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Client#: 458248
<br />MASTFI_F05
<br />ACOR�,M CERTIFICATE O LIABILITY INSURANCE
<br />oATEIMMIDD/YYYYj
<br />z/aa/2a13
<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 cerfiticate bolder is an ADDITIONAL INSURED, the polloy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain polleles may require an ondoraement. A statement onthe certificate does not confer rights to the
<br />certificate holder In lieu of such endorsoment(s),
<br />PRODUCER
<br />Hub International
<br />4371 LatIInsuranceSarv.Inc.
<br />4371 Latham St, Ste #101
<br />Riverside, CA 92501
<br />NT
<br />NRMEI Knetie Koehrer
<br />_
<br />PIIo r1E --- - -- ........�...�._� P
<br />INC No Ex 877 925 2691 1WO Na)I 951231-2672
<br />€9Arz
<br />aaRESS.
<br />CaI.CPU @hubinternational.com
<br />INSURBR(S) AFFORDING COVERAGE
<br />NAICB
<br />IWURERAI Travelers Indemnity Company of
<br />25882
<br />INSURED
<br />TSJ Electrical le Communications, Inc.
<br />din Masters Electric
<br />INEURERRI Travelers Propel 'tyCasualty CD
<br />25874
<br />INSURERCI Companion Prop and Gas Ins CD
<br />12157
<br />.....M.._..Ar,........,.....�..
<br />7490 Jurupa Avenue
<br />Riverside, CA 92504
<br />INSURER D
<br />PERSONAL& ADV INJURY
<br />INSURER E;
<br />-
<br />—
<br />INfiURERF:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE I.ISTEn BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDIOATED. 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 le SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INBR AGDL 511011 ppppLL''CYpp��F POLICY E %P - - - -- - --
<br />LTR TYPE OR INSURANCE NL'!P ,_.._._...... .POLICY NUMBER _'i ( %MIOBIYYYYj h`AMDD/YYYYJ LIMES
<br />A
<br />GENERALUABILRY
<br />4T22CO9011PQ41TCT1
<br />0412012012
<br />04120/2012
<br />�_,__w
<br />$1 OQO000
<br />X COMMF.RGIAI_6ENERALLIABILITY
<br />CLAIMS-MADE 0X1 OCCUR
<br />..
<br />_ ._..,_...
<br />T RENTED
<br />:b Eanuurre�2._..,.�30P000
<br />.....M.._..Ar,........,.....�..
<br />MED E %I" An we ersnn
<br />$5 Q00
<br />PERSONAL& ADV INJURY
<br />$1 Oo00� 00
<br />X PDDed -$2500
<br />RENERALAGGRECATr
<br />$2000,000
<br />CENT AGGREGATE LIMIT APPLIES
<br />PER:
<br />PRODUCTS - COMP/OP AGO
<br />$2,000,000
<br />POLICY POe
<br />TOG
<br />$
<br />A
<br />AUTOMOBILEUABILITY
<br />BA0B98218312CNS
<br />0412012OIZ
<br />041201201
<br />COMBINEDSINGL-LI I'I
<br />LA--AC2d_WD —_
<br />$1,000,000 __...__
<br />X
<br />ANY AUTO
<br />UGLILY INJURY (PSr person)
<br />$
<br />X
<br />—
<br />AU. OWNED RONEDULW AUT 8
<br />AUTOS _ — NON-_ 0
<br />X OWNE
<br />HIRkO AUTOS O
<br />BODILY INJURY PeraeclUhnl
<br />( 1
<br />$
<br />F'R�aP DAMAGE
<br />$
<br />$
<br />B
<br />X
<br />UMBRELLALIAd
<br />[X ]OCCUR
<br />DTSMCUP9011P041TIL
<br />4/20/2012
<br />04120/21]1
<br />oACFIUOCURRENLk
<br />$51 pp000.0_
<br />EXCESS LIAR
<br />CLAlIv19.MA0E
<br />_ .. _
<br />AGORE'CATE
<br />. -. .. .J - ..
<br />$5 000 000
<br />13FTFNTON_ $10 000
<br />`.
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS LIABILITY
<br />ANY PRGPRIER"PARTNEWE%ECUrIVF Y/N
<br />or FXC LIIODFFD9
<br />(Mnulf.Wry in NH)
<br />IAys eesa{he untle[
<br />UERCRIPTIONOFOPERATIONSG�IoW
<br />NIA
<br />CPCA16337
<br />10/18/2012
<br />10/19 /201
<br />X 4VC 1rrATU pTUI
<br />EL EACH ACCIDENT
<br />E.I... DISEASE -FA FMPI.OYBE
<br />$1 000000
<br />....rte._.._,__._.__
<br />1000000
<br />""-
<br />E.L. DISEASE- POLICYUMIT
<br />$1 000,000
<br />L
<br />DESCRIPTION OF OPERATION5I LOCATIONS I VCHICLUS (AUach ACORO 101, AWRIODsl B.rlt® Sch,,Llo, R mare space in Yagnkatl)
<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 signed endorsement farm, Primary/Non
<br />Contributory wording included. Separation of Insureds applies per Standard 150 060001 10101.
<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) /;, . - AS TO IFORM
<br />City of Santa Ana __ ( c� I I -- .— SHOULD ANY OFTHa ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE,
<br />20 Civic Center P1a2a, M 1 LatTTa. Stit S }lead}' ACCORDANCE WITH THE THEREOF,
<br />OLICY PROVISIONS. ILI_ DE DELIVERED IN
<br />Santa Ana, CA 92702 Assistant City Attorne}
<br />AUTHORIZED REPRESENTATIVE
<br />Q 1980.2010 ACORD CORPORATION. All rights reserved,
<br />ACGRD 25 (2010108) 1 of 2 The ACGRD name and Ingo are reglaterod marks of ACGRD
<br />#520809511 1973978 MB44
<br />
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