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<br />A <br />,a?coRL7 CERTIFICATE OF LIABILITY INSURANCE DATE <br /> 09//,6/211„ <br />_... <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER <br />THIS <br />. <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />MARSH USA, INC. .NAME: <br /> <br /> <br />445 SOUTH STREET PHONE <br /> <br />HONE FAX <br />_ <br />?? U•-__._ <br />Nol; <br />LC <br />1 <br />MORRISTOWN, NJ 07950-11454 ___ _-- ---- <br />, <br />_ - <br />- <br />E-MAIL <br /> <br /> __- __ INSURER?AFFORDING COVERAGE <br />NAIC e <br />100129-6-7BA-SBT1-11/12 610 Guzma _ <br />4 <br />INSURER A; HDI-Gefllrlg America Insurance Company 41343 <br />INSURED <br />SIEMENS INDUSTRY, INC. INCLUDING INSURER B Liberty Mutual Fire Ins Co 23035 <br />-__ <br />BUILDING TECHNOLOGIES DIVISION INSURER C : Liberty Insurance Corporabon 42404 <br />1000 DEERFIELD PARKWAY -- --- - ---- <br />BUFFALO GROVE, IL 60089A513 INSURER D_ <br /> INSURER E <br /> INSURER F <br />--'-- '-- - nctleArV1717VM6LIY: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N <br />AMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RE <br />P <br />S <br />ECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I <br />S SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />. <br />INSR ADDL UBR ---- - - - <br />POLICY EFF .? POLICY EXP-- - <br />- - --- ---- --- -" " ---""---- <br />LTR TYPE Of INSURANCE <br />POLICY NUMBER <br />D/YYYY MM/DD/YVVY LIMITS <br />A GENERAL LIABILITY GLD11101-03 10/0112011 10101/2012 ?EACH <br />O <br />C 1 <br />000 <br />000, <br /> X COMMERCIAL GENERAL LIABILITY ! C <br />URRLNCE <br />AMAd9 T?-RENTED , <br />, <br /> <br /> <br /> <br />_X] <br />PREMISES LEa occurrence] 1,000,000 <br />$ <br />-- - <br /> J CLAIMS-MADE <br />OCCUR <br />1 -- ---- <br />r i M_ ED EXP (Any ale person) <br />1 ER°ONALBADV INJURY $ - 100,000 <br />$ 1,000,000 <br /> j GENERAL AGGREGATE $ 10,000,000 <br /> GEN_ L AGGHEG_ArE LIMIT APPLIES PER: <br />-- - <br />f PRO' <br />X <br />PRODUCTS -COMP/OP AGG <br />-------------------- <br />$ INC:. <br /> POLICY LOC $ <br />B AUTOMOBILE LIABILITY <br />-i AS2-631-004334-211 10/01/2011 10/01/2012 COMBINED SINGLE LIMIT <br />E <br />000 <br />000 <br />2 <br /> X <br />ANY AUTO i I <br />, icciUrnt) <br />I . <br />, <br />§ - <br /> __ <br />X ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />? <br />j BODfLV INJURY (Pa, person) <br />BODILY INJURY (Per accrtlenq I $ N/A <br />$ N/A <br /> OWNED <br />X_ HIRED AUTOS I X NON PROPERTY DAMAGE - <br />$ <br />N/A <br /> j Per accident __- _ - <br /> $ <br /> UMBRELLA LIAB <br />OCCUR <br /> _ <br />EXCESS LIAR <br />CLAIMS MADE EACH OCCURRENCE <br />""------ ----- - $ <br /> <br /> <br />-"--- <br /> _ <br />- - <br />- --- AGGREGATE $ <br /> DED <br />RETENTION -- <br />$ <br />C WORKERS COMPENSATION <br />AND EMPLOYERS' UABILnY WA7-63D•004 4.011 (AOS) 10/01/2011 10/0112012 WC STATU- 0TH- <br />_TT <br />C <br /> <br />C <br />Y/N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFiCERlMEMBE <br />EXCLUDED? N ' N/A WC7-631-004334-021 (OR, WI) 10/01/2011 10/01/2012 - <br /> <br />E.L. EACH ACCIDENT - -- <br /> <br /> <br />1,000,000 <br />$ <br /> (Mandator in NH <br />) EW5-63N-004334-421 (OH) 1 10/0112011 10/0112012 E 1000 <br />000 <br /> D yes, describe under <br />ESCRIPTION OP UPERATIONS belo "1500K LIMIT I $5WK SIR" L DISEASE EA EMPLOYE , <br />$ <br /> w E .L. DISEASE POLICY LIMIT $ 1,000,000, <br /> f <br />i <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addhionat Remarks Schedule, if more space is required) <br />E: 401330, MAINTiREP ALARM SYSTEM - RD FACILITY 2600023858 ALL OPERATIONS I <br />i <br />EE ATTACHED <br />4v <br />;,e x <br /> <br /> <br />rFRTIFIrATF urm ncm <br />CITY OF SANTA ANA <br />ATTN: CLERK OF THE CITY COUNCIL <br />20 CIVIC CENTER PLAZA (M-30) <br />P.O. BOX 1988 <br />SANTA ANA, CA 92702-1988 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />of Marsh USA Inc. <br />Manashi Mukherjee <br />ar rwoo-zwIu Acunu L;UKFaURATION. Ali rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD