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

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A °® CERTIFICATE OF LIABILITY INSURANCE 1 9/16/2014 DATEIMMIDDNYYY) 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 N PHONE (714) 524-4949 FAIC. Nol: (714) 524 -4940 E-MA SS INSURERS AFFORDING COVERAGE NAICN INSURER A:Travelers Pro2 Cas CO of Amer LIMITS INSURED W.A. Rasic Construction CO., Inc. 4150 Long Beach Blvd. Long Beach, CA 90807 INSURER B: i INSURER C: INSURER O: INSURER E: $ INSURER F COMMERCIALGENERALLIABILITY COVERAGES 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF D YYY POLICY EXP MM /DD LIMITS Santa Ana, CA 92703 GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIALGENERALLIABILITY DAMA E T PREMISES (Ea occurrence)$ CLAIMS -MADE F—I OCCUR MED EXP (Any one person ) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ $ POLICY F7 PRO LOG IFCT F-1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS PROPERTY DAMAGE Per .cars $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION X WC STATU- I OTH- PR AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER /EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ® (Mandatory In NH) NIA TJVH- 3929R99 -5 -14 7/1/2014 /1/2015 E. L. EACH ACCIDENT $ 1,000,00( E. L. DISEASE - EA EMPLOYEE $ 1,000,00( If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, AddItlanal 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 30 days notice of cancellation except 10 days for non - payment. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) © 1 88.2010 CORD C PORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registers arks of ACORN "� 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.O. BOX 1988 Santa Ana, CA 92703 e ACORD 25 (2010/05) © 1 88.2010 CORD C PORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registers arks of ACORN "