HomeMy WebLinkAboutExcel Landscape CSA Annual Citywide Landscape Maintenance Services Amendment No. 1 07-12-2022AMENDMENT NO. 1
TO AGREEMENT FOR CONTRACTOR SERVICES
Excel Landscape, Inc.
Annual Citywide Landscape Maintenance Services
This Amendment No. 1 to Agreement for Contractor Services is made and entered into as
of 7/12/2022, by and between the City of Lake Elsinore, a municipal corporation (“City), and Excel
Landscape, Inc., a Corporation (“Contractor”).
RECITALS
A. The City and Contractor have entered into that certain Agreement for Contractor
Services dated as of 10/27/2020, (the “Original Agreement”). Except as otherwise defined herein,
all capitalized terms used herein shall have the meanings set forth for such terms in the Original
Agreement.
B. The Original Agreement provided for compensation to Contractor in an amount of
Two Hundred Thirteen Thousand Three Hundred dollars ($213,300).
C. Contractor has notified the City of unforeseen cost increases in material and labor
and has requested an adjustment to the extra work pricing. In addition, City requires Contractor
services in additional locations.
D. The Parties now desire to amend the scope of services and increase the payment
for such services as set forth in this Amendment No 1.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth
herein, City and Contractor agree as follows:
1. Section 3, Compensation, of the Original Agreement is hereby amended to read in
its entirety as follows:
Compensation to be paid to Contractor shall be in accordance with the fees set forth in
Contractor's Proposal which is attached to the Original Agreement as Exhibit A and
amended by this Amendment No. 1 in accordance with Exhibit A-1 attached hereto and
incorporated herein by reference. In no event shall Contractor's annual compensation
exceed Two Hundred Thirteen Thousand Three Hundred Dollars ($266,300) per fiscal year
commencing the Fiscal Year July 1, 2022 through June 30, 2023 without additional written
authorization from the City.
Notwithstanding any provision of Contractor's Proposal to the contrary, out of pocket
expenses set forth in Exhibit A to the Original Agreement and Exhibit A-1 attached hereto
shall be reimbursed at cost without an inflator or administrative charge. Payment by City
under this Agreement shall not be deemed a waiver of defects, even if such defects were
known to the City at the time of payment.”
2. Contractor’s Proposal attached to the Original Agreement as Exhibit A is hereby
amended as set forth in Exhibit A-1 attached hereto and incorporated by reference herein to
substitute the updated Price Sheet for Landscape Maintenance Extra Work (Exhibit “B” to
Contractor’s Proposal) and to include the additional services set forth therein.
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
3. Except for the changes specifically set forth herein, all other terms and conditions
of the Original Agreement shall remain in full force and effect.
IN WITNESS WHEREOF, the parties have caused this Amendment No. 1 to be executed
on the respective dates set forth below.
CITY”
CITY OF LAKE ELSINORE, a municipal
corporation
CONTRACTOR”
Excel Landscape, Inc., a Corporation
City Manager
Date:
Jose Alfaro, Sr.
Date:
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
Assistant City Manager
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
8/22/2022 | 4:53 PMCDT8/22/2022 | 2:54 PM PDT
Attachments: Exhibit A-1 – Contractor ’s Proposal
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
EXHIBIT A-1
CONTRACTOR ’S PROPOSAL
ATTACHED]
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
EL LANDSCAPE 710 Rimpau Ave. Suite 108.Corona, CA92879-5724
951 ) 735-9650 Fax (951 ) 735-0469. Lic # 694553
April 1,2022
City of Lake Elsinore
130 S Main St.
Lake Elsinore, CA 92530
Dear Rick,
This letter is to express our interest in renewing our existing Landscape Maintenance
contract with the City for an additional year. We will honor our current maintenance
contract amount, with the exception of the unit cost pricing for extra work. Due to
unforeseen cost increases to material and labor, we are requesting an adjustment to
the extra work pricing. Please see the attached worksheet for the proposed price
adjustments. I look forward to hearing from you.
Sincerely,
Tapu,CW
Jason Alfaro,
Project Manager
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
il.
