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<br />MARSH USA INC._ CERTIFICATE OF INSURANCE
<br />01r03r20108
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br />PRODUCER q
<br />pq �✓'I ��-
<br />NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
<br />POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
<br />Marsh USA Inc.
<br />—(J
<br />AFFORDED BY THE POLICIES DESCRIBED HEREIN,
<br />ua and 10VOR
<br />LAn watlovosl
<br />411 East Wisconsin Avenue „ „
<br />Suite 1600
<br />COMPANIES AFFORDING COVERAGE
<br />"See Below
<br />�t
<br />Milwaukee, Wisconsin 53202 -4419 fl -oZ�Q6 _�03
<br />Fax: 290 4953
<br />Com an
<br />P y ACE American Insurance Company
<br />A+ XV
<br />Attn: CPU. Phone (414) 290 -4912 (414)
<br />CPU _Milwaukee @marsh.com
<br />A P.O. Box 41484, Philadelphia, PA 19101
<br />Company Sentry Insurance A Mutual Co.
<br />A+ XV
<br />INSURED
<br />Johnson Controls, Inc. Attn: Corp. Risk Mgmt. X -92
<br />B 1800 North Point Dnve, Stevens Point W 1 54481
<br />Company Indemnity Insurance Company of North America
<br />Johnson Controls Battery Group, Inc. P.O. Box 591
<br />Johnson Controls Interiors, L.L.C. Milwaukee, W 1 53201
<br />C and for CA. WI and EX WC: ACE
<br />A+ XV
<br />Cal-Air, Inc.
<br />American Insurance Company
<br />GES America, L.L.C.
<br />PO Box 41484, Philadel hia, PA 19101
<br />Optima Batteries, Inc.
<br />USI Companies, Inc.
<br />Company Lexington Insurance Company
<br />A+ XV
<br />York International Corporation
<br />p 100 Summer Street, Boston, MA 02110
<br />COVERAGES TMS Certificates ersedeS and re laces: any previously issued certificate,
<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 />OR
<br />POLICIIESDDESCRIBED HEREIN IS SUBJECT TO ALL HET TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. SI LINT TS OWN
<br />AFFORDED TERM OR
<br />PERTAIN, THEN INSURANCE
<br />MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />CO
<br />POLICY
<br />EFFECTIVE
<br />POLICY EXPIRATION
<br />LIMITS
<br />LT
<br />TYPE OF INSURANCE
<br />POLICY NUMBER
<br />DATE (MMIDDIYY)
<br />DATE (MMIDD/YY)
<br />R
<br />$ 5,000,000
<br />A
<br />GENERAL
<br />LIABILITY (1) (3) (4)
<br />HDOG2373283A 14
<br />-1 -2007
<br />10-1 -2098
<br />GENERAL AGGREGATE
<br />$ 5,000,000
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />PRODUCTS- COMPIOP AGG
<br />PERSONAL 8 ADV INJURY
<br />$ 5,000,000
<br />CLAIMS MADE OCCUR
<br />EACH OCCURRENCE
<br />$5,000,000
<br />OWNER'S 8 CONTRACTOR'S PROT
<br />FIRE DAMAGE An one fire
<br />$ 5,000.000
<br />X
<br />Contractual
<br />$ 50,000
<br />X
<br />x.GU(E.vinwon. cnllaaso.uNergn�nal
<br />MED EXP An one erson
<br />X
<br />aaa�nn�I im�rm /sea aelowl
<br />B
<br />AUTOMOBILE
<br />LIABILITY (2) (3) (4)
<br />90- 04606 -01
<br />10-1 -2007
<br />10 -1 -2008
<br />COMBINED SINGLE LIMIT
<br />$ 5,000,000
<br />X
<br />ANY AUTO
<br />ALL OWNED AUTOS
<br />BODILY INJURY
<br />(Per person)
<br />SCHEDULED AUTOS
<br />X
<br />HIRED AUTOS
<br />BODILY INJURY
<br />(Per accident)
<br />X
<br />ON -OWNED AUTOS
<br />PROPERTY DAMAGE
<br />GARAGE LIABILITY
<br />AUTO ONLY EA ACCIDENT
<br />OTHER THAN AUTO ONLY
<br />ANY AUTO
<br />EACH ACCIDENT
<br />AGGREGATE
<br />$ 5,000,000
<br />D
<br />EXCESS LIABILITY
<br />10 -1 -2007
<br />10 -1 -2008
<br />EACH OCCURRENCE
<br />5577735
<br />$ 5,000.000
<br />X UMBRELLA FORM
<br />AGGREGATE
<br />OTHER THAN UMBRELLA FORM
<br />X WC STATU- OTH-
<br />C
<br />WORKERS COMPENSATION AND
<br />EMPLOYRS'LIABILITY(4)
<br />WLRC44473094 — AIDS
<br />10 -1 -2007
<br />10 -1 -2008
<br />TORY LIMITS ER
<br />W LRC44473136 — CA
<br />EL EACH ACCIDENT
<br />$1,000,000
<br />EL DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />X
<br />SCFC44473057 — WI
<br />$ 1,000,000
<br />THE PROPRIETOR/ INCL
<br />WCUC4447301A — EX WC
<br />PARTNERSIEXECUTIVE EXCL
<br />EL DISEASE EACH EMPLOYEE
<br />OFFICERS ARE
<br />OTHER
<br />(1) ADDITIONAL INSURED: If required by contract, Includes coverage for Additional Insureds per attached endorsement
<br />fl required by contract, includes coverage for Additional Insureds and Loss Payee as required by contract.
<br />insurance.
<br />(2) ADDITIONAL INSURED:
<br />"' PRIMARY COVERAGE: Where required by lease or contract, this coverage is primary and not excess of car contributing wilb other insurance or self-
<br />(4) WAIVER OF SUBROGATION: Insured waives subrogation to the extent required by contract.
<br />DESCRIPTION OF OFEHATIONSILOCATI.. S1 E" ICL SPECIAL ITEMS JC Contract ND. 83737111
<br />Project Name: Santa Ana Reg Trans BI Chiller 83737111 Ser
<br />Customer PONUmDer'. SIGNEDAGREEMENT 373119E+11 CITY OF SANTA ANA
<br />CERT{FICAiE.HOLDER
<br />CANCELLATION
<br />E OufJN
<br />SHOULD aNV OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION GATE THEREOF,
<br />THE ISSUING COZIP( WILL FN P5 VGR T MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
<br />CITY OF SANTA ANA
<br />NAMED HEREIN,
<br />Mario Ghizzi
<br />MARSH USA INC BY
<br />CLERK OF THE CITY COUNCIL
<br />20 CIVIC CENTER PLAZA M -30
<br />SANTA ANA, CA 91702-1988
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