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5STAR -1 OP ID: LP
<br />,wort °R CERTIFICATE OF LIABILITY INSURANCE DATE
<br />1110412013Y}
<br />11144!2413
<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 AI
<br />the terms and conditions of the policy, certain
<br />PRODUCER
<br />Jackson & Jackson Insurance
<br />2220 East Route 66 Ste 206
<br />Glendora, CA 91740
<br />Robert A. Mueller and
<br />IL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />may require an endorsement. A statement on this certificate does not confer rights to the
<br />Ins Cc
<br />INSURED 5 Star Elevator Services, Inc. INSURER B: National Union Fire of PA _ 19445
<br />1556 N. Case Street INSURER C: Preferred Employers 1.0900
<br />Orange, CA 92867 INSURER D: Sentinel Ins, Cc Limited
<br />INSURER E:
<br />_ INSURER F: _
<br />COVERAGES CERTIFICATE NUMBER: PPVIRICIN NI IlUIFi
<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
<br />HEREIN IS SUBJECT TO ALL THE
<br />TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Santa Ana, CA 92701
<br />AUT�HO}RIIZFI) REdPRESENTATIVVEE7—�
<br />INS TYPE OF INSURANCE DD SUB �— POLICY E Y EXP
<br />POLICY NUMBER MWDDiYYYY MMIDDIYY
<br />LIMITS
<br />GENERALLIABILITY
<br />EACH OCCURRENCE
<br />1,040,00
<br />A X COMMERCIAL GENERAL LIABILITY X X 13UENOJ6086 0212512013 02/2512014
<br />_$
<br />DAMAGE 10 HEN 7ED
<br />PREMISES Ea osourrence S
<br />300,00
<br />CLAIMS-MADE a OCCUR
<br />RED EXP (Any one person} S
<br />10,00
<br />PERSONAL &ADV INJURY $
<br />1,000,000
<br />GENERAL AGGREGATE $
<br />3,000,000
<br />GENT AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AEG $
<br />3,000,000
<br />POLICY X PRO- LOG
<br />$
<br />AUTOMOBILE LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />D ANYAUTO 13UENOJ6086 0212512013 02/26/2014
<br />BODILY INJURY (Per person) $
<br />ALLOWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident) i
<br />X HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />PER ACCIDENT
<br />S.�
<br />UMBRELLA LUAS X I OCCUR
<br />EACH OCCURRENCE
<br />5,000,00
<br />g X EXCESS LIAB _ CLAIMS -MADE ESU084763840 02/2612013 02/2512014
<br />_$
<br />AGGREGATE $
<br />5,000,00
<br />DED X RETENTION$ NIL
<br />$
<br />WORKERS COMPENSATION
<br />X WC STATU- OTH
<br />AND EMPLOYERS' LIABILITY YIN
<br />L E _-
<br />C ANY PROPRIETORIPAR "INERIEXECUTIVE WKN144421.3 08/0112013 08/0112014
<br />E. L. EACH ACCIDENT $
<br />1,000,000
<br />OFFICERIMEMBER EXCLUDED? NIA
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE $
<br />1,000,000
<br />If yyes, describe under
<br />DESCRIPTIONOF OPERATIONS below
<br />_ —
<br />E.L. DISEASE - POLICY LIMIT $
<br />- -'—
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
<br />RE: Project #13 -038 - Santa Ana Library Elevator Modernization. The r
<br />'j .7 'j G •�'( '0 RM
<br />of Santa Ana, 20 Civic Center Plaza, Santa Ana, CA 92741; its o££ice ,
<br />employees, agents, volunteers and representatives are named as additional
<br />-
<br />insureds with regard to general liability and defense of suits arising from
<br />the operations and uses performed by or on behalf of the named (over)
<br />Lama Stitt S •edy
<br />A,csistattt. Oity - ttornCy
<br />CERTIFICATE HOLDER CANCELLATION
<br />61988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CI of Santa
<br />City Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza, M -36
<br />Santa Ana, CA 92701
<br />AUT�HO}RIIZFI) REdPRESENTATIVVEE7—�
<br />61988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
<br />
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