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' CERTIFICATE OF LIABILITY INSURANCE
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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 05 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 pollcy(les) must he endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER. LICENSE NO. 0637431 CONrn
<br />
<br />CT PATRICK MCRAE
<br />NAME:
<br />PATRICK MCRAE INSURANCE SERVICES PHONE (714 779-6999 uD Na1. (7.14) 779-6903
<br />1290 N. HANCOCKST., SUITE 210 AD ADRESS pUrncrae@sbcgIoba1.net
<br />ANAHEIM HILLS, CA 92807 INSURER(S)AFFORDINGCOVERAGE NAICN
<br /> INSURER A: LIBERTY SUPLUS INSURANCE 10725
<br />INSURED INSURER B: AMERICAN GUARANTEE & LIABILITY INS 26247
<br />CROSSTOWN ELECTRICAL & DATA, INC. INSURER C: CENTURY-NATIONAL INSURANCE CO. 26905
<br />5463 DIAZ STREET INSURER D: PEERLESS INSURANCE COMPANY 24198
<br /> INSU_E: SGOTTSDALE INSURANCE COMPANY 41297
<br />IRWINDALE CA 91706
<br /> NSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 />..
<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 />ILTR TYPE OF INSURANCE ADDL
<br />INSR SUBR
<br />MO -
<br />POLICY NUMBER POLICY EFF
<br />MM D POLICYEXP
<br />MM/20. Y LIMITS
<br />A GENERAL LIABILITY 1000008273-02 06/03/2012 06/03/2013 EACH OCCURRENCE s 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY DEDUCTIBLE: DAMAGE TO RENTED
<br />PREMISES Ea occumnce 100,000
<br />$
<br /> ?X $5,000 PER OCC
<br /> CLAIMS.MAOE
<br />OCCUR MED ESP An one person) $ -
<br /> X XCU PERSONAL &ADV INJURY $ 1,000,000
<br /> X OCP GENERALAGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,060
<br /> POUCV X ?Gi LOC EBL EA CLAIM/AGG s 1,000,000
<br />C AUT OMOBILE. LIABILITY BAP0171987 11/05/2012 11/05/2013 C
<br />M
<br />B
<br />IN
<br />EEDSINGLE LIMIT 1
<br />000
<br />000
<br /> a
<br />BI
<br />1
<br />O $
<br />,
<br />1
<br />
<br />X
<br />ANY AUTO COMPREHENSIVE DED.
<br />BODILY INJURY (Per person)
<br />$ _
<br /> ALL .E. X SCHEDULED $1,000
<br />COLLISION DED BODILY INJURY (Per acddem) $ ..
<br />
<br />X
<br />X NON-OWNED . PROPERTY DAMAGE
<br />$
<br /> HIRED AUTOS AUTOS $1
<br />000 !Per aculdentl -
<br /> ,
<br />E UMBRELLALI X OCCUR XLS0082427 003/2012 06103/2013 EACHGCCURRENCE $ 10,000,000
<br /> X EXCESS LAB CLAIMSWADE UNDERLYING LIMITS: AGGREGATE $ 10,000,000
<br /> X 0 GL; AL; EL POLICIES
<br /> DIED RETENTIONS _ $ _
<br />B WORKERS COMPENSATION WC966082001 06/03/2012 06103/2013 X wC STATU- 0'rH-
<br /> AND £MPLOYERV LIABILITY
<br /> ANY PROPMETORIPARTNER/EXECUTIVE YEN NIA EL EACH ACCIDENT $ 1,000,000
<br /> OFFICEIRE
<br />(Mandatory In NH)CLUDEO? ' f _
<br />E.L.DISEASE-EA EMPLOYE-
<br />$ 1,000,000
<br /> 11 ps. DESCRIePTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000
<br />D BUSINESS OWNERS & CBP 8641920 4/10/20 04/10!201 $790,849 BUILDING
<br /> CONTRACTORS $1,000 DEDUCTIBLE 12 3 $385,780 BPP-$300,000 BI WI EE
<br /> EQUIPMENT GOV. INCL. THEFT $116,318 SCHEDULED EQ.
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 01, AHdManal Remarks Schedule, f more space is required)
<br />CITY OF SANTA ANA, ALONG WITH ITS OFFICERS, AGENTS, REPRESENTATIVES, & EMPLOYEES ARE LISTED AS ADDITIONAL
<br />INSURED AS REQUIRED PER WRITTEN AGREEMENT. INSURANCE BY THE AFFORDED BY THE GENERAL LIABILITY POLICY FOR THE
<br />BENEFIT OF THE ADDITIONAL INSURED IS PRIMARY INSURANCE AS RESPECTS TO ANY CLAIM, LOSS OR LIABLITY CAUSED IN
<br />WHOLE OR IN PART BY THE NAMED INSURED(S) OPERATIONS, AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL
<br />INSURED IS EXCESS AND NON-CONTRIBUTORY. 30 DAY NOTICE OF CANCELLATION IN ANYEVENT.
<br />RE: CITY OF SANTA ANA/ TRAFFIC ENGINEERING (CT 1695)
<br />CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />TRAFFIC ENGIN yT,??iE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENT ?U43T 'O?lACCORDANCEWITHTHEPOLICYPROVISIONS.
<br />AUTHORIZED REPREBENTA7 VE
<br />P.O. BOX 1988
<br />SANTA ANA, Cfk 92 r l,twl3yc ??2 +?
<br />All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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