Laserfiche WebLink
CERTIFICATE OF LIABILITY INSURANCE <br />oA <br />4/9/2018 <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 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 certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT <br />NAME_ Sherry Allen_ <br />SilverStone Group <br />11516 Miracle Hills Drive <br />_ <br />PHONE FAX <br />(A(c, No, €a%402-964-5644 _ _`(A/C Nal: <br />Suite 100 <br />AD E-MRESS: sallen@ssgi.com <br />Omaha NE68154 <br />INSURER(S) AFFORDING COVERAGE <br />NAICN <br />INSURERA: Liberty Insurance Corporation <br />42404 <br />INSURED <br />A CQ <br />INSURER B: AIG Specialty Insurance Company <br />26863 <br />DMS Facility Services LLC l <br />DMS Facility Services, Inc. <br />INSURERC: Liberty Mutual Fire Insurance Cc 23035 <br />INSURER D: First Liberty Insurance Corp. 33588 <br />1040 Arroyo Drive <br />South Pasadena CA 91030-2908 <br />_ <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 1450492872 REVISION NUMBER: <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 />INSR IADOL.SUBR <br />R TYPE OF INSURANCE POLICY NUMBER MMIDOYIYYYY MMIODYIYYYY <br />LIMITS <br />C X COMMERCIAL GENERAL LIABILITY TB2£91-458727-018 3/1/2018 10/1f2018 <br />OCCURRENCE $f00o" <br />X <br />_EACH <br />OAMAG-E-To RENTED <br />CLAIMS -MADE OCCUR <br />_ PREMISES (Ea occurrence $100,ow <br />_MED EXP(Any one person) $10,000 <br />_ <br />PERSONAL& ADV INJURY $1,000,000 _ <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERALAGGREGATE $2,000,000 <br />POLICY X '', <br />JECTPRO- _ LOC <br />_ <br />T <br />PRODUCTS AGG $2000000 <br />_ <br />OTHER: <br />5 <br />D AUTOMOBILE LIABILITY AS6-691-08727428 3/12018 10/1/2018 <br />_ <br />COMBINED SINGLE LIMIT 51,000000 <br />(Ea adectent) <br />X ANY AUTO <br />BODILY INJURY (Per person) $ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />-NON-OWNED <br />_ <br />BODILY INJURY (Per accident) $ <br />X- HIRED X <br />PROPERTY DAMAGE $ <br />_AUTOS ONLY _AUTOS ONLY <br />_(Per accident) <br />$ <br />A X UMBRELLA LIAB X OCCUR THE91-458727-038 3/12018 101112018 <br />EACH OCCURRENCE_ 510,000,000 <br />EXCESS LIAB CLAIMSMADEAGGREGATE <br />510,000,000 <br />DEO X RETENTION$ <br />$ <br />A WORKERS COMPENSATION WA769D458727087 10/1/2017 10110018 <br />X PR STATUTE ORH <br />AND EMPLOYERS'LIABILITY YIN <br />ANYPROPRIETORIPARTNER/EXECUTIVE <br />EL EACH ACCIDENT S1000,000 <br />OFFICER/MEMBEREXCLUDED4 [N] NIA <br />- --- - - - <br />(Mandatory in NH) <br />EL. DISEASE - EA EMPLOYEE S1,000000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT $1000000 <br />B Contractors Pollution CPO16083633 3/12018 10/112018 <br />Each Loss 1000000 <br />Liability <br />Aggregate 1000000 <br />DESCRIPTION OF OPERATIONS) LOCATIONSI VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) �p <br />Re: Landscape Maintenance (District 1 and 4) for the RFP No. 15-112 <br />`QJ��v \ <br />City of Santa Ana, its officers, employees, agents and representatives are <br />J <br />included as Additional insureds as respects General Liability, including completed operations, as required by �7 contract <br />Primary/Non-Contributory is included General Liability, by � <br />wording as respects as required written contract. <br />Waiver of Subrogation with respects to Workers Compensation applies in favor of the City of Santa Ana, its officers, <br />employ, ,lets representatives as <br />required by written contract. <br />r� <br />30 days' Notice of Cancellation provided with respects to General Liability, Auto, & Workers Compensation as required <br />1�Q'hi rt act. (Except for 10 days <br />for non-payment of premium) <br />\ <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br />Parks Recreation, and Community Services Agency <br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92701 <br />reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />