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AL ®RQ� CERTIFICATE OF LIABILITY INSURANCE
<br />DATEi01h14 Y")
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />8/2 612 0 1 4
<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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terns 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 endorsements .
<br />PRODUCER
<br />CONTAC
<br />NAME:
<br />Arthur J. Gallagher f Co.
<br />Insurance Brokers of CA, Inc, LIC #0726293
<br />PHONE exo B5M2_33- �___ FAX N9)a58-- AB1.7953 —,__
<br />EMAIL
<br />10505 Sorrento Valley Rd, Suite 200
<br />San Diego CA 92121
<br />_ INSURER(S) AFFORDING COVERAGE _ _ NAIC#
<br />I.GENL AGGREGATE LIMIT APPLIES PER:
<br />INSURERA: atLolialFire.a.n�sUranCQt�Doft
<br />INSURED AZTEC -5
<br />INSURER B:CypreSs IPSUranceCompany _ -- X0655
<br />Aztec@ Landscape, Inc.
<br />INSURERC Golden Eagle. lnsuranic_e-GOrporation— 10536___....
<br />1027 E Acacia Street
<br />1 Al
<br />INSURER D
<br />Ontario CA 91761 ,q - A0 1,3-
<br />e°a
<br />BODILY INJURY (Per person)',-S
<br />AOWAIED '.SCHEDULED ".
<br />'AUTOS
<br />INSURER E:
<br />NON OWNED
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 3g7547RAAn 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
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRI ----- �A�DCSOBR. POLICV EFF POLICY EXP
<br />LTRI TYPE OF INSURANCE INSR D'' POLICY NOMRER MMIDOIYVW MMIDDIYYYY
<br />LIMITS
<br />A GENERAL LIABILITY I Y 6086590418 e/V2014 9/1/2015
<br />i EACH OCCURRE NCE %81,000000 -'-- - --
<br />DAMAGE TUKeNTFO
<br />'I^ COMMERCIAL GENERAL LIABILITY
<br />_
<br />:
<br />PRE IN SESEaocwdnce).,$100000
<br />T CLAIMS-MADE IX OCCUR !
<br />�MEDEXP (Any onepersonf X55,000
<br />PERSONAL&ADVINJURY 151,000,000
<br />GENERAL AGGREGATE 152,000,000
<br />I.GENL AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS- COMP/OP AGO $2,000,000
<br />�1. PRO. li
<br />._.
<br />POLICY : LOC
<br />$
<br />C AUTOMOBILE LIABILITY BAS926733 9!1/2014 0/112015
<br />_
<br />_ (Ea eccmentl I $1.000,000
<br />X ANY AUTO !
<br />BODILY INJURY (Per person)',-S
<br />AOWAIED '.SCHEDULED ".
<br />'AUTOS
<br />! BODILY INJURY (Par accident) $
<br />NON OWNED
<br />PROPERTY DAMAGE S
<br />HIRED AUTOS 'AUTOS "',
<br />'(Per accldenl)
<br />A
<br />i OCCUR 5086590399 9/1/2014 9/1/2015
<br />EACHOCCURRENCE $2,000,000
<br />I
<br />XESS LIAR CLAIMS -MADE
<br />UEDRI REBTENTIO
<br />AGGREGATE $
<br />IX X�
<br />N310,000
<br />': 5
<br />B WORKERS COMPENSATION 3300064036141 4/112014 4/1/2015
<br />1X WCSTATU- OTH.'
<br />AND EMPLOYERS' LIABILITY YIN :
<br />'TORY LIMITS ER. _.
<br />ANY PROPRIETORIPARTNERIEXECUTI /5
<br />EL. EACHACCIDENT $1,000,000
<br />OFFICERIMEMSER EXCLUDED? L NIA
<br />C....J
<br />- —
<br />'. (Mandatory In NH)
<br />F.1. DISEASE -EA EMPLOYEE S1,000,000
<br />If Yes. describe under
<br />' --- —___ --
<br />DESCRIPTION OP OPERATIONS helm,
<br />E.L. DISEASE - POLICY LIMIT $1,000,000
<br />I
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, if mere apace Ie requlrod)
<br />RE: Landscape maintenance services of District 4 City of Santa Ana; its officers, employees, agents,
<br />volunteers and representatives are
<br />included as additional insured as respects general liability per the attached form.
<br />Reviewed by:
<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 />Attn: Purchasing Department
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 yy
<br />f�•fu/ ©19882010 ACORD CORPORATION. All rights reserved.
<br />ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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