Agenda Item
iii. RFP 22-752-012 Landscaping and Lawn Maintenance Services Contract Extension Approval (Yellowstone Landscape SE, LLC), renewal year 2 of 4 (Not to exceed $3,000,000)
Summary: Presented by: Mr. Erick Hofstetter, Chief Operating Officer, Division of Operations
Request: It is requested that the Board of Education approve the contract extension for RFP 22-752-012 Landscaping and Lawn Maintenance Services with Yellowstone Landscape SE, LLC, for an additional year through May 20, 2025, for a not to exceed amount of $3,000,000.
Why: An extension of this contract will allow Dekalb County School District to provide Landscaping and Lawn Maintenance Services required for the district on a set schedule.
Details: On April 18, 2022, the Board of Education approved Yellowstone Landscape SE, LLC, as the most responsive and responsible bidder to provide landscaping and lawn maintenance services throughout the District, on a scheduled and as needed basis. This recommendation is for the second of four (4) one-year (1-year) contract renewal options. Yellowstone Landscape SE, LLC is located at 3235 N State Street, PO Box 849 Bunnell, FL 32110.
Financial impact: It is anticipated that the cost for these services will not exceed $3,000,000 during the fiscal year and will be allocated from the General Fund Budget, Deferred Maintenance.
Contact: Mr. Erick Hofstetter, Chief Operating Officer, Division of Operations, 678.676.1475
Mr. Bobby Moncrief, Director of Facilities, Division of Operations, 678.676.1478
Effective: Upon Board Approval
Status: Approved by General Counsel
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 4/1/2025 3/22/2024
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).
CONTACT
PRODUCER Lockton Companies NAME:
3280 Peachtree Road NE, Suite #1000 PHONE FAX
(A/C, No, Ext): (A/C, No):
Atlanta GA 30305 E-MAIL
ADDRESS:
(404) 460-3600
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Safety National Casualty Corporation 15105
INSURED
Yellowstone Landscape, Inc. and all Subsidiaries INSURER B : ACE Property and Casualty Insurance Company 20699
1528310 See Attached List INSURER C :
3235 N State Street INSURER D :
P.O. Box 849 INSURER E :
Bunnell FL 32110
INSURER F :
COVERAGES Main NI COI's CERTIFICATE NUMBER: 19345989 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y GL6676218 4/1/2024 4/1/2025 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 300,000
X Pesticide&Herbicide MED EXP (Any one person) $ 10,000
X SIR $250,000 PERSONAL & ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
PRO-
POLICY X JECT X
LOC PRODUCTS - COMP/OP AGG $ 4,000,000
OTHER: $
COMBINED SINGLE LIMIT
A AUTOMOBILE LIABILITY Y Y CA6676217 4/1/2024 4/1/2025 (Ea accident) $
2,000,000
ANY AUTO BODILY INJURY (Per person) $
X XXXXXXX
OWNED SCHEDULED BODILY INJURY (Per accident) $ XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X AUTOS ONLY X AUTOS ONLY (Per accident) $ XXXXXXX
$ XXXXXXX
B UMBRELLA LIAB Y Y XOOG72569647 003 4/1/2024 4/1/2025 $ 10,000,000
X X OCCUR EACH OCCURRENCE
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED RETENTION $ $ XXXXXXX
WORKERS COMPENSATION PER OTH-
A Y LDS4066360 4/1/2024 4/1/2025 X STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED.
SEE NOTES FOR POLICY COVERAGE FORMS RE: LANDSCAPING AND LAWN MAINTENANCE SERVICES - RFP No. 22-752-012 DEKALB COUNTY BOARD
OF EDUCATION AND DEKALB COUNTY SCHOOL DISTRICT ARE ADDITIONAL INSURED AND A WAIVER OF SUBROGATION APPLIES AS REQUIRED BY
WRITTEN CONTRACT.
