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2020/07/01 West Coast Arborists, Inc. Certificate of Liability Insurance (7)7MIDD/YYYY)(M CERTIFICATE OF LIABILITY INSURANCE08/"/2020 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 cerlificate 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 Aon Risk Insurance Services West, Inc- CITY OF IriENIFE'. NAME. Los Angeles CA office FINANCE PHONE o.C1[t]: (866) 283-7122 FAX (800) 363-0105 707 Wi 1 shi re Boulevard E-MAIL Suite 2600 �I )r� ADDRESS: Los Angeles CA 90017-0460 USA J U L �� a ��4�D INSURER(S) AFFORDING COVERAGE NAIC # INSURED RECEIVED � n INSURER A: Starr indemnity & Liability company 38318 west Coast Arbori sts, Inc. I l E C E I VE V INSURER B: Starr Specialty Insurance Company 161 99 2200 E Via Burton Anaheim CA 92806 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570082348375 REVISION NUMBER: 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MmoofyYYY MMll76fYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 10=0141201 EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence)$1' 000' 000 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000, 000 POLICY []E] PRO- ❑ LOC JECT PRODUCTS - COMP/OP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY 1000 198198201 07/01/2020 07/0 /2021 COMBINED SINGLE LIMIT $2 , 000 , 000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Par accident UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LAB HOCCUR CLAIMS -MADE OED I RETENTION A a WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 1 Workers Comp AZ 1000004228 Workers Comp CA 7 1 D 07/01/2020 07/01/2021 X PER STATUTE OTH• E.L. EACH ACCIDENT $1, 000 , 000 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 SEhediiia, may be attached If more space is required) RE: 2018/19 on call Right-of-way (ROW) Tree MaintenanC2 Services. City of Menifee and its officers, employees, agents and authorized volunteers are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability policy evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A waiver of Subrogation is granted in favor of City of Menifee and its officers, employees, agents and authorized volunteers in accordance with the policy provisions of the General Liability, Automobile Liability and Workers compensation policies. O w x 0 m D `c d a W a 0 2 u� n a7 m N 0 n u> CERTIFICATE HOLDER CANCELLATION _�F- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE - - POLICY PROVISIONS. City of Menifee AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee CA 92586 USA �n ��n�rotanc� �cta�sxa / ��na ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1000100141201 Effective: 07/01 /2020 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACT ORS - 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) Or Organization(s): Location And Description Of Completed Operations Where Required By Written Contract Where Required By Written Contract 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 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. 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 1000198198201 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERE❑ 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 this 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. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: West Coast Arborists, Inc. Endorsement Effective Date: 07/01/2020 SCHEDULE Name Of Person(s) Or Organization(s): Where required by written contract 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 9 Insurance Services Office, Inc., 2011 Page 1 of 1 -=v - Starr Indemnity & Liability Company Uallas, IX 1-8bb-b19-1b22 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Policy Number: 1000198198201 Effective Date: 07/01/2020 at 12:01 A.M. Named Insured: West Coast Arborists, Inc. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, A. - Loss Conditions, 5. - Transfer of Rights of Recovery Against Others to Us, is amended to add: However, we will waive any right of recovery we have against any person or organization with whom you have entered into a contract or agreement because of payments we make under this Coverage Farm arising out of an "accident" or "lass" if: (1) The "accident" or "loss" is due to operations undertaken in accordance with the contract existing between you and such person or organization; and (2) The contract or agreement was entered into prior to any "accident" or "loss". No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, and we reserve our rights or lien to be reimbursed from any recovered funds obtained by any injured employee. All other terms, conditions and exclusions of the policy shall remain unchanged. Signed for STARR INDEMNITY & LIABILITY COMPANY eve Blakey, President Nehemiah E. Ginsburg, GeneratCounsel SICA 1020 (03/12) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission.