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HomeMy WebLinkAboutCROSSTOWN ELECTRICAL & DATA, INC. 6A - 2012 City of Santa ." .1a - Clerk of the Coy.. _il COTC Office Use Only AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with Glzes ca:v L P.4 T/?. ,it"4. No. A-20/2-/77 was completed on 0 l36//7- and final payment has been made. (List all amendments. Use space below if needed.) Department: ic'7/4`.4 !T irff iC A - / 7_02_ Phone/Ext.: yS--62 G Signature: Date: ry f 2-c'// - Revised:01-07-16 �a I } 1� �J MAYOR 11 Miguel A. Pmido MAYOR PRO I EM vmcentF Sarmlent0 COUNCILMEMBERS Angelica Amucua P, David Benavide s Michele Martinez Roman Reyno Sal Tinajero NSURA"' "N Fll- NOF1K MAY PROG6 IIPSTiL1NSlJRAt~&t i ' -. CLERK OF COUNG11 DATE:- \ I -`,� June 18, 2015 CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Conker Plaza M -36 + P.O. Box 19+18 M -36 Santa Ana, California 92702 ww� Crosstown Electrical & Data, Inc. Attn: David P. 1 -leer ante 5463 Diaz Street Irwindale, CA 91706 Re: Agreement A- 2012 -177, "Service Agreement for Advanced Traffic Management System and Communication Maintenance and Repair Services" Extension Dear Mr. Ileermance: i i Pursuant to Agreement A -2012 -177 entered by Crosstown Electrical & Data, Inc. and the City of Santa Ana, dated August 20, 2012, Section 3 "Tenn", the time period of said Agreement is hereby extended for an additional one (1) year period, through June 30, 2016. The insurance certificates are required to be extended and /or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. If you have any questions regarding this matter, please contact Vinh Nguyen in the Public Works Agency at 714-647-5612. Public Works Agency APPROVED AS TO FORM: Sonia R. Carvalho City Attorney Assistant City Attomey c: Clerk of the Council CITY OF SANTA ANA David Cavazos City Manager ATTEST: Crosstown Electrical & Data, Inc. SAN'I -AANA CnY COUNCLL. `y6F'I A.@er:UO 1 'maot, SAitAN. ehS i TIW,1I4 Nbli'll", i A?&,v Aalkkw- N tu"'i F.}WliY4tiLx 1 ilwaon Rg "', , ffiI f""vN AtJy4a I k'[y k pl3e t, SJ d I i WAd k, 3 *vId i W.d 5 WSN d ubll larzt<�, FFr,t.,v,� {_�i'rnm xit.atnl 7�}, ii Ai {�n: [.g1 •eH�4. tW9 b�vuh '::. a;.?r!a 3 I I_'.it'.t3.Hkb'2 ":.#:?4i .u�ir vg F2i3txkrvs i�az_MZw! &p?9 ;ytSnJet�i, m1{s- �yi act A� ®® CERTIFICATE OF LIABILITY INSURANCE DAT6 /22/2015 Y) 06/22/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO. 0637431 NAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210 Ext, (714) 779 -6999 ap No, (714) 779 -6903 Rest), nooaess: p.mcrae @sbcglobal.net INSURERS AFFORDING COVERAGE NAIL# ANAHEIM HILLS, CA 92807 INSURERA: BURLINGTON INSURANCE COMPANY 23620 /2016 INSURED INSURERS: INSURANCE COMPANY OF THE WEST 27847 DAVID HEERMANCE INSURER C: CENTURY - NATIONAL INSURANCE CO. 26905 CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET #525910867 IRWINDALE CA 91706 INSURERD: GREAT AMERICAN INS CO OF NY 22136 INSURERE: GREAT AMERICAN INSURANCE COMPANY 16691 INSURER F: X COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM /DDIYYYY POLICY EXP MMIDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X HGL0041516 06/03/201506/03 /2016 EACH OCCURRENCE IS 1,000,000 CLAIMS -MADE OCCUR XCU DEDUCTIBLE: $5,000 PER OCC RENTED PREA SES Ea occurrence $ 50,000 X MED EXP (Any one person) $ 5,000 X OCP PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER', GENERAL AGGREGATE $ 2,000,000 POLICY JEST 1-1 LOG PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER: C AUTOMOBILE LIABILITY ANY AUTO AUTOSNED X AUTOSULED HIRED AUTOS X NON -OWNED AUTOS X BAP0171987 COMPREHENSIVE DED. $1,000 COLLISION DED. $1,000 11/05/201411/05 /2015 COMBINED SINGLE UMIT Ea acc,dent $ 1,000,000 BODILY INJURY Per person) ( P ) $ - Ix BODILY INJURY(Per accdent) $ PROPERTY DAMAGE Per accident $ $ E UMBRELLALIAB X OCCUR TUE429515200 06/03/201506/03 /2016 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS -MADE UNDERLYING LIMITS: GL; AL; EL POLICIES X AGGREGATE $ 10,000,000 X BED I I RETENTION$ 0 _ $ - B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE YIN OFFICER /MEMBEREXCLUDED? � (MandatoryinNH) NIA x WLV503035400 06/03/201506/03 /2016 X I SEATUTE 6RH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE — $ 1,000,000 DE SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,004 D BUSINESS OWNERS & MAC4259136 $752,760 BUILDING CONTRACTORS $1,000 DEDUCTIBLE 04/10/201504/10 /2016 $367,200 BPP- $300,000 BI WI EE EQUIPMENT COV. INCL. THEFT $116,318 SCHEDULED EQ. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF SANTA ANA, ITS DIRECTORS, COM ISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS, ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON - CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS, WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. * SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. RE: PROJECT NAME: "SERVICE AGREEMENT FOR ADVANCED TRAFFIC MANAGEMENT SYSTEM AND COMMUNICATION MAINTENANCE AND REPAIR SERVICES" CROSSTOWN JOB #2413 CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M -36 ANY OF EXPIRATIIONH DATE DESCRIBED VTHEREOF, NOTIICEI WILL BE THE SHOULD CBE CDELIVERED BEFORE IN SANTA ANA, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. ,ROSSTOWN EL CTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED B AUTHORIZED REPRESENTATIVE EUNICE HEREDIA (PG 1 OF 10) @ 1988.2013 ACORD CORPORATION. All rights reserved. ACORD 25 (2013/04) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: HGL0041516 06/03/2015 TO 06/03/2016 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional insured on your policy. Such person or or- ganization is an additional insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. CROSSTOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY EUNICE HEREDIA (PG 2 OF 10) B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sureds) at the location of the covered operations has been completed; or J. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. 