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A ue & CERTIFICATE OF LIABILITY INSURANCE
<br />9/25/2018
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCE"S IverStone Grou
<br />11516 Miracle Hills Drive
<br />N: ° Sherry Allen
<br />PH'NA
<br />P q, Sol, 402-064-5644 NE ,Sic Not:
<br />Suite 100
<br />Omaha NE 68154
<br />Isgi.com
<br />__
<br />_ NSURERIS AFFORDING COVERAGE__ __
<br />NAICA
<br />�INSURERA: Uberly In8Ur8nCe GOmOraflOn
<br />_
<br />42404
<br />INSURED
<br />DMS Facility Services LLG a01 I'C�6Ca
<br />DMS Facility Services, Inc. '� �
<br />INSURER Se AIG Specially Insurence Company
<br />26883__
<br />INsuaEac_Uberl Mutual Fire Insurance Cq_.._.._.___
<br />I 23035_
<br />_
<br />INSURER o: First Liberty Insurance Corp.
<br />_
<br />1 33688
<br />1040 Arroyo Drive
<br />South Pasadena CA 91030-2908
<br />INSURER E: Travelers Property Casualty Cc of America
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 1285819545 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 />ILTR
<br />TYPEOFINSURANCE ��INADAb�l
<br />ppLICy NUMBER
<br />MMIOICDIYYYYFF
<br />MMIOO�Y
<br />LIMITS
<br />C
<br />X
<br />I COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE u OCCUR
<br />T82-691458727-088
<br />10/1/2018
<br />10/1/2019
<br />EACHOCCURRENCE
<br />$1,000,000
<br />U MA�T'O1FE�D
<br />PREMISES1E occur
<br />$1001000
<br />,e
<br />MEOEXPfAnnWperson
<br />$10,000
<br />_
<br />PERSON_AL&ADV INJ_UR_Y
<br />AGGREGATE LIMIT APPLIES PER:
<br />®JECr C LOG
<br />GENERAL AGGREGATE
<br />_$1,000,0_00 _
<br />$2,000,000
<br />GEN'L
<br />PRODOCTS_COMPIOPAGG
<br />$2,000,000
<br />OOLICY HER.
<br />0
<br />AUTOMOBILE
<br />LIABILITY
<br />A86-691458727.078
<br />10/1/2018
<br />10/1/2019
<br />(CO.BIN DSINGLEUMI
<br />$1,000.000
<br />X
<br />ANYAUTO
<br />BODILY INJURY
<br />$
<br />OWNED SCHEDULED
<br />AUTOS ONLY L.. AUTOS
<br />AUTOS ONLY L. AUTN SONLOY
<br />BODILY INJURY (Per acrJdaW
<br />$
<br />Pe� cdtlHIRnjAMAGE
<br />$
<br />I
<br />E
<br />X
<br />UMBRELLALIAS
<br />X
<br />OCCUR
<br />ZUP-21P17G59A8NF
<br />10/1/2010
<br />10/1/2019
<br />'EACH OCCURRENCE
<br />$10,000.000
<br />AGGREGATE .�
<br />$10,000,000
<br />EXCESS LIA13
<br />CLAIMS -MADE_
<br />(
<br />DEC)X I RETENTIONS
<br />A
<br />WORKERS COMPENSATION ANOEMPLOY RS'UASILnY YIN
<br />ANYPROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMDER EXCLUDED?
<br />yandatory In NH)
<br />M
<br />DESCRIPTION desedn QF OPERATIONS below
<br />NIA
<br />WA7$90458727-088
<br />10/1/2018
<br />J
<br />10(1/2019
<br />X STATUTE EAH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L.OISEASE - EA EMPLOYEE
<br />$1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />$1,000,000
<br />B
<br />Cammctors P011Won
<br />Uoutty
<br />CP016083633
<br />10/1/2018
<br />10/1/2019
<br />Esoh Loss
<br />Aggregate
<br />1.000,000
<br />11000,000
<br />DESCRIPTION OF OPERATIONS LOCATIONS1 VEHICLES(ACORD 104, Addl6oaal Re.dn Schedule, may bo attached If..,.apac. ierequired)
<br />Re: Landscape Maintenance (District 1 and 4) for the RFP No. 15-112
<br />Ciry of Santa Ana, Its officers, employees, agents and representatives me
<br />Inc as Additional Insureds as respects General Liability, including completed operations, as required by written contract. PrimarylNon-Contributory warding Is included as respects General Liability, as required by written contract.
<br />Waiver of Subrogation with respects to Workers Compensation applies In favor of the City of Santa Ana, is officers, employ presentatives as
<br />required byy written contract, r_
<br />30 days' tJGiles of Cancellation provided with respects to General Liability, Auto, & Workers Compensation as requi y write u1JaCI. (Except for 10 days
<br />for non-payment of premium)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL as DELIVERED IN
<br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Parks Recreation, and Community Services Agency
<br />20 Civic Center Plaza AUTHORIZED REPRES NTATVE
<br />Santa Ana CA 92701 / ) IV 41
<br />ACORD
<br />ACORD 25 (2016/03) The ACORD name end logo are registered marks of ACORD
<br />
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