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. 1. o' CERTIFICATE OF LIABILITY INSURANCE DATE
<br />3/2312011
<br />`.�' 03/23/2011
<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 0GE AFFORDED BYTHE POLICIES
<br />BELOW. THIS CERTIFICATE OF NSURANCE DOESAI�O'T OONSTrT EO�TND ORACTTBETWEEN THE ERTHE SU NG NSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an I�1NSUREQf e i (!as) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certai m�y�et�tliretib=ement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such undorsemen
<br />PRODUCER CONTACT
<br />MARSH USA INC. NAME:
<br />ONE STATE STREET PHOAIC.NENo, --- FAX-------------------
<br />AX ---- -
<br />HARTFORD, CT 06103-3187 E-MAIL — ---- "' (A/C, No): —_ „ - -.--
<br />ADDRESS,_.
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC N
<br />INSURERA:He rd Fire
<br />-- Insurance Comeag
<br />19682
<br />INSURED
<br />OTIS ELEVATOR COMPANY
<br />....•_---__„_
<br />INSURER B :The Insurance Company of the State of Penns Ivania ____
<br />-. _.. P Y _Y _
<br />_.
<br />19429 _
<br />.._
<br />ONE FARM SPRINGS ROAD
<br />INSURER C :IIIInol3 National Insurance Co.
<br />23817
<br />FARMINGTON, CT 06032
<br />- - - - ----- ........
<br />INSURER D :Chartis Casualty Company
<br />40258
<br />INSURER E :New Hampshire In prance Com pany --
<br />_ 23841
<br />INSURER F :National Union Fire Insurance Company of Pittsburgh, PA
<br />19445
<br />('CWFRAGF3
<br />.,,,unre_
<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 />POLICY EFF POLICY El(P_ff Cr U
<br />LTR TYPE OF INSURANCE IN R POLICY NUMBER MWDD/YYYY MMIDDMrYY LIMITS
<br />A
<br />GENERAL LIABILITY
<br />02CSET10004
<br />04/01/2011
<br />04/01/2012
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />COMMERCIAL GENERAL LIABILITY
<br />$2,000,000 general aggregate per
<br />DAMAGE TO
<br />PREMISES LEa NTED occurrence
<br />—-_
<br />S 300,000
<br />El
<br />locatlon/pr0lect
<br />—_
<br />CLAIMS-MADE OCCUR
<br />R
<br />$10,000.0170 policy general aggregate
<br />MED EXP (Any one person)
<br />$ 10,000
<br />_-,---._
<br />PERSONAL SAOVINJURY
<br />S 1,000,000
<br />__- ___
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />X1 POLICY PRO-
<br />LOG
<br />S
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />02CSET10000 (A/O)
<br />04101/2011
<br />04/01/2012
<br />COMBINED SINGLIELIMiT
<br />02CSET10019 (HI)
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />_,_,_ ____
<br />BODILY INJURY (Per person)
<br />ANY AUTO
<br />Hartford Underwriters Ins
<br />_,-
<br />$
<br />ALL AUTOS OWNED AUTOS SCHEDULED
<br />S
<br />BODILY INJURY (Per accident)
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PRC!PERtY DAMAGE
<br />Per accident)___—
<br />-
<br />$
<br />UMBRELLA LIAB OCCUR
<br />EACH OCCURRENCE
<br />EXCESS LIAB - CLAIMS -MADE
<br />AGGREGATE
<br />_S
<br />$
<br />DIED RETENTIONS
<br />B
<br />WORKERS COMPENSATION
<br />061967;CA-369
<br />04/01/2011
<br />04/01/2012
<br />X WCSTATU- OTH-
<br />C
<br />AND EMPLOYERS' LIABILITY Y I N
<br />FL-370 TX-371
<br />,TQRY11.
<br />.- ...... ........._____--_._
<br />E.L. EACH ACCIDENT
<br />D
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />MULTI-368
<br />$ 1,000.000
<br />E
<br />F
<br />OFFICERIMEM13ER EXCLUDED?
<br />in NH)
<br />N / A
<br />MA367;MN375;NJ374-MULTI372,373
<br />CT WC (SIR 2.5MM) 9X COV-
<br />--
<br />1,000.000
<br />------ -----
<br />(Mandatory
<br />If s,describeunder
<br />119238
<br />E.L. DISEASE - EA EMPLOYEE
<br />--
<br />S
<br />`- - -- -
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />$
<br />If
<br />$
<br />$
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space is mqulmd)
<br />City of Santa Ana Police and Holding Facility, Santa Ana, CA 92702.
<br />The City of Santa Ana, its officers, agents, volunteers, and employees are additional insured on the above Commercial General Liability as required by contract. The liability
<br />coverage afforded is primary and non-contributory.
<br />contract number: SAN 05208
<br />{.,GRI If'I�.NI C r1VLUCR
<br />I:ANGCLLAI IVN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />APPRO '
<br />THE EXPIRATION DATETHEREOF, NOTICE WILL BE DELIVERED IN
<br />v t, i)
<br />AS TO
<br />FO l t, `,';
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />City of Santa Ana
<br />/
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />-
<br />,L(�t
<br />/ " f
<br />Milt
<br />SlsteI7: 1'':...
<br />Pon.1 M1 G14Osta_9nin Ar`nOrl Pf%0Df10ATInId All A-k#- A
<br />logo are registered marks of ACORD
<br />-
<br />ACORD 25 (2010/05) The ACORD name a�ld
<br />
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