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, `" CERTIFICATE OF LIABILITY INSURANCE I��TE(M�"DDIY��;
<br />.... �/��/�016
<br />THIS CERTIFICATE IS VSSUED 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(ies) 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 endorsements)
<br />PRODUCER r•nxirnn
<br />Insurance Solutions
<br />License #0746539
<br />33302 V411e Rd, Suite 200
<br />San Juan Capistrano ggCA 92675
<br />INSURED
<br />Professional Sports Field Maintenance Inc
<br />23 Emerald Gln
<br />T Robin Holloway
<br />(949)348-7400
<br />FAX
<br />tl_.. - IXNC..Nai, (449).30.8-2373
<br />i:RobinH@ins-solutions.com
<br />INsURERIS AFFORDING COVERAGE NAEC k
<br />_
<br />asual
<br />B�lomericaCFinancial�Benefit company 24074
<br />_ _
<br />_ � .._�. � 41940
<br />ra can Fare and CaualtComlaanr 24066
<br />D : tate Cmmn Tn c 1:"w.rnA a .. �..
<br />J-91ina Niguel_.............-.. _
<br />'CA 92677 .. .—...�-.._
<br />INSURER F ;
<br />COVERAGES CERTIFICATE NUMBER:16-17 BA & f"TC renewal
<br />REVISION, NUMBER:
<br />� �A,, 'Qvv nriVt tsttly IbZ5uI=U IU CHL INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />IPIDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICAEE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSV .... -... -_.._. ..—., _.
<br />LTR TYPE OF INSURANCE --... Ak7DLSUi3R— _.._ ... ,.... - PbIICYEEF PL1LI'CYEXP ......._...�..._ ,... ._..--"'...,...— ._...._.....,.__.-__...
<br />IN MMlUDFYYYY MOLI'DYEX
<br />' :� COMMERCIAL GENERAL. LIABILITY D POLICY NUMBER #yy LIMITS
<br />EACHOGCURRENCE S.. 1,000,000
<br />A j CLAIMS -MAD- AMAGE TO ENTFO — _
<br />.. � �X OCCUR i 1
<br />PD RE MdSE5f_ocEunence_ E 500,000
<br />BKO57465702 10/1/2015 10/1/2016 MED EXP (Any ©ne perscsny 15,000
<br />PERSONAL & ADV INJURYF g 1 000, 000...
<br />p_.m m._ .... .. .
<br />GEh7`LAGGRLGATELIhd�ITAPfLpeSPER . GENERAL.AGGREGAT-E pS 2,.000,000...
<br />POLICY ,_.� RECJEC - J LONG
<br />- PRODUCTS' - COMPlfJPAaC $ 2,000,000
<br />�. __ _..
<br />AUTOMOBILE LIABILITY
<br />� ANY aIJ7G
<br />COMBINc.D SINGLE 1 IMIT I
<br />=a accoder 5 1,000,000
<br />� _..
<br />��
<br />B --
<br />ALj.OWNED '�_. .. 4 aCNiE'OLILED
<br />BODILY INJURY (Per person) $
<br />-_.- ...
<br />AUTOSAUTOS Aw3A377777
<br />N(7N-0'Wt'NED
<br />E3f26/2016 � 8/26/'2017 BODILY INJURY (Per accident) $
<br />H I'RPU AUTOS AUTOS
<br />Pera
<br />,.f�dernk
<br />I
<br />X. UMBRELLALIAB
<br />Y
<br />Uninsufed rraoltrrjst cnrnhinerl $ 3 00,000 '...
<br />_...,.- OCCUR
<br />C LIAR
<br />11
<br />EACH t7CCURRENC♦=• S ._-� 000, 000
<br />_. .._ ._ �.
<br />.—.._.._.-.-...,..� LAIPASMADE,
<br />1 - ...
<br />Y AGGRCGATE .._.-$ 2,000,0
<br />r.... ,.
<br />DFD RETEI"lTION $ ESA�57465702
<br />1
<br />_ _
<br />10/1,/'2015 1 10/1/2016 I
<br />WORKERS
<br />HERS COMPENSATION
<br />AND EMPLOYERS LIABILITY YIN
<br />.ANY PR(}PR9c7tD,RfPAR7NERJc.CECUTIVC
<br />S
<br />PER OTH
<br />STATUTE FR .._..
<br />D OFFtCeRIMEMRER 'XCLUDED� i _ .�:. N iA
<br />(Mandatory In
<br />E L. EACH ACCIDENT g , 000, 000
<br />..w_ .....� -, .. .__-._.._..
<br />and 16204176-.2016
<br />j If yes das<;nbe under
<br />2/26/261.6 2/26/2017 I ....._
<br />E L. P3dSEASE EA 1 000 000
<br />�0ESCRIP7Iph1 OF OPERATIONS ne9ow'
<br />'
<br />I
<br />E.L.OISIGASE-POLICYLIIMIT 5 1 000 000
<br />DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES 4ACORO 101, Additional Remarks Schedule, may be attached if more space is required)
<br />The City of Santa Ana, it's officers, employees, agents,
<br />insured per the attached endorsement.
<br />and representative are i. ed as additio
<br />q
<br />y �
<br />CFPTIr1(-ATI=` lurvr ncc7
<br />...
<br />(7141) 647-69'}4
<br />City of Santa Ana
<br />Attn: Purchasing Department:
<br />20 Civic Center .Plaza.
<br />Santa Ana, CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />v -�vrw,�ati.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of AC ZDvrcu lilltCYlitW I IIdN. All rlgflts reserved,
<br />I NS025 f?w am f
<br />
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