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HomeMy WebLinkAboutMIDORI GARDENS (PRIORITY LANDSCAPE SERVICES, LLC)City of Santa f a Clerk of the Council AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and all amendments (if any) are no longer in effect. Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. Is the agreement(s) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. Office Use Only City of Santa Ana 5. 02 c Clerk of the Council The agreement with No. A-Za DI was completed on \� �JI I l�1 and final payment has been made. (List all amendments. Use space below if needed.) Department: {'Q-(��'� I�C:tim'Lv\"" Phone/Ext.: �v Signature: Date: 7 13G1 L Revised: 10-18-16 A-2017-215-02 INSURANCE NOT ON FILE WORK MAY -0T PROCEED MAYOR CLERK OF COUNCIL Miguel MAYOR PRO TEM DATE, APR 0 4 2019 Juan Villages COUNCILMEMBERS CeciliDavid Iglesias David Penaloza Roman Rayne Vicente Sarmiento S 11Vt,q, C,K4Uw� Jose Salado CITY OF SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICES AGENCY 20 Civic Center Plaza M-23 • P.O. Box 1988 Santa Ana, California 92702 www.sante-ana.om January 28, 2019 Priority Landscape Services, LLC Attn: Simon C. Rocha, President 521 Mercury Lane Brea, CA 92821 CITY MANAGER Raul Godinez II CITY ATTORNEY Sonia R. Carvalho ACTING CLERK OF THE COUNCIL Norma Mitre -Ramirez Re: Second Extension of Contractor Agreement No. A-2017-215 to provide landscape maintenance services for District 1 Dear Mr. Rocha: Pursuant to your office's letter of September 1, 2018, wherein Priority Landscape Services, LLC, notified the City that it had acquired Midori Gardens, Inc. and pursuant to Section 3 ("Term") of Agreement No. A-2017-215, entered into by Midori Gardens, Inc., and the City of Santa Ana, dated August 15, 2017, the time period of the Agreement is hereby extended for an additional one (1) year period, from February 1, 2019 to January 31, 2020, The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. Sin�rel\ 1 LkaXudloff Executive Director Parks, Recreation, and Community Services Agency CITY OF SANTA ANA �n STEVEN MENDOZA ACTING CITY MANAGER APPROVED AS TO FORM A'�� Laura A. Rossini Senior Assistant City Attorney PRIORITY LANDSCAPE SERVICES, LLC B Simon C. Rocha . Title: President 4e Norma. Mitre Acting Clerk of Council SANTA ANA CITY COUNCIL Miguel A. Pulido Juan Villages Meenle 5armienlo David Penaloza Joe. Somme Roman Rayne cedlla Iglesias Mayor Mayor Pro Tom, Word 5 Ward1 Ward2 Ward Ward4 Wards mvulidonlemia-anaory IAleoas0santa-anaer yaarmiento(ersanta-ane 0m dvenalozalDsenlaanaom IsoJorlo0santa-ma.ora nevnafusanfa-ana vm Gialasiasfvlsanta-ana.ara /"R/OJT'/TY LANDSCAPE SERV2CE5, LLC. March 14, 2019 Mr. Mike V. Lopez City of Santa Ana — Park Services Re: Termination of Agreement for District # 1 and District # A Dear Mike, Priority Landscape Services, LLC. 521 Mercury Lane, Brea, CA 92821 Phone (714) 255-2940 Fax (714) 255-2952 This letter is a follow up to our phone conversation on 3/8/2019 about Priority Landscape Services, LLC not being able to continue/extend the above agreements for an additional year. As I mentioned to you on the phone Priority will stay on the job on a month to month basis until June 301h or before as the City of Santa Ana finalizes the request for proposal (RFP) process. We appreciate your understanding and we look forward to the new RFP. I am signing the Second extension of the contract agreement No. A-2017-215 so we can get our invoices process and with the understanding that Priority be staying on until your RFP process is completed. Again, thank you for the opportunity you have provided our company and hope we can continue to earn your trust. Sincerely, e"M Simon C Rocha President Visit us on-line at: http://www prioritylcitidsccipingservices.com/ nn,nm c /i°4L.JCl:�•� 7' r nlvn a (]P I,Q:,,y �... - CERTIFICATE OF LIABILITY INSURANCE I DATEIMfUDDNyyy) ..._II 00f13f2018 THIS CERTIFICATE 13 ISSUED qS 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED prOVISIOns or be endorsed. If ROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement this cortiticato does not confer rl hta to the certificate holder In IIeU of such endorsements . on PRODUCER 951.290.5040 r cr gill Frederick ISU Ins. Svc: Cormare Tiernan .r _...._.....