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PROOF OF INSURANCE (2020) CLOSED I DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02/2712019 ( 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 N 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 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 this w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT d NAME: � Aon Risk Services, Inc Of Florida PHONE (866) 263-7122 Fes" (800) 363-0105 m 1001 Brickell Bay Drive IIAM.No.C,I: I INC.1103; Suite 1100 E-MAIL p Miami FL 33131 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: XL Insurance America Inc 24554 Landcare USA, INSURER B: Safety National Casualty Corp 15105 a California General Partnership 5295 Westview Drive 'INSURER C: Suite 100 I INSURER D: Frederick MD 21703 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570075215135 REVISION NUMBER, THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED"1'09 THE INSURED NAMED ABOVE FOR THE P'O'LICY 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'DES'CRI'BED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limit's shown are as reouested' L p TYPE OF INSURANCE INjS SUBR SIR applies per policy C ter MJ0D�YLYYY l fM'MM JY wl EACH OCCURRENCE LIMITS II X COMMERCIALCLAIMGENE�XMADE OCICI UR .. 0.GL4058321 ER �j/Ol/2t<}1�9 03/Ul%1020� E $1,000,000 pp p p y �Us & condi ions I5 IQHLNI_'IU $1,000,000 PREMISES(Ee occurrence) J X I SIR$250,000 Y MED EXP(Any one person) $5,000 V PERSONAL 8 ADV INJURY $1.600,006, GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 0CT �LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: n B CAA4058323 03/01/2019 03/01/2020 COMBINEDSINGLELIMIT ° AUTOMOBILE LIABILITY $5,000,000 � nn _ X ANYAUTO BODILY INJURY(Perperson) Z OWNED SCHEDULED AUTOS ONLY �BODILY INJURY(Per accident) ted) _ HIRED AUTOS NON-OWNED I PROPERTY DAMAGE .-..�—ONLY AUTOS ONLY leer eccidenll w A x um9 SLAIAB X CLAIUR MS-MADE U500079227LI19A 03/01/2019 03/0l/2020 EACH OCCURRENCE $5N000,000 V AGGREGATE $5,060,0001 T-61 XRETINTI.d $10,000 13 WORKERS EMPLOYERS COMPENSATION ION AND LDc405$321 03/0'1/20'19'03/01/ 026 �(I PER V IOTH-I, ANY PROPRIETOR I PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,0001 OFFICERIMEMBER EXCLUOED1 N NIA (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,dumnhe under' i DESCRIPTION OF OPERATIONS below V E.L.DISEASE-POLICY LIMIT $1,000,000'— DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AdOtlonal Remarks Schadkft,may be attached If more apace is requVred) qRE: All California Landscape operations. The City of` El Segundo, its officers, employees and agents are included as )Additional Insured in accordance with the polic,y' provisions of the General Liability policy. General Liability policy evidenced herein is Primary and Non-CDntrif�utor'y' to other insurance available to an Additional Insured, but only in accordance with the policy's. provisions. 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 POLICIEB BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE 350 Main Street El Segundo CA 90245 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GL 4058322 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s)Or Organization(s): As required by written contract or agreement when such written contract or agreement is executed prior to an occurrence, offense or loss to which this endorsement applies, but only for the limits agreed to in such contract or the Limits of Liability provided by this policy, whichever is less. Any individually scheduled additional insureds shall not be construed to override nor negate this blanket 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for"bodily injury", "property If coverage provided to the additional insured is damagem' or "personal and advertising injury"' required by a contract or agreement, the most we caused, in whole or in part, by your acts or will pay on behalf of the additional insured is the omissions or the acts or omissions of those acting amount of insurance: on your behalf: 1. Required by the contract or agreement;or 1. In the performance of your ongoing operations; or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations; rented to you. whichever is less. However: This endorsement shall not increase the applicable 1. The insurance afforded to such additional Limits of Insurance shown in the Declarations. insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 0413 ©Insurance Services Office, Inc., 2012 Pagel of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE Name of Additional Insured Person(s)or Organization(s): Person(s) or organization(s) as required by written contract. Any individually scheduled Designated Additional Insured shall not be construed to override nor negate this blanket Designated Additional Insured. CHANGE