|
A C>Rom CERTIFICATE OF LIABILITY INSURANCE DATE(MM- D/YYYY)
<br />06/07/2010
<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 LICENSE NO. 0637431NTA '
<br />NAME: PATRICK MCRAE
<br />PATRICK MCRAE INSURANCE SERVICES PHONE 714 77 FAX
<br />IAL4�N_o ExI) _- .....- ..._ � _) 9-6999 bac, r og_ (714) 779-6903
<br />1290 N. HANCOCK ST., SUITE 210 E-MAIL —
<br />AuDREAs;_PMcrae ®Sbc lobal.net
<br />ANAHEIM HILLS, CA 92807 PRODUCER -- --
<br />G.USTOMERIDIII: E201ORRPS
<br />----
<br />INSURED -
<br />.._...__--
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5463 DIAZ STREET
<br />A-2008-308
<br />IRWINDALE CA 91706
<br />7�1..^_„y........a...w crwvc _..._-----
<br />INSURER A_ OTTSDALE INSURANCE COMPANY
<br />NAIC t♦
<br />41297
<br />INSURER B: AMERICAN ZURICH INSURANCE COMPANY
<br />' 40143
<br />IN.
<br />SURER C: REDWOOD FIRE & CASUALTY INS
<br />11
<br />11673
<br />INSURER D PEERLESS INSURANCE COMPANY
<br />... _
<br />24198
<br />INSURER E: - --
<br />_— -
<br />�.vvcrwtaca 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 />—
<br />�A L UBR
<br />LTR TYPE OF INSURANCE POLICY EFF - ------ --
<br />'rNCR 11111/1] POl_ICv ruuuaco .. ..-.......: �
<br />A GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X ' XCU
<br />X: OCP
<br />G_ EN'L AGGREGATE LIMIT APPLIES PER:
<br />- POLICY X.... PRO LOC
<br />C AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />. ALL OWNED AUTOS !.
<br />_X SCHEDULED AUTOS
<br />X HIRED AUTOS
<br />X NON -OWNED AUTOS
<br />X HIRED PHYS $300,000 LIMIT”
<br />A UMBRELLA LIAB X OCCUR
<br />X EXCESS LIAB CLAIMS -MADE
<br />X DEDUCTIBLE
<br />RETENTION S 0 1
<br />13 WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETORIPARTNERIEXECUTI VE
<br />OFFICERIMEMBER EXCLUDED" Eyl ' N I A
<br />(Mandatory in NMI
<br />If yes. describe under
<br />LIMITS
<br />__. " -- - "'" 'v w' ' EACH OCCURRENCE —$
<br />$5,000 PER OCC DED.
<br />1,000,000
<br />PREMI. lEaocwTwceLS_
<br />100,000
<br />-MED EXP (My one person)
<br />--
<br />PERSONAL 8 ADV INJURY $
<br />— -
<br />1,000,000
<br />'.. ! GENERAL AGGREGATE $
<br />2,000,000
<br />PRODUCTS - COMPIOP AGO 1 $
<br />2,000,000
<br />EBL EACLAIM/AGG $
<br />CAA10050511/05/2010'I COMBINED SINGLE LIMIT
<br />11/05/2009
<br />1,000,000
<br />gqPPROVED1 4S TO; - $
<br />COMPREHENSIVE DEtt O L n
<br />1,000,000
<br />RY(Perperson)
<br />$1,000 - -
<br />BODILY INJURY (Per acatlent)
<br />COLLISION DED. j - _ _ —_
<br />PROPERTY
<br />$
<br />--
<br />-
<br />$1,000 Yom^-c./.F� DAMAGE $
<br />Laura St}tt Sbeedy
<br />Assista City Attorrev ---- $
<br />06/03/2010 06/03/20111 EACH OCCURRENCE g 5,000,000
<br />AGGREGATE g 51000,000
<br />06/03/2010 $
<br />06/03/?011 XiT ��IMITs, .��K ,
<br />I _
<br />_
<br />E.LEACHACCIDENT $ __- 1,000,000
<br />E.L DISEASE - EA EMPLOYEE $ 1,000,000
<br />_ __. -- _..._.
<br />BU51NESS OWNERS& CBP 8641920 1 EL DISEASE -POLICY LIMIT $ 11000,000
<br />$1.0000NTRACTORS EQUIPMENT 1 COV. DEDUCTIBLE $367,200 BPP -$300,000 BI WI EE
<br />(i COV. INCL. THEFT 04/10/2010 $367,200 $116,318 SCHEDULED EO.
<br />THE CITY OF ON SANTA ANA 220 CIVIC NS i CENTEVEHICLES
<br />PHI AZp SANTA AACORD
<br />A CA�IFdRN1A 92701ional , ALONG Schad
<br />EmoreLECTED OFFICIALS:OFFICERS, AGENTS, EMPLOYERS AND VOLUNTEERS ARE
<br />LISTED AS ADDITIONAL INSURED AS REQUIRED PER WRITTEN AGREEMENT. INSURANCE BY THE AFFORDED BY THE GENERAL LIABILITY POLICY FOR THE BENEFIT OF THE
<br />ADDITIONAL INSURED IS PRIMARY INSURANCE AS RESPECTS ANY CLAIM, LOSS OR LIABILITY CAUSED IN WHOLE OR IN PART BY THE NAMED INSURED(S) OPERATIONS, AND ANY
<br />OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED IS EXCESS AND NOW CONTRIBUTORY. '30 DAY NOTICE OF CANCELLATION IN ANY EVENT.
<br />PROJECT DESCRIPTION: CITY OF SANTA ANA/ TRAFFIC ENGINEERING (CT 1695)
<br />CITY OF SANTA ANA �
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />TRAFFIC ENGINEERING
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA (M-43) ACCORDANCE WITH THE POLICY PROVISIONS.
<br />P.O. BOX 198/8
<br />SANTA ANA, CA 92702 02 AUTHORIZED REPRESENTATIVE
<br />ACORD 252009109) ©1988-2009 ACORD CORPORATION. All rights reserved.
<br />( The ACORD name and logo are registered marks of ACORD
<br />
|