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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
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<br />l ® CERTIFICATE OF LIABILITY INSURANCE
<br />ACORO
<br />Lam'
<br />DATE YYYY)
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<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, certiffrVio6ififlesi6sly foul }e B @Qndorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such enciorsemarif b
<br />PRODUCER
<br />MARSH USA, INC. -
<br />TWO ALLIANCE CENTER - ` +
<br />3560 LENOX ROAD, SUITE 2400
<br />CONTACT
<br />NAME:
<br />PHONE FNC NO:
<br />E+naa
<br />ATLANTA, GA 30326
<br />0613012011
<br />06130/2012
<br />Ath1: Email: AdantaO fBce.CertRequmt(a)Marsh.com
<br />930465- MAIN- GL -11 -12
<br />INSURERS AFFORDING COVERAGE
<br />NAIC Y
<br />INSURER A: XL Insurance America, Inc.
<br />MED EXP (Any one erson )
<br />INSURED
<br />BRAMBLES USA, INC.
<br />Gba RECALL SECURE DESTRUCTION SERVICES
<br />INSURER B: WA
<br />WA
<br />INSURER C: Travelers Prop. Casualty Co. IN America
<br />INSURER 0:
<br />S 4.000,000
<br />180 TECHNOLOGY PARK, RM 600
<br />NORCROSS, GA 30092
<br />PRODUCTS - COMP /OP AGG
<br />$ 4,000,000
<br />INSURER E:
<br />C
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: ATL- 002837884-04 REVISION NUMBER:4
<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 />INSP
<br />TYPE OF INSURANCE
<br />A O
<br />Ina
<br />R
<br />AM
<br />POLICY NUMBER
<br />POLICY
<br />POLDDYEXP
<br />LIMITS
<br />A
<br />GENERAL UASILm
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE M OCCUR
<br />USOD009799LI11A
<br />-
<br />0613012011
<br />06130/2012
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />DAMA mcurr.ncal
<br />S 1,000,000
<br />MED EXP (Any one erson )
<br />$ 25,000
<br />PERSONAL S ADV INJURY
<br />$ 2,000,000
<br />GENERAL AGGREGATE
<br />S 4.000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO- LOC
<br />IFr.T [7
<br />PRODUCTS - COMP /OP AGG
<br />$ 4,000,000
<br />$
<br />C
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS
<br />AUTOS NON -OWNED
<br />HIRED AUTOS AUTOS
<br />P
<br />TC2JCAP- 9526870 -D11
<br />0 &3012011
<br />0613012012
<br />COMBINED SINGLE LIMIT
<br />Me accident)
<br />$ 5,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />P r n
<br />S
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />EACH OCCURRENCE
<br />$
<br />HOCCUR
<br />AGGREGATE
<br />$
<br />DED RETENTION
<br />$
<br />C
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNEWEXECUTIVE Y�
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />TC JUB 9519B12- A- 11(ADS)
<br />TRXUB- 9526871 -2 -11 (AZ, MA, OR, WQ
<br />0613012011
<br />OW3012011
<br />061301201
<br />0613012012
<br />WC STATU- OTH-
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE. EA EMPLOYE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />S 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Nemarke Schedule, N more apace Is required)
<br />HE CITY OF SANTA ANA, 20 CIVIC CENTER PLAZA, SANTA ANA, CALIFORNIA 92701; ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES ARE INCLUDED AS
<br />DDITIONAL INSURED (EXCEPT WORKER'S COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT BUT ONLY AS RESPECTS OPERATIONS OF THE NAMED INSURED. THE GENERAL
<br />ABILITY COVERAGE IS PRIMARY AND NOT CONTRIBUTORY WITH ANY OTHER INSURANCE AVAILABLE TO THE CERTIFICATE HOLDER,
<br />APPROVED AS TO FORM
<br />CITY OF SANTA ANA v, ,a11Ta 5T1u o �w
<br />ATTN: LYNDA KELLY ttOrney SHOULD ANY EXPIRATION ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 CIVIC CENTER PLAZA, M12 A$S1Stant City ACCORDANCE WITH THE POLICY PROVISIONS.
<br />WILL BE DELIVERED IN
<br />SANTA ANA, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Ted L. Young �•-T-
<br />0 1988 -2010 ACORD CORPORATION. All rlahts reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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