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
19345989 ACCORDANCE WITH THE POLICY PROVISIONS.
DEKALB COUNTY SCHOOL DISTRICT
Robert R. Freeman Administrative Complex AUTHORIZED REPRESENTATIVE
1701 Mountain Industrial Blvd
Stone Mountain GA 30083 USA
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Attachment Code: D613185 Master ID: 1528310, Certificate ID: 19345989
List of Named Insureds
Yellowstone Parent, L.P
Elk Intermediate Company I, Inc.
Elk Intermediate Company II, Inc.
Elk Buyer, Inc.
YLG Holdings, Inc.
Yellowstone Intermediate Holdings, Inc.
Yellowstone Landscape, Inc.
Yellowstone Landscape – Southeast, LLC
ALSW, LLC
Leaderscape – Palm Beach, LLC
Florida Landscape Consultants, LLC
Southeast Landscape Management Company, LLC
YLA - Midwest, LLC
Crawford Landscape Group, LLC
Acres Maintenance, LLC
Hayden Landscaping & Maintenance, LLC
Green-Up Landscape, LLC
Acres Enterprises, LLC
Yellowstone Landscape - Central, Inc
BLSW LLC
YLCSW, LLC
Texas Services, LLC
Native Land Design, LLC
Landscape USA- Austin, LLC
Ecoscape Solutions Group LLC
ELSW, LLC
Heads Up Landscape Contractors, LLC
Yellowstone Landscape West, LLC
SLM Holdings , LLC
Somerset Landscape LLC
Park Landscape LLC
Greener Pastures Landscaping LLC
Premier Sports Fields, LLC
Duke's Grounds Maintenance, LLC
Landscape Management Professionals, LLC
RKLT Properties, LLC
Arizona’s Best Landscape Management
Bloom Floralscapes, LLC
KCS Landscape Management, LLC
Premier Sports Fields, LLC
Moore Landscapes, LLC
O’Donnell’s Landscape Service, LLC
Attachment Code: D613185 Master ID: 1528310, Certificate ID: 19345989
Gleason Johndrow Landscaping, LLC
Davis Landscape Company LLC
Townscapes, LLC
Green Pastures Landscape Company, LLC
Attachment Code: D605923 Master ID: 1528310, Certificate ID: 19345989
Policy Forms
General Liability
1. CG 20 10 12 19 Additional Insured - Owners, Lessees or Contractors - Ongoing Operations
2. CG 20 37 12 19 Additional Insured - Owners, Lessees or Contractors - Completed Operations
3. CG 20 28 12 19 Additional Insured - Lessors of Leased Equipment
4. CG 20 07 12 19 Additional Insured - Engineers, Architects or Surveyors
5. CG 24 04 12 19 Waiver of Subrogation
6. CG 20 01 12 19 Primary and Non-Contributory Coverage
7. SNGL 047 0514 Earlier Notice of Cancellation Provided to Third Parties
Attachment Code: D589863 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: GL 6676218 COMMERCIAL GENERAL LIABILITY
CG 20 10 12 19
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
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
As required by written contract or agreement As per written contract.
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 additional
organization(s) shown in the Schedule, but only with exclusions apply:
respect to liability for "bodily injury", "property
This insurance does not apply to "bodily injury" or
damage" or "personal and advertising injury" caused, "property damage" occurring after:
in whole or in part, by: 1. All work, including materials, parts or
1. Your acts or omissions; or equipment furnished in connection with such
2. The acts or omissions of those acting on your work, on the project (other than service
behalf; maintenance or repairs) to be performed by or
in the performance of your ongoing operations for the on behalf of the additional insured(s) at the
additional insured(s) at the location(s) designated location of the covered operations has been
above. completed; or
However: 2. That portion of "your work" out of which the
1. The insurance afforded to such additional insured injury or damage arises has been put to its
only applies to the extent permitted by law; and intended use by any person or organization
2. If coverage provided to the additional insured is other than another contractor or subcontractor
required by a contract or agreement, the insurance engaged in performing operations for a
afforded to such additional insur edwill not be principal as a part of the same project.
broader than that which you are required by the
contract or agreement to provide for such
additional insured.
