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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br />_ 2/22/2016 <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 endorsement(st. <br />'PRODUCER -- <br />Andreini & Co. <br />CONTACT Laura I3ru er <br />g_ <br />1 MacArthur Place <br />Suite 100 <br />South Coast Metro CA 92707 <br />PHONE 714.327-1400 ~`Tax c-(AlC.Na_Exl)• ..� tgr-_N;); 714-327-14., <br />E*'AIL .lbrugger@andrieni.com <br />INSURER S) AFFORDING COVERAGE _ <br />NA <br />-- ---- ___ <br />INSURED DMSFA-1 <br />DMS Facility Services, LLC <br />DMS Landscaping <br />1040 Arroyo Drive <br />South Pasadena CA 91030 <br />INSURER A: Liberty I RsurAnqLCorporatlon _ <br />INSURERa:FIRST LIBERTY INS CORP <br />42404 <br />33588 <br />INSURER _ <br />P.NSURERD: <br />R E;- —�- <br />4VVrKAULb CERTIFICATE NUMBER: 184736512 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 />ISSR TYPE OF INSURANCE POLICY EFF POLICY EXP — <br />SD : WYO POLICY NUMBER I MNNDDIYY MNVODIYYYY LIMITS <br />A X COMMERCIAL GENERAL LIABILITY Y TB7Z91458727016 I31112016 31112017 EACH OCCURRENCE E1A00,000 <br />CLAIMS -MADE �^ 1 OCCUR I �..�..._-_b1�ENT <br />GEN'L AGGREGATE LIMI T APPLIES PE R: <br />POLICY PRO- <br />JECT <br />[2 LOC <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />X <br />ANY AUTO <br />AUFQS NED <br />Cr�---��� <br />- <br />5 Ep <br />AUTOSULEO <br />ANON--OSWNED <br />X <br />I HIREDAUTOS <br />X <br />AUTOS <br />UMBRELLA LIAB OCCUR <br />EXCESS LIAB ,., ..— <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERI <br />OFFICER/MEMBER EXCLUDE <br />(Mandatary in NH) <br />R Yes, describe under <br />NIA <br />AS6Z91458727026 1 311 /2016 1 311 /2017 <br />0& <br />MED EXP (Any one person) <br />E1 <br />PERSONAL &ADV INJURY <br />E1 <br />GENERAL AGGREGATE <br />E2 <br />PRODUCTS -COMP/OPAGG <br />E2 <br />COMBINED <br />£a-ccklera <br />E1 <br />80DID INJURY(Perperson) <br />E <br />BODILY INJURY (Peraccidenl) <br />S <br />DOPER <br />Per accident <br />E <br />E <br />EACH OCCURRENCE <br />E <br />E.L. EACH ACCIDENT E <br />E.L. DISEASE • EA EMPLOY£ f <br />E.L. DISEASE - POLICY I ]MIT ! k <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, my be aeached Ir more space is required) <br />Re: Landscape Maintenance (District i and 4) for the RFP NO. 15.112 <br />ityy of Santa Ana, its officers, employees, agents and representatives are <br />ncluded as additional insured as respects General Liability only per the attached CIS 20 10 04 13 and CG 20 37 04 13 forms which are part of <br />he insurance policy shown above. <br />See Attached,,, <br />CANCELLA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE N ATE THEEOF, <br />City of Santa Ana - Parks Recreation, and Community ACCORDANCEIWITHTHE POLICYPROVISIONSE WILL BE DELIVERED IN <br />Services Agency <br />20 Civic Center Plaza <br />Santa Ana CA 92701 AUTHORIZEMEPRESENTATIVE <br />t F' <br />® 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />