PROOF OF INSURANCE (2015) CLOSED4096D
TruGreen Landcare
A`.0 • 4/29/2015 DATE(MMMDNYYY)
CERTIFICATE OF LIABILITY INSURANCE 4/28/2014
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 polrcy(res)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 Ileu of such endorsement(s).
PRODUCER Lockton Insurance Brokers,LLC NO
725 S.Figueroa Street,35th Fl. wa Nto Hit, "
CA License#OF15767
Los Angeles CA 90017
(213)689-0065
INSURER A.- Zurich American Insurance Company 16535
INSURED TruGreen LandCare,L.L.C. INSURER B:
1339932 9416 Doctor Perry Rd. INSURER C:
Ijamsville MD 21754
[INSURER 1;
COVERAG S 19L)LAO I, CSBTIFICATE N MSE ; 11222341
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.
l TYPE OF INSURANCE U6 POLICY NUMBER CY FE P LC LIMITS
A COMMERCIAL GENERAL LIABILITY Y Y GLO 4783593 03 4/29/2014 4/29/2015 EACH OCCURRENCE 1,000,000
CLAIMS-MADE OCCUR PS2110 RENI ED j 3000 1000
MED EXP 1Any one arson 5,000
PERSONAL 8 ADV INJURY S 1 000 000
GEN1/AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 10,000,000
IPOLICY❑JECOT LOC PRODUCTS•COMPfoP AGO s 2.000.000
X OTHER I s
• AUTOMOBILE LIABILITY Y Y DAP 4783594 03 4/29/2014 4/29/2015 IN IN' tMl s 5,000,000
I ANLLY AUTO BODILY INJURY(Per person) S XXXXXXX
AUTSS NEO gUH�DULED BODILY INJURY(Par eocidenl S XXxxxx
ApoTNN ooaS _XXXX
HIRED AUTOS AUTOSWNED r i Y 'A A S XXXXXXX
$ XXXXXXX
UMBRELLA LIAR OCCUR EACH OCCURRENCE S XXXXXXX
EXCESS LIAR CLAIMS•MAOE NOT APPLICABLE AGGREGATE $ XXXXXXX
DEC) RETENTION$ 1, 1 $
• AND EMPL0'YERS'LIABILITY YIN Y WC 4783592 03 4/2912014 4/29/2015 X STATUTE H"
OFFICE�EMBERPEXCLUODED?ecurlaE E.t.DISEASE csA EMPLOYEE ^, 1 QOQapUQ
NIA Q
(Mandatory In NHI
0-SCRIPTTIIONN Of OPERATIONS below
ae A f-POUIDY LIMIT I.L 11,0_0 Q QUA
DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES(Attach ACORD 1011 Additional Ramsnas Schadolo,may be sttsehsd lr more space Is ragrrire,d)
RL`g•ruOrctit LandC`are 13Rf1 6245.Cit dal"El tic undo,its of3"lecrs,officials,eulployces agonts and volunteers are is Included as Additional Insured under
the Gcncrai Liability Policy per atlachcr9l CG2010 704 and CG20,31 0704 unit Auiolatttlsa)c f lability Policy if required by,written contract. Waiwr of
Subro Lion applics to the Gencral Liability,Automobile Liability and Workers Compensation Policies tj required by Avrau t contract with City orEl
Scgundoa
silt;111 621L
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
� P
11239341 AUTHORIZED REPRESENTATIVE
City of El Segundof
Department of Public Works
Attn:Yvette Slmoneau
150 Illinois Street
El Segundo CA 90245 USA .
ACORD 26(2014101) 01 BM201 C O C RPORATION.All rights reserved
Additional Insured-Automatic-Owners,Lessees Or Contractors ZURICH
Policy No. EfE Date of Pot. l'sxp.Date of Pot. Eff.Date of End. Producer No. Add'I.Prcm. Return Prcm.
GLO 4783593 03 4/29/2014 4/29/2015 4/29/2014
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:TruGreen Landcare,L.L.C.
A.Section II-Who Is An Insured is amended to include as an insured any person or organization who you are
required to add as an additional insured on this policy under a written contract or written agreement.
B.The insurance provided to the additional insured person or organization applies only to"bodily injury","property
damage'or"personal and advertising injury"covered under Section I-Coverage A-Bodily Injury And Property
Damage Liability and Section I-Coverage B-Personal And Advertising Injury Liability,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,
and resulting directly from your ongoing operations or"your work"as included in the"products-completed operations
hazard",which is the subject of the written contract or written agreement,performed for the additional insured person
or organization.