-..._,.�..._.__[. License#OE63467 PH Nb"E . ...... . 0HancockAve.#200 N., Set: 0.5040 851-278.0664 Mu"1B, CA 02562 .._.... ..___. Bill Frederick __•u_,C__N_o.._._.._ __.. _._ 9iSV..RF,g13l.9pentigiNQ.gavegapg. . -"'------- ,,ILRfa,n Financial Pacific Ins Co AXI 31453 INSURED Priority Landscape Services "—-- -'--- r''� LLD `(,}[�i 1 �,[7 `"• 4J INSURER6 Capitol Indemnity Corp A, IX $25 S Mercurryy Lane NSURER Brea, CA 92821 ft-&-O t(s- is-i-Ci INSURER E INB RE F: NUMBER;_ THIS INDICATED, LISTED BELOW HAVE BEEN TERM OR CONDITION OF 8EVISION NUMBER-. -CERTIFICATE IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, OF INSURANCE ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CERTIFICATE EXCLUSIONS MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH PERTAIN, POLICIES, ANY THE INSURANCE AFFORDED BY LIMITS CONTRACT THE POLICIES OR OTHER DESCRIBED DOCUMENT WITH RESPECT HEREIN IS SUBJECT TO TO WHICH THIS ALL THE INSN.._..._...._...._.-........_..�_ ................_ _ SHOWN MAY HAVE BEEN � � REDUCED SY PAID CLAIMS. TERMS, A TYPE OFINBURANCE X COMMERCIAL A40L SUB "--'------ POLICY" UMBBN POLI Y EPF --- CY POL XP � �'......_.....___...__.. LIMITS ------,----_-..-----,_ �.• GENERAL .....,. _ calMs-MnoE X�OCCUR y 60503512 _Eai%J99UgRE.N__. 1000,000 ...-'"-14---' -•• 04121/2018 04/2112019 DA�'FroRENTED 90tl,b00 -06 ._----....�___._. ---- _MEq_Exg. Ana on. ,, 61000 ...., ,,,_,,,.._. fNL AOGRErOQTIE LIgqM��IT AP��P�IE7S PER' Pg68QNAi;,e NOVINJtIRY 1 1 OOtl,000 --___ X POLICY t,__J JECT L—j LOC 9E.?A_LAO�fj,�„0(1,jP,-„_...... j.. 2 000,000 I.. ?I5.4tw.Tss agmP., PA G � — AUTOMOBILE LIABILITY COMDINEOSINOLILIMIT ANYAUTD -ifitlAGGtlOOU..,__..,..,..,,„„-„•,_ .E_..______....�_ _ OMOWNEpp 3CHEOULED _ ONLY AUTOpSW _NfJ411AY�NAURY Fp _. AUTOS ONLY NbNNSONLY .— AU Ta N 8.On�QIJ.V INT,(UpRAYJPar (pd„�aRifayr,� AMAGE g UMBRELLA LIAR OCCUR _ X excess uAa CLAIMS -MADE XS18000406448622 04/29/2018 0412112019 . EngH_gt;,cuRReegE _ 1 $1000,000 OED RETENTION AQQgF s 5,000,Q00 "OR SRSC%PENSATIpN AND EMPLOYERS' LIABILITY ANYPRCPRIETORIP RTN RIEXECUTIVE N qq pp OEFICLRIMEHREXCLUOED? and Me MIA PER O1H- —.. 6TATOTE_Ir_.....ER" ......_.._.._..__..___.._... ( n rr�BI�9) If as 0,sr mUnder TI N F P R TI 4 Ei, DISEASE-FA@ElP — LQ,.� E. D LMYLIMIT 1._._.........__.___.___-_... DESCRIPTION OF OPEMTIONIII LOCATIONS /VEHICLES (ACORO 101. AedIllaMi Remark. Schelde, maybe aMtebod If mom apace I. NequHad) The CiI of Santa Ana, It's Officers, Employees, Agents, and Reppresentative are included as additional insured to General Liability per farm CG201OR A 1211. -, �l a5 -QERTIFi AT HOLDER _...__.. _._.. ..' SHOULD ANY OF THE ABOVE DESCRI1i0 POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS, 20 Civic Center plaza Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ACORD 26 (2016103) ®1988-2018 ACORD CORPORATION. en w n, wnv marne and logo are registered marks of ACORD A� ar CERTIFICATE OF LIABILITY INSURANCE D 1E90�2 19 TEIAIDDIYYYY) 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subjectto 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 01211 :CT LarrY Draper Colony West Financial Insurance Services License # OC42920 pHCNNo Est: (714)542-4870 qjC No: Innl saz-aan EMAIL ADDRESS: ldraper@colony-west.com 201 East Sandpointe Dr #360 INSURERIS AFFORDING COVERAGE NAICIf INSURERA: Ore on Mutual Insurance Company 14907 Santa Ana CA 92707 INSURED INSURER B : Priority Landscape Services, LLC INSURER C: 521 Mercury Lane INSURER D: INSURER E Brea CA 92821-4831 1 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1810323940 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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 OF INSURANCE ADDL SUBR POUCYNUMBER POLICY EFF MMIDO/YYYY POLICY EXP MMIOD/YYYV LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 71 OCCUR -RENTED PREMISES PREMISES (ER occurrence) (ER occurrence) $ MED ENE (Any one person) $ PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ PRO- ❑ POLICY JECT LOC PRODUCTS - COMP/OP AGO $ $ OTHER', AUTOMOBILE LIABILITY COMB NED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANYAUTO BODILY INJURY Pdent (Per acci) $ ALL OWNED SCHEDULED AUTOS AUTOS CM0919473 30/3/201E 10/3/2019 NON -OWNED HIRED AUTOS M AUTOS X PROPERTY DAMAGE Per accident) $ X Medical payments $ 5,000 UM UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER E. L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatorym NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remark, Schedule, may be attached if more space Is required) yI WNI`� C�\� City of Santa Ana. Parks, Recreation Community Services Agency 20 Civic Center Plaza M-23 P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Draper/LARRY tTION. All rir ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) ATE IM CERTIFICATE OF LIABILITY INSURANCE DOB/MIDGIYPYY)74/iB THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO CONFBRS Nq RIGHTS UPtlN THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, Fa(TEND OR ALtER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER; AND THE CERTIFICATE HOLDER. IMPORTANT: It the certi}Icate holder Is an ADDITIONAL INSUREp, the policy(ies) must have ADDITIONAL INSURED provisions or he endorsatl. If SUBROGATION IS WAIVED, subJect t0 the terms and conditions of the policy, certain policies may require an endorsement. A statement on this cortlficate does not confer ri hts to the certificate nemnr I„ ue„ „r e,.w ,....,_._____..., Miami, FL ADP TotaISoume FL XVIIi, Inc. 102 Sunset Once Miami, FL 33173 LIGF PEonty Landscape Services LLC 521 Ms., Ln 'E MAY BE ISSUEOF D OR VMAYePERTAIN. THE EN RM OR URANCENAFIFORDED 'SAND CONDITIONS OF SUCH PgLiCIEa. LIMITS SHOWN MAY HAVE BE TYPE OR INSURANCE ADOL SUER INSR NND POLICY NUMBER SRGIAL GENERAL VABnITY I I 41MS-MADE ❑ OCCUR 'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PROJECT F-1LOC OTHER__ OMOBILE LIABILITY AUTOS ONLY AUT03 UMBRELLA UAB OCCUR A All CHYOFSANTAANA 20 CIVIC CENTER PLAZA SANTA ANA, CA 92701 ACORD 25 (2016103) WC 047019003 CA I 0710111E I 07701Ag SHOULD ANY OF THE ABOVE DESCRIBED THE EXPIRATION DATE THEREOF, N ACCORDANCE WITH THE POLICY PROWEIII AUTHORIZED REPRESENTATIVE pioer, p�isk(Tiatvtce The ACORD name and logo are regtstered ma ks of ACORD RD CO PELT TO WHI ' TO ALL THE I ARE AS REOI LIMITS M IN POLICY NUMBER:60503512 CG 2010R 1211 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERATIONS COVERAGE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART BUSINESSOWNERS COVERAGE FORM PREMIUM Incl SCHEDULE NAME �F pryr$p'r't3R ORGAi\! Any person or organization to whom or to which the named insured is obligated by a virtue of a written contract to provide insurance that is afforded by this policy. Where required by contract, the officers, officials, employees, directors, subsidiaries, partners, successors, Parents, divisions, architects, surveyors and engineers are included as additional Insureds, All other entities, including but not limited to agents, volunteers, servants, members and partnerships are included as additional Insureds, If required by contract, only when acting within the course and scope of their duties controlled and supervised by the primary (first) additional insured. If an Owner Controlled Insurance Program Is Involved, the coverage applies to off - site operations only. If the purpose of this endorsement is for bid purposes only, then no coverage applies. WHO IS AN INm tRM (Section II) This section is amended 10 include as an insured the person or organization within the Scope of the qualifying language above, but only to the extent that the person or organization is held liable for your acts or omissions in the course of "your work" for that person or organization by or for you. The "products. completed operations hazard" portion of the policy coverage as respects the additional insured does not apply to any work involving or related to properties intended for residential or habitational occupancy (other than apartments). This clause does not affect the "products - completed operatlons" coverage provided to the named insured(s). WAIUER OP SUBROr3AT1ON We waive any right of recovery, when required by written contract, that we may have against the person or organization within the scope of CG 2010R 12 11 the qualifying language above because of Payments we make for injury. LOCATION OF JOB The job locat!on must be within the State of domicile of the named insured, or within any contiguous State thereto, _DESCRIPTION OF WORK The type of work performed must be that as described under classifications In the CGL Cavern a Part Declarations. PRlMARY'C A `5 When 'this 'endorsement applies and when required by written contract, such Insurance as Is afforded by the general liability policy is primary Insurance and other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement, EXCLUSION This insurance provided to the additional Insured does not apply to "bodily injury", "property damage" or 'personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering or failure to render any Professional services, including: 1. The preparing, approving, or failing to prepare or approve, maps, designs, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and 2. Supervisory spection, architectural or SEE DEC Endorsement "J Fi tOQd j� - SEE DEC s� �" Includes copyrighted material of Insurance Servloes Page 1 of 1 PRIOR-5 OF IDJS DA04/19/2019Y) 04/19/2019 ACORO' CERTIFICATE OF LIABILITY INSURANCE 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 INSURER(S), 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 endorsements . PRODUCER 951-290-5040 ISU Ins. Svc. Cormarc Tasman License# OE63467 25220 Hancock Ave. #200 Murrieta, CA 92562 cpNTACT Bill Frederick `NBME;.— - - - - II PHONE EatJ:951-290.5040 FAX Ne).951-278.0664 E-MAIL - AD REss: INSURER LSJ AFFORDING COVERAGE NAIC# Bill Frederick _ INSURER A: Financial Pacific Ins. Co.,AXI 31453 Fr URED ✓� _�O-�� I�—y/' INSURERS, Capitol Indemnity Corp, A, IX n(((8rity Landscape Services rr tt INSURERC: _ J21Mercury LaneLL Brea, CA 92821 OI tv 4�1 - D1 'INSURER D: INSURER E: INSURER F : COVFRAGFS CFRTIFICATF NIIMRFR• RFVLCInM NI IIVIRFR- 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 rypE OF INSURANCE ADDL WDR POLICY NUMBER POLICY EFF POLICY E%P Yyy LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR 60503512 04I21I2019 04/21/2020 X DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 $ 5,000 M ED EXP LAny one pemom $ 1,000,000 __- PERSONAL B ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIM IT APPLIES PER: GE NERAL AGGREGATE X POLICY ',J JEET L- LOC PRODUCTS - COMP/OP AGO $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accitlem $. ANY AUTO OWNED (SCHEDULED BODILY INJURY Per arson $ AUTEEO��S ONLY —!AUTOS BODILY INJURY Per aaiaem $ AUTOS �I gUTOS ONED P�20PERdYtDAMAGE $ ONLY B _ UMBRELLALIAB OCCUR EACH OCCURRENCE_ 5,000,000 X EXCESS LIAB 'CLAIMS -MADE XS18000406-01-746522 04/21/2019 04/21/2020 �DED _$ AGGREGATE $ 5,000,000 I I RETENTION$ $ i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER OTH- 'STATUTE ER Y / N �AAOFFICERPRIETgORqIEXCLUDED?ECUTIVE - NIA E L. EACH ACCIDENT _ _$_ (Mantlatory In NH) - E.L. DISEASE - EA EMPLOYEE $ If yes, tlescbbe untler DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aMchetl if more space Is requinun The City of Santa Ana, It's Officers, Employees, Agents, and Representative are included as additional insured to General Liability per form CG201 OR 1211. Eby 1 City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED Q, I 'BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N E WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC(:>Ro® CERTIFICATE OF LIABILITY INSURANCE F GAl/JMM1DD119Y) 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 endomement(s). PRODUCER CONTACTLai Dig NAME: Larry per Colony West Financial Insurance Services PHONES (714)542-4870 FAX No: 01USU-e71 License li OC42420 EMAfL ADDRESS: P Y ldra Br@Colon Me9t.COID 201 East Sandpoints Dr X360 INSURERS AFFORDING COVERAGE NAIC9 INSURER A: Ore On Mutual Insurance Compary 14907 Santa Ana CA 92707 INSURED INSURER B: Priority Landscape Services, LLC INSURER C: 521 Mercury Lane INSURER O: INSURER E: INSURER F: Brea CA 92821-4831 COVERAGES CERTIFICATE NUMBER: CLIS10323940 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 OF ADDL BUBR POLICY NUMBER POLICY EFF MM/00/YYYY POLICY EXP MMIDONYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES adccurm $ MED EXP (My one pwaM ) 3 PERSONAL aADV INJURY 5 LIMITAPPUES PER: GENERALAGGREGATE S GEN'LAGGREGATE ❑PRO- ❑ POLICY ECT LOC PRODUCTS-COMPIOPAGG IS 5 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT E,a x ide 5 1,000,000 BODILY INJURY (Par pxson) $ A X ANY AUTO ALL OWNED AUTOSSCHEDIED AUTOS AUTOS CHO919473 10/3/2018 10/3/2019 BODILY INJURY (Pm amld") 3 X HIREDAUTOS x NON-OYYNED AUTOS PROPERTY DAMAGE Pe acad S R Medlin PaYn $ 5,000 UM UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 AGGREGATE $ EXCESS LIAB C ZMAOE DED I I RETENTION 5 $ WORHERSCOMPENSATION PER OTH- ANDEMPLOYERVLIABILITY YIN T R EL EACH ACCIDENT 5 ANYCERIMEETORIPARTNDED' THE OFFIOERIMEMBEI EXCWOfp7 ❑NIA EL DISEASE -EA EMPLOYEE 3 IM90drt9ry In NH) M. E.L. DISEASE-PoLICV LIMIT S IPTION DESCRIPTION FO DESCRIPTION OF OPERATIONSbdox DESORIPnONOFOPERATICNSILOGATIONSIVEHICLES(ACORD 101, Addilioml RIMA&S SchedUle. may beamahed if mom spa �G5 P City of Santa Ana. Parks, Recreation Community Services Agency 20 Civic Center Plaza M-23 P.O. Box 1988 Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEO REPRESENTATIVE Draper/LARRY FM ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 po14o1) "u a' CERTIFICATE OF LIABILITY INSURANCE DATE 1W, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATO IN ONLY AND IF ''AD 4",RS 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the 11 11c11,11 '' must have ADDITIONAL INSURED provisions or be stat PRendorsed. It SUBROGATION IS WAIVED, subJecl to the terms and conditions of the Policy, certain Policies may require an endorsement A ement on this certificate does not confer rights hts to the certiRcate holder In Ileu of such entlanement s . ODUCER APn R.k SON"$, Inc PI FIMpa CONTACT 1001 S.ke. Bay D. Suite p11W NAME: ADD Risk Service.. Ilse of Fbnde Palau" FL XNII. IN Z.ON` FL.91]D LxMPrepe Semca. LLC 'MCATE MAY BE ISSUED OR ,! SION$ ANO CONDI TIONS OF TYPEOF INSURANCE COMMERCIAL GENERAL LIABILITY ] CLAIMS MAOE .00CUR 'L AGGREGATE LIMIT APPLIES PER. POLICY ❑ PROJECT ❑ LOC OTHER DMOBILE LIABILITY ONLY OCCUR A wuksre Nnpbyez. wnon9 CITY OF SAWA ANA W CIVIC CENTER PI SANTA ANA, CA Wnj TERM OR CONDITION OF AN, i INSURANCE AFFORDED BY IITS SHOWN MAY HAVE BEEN 1 POLCYNUMBER INC U7019003 CA 074111a 1 07/01/19 HEREIN SHOULD ANY OF THE ABOVE DESCRIBED THE EXPIRATION DATE THEREOF, NI ACCORDANCE WITH THE POLICY PROVNdi AUTHORREDREPRESENTATNE ACORD 25 (2016103) The ACORD name and 1090 are registeredIS) 1988-2015 ACC marks of ACORD IECT TO WHICH THIS TO ALL THE TERMS. ARE AS REQUESTED LIMITS IN POLICY NUMBER:6D5o3512 CG 2010R 1211 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERATIONS COVERAGE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART BUSINESSOWNERS COVERAGE FORM PREMIUM Incl SCHEDULE NAM_ EOFpIRygONOROR�t�n„�T Any person or organization or to which the named insured Is obligated by a virtue of a written contract to provide Insurance that is afforded by this policy. Where required by contract, the officers, officials, employees, directors, subsidiaries, partners, successors, parents, divisions, architects, surveyors and engineers are included as additional insureds. All other entities, including but not limited to agents, volunteers, servants, members and partnerships are Included as additional Insureds, If required by contract, only when acting within the course and scope of their duties controlled and supervised by the primary (first) additional insured. If an Owner Controlled Insurance Program Is involved, the coverage applies to off - site operations only. If the purpose of this endorsement is for bid purposes only, then no coverage applies. WHO IS AN INSURED (Section II) This section is amended to include as an insured the person or organization within the scope of the qualifying language above, but only to the extent that the person or organization is held liable for your acts or omissions in the course of 'your work' for that person or organization by or for you. The 'products. completed operations hazard" portion of the Policy coverage as respects the additional Insured does not apply to any work involving or related to properties intended for residential or habitational occupancy (other than apartments). This clause does not affect the ^products - completed operations" coverage provided to the named Insured(s). the qualifying language above because of Payments we make for Injury. LOCATION OF JOB: The job location must be within the State of domicile of the named insured, or within any contiguous State thereto, DESCRIPTION OF WORK: The type of work performed must be that as described under classifications