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<br />~ <br />ACORD" <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br />DATE (MMlDDIYYYY) <br /> <br />PROOUCER Phone: (71-4) 973-1-436 Fax; (71-4) 973-0811 <br />ELMCO INSURANCE, INC. <br />1905 N. MAIN STREET <br />SANTA ANA CA 92706.2719 <br /> <br />0410212010 <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE Does NOT AMEND, EXTEND OR <br />TH V FORD 0 TH P ICI W. <br /> <br /> <br />Agency LioJ: 0509747 <br /> <br />INSURERS AFFORDING COVERAGE <br />INSURER A: GOLDEN EAGLE INSURANCE CORPORATION <br />INSURER B: GOLDEN EAGLE INSURANCE CORPORATION <br />INSURER C: GOLDEN EAGLE tNSURANCE CORPORATION <br />INSURER D: <br />INSURER E; <br /> <br />NAIC# <br />10836 <br />10838 <br />10836 <br /> <br />INSURED <br />MASTER LANDSCAPE AND MAINTENANCE, INC. <br />10171 NORTHAMPTON AVENUE <br />WESTMINSTER, CA 92683-7558 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED E1Y THE POLICIES DESCRIElED HEREIN IS SUBJECT TO ALL THE TERMS, EXCWSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE ElEEN REDUCED BY PAID CLAIMS. <br />N8R I:~ TYPE OF INSURANCE POLICY NUMBER ~~E POUCY EllPIRAnON LIMITS <br />LTll. ~ <br /> GENERAL LIABILITY CBP9572743 04102110 04102111 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY ~~:;~~~E=OI) $ 100,000 <br /> I CLAIMS MADE [!] OCCUR MED. EXP (Any one person) $ 5,000 <br />A PERSONAL & ADV INJURY $ 1,000,000 <br /> - 2,000,000 <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $ 2,000,000 <br /> Xl n PRO- nl <br /> x POLICY ""'.T LOC $ <br /> AUTOMOBILE LIABILITY BA9826971 ti 04102111 COMBINED SINGLE LIMIT <br /> - (Ea accident) $ 1,000,000 <br /> ANY AUTO P O~./ S TC <br /> - AF FORM <br /> ALL OWNED AUTOS BODILY INJURY <br /> X (Per penon) $ <br /> SCHEDULED AUTOS <br />B X HIRED AUTOS V <br /> BODILY INJURY <br /> - PH W. FLt. (Per aa:ident) $ <br /> X NON.{)WNED AUTOS ;- '-' ,~, <br /> - CITY ATTORr EY <br /> X COMPo OED. $500 PROPERTY DAMAGE <br /> X (Per accident) $ <br /> COLLISION OED. $500 <br /> GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ <br /> ~ ANY AUTO OTHER THAN EAACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS I UMBRELLA LIABILITY CU9614669 04/02110 04102111 EACH OCCURRENCE $ 2,000,000 <br /> ~ OCCUR o CLAIMS MADE AGGREGATE $ 2,000,000 <br />C $ <br /> t, DEDUCTIBLE $ <br /> X RETENTION $ 10,000 $ <br /> IWCSTAru. I I OTHER <br /> WORKERS COMPENSATION AND lOR'f U"'ITS <br /> EMPLOYERS' LIABILITY 'fIN E.L EACH ACCIDENT $ <br /> Nf'( PROPRIETOIIIPMTNERlEXECUTlVE 0 <br /> OFFICERlMEMBER EXCLUDED? E.L DISEASE-CA EMPLOYEE $ <br /> l-ry In NH) <br /> ~yeI. dOlCllbo._ E.L. DISEASE..pOLICY LIMIT $ <br /> SPECIAL PROVISIONS below <br /> OTHER OTHER BUSINESS PERSOANL CBP9512743 04/02110 04/02111 BUSINESS PERSONAL PROPERTY <br />A PROPERTY;SPEC~L;REPLACEMENT LIMIT: $10,000 <br /> COST; 90% COINSURANCE DEDUCTIBLE: $600.00 <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS <br />SEe SUPPLEMENTAL CERTIFICATE. INFORMATION <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />CITY OF SANTA ANA SHOULD AN'Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL EHl)~vUK Iv MAIL '30 DAYS <br />P.O. BOX 1988 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,..", ~)l..ILt:ll\! TO <br />SANTA ANA CA 92702 8e S6 81 W..J. IMP-:"~r::' ....... eQb.ICo&TI61 t:8flll L._II I vr I"\nT Nl"4u urOI~ I hI::. 1I"~Vt'(t:.K. ITS <br /> AUTHORIZED REPRESE~ <br />Attention: 'i1~ C . Erin Walsh <br /> <br />ACORD 25 (2009/01) <br /> <br />Certificate # 42419 @) 1988-2009 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />