2010/11/01 Adame Landscape, Inc. Certificate of Liability InsuranceAc®Ro' CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDYYYYI
07/20/2011
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 Phone: (559)440-9330 Fax: (559)440-9335
FIRST TEAM INSURANCE SERVICES, INC.
215 W. FALLBROOK AVE.
SUITE 103
FRESNO 93711
CONTACT NAME: Steven W. Hartman
we PHONE
Ext: 559 440-9330 w Ne: (559) 440-9335
EMAIL steven.hartman@firstteamins.com
ADDRPRODEss:
_
UCER
CUSTOMER ID: 173
INSURER(S) AFFORDING COVERAGE
NAIC #
Agency Li70G23]790
INSURED
ADAME LANDSCAPE, INC.
INSURER : GREAT AMERICAN INSURANCE GROUP
16691
41863 JUNIPER ST
INSURER B
INSURER
MURRIETA CA 92562
INSURER D.
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 964 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
CERTI ICA
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,
FXCI ( JqIONS AND QQNnITION,' , OF St ICH POI Ir. Fq I IMITR SHOWN MAY HAVE BEEN RFnJ )(-ED By PAID (-I AIMS
INSR
_ LTR
TYPE OF INSURANCE
ADD'L
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MMIDDM'YY
LIMITS
A
GENERAL
LIABILITY
PAC1808303
11/01/10
11/01/11
EACH OCCURRENCE
$ 1,000,000
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE IXI OCCUR
DAMAGE TO RENTED
PREMISES Ea occurenco
$ 100,000
_
MED. EXP (Any one person)
$ 5,000
X
PERSONAL & ADV INJURY
$ 1,000,000
$500 PD Deductible
GENERAL AGGREGATE
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
X I POLICY PRO LOC
EMPLOYEE BENEFITS LI
$ 1,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
-
SCHEDULED AUTOS
$
PROPERTY DAMAGE
HIRED AUTOS
(Per accident)
$
$
NON -OWNED AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
AGGREGATE
$
Excess LIAB
CLAIMS -MADE
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
WC STATU- OTH
TORY LIMITS
$
E-L. EACH ACCIDENT
$ ----------
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? I�
N/A
E.L. DISEASE -EA EMPLOYEE
(Mandatory in NH)
It yes, describe under
$
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: Cherry Hills Sun City Shopping Center
The City of Menifee, its officers, employees, represenatives, attorneys, and volunteers are additional insured per CG 85 19 08 10.
Coverage is primary & non-contributory. **A 10 Day Notice of Cancellation applies in the event of non-payment of premium or
*.
.._YF
DER CANCELLATION
City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
29740 Haun Rd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Menifee, CA. 92586 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Attention: CA Lic. # OG23790 `
�teven Hartman
(V 9ytst5-'Lun9 ACOKD CORPORATION. All rights reserved.
The ACORD name and loao are registered marks of ArORD
Administrative Offices CG 85 19
iiREAT 580 walnut Street (Ed. 08 10)
AMERICAN Cincinnati, Ohio 45202
INSURANCE GROUP Tel: 1-513-369-5000
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED — OWNERS, LESSEES, OR CONTRACTORS — AUTOMATIC
STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU — YOUR
ONGOING OPERATIONS DURING POLICY PERIOD ONLY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION II — WHO IS AN INSURED is amended to include as an Additional Insured any person
or organization for whom you perform ongoing operations during the policy period of this policy,
but only when you and that person or organization expressly agreed in writing, in a written contract
or agreement made before the "bodily injury," "property damage," or "personal and advertising
injury" occurs, that such person or organization would be added as an Additional Insured under this
policy. Our coverage for such an Additional Insured is subject to the terms, conditions, exclusions,
and limitations of this insurance, as modified by this endorsement.
B. A person or organization described in Section A. of this endorsement is an Additional Insured only
until the earliest of the following times:
a. at the end of the period of time for which such Additional Insured status is required by the written
contract or agreement between you and that person or organization, described in Section A. of
this endorsement;
b. when your ongoing operations for that person or organization end; or
c. at the end of the policy period of this policy.
A person or organization described in Section A. of this endorsement is an Additional Insured only
as respects "bodily injury" or "property damage" that:
1. is caused, in whole or in part, by your acts or omissions, or the acts or omissions of one acting on
Your behalf,
2. is caused, in whole or in part, by "your work" performed for that Additional Insured;
3. is not within the "products -completed operations hazard"; and
4. occurs after the making of the written contract or agreement described in Section A. of this
endorsement.
No person or organization is an Additional Insured under this endorsement as respects any "bodily
injury" or "property damage" within the "products -completed operations hazard."
A person or organization described in Section A. of this endorsement is an Additional Insured only
as respects "personal and advertising injury" caused by an offense that:
1. is committed, in whole or in part, by you or one acting on your behalf, and
2. arises out of "your work" performed for that Additional Insured.
Includes copyrighted material of Insurance Service Office with its permission.
Copyright, Insurance Services Office, Inc. 2010
(Page 1 of 3)
CG 85 19 (Ed. 08/10) PRO
C. We have no duty to defend or indemnify such an Additional Insured against a claim or "suit" unless
and until that Additional Insured provides us with written notice of that claim or "suit," of the kind
described in SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 2.