In the CGL Covers a Part Declarations. PRIMARY C a tg •' When this endorsement applies and when required by vrtitten contract, such Insurance as Is afforded by the general liability policy Is Primary insurance and other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. EXCLUSION This insurance provided to the additional insured does not apply to 'bodily injury", 'property damage' or 'personal and advertising injury - arising out of an architect's, engineer's or surveyor's rendering or failure to render any professional services, Including: 1. The preparing, approving, or failing to prepare or approve, maps, designs, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and 2. SupervisoN ifspection, architectural or WAff&ZA&R0GATI0N end We waive any right of recovery, when required Endorser by written contract, that we may have against the person or organization within the scope of Endorsement CG 20 IOR 12 11 Includes copyrighted material of Inswance Services Ofitce. SEE DEC SEE DEC Page 1 of 1 A`oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/19/2019 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 INSURER(S), 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 1S 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 endorsements . PRODUCER CONTAISU Insurance Services Cormarc Tasman NAME.. iT NAME: $Urlltha Jana 25220 Hancock Ave, Suite 200 PHONE 951)290-5040 FPn :]; {951)278-0884 Murrieta, CA 92562 pooAl saLsw _tbagIncormarc.com License #: OE63467 NSUREfgSSJAFFORDING COVERAGE NAIC0 _IINSUkRRA:_ Fb n-cial Pacific l,rls C-o,,M INSURED INSURERB: Capitol Indemnity COrD_A,,lx_ 10472 _ PRIORITY LANDSCAPE SERVICES, LLC INSURERC: 521 MERCURY LANE INSURER D: BREA, CA 92821 INSURER E: INSURER F : COVERAGES CFRTIFICATF KIIIMRFR• rfhfl HrVirift_A4dliR o�Lnetn\I sn teen co. 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. 1N SR TYPE OF INSURANCE ADOL SUBR' POLICY POLICY.EXP LTR so-yyY POLICY NUMBER IMMJD_D1YYYY1 tMpowyYyY1 LIMITS A X COMMERCIAL GENERAL LIABILITY Y 60503512 04/21/2019 04/21/2020 EACH OCCURRENCE $ 1,000,000 _ — CLAIMS -MADE LDAWA�NT� � OCCUR PREMISES LEa oc=oncel$ 100,000 MED EXP tAny one person) $ 5 000 _ PERSONAL & ADV INJURY $ 1,000,000 _ G_EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 O00 }[ POLICY ! JECT n LOC — PRODUCTS -COMP/OP AGG $ 2,000 OOO — OTtim $ AUTOMOBILE LIABILITY COMBINED MINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ OWNED 1 AUTOS ONLY AUTOS SCHEDULED _� BODILY INJURY Per accident) $ HIRED NON -OWNED AUTOS ONLY _— AUTOS ONLY $ 'ryylppER-ry DAMAGE (pqf aEgfypn $ B UMBRELLA LIAB OCCUR XS18000406-01-746522 04/21/2019 04/21/2020 EACHOCCURRENCE S 5,00000 AGGREGATE $ 5,000,000 EXCESS LIAB _ CLAIMS -MADE $ DED I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PXCLUOE/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA. PER OT - ER $ — _..STATUTE, E.L. EACH ACCIDENT _-E,L DISEASE - EA EMPLOYEE --' E.L. DISEASE - POLICY LIMIT (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below $ 'S DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, Its officers, agents and employees, Risk Management are included as additional insured to General Liability, such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory per form CG201 OR1211. "Except 10 day notice for non-payment of premium/ 30 days for all other reason. REVIEWED & APPROVED By RISK MANAGEMENT DIVISION %,r-m I IrILA 1 C rIVLLJr_K C.AtYL:CLLA 1IUR 242019 S LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management DivisiorRANCI E R. VILLAR A CCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, 4th loor SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE J <jC�+L�l (SUN) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by SUN on September 19, 2019 at 07:46AM POLICY NUMBER:60503512 CG 20 10R 12 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (WITH LIMITED COMPLETED OPERATIONS COVERAGE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PREMIUM Incl BUSINESSOWNERS COVERAGE FORM SCHEDULE NAME OF PER,9QN OR ORGANIZAIIQN Any person or organization to whom or to which the named insured is obligated by a virtue of a written contract to provide insurance that is afforded by this policy. Where required by contract, the