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
Attachment Code: D589863 Master ID: 1528310, Certificate ID: 19345989
C. With respect to the insurance afforded to these 2. Available under the applicable limits of
additional insureds, the following is added to Section insurance;
III – Limits Of Insurance: whichever is less.
If coverage provided to the additional insured is This endorsement shall not increase the applicable
required by a contract or agreement, the most we will limits of insurance.
pay on behalf of the additional insured is the amount
of insurance:
1. Required by the contract or agreement; or
Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19
Attachment Code: D589864 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: GL 6676218 COMMERCIAL GENERAL LIABILITY
CG 20 37 12 19
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) Location And Description Of Completed
Or Organization(s) Operations
As required by written contract or As per Written Contract
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" or If coverage provided to the additional insured is
"property damage" caused, in whole or in part, required by a contract or agreement, the most
by "your work" at the location designated and we will pay on behalf of the additional insured is
described in the Schedule of this endorsement the amount of insurance:
performed for that additional insured and 1. Required by the contract or agreement; or
included in the "products-completed operations
hazard". 2. Available under the applicable limits of
insurance;
However:
whichever is less.
1. The insurance afforded to such additional
insured only applies to the extent permitted This endorsement shall not increase the
by law; and applicable limits of insurance.
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 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
Attachment Code: D589868 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: GL 6676218 COMMERCIAL GENERAL LIABILITY
CG 20 01 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (2) You have agreed in writing in a contract or
Condition and supersedes any provision to the agreement that this insurance would be
contrary: primary and would not seek contribution
from any other insurance available to the
Primary And Noncontributory Insurance
additional insured.
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
Attachment Code: D589869 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: GL 6676218 COMMERCIAL GENERAL LIABILITY
CG 24 04 12 19
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:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
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 Uofs
Section IV – Conditions:
We waive any right of recovery against the
person(s) or organization(s) shown in the Schedule
above because of payments we make under this
Coverage Part. Such waiver by us applies only to
the extent that the insured has waived its right of
recovery against such person(s) or organization(s)
prior to loss. This endorsement applies only to the
person(s) or organization(s) shown in the Schedule
above.
CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
Attachment Code: D589867 Master ID: 1528310, Certificate ID: 19345989
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SPECIAL NOTICE OF CANCELLATION SERVICE
PROVIDED TO IDENTIFIED THIRD PARTIES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CHANGE
The following new provision is added toA . Cancellation of the COMMON POLICY CONDITIONS or such other
applicable state cancellation endorsement:
As a special service to you, if we cancel this policy for any reason other than non-payment of premium,
within thirty (30) days prior to the effective date of cancellation, we will mail a copy of such written notice
of cancellation to all third persons whose name and address have, during the applicable policy period,
been placed on file with us through your broker of record due to third party contractual requirements
relating to such notice.
As a special service to you, if we cancel this policy for non-payment of premium, within ten (10) days prior
to the effective date of cancellation, we will mail a copy of such written notice of cancellation to all third
persons whose name and address have, during the applicable policy period, been placed on file with us
through your broker of record due to third party contractual requirements relating to such notice.
If we have been provided with an electronic address of such third parties, at our election we may send
notice of cancellation to such third parties by electronic mail.
Notice of cancellation of coverage provided to a certificate holder is a courtesy only. Failure to provide
such notice will not extend the policy cancellation date, negate the cancellation of the policy, nor confer
any rights nor expectations upon the certificate holder nor subject us, our agents nor representatives to
liability for failure to provide notice.
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: 04/01/2024 Policy No. GL 6676218 Endorsement No.
Named Insured: YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE Premium $ Included
INTERMEDIATE HOLDINGS, INC.
