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ACORQ® V CERTIFICATE OF LIABILITY INSURANCE t DATE (MMIDDIYYYY) 7/29/2024 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 Venbrook Insurance Services 6320 Canoga Avenue, 12th Floor Woodland Hills, CA 91367 NAME, Venbrook Insurance Services PHONE 818-598-8900 ac Ho: 818-598-8910 EWAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICN INSURERA: Alaska National Insurance Company 38733 www.venbrook.com CA Lic No. OD80832 INSURED Mariposa Landscapes, Inc. 6232 Santos Diaz St. INSURER B : NSURER C: INSURER D: Irwindale CA 91702 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: R11R7RR9 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYpE OEINSURANCE ADDL SUBR POLICY NUMBER MM/UD EFF MM/ODY/YYYY LIMITS COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GEN-L AGGREGATE LIMIT APPLIES PER: POLICY jEC1:1 LOC OTHER: GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ $ AUTOMOBILELIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accitlent $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYBAMAGE Per accitlen[ $ UMBRELLALMB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNERIEXECUTIVE YIN OFFICERIMEMBEREXCLUDEDy (Mandatory in NH) If yes, tlescdba under DESCRIPTION un OPERATIONS below NIA �/ 24D INS 12057 4/1/2024 4/1/2025 �/ STATUTE ERH E.L. EACH ACCIDENT $1000000 E.L. DISEASE -EAEMPLDYE $1 E.L. DISEASE -POLICY LIMIT $1 Goo 000 DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Water facilities, well sites and vacant lots throughout the city of Santa Ana Waiver of Subrogation applies to Workers Compensation. •10 Days Notice Of Cancellation for Non -Payment of Premium, 30 Days All Other SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Attn Purchasing Dept THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVEREn IN 20 Civic Center PIZ ACCORDANCE WITH THE POLICY PRC Santa Ana CA 92701-4058 Mti Risk MMtagemadDM6lun AUTHORGED REPRESENTATIVE . �ei REVIEWED&APPROVED BY: I I\ it AfAaV4011 Windy West ® Risk Management Specialist ©1988-2015 ACORD Of ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 81167869 1 24-25 WC - rr I Adziam,a Padilla 17/29/2024 11:5a:03 AN (Purl I page 1 of 2