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,a`co'R? CERTIFICATE OF LIABILITY INSURANCE <br />v DATE (MM/DD/VYVV) <br />10/5/2011 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsements . <br />PRODUCER CONTA T Debbie Cerkueira <br />NAME: <br />Landscape Cont rac tore (Lic#0755906) PHGNE (559) 650-3555 FAX (559)650-3550 <br />xnsuraace Se:rviCe:a, 2nc. E-MAIL .dcerkueiraC?9lciainc.com <br />1635 N. Fine Avenue INSURERS AFFORDING COVERAGE NAIC# <br />Fresno CA 93727 INSURERA:ARCFI insurance CO an 11150 <br />INSURED INSURER B <br />tTista de:1 Ve:rda Landscape, xnC INSURERC: <br />250 Fischer Avenue <br />INSURER D: <br />??? 1_??? INSURER E <br />(.'OSta Mesa CA 92626 INSURER F: <br />?.orcrlr lt, /11C ryUIYIOCR:++-+? +?y m ?+u a..v KCVISIVN NUMlSCK' <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONR OF RI ICH POI ICIFC 1 IMITR CHrI\AM nncv I-IAVI= at=r nl PFnI Iron RV onln rI ol?nc <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFF <br />YY POLICY EXP <br />LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 <br /> X COMMERCIAL GENERAL LIABILITY <br />R Ee occurrence 100, 000 <br />$ <br />A CLAIMS-MADE ? OCCUR X CPKG0053903 /1/2011 /1/2012 MED EXP (An one arson $ 5, 000 <br /> PERSONALBADV INJURY $ 1, 000, 000 <br /> X $500 PD DED GENERAL AGGREGATE $ 2, 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 , O O O , O O O <br /> X POLICY PRO LOC $ <br /> AUT OMOBILE LIABILITY C MBI aE DL SINGLE LIMIT 1 000 000 <br />A ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED <br />AUTOS X SCHEDULED <br />AUTOS CPKG0053903 /1/2011 /1/2012 BODILY INJURY Per accident <br />( ) $ <br /> <br />X <br />HIRED AUTOS <br />X NON-OWNED <br />AUTOS PROPERTY DAMAGE <br />Per accident <br />$ <br /> Medical a manta $ 5 000 <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ <br /> WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY WC $TATU- OTH- <br /> Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER E <br />? <br />C <br /> <br />N / A <br /> <br />E. L- EACH ACCIDENT <br /> <br />$ <br /> X <br />LUDED? <br />(Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ <br /> H yyes, describe under <br />U ESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br /> <br />V CSG RIr I Wrv VY VrERA \ IONS /LOCATIONS / V EHIGLES (Atte Ch AGORD 101, Addltlonel Reme,KS SChetlub, IT IhOre epete le roqulretl) <br />REa All landscape operations performed by or on behalf of the named insured. <br />Primary 2naurance/Non Contributory Blanket Additional insured per attached OOGL0434000105 <br />City of Santa Ana, xts officers, agents !r employers (Excluding Professional Liability) are named as <br />additional insured. Thies revises certificate dated 07-06-2011 <br />>YP1?(;V?i? f?;? ?j??? ) C?Jt?i <br />La.u r al ? i : r r `i t??cdy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />'v?.is[FIIIC City .e!!?. .'^?.CY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City Of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Parka & Recreation and Community Services <br />Agency At to Silvia Ctle:VaB AUTHORIZED REPRESENTATIVE <br />26 Civic Center Plaza <br />Santa Aaa, CA 92701-4010 }? -- C1?.?Y --- - --- <br />D Cerkueira /ICSAENZ <br />ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. <br />INS025 (2otoos).ot The ACORD name and logo are registered marks of ACORD