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Ate , CERTIFICATE OF LIABILITY INSURANCE OIZO51D2012)
<br />FaocuCETt 213.553.8400 FAX 213.553.8466 ! 0 ATE (M"5/ 012
<br />Wilshire Insurance Agency
<br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIF INFORMATION
<br />835 Wilshire B1 vd. , 4th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />Los Angeles , CA 90017-2603 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />#INRERS AFFORDING COVERAGE NAIL p
<br />INSURED United Pumping Service, Inc. RA Starr Surplus Lines Insurance Co parry
<br />United Storm Water, Inc. Re Starr Indemnity & Liability Comp ny
<br />4 Lease, Inc. LNSURERC Federal Insurance Company
<br />14000 East Valley Blvd. INSUREaD' -"-
<br />City of Industry, CA 91746 ?INSURERE. --
<br />COVERAGES
<br />Tk-- P[!, Iricc rc i"C„Dn,,,-
<br />AMY REQUIREMENT, TERM OR CGNDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTOTO W
<br />,DING
<br />R
<br />HICH THIS CERTIF CATE MA
<br />Y BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
<br />POL
<br />EX
<br />.
<br />CLUSIONS AND CONDITIONS OF SUCH
<br />ICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS.
<br />MSR D'
<br /> TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PO LICYEXPIRATION
<br />
<br />GENERAL LIABILITY
<br />
<br />X COI.'A7:RCIAL Gc"N£RAL LIABILITY
<br />SLSLEIL72023512
<br />12/31/2011
<br />12/31/2012 LIMI
<br />EACH OCCURRENCE TS
<br />
<br />1,000,00
<br />
<br />CLAiVS I.L=??E X {OCCUR DAMAGE TO RENTED 50,00
<br />S
<br />
<br />A
<br />X!$25
<br />000 SIR MED EXl' (Any one wscn) 5 5,00
<br /> ,
<br />-
<br />X i 5L-024 (01/09) PERSONAL & A I s 1 -.000'(0) 0
<br />
<br />GE!,' L AGCREGA e LIMIT APPLIES PER:
<br />"T TE
<br />GENERAL AGGREGATE 1,000,00
<br /> RANSPORTATION PRODUCTS
<br />C
<br />P
<br />
<br />
<br />I
<br />
<br />F'=''L?c'' X P'0 n Luc
<br />
<br />POLLUTI
<br />` -
<br />OM
<br />roP AGG S
<br />1,000,00
<br /> ON LIABILITY f
<br /> AUT OM081LE UAWLITY SISIPCA08223612 12/31/2011 12/31/2012
<br /> X ANY AUTO GO!I.HINED SINGLE LIMIT
<br />IEa sxidenq
<br />°
<br />
<br />ALL OWNED AUTOS 1.660.OD
<br />
<br />
<br />B
<br />I
<br />SGHEOJLEC AUTOS
<br />.
<br />" BODILY INJURY
<br />(Pe:Derson)
<br /> X HrR.O AUTOS . , .. ..
<br />
<br /> X
<br />NGN-G'rVNEO AUTOS BODILY INJURY
<br />
<br />(PereccCem)
<br /> x roes-9o 'd
<br />? e
<br />?e
<br /> ? -
<br />.. .. . _ -
<br /> ? i .. PROPERTY DAMAGE
<br />(P6I acc+a?t)
<br /> GARAGE LIABILITY
<br />
<br />A:'JY AUTO j AUTO ONLY - EA ACCICENT S
<br /> OTHER THAN EA MCC
<br />
<br />EXCESSIUMBRELLALIABILITY
<br />X OCCUR C A
<br />SLSLXNV73017412
<br />1Z/31/2011
<br />12/31/2012 AUTO ONLY AGG
<br />EACH OCCURRENCE S
<br />S 9,000,00
<br />
<br />A lA1S'AAVE AGGREGATE S 9
<br />1006,66
<br />
<br />DEDUCTI _
<br />i
<br /> BLE --
<br /> f RETENT $
<br /> ION i I ___.___.........
<br />5
<br />WORKERS COMPENSAnoNAND 00447272441 12/31/2011 12/31/2012 X INCSTATIrj orH_
<br />EMPLOYERS' IUBiL1TY Y E?
<br />C ANY PRt:PAfETORJPARTNE;tfXECUT)VE E_L EACH ACCIDENT 1,000, OO
<br />ii: F;L'ERIAIEMBER cJt CLUCED?
<br />i
<br />3! yes. describe under
<br />E,L. DISEASE • EA EMPLOYE > 1 , D66 , 66
<br />SPECIAL PROVISIONS telor
<br />E.L. DISEASE -POLICY L1Aa1T i 1,000,001
<br />tion Liability SLSLEIL72023512 12/31/2011 12/31/2012 $1,000,000 Each Occ Pollution
<br />n
<br />A
<br />ssional Liability $1,000,000 Each Claim Prof
<br />H
<br />S MADE $50,000 SIR EAC
<br />51,000,000 Aggregate
<br />DESCR1P
<br />.
<br />nON OF ..
<br />ERATIONS 7 LOCATIOgS 1 VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISI
<br />C?N
<br />S
<br />he City of Santa Ana, it's officers, agents, volunteers and emp oyees are included as additional
<br />nsured with primary and non-contributory, but only as respects their interest in the operations of the
<br />amed insured and as per the attached endorsement form SL-023 (01/09).
<br />except 10 days notice of cancellation for non-payment of premium.
<br />City of Santa Ana
<br />Public Works Department
<br />20 Civic Center Plaza M-36
<br />Santa Ana, CA 92701
<br />ACORD 25 (2001108)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED To THE LEFT,
<br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
<br />OF ANY KIND UPON THE I R. ITS AG NW , REPRESENTATIVES.
<br />AUTHORIZED REPRESENTAT ?n
<br />RD CORPORATInNt iORA
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