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Ac=s CERTIFICATE OF LIABILITY INSURANCE GATE (MM ODIYYYY) 9/12/2013 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 REPRESENTATIVE OR PRODUCER, INSURANCE DO ESj%NISLNSTI J TE,1 CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 _ NAME: ,1bodi HOIIOW 3.S. Levine Insurance .Services, Inc. PHONE FAX 10505 Sorrento Valley Rd. #200 Ei,1Nl - AIC No : - - ian Diego CA 92121 ADMEss:corieg @gslevi_ne.com INSURED Azteca Landscape, Inc. 1027 E Acacia Street Dntado CA 91761 INSURERS) AFFORDING COVERAGE INSURER A:Natlonal.Fire Insurance of Her AZTEC -5 INSURER B:CYpreSS.lns�lrance Company.__... INSURER C :Golden Eagle I_nsllrance. Corp. INSURER D: INSURER E : COVERAGES CERTIFICATE NUMBER: 1857727103 REVISION NUMBER: NAIC N 20478 10855 10836 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 ADD SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS LISLE WVDI POLICY NUMBER MMIODIYYYY DDIYYYY LIMITS A GENERAL LIABILITY IY';Y 15086590418 T; 2813''. /t1014 l" t. EACH OCCURRENCE $_1000000 X COMMERCIAL GENERAL LIABILITY `fr'r tact TDAMAGE T R� T PREMISES t3f! ��y-� -- (Ea occurrence) _$100000 _ /�y � CLAIMS -MADE X OCCUR Si" -JnL �es MED EXP(Any one Person) $5000 { PERSONAL& ADV INJURY $1000000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER. ASg15ta. \t C.(i 1 p,ttVrneY ._$2000000__ _ PRODUCTS - COMPIOP AGG $2,000,000 POLICY PRO- I LOD $ C 1 AUTOMOBILE LIABILITY Y BA8926736 6!1/2013 19/1/2014 (Ea accident) $1,000,000 X BODILY INJURY (Per person) ANY AUTO ALL OWNED I SCHEDULED 1 AUTOS 'AUTOS (Paramtlen[) $ NON-OWNED ',.. PROPERTY DA PROPERTY DAMAGE TS HIRED AUTOS AUTOS (Per accident) _ 1E A UMBRELLA LIAR X OCCUR 5086590399 9/1/2013 9/1/2014 EACH OCCURRENCE $2,000,000 EXCESS UAB CLAIMS-MADE 1 AGGREGATE 1$2000,000 DED 1X RETENTION S 10, 000 1 8 B WORKERS COMPENSATION 3300064036131 4/112013 1112014 'X WCSTATU 0TH ANO EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICER,MEMBER EXCLUDED? NIA I E L EACH ACCIDENT $1 000,000 (Mandatory in NH) ' E L DISEASE - EA EMPLOYEE( $1,000,000 If Yes, describe under DE SCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B mom spars is requireEl RE: Landscape maintenance services of District 4 City of Santa Ana; its officers, employees, agents, volunteers and representatives are included as additional insured as respects general liability per the attached form. CFRTIFICATF NM nFR CANCFI I ATION ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing Department 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 J . ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD