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ALDR CERTIFICATE OF LIABILITY INSURANCE ����,� ��' �� of /(o�l2 3
<br />PRODUCER 213 . 5 S3 . 8400 FAX 213. 553. 8466 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Wilshire Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />835 Wilshire Blvd. , 4th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
<br />Los Angeles, CA 90017 -2603
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />INSURED United Pumping Service, Inc. ,NSURERA Starr Surplus Lines Insurance CoG pany
<br />United Storm Water, Inc. ,NSURERB Starr Indemnity & Liability Company
<br />4 Lease, Inc. INSURERc: Federal Insurance Company
<br />14000 East Valley Blvd. NSURER0
<br />City of Industry, CA 91746 NSURERE
<br />rnvca A r_=C
<br />THE POLICIES OF INSURANCE LISTED BEL O`,V HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWI T HSTA``iDMG
<br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF j!,;CH
<br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />,NSR ADD'!.I TYPE OF INSURANCE j POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY EXPIRATION
<br />LIMITS
<br />EACH OCCURRENCE [ s 1,000,00(
<br />GENERAL LIABILITY SLSLEIL72023 513
<br />12/31/2012
<br />12%31/2013
<br />X C0%11'.z RCIAL..:ENE ?AL LIAy?L €TY I
<br />OA)JAGE TO RENTED 5 S0 ,00C
<br />Cwf +; IS'a -DE OCOL °R
<br />NIEO Exp (Anyone pemooI 5 5,00C
<br />PERSONAL & AGV INJURY S 1,000,00(
<br />GENERAL AGGREGATE s 11 000 , 00
<br />'
<br />PROD 5 1,000,00
<br />Ea`L A- CHc. - Ec., -i'T AFPi SrtR.j
<br />(
<br />I X F J-
<br />Pi; #
<br />_CY . '. i iLu
<br />--
<br />AUTOMOBILE LIABILITY SISIPCA08223613
<br />12/31/2012
<br />; 12/31/2013
<br />`EJ5 :s
<br />A :
<br />Ccle 10 #,y is
<br />(Ea a.xenn
<br />_
<br />1,000,000
<br />' APPRO
<br />-
<br />ECC LY BURY
<br />i I NC. CN.E')A -1-3 '
<br />X
<br />X
<br />{PEI acc3den1
<br />X MCS 90 -
<br />PROPERTY DAMAGE
<br />(Per 3..ts'iEnt) 3
<br />GARAGE LIABILITY �.dll
<br />d ail l- ...:.0
<br />AUTO ONLY .EAAuGIDEhbT S
<br />,Si
<br />j SL
<br />nl.
<br />O TH. EIR AN EA ACC S
<br />-
<br />_..._- — .......
<br />AUTO OILY:
<br />AG_- i S
<br />EXCESSUMBRELLA !- ,ABiLT'Il' SLSLXNV73017413.
<br />12/31/2012
<br />12/31/2013
<br />EAc,iiO:,CURR£!Iv;: is 9,000,00
<br />AL SCAT_ ; s 9.000,00,
<br />A..._.__..__
<br />E
<br />is
<br />WORKERS COMPENSATION AND 00447272441
<br />12/31/2012
<br />12/31/2013
<br />X ( 4csTAr
<br />R' _IMT4 ± Eo_
<br />EMPLOYERS' LIABILITY [
<br />E.L. EACH ACCIrEr ' is 1,000,000
<br />C
<br />-1i< f' 1.1EM3L 7 Y.i,_U'`..D':
<br />— --
<br />EL DISEASE EA EMP 01 "' i 1 , 000,000
<br />I Y;C descrine in n,
<br />cL. AL PR'J"`.,' ,7 :S Cnir�e.
<br />EL. DISEASE POi ICY �AMI�: S 11000,000
<br />a elution Liability SLSLEIL720235131
<br />12/31/2012
<br />12/31/2013
<br />$1,000,000 Pollution Limit
<br />A Professional Liability
<br />$1,000,000 Professional Limit
<br />Claims Made $50,000 SIR
<br />$1,000,000 Aggregate
<br />DESC RIPI ION OF OPERATIONS ! LOCATIONS J VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT,' SPECIAL PROVISIONS
<br />he City of Santa Ana, it's officers, agents, volunteers and employees are included as additional
<br />nsured, with this insurance primary and non - contributory, as per the attached endorsement form CG 20
<br />7 07 04 and SL 804 (04 -11).
<br />E
<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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
<br />*3k- 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 THg INSURER, ITS AGENTS OR REPRESENTATIVES.
<br />AUTHORIZED REPRESENT`ATIVE
<br />Af,;UKU 25 (2001108) I vACORD CORPORATION 1988
<br />
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