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
(Countersignature by the Broker or Agent shall only occur
in the mailing states that require countersignature)
SNGL 047 0514 Safety National Casualty Corporation Page 1 of 1
Attachment Code: D623971 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: GL 6676218 COMMERCIAL GENERAL LIABILITY
CG 02 24 10 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EARLIER NOTICE OF CANCELLATION
PROVIDED BY US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Number of Days' Notice 90 days except 10 days’ notice for non-payment of premium where
allowed by state law.
(If no entry appears above, information required to complete this Schedule will be shown in the Declarations as
applicable to this endorsement.)
For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of
cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended
by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule
above.
CG 02 24 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1
Attachment Code: D589859 Master ID: 1528310, Certificate ID: 19345989
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) 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
Attachment Code: D589859 Master ID: 1528310, Certificate ID: 19345989
(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 04/01/2024 Policy No. CA 6676217 Endorsement No.
Named Insured YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE
INTERMEDIATE HOLDINGS Premium $ Included
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
Page 2 of 2 Safety National Casualty Corporation SNCA 026 10 13
Attachment Code: D589862 Master ID: 1528310, Certificate ID: 19345989
POLICY NUMBER: CA 6676217 COMMERCIAL AUTO
CA 04 49 11 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
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.
A. The following is added to the Other Insurance B. The following is added to the Other Insurance
Condition in the Business Auto Coverage Form Condition in the Auto Dealers Coverage Form and
and the Other Insurance – Primary And Excess supersedes any provision to the contrary:
Insurance Provisions in the Motor Carrier This Coverage Form's Covered Autos Liability
Coverage Form and supersedes any provision to Coverage and General Liability Coverages are
the contrary: primary to and will not seek contribution from any
This Coverage Form's Covered Autos Liability other insurance available to an "insured" under
Coverage is primary to and will not seek your policy provided that:
contribution from any other insurance available to 1. Such "insured" is a Named Insured under such
an "insured" under your policy provided that: other insurance; and
1. Such "insured" is a Named Insured under such 2. You have agreed in writing in a contract or
other insurance; and agreement that this insurance would be primary
2. You have agreed in writing in a contract or and would not seek contribution from any other
agreement that this insurance would be primary insurance available to such "insured".
and would not seek contribution from any other
insurance available to such "insured".
CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1
Attachment Code: D589861 Master ID: 1528310, Certificate ID: 19345989
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 04/01/2024 Policy No. CA 6676217 Endorsement No.
Named Insured YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE
INTERMEDIATE HOLDINGS Premium $ Included
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
SNCA 027 10 13 Safety National Casualty Corporation Page 1 of 1
Attachment Code: D589860 Master ID: 1528310, Certificate ID: 19345989
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
SPECIAL NOTICE OF CANCELLATION SERVICE
PROVIDED TO IDENTIFIED THIRD PARTIES
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE COVERAGE PART
CHANGE
The following new provision is added to A. Cancellation of the COMMON POLICY CONDITIONS or such other
applicable state cancellation endorsement:
As a special service to you, if we cancel this policy for any reason other than non-payment of premium,
within thirty (30) days prior to the effective date of cancellation, we will mail a copy of such written notice of
cancellation to all third persons whose name and address have, during the applicable policy period, been
placed on file with us through your broker of record due to third party contractual requirements relating to
such notice.
As a special service to you, if we cancel this policy for non-payment of premium, within ten (10) days prior
to the effective date of cancellation, we will mail a copy of such written notice of cancellation to all third
persons whose name and address have, during the applicable policy period, been placed on file with us
through your broker of record due to third party contractual requirements relating to such notice.
If we have been provided with an electronic address of such third parties, at our election we may send
notice of cancellation to such third parties by electronic mail.
