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ACC PJZbP CERTIFICATE 4F LIABILITY INSURANCE
<br />�....• -''
<br />DATE(MM /DD/YYYY)
<br />F06/01/2016
<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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must be 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
<br />CONTACT NAME: PATRICK MCRAE
<br />PATRICK MCRAE INSURANCE SERVICES
<br />1290 N. HANCOCK ST., SUITE 210
<br />P/HC °NN EXt: (714) 779 -6999 AX "o: (714) 779-6903
<br />AJC
<br />E-MAIL SS: p.mcrae @sbcglobal.net
<br />ANAHEIM HILLS, CA 92807
<br />INSURER (S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: COLONY INSURANCE COMPANY
<br />39993
<br />INSURED
<br />INSURER B: INSURANCE COMPANY OF THE WEST
<br />27847
<br />INSURER C: CENTURY - NATIONAL INSURANCE CO.
<br />26905
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5463 DIAZ STREET
<br />IRWINDALE CA 91706
<br />INSURER D: TOPA INSURANCE COMPANY
<br />18034
<br />INSURER E: TOKIO MARINE SPECIALTY INSURANCE COI
<br />23850
<br />INSURER F:
<br />$ 1,000,000
<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 />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
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />MM /DD /YYYY
<br />MM /DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />rr�-CLAIMS -MADE OCCUR
<br />XVU
<br />X
<br />X
<br />103 GL 0014267 -00
<br />DEDUCTIBLE $5,000 PER
<br />OCCURENCE
<br />06/03/201606/03/2017
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TORENTED
<br />PREMISES (Ea occurrence)
<br />$ 100 000
<br />X
<br />MED EXP (Any one person)
<br />_
<br />$ 5,000
<br />X
<br />OCP
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY I " 1 jECT EJ LOC
<br />GENERAL AGGREGATE
<br />$ 2,.000,000
<br />PRODUCTS - COMP /OP AGG
<br />I $ 2,000,000
<br />OTHER:
<br />$
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />BAP0171987
<br />11/05/2015
<br />11 /05/2016
<br />CEa OMBINaccident ED SINGLE LIMIT
<br />- __ —_ —_
<br />1 000 000
<br />ANY AUTO
<br />BODILY INJURY (Per person)
<br />$ -
<br />ALL AUTOS OWNED X AUTOSULED
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />$
<br />E
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />PUB542883
<br />UNDERLYING LIMITS:
<br />GL; AL; EL POLICIES
<br />06/03/2016
<br />06/03/2017
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />X
<br />AGGREGATE
<br />$ 10,000,000
<br />X
<br />DED RETENTION 0
<br />- - --
<br />$ -- --
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE
<br />OFFICER /MEMBER EXCLUDED? �
<br />(Mandatory in NH)
<br />N/A
<br />x
<br />WVE 5030354 -01
<br />06/03/2016
<br />06/03/2017
<br />X PER OTH-
<br />E.L. EACH ACCIDENT _
<br />--- --- - -- - -- --
<br />E.L. DISEASE - EA EMPLOYE
<br />-
<br />$ _ 1,000,000
<br />_ —
<br />1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />—
<br />$ 1,000,000
<br />D
<br />PROPERTY &
<br />CONTRACTORS
<br />PC 6600295
<br />$1,000 DEDUCTIBLE
<br />04/10/2016
<br />04/10/2017
<br />$790,849 BUILDING
<br />$385,780 BPP - $300,000 BI WI EE
<br />$116,318 SCHEDULED EQ,
<br />EQUIPMENT
<br />COV. INCL. THEFT
<br />$50,000 MISCELLANEOUS TOOLS
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more sppace Is re wired,
<br />THE CITY OF SANTA ANA, ITS DIRECTORS COMMISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEE�iS ARE NAMED AS ADDITIONAL INSURED WITH
<br />RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON - CONTRIBUTORY AS REQUIRED BY
<br />WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT.
<br />" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED.
<br />RE: PROJECT NAME: "SERVICE AGREEMENT FOR ADVANCED TRAFFIC MANAGEMENT SYSTEM AND COMMUNICAT N MAINTENANCE AND REPAIR SERVICES."
<br />CROSSTOWN JOB #2413 ._. ..___.__.__._._.,� �__.._ _' „4 -_..E UNI E 9 9C REDh A PG % OF �°
<br />_..... _w__._ (
<br />CERTIFICATE HOLDER
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA M -36
<br />SANTA ANE, CA 92702
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE /�Z�
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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