1�,_/ d CG 20 33 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 11 POLICY NUMBER: HGL0041516 06/03/2015 TO 06/03/2016 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations : Location And Description Of Completed Operations Any owner, lessee or contractor with whom you Any and all of your completed operations. have agreed, in a written contract, that such person or organization should be added as an additional insured on your policy, provided such written contract is fully executed prior to an 'occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for 'bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard ". CROSSTOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY EUNICE HEREDIA (PG 3 OF 10) "' CG 20 37 07 04 O ISO Properties, Inc., 2004 4 Page 1 of 1 ❑ POLICY NUMBER: HGL0041516 06/03/2015 TO 06/03/2016 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 NUAMIUI .. *y * • �, , This endorsement modifies insurance provided underthefollowing: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization with whom you have agreed, in a written contract to waive the transfer of rights of recovery against others to us, provided such written waiver is fully executed prior to an 'occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Decla ations. The following is added to Paragraph B. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive anyright of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above, CG 24 04 05 09 © Insurance Services Office, Inc., 2008 CROSSTOWN ELECTRICAL & DATA A -2012 -177 & EXTENSION REVIEWED BY �G �- EUNICE HEREDIA (PG 4 OF 10) Pagel of 9 71 POLICY NUMBER: HGL0041516 06/03/2015 TO 06/03/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A OTHER This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTS - COMPLETED OPERATIONS LIABI LITY COVERAG E PART Schedule of Addition Ed Insured(s): Any person or organization named in an Additional Insured endorsement attached to this policy with whom you have agreed, in a written contract, that such person or organization should be provided primary and non - contributory coverage, but only when such written contract Is fully executed prior to an "occurrence" in which coverage is sought under this policy. A. Paragraph C. of this endorsement replaces cover under the applicable Coverage Part to paragraph 4. Other Insurance of Section IV- which this endorsement is modifying, this Commercial General Liability Conditions, but insurance is primary and non- contributory. only with respect to the insurance afforded to the However, this endorsement: additional insured(s) scheduled above. 1. Applies only when you are required by contract, agreement or permit to provide B. Paragraph C. of this endorsement replaces primary and non - contributory coverage for paragraph 4. Other Insurance of Section IV- the additional insured, provided such written Products- Completed Operations Liability contract, agreement or permit is fully Conditions, but only with respect to the executed prior to an "occurrence" in which insurance afforded to the additional insured(s) coverage is sought under this policy, and scheduled above. 2. Does not apply to any claim, loss or liability due to the sole negligence of the additional C. Oth er I ns u ran ce insured. Notwithstanding other valid and collectible insurance available to the insured for a loss we IFG -G -0094 02 12 Includes copyrighted material of Page 1 of 1 ISO Properties, Inc., with permission CROSSTOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY A EUNICE HEREDIA (PG 5 OF 10) POLICY NUMBER: HGL0041516 06/03/2015 TO 06/03/2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. r i This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Each construction project described in a separate written contract. If multiple construction projects are grouped together under one written contract, all such projects will be considered one project and subject to a single general aggregate limit for that contract. Limits:_. Designated Construction Project General Aggregate Limit as shown in the Commercial General Aggregate Limit General Liability Declarations, IFG- G- 0002•DL General Aggregate For Al I Projects $ 5,000,000 Combined (If no entry appears above, information required to complete this endorsementwill be shown in the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. IFG -G -0065 02 09 Z The Designated Construction Project General Aggregate Limit is the most we will pay for the suni of all damages under COVERAGE A, except damages because of "bodily injury' or "property damage" included in the "products - completed operations hazard ", and for medical expenses under COVERAGE C regardless of the number of a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". Includes copyright material of ISO Properties, [no., with its permission. CRO STOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY EUNICE HEREDIA (PG 6 OF 10) Page 1 of 2 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products- Completed Operations Aggregate Limit, whichever is applicable; and IFG -G -0065 02 09 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. The most we will pay as damages caused by "occurrences" for all Construction Projects whether designated or not is the General Aggregate For All Construction Projects Combined Limit shown in the Schedule above. D. When coverage for liability arising out of the "products- completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Products - Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. E. if the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviatefrom plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. F. The provisions of Limits Of Insurance (SECTION 111) not otherwise modified by this endorsement shall continue to apply as stipulated. Includes copyright material of ISO Properties, Inc., with its permission. CRO STOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY X_ /. EUNICE HEREDIA(PG 7 OF 10) Paga2of2 C7a3MtRC1AL AUTO CAM 6122 10 06 TIRS ENDORSEMENT CY1eYN(`ES. TIR, A'pl. WVC PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED ENDORSEMENT ENT - PRIMARY This endorsement modifies insurance provided under Ilia follatv€ng:. MOTOR CARRIER COVERAQE3 FORM B09INESS AUTO COVERAGE FORM TRUCKERS COVERAGE FC9RM The intenstaw provided botchy to tho Additional Insured(s) is limited as °lbllows: F 1. The coverage ftfliarrled harelip to such additional insured is limited to immakad liability specifically resulting from the conduct al the Named Ins xed for which the additional inswed was hold 2. Ilia hrniti of insurance applicable to the insurance afforded hereby are those specified in the written ageement or in the Deolarnaktos or Schedules of this policy, whichever is less, The Resits of Insurance applicable to the insurance afforded hereby are not hicksive mad net in addition to Phc limits of ntsdraucc shown the Mclarations ar Sthodtdce of this, Policy. Any coverage provided under Ads endotseutent for any additional insured will bevel he hmader than coverage proAdod to any names insured. Any other policy tents, conditions,' limitations, exeluarons, and de,fulidons apply to this enAatsptuerst.. CAM 61281006 CROSSTOW�LECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY ((// / /�� a A EUNICE HEREDIA (PG 8 OF 10) COMMlERCIAL. UTO CANT 6130 09 016 THIS tN I)OiRSEMENT CHANCES THE 1701ACY. PLEASE IIL:,AD IT CAREFULLY. BLANKET WAIVER OF SUBROGATION Ttus endomoncrt modi.fws lnsau)encc pro'n,kd not cr ffie Polloie i g: MOTOR CARRIER COVERAGE rORM BUSMSS AUTO COVC.RAOE FORM GARAGE C;OVERAGR PORM TRuckERs CCJwmu PoRm CAM 612[1:09 06 CROSSTOWN ELECTRICAL & DATA A- 2012 -177 & EXTENSION REVIEWED BY /A ( A EUNICE HEREDIA (PG 9 OF 10) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA JOBS PERFORMED BY NAMED INSURED. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/03/2015 Policy No. WLV 5030354 00 Insured CROSSTOWN ELECTRICAL & DATA Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 06 34 /t (.9 CROSST���1 C�j,6�)TRICAL &DATA A- 2012 -177 &EXTENSION REVIEWED BY " "" vvv"` EUNICE HEREDIA (PG 10 OF 10) INSURED Endorsement No. Premium $ INCL. ACC>R& CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDfYYYY) 01/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO. 0637431 CONTACT NAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210 PHONE (714) 779 -6999 AJC Na : (7'14) 779 -6'903 E -MAIL ADDRESS: p.mcrae@slbcglobal.net ANAHEIM'' HILLS, CA 92.807 INSURER S AFFORDING COVERAGE NAIC # INSURER A: BURLINGTON INSURANCE COMPANY 23620 INSURED INSURER B: INSURANCE COMPANY OF THE WEST 2.7847 INSURER C; CENTURY- NATIONAL INSURANCE CO. 2.6905 X CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET IRWINDALE CA 91706 INSURER D: GREAT AMERICAN INS CO OF NY 22136 INSURER E: GREAT AMERICAN INSURANCE COMPANY 16691 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTRR. TYPE OF INSURANCE INSDL SURD POLICY NUMBER MMIDIYYYY POLICY IIYYYY ......LIMITS A X COMMER.MAL GENERAL LIABILITY CLAIMS -MADE OCCUR XCU X X HGL004151 6 DEDUCTIBLE..: $5,000 PER OCC .06/03/201506/03/2016 EACH OCCU CE RREN l$ 1'000'000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person) $ 0,000 X OCP' PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE UMIT APPLIES PER: PRO- POLICY II JECT 0 LOC GENERAL AGGREGATE $.. 2,000,000 GEN'L PRODUCTS - COMPIOP AGG $ 2,0'00,000 I� $ OTHER C AUTOMOBILE UABILITY X BAP0171987 11/05/201511/05 /2.016 COMBINED SINGLE LIMIT Ea accident $ 1,000,OC10 X BODILY INJURY (Per person) '��, $ - ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS HIRED AUTOS v NON -OWNED AUTOS X BODILY INJURY (Per accident) $ _ PROPERTY DAMAGE Per accident. $ - $ E —x], UMBRELLA LIAR EXCESSLIAB X OCCUR CLAIMS -MADE TUE429515200 UNDERLYING LIMITS: GL; AL; EL POLICIES 06/03/2015 06/0312018 OCCURRENCE $ 10,000,0100 X AGGREGATE $ 10,000,000 DED RETENTION$ 0 .EACH - B WORKERS COMPENSATION ...... AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER(EXEDUTI.. OFFICER/MEMBER EXCLUDED? IMaradatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N f A x WLV503035400 06/03/2015 06/03/2016 U X.1 STATUTE ©RH E.L. EACH ACCIDENT $ 1,000,000 : E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 D BUSINESS OWNERS & MAC4259136 $752,760 BUILDING CONTRACTORS $1,000 DEDUCTIBLE 04/10/201504/10 /2016 $367,200 BPP - $300,000 BI WU. EE EQUIPMENT COV. INCL. THEFT $1116,318 SCHEDULED EQ. DESCRIPTION OF OPERATIONS d LOCATIONS I VEHICLES IACORD 161, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF SANTA ANA, ITS DIRECTORS COMMISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON — CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF„ A 30 DAY WRITTEN NOTICE WILL BE ISSUED RE: PROJECT NAME: "SERVI�CE µ N MAINTENANCE MAINTENANCE AND .......... REPAIR SERVICES. "' CROSSTOWN JOB #2 --- T Q �„ �, - 413 EN R ADVANCED TRAFFIC MANAGEMENT VN;TE -I1 SY SYSTEM D C UNICATI I� II({ l II „l I,:.I.)fl M (Ip'C,:a 101--10) is1 a all if id 07-171111 WE aILVA ■I NJ L11 CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA M-36 THE EXPIRATION DATE THEREOF, NOTICE 'lIVlILL BE DELIVERED IN SANTA AN E, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988 -2014 ACORD CORPORATION. All rights reserved.. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY., 3 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addli- tionall insured on your poNcy. Such person or or- ganization is an additional insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part~ by: 1. Your acts or ornissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: I'. "Bodily injury", "property damage" or "Personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities, 2. "Bodily injury" or "property darnage" occurring after: F?, EVV EWED BY,- a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed,- or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project, l(r ELJN ;E HE REM (F1G,Z_of4C,) CG 20 33 07 04 @ ISO Properties, Inc., 2004 Page 1 of 1 n POLICY NUMBER: HGL0041516 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured P,erson(s) Or_ Organizations J.. Location And Description Of Complete# ons Any owner, lessee or contractor with whom you _�ati Any and all of your completed operations. have agreed, in a written contract, that such person or organization should be added as an additional insured on your policy, provided such written contract is fully executed prior to an "occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additlonal insured and included in the "products- completed operations hazard ". REVIEWED BY HEREDIA (FT3, CG 20 37 07 04 @ ISO Properties, Inc,, 2004 Page I of 1 ❑ PQLICYNUKNBER� HGL0041518 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 7hiaendonsementmvdifies insum rue provided under thefohmwing: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name [f Person QrOrganization: Any person or organization with whom you have agreed, in a written Contract to waive the transfer of rights of recovery against others to us, provided such written waiver is fuHy executed prior to an "occurrence" in which coverage is Sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declaratio ----I Eis —I- Tha following is added Uo Pa h8, Transfer Of Rights Of Recovery A0ainat Others To Us of Sectiom|V– Comditioms: We waive anyrightof recovery m/emay have against the person or organization shown in the Schedule above because ofpayments we make for injury or- damage arising out of your ongoing operations or "yuur work" done under a coobadv�th that per-son or organization and included in the "products- completed operations hazard". This waiver applies on�y to the person or mGmn|zelion ahemm in the Schedule above. REVEVVE0B)1� CG 24 04 05 09 Q Insurance Services Office, Inc,, 2008 Page 1 of 1 171 Iiii 111' This endorsement modifies insurance provided under tie following: COMMERCIAL GENERAL LIAB0TY COVERAGE PART Schedule of Additional |nsured(s)� Any person or organization named in am Additional Insured endorsement attached tu this poicy with whom you have agreed, in a written contract, that such person or organization should be provided primary and non-contributory coverage, but only when such written contract is, fully mxetutodprimxto,nn''occurrenm*''im*vhichcovorageiosouQhtunderthiepohcy. A. Paragraph C. of this endorsement replaces cover under the applicable Coverage Part to paragraph 4^ Other Insurance a[ Section IV_ which this endorsement /o omanyiog' this General LiabUityCmmdkioms. but ' insurance i's primary and non- contributory. only with respect tm the insurance afforded |othe However, this endorsement: additional iomured(o) scheduled above, 1. Applies only when You are required by B' Paragraph C. of this endorsement replaces contract, agreement or permit to provide primary and non-contributory coverage for paragraph 4. Other Insurance of Section |V- the additional insured, provided such written � Prod m�s'Cmmp(etad Operations Liability contract, agreement or nr penmit is h/|[y Conditions, but only mdth respect to the executed prior to, an ^anournenne' in which insurance afforded to the additional' insured(s) coverage io sought under this poUoy.and scheduled above. 2. Does not apply toany daim. loss or liability due to the sole negligence of the additional C. [)ther|msurunoe inuurod Notwithstanding ether valid and collectible insurance uvai�ab/n to the insured for u|psn we |FG-G'00940212 Includes /u�re/ of Page of 1 IS 0 Properties, Inc., with perm ission REVII'MED-BY�_ '44, l POLICY NUMB ER; HGL0041516 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. 00 This endorsement modifies insurance provided Linder the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects- Each construction project described in a separate written contract. If multiple construction projects are grouped together under one written contract, all such projects will be considered one project and subject to a single general aggregate limit for that contract, Limits: Designated Construction Project General Aggregate Limit as shown in the Commercial General Aggregate Limit General Liability Declarations, IFG•G-0002-DL General Aggregate For All Projects $5,000,000 Combined wn I lu m Ju y appt:,11a -IuuvG, I I lIU1111dkim I I equirea to compieie Ln s onaorsement Will be shown B n the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences "" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 2, The Designated Construction Project General Aggregate Limit is tile most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: 1. A separate Designated Construction Project a. Insureds; General Aggregate Limit applies to each b. Claims made or "suits" brought; or designated construction project, and that limit is equal to the amount of the General c. Persons or organizations making claims or Aggregate Limit shown in the Declarations. bringing "suits". IFG-G-006,5 02 09 includes copyright material of Page I of 2 ISO Properties, Inc., with its permission. REVlONED BY� EUNCE HEREDIA (P(,,; ,"cal - R5 Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The I imi ts shown in the D ec iaratio n s for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all surns which the insured becomes legafly obligated to pay as damages caused by " occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION' 1), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products- Completed Operations Aggregate Limit, whichever is applicable, and IFG-G-0065 02 09 2. Such payments shall not reduce any Designated Construction Project General Aggregate Urn it. C. The most we will pay as damages caused by "occurrences "' far all Construction Projects whether designated or not is the General Aggregate For All Construction Projects Combined Limit shown in the Schedule above, D. When coverage for liability arising out of the `"products - completed operations hazard" is provided, any payments for damages because of "bodily injury" or "Property damage" included in the "products, - completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. E. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from pi an:s, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. F. The provisions of Limits Of Insurance (SECTION 111) not otherwise modified by this endorsement shall continue to apply as stipulated. Includes copyright material of ISO Properties, Inc., with its permission. Page 2 of 2 FREVIEWEI.) BY: EUNU-z-1 I 1ERE(NA (F'G _7�­)F/ COMMEW JAL AUT 0 C A INI 6122 10 06 THIS ENDORSENJEN I' (AI TUE POLICY, PLEASE READ JJ'CAAEFClJ,N% Bl,,ANKFT ADDITIONAL INSUIU11) ENDORSEMENT PRIMARY This nvedifiws i 'uSumncc providcd tuldcr thou fkqkpwijlg,- MOTOR CARRIER, COVEIRAOE FOR,Nt NUSUNESS AUTO FORM GARMT (`0VT,,.R law F FORM TR(JCKERS C'OVERAGiF, FID10,1 Nk^c th rcspoct to S [,CTV)N tl l - L.1.+ 8f L I FN' (70 V E KAG L on Who k A n lmw u rud r s amended w, b ,.- aura as all ad d k km �al r f1sured any re r sm(s) or ongano a kml(s)whorn w ou are requi rud w add to this pol ky as an a dditioaM insurecl under a vriven aglow alent n efrCul or 9wecnn6ng eff�cfi ve durnne , lbe pohcv pvikA insurmlee applies mfly to "t"'c'Xidy aq�urn aro 'pjr cperry damage" th.lt MCUTS SUbSef,3991 Wl CA CT LH iM) (if file, w ritte rl ngree me nr and S Lbscq Will tO thic s SsUarlu of cul ificale of fiir urance ind icwm n g Such Fmr%t)ufS) In urganizatilm(s), as ld%Ju6q mal Olvml I vd(s), 'llic irriurancc pmwided hcrt!by io the Additional hismvd'(5) is limitej As fir.)l wawa s� The cover(qe aftowded lWeNhy to such addhional im,'wred is Ifir6ted tc):imput"l Ubifit), SpecificaUy gvsuhing from the conduct of he Named InNured fim- the addilional insurtvd was hckl H'able, 2. fle hrlliu� ofillmirance appticable to the inmArmice aflordod hereby an dloi;e qjv,:ifiud in Lfic t), in Ifiv, Ficclanaiurn of SJiedules (Y' fl6s policy, vdlichevv is hcav The limils cd hmnuarwe applicabie lo th( 41,'iflrarwe aflorded herebl ate and not in a&Edo�i lo, d& hirnits of anAMIHCC ShOIN11 zhe F)cchraficvlr cm- Schedules ofthis policy. 3 piovitkAl untler dis broader ifian covvrage prov&dcd to n,,,, An%� other, fwdi.% tt�.rms, cvuch6ows, hrOafi m", evlosiowls, and duff oiriows applY t,„ fl6i C ANI 01'' 2 14106 REMEWED BY� I/j/ k,_ EUN!ICE 118 RENA (PG� -)I'rl(-)) _3 ( COMMERMAL AUTO CAM 6UO N 06 THIS ENDORSEMEIN'T CHANGES THE POLICY� PLEASE READ ITCAREFI)LLY', BLANKETWAIVER OF SUBROGATION Thk Mommmu mo& % vmm=u,mM&d WW" 9, rd0r(AZ (ARRJERC(,,)VER,AGF, IH.rR,M 131-ISINESS AUTO �20VERA(iE H)RAI GARAGE MTRAGG PORN/i TRUCKERS COVERAGE FORNI, We agrev k, w-uivc any and alb submgmimi chims orng�vs oficc vet T anyperson(s) i�,)r ifthere is an cxcemcd wduc:"pwmmg N& Mm pmwjQ m uqmAA,,W, mtkh mqWms as %I&r cd Subrogafl ur, Clause from 1he Narncd Insumd, excep 1,101 losses, as my dw in whole or pan to Te negligence auk ,.uors and ur (vgaWzmi0NQ UAM M 20 N 00 REWEWED BY ij EUNI(.,,E [-IEREfAA (PG "JOFIC)) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 1499mi WAIVER OF' OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA JOBS PERFORMED BY NAMED INSURED. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/03/2015 Policy No. WLV 5030354 00 Endorsement No. Insured CROSSTOWN ELECTRICAL & DATA Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 fii46 34 HEREUA (FIG16)F 10) (Ed. 8-00) or SURIM ACC>R& CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDfYYYY) 01/21/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO. 0637431 CONTACT NAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210 PHONE (714) 779 -6999 AJC Na : (7'14) 779 -6'903 E -MAIL ADDRESS: p.mcrae@slbcglobal.net ANAHEIM'' HILLS, CA 92.807 INSURER S AFFORDING COVERAGE NAIC # INSURER A: BURLINGTON INSURANCE COMPANY 23620 INSURED INSURER B: INSURANCE COMPANY OF THE WEST 2.7847 INSURER C; CENTURY- NATIONAL INSURANCE CO. 2.6905 X CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET IRWINDALE CA 91706 INSURER D: GREAT AMERICAN INS CO OF NY 22136 INSURER E: GREAT AMERICAN INSURANCE COMPANY 16691 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTRR. TYPE OF INSURANCE INSDL SURD POLICY NUMBER MMIDIYYYY POLICY IIYYYY ......LIMITS A X COMMER.MAL GENERAL LIABILITY CLAIMS -MADE OCCUR XCU X X HGL004151 6 DEDUCTIBLE..: $5,000 PER OCC .06/03/201506/03/2016 EACH OCCU CE RREN l$ 1'000'000 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person) $ 0,000 X OCP' PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE UMIT APPLIES PER: PRO- POLICY II JECT 0 LOC GENERAL AGGREGATE $.. 2,000,000 GEN'L PRODUCTS - COMPIOP AGG $ 2,0'00,000 I� $ OTHER C AUTOMOBILE UABILITY X BAP0171987 11/05/201511/05 /2.016 COMBINED SINGLE LIMIT Ea accident $ 1,000,OC10 X BODILY INJURY (Per person) '��, $ - ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS HIRED AUTOS v NON -OWNED AUTOS X BODILY INJURY (Per accident) $ _ PROPERTY DAMAGE Per accident. $ - $ E —x], UMBRELLA LIAR EXCESSLIAB X OCCUR CLAIMS -MADE TUE429515200 UNDERLYING LIMITS: GL; AL; EL POLICIES 06/03/2015 06/0312018 OCCURRENCE $ 10,000,0100 X AGGREGATE $ 10,000,000 DED RETENTION$ 0 .EACH - B WORKERS COMPENSATION ...... AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER(EXEDUTI.. OFFICER/MEMBER EXCLUDED? IMaradatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below N f A x WLV503035400 06/03/2015 06/03/2016 U X.1 STATUTE ©RH E.L. EACH ACCIDENT $ 1,000,000 : E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 D BUSINESS OWNERS & MAC4259136 $752,760 BUILDING CONTRACTORS $1,000 DEDUCTIBLE 04/10/201504/10 /2016 $367,200 BPP - $300,000 BI WU. EE EQUIPMENT COV. INCL. THEFT $1116,318 SCHEDULED EQ. DESCRIPTION OF OPERATIONS d LOCATIONS I VEHICLES IACORD 161, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF SANTA ANA, ITS DIRECTORS COMMISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON — CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF„ A 30 DAY WRITTEN NOTICE WILL BE ISSUED RE: PROJECT NAME: "SERVI�CE µ N MAINTENANCE MAINTENANCE AND .......... REPAIR SERVICES. "' CROSSTOWN JOB #2 --- T Q �„ �, - 413 EN R ADVANCED TRAFFIC MANAGEMENT VN;TE -I1 SY SYSTEM D C UNICATI I� II({ l II „l I,:.I.)fl M (Ip'C,:a 101--10) is1 a all if id 07-171111 WE aILVA ■I NJ L11 CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 CIVIC CENTER PLAZA M-36 THE EXPIRATION DATE THEREOF, NOTICE 'lIVlILL BE DELIVERED IN SANTA AN E, CA 92702 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1988 -2014 ACORD CORPORATION. All rights reserved.. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY., 3 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addli- tionall insured on your poNcy. Such person or or- ganization is an additional insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part~ by: 1. Your acts or ornissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: I'. "Bodily injury", "property damage" or "Personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities, 2. "Bodily injury" or "property darnage" occurring after: F?, EVV EWED BY,- a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed,- or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project, l(r ELJN ;E HE REM (F1G,Z_of4C,) CG 20 33 07 04 @ ISO Properties, Inc., 2004 Page 1 of 1 n POLICY NUMBER: HGL0041516 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured P,erson(s) Or_ Organizations J.. Location And Description Of Complete# ons Any owner, lessee or contractor with whom you _�ati Any and all of your completed operations. have agreed, in a written contract, that such person or organization should be added as an additional insured on your policy, provided such written contract is fully executed prior to an "occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additlonal insured and included in the "products- completed operations hazard ". REVIEWED BY HEREDIA (FT3, CG 20 37 07 04 @ ISO Properties, Inc,, 2004 Page I of 1 ❑ PQLICYNUKNBER� HGL0041518 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 7hiaendonsementmvdifies insum rue provided under thefohmwing: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name [f Person QrOrganization: Any person or organization with whom you have agreed, in a written Contract to waive the transfer of rights of recovery against others to us, provided such written waiver is fuHy executed prior to an "occurrence" in which coverage is Sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declaratio ----I Eis —I- Tha following is added Uo Pa h8, Transfer Of Rights Of Recovery A0ainat Others To Us of Sectiom|V– Comditioms: We waive anyrightof recovery m/emay have against the person or organization shown in the Schedule above because