Turf ilaintenance (All Turf Areasl
l . Mowing (lncluding Bagging of Clippings)
2. Edging
3. String Trimming
4. Aerification (Core/3")
5. Aerification (Deep Tine/6")
6. Weed Removal (Manual)
7. Pest Control (Manual)
8. Fertilization (Placement Only)
9. Materials (Fertilizer, Soil Amends)
10. Over seeding of Sports turf (Soccer Field, Football Field)
1 1 . Over seeding of Sports turf (Baseball Field)
12. Over seeding of General use turf areas
13. Artificial Turf areas
General Landscape Maintenance (Planters and SloDe Areas)
1. Edging (Ground Cover)
2. Trimming (Shrubs, Ground Cover)
3. Pruning/Shrubs, Vines, Roses
4. Pruning/Trees (To 18')
5. Weed Removal (Manual)
6. Pest Control (Manual)
7. Fertilization (Placement Only)
8. Vegetation Removal
9. Materials (Fertilizer, Soil Amends)
Plant ilaterial (lnstalled. All Areasl
1. Annual Color (4" Container)
2. Ground Cover
3. One (1) Gallon
4. Five (5) Gallon
5. Fifteen (15) Gallon
6. 24" Box Tree
7. Seeded Turf
8. Sodded Turf
9. Hydroseed
10. Soil Preparation (Existing Area)
1 1 . Soil Preparation (New Area)
12. Wood Mulch
ADDENDA NO, l &2&3
EXHIBIT *8"
CITY OF LAKE ELSINORE
LANOSCAPE MAINTENANCE EXTRA WORK
PRICE SHEET
Unit Cost
i-!-:-!-9
l-:-:-!-3
l-l-:-9-9
q!e!c sq. ft.
r.,l/A sq. ft.
sq*. Per nun HR'
litrcll+t. Per man HR.
liic!#t. Per man HR.
srote_per man hr.
j-!-jj-Per man hr.(Labor only)
9"1"sq. ft.
ge!t_l_tI
sggte_sq. ft. (min.40,000 sq. ft.)
orot" _sq. ft. (min.5,000 sq. ft.)
ouoie_Sq. fr. (min. 1 ,000 sq. ft.)
o,"G_sq. ft. (min. 1 ,000 sq. ft.)
a4 5 00 l.ll..lr*. Per rnan HR.
Cq# Per man HR.$t_:___00
1_:_:fq$ Per man HR.
q!q"each
j-l-:L9-Per man hr.
r-!j-Per man hr.
99 _.eq# Per rnan HR.
sq. ft.
c""t - 15%
aL:-LL-each
l_9_:9_9_flat
f-1-:-L1-eacn$
al:_t 1_each$
j-1L-0 l-each
1L1_:_L1_each
qge sq. ft.
Ouote .sq. ft.
919
sq.ft.
sq. ft.
sq. ft.$ !y9!9
00
ilt.
B-1
I-:9-cu.Yd.
t.
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
lV. lrrioation Svstem Maintenance
1. lnspection
2. Repair (Main Line, Lateral Line, Sprinklers)
3. Parts
11_:_o 1_per hr.
j_1_:_o 1_per hr.
e!ll!t
V. General P*t Control
1. Written Recommendation by PCA g ouoLeach
2. Qualified Applicator (QAC) $:j_:_:jlper hr.
3. Trained Applicator $1LLL_per hr.
4. Material $ ouoc _
B-2
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
EL LANDSCAPE
City of Lake Elsinore
Grand ave .
Lake Elsinore , California 92530
Estimate #10098
From Excel Landscape South
800) 734-9650
1185 Magnolia Ave . E400
Corona CA, 92879
Bill To Downtown Main st
130 South Main St.
Lake Elsinore , California 92530
Sent On 05/03/2022
Job Title Medians in the Grand . Planting
Job Number 7721
Location Medians in the grand ave
PRODUCT/ SERVICE DESCRIPTION QTY . UNIT PRICE TOTAL
Rose 5 gallon 5 gallon rose installed (red yucca)
Plant 5 gallon 5 gallon plant installed (Little Johns)
Plant 5 gallon 5 gallon plant installed (westringia mandi )
Plant 5 gallon 5 gallon plant installed (Raphiolepis)
Plant 5 gallon 5 gallon plant installed (pyracantha )
This quote is valid for the next 30 days, after which values may be subject to
change .
224 $25.00 $5,600.00
190 $25.00 $4,750.00
146 $25.00 $3 ,650.00
77 $25.00 $1 ,925.00
14 $25 .00 $350.00
Total [_-$16,275.00 I
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
EL LANDSCAPE
City of Lake Elsinore
Lincoln ave
Lake Elsinore , Cal ifornia 92530
Estimate #10099
From Excel Landscape South
800) 734-9650
1185 Magnolia Ave . E400
Corona CA , 92879
Bill To Downtown Main st
130 South Main St.
Lake Elsinore, California 92530
Sent On 05/05/2022
Job Title Lantern hill LN ( planting)
Job Number 7721
Location Lantern hill LN.
