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AC0IR 6r CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDfYYYY) <br />7 /112010 <br />PRODUCER <br />Bolton & Company <br />245 S, Los Robles Ave., Suite 105 <br />Pasadena, CA 911Q2 <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 />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />0008309 (626) 799-7000 <br />www.belionco.com 626-583-2125 <br />INSURED Merchants Landscape Services, Inc. <br />1190 Monterey Pass Road <br />Monterey Park CA 91754 <br />INSURER A G 1 <br />INSURERB:Liber(V Mutual Fire Insurance Qgmpa <br />INSURERC: Midwest Employers Casualty Company <br />INSURER D:Federal Insurance Company <br />INSURER E: <br />.OVERAGES <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 114SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />DD' <br />POLICY NUMBER <br />CBP8699930 <br />POUCV EFFECTfVE <br />7/1/2010 <br />POLICY EXPIRATION <br />LIMITS <br />A <br />✓ <br />GENERAL LIABIUTY <br />711/20i1 <br />EACH OCCURRENCE <br />— <br />S 1,000.000 <br />✓ COMMERCIAL GENERAL LIASILTTY <br />PREMISETO-PENT <br />S 500,000 <br />MED EXP(MYons person) <br />S 10.000 <br />CLAIMS MADE 0 OCCUR <br />PERSONAL&AOV INJURY <br />3 1 000 000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />OENLAGGREGATE UMITAPPLIESPM <br />PRODUCTS-COMP/OP AGO <br />3 2000000 <br />POLICY P 0T F./I LOC <br />A <br />AUTOMOBILE LIABILITY <br />BA8690031 <br />711/2010 <br />7/1/2011 <br />COMBINED SINGLE LIAUT <br />S <br />ANY AUTO <br />(Ee soddenl) <br />1,000,000 <br />ALL OWNED AUTOS <br />SCHEDULEDAUTOS <br />AP!C�OV�ED <br />TO FOR <br />(PP.�URY <br />(Per ) <br />3 <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />BODILY INJURY <br />(Pareoddent) <br />$ <br />JPSVH W <br />FLE ER <br />PROPERTYOAI.WOE <br />$ <br />(Perecddenq <br />GARAGELIABILITY <br />AUTO ONLY -EA ACCIDENT <br />S <br />ANY AUTO <br />OEAACC <br />THERTHAN <br />$ <br />S <br />AUTOONLY: AGO <br />B <br />EXCESS I UMBRELLA LIABILITY <br />TH2661065881010 <br />7/1/2010 <br />7/1/2011 <br />EACHOCCURRENCE <br />s 6,000,000 <br />AGGREGATE <br />3 6,000,000 <br />✓ OCCUR CLAIMS MADE <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION $10 000 <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />EWC008280 Excess WC CA <br />t ) <br />3/1/2010 <br />3/1/2011 <br />TH- <br />✓ WC$TATU• OJER <br />S <br />YIN <br />ANY PROPRIETOR(PARTNERIEXECUTNE a <br />OFFICERJUEIA8ER EXCLUDED? <br />E.L. EACH ACCIDENT <br />3 <br />(Mandatory A102CA16 NH)—d <br />If yes, describe under <br />E.L. DISEASE - EA EMPLOYE <br />S 3,00010 <br />E.L. DISEASE -POLICY LIMIT <br />S 1,000 00 <br />SPECIAL PROVISIONS below <br />OTHER <br />0 <br />Employee Theft/ <br />81585028 <br />6/1/2010 <br />6/1/2011 <br />Limit: $1 MILIDed. $25,000 <br />Forgery <br />DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Workers Comp Is Self -Insured under California Certificate of Consent to Self insure #03-1-1793-01 for CA operations. <br />Blanket GL Additional Insured per CG2037 07104 & CG2010 07104 attached, only If required by written contacl. <br />GL Primary Wording applies per 22-111 01107 attached. Job: #3011. City Santa <br />of Ana Parka, <br />Additional lnsured(s): City of Santa Ana, its officers, agents, employees, representatives, and volunteers. <br />MLS CA, 93011 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BECANCELLED B£FORETHE EXPIRATION <br />City of Santa Ana DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3Q • DAYS WRITTEN <br />Attn: Clerk of the City Council NOTICE TO 114E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 30 SHALL <br />20 Civic Center Plaza IMPOSE NOOBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Santa Ana, CA 92701 REPRESENTATIVES- ' 1e Days for Non.Psyment at Premium. <br />AUTHORIZED REPRESENTATIVE �. <br />Cheryl Fels pn C - " ` , <br />1I O 1988.2009 ACORD CORPORATION, All rights reserved, <br />CERr NO., 7730390 CI.L&rr CODE, 44BROI-1 Bolton Certi CitaLe PraCeeeing 7/1/2010 3:1e_55 AN Page 1 of 5 <br />