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<br />AFRO CERTIFICATE OF LIABILITY INSURANCE
<br />OATE(MMIDDIYYYY)
<br />03/07/2019
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />MARSH USA, INC.
<br />445 SOUTH STREET
<br />MORRISTOWN, NJ 07960-6454
<br />CONTA Marsh USA, Inc.
<br />NAME: CT
<br />PHONE (g73) gp1.6p0p FAX
<br />Not:
<br />EMAIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAICIf
<br />INSURER A: HDI Global Insurance Company
<br />41343
<br />100129-SBT--18I19 610 Kapust NOC60
<br />INSURED
<br />SIEMENS INDUSTRY, INC.
<br />BUILDING TECHNOLOGIES
<br />INSURER B: Travelers Property Casualty CO. of America
<br />25674
<br />INSURER C : The Travelers Indemni Com an
<br />25658
<br />INSURER D
<br />1000 DEERFIELD PARKWAY
<br />BUFFALO GROVE, IL 60089
<br />INSURER E
<br />INSURER F
<br />rcoTmlr^AT'c RUINIGGDCN • NY(.411191HH/9/-16 NVISIVNUMBER:
<br />COVERAGES �u� a ��, � ..........�... _ .
<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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />MMIDDYIYrn
<br />MMLDKYYVEXPY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />GLD11101-10
<br />10N1I2018
<br />101012019
<br />EACHOCCURRENEE
<br />$ 1,000,000
<br />PREMISES (Ea
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 100,000
<br />PERSONALS ADV INJURY
<br />S 1,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PELT LOG
<br />GENERALAGGREGATE
<br />$ 10,000,000
<br />PRODUCTS. COMRADE AGG
<br />$ INCL
<br />B
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />TC2J-CAP-7440L34A-18
<br />10101/2018
<br />10/01/2019
<br />ED MBid,D SINGLE LIMIT
<br />$ 2,000,000
<br />BODILY INJURY (Per person)
<br />$ N/A
<br />X ANY AUTO
<br />BODILY INJURY (Per accident)
<br />$ NIA
<br />X OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED NON -OWNED
<br />X AUTOS ONLY X AUTOS ONLY
<br />PROPERTY DAMAGE
<br />Per accident
<br />$ NIA
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS�MADE
<br />CUD11102-10
<br />10101/2018
<br />10/01/2019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />DIED RETENTION$
<br />WORKERS COMPENSATION
<br />ER _
<br />X STATUTE ERH
<br />$
<br />B
<br />TC2J-UB-8049X508-18(ADS)
<br />1 AJ I2019
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />C
<br />B
<br />AN DEMPLOYERS'LIABILITY YIN
<br />AFFICEWMEMBE EXCL DEDI CUTIVE
<br />inN RExcluoeoa N
<br />(Mandatory in NH)
<br />(Mandatory
<br />If yes, desc,ibe antler
<br />DESCRI ETION OF OPERATIONS below
<br />NIA
<br />TRK-UB-8049X51A-18 AZ,MA,OR,WI
<br />(
<br />TWXJ-UB-744OL338-18 (OH&WA
<br />�
<br />$500K LIMIT / $500K SIR""""
<br />10/01/2018
<br />10/01/2018
<br />10/0112019
<br />10/01/2019
<br />E.L. DISEASE - EA EMPLOYE
<br />$ 1,000,000
<br />E. L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AC ORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />RE SII#2600070990 PO#32001015 PROJECT# 31007058 PROJECT NAME: BCA6-SES-CITY OF SANTA ANA POLICE DEPT
<br />SEE ATTACHED
<br />CITY OF SANTA ANA, M-93 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 CIVIC CENTER PLAZA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />SANTA ANA, CA 92702 1 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Manashi Mukherjee �lcL+nnew �.tiw.du
<br />©1988-2016 ACORD CORPORATION. All rights rese
<br />ACORD 25 (2016/03) a AC D name and logo are registered marks of ACORD
<br />per n, �i C�—
<br />
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