officers, officials, employees, directors, subsidiaries, partners, successors, parents, divisions, architects, surveyors and engineers are included as additional insureds. All other entities, including but not limited to agents, volunteers, servants, members and partnerships are Included as additional Insureds, if required by contract, only when acting within the course and scope of their duties controlled and supervised by the primary (first) additional insured. If an Owner Controlled Insurance Program is Involved, the coverage applies to off - site operations only. If the purpose of this endorsement is for bid purposes only, then no coverage applies. WHO IS AN INSURED: (Section II) This section Is amended to include as an insured the person or organization within the scope of the qualifying language above, but only to the extent that the person or organization is held liable for your acts or omissions in the course of "your work" for that person or organization by or for you. The "products - completed operations hazard" portion of the policy coverage as respects the additional insured does not apply to any work involving or related to properties intended for residential or habltatlonal occupancy (other than apartments). This clause does not affect the "products - completed operations" coverage provided to the named insured(s), WAIVER OF SUBROGATION: the qualifying language above because of payments we make for injury. LOCATION OF JOB: The job location must be within the State of domicile of the named insured, or within any contiguous State thereto. DESCRIPTION OF WORK: The type of work performed must be that as described under classifications in the CGL Coveracie Part Declarations, PRIMARY CLAUSE: When this endorsement applies and when required by written contract, such insurance as is afforded by the general liability policy is primary insurance and other insurance shall be excess and shall not contribute to the insurance afforded by this endorsement. EXCLUSION This insurance provided to the additional insured does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of an architect's, engineer's or surveyor's rendering or failure to render any professional services, including: 1. The preparing, approving, or failing to prepare or approve, maps, designs, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. We waive any right of recove�w,# r g Vit ridorsement EFFECTIVE DATE: SEE DEC by written contract, that wei�PROVE.1the erson or or anization I �"INT Divisio�ndorsement EXPIRATIONDATE:SEE DEC p g CG 20 1011 12 11 Includes copyrightedSODrIg4Ir Bice Services Office, Inc., with its permission Page 1 of 1 "kq M&Dt� FRANCINE R. VILIAREAL '4k R�r CERTIFICATE OF LIABILITY INSURANCE TE (MMIDDNYY DA9/9/2019Y1 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 NAMEArONTCT :Certificates Dept. Colony West Financial Insurance Services P°IgNe (714 542-9870 FjX (714I 542-4B71 Ali NO : License # OC42420 E'MAL Certificates@colony-west.com ADDREsa; INSURERS AFFORDING COVERAGE NAIC # 201 East Sandpointe Dr #360 INSURERA:Ore on Mutual Insurance Company 14907 Santa Ana CA 92707 INSURED INSURER B INSURER C: Priority Landscape Services, LLC INSURER D: 521 Mercury Lane INSURER E : _ INSURER F: Brea CA 92821-4831 COVERAGES CERTIFICATE NLIMRFR-CLIB10323940 RFVISIr)N NIIMRFR• 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. 1NSR R TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMI➢D/YYYY POLICY EXP OIY M ❑YY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑OCCUR $ _ 11 MAGETO RENTED PREMISES [ e MED EXP (Any one pe son $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GEN ERAL AGGREGATE $ POLICY ❑ PRO- JECT LOC ❑ PRODUCTS - COMP/OP AGG $ $ - OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE"- LIMIT dnnl $ 1,000,000 X BODILY INJURY (Per person) $ A ANYAUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS X CM0919473 10/3/2018 10/3/2019 $ X PRdPEJ1tY DAMAQF Per acddent _ $ NON -OWNED HIREDAUTOS N AUTOS X Medical payments $ 5,000 UM UMBRELLA LIAB H. OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAR CLAIMS -MADE $ DED RETENTION $ WORKERS COMPENSATION PL-R OIH- AND EMPLOYERS' LIABILITY Y / N _ E — ANYPROPRIETOR/PARTNER/EXECUTIVE E.L, EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A E.L. DISEASE - EA EMPLOYEE (Mandatory In NH) $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) 30 Day Notice of Cancellation City of Santa Ana, Its officers, agents and employees, Risk Management are included as additional insureds with regards to Business Auto Policy per attached endorsement form. REVIEWED & APPROVED CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Divisi 20 Civic Center Plaza 4th floor Santa Ana, CA 92702 EP2 4 2019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. RANCINE R. VILLAREAL AUTHORIZED REPRESENTATIVE Larry Draper/LARRY © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) ACOPRD CERTIFICATE OF LIABILITY INSURANCE DATE 08/23/19 1 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 INSURER(S), 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 Aon Risk Services, Inc of Florida 1001 Brickell Bay Drive, Suite 91100 Miami, FL 33131-4937 CONTACT NAME: Aon Risk Services. Inc of Florida PHONE FAX Ara No. o Ex1 : 800-743-813U A!C No : 800-522-7514 EMAI ADDRESS: ADP.COI.Conter Aon.corn INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American Home Assurance Co. 19380 INSURED ADP TolalSource FL XVIII, Inc. INSURER B INSURER C 10200 Sunset Drive Miami, FL 33173 INSURER D L/C/F Priority Landscape Services LLC 521 Mercury Ln INSURER E INSURER F : Brea, CA 92821 COVERAGES CERTIFICATE NUMBER: 2609967 RFVI.RinN Nl1MRFR- 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, LIMITS SHOWN ARE AS REQUESTED INSS LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIVYYY POLICY EXP MM/DDIYVYV LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one porsor $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPUES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ POLICY D PROJECT LOC $ OTHER AUTOMOBILE LIABILITY COMB3NE0 SINGLE LIMIT Ea acarlenl 5 BODILY INJURY Par orson $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 130DILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Por accident $ 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DEC J I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC 080376966 CA 07/01/19 07/01/20 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 ANY PROP RI ETOR/PARTN ER/EXEC UIIVE OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory In NH) If yes, describe under E L DISEASE - POLICY LIMIT S 2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) See attached Certificate Holder Cancellation Notice. All worksile employees working for PRIORITY LANDSCAPE SERVICES LLC, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. CERTIFICATE HOLDER 10:VILWCL1 HIT-F1%%JTI__ CANCELLATION City of Santa Ana Risk Management Division { (� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza, 4th Floor 1&i�. ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92702 FRANCINE R. VILLAREAL AUTHORIZED REPRESENTATIVE ort &AA (fe-tvieea, Qnn of c7rlo�tida © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY HOLDER NOTICE CERTIFICATE HOLDER CANCELLATION NOTICE SCHEDULE Should this policy be cancelled before the expiration date hereof, the producer will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to do so shall impose no obligation or liability of any kind upon the insurer, the producer, or the respective agents or representatives of each. SCHEDULE: CERTIFICATE HOLDERS AS IDENTIFIED ON THE MOST RECENT QUARTERLY SCHEDULE OF CERTIFICATE HOLDERS PROVIDED BY THE INSURED'S BROKER OF RECORD TO THE INSURER. REVIEWED & APPROVED By RISk MANAGEMENT DIVISION �V SEP 4 2019 FRANCINE R. VILLAREAL a PMff9VM■'ArV September 23, 2019 City of Santa Ana Risk Management 20 Civic Center Plaza Santa Ana, CA 92701 Re: Professional Liability To Whom It May Concern: PRIORITY LANDSCAPE SERVICES, LLC 521 MERCURY LANE BREA, CA 92821 T (877) 508-0770 F (714) 255-2940 Itt�: ..:.w,;;r:o,tyscrvic�, retJlaridscapirtg 4.ernce=. Priority Landscape Services, LLC will not be hiring professionals or consultants to complete any work under this contract. Therefore, we are not required to provide Professional Liability (errors & omissions). If you have any additional questions, please do not hesitate to give me a call at the number provided above. Regards, Michael S. Rocha Operations Manager REVIEWED & APPROVED By Risk MANAGEMENT DivisiON SEP 2 4 2019 FRANCINE R. VILIAREAL