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AC"RV
<br />CERTIFICATE T� F LIABILITY INSURANCE
<br />DATE (MMIDD�'Y`YYY)
<br />1
<br />121,12016
<br />11/25/2015
<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(les) 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 lien of such endorsement(s),
<br />PRODUCER L°e1ckion Companies
<br />CONTACT
<br />NAE
<br />'PHONE
<br />444 W. 47th Street, Suite 900
<br />FAX
<br />Kansas C iLy!'WO64112- 1 90 6
<br />GA1C. No. ExU 4AlC N41:_ __w
<br />E-MAIL
<br />(816) 9641-943410
<br />GENERAL AGGREGATE � $2,000,000
<br />PRO -
<br />. INSURER(S)..AFFORDING COVERAGE MAIC #
<br />__. __ _. ...._ .......
<br />..INSURED
<br />...INSURER A.; /',Inch American Iris rancc (',0111pallb" 16535
<br />DAVID F VAlvSANI) ASSOC INC
<br />INSURER 8 r, H13yds of London _
<br />13318942IOU SW RIVER PAItKWAY
<br />INSURER C:
<br />PORTLAND OR 97201
<br />INSURER D
<br />.I
<br />ANY 'AU'IC} '..,.. I,..
<br />INSURER F
<br />COVERAGES DEAIN01 CERTIFICATE NUMBER: 116AIf1I T RFVI%ION NIPM RFiR� YYYVVVV
<br />THIS IS TO CERTIFY' THAT THE POLICIES OF dNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATE[). NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR CYPHER DOCUMENT S+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 CONDITIONS. OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />Ail"TN: SUZI FUR.IANIC.,
<br />INSR ADDL,SUBR;, _ _.. POLICY EFF....... POLICY EXP
<br />... _ ... ..
<br />TYPE OF INSURANCE
<br />LTR POLICY NUMBER i MMdDDIYYYY MhgIDWYYYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY d,iL0 r�1F1:�M 399 f 12ll 2015 12 1l?1
<br />A 5' N _'11Th
<br />EACH 1.�CCURRENCF. S S 1..(.00 �.�00
<br />, . -
<br />_- a......
<br />_ CLAIMS -MADE X OCCUR 1
<br />_
<br />DAM.NAOE ICA°4121NiFD
<br />PREMISES (Ea raccurrencrs) S S300!00O
<br />f'
<br />I
<br />MED EXP (Amy one PW80. ,
<br />.
<br />PEHSf7NAL d ADW pN,1URY 1,()00,000
<br />GEN'L AGGREGATE OMIT' APPLIES PER. ! "',.
<br />GENERAL AGGREGATE � $2,000,000
<br />PRO -
<br />,
<br />, POLICY I ,}ECT i.00 I
<br />PRODUCTS • COMPiOP G a
<br />AG
<br />OTHER: I
<br />,j+,
<br />AUTOMOBILE.LIABILI:TY
<br />7/?it(
<br />�OhBEDSENGLLNII73
<br />....... SEaccident) �I.U411J,111)t)
<br />ANY 'AU'IC} '..,.. I,..
<br />BODILY INJURY'Wer Perconl � S
<br />ALL OWVNED SCHEDULED
<br />AUTC7,r ._..__ AUTC75
<br />.rX.rX�X�S..r�i.�{.A1`.
<br />BODILY INJURY fPr=r acr:icicnt)� S ._ ,..
<br />x�}rAl�.xxx
<br />x NON -OWNED -
<br />HIRED AUTOS AUTOS
<br />_
<br />PROOEkT, DA.hl;we .... $ r r�A' .:1. .
<br />. IPer avx,sa9e�roCY__.
<br />S 1�x ''X''
<br />UMBRELLA LIIAB OCCUR- Pv()T �-'tibl Ll�i,e1BL�'�= 1
<br />EAC.h°E47CCP,]RREB+9CE Sri �4'%1X..�i.,rA't
<br />EXCESS LIAB_.....
<br />-.. _.
<br />_.. C:I.AIM.SIu7ADC
<br />AGGREGATEj $ 1{�O,X.X�:xx
<br />_
<br />DED RETENTfONS
<br />XX
<br />WORKERS COMPENSATIONPER
<br />N
<br />01H -
<br />X
<br />\V('9336626 12/ 1 `201 5 121'2016
<br />AND EMPLOYERS' LIABILITY Y P N .
<br />STATUTE .... ER .. _
<br />ANY PROPRIE 0RIPARTNERJEXECDT
<br />E L EACH ACCIDENT S 1,000,000
<br />OFFICERIMENIBER. EXCLUDED°r N NIA
<br />_.
<br />gMandatory'in NH)
<br />E L DISEASE - EA EKIPLOYEE S 1.( 00,000
<br />If yea. describe under
<br />''
<br />_
<br />DESICRIPTQN OF OPERATIONS helow
<br />E.L. DISEASE - POLICY LIMN I, I. ()0 ()0()
<br />li PRC,7LI;S.SIONAL N hd '', I,DIJSAI504025°, I2,'V2015 Qel`?I,I16
<br />ITR CLAIM SI.IIM.000
<br />LIABILITY
<br />,rENNI1A1. A,CiCi1L1°CiA'I'"N°. n?-I)tIC6.1)t)t1
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may he attached i1 more space is. required)
<br />R1;: LANDSCAPE ;C(JNSU1-HN6- MENIORY I..r\NI IS.AN1'A ANA 1k]VER 1'FIR hrllutMORY LAN 'SAN fFA ANA RIVER
<br />IIAR i RI'`C' N( I, I _H58 1IIF (,I'I``r'
<br />OF SANTA ANA, 20 CIVIC C EXTEli.1'LAZA,, SAN I A AN A, CALIFORNIA 92701: I"('S OFFICERS, FENIPI-.ON' EFS. VOI
<br />I%'N°TEERS AND
<br />RITRLSFN 1AHVESARF AL1DITIC)NAl INSUREDS AS RLSPEC:'"IS F0 GENT R AI. I.dABILI`I"r", HUS C0VkRAGF dS
<br />PREMARY AND
<br />twO N -C" ONTRIBUTORY AS ICLt,pl°ARI'D BY A'ArI ITI'Fh CONTRACT.
<br />FEVIE.'VW.-J-, n 1�r
<br />BJNICE HE Ilwri°[N (P(3, /() �w
<br />CERTIFICATF HOI_DFR C`.ANC`F11 ATION gtiao Altsrr•iir%r ralc
<br />13663013
<br />CITY 01: SANTA ANA
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Ail"TN: SUZI FUR.IANIC.,
<br />THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN
<br />C.I'v'li�' C�`L-N"�'l~:IL PLAZA, 3RD FLOOR, Rd)`.` ANNEX
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Sr1,NTA tx.l'~IA f.°A O-27 1
<br />AUTHORIZED RE,PRESENTATIVF'
<br />f'
<br />I
<br />CP 1989/014 ACORN CORPORATION, All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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