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<br />� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />F05/26/2017
<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(les) 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 />PATRICK MCRAE INSURANCE SERVICES
<br />1265 N. MANASSERO ST. SUITE 303
<br />ANAHEIM HILLS, CA 92807
<br />NAME CT PATRICK MCRAE
<br />PHCNNo Ext): (714) 779 6999 FAX,No: (714) 779-6903
<br />AoRIESS: p.mcrae@sbcglobal.net
<br />INSURERS AFFORDING COVERAGE NAIL#
<br />INSURERA: COLONY INSURANCE COMPANY 39993
<br />INSURED
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5454 DIAZ STREET
<br />IRWINDALE CA 91706
<br />INSURER B: INSURANCE COMPANY OF THE WEST 27847
<br />INSURER C: CENTURY -NATIONAL INSURANCE CO. 26905
<br />INSURER D: TOPA INSURANCE COMPANY 18034
<br />INSURER E: TOKIO MARINE SPECIALTY INSURANCE COI 23850
<br />INSURER 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 />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 IN L S BR POLICY NUMBER MM%DDIYYYY POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 1XI OCCUR
<br />XCU
<br />X
<br />X
<br />103 GL 0014267-01
<br />DEDUCTIBLE $5,000 PER
<br />OCCURENCE
<br />06/03/2017
<br />06/03/2018
<br />EACH OCCURRENCE $ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence $ 100,000
<br />X
<br />MED EXP (Any one person) $ 5,000
<br />X
<br />OCP
<br />PERSONAL & ADV INJURY $ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY [ 7X PE 0 LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMP/OP AGG $ 2,000,000
<br />$
<br />OTHER:
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />X
<br />X
<br />BAP0171987
<br />11/05/201611/05/2017
<br />DO BIKaccidED SINGLE LIMIT $ 1,000,000
<br />BODILY INJURY (Per person) $ _
<br />X
<br />ANY AUTO
<br />X
<br />ALL OWNED�( SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NOWOWNED
<br />AUTOS
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />E
<br />X-
<br />UMBRELLA LIAB
<br />EXCESS kIA6 -
<br />X
<br />OCCUR
<br />CLAIMS=MADE
<br />-
<br />PUB585602
<br />UNDERLYING -LIMITS:- _ -
<br />GL; AL, EL POLICIES
<br />06/03/2017
<br />- - -- --
<br />06/03/2018
<br />-
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE. $ 10,000,000
<br />X
<br />DED RETENTION$ 0
<br />$ -
<br />B
<br />WORKERS COMPENSATION x WVE 5030354-02 06/03/2017 06/03/2018X
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N N / A
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH) iA
<br />STATUTE ETH
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE- EA EMPLOYEE $ 1,000,000
<br />If es, describe under
<br />DESCRIPTION OF OPERATIONS below REVIEWED BY EUNICE HEREDIA PG OF
<br />PROPERTY & -5 . u.��� _ t. �.W)
<br />CONTRACTORS $1,000 DEDUCTIBLE 04/10/2017 04/10/2018
<br />EQUIPMENT COV. INCL. THEFT
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />1,4 780 B P Buildings
<br />$198:968Popertyoff Premises
<br />$300,000 Leased BPP
<br />$300,000 BI/EE
<br />D
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 707, Additional Remarks Schedule, may be attached if more space Is required)
<br />CITY OF SANTA ANA, MICHAEL BAKER, INTERNATIONAL, OCTA, CITY OF BREA, CITY OF ANAHEIM, CITY OF ORANGE, CALTRANS, CITY OF PLACETIA, ALONG WITH
<br />THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED
<br />POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED
<br />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: GRAND AVE RTSSP PROJECT NO.: 14-6817 CROSSTOWN # 3435 PROJECT LOCATION: GRAND AVE
<br />CITY OF SANTA ANA
<br />20 CIVIC CENTER PLAZA
<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 WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<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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