Loading...
PROOF OF INSURANCE (2018) CLOSED (2) DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 02/27/2017 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. c1 Q IMPORTANT: If the certificate'holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on w this certificate does not confer rights to the certificate holder in lieu of such endorselinerlt'(s). CONTACT N PRODUCER 'C ,.,,SAME: .. FAX.................... ... Aon Risk Services, Inc of Florida (tiled.No...Ex[L_...�866�....2.83.-.7122 ................................... No I; (600 .....363....0105.....................�..... d 1001 Bri ckel l Bay Drive ....o...._......l: (86. 7 �... .._ ....�......................................................................................................m.....,..................... a Suite 1100 E-MAIL p Miami FL 33131 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Starr Indemnity & Liability Company 38318 LandCare USA, INSURER B: XL Insurance America Inc 24554 a California General Partnership 5295 westview Drive INSURER C: suite 100 FrederickMD 21703 USA INSURER D:........m... m.......m............................ ...... ...................._...___....._. ........... .........._............ .......... .......... INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570065601006 REVISION NUMBER: THIS IS TO CERTIFY THAT THE PO'LK,IES 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 Limits shown are as requested NNSA# AOUL SUB'R FULICY EFt- PULICY kXP 6 TR TYPE OF INSURANCE INSD wVD POLICY NUMBER IMMIDDIYYYYA iMFA DbiYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 100U1OU01b1/1 U3/Ul/201/U3/U1JCU1 EACH OCCURRENCE $1,000,000 _....,.... ..,I CLAIMS-MADE cC X OCCUR (' $1,000,000 —� SIR applies per policy terns & con T_,Tons ME M(sPS�2occu encq).........._............................. .......... ..... X SIR$250,000 (Any one person) $5,000 PERSONAL,.&..ADV INJURY ___._$.1.�.......................... 000,000 0 GEML AGGREGATE LIMIT APPLIES PER ��GENERAL AGGREGATE $2,000,000 0 co OTHER: X LOC PRODUCTS-COMP/OPAGG $2,000,OOQI o C) PRO- POLICY JECT U) 0 0 n AUTOMOBILE LIABILITY $5,000,000 A SISIPCA08328717 03/01/2017 03/01/2018 COMBINED SINGLE LIMIT `) (Ea accident) , IT .w. ....Per person) O ITITm X ANY AUTO ..BODILY INJURY...........................................,.,.,._.,.,.,.,.,...........................,_.,.,.,.,.,...... Z ^I OWNED SCHEDULED BODILY INJURY(Per accident) 0) ,AUTOS ONLY AUTOS itHIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY (Per accident) X Comp Ded$1,000 X Coll Ded$1,000 E B X UMBRELLA LIAR I X OCCUR US00078227L117A 0310112017 03/01/2018 EACH OCCURRENCE $5,000,000 V �. 1-1............................. ..5,0.0...0...,000 EXCESS LAB CLAIMS-MADE ......._�. .,., 999 .,.,.,., ........, AGGREGATE $._.._..... 0EDJ'X RETENTION$10,000 * WORKERS A LOOP RS'LIABILITY TNEOR I EXECUTIVE rY"�N'N 1000001706 03/01/2017 03/01/2018"E�.IEAT.,H UT ACCIDENT . ..................................................................................... / X A ( 0TH• 03/01 1 FB OFrIC'Af R,aAi,AAEREXCLUDED? I NIA 1000002166 03/01/2017 2018 c AC $1,000,000 (Mandalwy flit NI-11 JJJ E DISEASE-EA EMPLOYEE $1,000,000 fY,i Srd:R'YNSnIV under . .................................... ......._........,........._0.,.0 E LDISEASE-POLICYLIMIT $1,000,0 ... WN— DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: All California Landscape Operations. y The City of El Segundo its officers, employees and agents are included as Additional Insured in accordance with the policy I� provisions of the General Liability and Automobile Liability policies. G A waiver of Subrogation is granted in favor of The City of E1 Segundo its officers, employees and agents in accordance with the policy provisions of the General Liability, Automobile Liability and workers Compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE City Clerks office/Purchasing 350 Main Street El Segundo CA 90245 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1000100016171 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL (INSURED - O"W"NERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON O ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations Any person or organization that the insured has agreed Where required by written contract. and/or is required by written contract to name as an additional insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 1. All work, including materials, parts or include as an additional insured the person(s) or equipment furnished in connection with such organization(s) shown in the Schedule, but only work, on the project (other than service, with respect to liability for "bodily injury", "property maintenance or repairs) to be performed by or damage" or "personal and advertising injury" on behalf of the additional insured(s) at the caused, in whole or in part, by: location of the covered operations has been 1. Your acts or omissions; or completed; or 2. The acts or omissions of those acting on your 2. That portion of "your work" out of which the behalf; injury or damage arises has been put to its in the performance of your ongoing operations for intended use by any person or organization other than another contractor or subcontractor the additional insured(s) at the location(s) engaged in performing operations for a designated above. principal as a part of the same project. However: 1. The insurance afforded to such additional C. With respect to the insurance afforded to these insured only applies to the extent permitted by additional insureds, the following is added to law; and Section III— Limits Of Insurance: 2. If coverage provided to the additional insured is If coverage provided to the additional insured is required by a contract or agreement, the required by a contract or agreement, the most we insurance afforded to such additional insured will pay on behalf of the additional insured is the will not be broader than that which you are amount of insurance: required by the contract or agreement to 1. Required by the contract or agreement; or provide for such additional insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable Limits of Insurance shown in the "property damage"occurring after: Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 a� y� ; ".' Starr Indemnity & Liability Company Y Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: SISIPCA08328717 Effective Date: 03/01/2017 at 12:01 A.M, Named Insured: LandCare USA, LLC dba LandCare ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO" I, SECTION II — LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. Signed for STARR INDEMNITY& LIABILITY COMPANY Charles k. Dangelo,IlPresident Nehemiah E. Ginsburg, General�,Counsel SICA 1016 MD (04/12) Page 1 of 1 Includes copyrighted material of ISO Properties,Inc.,used with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) 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 Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. 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.) Endorsement Effective: Policy No.: Endorsement No.: Insured: Premium: Insurance Company: Countersigned by: WC 00 03 13 (Ed. 04-84) Page i of 11 :.: Starr Indemnity & Liability Company Y Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Policy Number: SISIPCA08328717 Effective Date: 03/01/2017 at 12:01 A.M. Named Insured: LandCare USA, LLC dba LandCare This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery Against Others to Us, is amended to add: However, we will waive any right of recovery we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Form arising out of an "accident"or"loss" if: (1) The "accident" or "loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization; and (2) The contract or agreement was entered into prior to any "accident" or "loss". No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovered funds obtained by any injured employee. All other terms, conditions and exclusions of the policy shall remain unchanged. Signed for STARR INDEMNITY& LIABILITY COMPANY „ CCCharles H'. Dan e to,,�resident Nehe miah E. Ginsburg, General�r ounsel SICA 1020 MD (03/12) Page 1 of 1 Includes copyrighted material of ISO Properties,Inc.,used with its permission. POLICY NUMBER: 1000100016171 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations, The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1