W.A. RASIC CONSTRUCTION COMPANY, INC.-2014

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�`� °® CERTIFICATE OF LIABILITY INSURANCE DATE /16 /IODIY4 9/16/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Commercial Associates Insurance 1594 N. Batavia Street Orange, CA 92867 CONTACT A ' PHONE (714) 524 -4949 FAX . (714)529 -4940 EMAIL POLICY NUMBER INSURERS AFFORDING COVERAGE NAICN INSURER A:Travelers Prop Cas Cc of Amer Santa Ana, CA 92703 INSURED W.A. Rasic Construction Co., Inc. 4150 Long Beach Blvd. Long Beach, CA 90807 INSURER B: I INSURER C: INSURER D: EACH OCCURRENCE INSURER E: INSURER F: r nVFRAP,FC CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LT TYPE OF INSURANCE AD L SUBR POLICY NUMBER POLICY EFF MIDD/YY POLICY EXP Y LIMITS Santa Ana, CA 92703 GENERALLIABILITY EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED R Ee accu re ce $ 300,000 MED EXP Any one person) $ 10,000 A CLAIMS -MADE FX1 OCCUR X DTE CO 867OX247- TIL -14 /1/2014 5/1/2015 PERSONAL &ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 4,000,000 $ POLICY PRO LOC ELIT AUTOMOBILE LIABILITY (CEO, MIINED SINGLE LIMIT ce point 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED PROPERTYDAMAGE HIRED AUTOS AUTOS T 810 8670X247 - TIL -14 5/1/2014 /1/2015 BODILY INJURY (Per accident) $ a accident $ Uninsured motorist combined $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? F—] NIA IMandatory In NH) E, L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT. $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: Operations usual to the named insured - Master Service Agreement - On -call emergency sewer and water systems repair services contract City of Santa Ana, its officers, employees, agents, volunteers and representatives are added as additional insured including primary wording where required by written contract as respects general liability per attached CGD246 8/05. 30 days notice of cancellation except 10 days for non - payment. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) 1988.2 10 CORD CC) ORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered rks o ACORD. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, City of Santa Ana 220 S. Daisy Ave., M -85 AUTHORIZED REPRESENTATIVE P.Q. BOX 1988 Santa Ana, CA 92703 ACORD 25 (2010105) 1988.2 10 CORD CC) ORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered rks o ACORD.