The person(s)or organization(s)shown in the Schedule above with whom you have agreed in a written contract to provide insurance such as is afforded under this Coverage Form, is included as an Additional Insured subject to the below: (1) Insurance for such Additional Insured(s) scheduled above shall be afforded only to the extent that such Additional Insured is liable for "bodily injury' or "property damage" arising out of your operations and resulting from the ownership, maintenance or use of covered"autos"by you while the covered"autos"are on premises owned or leased by the above scheduled Additional Insured(s). (2) The insurance afforded under this Coverage Form to such Additional Insured(s)applies only: (a) If the"accident" takes place subsequent to the execution and effective date of such written contract: and, (b) While such written contract is in force, or until the end of the policy period,which ever occurs first. (3) How Limits Apply to Additional Insured(s) The most we will pay on behalf of the Additional Insured(s)scheduled above is the lesser of.- (a) f:(a) The limits of insurance specified in the written contract or written agreement; or, (b) The Limits of Insurance provided by the Coverage Form. The amount we will pay on behalf of such Additional Insured(s)shall be a part of, and not in addition to,the Limits of Insurance shown in the Coverage Form Declarations and described in this section. Such amount will thus not increase the Limits of Insurance shown for the Coverage Form. (4) Exclusions (a) This endorsement does not apply to liability of the Additional Insured which arises out of the ownership of transportation operating rights granted to the Additional Insured by public authority. (b) This endorsement does not apply to the liability of the owner or anyone else from whom you hire or borrow a covered auto. SNCA 026 10 13 Safety National Casualty Corporation Page 1 of 2 (5) Obligations at the Additional Insured's Own Cost No Additional Insured will, except at their own cost,voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid,without our consent. The Additional Insured(s)scheduled above shall be subject to all other conditions set forth in the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. 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 03/01/2019 Policy No. CAM 058323 Endorsement No. Named Insured LANDCARE USA LLC DBA: LANDCARE Premium$ Included Insurance Company Safety National Casualty Corporation Countersigned By Page 2 of 2 Safety National Casualty Corporation SNCA 026 10 13 POLICY NUMBER: GL 4058322 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: Person(s) or organization(s) as required by written contract when such written contract is executed prior to an occurrence, offense or loss to which this endorsement applies. Any individually scheduled waivers shall not be construed to override nor negate this blanket Waiver. 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 06 09 C Insurance Services Office, Inc., 2008 Pagel of l THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE Name Of Person Or Organization: Person(s) or organization(s) as required by written contract when such written contract is executed prior to an accident to which this endorsement applies. Any individually scheduled Waivers shall not be construed to override nor negate this blanket Waiver. - --------- Information required to complete this Schedule, if not shown above,will be shown in the Declarations. CHANGE 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"bodily injury"or"property damage"to which this insurance applies, caused by an "accident" and resulting from the ownership, maintenance or use of a covered"auto". This waiver applies only to the person or organization shown in the Schedule above. 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 03/01/2019 Policy No. CAA405e323 Endorsement No. Named Insured LANDCARE USA LLC DBA: LANDCARE Premium$ Included Insurance Company Safety National Casualty Corporation Countersigned By SNCA 027 10 13 Safety National Casualty Corporation Pagel of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 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 A WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS IS REQUIRED BY WRITTEN CONTRACT, SUCH ADDITIONAL ENTITIES SHALL BE CONSIDERED AUTOMATICALLY SCHEDULED BY THE COMPANY. INDIVIDUALLY SCHEDULED WAIVERS SHALL NOT BE CONSTRUED TO OVERRIDE NOR NEGATE THIS BLANKET WAIVER. 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 03/01/2019 Policy No. LDC4058321 Endorsement No. Insured LANDCARE USA LLC DBA: LANDCARE Premium$ Included Insurance Company Safety National Casualty Corporation Countersigned By WC 00 03 13(04 84) Page 1 of 1 01993 National Council on Compensation Insurance.