PRODUCT / SERVICE DESCRIPTION QTY. UNIT PRICE TOTAL
Irrigation Labor
Mulch
Material
Plant 5 gallon
Plant 5 gallon
Irrigation Labor
1 yard Cover mulch installed
Drip hose. 9 GPH 18" space ( 200 ft Roll)
5 gallon plant installed(Litter Johns)
5 gallon plant installed (Red yucca)
This quote is valid for the next 30 days , after wh ich values may be subject to
change .
Date: 5 · 33· 0d
6
15
200
31
22
60.00
50.00
0.32
22.00
25.00
Total
360.00
750.00
64.00
682.00
550.00
2,4os.oo I
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
EL LANDSCAPE
City of Lake Elsinore
Mission Trail median
Lake Elsinore , California 92530
Estimate #10094
From Excel Landsc ape South
800) 734-9650
1185 Magnolia Ave . E400
Corona CA , 92879
Bill To Downtown Main st
130 South Main St.
Lake Elsinore, California 92530
Sent On 05/02/2022
Job Title Mission trail median planting
Job Number 7721
Location Mission trail median
PRODUCT / SERVICE DESCRIPTION QTY. UNIT PRICE TOTAL
Plant 5 gallon 5 gallon plant installed (raphs)
This quote is valid for the next 30 days , after which values may be subject to
change.
Date: 6 · o-3 · Do
57 $25.00 $1,425.00
Total L $1,425.00 I
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
A/C, No):(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF POLICYEXPTYPEOFINSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TORENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
PRO-
POLICY LOC PRODUCTS - COMP/OPAGGJECT
OTHER:$
COMBINED SINGLE LIMIT
Ea accident)
ANY AUTO BODILY INJURY (Per person)$
OWNED SCHEDULED
BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICYLIMITDESCRIPTIONOFOPERATIONSbelow
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
8/18/2022
License # 0M63276
951) 368-0700 (951) 368-0707
23434
Excel Landscape, Inc.
1185 Magnolia Ave., #E400
Corona, CA 92879
34630
A 1,000,000
X X A0133421004 8/1/2022 8/1/2023 500,000
5,000
1,000,000
3,000,000
2,000,000
1,000,000A
X X A0133421001 8/1/2022 8/1/2023
Comp/Coll Ded 1,000
3,000,000A
A0133421005 8/1/2021 8/1/2022 3,000,000
0
B
EXWC318625 4/1/2022 4/1/2023 1,000,000
Y
1,000,000
1,000,000
30 days notice of cancellation to the certificate holder.
Job # 7721
Re: All landscape operations performed by or on behalf of the named insured.
The City of Lake Elsinore, The Community Redevelopment Agency of the City of Lake Elsinore (RDA), Its directors, officers & employees are named as
additional insured.
City of Lake Elsinore
Attn: Public Works Department
521 N. Langstaff Street
Lake Elsinore, CA 92530
EXCELAN-01 ASHUNN
Gallant Risk and Insurance Services, LLC
4160 Temescal Canyon Rd. Suite 214
Corona, CA 92883
Middlesex Insurance Company
Oak River Insurance Company
X
X
X
X
X
X
X
X
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
POLICY NUMBER:
Insurance Services Office, Inc., 2008
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 from whom you are required to
waive your right to recover under a written contract or
agreement in effect prior to any loss or damage
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.
A0133421004
Page 1 of1CG24040509
07/29/2022A0133421
Middlesex Insurance Company
00001 0000000000 22210 0N1 9b1287de-3f2d-4a17-9741-58ca38b87b899b1287de-3f2d-4a17-9741-58ca38b87b89
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
Insurance Services Office, Inc., 2012
POLICY NUMBER:COMMERCIAL GENERAL LIABILITY
CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)
Location And Description Of Completed
Operations
Any person or organization you are required to add as
an
additional insured under a written contract or
agreement
in effect prior to any accident, injury, loss or damage
All locations and jobs performed that have a written
contract, agreement or permit
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
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury" or
property damage" caused, in whole or in part, by
your work" at the location designated and
described in the Schedule of this endorsement
performed for that additional insured and included
in the "products-completed operations hazard".
However:
1.The insurance afforded to such additional
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.
B.With respect to the insurance afforded to these
additional insureds, the following is added to
Section III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1.Required by the contract or agreement; or
2.Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
A0133421004
Page 1 of1CG20370413
07/29/2022A0133421
Middlesex Insurance Company
00001 0000000000 22210 0N1 dab9b575-ce7d-4dd9-b0b7-3d9b59910411dab9b575-ce7d-4dd9-b0b7-3d9b59910411
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
Page 1 of2CG20100413
A0133421
Middlesex Insurance Company
Insurance Services Office, Inc., 2012
POLICY NUMBER:COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
CG 20 10 04 13
Name Of Additional Insured Person(s)
Or Organization(s)Location(s) Of Covered Operations
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
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.
