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2019/09/25 West Coast Arborists, Inc. Certificate of Liability InsuranceCertificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER, THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NO.1' AMEND, EXTEND. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED. ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMITILIMITS NOT LISTED BELOW. This is to Certify that I WEST COAST ARBORISTS, INC 2200 EAST VIA BURTON NAME AND � Llb�,� T Mutual. ANAHEIM CA 92806 ADDRESS 1 �.�' OF INSURED I� INSURANCE is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, 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 way be issued. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ❑ POLICY TERM WORKERS COMPENSATION Statutory Limits 7/1 /2020 WA7-66D-039499-079 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: All States Except: ND, OH, WA, WY EMPLOYERS LIABILITY Bodily In'nry by Accident 1 000 000e,a .«,eem Bodily Injury By Disease $1 000 000 P Bodily Injury By Disease 1 000,000 Bach P r COMMERCIAL GENERAL LIABILITY 7/1 /2020 TB2-661-039499-019 General Aggregate $2,000,000 ❑ OCCURRENCE Products / Completed Operations Aggregate ❑ CLAIMS MADE $2 , 000 , 000 Each Occurrence $2,000,000 Rf: I I] •N7 I. Personal & Advertising Injury $2,000,000 Per Person/Organisation Other Damage to remises rented to ther AUTOMOBILE LIABILITY 7/1/2020 AS7-661-039499-039 Each ngle Limit $2,000,000 B.I. And cN.D.(Combined Each Person �••� IJ OWNED ❑ NON -OWNED Each Accident or Occurrence ❑ HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS RE: Project: GPS Tree Inventory Project (Menifee Proposal #56723) 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 an WC, General Liability and/or Auto Liability applies only to the specific jobs of the insured performed under written contract. GL deductible -8250.000. If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) 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 OF SUCH CANCELLATION HAS BEEN MAILED TO: Project: GPS Tree Inventory Project (Menifee Proposal #56723) Liberty Mutual Insurance Group FCityy of Menifee 29844 Haun Rd Elaine Ulan d Menifee CA 92586 Los Angeles / 0603 AUTHORIZED REPRESENTATIVE x 818 W 7th Street, Suite 850 0564408 Los Angeles CA 90017 213-443-0782 9/25/2019 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 51365321 1 LM_2819 1 7/19-7/20 - GL/2/2, AL/2, WC/1 I Connie Myszka 1 9/25/2019 4:11:39 PM (CDT) I Page 1 of 1 LDI COI 268896 02 11 POLICY NUMBER: TB2-661-039499-019 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 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: 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 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. 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: SCHEDULE 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. 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 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:TB2-661-039499-019 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 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. Name Of Additional Insured Person(s) Or Organization(s): 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 All persons or organizations with whom you have entered into a written contract or agreement, prior to an occurrence or offense, to provide additional insured status. Location And Description Of Completed Operations All locations as required by a written contract or agreement entered into prior to an occurrence or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 0413 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: TB2-661-039499-019 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 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 01 04 13 C Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:AS7-661-039499-039 COMMERCIAL AUTO CA 20 48 1013 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 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 requited 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 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS7-661-039499-039 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 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER:TB2-661-039499-019 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 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 20/6 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 Where required by contract or written agreement prior to loss and allowed by law Issued by Liberty Insurance Corporation 21814 Job Description For attachment to Policy No. WA7-66D-039499-079 Effective Date Premium $ Issued to West Coast Arborists, Inc. WC 04 03 06 Page 1 of 1 Ed: 04/1984 A �® L. AAA CERTIFICATE OF LIABILITY INSURANCE DATE (M/V) 09,24,20192019 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). PRODUCER CONTACT Theresa Roque NAME: Huggins Dreckman Insurance PHONE (562) 594-6541 FAX (562) 594-0376 A/C No Ext : YA/C_Nol'T License No 0212199 _ ADDRESS. theresa@hdinsure.com ODR 5152 Katella Ave, Suite 206 INSURER(S) AFFORDING COVERAGE NAIC # Los Alamitos CA 90720 INSURERA: Ironshore Specialty Ins Co. 25445 INSURED INSURER B : West Coast Arborists, Inc INSURER C : 2200 E Via Burton St INSURERD. Anaheim CA 92806 INSURER E. INSURER F : COVERAGES CERTIFICATE NUMBER: 2019/2020 REVISION NUMRFR• 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 CONTRACTOR 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 ADUL SUHR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE APO— WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 71 OCCUR EACH OCCURRENCE S DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one aerson) $ PERSONAL& ADV INJURY S GEN'LAGGREGATE LIMITAPPLIES PER: POLICY ❑PRO- ❑ LOC JECT GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG $ $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acciden! $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED 1 1 RETENTION S $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE I I ER E L EACH ACCIDENT S ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA EL DISEASE - EA EMPLOYEE S - s (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT Professional Liability A Retroactive Date: July 1, 2010 Y 003666901 07/01/2019 07/01/2020 Each Occurrence Aggregate 5,000,000 5,000,000 Retention 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is additional insured with respects City of Menifee Right -Of -Way (ROW) GPS Tree Inventory and Survey Project CERTIFICATE HOLDER reurl=l t ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee Attn: Margarita Cornejo ACCORDANCE WITH THE POLICY PROVISIONS. Financial Services Mgr. AUTHORIZED REPRESENTATIVE 29844 Haun Rd. Menifee CA 92586 I @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IRONSHORE A Liberty Mutual Company IRONSHORE SPECIALTY INSURANCE COMPANY 175 Berkeley Street Boston, MA 02116 Toll Free: (877) IRON411 Endorsement # 6 Policy Number: 003666901 Insured Name: West Coast Arborists,lnc. Effective Date of Endorsement: July 01, 2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED(S) ENDORSEMENT - LIMITED It is hereby understood and agreed that for the additional Premium of $ 0.00., Section II. DEFINITIONS G. Individual Insured, is amended to add the following Additional Insured(s), but only for Damages or Claim Expenses arising out of actual or alleged Wrongful Acts committed by, on behalf of or at the direction of the Named Insured: any client of the Insured, if required by contract and provided that contract is in effect between the Insured and the client prior to the performance of any Professional Services; ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS OF THIS POLICY REMAIN UNCHANGED. Authorized Representative July 29, 2019 Date MPL.END.002 (0118) Page 1 of 1