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<br />A�,R'� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />01/12/2011
<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 SUBROGAyT" AS 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 />PATRICK MCRAE INSURANCE SERVICES
<br />N. HANCOCK ST., SUITE 210
<br />ANAHEIM HILLS, CA 92807
<br />NAME,_ PATRICK MCRAE
<br />a/c°NN Ext; (714) 779-6999 FAX Na: (714) 779-6903
<br />E -M1290
<br />ADDRESS: p.mcrae@sbcglobal.net
<br />PRODUCER
<br />CUSTOMER ID #;
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURED
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5463 DIAZ STREET
<br />IRWINDALE CA 91706
<br />INSURERA: SCOTTSDALE INSURANCE COMPANY 41297
<br />INSURER B: AMERICAN ZURICH INSURANCE COMPANY 40143
<br />INSURERC: CENTURY -NATIONAL INSURANCE CO. 26905
<br />INSURER D: PEERLESS INSURANCE COMPANY 24198
<br />INSURER E:
<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 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/DDfYYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A GENERAL LIABILITY
<br />BCS0022281
<br />06/03/2010
<br />06/03/2011
<br />EACH OCCURRENCE $ 1,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I OCCUR
<br />DEDUCTIBLE:
<br />5,000 PER OCC
<br />DAMAGE TO RENTED 100,000
<br />PREMISES Ea occurrence $
<br />MED EXP (Any one person) $ -
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />XXCU
<br />X ; OCP
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OPAGG $ 2,000,000
<br />j POLICY X PRO- LOC
<br />EBL EA CLAIM/AGG $ 1,000,000
<br />C AUTOMOBILE
<br />X
<br />X
<br />X
<br />LIABILITY
<br />1 ANY AUTO
<br />ALL OWNED AUTOS
<br />SCHEDULED AUTOS
<br />HIRED AUTOS
<br />BAP171987_11/05/20101.1/05,2,01
<br />COMPREHEN9#w_'I �`� -
<br />$1 000
<br />COLLISION DED,
<br />.--.1
<br />Lau,ia't
<br />1 ' �' d
<br />,
<br />" } dI,-•
<br />,POMBINEDSINGLE LIMIT $ 1,000,000
<br />(Ea accident)
<br />BODILY INJURY (Per person) $ -
<br />BODILY INJURY (Per accident) $ -
<br />PROPERTY DAMAGE _
<br />$
<br />(Per accident)
<br />_ $ _
<br />X
<br />NON-OWNEDAUTOS�.55tSld;J1
<br />(-:i'ti `lig,:'
<br />$
<br />A
<br />UMBRELLA LIAB
<br />I X
<br />OCCUR
<br />I XLS0067479
<br />06/03/2010
<br />06/03/2011
<br />EACH OCCURRENCE $ 10,000,000
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />UNDERLYING LIMITS:
<br />GL; AL; EL POLICIES
<br />AGGREGATE $ 10,000,000
<br />X
<br />DEDUCTIBLE
<br />_ $ -
<br />RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
<br />OFFICER/MEMBER EXCLUDED? �Y
<br />(Mandatory in NH)
<br />N / A
<br />WCO283135402
<br />I
<br />I
<br />06/03/2010
<br />06/03/2011
<br />X I WCTORYTATT- OTH-
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />D
<br />! BUSINESS OWNERS & CONTRACTORS
<br />EQUIPMENT
<br />CBP 8641920
<br />$1,000 DEDUCTIBLE
<br />COV. INCL. THEFT
<br />04/10/2010
<br />04/10/2011
<br />$752,760 BUILDING
<br />$367,200 BPP -$300,000 BI WI EE
<br />$116,318 SCHEDULED EQ.
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required)
<br />THE CITY OF SANTA ANA, ALONG WITH ITS ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYERS AND VOLUNTLERS ARE LISTED AS ADDITIONAL INSURED AS REQUIRED PER WRITTEN AGREEMENT.
<br />INSURANCE BY THE AFFORDED BY THE GENERAL LIABILITY POLICY FOR THE BENEFIT OF THE ADDITIONAL INSURED IS PRIMARY INSURANCE AS RESPECTS ANY CLAIM, LOSS OR LIABILITY CAUSED IN
<br />WHOLE OR IN PART BY THE NAMED INSURED(S) OPERATIONS, AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED IS EXCESS AND NOW CONTRIBUTORY. SHOULD ANY OF THE ABOVE
<br />DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEROF, 30 DAYS WRITTEN NOTICE WILL BE ISSUED.
<br />PROJECT DESCRIPTION: CITY OF SANTA ANA/ TRAFFIC ENGINEERING (CT 1695)
<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 />Lht1�Ltla11W-11
<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 />©1988-2009 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
<br />
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