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AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
<br />12/22/2015
<br />THIS CERTIFICATE OS 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 pollcy(i'es) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms 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 endorsement(s).
<br />PRODUCER CONTACT Susan Dias --
<br />insurance Solutions
<br />License #0746539
<br />33302 Valle Rd, Suite 200
<br />San Tuan Capistrano CA 92675
<br />INSURED ,... -
<br />Professional Sports Field Maintenance Inc
<br />23 Emerald Gln
<br />4) (949)348-7400
<br />SusanD@ins-solutions.com
<br />INSURER(S),AFFORDING COVERAGE
<br />g:The Ohio Casualty. Insurance.
<br />B Allmerica Financial Benefit
<br />c -American Fire and Casualty
<br />INSURER E :
<br />Laguna Niguel CA 92677 INSURER F:
<br />COVERAGES CFRTIFICATF NtIMRFR^15-16 ALL RFVI:gIr)m NI IMRFP-
<br />(949)348-237'3
<br />NAIL
<br />24074
<br />0
<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 CONDFION OF ANY
<br />CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY
<br />THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL,
<br />THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN
<br />REDUCED BY PAID CLAIMS.
<br />--{ POLICY NUMBER_.-.....
<br />.ILTR '.. TYPE OF INSURANCE ADDL SUBR -
<br />.L......FOLICY EFF POLICY EXP ----.._._.... .. ...... .. .. ...
<br />MMfDDIYYYY MMIDDIYYYY LIMITS
<br />-..-
<br />CO
<br />X MMERCIAL GENERAL LIABILITY
<br />j
<br />EACH OCCURRENCE $
<br />..
<br />1,000,000
<br />A
<br />- —- % CLAIMS MADE, I OCCUR
<br />DAMAGE T® FtEN7Ed .... .....
<br />PREMISES (Ea occurrence) $
<br />..500, 000
<br />..,..,,,._,
<br />BKO57062484
<br />12/21/2015 12/21/2016 ME'DEXP(Anyoneperson) _ _$
<br />15,000
<br />PERSONAL& ADV INJURY S
<br />1,000,000
<br />--� _. ......,...
<br />GENT ATE iEC,r APF"LIE PER:
<br />LIMIT
<br />I ---
<br />GENERAL AGGREGATE j $
<br />_ ...,...
<br />2 000,0 00
<br />i ..
<br />I ..
<br />PQLOCY LOC
<br />....) L—_ -
<br />......
<br />PRO UCTS - COMP/OP AGG j $
<br />_ .-.......
<br />2 000 404
<br />r
<br />OTHiER,
<br />$
<br />. AUTOMOBILE LIABILITY
<br />I COMBINED SINGLE LIMIT
<br />(9a academy
<br />1,000,000
<br />` X ANY AUTO
<br />BODILY INJURY (Per person)
<br />8
<br />I
<br />� ALL C'w"JNED i SCHEDULED
<br />AUTOS �� AUTOS I AW3A377777
<br />AUTO
<br />NON -OWNED
<br />8/26/2015
<br />Iii' 'ODIL INJURY (Per accident) $
<br />8/26/'2016 BODIL
<br />P RTY DAMAGE
<br />AUTOS AUTOS
<br />uninsured mDIDTist combined i is
<br />300,000
<br />'....
<br />X UMBRELLA LIAR X OCCUR
<br />_,..._.
<br />,. EACH OCCURRENCE $
<br />2,000,000
<br />C
<br />uEXCESS LIAB CLAIMS MADE
<br />�'ESA56274048
<br />_
<br />Af,GREGATE�.,..... I $
<br />2, 000, 000
<br />..
<br />DED 1 RETENTIONS
<br />10/1f2015
<br />Y0f1/2016._. $
<br />WORKERS COMPENSATION1r
<br />PER OTH-
<br />ND EMPLOYERS` LIABILITY Y 1 N!
<br />�—
<br />ANY PROPRtlETORIPARTNERItECU1l'VE
<br />OFFICERJMEMBER EXCLUDED7 NfA!
<br />E' L. EACH ACCIDENT
<br />-..._ _.
<br />$
<br />1,000,000
<br />D
<br />+
<br />(Mandatory f 1.6207476-2015
<br />{
<br />2/26/2.015 2/26/201-6 E.L. DISEASE - EA EMPLOYED
<br />$...,,mm_.
<br />1 O00 040
<br />`,.....0
<br />If yes, describe under
<br />- ..
<br />-
<br />.......' . ...
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />1,000,000
<br />f 1
<br />yL �
<br />1
<br />DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES ACORD 101, Additional Remarks Schedule, may be attached if more is required) s
<br />( p ce
<br />The City Santa Ana, it's
<br />of officers, employees, agents,
<br />and representa are i ed as additional
<br />insured per the attached endorsement.
<br />w
<br />va '
<br />CERTIFICATE HOLDER
<br />(714)647-6944
<br />TION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City ,of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Attn : Purchasing Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, SCA 92701 AUTHORIZED REPRESENTATIVE
<br />`[' Alessandra/PETERS
<br />X31988-201'4 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />INS025 omnia
<br />
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