Duties In the Event Of Occurrence, Offense, Claim Or Suit, paragraph b. Notice of a claim or
"suit" provided to us by or on behalf of the Named Insured, or by or on behalf of any other Insured,
person, or organization, is not notice by the Additional Insured.
D. Coverage we provide for an Additional Insured will not, under any circumstances, be broader in any
respect than either:
1. the coverage we provide for you under this policy; or
2. the coverage required to be provided for that Additional Insured by the written contract or
agreement described in Section A. of this endorsement.
E. Under no circumstances will we pay more than the applicable Limit of Insurance. Neither this
endorsement, nor any contract or agreement described in Section A. of this endorsement, nor our
agreement to defend or indemnify an Additional Insured, can increase, enlarge, or reinstate any Limit
of Insurance described in this policy. Any sum we pay for damages will be paid from, and will not be
in addition to, the applicable Limit of Insurance.
Under no circumstances will we pay for or on behalf of an Additional Insured any amount of
insurance that exceeds the lesser of:
1. the applicable Limit of Insurance that would be available to you under this policy; or
2. the amount of insurance you promised to provide in the written contract or agreement described
in Section A. of this endorsement.
F. As respects an Additional Insured described in Section A. of this endorsement, and in addition to the
exclusions stated in either Coverage A — Bodily Injury and Property Damage Liability, 2.
Exclusions, or Coverage B — Personal and Advertising Injury Liability, 2. Exclusions, our
insurance of an Additional Insured under this endorsement also does not apply to any of the
following:
1. "Bodily injury," "property damage," or "personal and advertising injury," to the extent caused by
any act or omission of the Additional Insured or any of the Additional Insured's "employees";
2. "Bodily injury" or "property damage" that occurs before you commence operations at the
location where such "bodily injury" or "property damage" occurs;
3. "Personal and advertising injury" arising out of any offense committed before you commence
operations pursuant to the written contract or agreement described in Section A. of this
endorsement; and
4. "Bodily injury," "property damage," or "personal and advertising injury," arising out of the
rendering of, or the failure to render, any professional architectural, engineering, or surveying
services, including, but not limited to:
(a) preparing or approving, or failing to prepare or approve, maps, shop drawings, opinions,
reports, surveys, field orders, change orders, drawings, or specifications; or
(b) supervisory, inspection, architectural, or engineering activities.
Includes copyrighted material of Insurance Service Office with its permission.
Copyright, Insurance Services Office, Inc. 2010
(Page 2 of 3)
CG 85 19 (Ed. 08/10) PRO
G. As respects an Additional Insured described in Section A. of this endorsement, Coverage A — Bodily
Injury and Property Damage Liability, 2. Exclusions, 1. Damage to Your Work, is deleted and
replaced by the following:
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."
H. Subject to Section D. of this endorsement, an Additional Insured described in Section A. of this
endorsement must comply with all applicable provisions of SECTION IV — COMMERCIAL
GENERAL LIABILITY CONDITIONS to the same extent as any Insured other than you. This
includes, but is not limited to, compliance with Condition 2. Duties in the Event of Occurrence,
Offense, Claim or Suit.
I. In SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is
added at the end of 4. Other Insurance, a. Primary Insurance:
With respect to other insurance under which an Additional Insured is designated as a
Named Insured, our insurance will be primary only if you and the Additional Insured
have expressly agreed in writing, in a contract or agreement made before the "bodily
injury," "property damage," or "personal and advertising injury" occurred, that our
insurance is primary or primary and non-contributory. Our obligations are not affected
unless any of the other insurance is also primary. Then, we will share with all that other
insurance by the method described in provision 4.c. Method of Sharing.
J. In SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is
added at the end of 4. Other Insurance, b. Excess Insurance, subparagraph (1):
With respect to other insurance under which an Additional Insured is designated as a
Named Insured, when the written agreement between you and the Additional Insured
does not expressly require this insurance to be primary or primary and non-
contributory, this insurance is excess over any other insurance for which the Additional
Insured is designated as a Named Insured.
Regardless of the written agreement between you and the Additional Insured, this
insurance is excess over any other insurance, whether primary, excess, contingent, or on
any other basis, for which the Additional Insured has been added as an Additional
Insured by attachment of an endorsement or otherwise.
K. An Additional Insured described in Section A. of this endorsement must promptly request defense
and indemnity of the claim or "suit' under each policy issued by any other insurer, under which the
Additional Insured may be insured in any capacity. The Additional Insured must assist us in
enforcing its rights to defense and indemnity under any such other insurance. However, the previous
two sentences do not apply to other insurance under which the Additional Insured is a Named
Insured, if the written contract or agreement described in Section A. of this endorsement expressly
provides that our policy is to be primary and non-contributory.
This endorsement does not change any other provision of the policy.
Includes copyrighted material of Insurance Service Office with its permission.
Copyright, Insurance Services Office, Inc. 2010
CG 85 19 (Ed. 08/10) PRO (Page 3 of 3)
n