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2018/07/01 West Coast Arborists, Inc. Certficiate of Liability Insurance (3)Certificate of Insurance IIIIS CERIIFICA 1171ISISS( ED 1S 1 V.11 II R of INIORMATION ONLY AND CONFERS NO RIGIITS UPON YOU 111L. CERI'IFICAIE BOLDER IFIIS CFRI1FICATE IS NO-1AN INSCRAN T.. VOLI 'Y A,N'D I x t! ti Nti I yS11 %ll" F.N WL lI. OR ALTER I I IE COVERAGE AFFORDED BY I I II[ POLICIES I.IS"ITD BELOW POLICY LIMITS ARE NO I FSS TIIAN TIIOSF f.15lI:D AI_iElUl:(ill IiOI.[t"tl S.�I 15 INt I i DI ADDIIION: 1211i, '1 MI N 'C hU fiLibw -Phis is, to ('crtifv Iitr11 ' I WEST COAST ARBORISTS, INC 2200 EAST VIA BURTON ` ■ ANAHEIM CA 92806 ADDRESS ►ND -Liberty 1be� Mutual. :ADDRESS L • OF INSURFI) L I INSURANCE is" al the rssuc dnte of this cctufrcale, utsured by the Ctmlpuny outer She pohcy(ics) listed below I he insurance anorded by the hsted policy(ies) is subject to all their terms, exclusions and I'nrtdtttons and knot aliv red by any requirement. tarmw cmxtnion of any contractor other document with respect to which this certificate may be issued F XP DATE: ❑ ('ON'I INCOUS TYPE OF POLICN' ❑ EXTENDED POLICY NUMBER LLMI"I' OF LIABlIXI-V 0 POLICY TERNI WORKERS 7/1/2019 WA7-66D-039499-078 AFFORDED UNDER we OF OF EMPLOYERS LIABILITY COMPENSATION TIFF LAWTIIe FOLI-owING sTn rrs: LAW All States Exceppt Bold, Idaryby Accident C6 Statutory Limits ND, OH, WA, WY 1 00 , Bodily Injury By Disease 1,000,000 Bodily Injury By Disease 1 0 0 000 COMMF:RCIAI 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 $1000,000 RETRO DA I li Personal &Advertising Injury $1 , QQQ,QQQ Per Person 'Organization t hhci �)v­ Dama a to remises rented to Medical Expense $5,000 A(� roMOBII,E 7/1/2019 AS7 661-039499-038 Each Accident Single Limit $2.000.000 n.l, And P D. Combined LIAH1L,ITY• Each Person LCJ OWNED Each Ace ident or Occurrence ❑ NON -OWNED ❑ AIRED 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: 201Bit 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 milten contract • If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the ecrnficate expiration date NO'FICE OF CANCELLATION (NOT APPI.ICABLI: UNLESS A NUMBER OF DAYS IS EN fF:RED BELOW ) BFI.ORE THE S-FATED EXPIRATION DATE -FILE COMPANY WILL NOT CANCEL OR REDUCE "fill: INSURANCE AFFORDED LINDER THE ABOVE POLICIES UN Ill AT LEAST 30 DAYS NOTICE OF SUC'II C'ANCFLLATION HAS BEEN MAILED TO FiCity of Menifee 29714 Haun Road Menifee CA 92586 �x u L This certificate is executed by IABF'RTY MUTUAL 46915532 1 LM 2a19 1 r/1B-�/1N - GL/2/1, AL/2, WC/1, LDI COI 268896 02 11 Liberty Mutual Insurance Group Elaine Ulan Los Angeles / 0603 AU I IIORI7,ED RLPRESFNTAJIVE 818 W 7th Street, Suite 850 0564408 Los Angeles CA 90017 213-443-0782 2/512019 OFFICF PI IONL' DATE ISSUED , INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 ❑/5 1 Connie Myszka 1 2/5/2019 10:20:54 AM (CSTI I Page I of I 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 include as an additional insured the person(s) or organization(s) showri 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; 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. 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 additi"I 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 endorsement modifies insurance provided under the following, COMMERCIAL. GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organ;zabon(s-p shown in the Schedule. but only with respect to liability for "bodily injur)('. "property tfarrragc ' or -personal and adK"istng injury' caused. in w,Ve 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: Name Of Additional Insured Person(s) Or Organization(s): Any owner, lessee, or contractor for whom you have agreed in writing prior to a loss to provide liability insurance 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 insuredrs) 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- 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 SCHEDULE Location(s) Of Covered Operations Any location work is performed 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 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 Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance 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 (2) 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 additional insured. 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 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 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.BS lion 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 Ed 041984 Page 1 of 1