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PROOF OF INSURANCE (2013) CLOSED✓ DATE (MMIDD/YYYY) `�"" CERTIFICATE OF LIABILITY INSURANCE 4/29/2013 4i20i20I2 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 Lockton Insurance Brokers, LLC CONTACr NA E; 725 S. Figueroa Street, 35th Fl. PHONE F CA License #OF15767 _� ..Fx* ...... ........_ A1C Nc s - -- _ ..._.__ Los Angeles CA 90017 AoDRC;; °_.... (213) 689 -0065 INSURERS AFFORDING COVERAGE NAIC N INSURER A; Zurich American Insurance Company 16535 4/29/2013 INSURED TruGreen LandCare, L.L.C. 1339932 INSURER B: DAMAGE TO RENI ED PREMISES (Ea c i.r ence) 9416 Doctor Perry Road INSURER C: El Segundo CA 90245 USA INSURER D: .,, 110 1 Ijamsville MD 21754 INSURER E: INSURER. F ......��' COVERAGES TRULA01 D6 CERTIFICATE NUMBER: 11239341 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE AOD SUBR POLICY NUMBER. POLICY EFF MMID1? /YYIfY POLICY EXP MMIDDIYYYY. LIMITS A ,_GENERAL LIABILITY Y Y GLO 4783593 01 4/29/2012 4/29/2013 EACH F DAMAGE TO RENI ED PREMISES (Ea c i.r ence) $ 1,000.000 El Segundo CA 90245 USA � hN�iRE'dAf� I Awl Bpll TY .,, 110 1 ......��' m , 1� PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: $ POLICY PER, - X" I LOC P' AUTOMOBILE .... LIABILITY y y BAP 4783594 01 4/29/2012 4/29/2013 (Ea accident). " $ X ANY AUTO BODILY INJURY (Per person) BODILY $ XX ALLOSNED SCHEDULED UTOS BODILY INJURY Per accident $ XXXX�X PROPERTY DAMAGE fPer dent) $ XXXXXXX NON -OWNED HIRED AUTOS w,.. AUTOS $ XXXXXXX UMBRELLA LIAR . OCCUR NOT APPLICABLE EACH OCCURRENCE $ },'}{XXXXX EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED ''.. RETENTION $ $ xxxxxxx • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN y WC 4783592 01 4/29/2012 4/29/2013 X WC A TORY LIMIT ER I E L EACH ACCIDENT $ 1 QQO.000 ANY OFFICER/MEMBER/ EXCLUDED ECUTIVE N/A 1 E L DISEASE - EA EMPLOYEE $ 1000000 E L DISEASE - POLICY LIMIT $ 000 (Mandatory in NH) If yes, describe under ES CRIPTIQN OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: TruGreen LandCare BR# 6245. City of El Segundo, its officers, officials, employees, agents and volunteers are is included as Additional Insured under the General Liability policy per attached CG2010 0704 and CG2037 0704 and Automobile Liability policy if required by written contract Waiver of Subrogation applies to the General Liability, Automobile Liability and Workers Compensation policies if required by written contract with City of El Segundo, Site ID 6245 CERTIFICATE HOLDER CANCELLATION See Attachments ACORD 26 (201,0106) The ACORD name and logo are registered marks of ACORD R11988-MO, ACORD CORPORATION, All rights reserved SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11239341 AUTHORIZED REPRESENTATIVE City of El Segundo Department of Public Works Attn: Yvette Simoneau 150 Illinois Street El Segundo CA 90245 USA .,, 110 1 ACORD 26 (201,0106) The ACORD name and logo are registered marks of ACORD R11988-MO, ACORD CORPORATION, All rights reserved Additional Insured - Automatic - Owners, Lessees Or Contractors ZURICH Policy No. Eff. Date of Pol. Exp. Date of Eff. Date of End. Producer AddT Return Pol. No. Prem, Prem. GLO 4783593 01 4/29/2012 4/29/2013 4/29/2012 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 w � 7797M - .. and resulting directly from your ongoing operations or "'your work" as included in the "products - completed operations hazard ", which is t "he 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 the written contract or written agreement; and 2. We will not provide Limits of Insurance to any 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 the additional insured person or organization does not apply to: 'Bodily injury"" "property damage" or "personal and advertising injury arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: U -GL- 1175 -C CW (07/10) Attachment Code: D464900 Certificate ID: 11239341 Page 1 of 2 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 1 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„ e LEM 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. All other terms and conditions of this policy remain unchanged. U -GL- 1175 -C CW (07110) 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 01 4/29/2012 4/29/2013 4/29/2012 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 yoti area required by a written contract or agreciiient, which is executed betbre 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 01 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. indicated below. Endorsement Effective: 4/29/2012 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 1 o 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 01 4/29/2012 4/29/2013 4/29/2012 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 Road Ijamsville, MD 21754 This endorsement modifies insurance provided under the: Business Auto Coverage From Truckers Coverage Fprm ��00000 ��0000 ��0000�� oo G!aragi�..,Ctiv�irge F+df ............ 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 (4/94) Page 1 of 1 Attachment Cade: D464950 Certificate ID: 11239341 WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE POLICY WC 00 03 13 (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 01 Insurance Company: Zurich American Insurance Company Attachment Code: D464968 Certiriicate ID: 11239341