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Client#: 458248
<br />MASTELEC5
<br />ACORD. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 112012 YYj
<br />5/01/2012
<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 certifioate 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 />Hub International
<br />NAWCT Kristie Koehrer
<br />T"P
<br />acc° Np, E, : 877 825 -2681 (AIC NoI: 951231-2572
<br />HUB Int'i Insurance Serv. Inc,
<br />E -mna Cal.CPU huhinternational.c_om___
<br />ADOness. @
<br />4371 Latham St, Ste #101
<br />Riverside, CA 92501
<br />INSURERS) AFFORDING COVERAGE � NAICM
<br />INSURER A: Travelers Indemnity Company of 25662
<br />X
<br />INSURED
<br />TSJ Electrical le Communications, Inc.
<br />dha Masters Electric
<br />INSURER e: Travelers Property Casualty Co 125674
<br />INSURERC: Companion Prop and CBS Ins Co 12157
<br />—.�
<br />— ----- _.._.._...._..__._
<br />7490 Jurupa Avenue
<br />Riverside, CA 92504 ig p Oil
<br />INSURER D:---.-
<br />--
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE N MBER: REVISION NUMBER:
<br />THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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
<br />LTR
<br />TYPE OF INSURANCE
<br />AOnI
<br />S6
<br />UBR�
<br />_I
<br />POLICY NUMBER _ _
<br />POLICYEFF
<br />MMIDBIYYYY-
<br />POLICY EXP
<br />MMl00IYYYV
<br />LIMBS
<br />A
<br />GENERALLIABILIrY
<br />X COMMERCIALCENERALLIASILITY
<br />CIA IMS -MADE a OCCUR
<br />X PD Dad: $2,500
<br />X
<br />n ^
<br />4T22CO9011P041TCT1
<br />0412012012
<br />04/2012013
<br />EEAACHcccuRRENcr.
<br />S-1,000,000
<br />pREIh1131Ey i-„Hi ocri�,rancuY
<br />5300,000
<br />MEO E %P pn onsemnn}
<br />55,000
<br />PERSONA- &ADVINJURY
<br />51000000
<br />CENEFVL AGGREGATE
<br />52,000,000
<br />_
<br />GE ML AGGREGATE
<br />_1Y
<br />LIMIT APPLIES PER:
<br />PRA- LOC
<br />PRODUCTS- COMP /CP AGG
<br />52,000,000
<br />__.�._...'..�...
<br />$
<br />A
<br />AUTOMOEILE LWaLLITY
<br />X ANY ALII'0
<br />ALI. OWNED SCHEDULED
<br />_ AUTOS AUTOS
<br />X I11REL`AUTOS X NON -Pro
<br />AUTOS
<br />BA6B98218312CN$
<br />0412012012
<br />041201201
<br />En eccManI51NGLE LIMIT'
<br />$1,000,000
<br />BODILY INJURY (Par por:m,)
<br />S
<br />BODILY INJURY (par amHanl)
<br />5
<br />FROPERTY OAMACE
<br />Pcr nccitlnnl ___ -,_
<br />5
<br />S
<br />B
<br />X
<br />UMBRELLA UAe
<br />EXCESS UAB
<br />X
<br />OCCUR
<br />CLAIMS. MALE
<br />DTSMCUP9011P041TIL
<br />0412012012
<br />04/2012013
<br />EACH OCCURRENCE
<br />55000000
<br />AGGREGATE Y
<br />$5,000.000
<br />CED I X1 RMENTICN$10,000
<br />5
<br />Q
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTNrYIN
<br />DPFICERIMCMBF.REXCLUOED7
<br />(Myanddwy In NII)
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />CPCA14114
<br />10/1812011
<br />10/1812012
<br />X WC SIATU- CN--
<br />E1. EACI'I ACCIDENT
<br />S1,00000D
<br />E.L. DISEASE -CA EMPLOYEE
<br />$1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />1 $1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Alfach ACORO 101, Addillonal Ramarks Schedule, 0 mm Spero is requ Vod)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are Additional
<br />Insured In regards to the General Liability policy per attached endorsement form CG D2 46 08 05,
<br />Primary/Non - Contributory wording included. Separation of Insureds applies per Standard ISO CG0001 10/01.
<br />Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc.,
<br />independent of any rights which may be afforded within the policies to the Certificate Holder named below,
<br />(See Attached Descriptions)
<br />City of Santa Ana
<br />20 Civic Center Plaza
<br />L��D , V i.i3 AS I, tJ r
<br />C
<br />AN4'a
<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 />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />LatlTa 5 L 5i1C1.
<br />Assilt:lnt
<br />,.'.itY Attonle'
<br />n ^
<br />ACORD 25 (2010/05) 1 of 2
<br />#S1659547IM1650064
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<br />The ACORD name and logo are registered maxim of ACORD
<br />KC499
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