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2017/11/01 Adame Landscape, Inc. Certificate of Liability Insurance
ACoORGIr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) F11/6/2017 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 Landscape Contractors (Lic#0755906) Insurance Services, Inc. CONTACT NAME: Benita Hall, CISR A/coNNo E (559) 650-3555 FAX No; (559)650-355.8 E-MAIL bhall@lcisinc.com ADDRESS: 1835 N. Fine Avenue Fresno CA 93727 INSURERS AFFORDING COVERAGE NAIC # INSURER A Atlantic Specialty Insurance 27154 INSURED Adame Landscape, Inc. 41863 Juniper St. INSURER B : INSURER C : INSURER 0: INSURER E : Murrieta CA 92562 1 INSURERF: COVERAGES CERTIFICATE NUMRFR-Adame Onlv DMncrnkr .0 Henoon. THIS IS TO GERTIFY 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 618-00-11-74-0001 11/1/2017 11/1/2018 X $1,000 Pd Ded PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 N.. POLICY PECLOC PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits S 1,000,000 OTHER: AUTOMOBILE LIABILITY, COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A ANY AUTO X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS 618-00-11-74-0001 11 1 2017 / / 11/1/2018 BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ Underinsured motorist $ 1,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: All landscape operations performed by or on behalf of the named insured. Blanket Additional insured per attached OBPGGLO4340414 City of Menifee, its officers, employees, representatives and authorized volunteers (Excluding Professional Liability) are named as additional insured. "w' ""IN %,ANt r_LLA I IUN City of Menifee 29714 Haun Rd Sun City, CA 92586 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 B Hall, CISR/DURIBE ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following is added to Paragraph 2. In SECTION II - WHO IS AN INSURED: Any person or organization you are required by written contract or agreement to name as an additional insured subject to the following: Any such person or organization must be approved in writing by us as an additional insured. Coverage for such person or organization will begin on the date of our approval. a. No such person or organization is an additional insured for your acts, errors or omissions if such acts, errors or omissions are not also covered under such person or organization's liability insurance. b. No such person or organization is an additional insured for "bodily injury" or "property damage" for acts, errors or omissions of any additional insured. B. With respect to the insurance afforded to the additional insureds under Paragraph A. above, the following is added to SECTION III - LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement does not increase the applicable Limits of Insurance shown in the Declarations. C. With respect to the insurance afforded to the additional insureds under Paragraph A. above, Paragraph I. Damage To Your Work in Paragraph 2. Exclusions of COVERAGE A — BODILIY INJURY AND PROPERTY DAMAGE LIABILITY in SECTION I — COVERAGES is replaced by the following This insurance does not apply to: I. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". D. With respect to the insurance afforded to the additional insureds under Paragraph A. above, The following is added to Paragraph 4. Other Insurance in SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is primary if required by the contract or agreement. If there is no such requirement, this insurance will be excess and paragraph b. Excess Insurance applies. OBPG GL 0434 04 14 Contains copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 2 Copyright, OneBeacon Insurance Group, 2014