DMS FACILITY SERVICES, LLC 2C -2015

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SOI6785 A� CERTIFICATE OF LIABILITY INSURANCE DATE YI "R 2/20/2015 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 pollcy(ies) must 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 NAME: Commercial Lines PHONE FAX 019, Na, BAY 888-572-2412 No): Wells Fargo Insurance Services USA, Inc. E-MAIL SS: certs @trinet.com 6100 Fairview Road _ INSURER(S)AFFORDING COVERAGE_ NAICM Charlotte, NC 28210 _� INSURERA ACE American Insurance Company 22667 INSURED INSURER B: Strategic Outsourcing, Inc. - - _ $ INSURER C: L /C /F DMS Facility Services, LLC dba DMS Facility INSURER D: Services, LLC - Landscaping Services, LLC INSURER E: INSURER F: PO Box 241448 / Charlotte, NC 28224 COVERAGES CERTIFICATE NUMBER: 8751678 REVISION NUMBER: See below 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. ILTR R TYPE OF INSURANCE INSU WVD POLICY NUMBER MMIDOmVV MMLOD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -- CLAIMS MADE j _ OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence ) - _ $ MED EXP (Any one person) $ PERSONAL &ADV INJURY S GENERAL AGGREGATE $ GENLAGGREGATE LIMITAPPLIES PER POLICY [:] PRO- ❑ JECTOC Reviewed y PRODUCTS - COMP /OP AGG — _ $ OTHER $ AUTOMOBILE LIABILITY " COMBINED SINGLE LIMIT (Ea acct- -dent $ _ $ MANY AUTO BODILY INJURY (Per person) _ ALL OWNED SCHEDULED AUTOS - NON -OWNED HIRED AUTOS AUTOS — + ( -� O(iVlf� /`�+ /u�' PRCSH/Ad 1 v a`Sn `II rein ,./ t/ P9 $ S BODILY INJURY (Per accident) PROPERTY DAMAGE - SPer accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _ AGGREGATE EXCESS LIAR CLAIMS -MADE $ H DEO RETENTION$ i $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE X WLRC48561116A 0310112015 03/01/2016 X STATUTE URH _ $ 1,000,000 -- E.L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? tMandatarylnNH) NIA EL. DISEASE - EA EMPLOYEE _ - S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT -I$ 1,000,000 DESCRIPTION OF OPERATIONS) LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Districts 1, 4 and 5 Park Landscape RFP Workers' Compensation Coverage is limited to employees leased to DMS Facility Services, LLC dba DMS Facility Services, LLC- Landscaping Services by Strategic Outsourcing, Inc. pursuant to the terms of a fully executed service agreement. CERTIFICATE HOLDER CANCELLATION City of Santa Ana AIM: Purchasing Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)