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Client#: 458248 MASTELECS N-2014-067 <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE ATE (MMOOIYYYY) <br />F <br />1 0/1 51201 4 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIIO N 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: It the certificate holder Is an ADUITiONAL INSURED, the poicy(los) must be endorsed If SUBROGATION IS WAj-VED, -subjecf 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 IiOLI Of Such endorsoment(s). <br />PRODUCER CON E'� CT I�rjStle <br />N4 Koehrer <br />HUB Int'l Insurance Serv. Inc. <br />-2681 <br />N., EKt): 877 825 <br />License ft 0757776 EMAIL <br />4371 Latham St, Ste 9101 AD❑RES& Cal.CPU@hubinternatlona].corn <br />Riverside, CA 92501 . INSURERISI AFFORDING COVERAGE -- NAIC # <br />INSURER A: Ohio Casualty Insurance, Company 24074 <br />INSURED .# A 1 11 <br />TSJ Electrical & Communications, Inc, <br />dba Masters Electric <br />7490 Jurupa Avenue <br />Riverside, CA 92504 . <br />B: medcan ....ance omplany <br />c: State Comp Insurance Fund of CA <br />Is! <br />tr7r-1rIIZIrATr- FdIIAADI=D- <br />THS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICA1 ED. NOW)FFHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 01-HER DOCUMENT fflTH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PER-FAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE ADULSUBR POLICY E .. . FF - POLICY rXP <br />LTR INSR WPYD POLICY NUMBER (14MOuNyrf) LmRt�j� LIMITS <br />A <br />GENERAL LIABILITY <br />- <br />BKW5607361 0 <br />0412012014 <br />04/2012`01. <br />OCCURRrNcE <br />X COMMEROAL GENERAL LIABILITY <br />—E] CLAWS-MADE a OCCUR <br />RENTED <br />MED EXP (Any one mrson) <br />s500000 <br />$15,000 <br />f�D.P!ed. $2 000 <br />PERSONAL & AL3V ]NJ LJRY <br />$1,0':00,000 <br />-GENL AGGRECATE LIMIT APPLIES PER: <br />I POLIGYF--� <br />PRO CLC <br />JECI <br />PRODUCTS - COMPIOP AGO <br />2,000 000 <br />B <br />AUTOMOBILE <br />LIABILITY <br />BAWS6073610 <br />0412012014 <br />0412012015 <br />ldent <br />X <br />X <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIREDAUFOS X FICN,OWNED <br />AUTOS <br />BODILY INJURY QPer pe=n) <br />BODILY INJURY Per acmdant) <br />-11,000,000 <br />$ <br />'ROPEi% I UANWiL <br />$ <br />UMBRELLA LIAO OCCUR <br />ESA560736110 <br />04/2,012014 <br />0412012016 <br />EACH DrCIJFRFN;rE <br />$M OK-0-00 <br />AGGREGATE <br />$5 <br />X <br />EXCESS LIAR X CLAIMS NIADE <br />13E.D. RETENTION $ <br />C <br />WORKERS COMPENSATION' <br />AND EPAPLOYERS'LIABILRY <br />ANY I'ROFRIL"IC)�WPART�ERA-XECUI'IVF Y - IN <br />OFFICERIMEMBER EXCL DED� �Nf <br />A <br />D0761452014 <br />1011812014 <br />101181201 <br />r' SWU73 <br />TQEY1111.173 <br />.LIT <br />-��-L —A"'HACC""rN!-- <br />—'t1L0—Q0-L0-00-r1rr.r <br />r.L. MSEASE - CA EMPLOYFE <br />$1 000 000 <br />(Mandatary in NH) <br />If you, duvcnbo wider <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE- POLICY LIAAIT <br />41,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO 101,.. Adchdorial Remarks Schedule, if mare, space is requIreco <br />The City of Santa Ana is Additional Insured in regards to the General Liability policy per attar-lied <br />forin CG,8810 04113. <br />TSJ ELECTRICAL &XU2CAT NS:AGREEMENT#N-2014-067 <br />RE , VIEWED BY, EUNICE HEREDIA (Pg. 1 of 9) <br />The Depot at Santa Ana <br />1000 E. Santa Ana Blvd., <br />Suite 108 <br />Santa Ana, CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITIT THE POLICY PROVISIONS, <br />AUTHORIZED REPRESENTATIVE <br />CP 1980-2010 ACORD CORPORATION. All rights reserved, <br />ACORD 26 (2010105) 1 of The ACORD name and logo are registered marks of ACORD <br />#S3'140838IM31407,65 JM43 <br />