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,�^ 0 DATE (MM)DDIYYYY)
<br />AC"R" CERTIFICATE OF LIABILITY INSURANCE 8/17/2017
<br />THIS CERTIFICATE IS ISSUED AS A MA'TTE'R 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 pollcy(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 lieu of such endorsement(s).
<br />PRODUCER CONTACT Benita Hall, CISR
<br />NAME:
<br />Landscape Contractors (Lic#0755906) PHCc Na Ext: (559) 650-3555 Fare No: (559)650-3558
<br />Insurance Services, Inc. E-MAIL
<br />ADDRESS: all@lcisinc.00rn
<br />1.835 N. Fine Avenue INSURER(S)AFFORDING COVERAGE NAIC
<br />Fresno CA 93727 INSURERA.Atlantic Specialty Insurance 27154
<br />INSUREo .. INSURERIB :Navigators Specialty Ins Cc 36056...
<br />Mariposa Landscapes Inc INSURERC:
<br />1552,9 Arrow Highway INSURERD:
<br />Irwindale CA 91706 1 INSURERF:
<br />COVERAGES CERTIFICATE NUMBER -17/18 Pkq & Auto REVISION NUMBER:
<br />THIS 15 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SLIER
<br />POLICY'NUMBER
<br />MM)�QYYYY
<br />MMID�IYYYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1,000,000
<br />.....500,000
<br />A
<br />CLAIMS -MADE ' ] OCCUR
<br />{w1 �- -mi
<br />PREMISES Ea occvrro=•nc� $
<br />618-011.1.1-2'..1-0001
<br />4/1/2017
<br />4/1./2'.018
<br />EXP (Any one persan) $ 5,000
<br />X $1,000 Pd bed
<br />Blanket Contractual
<br />-MED
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000.
<br />GENLAGGREGATE LIMIT APPLIES PER :
<br />Liability
<br />POLICY ,JE.C7PRO- LOC
<br />PRODUCTS ..COM1PdOPAGG $ __. 2,000,000
<br />''... OTHER
<br />Employee Benefits $ 1,000,000
<br />AUTOMOBILE
<br />LIABILITYIu111t11..
<br />'INGL. LMII $, 1,000,000Ea
<br />Brocade.'
<br />F3G...uFYIN,IU'RY(Perparson) $
<br />A
<br />ANY AUTO
<br />BODILY INJURY (Per accident) $
<br />ALL OvvlIED SCHEDULED
<br />AUTOS AUTOS
<br />618-00-11-21-0001
<br />4/1/2017
<br />4/1/2018
<br />xNON-OVI"ED
<br />PROPERTY DAMAGE $
<br />HIRED AUTOS ALIT0 8
<br />,,.(Peracclidentrd
<br />Uninsured mol:05lcombined $ 1,000,000
<br />X
<br />UMBRELLA LIAB X OCCUR
<br />EACH OCCURRENCE $ 5,000,000
<br />AGGREGATE. $ 5,000,000
<br />Fi
<br />E%OESSLIAB CLAIMS -MADE.
<br />$
<br />DEL? RETENTIGN$
<br />SFI7EXC840614IC
<br />4/112017
<br />4/1/2018
<br />WORKERS COMPENSATION
<br />PER OTT -i-
<br />AND EMPLOYERS' LIABILITY' YIN
<br />STATUTE ER
<br />E..L EACH ACCIDENT $
<br />ANY PROPPIETORIPARTNEWEXECUTIVE:
<br />OFFICER/MEMBER EXCLUDED? E
<br />NIA
<br />-- .
<br />E..L DISEASE - EA EMPLOYEE $
<br />(Mandatory in NH)
<br />IR yes, describe under
<br />-
<br />DESCRIPTION OF OPERATIONS bdo,w
<br />E.I.. DISEASE - POLICY LIMIT Is
<br />Rented/Leased Equipment
<br />618-00-11-21-0001
<br />4/1/2017
<br />4/1/2018
<br />Limil:Ced$500 $300,000
<br />Scheduled Equip
<br />618-00-11-21.-0001
<br />4/1/20..17
<br />4/1/2018
<br />Lim1t4-'ed.$5ffl $3,,762,565
<br />DESCRIPTION OF OPERATIONS I LOCATIONS 1' VEHICLES(ACORD 181, Addlfional Remarks Schedule, may be attached if mere space Is required)
<br />RE: All landscape operations performed by or on behalf of the named insured
<br />Primary Insurance/Non Contributory Blanket Additional insured per attached OBPGGLO CIA & CG2001041.3
<br />City of Santa Ana, it's officers, employees, agents and. representatives (Excl�( rofessional 000
<br />Liability) are named as additional insured This revises certificate date 'A31-2017 p
<br />gym.
<br />City of Santa Alla
<br />Attn: Purchasing Department
<br />20 Civic Center Plaza
<br />Santa.. Ana„ CA 92701
<br />SHOULD ANY OF THE ABOVE DESC MP-OLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are reglisteredl marks of ACORD
<br />INS025 (201401 )
<br />
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