PROFESSIONAL SPORTS FIELD MAINTENANCE, INC

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Digitally signed by Francine R. Francine R. Villareal Villareal A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/17/2021 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 CONTACT Kimberely Kelley NAME: Insurance Solutions ACNE. Ext : (949) 348-7400 q c, No): (949) 201-4515 License #0746539 E-MAIL KimK@ins-solutions.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 33302 Valle Rd, Suite 200 San Juan Capistrano CA 92675 INSURERA: Ohio Security Ins. Co. 24082 INSURED INSURER B : Allmerica Financial Benefit 41840 Professional Sports Field Maintenance, Inc INSURER C : American Fire and Casualty Company 24066 29466 Ridge Rd INSURER D : INSURER E : San Juan Capistrano CA 92675 INSURER F : COVERAGES CERTIFICATE NUMBER: 21-22 BA 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSD WVD POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO PRRETED SES Ea occecurrren $ 500,000 MED EXP (Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 A BKS59328473 11/01/2020 11/01/2021 LAGGREGATE LIMITAPPLIES PERGENERAL AGGREGATE $ 2,000,000 POLICY ElPRO ❑X LOC JECT: MOTHER PRODUCTS-COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS AW3D995243 07/26/2021 07/26/2022 BODILY INJURY (Pe r accide nt) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 C EXCESS LIAB CLAIMS -MADE ESA59328473 11/01/2020 11/01/2021 DED I I RETENTION $ $ P` WORKERS COMPENSATION AND EMPLOYERS' LIABI LI TY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N /A XWS59328473 10/30/2020 10/30/2021 X STATUTE EORH E.L. EACH ACCIDENT 1,OOD,ODO $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, it's officers, employees, agents, and representative are included as additional insured per the attached endorsement. thirty day notice of cancellation - 10 day notice for nonpayment premium CERTIFICATE HOLDER CANCELLATION City of Santa Ana, Risk Management 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE o @ 1988-2015 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD _ Risk M&T7Agmerd DiMisiun REVIEWED & APPROVED BY.- z Risk Management Analyst