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DATE
<br />�3 �R'IFi�T�f
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<br />� 08
<br />PRODUCER
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br />Marsh USA Inc. 4831 SE
<br />POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br />411 East Wisconsin Avenue
<br />AFFORDED BY THE POLICIES DESCRIBED HEREIN.
<br />Suite 1600
<br />AM Best Rating
<br />Milwaukee, Wisconsin 53202 -4419
<br />(As of 09 /26/05)
<br />COMPANIES AFFORDING COVERAGE
<br />Attn: CPU, Phone (414) 290 -4912 Fax (414) 290 -4953
<br />*See BeIOW
<br />CPU_Milwaukee @marsh.com
<br />an COm
<br />p y Illinois Union Insurance Company
<br />A+ XV
<br />A P.O. Box 41484, Philadelphia, PA 19101
<br />INSURED
<br />Johnson Controls, Inc. Attn: Corp. Risk Mgmt. X -92
<br />Company Sent Insurance A Mutual Co.
<br />Point
<br />A+ XV
<br />Johnson Controls Battery Group, Inc. P.O. Box 591
<br />B 1800 North Drive, Stevens Point, WI 54481
<br />Company Indemnity Insurance Company of North America
<br />Johnson Controls Interiors, L.L.C. Milwaukee, WI 53201
<br />Johnson Controls of Puerto Rico, Inc.
<br />C and for CA: ACE American Insurance Company
<br />A+ XV
<br />Cal -Air, Inc.
<br />P.O. Box 41484, Philadelphia, PA 19101
<br />GES America, L.L.C.
<br />Company
<br />Optima Batteries, Inc.
<br />D Lexington Insurance Company
<br />USI Companies, Inc.
<br />P
<br />100 Summer Street, Boston, MA 02110
<br />+
<br />A XV
<br />Pro -Tel, Inc.
<br />4111101; s
<br />� ill,
<br />� ,, � r u,,•,;.
<br />THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
<br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
<br />PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDI i IONS AND EXCLUSIONS OF SUCH POLICIES, LIMITS SHOWN
<br />MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />CO
<br />LT
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />POLICY EFFECTIVE
<br />POLICY EXPIRATION
<br />LIMITS
<br />R
<br />DATE (MWDD/YY)
<br />DATE (MWDD/YY)
<br />A
<br />GENERAL
<br />LIABILITY (1) (2) (3)
<br />GENERAL AGGREGATE
<br />$ 5,000,000
<br />COMMERCIAL GENERAL
<br />HDOG21723551
<br />10 -1 -2005
<br />10 -1 -2006
<br />X
<br />LIABILITY
<br />PRODUCTS - COMP /OPAGG
<br />$5,000,000
<br />CLAIMS MADE X❑ OCCUR
<br />PERSONAL & ADV INJURY
<br />$ 5,000,000
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />OWNER'S & CONTRACTOR'S PROT
<br />)(
<br />Contractual
<br />FIRE DAMAGE (Anyone fire
<br />$ 5,000,000
<br />X
<br />X,C,U (Explosion, Collapse, Underground)
<br />$ 50,000
<br />X
<br />Additional Insured - Owners Lessees or
<br />Contractors See Below
<br />MED EXP (Any one person)
<br />B AUTOMOBILE
<br />LIABILITY (1) (2) (3)
<br />X
<br />ANY AUTO
<br />90- 04606 -01
<br />10 -1 -2005
<br />10 -1 -2006
<br />COMBINED SINGLE LIMIT
<br />$ 2,000,000
<br />ALL OWNED AUTOS
<br />BODILY INJURY
<br />SCHEDULED AUTOS
<br />(Per person)
<br />X
<br />HIRED AUTOS
<br />BODILY INJURY
<br />X
<br />NON -OWNED AUTOS
<br />(Per accident)
<br />PROPERTY DAMAGE
<br />GARAGE LIABILITY
<br />AUTO ONLY -EA ACCIDENT
<br />ANY AUTOI1�,,
<br />OTHER THAN AUTO ONLY:
<br />EACH ACCIDENT
<br />C+ EXCESS LIABILITY
<br />$ 5,000,000
<br />X
<br />5577313
<br />10 -1 -2005
<br />10 -1 -2006
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />UMBRELLA FORM
<br />AGGREGATE
<br />OTHER THAN UMBRELLA FORM
<br />C WORKERS COMPENSATION AND
<br />WLRC44333879
<br />10 -1 -2005
<br />10 -1 -2006
<br />X
<br />WC STATU-
<br />EMPLOYERS' LIABILITY (3)
<br />WLRC44333880 - CA
<br />TORY LIMITS
<br />I
<br />ER
<br />4;BF F.
<br />EL EACH ACCIDENT
<br />$ 1,000,000
<br />The Indemnity Insurance Company of North
<br />EL DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />THE PROPRIETOR/ X INCL
<br />America program applies to all JCI entities in all
<br />PARTNERSlEXECUTIVE
<br />slates except for the self- insured entities and the
<br />EL DISEASE -EACH EMPLOYEE
<br />$ 1,000,000
<br />OFFICERS ARE: EXCL
<br />monopolistic states.
<br />OTHER
<br />(1) ADDITIONAL INSURED /LOSS PAYEE: Includes coverage for Additional Insureds & Loss Payees as required by lease or contract.
<br />If specific naming is required: Per Attached
<br />(2) PRIMARY COVERAGE: Where required by lease or contract, this coverage is primary and not excess of or contributing with other insurance or self- insurance.
<br />(3) WAIVER OF SUBROGATION: Insured waives subrogation to the extent required by contract.
<br />DESCRIPTION OF OPERATIONS /LOCATIONSA/EHICLES /SPECIAL ITEMS JCI Contract No.
<br />Project Name:
<br />Customer PO Number:
<br />fTw yy� j5� k
<br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
<br />Clerk of the City Council
<br />THE ISSUING COMPANY WILL 61,1D14110R X MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
<br />City of Santa Ana
<br />NAMED HEREIN,
<br />20 Civic Center Plaza (M -30)
<br />P.O. Box 1988
<br />MARSH USA INC. BY:
<br />Santa Ana, CA 927021988
<br />
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