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A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) O8/19/2021 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 Wanza Tolliver NAME: StateFarm Wanza Tolliver HONN Ext : 310.973.6044 FAX No : 310.973.6088 Insurance and Financial Services Inc E-MAILwanza@askwanza.com INSURER(S) AFFORDING COVERAGE NAIC # 15223 Crenshaw Blvd Suite B INSURERA: State Farm Mutual Automobile Insurance Company 25178 Gardena, CA 90249 INSURED INSURER B INSURERC: Greentech Landscaping Inc. INSURER D : PO Box 911124 INSURER E : Los Angeles, CA 90091 INSURER F : COVERAGES CERTIFICATE NUMBER: 1 REVISION NUMBER:0 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DA CLAIMS -MADE 1:1OCCUR PREM SESOEa occurrDence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY Y 654 4003-B19-75 - 2013 Ford 08/19/2021 02/19/2022 COEaMBINED ccident SINGLE LIMIT a $ BODILY INJURY (Per person) $ 1,000,000 ANY AUTO A X OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY (Per accident) $ 1,000,000 X PROPERTY DAMAGE Per accident $ 1,000,000 HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICE R/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Business Description: Landscaping City of Santa Ana, officers, agents, employees, and volunteers are named as additional insured. Agreement Number N-2020-097 CERTIFICATE HOLDER CANCELLATION 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 Risk Management Division AUTHORIZED REPRESENTATIVE lftim- 20 Civic Center Plaza RenEwm � APPRovED B : Santa Ana, CA 92702 ,I,, ;6 ,,� Tani �ceedar¢ © 1988-2015 ACORD CC Risk rJanagement oenrel Aide - ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 1001486 132849.13 04-22-2020