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Ate' /�R�'�� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 12014 M/YY)
<br />0912912014
<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 pollcy(ies) must he 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 endorsemen! s .
<br />PRODUCER
<br />MARSH USA, INC.
<br />445500TH STREET
<br />CONTA T
<br />NAME'
<br />PAHONE E. ac No;
<br />E.p Aless:
<br />MORRISTOWN, NJ 07050.8454
<br />INSURERS AFFORDING COVERAGE
<br />NAIC k
<br />GLD1110106
<br />INSURER A; HDI-Gerling America Insurance Company
<br />41343
<br />100120.5- 7BA- $BTI.I4115 510 Watson NOC60
<br />INSURED SIEMENS INDUSTRY, INC INCLUDING
<br />.
<br />BUILDING TECHNOLOGIES DIVISION
<br />INSURER 8: The Travelers Indemnity Company
<br />25658
<br />INSURER D; The Charier Oak Fire Insurance Company
<br />25815
<br />INSURER 0: Twelsrs Property Casually Co. of Amarioa
<br />25674
<br />1006 DEERFIELD PARKWAY
<br />BUFFALO GROVE, IL 60060.4513
<br />MED EXP (Any one arson)
<br />$ 100,000
<br />INSURER E
<br />$ 1,600,000
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: NY00006326533.10 REVISION NUMBER:
<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 HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />R
<br />TYPE OFINSBRANCE
<br />Jum ADOLSUBR
<br />WVD
<br />POLICYNUMBER
<br />MM00 SEE
<br />MMLO�YEVY
<br />LIMITS
<br />A
<br />GENERAL LIAeP.ITY
<br />GLD1110106
<br />1010112014
<br />10101/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />REMISES Ea occur coca
<br />$ 1,OD0,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE M OCCUR
<br />MED EXP (Any one arson)
<br />$ 100,000
<br />PERSONAL &ADV INJURY
<br />$ 1,600,000
<br />GENERALAGGREG41E
<br />$ 10,000,000
<br />GERL AGGREGATE
<br />LIMIT APPLIES PER;
<br />PRODUCTS- COMPIOP AGO
<br />$ INCL
<br />X POLICY
<br />PRO- LOC
<br />$
<br />D
<br />AUTOMOBILE
<br />LIABILITY
<br />TC2JCAP7440L34A14
<br />10/0112014
<br />1010112015
<br />EaaBI EDCSINGLE LIMIT
<br />2,000,000
<br />BODILY INJURY (Per person)
<br />$ NIA
<br />X
<br />ANY AUTO
<br />g
<br />ALL OWNED SCHEDULED
<br />BODILY INJURY (Par accident)
<br />$ NIA
<br />X
<br />IIREOD AUTOS X AUTOS
<br />(Par Per aoaldenl An AGE
<br />$ N/A
<br />S
<br />A
<br />X
<br />UMBRELLA MAB
<br />X
<br />OCCUR
<br />CUD1110206
<br />10/01/2014
<br />10/0112015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />TC20UB7440L27114 (ADS)
<br />10101120'14
<br />10101/2015
<br />WC STATU• OTH-
<br />B
<br />D
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNEWEXECUTIVE YIN
<br />pPPICER /MF.MRER F.XCLUOED4
<br />(Mandatary In NH)
<br />NIA
<br />TRKUB7440L28314(AZ, MA, OR &WI)
<br />TWXJUB7440L33814 (OH &VJA)
<br />10/0112014
<br />1010112014
<br />10!01/2015
<br />1010112015
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE EA EMPLOYEE
<br />$ 1,000,000
<br />S yea, desonba undar
<br />DESCRIPTION OF OPERATIONS below
<br />" "'$500K LIMIT/ $500K SIR '
<br />EL, bISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONSI LOCATIONSI VEHICLES (Attach ACORD 101, Additional Re marks Schedule, fmore space is required) r �.
<br />RE: JOB N0. NIA
<br />.t
<br />SEE ATTACHED y ""- -••
<br />III ell
<br />CERTIFICATE HOLDER CANCELLATION ), I
<br />CITY OF SANTA ANA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />ATTN: PURCHASING DEPT,
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 CIVIC CENTER PLAZA
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTAANA, CA 627014010
<br />AUTIIORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Manashl Mukherjeo
<br />©1988.2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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