Loading...
2018/07/01 West Coast Arborists, Inc. Certficiate of Liability Insurance Certificate of Insurance IIIIS CERII FICA II'.ISISS( LD 1S 1 V.11 II R of INIORMATION ONLY AND CONFERS NO RIGIITS UPON YOU 111L.CERI'FFICA E BOLDER IFIIS CFRIIFICATE IS NOT AN INSCRAN T.. VOLI 'Y A,N'D I x if ti Nti I '511%ll"F.N SEMI,OR ALTER I I IE COVERAGE AFFORDED BY I I II[POLICIES I.IS"11?D BFLOW POLICY LIMITS ARE NO I FSS TIIAN TIIOSF f.15lI:D AI_iElUl:(ili IiOI.[t"FI>;.�115 I\t l i DI ADDIIION: 1211i, 'J MI N 'C hU fiLibw -I'his is,to('crtifv Iitr11 I WEST COAST ARBORISTS, INC 2200 EAST VIA BURTON ` ■ ANAHEIM CA 92806 ADDRESS ►ND - Liberty 1be� Mutual :ADDRESS L l.0 • OF INSURFI) L I INSURANCE is"al the Issue dnte of thus cetuficale,insured by the 0101 Ally utxlar She pohcy(ics)listed below I he insurance anorded by the hsted policy(ies)is subject to all their terms,exclusions and I'-in Mons and knot aliv red by any requirement.telmw cmxtnion of any contractor other document with respect to which this certificate may be issued FXPDATE ❑('ON'I INCOUS TYPE OF POLICN' POLICY NUMBER LLMI'I'OF LIABILI'FV ❑EXTENDED 0 POLICY TERNI WORKERS 7/1/2019 WA7-66D-039499-078 COVERAGE.AFFORDED UNDER WC EMPLOYERS LIABILITY LAW'OF TIFF FOLLOWING STA FE:S: COMPENSATION All States Exceppt: Bold,Idnryby Accident Statutory Limits ND,OH,WA,WY 1 00 C6, Bodily Injury By Disease 1,000,000 Bodily Injury By Disease 1 0 0 000 COMMERCIAL 7/1/2019 T62-661-039499-018 (General Aggregate GENERAI.I,IABI1.1'rl $2,000,000 m OCCURRENCE: Products/Completed Operations Aggregate $2,000,000 ElCLAIMS MADE Fach Occurrence $1 000,000 RETRO DA I Li Personal&:Wvenising Injury $1,QQQ,QQQ Per Person'Organization t hhcr )v r Dama a to remises rented to Medical Expense$5,000 A(�roMOBII.E 7/1/2019 AS7 661-039499-038 Each Accident Single Limit LIAH1L,ITY• $2.000.000 n.1,And P D.Combined Each Person LCJ OWNED ❑NON-OWNED Each Ace ident or Occurrence ❑HIRED Each Accident orOccurremc OTIIER 7/1/2018-7/1/2019 TH7-661-039499-048 $5,000,000 Per Occurrence/Aggregate Umbrella Excess Liability ADDITIONAL.COMMENTS RE:201 Bit 9 On Call Right-of-Way(ROW)Tree Maintenance Services City of Menifee and its officers,employees,agents and authorized volunteers are additional Insured with regards to general liability and auto liability as their interest may appear where required by written contract The Insurance afforded by the GL policy for the benefit of the additional insured shall be primary and non-contributory Waiver of Subrogation In favor of City of Menifee and its officers,employees,agents and athorized volunteers on WC,General Liability andlor Auto Liability applies only to the specific jobs of the insured performed(ender written contract If the certificate expiration date is continuous or extended teen,you will be notified if coverage is terminated or reduced before the certificate expiration date NO'FICE OF CANCELLATION (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS EN fF:RED BELOW) BFI.ORE THE S-FATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE"fill: Liberty Mutual INSURANCE AFFORDED LINDER THE ABOVE POLICIES UN Ill AT I.FAST 30 DAYS NOTICE Insurance Group OF SUC'II CANCELLATION HAS BEEN MAILED TO FiCity of Menifee 29714 Haun Road Elaine Ulan Menifee CA 92586 AU I IIURI7,ED RFPRESFNTAIIVE Los Angeles/0603 0564408 x 818 W 7th Street,Suite 850 Los Angeles CA 90017 213-443-0782 2/512019 OFFICF PI IONL' DATE ISSUED This certificate is executed by LIBI:'RTY MUTUAL.INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 46915532 1 LM_2819 I r/1B-�/1N - GL/2/1, AL/2, WC/1, ll/5 1 Connie Myazka 1 2/5/2019 10:20-54 AM (CSTI Page t of 1 LDI COI 268896 02 11 POLICY NUMBER TB2-661-039499-018 COMMERCIAL GENERAL LIABILITY CG 20 37 D4 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 PRODUCT&COMPLETED OPERATIONS LIABILITY COVERAGE PART 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) showri 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 "y(xjr ry damage" caused- in while or �n pert, by required by a contract or agreement, the most we 'yoci► work" at the Ic]Catipn designated and described in the Schedule of this endorsement will pay on behalf of the additional insured is the amount of insurance: performed for that additional insured and included in the"products-completed operations hazard" 1. Required by the contract or agreement', or However 2. Available under the applicable Limits of 1. The insurance afforded to such additional insurance shown in the Declarations, insured only applies to the extent permitted by whichever is less. law:" This endorsement shall not increase the applicable 2. If coverage provided to the additional insured is Limits of Insurance shown in the Declarations. 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- SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations with whore you have All locations as required by a written contract or entered into a written contract or agreement, prior to an agreement entered into prior to an occurrence or occurrence or offense,to provide additional insured offense status Information required to complete this Schedule. if not shown above,will be shown In the Declarations CIS 20 37 04 13 c: Insurance Services Office. Inc , 2012 Page 1 of 1 POLICY NUMBER:T82 661-039499-018 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This er-dorsement modifies insurance provided under the following, COMMERCIAL. GENERAL LIABILITY COVERAGE PART 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 orgawabon(s) shown in the Schedule. but only with work, on the project (other than service, respect to liability for "bodily injury'. "property maintenance or repairs) to be performed by or tfarrrag[ ' or -personal and ac K"Istng injury.' on behalf of the additaial insuredrs) at the caused. in wficifeor 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 the additional insured(s) at the location(s) other than another contractor or subcontractor designated above. engaged in performing operations for a However: principal as a part of the same project- C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional insureds, the following is added to insured only applies to the extent permitted by Section III—Limits Of Insurance: law: and If coverage provided to the additional insured is 2. If coverage provided to the additional insured is required by a contract or agreement, the most we required by a contract or agreement, the will pay on behalf of the additional insured is the insurance afforded to such additional insured will amount of insurance: not be broader than that which you are required 1. Required by the contract or agreement; or by the contract or agreement to 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 SCHEDULE Name Of Additional Insured Person(s) Location(s)Of Covered Operations Or Organization(s): Any owner, lessee, or contractor for whom you have Any location work is performed agreed in writing prior to a loss to provide liability insurance Information required to complete this Schedule,if not shown above, will be shown in the Declarations. CG 20 10 04 13 � Insurance Services Office, Inc , 2012 Page 1 of 1 POLICY NUMBER AS7-661-039499-038 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE 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 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 does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Persori Or Organization(s): i Any person or organization whom you have agreed in writing to add as an additional insured, but only to Coverage and minimum limits of insurance required by the written agreement. and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy i Information required to complete this Schedule, if not shown above, will be shown in the Declarations 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 Paragraph A.1.of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2.of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form CA 20 48 10 13 Oc Insurance Services Office, Inc.. 2011 Page 1 of 1 POLICY NUMBER: TB2-661-039499-018 COMMERCIAL GENERAL LIABILITY CG 20 0104 13 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 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 Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. 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 0104 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:TB2-661-039499-018 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 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 below 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 below SCHEDULE Name Of Person Or Organization: Any person or organization with whom you have agreed in writing to waive any right of recovery prior to a loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 24 04 05 09 C)Insurance Services Office. Inc , 2008 Page t of 1 POLICY NUMBER AS7-661-039499-038 COMMERCIAL AUTO CA04441013 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 SCHEDULE Name(s)Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring I Y I Premium: $ INCL f 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 CA 04 44 10 13 'Z Insurance Services Office, Inc- 2011 Page 1 of 1 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 201. of the California workers' compensation premium otherwise due on such remuneration Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of$250, Person or OrganlzaiigLo Job 0.BScrt ton Where required by contract or written agreement prior to loss and allowed by law Issued by Liberty Insurance Corporation 21814 For attachment to Policy No WA7-66D-039499-078 Effective Date Premium$ Issued to West Coast Arborists, Inc WC 04 03 06 Page 1 of 1 Ed 041984