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Insurance-Ortiz Landscaping- 2012-12-14ACORO CERTIFICATE OF LIABILITY INSURANCE DATEIMMm02wl L� 112/1412012 12 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION FREXINY LAZO INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ^280 E LINCOLN AVE 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ,NAHEIM, CA 92805 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PH(714)535 -1854 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A. PREFERRED CONTRACTORS INSURANCE ORTIZ LANDSCAPING INSURER a: 730 WASTER PLACE INSURER C SANTA ANA CA 92706 INSURER D INSURER E. 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRINSRE ADD-L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIODIYY POLICY EXPIRATION DATE MM /DD/VY LIMITS A GENERAL LIABILITY x COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx] OCCUR PCI005017 -PCA -96711 12/12112 12/12/13 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGO $ 1,000,000 POLICY PRO- JECT OC $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea acedenp $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY (Per accltlenQ $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Perawdent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EAACC OTHER THAN $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TOR WCSTATU- OTH- V LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER /EXECUTIVE E. L. DISEASE - EA EMPLOYE $ OFFICER /MEMBER EXCLUDED? K yes, under E. L. DISEASE - POLICY LIMIT $ ALPRe SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS DISTRICT, ITS DIRECTORS, OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK OR OPERATIONS PERFORMED PER CONTRACT. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. V CR I IfIVM 1 C RVLIICR UAINU:LLLA I ILI N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION COSTA MESA SANITARY DI R DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 628 W 19TH ST \\f \� COSTA MESA CA 92627 f "v NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL JI n\ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE nsumy Mmd by HAHnDI Myer HANADI NASRI:m. -eu ybwol.... -u mr :: mix,z 11Ir.1 n. ACORD 25 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Pmfi6md Contmiors Insurance Compan}, RRG THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS. LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION INCLUDING PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person(s) or Organization(s); Location(s) of covered operations; Additional Insured(s) Address: Certificate Holder —DISTRICT, ITS DIRECTORS, OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK OR OPERATIONS PERFORMED PER CONTRACT. (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor engaged in performing operations for a principal as part of the same project. C. The insurance afforded by the policy to the Additional Insured's) listed in the Schedule for the described location(s) is primary insurance. Any other insurance or self - insurance maintained by the Additional Insured(s) is excess of this insurance and shall not contribute to it. Policy No.: PCIC5017- PCA96711 Date: 12/12/12 Time: 12:01 a.m. Preferred Contractors Insurance Company Risk Retention Group, LLC 27 North 27th Street, Suite 1900 Billings, Montana 59103 By _PJ Authorized Itepresentative PCIC 24 7 10 07 POLICY NUMBER: PCIC5017- PCA96711 COMMERCIAL GENERAL LIABILITY PCIC 24 10 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person(s) or Organization(s); Location(s) of covered operations; Additional Insured(s) Address: Certificate Holder — DISTRICT, ITS DIRECTORS, OFFICIALS, OFFICERS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE NAMED AS ADDITIONAL INSURED WITH RESPECT TO WORK OR OPERATIONS PERFORMED PER CONTRACT. (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1, Your acts or omissions, or 2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.