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2019/02/05 West Coast Arborists, Inc. Certificate of Liability Insurance (3) Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATFER OF INFORMA ITON ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFIC/TE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE ND LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that I WEST COAST ARBORISTS, INC EAST VIA N NAME AND ANA Liberty Mutual ANAHEIM CA 92806 2606 ADDRESS , OF INSURED L INSURANCE is,at the issue date of this certificate,insured by the Company under the policy(iea)listed below. The insurance afforded by the listed policy(ies)is subject to all their terns,exclusions and Conditions and is not altered by any requirement,term or condition of any contract or other document with respect to which this certificate may be issued. E XP DATE: TYPE OF POLICY ❑CONTINUOUS POLICY NUMBER LIMIT OF LIABILITY ❑EXTENDED m POLICY TERM WORKERS 7/1 12019 WA7-66D-039499-078 COVERAGE AFFORDED UNDER WC EMPLOYERS LIABILITY LAW OF THE FOLLOWING STATES: COMPENSATION All Slates Except: Bodily m'ary by Accident Statutory Limits ND,OH,WA,WY1 000 o00Eech Accident Bodily Injury By Disease 1004 000 Bodily Injury By Disease 1 004 000 COMMERCIAL 7/1/2019 TB2-661-039499-018 General Aggregate GENERAL LIABILITY $2,000,000 m OCCURRENCE Products/Completed Operations Aggregate $2,000,000 ❑CLAIMS MADE Each Occurrence $1000 000 RETRO DA I Personal&Advertising Injury $1,004,440 Per Person/Organization Other her Dam a to remises rented to Medical Expense$5,000 AUTOMOBILE; 7/1/2019 A57 661 039499 038 Each Accident single Limit LIABILITY $2,000,000 B.I.And P D Combined Each Person ❑OWNED NON-OWNED Each Accident or Occurrence HIRED Each Accident or Occurrence OTHER 71112018-7/112019 TH7-661-039499-048 $5.000,000 Per Occurrence/Aggregate Umbrella Excess Liability ADDITIONAL COMMENTS RE:2018119 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 authorized volunteers on WC.General Liability and/or Auto Liability applies only to the specific jobs of the insured performed under written contract. •If the certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the cenifcate expiration date NOTICE OF CANCELLATION:(NOT APPLICABLE LNLESS A NUMBER OF DAYS IS ENTERED BELOW) Liberty Mutual BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE Insurance Group OF SUCH CANCELLATION HAS BEEN MAILED TO: City of Menifee 29714 Haun Road Elaine Ulan Menifee CA 9258E AUTHORIZED REPRESENTATIVE 11! Los Angeles/0603 818 W 7th Street,Suite 850 0564408 I Los Angeles CA 90017 213-443-0782 2/5/2019 LJ OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 46915532 1 LM 2819 17/16-7/19 - GL/2/1, AL/2, WC/1, U/5 I Connie Myszka 12/5/2019 10:20:54 AM (CST) I Page 1 of 1 LDI COI 268896 02 11 POLICY NUMBER-TI32-661-039499-018 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 PRODUCTSICOMPLETED 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) 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. by "your work" at the location designated and required by a contract or agreement, the most we described in the Schedule of this endorsement will pay on behalf of the additional insured is the performed for that additional insured and included amount of insurance: 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: and 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 whom 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 Insurance Services Office. Inc., 2012 Page 1 of 1 POLICY NUMBER:TB2-661-039499-018 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 endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section Il — 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 with work, on the project (other than service, 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 the additional insured(s) at the location(s) other than another contractor or subcontractor designated above. engaged in performing operations for a principal as a part of the same project. However 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 S. 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 2010 04 13 ,c)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 Person(s) Or Organization(s): 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. 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.I. 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 ©Insurance Services Office, Inc.. 2011 Page 1 of 1 POLICY NUMBER: TB2-661-039499-018 COMMERCIAL GENERAL LIABILITY CG 20 01 04 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 0 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 PRODUCTSICOMPLETED 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 u Insurance Services Office, Inc., 2008 Page 1 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 respectto coverage provided by this endorsement,the provisionsof 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. Premium: $ INCL 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 4410 13 C 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 2% 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 Organization Job Description 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 S Issued to West Coast Arborists. Inc WC 04 03 06 Page 1 of 1 Ed 04/1984