Notice of cancellation of coverage provided to a certificate holder is a courtesy only. Failure to provide
such notice will not extend the policy cancellation date, negate the cancellation of the policy, nor confer
any
rights nor expectations upon the certificate holder nor subject us, our agents nor representatives to liability
for failure to provide notice.
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
Named Insured 04/01/2024
YELLOWSTONE Policy&No.
LANDSCAPE, INC. CA 6676217
YELLOWSTONE Endorsement No.
INTERMEDIATE HOLDINGS Premium $ Included
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
SNCA 039 10 13 Safety National Casualty Corporation Page 1 of 1
Attachment Code: D589870 Master ID: 1528310, Certificate ID: 19345989
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 FORM APPLIES ONLY TO THE FOLLOWING STATE(S) IF COVERED BY YOUR POLICY. IF A
STATE IS NOT LISTED BELOW, THIS FORM DOES NOT APPLY IN THAT STATE.
AZ, CO, FL, GA, IL, KS, MA, MI, NV, NM, NC, PA, SC, TN, VA
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 04/01/2024 Policy No. LDS4066360 Endorsement No.
Insured YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE INTERMEDIATE Premium $ Included
HOLDINGS, INC.
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
WC 00 03 13 (04 84) Page 1 of 1
© 1983 National Council on Compensation Insurance.
Attachment Code: D643724 Master ID: 1528310, Certificate ID: 19345989
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of
the Information Page.
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, but this waiver applies only with
respect to bodily injury arising out of the operations described in the Schedule where you are required by a
written contract to obtain this waiver from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
SCHEDULE
1. ( ) Specific Waiver
(X) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this
waiver.
2. Operations:
3. Premium: $
The premium charge for this endorsement shall be percent of the premium developed on payroll in
connection with work performed for the above person(s) or organization(s) arising out of the operations
described.
4. Advance Premium:
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 04/01/2024 Policy No. LDS4066360 Endorsement No.
Named Insured YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE Premium $ Included
INTERMEDIATE HOLDINGS, INC.
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
WC 42 03 04 B (06 14)
© Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved.
Attachment Code: D589871 Master ID: 1528310, Certificate ID: 19345989
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 99 35
SPECIAL NOTICE OF CANCELLATION SERVICE
PROVIDED TO IDENTIFIED THIRD PARTIES ENDORSEMENT
As a special service to you, if we cancel this policy for any reason other than non-payment of premium,
within thirty (30) days prior to the effective date of cancellation, we will mail a copy of such written notice
of cancellation to all third persons whose name and address have, during the applicable policy period,
been placed on file with us through your broker of record due to third party contractual requirements
relating to such notice.
As a special service to you, if we cancel this policy for non-payment of premium, within ten (10) days prior
to the effective date of cancellation, we will mail a copy of such written notice of cancellation to all third
persons whose name and address have, during the applicable policy period, been placed on file with us
through your broker of record due to third party contractual requirements relating to such notice.
If we have been provided with an electronic address of such third parties, at our election we may send
notice of cancellation to such third parties by electronic mail.
Notice of cancellation of coverage provided to a certificate holder is a courtesy only. Failure to provide
such notice will not extend the policy cancellation date, negate the cancellation of the policy, nor confer
any rights nor expectations upon the certificate holder nor subject us, our agents nor representatives to
liability for failure to provide notice.
THIS FORM APPLIES ONLY TO THE FOLLOWING STATE(S) IF COVERED BY YOUR POLICY. IF A
STATE IS NOT LISTED BELOW, THIS FORM DOES NOT APPLY IN THAT STATE.
CO, GA, IL, KS, MA, MI, NV, NM, PA, SC, VA
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 04/01/2024 Policy No. LDS4066360 Endorsement No.
Insured YELLOWSTONE LANDSCAPE, INC. & YELLOWSTONE INTERMEDIATE Premium $ Included
HOLDINGS, INC.
Insurance Company Safety National Casualty Corporation
Countersigned By ________________________________
WC 99 99 35 (07 12) Page 1 of 1