MIDORI GARDENS (PRIORITY LANDSCAPE SERVICES, LLC)

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ACOPRD CERTIFICATE OF LIABILITY INSURANCE DATE 08/23/19 1 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 have ADDITIONAL INSURED provisions or 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 Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite 91100 Miami, FL 33131-4937 CONTACT NAME: Aon Risk Services. Inc of Florida PHONE FAX Ara No. o Ex1 : 800-743-813U A!C No : 800-522-7514 EMAI ADDRESS: ADP.COI.Conter Aon.corn INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American Home Assurance Co. 19380 INSURED ADP TolalSource FL XVIII, Inc. INSURER B INSURER C 10200 Sunset Drive Miami, FL 33173 INSURER D L/C/F Priority Landscape Services LLC 521 Mercury Ln INSURER E INSURER F : Brea, CA 92821 COVERAGES CERTIFICATE NUMBER: 2609967 RFVI.RinN Nl1MRFR- 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, LIMITS SHOWN ARE AS REQUESTED INSS LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIVYYY POLICY EXP MM/DDIYVYV LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one porsor $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPUES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ POLICY D PROJECT LOC $ OTHER AUTOMOBILE LIABILITY COMB3NE0 SINGLE LIMIT Ea acarlenl 5 BODILY INJURY Par orson $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 130DILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Por accident $ 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DEC J I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC 080376966 CA 07/01/19 07/01/20 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 ANY PROP RI ETOR/PARTN ER/EXEC UIIVE OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory In NH) If yes, describe under E L DISEASE - POLICY LIMIT S 2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) See attached Certificate Holder Cancellation Notice. All worksile employees working for PRIORITY LANDSCAPE SERVICES LLC, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. CERTIFICATE HOLDER 10:VILWCL1 HIT-F1%%JTI__ CANCELLATION City of Santa Ana Risk Management Division { (� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, 4th Floor 1&i�. ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 FRANCINE R. VILLAREAL AUTHORIZED REPRESENTATIVE ort &AA (fe-tvieea, Qnn of c7rlo�tida © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD