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ACOR[7® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 8/17/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Benita Hall, CISR NAME: Landscape Contractors (Lic#0755906) (PA Hc° No Est: (559) 650-3555 nlc No: (55e)650a558 E-MAIL bhall@lcisinc.com ADDRESS: Insurance Services, Inc. 1835 N. Fine Avenue INSURER(S)AFFORDING COVERAGE NAIL INSURERA Atlantic Specialty Insurance 27154 Fresno CA 93727 INSURED ry(r- �t §��.=/f�- Mariposa Landscapes Inc / ''t 41 { "" I INSURERS:Nav1 ators Specialty Ins CO 36056 INSURERC: INSURERD: 15529 Arrow Highway INSURER E INSURERP; Irwindale CA 91706 COVERAGES CERTIFICATE NUMBER:17/18 Pkg & Auto REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS. ILTR TYPE OF INSURANCE ADOL BURR POLICY NUMBER MMID�IYYYV MMIGDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR N PREMISES (Ea occurrence) $ 500,000 MED EXP(Any one Person) IS 5,000 618-00-11-21-0001 4/1/2017 4/l/2018 $1,000 Ed Dad PERSONAL &ADV INJURY $ 1,000,000 X Slankat contractual AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L Liability POLICY PRLOC PRODUCTS-COMPIOPAGG$ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea amident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 618-00-11-21-0001 4/1/2017 4/l/2018 BODILY INJURY(Peraccident) $ PROPERTY DAMAGE Peracd dent $ X NON-OVMED HIRED AUTOS X AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000 000 AGGREGATE $ 5,000,000 B EXCESS LIAB CLAIMS -MADE DEO RETENTION$ 1 ISF17EXC8406141C 4/1/2017 4/1/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORfPARTNERIEXECUTIVE PER OTH- STATUTE ER EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA E. L. DSHADE -EA EMPLOYEE $ (Mandatory In NH) Diyes describe under ESCRIPTION OF OPERATIONS below I EL DISEASE -POLICY LIMIT $ Rented/Leased Equipment 618-00-11-21-0001 4/1/2017 4/l/2018 UmibOed'.$500 $300,000 Scheduled Equip 618-00-11-21-0001 4/l/2017 4/1/2018 Ll.VDed:$500 $3,762,565 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) RE: A11 landscape operations performed by or on behalf of the named insured Primary Insurance/Non Contributory Blanket Additional insured per attached OBPGGLO�jLW1}�I & CG20010413 City of Santa Ana, it's officers, employees, agents and representatives (Exc-L d>i i`2rofessional Liability) are named as additional insured This revises certificate dated 2_01`7`,(, u��as�. City of Santa Ana Attn: Purchasing Department 20 Civic Center Plaza Santa Ana,, CA 92701 SHOULD ANY OF THE ABOVE DESIGNISEDPOLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Hall, CISR/KSAENZ '� �=_s.r-�.;1<z��-�•'_�eJ�-r'. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD I NS025 (201401)