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ACII CERTIFICATE OF LIABILITY INSURANCE DAT4nM016YYY1 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this Certificate does not confer rights to the certiflcato holdar In tion of such nndorsamentlsl. <br />3475 E. Foothill Blvd., Suite 100 <br />PHONeFAX <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 />Pasadena, CA 91107 <br />(No.EA) <br />_. (625) 799-7000 _ (Ale, No): <br />(626) 583-21.17 <br />EACHOCCURRENCE S <br />ADDRESS: <br />DAMAGE 10 RENTED - <br />PREMISES_(Eaaccueeace) $__ _ <br />MEDEXP(Anycne person) $ <br />INSURER($) AFFORDING COVERAGE <br />NAICN <br />vwvw.bolionco.com 0008309 <br />INSURERA: <br />Berkshire Hathaway Homestate ins Cc _ <br />20044 <br />INSURED <br />Mari' Landscapes Inc. <br />INSURER B: <br />COMBINED SINGLE LIMIT S <br />15529 Arrow Higghway <br />INSURERC: <br />BODILY INJURY (Par person) S <br />OWNED SCHEDULED— <br />AUTOS ONLY AUros <br />Irwindale CA 9T706 <br />INSURER D: <br />PROPERTYDAMAGE S <br />AUTOS ONLY _._AUTOS ONLY <br />LPoracadpnt). _. <br />INSURER E <br />UMBRELLA LIAR _ OCCUR <br />EACHOCCURRENCE $ <br />INSURER F: <br />AGGREGATE 5 <br />_ DEO RETENTIONS <br />C0VPRAr1ES ftFRTIPICATP NIIMRPR• o, Iaa-re <br />A WORKERS COMPENSATION �/ MAWC707593 4/1/2016 4/1/2017I/ <br />RP\115V1N All IMRPG• <br />EMPLOYERS' LIABILITY YIN <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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR TYPE OF INSURANCE ADO�UBR - POLICY EFP- POLICYE%P <br />p POLICY NUMBER ,,,DDIYYYY MMIDDM'WI <br />--- - <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />EACHOCCURRENCE S <br />CLAIMS -MADE OCCUR <br />__._. <br />DAMAGE 10 RENTED - <br />PREMISES_(Eaaccueeace) $__ _ <br />MEDEXP(Anycne person) $ <br />PERSONAL&ADVINJURY S <br />G•EN'L AGGREGATE LIMIT APPLIES PER: <br />GENERALAGGREGAF 5 <br />POLICY PRO- <br />_._ _.. JECT LOC <br />- - - - <br />PRODUCTS - COMPIOP AGO S <br />OTHER'. <br />$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT S <br />(Ea smidaM) <br />ANY AUTO <br />BODILY INJURY (Par person) S <br />OWNED SCHEDULED— <br />AUTOS ONLY AUros <br />BODILY INJURY (Per accidenQ S <br />HIRED NON OWNED <br />PROPERTYDAMAGE S <br />AUTOS ONLY _._AUTOS ONLY <br />LPoracadpnt). _. <br />UMBRELLA LIAR _ OCCUR <br />EACHOCCURRENCE $ <br />EXCESS LIAR _CLAIMS -MADE <br />AGGREGATE 5 <br />_ DEO RETENTIONS <br />5 <br />A WORKERS COMPENSATION �/ MAWC707593 4/1/2016 4/1/2017I/ <br />STATUTE ORH <br />EMPLOYERS' LIABILITY YIN <br />AND <br />-- <br />ANYPROPRIETORlPARTNERMXECUTIVE <br />EL EACH ACCIDENT S 1,000,000 <br />OFFICERIMEMBEREXCWDE09 NIA <br />_ <br />(Mandatory In NH) <br />EL DISEASE,EAEMPLOYEES 1,000,000 <br />If yyes, desaiba under <br />DF.SCRIPTIONOFOPERATIONS belm <br />- -- _ - <br />E. L. DISEASE - POLICY LIMIT S 1,000,000 <br />f <br />�aay <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 101, Accidents; Romarke Schedule, maybe attached if more apace lsmotdred)e+ry '14 <br />Re: Job: Median Landscape Maintenance Services. <br />WC Waivers of Subrogation apply per WC99041OB0914 attached. <br />�\\JG��,POj� <br />ence <br />Cityy of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Public Works A THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />220 South Daisy Avnue ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana, CA 92703 <br />AUTHORIZED REPRESENTATIVE <br />Chau Tran <br />©1988-2015 ACORD CORPORATION. All riahts reserved. <br />ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD <br />J -e3.1971 1 rvLARILAN-0I I L6 I' Nc I A1iea lOpea 1 4/1/2014 1,01:.40 eM IPPI'I I Page 1 of 2 <br />