ofpayments we make for injury or- damage arising out of your ongoing operations or "yuur work" done under a coobadv�th that per-son or organization and included in the "products- completed operations hazard". This waiver applies on�y to the person or mGmn|zelion ahemm in the Schedule above. REVEVVE0B)1� CG 24 04 05 09 Q Insurance Services Office, Inc,, 2008 Page 1 of 1 171 Iiii 111' This endorsement modifies insurance provided under tie following: COMMERCIAL GENERAL LIAB0TY COVERAGE PART Schedule of Additional |nsured(s)� Any person or organization named in am Additional Insured endorsement attached tu this poicy with whom you have agreed, in a written contract, that such person or organization should be provided primary and non-contributory coverage, but only when such written contract is, fully mxetutodprimxto,nn''occurrenm*''im*vhichcovorageiosouQhtunderthiepohcy. A. Paragraph C. of this endorsement replaces cover under the applicable Coverage Part to paragraph 4^ Other Insurance a[ Section IV_ which this endorsement /o omanyiog' this General LiabUityCmmdkioms. but ' insurance i's primary and non- contributory. only with respect tm the insurance afforded |othe However, this endorsement: additional iomured(o) scheduled above, 1. Applies only when You are required by B' Paragraph C. of this endorsement replaces contract, agreement or permit to provide primary and non-contributory coverage for paragraph 4. Other Insurance of Section |V- the additional insured, provided such written � Prod m�s'Cmmp(etad Operations Liability contract, agreement or nr penmit is h/|[y Conditions, but only mdth respect to the executed prior to, an ^anournenne' in which insurance afforded to the additional' insured(s) coverage io sought under this poUoy.and scheduled above. 2. Does not apply toany daim. loss or liability due to the sole negligence of the additional C. [)ther|msurunoe inuurod Notwithstanding ether valid and collectible insurance uvai�ab/n to the insured for u|psn we |FG-G'00940212 Includes /u�re/ of Page of 1 IS 0 Properties, Inc., with perm ission REVII'MED-BY�_ '44, l POLICY NUMB ER; HGL0041516 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. 00 This endorsement modifies insurance provided Linder the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects- Each construction project described in a separate written contract. If multiple construction projects are grouped together under one written contract, all such projects will be considered one project and subject to a single general aggregate limit for that contract, Limits: Designated Construction Project General Aggregate Limit as shown in the Commercial General Aggregate Limit General Liability Declarations, IFG•G-0002-DL General Aggregate For All Projects $5,000,000 Combined wn I lu m Ju y appt:,11a -IuuvG, I I lIU1111dkim I I equirea to compieie Ln s onaorsement Will be shown B n the Declarations as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences "" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 2, The Designated Construction Project General Aggregate Limit is tile most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: 1. A separate Designated Construction Project a. Insureds; General Aggregate Limit applies to each b. Claims made or "suits" brought; or designated construction project, and that limit is equal to the amount of the General c. Persons or organizations making claims or Aggregate Limit shown in the Declarations. bringing "suits". IFG-G-006,5 02 09 includes copyright material of Page I of 2 ISO Properties, Inc., with its permission. REVlONED BY� EUNCE HEREDIA (P(,,; ,"cal - R5 Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The I imi ts shown in the D ec iaratio n s for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all surns which the insured becomes legafly obligated to pay as damages caused by " occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION' 1), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products- Completed Operations Aggregate Limit, whichever is applicable, and IFG-G-0065 02 09 2. Such payments shall not reduce any Designated Construction Project General Aggregate Urn it. C. The most we will pay as damages caused by "occurrences "' far all Construction Projects whether designated or not is the General Aggregate For All Construction Projects Combined Limit shown in the Schedule above, D. When coverage for liability arising out of the `"products - completed operations hazard" is provided, any payments for damages because of "bodily injury" or "Property damage" included in the "products, - completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. E. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from pi an:s, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. F. The provisions of Limits Of Insurance (SECTION 111) not otherwise modified by this endorsement shall continue to apply as stipulated. Includes copyright material of ISO Properties, Inc., with its permission. Page 2 of 2 FREVIEWEI.) BY: EUNU-z-1 I 1ERE(NA (F'G _7�­)F/ COMMEW JAL AUT 0 C A INI 6122 10 06 THIS ENDORSENJEN I' (AI TUE POLICY, PLEASE READ JJ'CAAEFClJ,N% Bl,,ANKFT ADDITIONAL INSUIU11) ENDORSEMENT PRIMARY This nvedifiws i 'uSumncc providcd tuldcr thou fkqkpwijlg,- MOTOR CARRIER, COVEIRAOE FOR,Nt NUSUNESS AUTO FORM GARMT (`0VT,,.R law F FORM TR(JCKERS C'OVERAGiF, FID10,1 Nk^c th rcspoct to S [,CTV)N tl l - L.1.+ 8f L I FN' (70 V E KAG L on Who k A n lmw u rud r s amended w, b ,.- aura as all ad d k km �al r f1sured any re r sm(s) or ongano a kml(s)whorn w ou are requi rud w add to this pol ky as an a dditioaM insurecl under a vriven aglow alent n efrCul or 9wecnn6ng eff�cfi ve durnne , lbe pohcv pvikA insurmlee applies mfly to "t"'c'Xidy aq�urn aro 'pjr cperry damage" th.lt MCUTS SUbSef,3991 Wl CA CT LH iM) (if file, w ritte rl ngree me nr and S Lbscq Will tO thic s SsUarlu of cul ificale of fiir urance ind icwm n g Such Fmr%t)ufS) In urganizatilm(s), as ld%Ju6q mal Olvml I vd(s), 'llic irriurancc pmwided hcrt!by io the Additional hismvd'(5) is limitej As fir.)l wawa s� The cover(qe aftowded lWeNhy to such addhional im,'wred is Ifir6ted tc):imput"l Ubifit), SpecificaUy gvsuhing from the conduct of he Named InNured fim- the addilional insurtvd was hckl H'able, 2. fle hrlliu� ofillmirance appticable to the inmArmice aflordod hereby an dloi;e qjv,:ifiud in Lfic t), in Ifiv, Ficclanaiurn of SJiedules (Y' fl6s policy, vdlichevv is hcav The limils cd hmnuarwe applicabie lo th( 41,'iflrarwe aflorded herebl ate and not in a&Edo�i lo, d& hirnits of anAMIHCC ShOIN11 zhe F)cchraficvlr cm- Schedules ofthis policy. 