However:
1.The insurance afforded to such additional
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.
B.With respect to the insurance afforded to these
additional insureds, the following additional
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 or
subcontractor engaged in performing
operations for a principal as a part of the same
project.
Any person or organization you are required to add as
an
additional insured under a written contract or
agreement
in effect prior to any accident, injury, loss or damage
All locations per written contract, agreement or permit
Description:
All jobs performed that have a written contract,
agreement or permit
A0133421004
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
C.With respect to the insurance afforded to these
additional insureds, the following is added to
Section III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1.Required by the contract or agreement; or
2.Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
Insurance Services Office, Inc., 2012 CG 20 10 0413Page2of2
A0133421
Middlesex Insurance Company
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
Named Insured:
Endorsement Effective Date:
Name(s) Of Person(s) Or Organization(s):
POLICY NUMBER: A0133421001 COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
SCHEDULE
Any person or organization from whom you are required to
waive your right to recover under a written contract or
agreement in effect prior to any loss or damage
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against
Others To Us condition does not apply to the
person(s) or organization(s) shown in the Schedule,
but only to the extent that subrogation is waived
prior to the "accident" or the "loss" under a contract
with that person or organization.
Insurance Services Office, Inc., 2011
Excel Landscape Inc
08/01/2022
Page 1 of1CA04441013
07/29/2022A0133421
Middlesex Insurance Company
00001 0000000000 22210 0N1 0b4a9ea6-53fa-4cde-9f54-f29054d2dac20b4a9ea6-53fa-4cde-9f54-f29054d2dac2
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
POLICY NUMBER:
SCHEDULE
COMMERCIAL AUTO
CA 76 01 06 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED - PRIMARY AND
NONCONTRIBUTORY - COVERED AUTOS
LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
AUTO DEALERS 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" for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated.
Named Insured:Excel Landscape Inc
Endorsement Effective Date:08/01/2022
Name Of Person(s) Or Organization(s):
Any person or organization you are required to add as an
additional insured under a written contract or agreement
in effect prior to any accident, injury, loss or damage
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A.Each person or organization shown in the
Schedule is an "insured" for Covered Autos
Liability Coverage, but only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in:
1)Paragraph A.1. of Section II - Covered Autos
Liability Coverage in the Business Auto and
Motor Carrier Coverage Forms; or
2)Paragraph D.2. of Section I - Covered Autos
Coverages of the Auto Dealers Coverage
Form.
B.Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other auto insurance issued
to the person or organization in the schedule
under your policy provided that:
1)The person or organization is a Named Insured
under such other insurance; and
2)Prior to the “accident” you have agreed in
writing in a contract or agreement that this
insurance would be primary and would not
seek contribution from any other insurance
available to the person or organization.
Includes copyrighted material of Insurance Services Office, Inc.,
with its permission.
A0133421001
Page 1 of1CA76010615
07/29/2022A0133421
Middlesex Insurance Company
00001 0000000000 22210 0N1 4c9cb5b1-a664-4e05-b188-f7802c569abd4c9cb5b1-a664-4e05-b188-f7802c569abd
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F
CITY OF LAKE ELSINORE
TO BE POSTED IN A CONSPICUOUS PLACE
Business Name:
Business Location:
Owner Name(s):
BUSINESS LICENSE NO.
Issue Date: Expiration Date:
BUSINESS LICENSE
THIS IS YOUR LICENSE • NOT TRANSFERABLE
710 RIMPAU STE 108 Business Type:
CORONA, CA 92879
EXCEL LANDSCAPE, INC.
1185 MAGNOLIA AVE STE E-400
CORONA, CA 92879-3218
This business license is issuedfor revenue purposes only anddoes not grant authorization
to operate a business. This business license is issuedwithout verificationthat the holder is
subject to or exempted from licensing by the state, county, federal government, or any
other governmental agency.
Administrative Services - Licensing
130 South Main Street, Lake Elsinore, CA 92530
PH (951) 674-3124
EXCEL LANDSCAPE, INC.
JOSE ALFARO
LANDSCAPING CONTRACTOR
004404
5/1/2022 4/30/2023
Starting January 1, 2021, Assembly Bill 1607 requires the prevention of gender-based discrimination of business establishments. A full notice is available in English or other
languages by going to: https://www.dca.ca.gov/publications/
DocuSign Envelope ID: F46801EE-66D4-4C2A-A0E0-D0D00AEE707F