVED
<br />(
<br />/ / 10
<br />�R
<br />10/1/2011
<br />0/1/2011
<br />Each accident
<br />BODILY INJURY (Per person)
<br />F
<br />ALL OWNED AUTOS
<br />CA 3976624 (NH) (Primary )
<br />10/1/ T 0
<br />1/2011
<br />BODILY INJURY (Per accident)
<br />SCHEDULED AUTOS
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />X
<br />HIRED AUTOS
<br />_-
<br />X
<br />NON -OWNED AUTOS
<br />MEL SSA M. CR
<br />NEW HAMPSHIRE (CSL)
<br />$250,000
<br />. THWAITF.
<br />UMBRELLA LIAB
<br />OCCUR
<br />CPU {' Its' t
<br />ttOrnc�
<br />EACH OCCURRENCE
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />AGGREGATE
<br />DEDUCTIBLE
<br />PRODUCTS - COMP /OP AGG
<br />NEW HAMPSHIRE (CSL)
<br />RETENTION $
<br />B
<br />C
<br />D
<br />E
<br />F
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY y / N
<br />ANY PROPRIETOR/PARTNER /EXECUTIVE
<br />(Mandatory in ER EXCLUDED?
<br />(Mandatory in and
<br />If yes, describe under
<br />NIA
<br />WC 026149 17 T, A,PA, )
<br />WC 026149514 (FL)
<br />WC 026149516 (MI)
<br />WC 026149513 CA
<br />WC 026149518 (MA) ND, NY, OH,
<br />(
<br />10/1/2010
<br />10/1/2010
<br />10/1/2010
<br />10/1/2010
<br />10/1/2010
<br />10/1/2011
<br />10/1/2011
<br />10/1/2011
<br />10/1/2011
<br />10/1/2011
<br />X WRYTATIT- OTH-
<br />E.L. EACH ACCIDENT
<br />$2,000,000.00
<br />E.L. DISEASE - EA EMPLOYE
<br />$2,000,000.00
<br />E.L. DISEASE - POLICY LIMIT
<br />$2,000,000.00
<br />DESCRIPTION OF OPERATIONS below
<br />WA, WI, WY )
<br />A
<br />•
<br />Builder's Risk/installation /Contract Works
<br />Rental Equipment/Contractor's Equipment
<br />OC & OCW 91128600
<br />OC & OCW 91128600
<br />5/1/2010
<br />5/1/2010
<br />5/1/2011
<br />5/1/2011
<br />USD $1,000,000.00 perjobsite
<br />USD $1,000,000.00 perjobsite
<br />•
<br />Blanket Transit
<br />I
<br />OC & OCW 91128600
<br />1
<br />r conveyance
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Project: ACCESS CONTROL SYSTEM AT SANTA ANA POLICE DEPARTMENT
<br />Please refer to attached ACORD 101 for further remarks.
<br />SANTA ANA POLICE DEPARTMENT
<br />60 CIVIC CENTER PLAZA
<br />SANTA ANA, 92710
<br />United States
<br />VHIY IrCLL/1 I lum
<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 />.-J�1
<br />MARSH USA INC, BY:
<br />Franklin Hallock, Global Marine
<br />© 1988 -2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD
<br />Generated by EXIGIS LLC. For more information visit www.exigis.com.
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