3 piovitkAl untler dis broader ifian covvrage prov&dcd to n,,,, An%� other, fwdi.% tt�.rms, cvuch6ows, hrOafi m", evlosiowls, and duff oiriows applY t,„ fl6i C ANI 01'' 2 14106 REMEWED BY� I/j/ k,_ EUN!ICE 118 RENA (PG� -)I'rl(-)) _3 ( COMMERMAL AUTO CAM 6UO N 06 THIS ENDORSEMEIN'T CHANGES THE POLICY� PLEASE READ ITCAREFI)LLY', BLANKETWAIVER OF SUBROGATION Thk Mommmu mo& % vmm=u,mM&d WW" 9, rd0r(AZ (ARRJERC(,,)VER,AGF, IH.rR,M 131-ISINESS AUTO �20VERA(iE H)RAI GARAGE MTRAGG PORN/i TRUCKERS COVERAGE FORNI, We agrev k, w-uivc any and alb submgmimi chims orng�vs oficc vet T anyperson(s) i�,)r ifthere is an cxcemcd wduc:"pwmmg N& Mm pmwjQ m uqmAA,,W, mtkh mqWms as %I&r cd Subrogafl ur, Clause from 1he Narncd Insumd, excep 1,101 losses, as my dw in whole or pan to Te negligence auk ,.uors and ur (vgaWzmi0NQ UAM M 20 N 00 REWEWED BY ij EUNI(.,,E [-IEREfAA (PG "JOFIC)) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 1499mi WAIVER OF' OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 3 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA JOBS PERFORMED BY NAMED INSURED. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/03/2015 Policy No. WLV 5030354 00 Endorsement No. Insured CROSSTOWN ELECTRICAL & DATA Premium $ INCL. Insurance Company INSURANCE COMPANY OF THE WEST Countersigned By WC 99 fii46 34 HEREUA (FIG16)F 10) (Ed. 8-00) or SURIM ACC PJZbP CERTIFICATE 4F LIABILITY INSURANCE �....• -'' DATE(MM /DD/YYYY) F06/01/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICENSE NO. 0637431 CONTACT NAME: PATRICK MCRAE PATRICK MCRAE INSURANCE SERVICES 1290 N. HANCOCK ST., SUITE 210 P/HC °NN EXt: (714) 779 -6999 AX "o: (714) 779-6903 AJC E-MAIL SS: p.mcrae @sbcglobal.net ANAHEIM HILLS, CA 92807 INSURER (S) AFFORDING COVERAGE NAIC # INSURERA: COLONY INSURANCE COMPANY 39993 INSURED INSURER B: INSURANCE COMPANY OF THE WEST 27847 INSURER C: CENTURY - NATIONAL INSURANCE CO. 26905 CROSSTOWN ELECTRICAL & DATA, INC. 5463 DIAZ STREET IRWINDALE CA 91706 INSURER D: TOPA INSURANCE COMPANY 18034 INSURER E: TOKIO MARINE SPECIALTY INSURANCE COI 23850 INSURER F: $ 1,000,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM /DD /YYYY MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY rr�-CLAIMS -MADE OCCUR XVU X X 103 GL 0014267 -00 DEDUCTIBLE $5,000 PER OCCURENCE 06/03/201606/03/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TORENTED PREMISES (Ea occurrence) $ 100 000 X MED EXP (Any one person) _ $ 5,000 X OCP PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I " 1 jECT EJ LOC GENERAL AGGREGATE $ 2,.000,000 PRODUCTS - COMP /OP AGG I $ 2,000,000 OTHER: $ C AUTOMOBILE LIABILITY X BAP0171987 11/05/2015 11 /05/2016 CEa OMBINaccident ED SINGLE LIMIT - __ —_ —_ 1 000 000 ANY AUTO BODILY INJURY (Per person) $ - ALL AUTOS OWNED X AUTOSULED NON -OWNED HIRED AUTOS X AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ E UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PUB542883 UNDERLYING LIMITS: GL; AL; EL POLICIES 06/03/2016 06/03/2017 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 X DED RETENTION 0 - - -- $ -- -- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? � (Mandatory in NH) N/A x WVE 5030354 -01 06/03/2016 06/03/2017 X PER OTH- E.L. EACH ACCIDENT _ --- --- - -- - -- -- E.L. DISEASE - EA EMPLOYE - $ _ 1,000,000 _ — 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT — $ 1,000,000 D PROPERTY & CONTRACTORS PC 6600295 $1,000 DEDUCTIBLE 04/10/2016 04/10/2017 $790,849 BUILDING $385,780 BPP - $300,000 BI WI EE $116,318 SCHEDULED EQ, EQUIPMENT COV. INCL. THEFT $50,000 MISCELLANEOUS TOOLS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more sppace Is re wired, THE CITY OF SANTA ANA, ITS DIRECTORS COMMISSIONERS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEE�iS ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S). COVERAGE IS PRIMARY & NON - CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT. " SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, A 30 DAY WRITTEN NOTICE WILL BE ISSUED. RE: PROJECT NAME: "SERVICE AGREEMENT FOR ADVANCED TRAFFIC MANAGEMENT SYSTEM AND COMMUNICAT N MAINTENANCE AND REPAIR SERVICES." CROSSTOWN JOB #2413 ._. ..___.__.__._._.,� �__.._ _' „4 -_..E UNI E 9 9C REDh A PG % OF �° _..... _w__._ ( CERTIFICATE HOLDER CITY OF SANTA ANA 20 CIVIC CENTER PLAZA M -36 SANTA ANE, CA 92702 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /�Z� ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1o3GILU014207-0O 06/03/2010T000N3/2017 103GIL0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations All persons or organizations as required by written contract As designated in written contract with the Named with the Named Insured Insured Information required to complete this Schedule, if not shown above, will shown in the Declarations. A. Section U— VVhn Is An Insured is amended 0o include aean additional insured the person(s) or organizadion(o)ohmwn in the 8ohedu|e, but only with respect 0n liability for "bodily injury", "property damage" or "personal and advertising injury" omuoed, in whole orin part, by: t Your acts ur omissions; or %. The acts or omissions nf those acting onyour behalf; in the rfb o oeof your ongoing operations for the additional insured(s) at the location(s) desig- nated [G 20 10 0704 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury^ or '.property damage" occurring after: 1. All work, including muteho|o, pads or equip- ment furnished in connection with such mmMh, on the (other than oervioe, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; nr 2. That portion of 'your work" out of which the injury or damage ohsao has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal aaapart of the same project. @ ISO Properties, Inc., 2004 REVEWED BY: Page I of 1 POLICY NUMBER: 103GL0014207-00 0003/2018TO06@3/2017 103GL0014267-00 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section U — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "prod ucts-com pleted operations hazard". CG 20 370704 @|SO Properties, Inc., 2004 Page of r / POLICY NUMBER: 103 GL 0014267 -00 06/03/2016 TO 06/03/2017 103 GL 0014267 -00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. r • • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard" if: a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047 -0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 1 with its permission. R \ /EVVL, u a BY:. �L ..w. C .. F �kd+ IC � GE Y +, DA (p, r Cyr ) ��_ '� 1 POLICY NUMBER: 103 GL 0014267 -00 06/03/2016 TO 06/03/2017 103 GL 0014267 -00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 7,RIMARY AND NON-CONTRIBUTING INSURANCE (Third-Party) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS,4. Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirety and replaced with the following condition as respects the Third Party shown below: 4. Other Insurance a. With respect to the Third Party shown below, the insurance provided by this policy shall be primary and non - contributing insurance. Any and all other valid and collectible insurance available to such Third Party in respect of work performed by you under written contractual agreements with said Third Party for a loss covered by this policy, shall in no instance be considered as primary, co- insurance, or contributing insurance. Rather, any such other in- surance shall be considered excess over and above the insurance provided by this policy. Third Party to whom this endorsement applies is: All persons or organizations as required by written contract with the Named Insured Absence of a specifically named Third Party above means that the provisions of this endorsement apply "as required by written contractual agreement with any Third Party for whom you are perform- ing work ". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U407 -0707 Contains material © ISO Properties, Inc., 2000 with its permission. Page1of1 k%EAEVVE D E %Y:._.. „_......... r _ EUNK.",E H eVE_MA (k Q...._15, , ..._.� POLICY NUMBER: 1o8EuOO14207-0O 06/03/2016 TO 06/03/2017 103GL0014287-00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: All projects during the policy period. If no entry appears above, information required to complete this endorsement will be shown in the Decla tions as applicable to this endorsement.) a' A.FmaUsumowhich the insured becomes legally obligated to pay as damages caused by "occurrences" Under SECTION | —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, and for all medical expenses caused by accidents under SECTION | — COVERAGE C MEDICAL FAYK8ENTG, which can be attributed only to ongoing operations at single designated con- struction project shown in the Schedule above: 1. A ueponmhe Designated Construction Project General Aggregate Limit applies to each designated construction pnoject, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit ie the most wm will pay for the sum of all damages under SECTION |— COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE L|AB|L|Tf, except damages because of "bodily injury" or "property damage" included in the "prod ucts-comp|eted operations hazard^, and for medical expenses under SECTION | — COVERAGE C MEDICAL PAYMENTS regardless of the number of: o. Insureds; b. Claims made or"suits" brought; o, o. Persons or organizations making claims or bringing ^euita^ 3. Any payments made under SECTION | — COVERAGES. COVERAGE BODILY INJURY AND PROPERTY DAMAGE LIABILITY for damages or under SECTION |'COVERAGE C0YED|CAL PAYMENTS aheU n*duos the Designated Construction Project General Aggregate Limit for that des- ignated construction project. Such payments eheU not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each 0ccunenco, Damages to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. 5. The most we will pay for the sum of all Designated Construction Project General Aggregate Limits combined and to which this insurance applies ia$5.0OO.00O. UCG2503-1013 Includes copyrighted material of Insurance Services Office, |no,1QQ6 Page 1uf2 with its permission. COMMERCIAL XUTO CAM 602 IH 06 llf IS ENDORSFAIENUCIIAN(J'S CIWPOLJCY I'll-ASC READ ('1'(,AkUf'ULIX BOVOCET ADDITIONAL INSURED ENDORSEMENT- PRIMARY lNh embnemmu arc difle's vnswailcta prcvidcd tjnd,..,r Ow k4lomhng,: M ()TOR CAR-RIER C0%'F,R,A('fl,-,,, FORNI AUTO FORTO GARAGE COVERAOF FORM 11NU(1,LL.'RS COVEILN(liT: FORM, With respeel, To SU" FION H - LABOMY COVU.R Ad. E '4110 k I'M 111.5ill-L'd is W-1lerldeld 10 iackldc ss un addkiofaa 4i,swud wfy or orgain"atuxi(s) whoin p.w,-ire required to tidd to thiq pcflicy as an aWkW hisured under a wr4wn agwNaerk it) efft!cl M'bOCiallil';,g Ofil'CCfiVe (JUTrTWg the 'I hii applies only to '1�'odily h�jwy" 'lnd -prcporty (kawige" that accur to excarfinn cif dw wilmn agurrion aW nhqmm w dw Kamm W! mr-dlkat"& Kwum 'I'lle iJtsurwlCx p•ovkled h'orcby to die Addkional ps livniW,'t.s foflovv�� I 1-lio, ct.,,va�trtige aflbMed IWV to swhadcfiiiorio iwured k lirnited to impwo�j NaN6t�' WMHkok WAg Am"n lhc' conduct ofthe Nitmed Insured fi)r whieh the sd(hflomd in crs�ssr9 %as hem HAIC The Hain of Wmiace qQwbk: w Ow o"maux aMwkd A"by my aume WOW 5 die urken agmerneW cv is he Whurmums or SAWAs a Am "ky, w i&mw 6 Ow I wi,,r lindis rot isi� urwii,'e ter tl'XL a. MINM hu6v me xv OWN mid not in adds on to the Hmib of Onmnm shnma Me DMbrNmia m S&WWn &Tk Qc) An�' 'uvvmg. jaw, kl'.A undee t,lai , toldol-yeirwill fo uny vWdiflcnit�fl vvid nv,,wer [x, brvadcr tfvilo- c"o"wagc prcwkh;d is: iwy ilurilos ;w,urcd CAM WN W06 � Z7 RE'0E', `JUG '..[J BY, EUNK.,E CnMMFRrIAL AUU) (AM WN 09 06 1111S ENDORSENIENTCHAN(: S THE POLICA, PLEASE READ I'TCARE.FULLY BLANKFUNVAI'VER 0F'SUBR0(.,A'T1()PN nk cmmwmm"ura fifics imisurwlcc, J:Irovi(h-cf ur](I•t- "hc fbllwvillt,� N10FOR, CARRJER FORAI BUSINESS AU'ro COV['RAGEFORNI GARAGE COVERAGE PnRm TRUCKERS COVERAGE FORM W'cagree o),%-uive ,,uiy amf ufl 3ribrogjItioll claims or orircovcry agai¢r,s, any c,'r if),here N m =Md wrin) agnoemeof with fliat, pci-scrti(s) or ovgati,.zafions(sP, Aid mqhn a Wdwr of Subrogation (Imse Rom dw Wmed QW, unco Ag hmns, which are du i.rt whole or pan try the neWigeme ui cuovs, ancl uniissiow� ufwch posonN) ur MgM&AMYS) ( AM M20 00 06 RETEWED BY: EUNICE HE"', ... ... ......... WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVC9SUS34 Emm WAIVER OF OUR RIGHT TD RECOVER FROM OTHERS ENDORSEMENT -BLANKET VVo have the right to recover our payments from anyone liable for an injury oovermdbvthisonioy.VVewiUnot enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall bo3%ofthe total California Workers' Compensation premium otherwise due. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION ALL CALIFORNIA OPERATIONS. FOR WHOM THIS WAIVER IS REQUIRED. Policy Number: VVVE5030354O1 Insured: Crosstown Electrical & Data Inc Endorsement Effective: 8/3/2O10 Coverage Provided by: Insurance Company of the West Issue Date: 5/27/2016 Countersigned by: VVCQQD834 '