C.However,regardless of the provisions of Paragraphs A.and B.above:
1.We will not extend any insurance coverage to any additional insured person or organization:
a.That is not provided to you in this policy;or
b.That is any broader coverage than you are required to provide to the additional insured person or organization in die
written contract or written agreement;and
2.We will not provide Limits of Insurance to an},additional insured person or organization that exceed the lower of:
a.The Limits of Insurance provided to you in this policy;or
b.The Limits of Insurance you are required to provide in the written contract or written agreement.
D.The insurance provided to die additional insured person or organization does not apply to:
"Bodily injury","property damage"or"personal and advertising injury"arising out of die rendering or failure to render
any professional architectural,engineering or surveying services including:
U-GL-1175-C CW(07/10) Page 1 of 2
Attachment Code: D464900
Certificate ID: 11239341
1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field
orders, change orders or drawings and specifications; and
2. Supervisory, inspection, architectural or engineering activities.
E. The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to
insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that
this coverage be primary and non - contributory.
F. For the coverage provided by this endorsement:
1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV - Commercial
General Liability Conditions:
This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the
written contract or written agreement requires that this insurance be primary and non - contributory with respect to any
other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from
any other such insurance policy available to the additional insured on which the additional insured person or
organization is a Named Insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV - Commercial
General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured,
in which the additional insured on our policy is also covered as an additional insured on another policy providing
coverage for the same "occurrence ", offense, claim or "suit ". This provision does not apply to any policy in which the
additional insured is a Named Insured on such other policy and where our policy is required by written contract or
written agreement to provide coverage to the additional insured on a primary and non - contributory basis.
G. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement
showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that
identified additional insured.
.'ill other terms and conditions of this policy remain unchanged,
U- GL-1175 -C CW (07/10)
Attachment Code : D464900
Certificate ID : 11239341
Page 2 of 2
WAIVER OF SUBROGATION (BLANKET) ENDORSEMENT ZURICH
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of Endt.
GLO 4783593 03 4/2912014 4/29/2015 4/2912014
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of
recovery from others,we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a
waiver with respect to any other operations in which the insured has no contractual interest.
Attachment Code : D464940
Certificate ID: 11239341
POLICY NUMBER: BAP 4783594 03 COMMERCIAL AUTO
CA 20 48 02 99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
DESIGNATED INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply
unless modified by this endorsement.
This endorsement identifies person(s)or organization(s)who are"insureds" under the Who Is An Insured
Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage
Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Endorsement Effective: 4/29/2014
Named Insured: TruGreen LandCare, L.L.C..
SCHEDULE
Name of Person(s) or Organization(s):
WHERE REQUIRED BY WRITTEN CONTRACT
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to the endorsement.)
Each person or organization shown in the Schedule is an "insured"for Liability Coverage, but only to the
extent that person or organization qualifies as an "insured" under the Who Is An Insured provision
contained in SECTION II of the Coverage Form.
CA 20 48 02 99 Copyright, Insurance Services Office, Inc. 1998 Page 1of 1
Attachment Code : D464942
Certificate ID: 11239341
ZURICH
Waiver Of Transfer Of Rights Of Recovery Against Others To US
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of Endt.
BAP 4783594 03 4/29/2014 4/29/2015 4/2912014
This endorsement is issued by the company named in the Declarations. It changes the policy on the
effective dated listed above at the hour stated in the Declarations.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:
TruGreen LandCare, L.L.C.
9416 Doctor Perry Rd.
Ijamsville, MD 21754
This endorsement modifies insurance provided under the:
Business Auto Coverage From
Truckers Coverage Form
Garage Coverage Form
Motor Carrier Coverage Form
SCHEDULE
Name of Person or Organization:
BLANKET-AS REQUIRED BY WRITTEN CONTRACT
We waive any right of recovery we may have against the designated person or organization shown in the
schedule because of payments we make for injury or damage caused by an "accident" or"loss"resulting
from the ownership, maintenance, or use of a covered "auto"for which a Waiver of Subrogation is
required in conjunction with work performed by you for the designated person or organization, The waiver
applies only to the designated person or organization shown in the schedule.
U-CA-320-B CA(4194)
Page 1 of 1
Attachment Code: D464950
Certificate 1D: 11239341
WORKERS'COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE POLICY WC 00 0313
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will
not enforce our right against the person or organization named in the Schedule. (This agreement applies
only to the extent that you perform work under a written contract that requires you to obtain this
agreement from US.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule
Schedule
WHERE REQUIRED BY WRITTEN CONTRACT
This endorsement changes the policy to which it is attached and is effective on the date issued unless
otherwise stated.
(The information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.)
Insured: TruGreen LandCare, L.L.C. Policy No: WC 4783592 03
Insurance Company: Zurich American Insurance Company
Attachment Code:D464968
Certificate ID : 11239341