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<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(les) 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 Ed ewood Partners Insurance Center (EPIC) CONTACT NAME:
<br />19000 MacArthur Blvd. PH Floor PRONE role N gIat; 1849) 2s3 -0606 Fax tA_c yo (gng) 263 -DSOs
<br />Irvine, CA 92612
<br />INSURED
<br />Sierra Pacific Electrical Contracting
<br />2542 Avalon Street
<br />Riverside CA 92509
<br />nnvcon nee nCOTICInn TCKIIRAMCND- n RPI11Q1nMNIIMRPP-
<br />THIS IS 7'0 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
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INS@ �— ADDL SUBR -- POLICYY EFF POLICY EXP
<br />LTR TYPE OF INSURANCE a POLICY NUMBER MMI D Y Y 1 (MMIODNYYYI
<br />---
<br />LIMITS
<br />A GENERALUAB1u7Y 023462673 613612012 613012013
<br />EACH OCCURRENCE _$ 1,000,000
<br />COh1MEROW. GENERAL LV.9ILITY $5.000,000 Per
<br />DAM 50,000
<br />PREMISES (Ea AGE TO RENTED ocourrnce} $
<br />Project AggtLimit
<br />�CLAIMS-MADE �OCCUR
<br />__
<br />M €O EXP (Am/or�persen) $ Excluded
<br />Contractual Liability
<br />_
<br />✓ W_ran EXCiusion Included
<br />PERSONAL& ADV INJURY S 1,000,00
<br />�( $sr7.OQUI)9400,t
<br />GENERAL AGGREGATE s_ 2,000,00
<br />GB N'L AGGR EGATE LI MIT APPLI ES PER',
<br />PRODUCTS - COMPIOP AGG $ 2,000,000
<br />pR0-
<br />POLICY ` LOC
<br />$
<br />B AUTOMOBILE LIABILITY BA8161433
<br />6130/2012 6/30/2013
<br />Eg eoadeDISINGLE LIMIT $ 1 000,000
<br />ANY AUTO
<br />BODILY INJURY (Per person) $
<br />ALL OWNED
<br />BODILY INJURY (Per accltlent) $
<br />AUTOS L' ALTOS
<br />ED
<br />hIIRF.D Al1T06
<br />NOacdEenry AMAGE $
<br />AUTOS
<br />APPROVE
<br />AS 'Td FORM
<br />— $�-
<br />C7 ti
<br />$
<br />UMBRELLA LIAR OCCUR NHA230771
<br />C
<br />6/3012012 613012013
<br />EACH OCCURRENCE $ — 2,000,000
<br />�_.
<br />EXCESS LIAR CLAtMSMADE
<br />..- w.. -.- --
<br />AGGREGATE 5 2,000,000
<br />,._........D IL Laura
<br />tstt S6ee y
<br />060 RETENTIONS
<br />Assistant
<br />City Atto •ney
<br />$
<br />D WORKERS COMPENSATION (;$7500342$
<br />1/112013 1/1/2014
<br />WC SrATU- QLTRH
<br />TORY LIMITS
<br />AND EMPLOYERS' LIABILITY
<br />-_
<br />ANY PROPMETORIPARTNERIEXECUTIVE�
<br />E. L. EACH ACCIDENT $ 1,000,000
<br />OFFICERIMEMDER EXCLUDED? NIA
<br />(Mandatory In NH)
<br />_ -
<br />E.L. DISEASE - EA EMPLOYEE $ 1 QQO OOQ
<br />If yes, dasrdbx undar
<br />DESCRIPTION OF OPERATIONS below
<br />E. L. DISEASE- POLICY LIMIT $ 1,000,000
<br />E Business Personal Property CBP8917155
<br />6/30/2012 6/30/2013
<br />$267,000 Limit $1,000 deductible
<br />Special Form - Replacement Cost
<br />n E ui
<br />$90.000 Limit $1.000 deductible ,_.._..-
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare apace is requtred)
<br />Certificate holder Is additional insured for general liability as required by written contract with the named
<br />insured prior to an occurrence as per form 11 -85 subject to all policy terms & conditions.
<br />GL Waiver of Subre LEXOCC234 1103 & Prof Agg LX9695 & Prima Wording LX98380805 Will apply If required by written contract.
<br />Work Waiver 5 bro WC040306 & auto + in G CA 701 an if required nt ct.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />its officers, agents, employees, contractors,
<br />ACCORDANCE WITH THE POLICY
<br />PROVISIONS,
<br />special counsel, and representatives
<br />AUTHORIZED REPRESENTATIVE
<br />P.C, Box 9-21
<br />Santa Ana CA 92702
<br />CA
<br />Susan J. Sampson
<br />C019OU -ZOIU ACURU CURPURA f RUN. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />CDET 10- .5'188112 Lupe 0rt3¢ 3/21/2033 1:12:00 PM P.", S o>` e
<br />
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