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2022/07/01 West Coast Arborists, Inc. (4)ABDHEJOHolder Identifier : 7777777707070700077763616065553330773617546304557707553126763516201072650576046331130772405113067011207126011776274512071662775324723300754063713267631207544017172274570077727252025773110777777707000707007 6666666606060600062606466204446200622200624006202006020026262062000060002242622620220622220406024002206020006262242200060222260402402220622000624026202006222024240020400066646062240664440666666606000606006Certificate No :570094093953CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/27/2022 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). 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. PRODUCER Aon Risk Insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 Los Angeles CA 90017-0460 USA PHONE(A/C. No. Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED 38318Starr Indemnity & Liability CompanyINSURER A: 16109Starr Specialty Insurance CompanyINSURER B: INSURER C: INSURER D: INSURER E: INSURER F: FAX(A/C. No.):(800) 363-0105 CONTACTNAME: West Coast Arborists, Inc. 2200 E Via BurtonAnaheim CA 92806 USA COVERAGES CERTIFICATE NUMBER:570094093953 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 POLICY EXP (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)SUBRWVDINSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $1,000,000 $5,000 $2,000,000 $4,000,000 $4,000,000 A 07/01/2022 07/01/20231000100141221 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $2,000,000A07/01/2022 07/01/2023 COMBINED SINGLE LIMIT (Ea accident) 1000198198221 EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH-ERPER STATUTEB07/01/2022 07/01/2023 Workers Comp CA SIR applies per policy terms & conditions $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / AN WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 1000004228 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Project: City of Menifee Right-of-Way (ROW) GPS Tree Inventory Services. City of Menifee, its officers, agents and employees 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, its officers, agents and employees in accordance with the policy provisions of the General Liability, Automobile Liability and Workers Compensation policies. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Menifee 29714 Haun Road Menifee CA 92586 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE LOC #: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:ACORD 25 FORM TITLE:Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER NAMED INSUREDAGENCY See Certificate Number: See Certificate Number: 570094093953 570094093953 Aon Risk Insurance Services West, Inc. 570000083713 ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSURER INSURER INSURER INSURER INSURER(S) AFFORDING COVERAGE Page _ of _ NAIC # West Coast Arborists, Inc. TYPE OF INSURANCE POLICY NUMBER LIMITS WORKERS COMPENSATION A 1000004229 07/01/2022 07/01/2023 Workers Comp AZ N/A ADDL INSD INSR LTR SUBR WVD POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) SIR applies per policy terms & conditions ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F COMMERCIAL GENERAL LIABILITYCG 20 10 04 13POLICY NUMBER: 1000100141221 Effective: 07/01/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON ORORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 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 suchorganization(s) shown in the Schedule, but only work,on the project (other than service, with respect to liability for "bodily injury", "property maintenance or repairs) to be performed by ordamage"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 beencompleted; or1.Your acts or omissions; or 2.That portion of "your work" out of which the2.The acts or omissions of those acting on your injury or damage arises has been put to itsbehalf;intended use by any person or organizationin the performance of your ongoing operations for other than another contractor or subcontractortheadditionalinsured(s)at the location(s)engaged in performing operations for adesignated above.principal as a part of the same project.However:C.With respect to the insurance afforded to these1.The insurance afforded to such additional additional insureds, the following is added toinsured only applies to the extent permitted by Section III – Limits Of Insurance:law; and If coverage provided to the additional insured is2.If coverage provided to the additional insured is required by a contract or agreement, the most werequiredbyacontractoragreement,the will pay on behalf of the additional insured is theinsurance afforded to such additional insured amount of insurance:will not be broader than that which you arerequiredbythecontractoragreementto 1.Required by the contract or agreement; orprovide for such additional insured.2.Available under the applicable Limits ofInsurance shown in the Declarations;B.With respect to the insurance afforded to theseadditionalinsureds,the following additional whichever is less.exclusions apply:This endorsement shall not increase theThis insurance does not apply to "bodily injury" or applicable Limits of Insurance shown in the"property damage" occurring after:Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Name Of Additional Insured Person(s) OrOrganization(s):Location(s) Of Covered 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. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F COMMERCIAL GENERAL LIABILITYCG 20 37 04 13POLICY NUMBER: 1000100141221 Effective: 07/01/2022 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 PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE A. Section II – Who Is An Insured is amended to required by the contract or agreement toprovide for such additional insured.include as an additional insured the person(s) ororganization(s) shown in the Schedule, but only B.With respect to the insurance afforded to thesewithrespecttoliabilityfor"bodily injury"or additional insureds, the following is added to"property damage" caused, in whole or in part, by Section III – Limits Of Insurance:"your work"at the location designated anddescribed in the Schedule of this endorsement If coverage provided to the additional insured isperformed for that additional insured and included required by a contract or agreement, the most wein the "products-completed operations hazard".will pay on behalf of the additional insured is the amount of insurance:However: 1.Required by the contract or agreement; or1.The insurance afforded to such additionalinsured only applies to the extent permitted by 2.Available under the applicable Limits oflaw; and Insurance shown in the Declarations;2.If coverage provided to the additional insured is whichever is less.required by a contract or agreement,the This endorsement shall not increase the applicableinsurance afforded to such additional insured Limits of Insurance shown in the Declarations.will not be broader than that which you are CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Name Of Additional Insured Person(s) OrOrganization(s):Location And Description Of CompletedOperations 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. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F Dallas, TX 1-866-519-2522 Primary and Non-Contributory Condition Effective Date: July 1, 2022 at 12:01 A.M.Policy Number: 1000100141221 Named Insured: West Coast Arborists, Inc. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. SECTION IV – CONDITIONS, condition 4. Other Insurance is amended as follows: 1.The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the writtencontract or written agreement requires that this insurance be primary and non-contributory. In thatevent, we will not seek contribution from any other insurance policy available to the additional insuredon which the additional insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President Nehemiah E. Ginsburg, General Counsel OG 107 (04/11) Page 1 of 1Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved.Includes copyrighted material of ISO Properties, Inc., used with its permission. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F POLICY NUMBER: 1000198198221 COMMERCIAL AUTOCA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FORCOVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORMBUSINESS AUTO COVERAGE FORMMOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unlessmodified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverageunder the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverageprovided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicatedbelow. Named Insured: Endorsement Effective Date: 07/01/2022 SCHEDULE Each person or organization shown in the Schedule isan "insured" for Covered Autos Liability Coverage, butonly to the extent that person or organization qualifiesas an "insured" under the Who Is An Insuredprovision contained in Paragraph A.1.of Section II –Covered Autos Liability Coverage in the BusinessAuto and Motor Carrier Coverage Forms andParagraph D.2. of Section I – Covered AutosCoverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 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. West Coast Arborists, Inc. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F COMMERCIAL GENERAL LIABILITYCG 20 12 04 13POLICY NUMBER: 1000100141221 Effective: 07/01/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICALSUBDIVISION – PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE a."Bodily injury","property damage"orA. Section II – Who Is An Insured is amended to "personal and advertising injury" arising outinclude as an additional insured any state or of operations performed for the federalgovernmental agency or subdivision or political government, state or municipality; orsubdivision shown in the Schedule, subject to thefollowing provisions:b."Bodily injury"or "property damage"included within the "products-completed1.This insurance applies only with respect to operations hazard".operations performed by you or on your behalffor which the state or governmental agency or B.With respect to the insurance afforded to thesesubdivision or political subdivision has issued a additional insureds, the following is added topermit or authorization.Section III – Limits Of Insurance: However:If coverage provided to the additional insured isrequired by a contract or agreement, the most wea.The insurance afforded to such additional will pay on behalf of the additional insured is theinsured only applies to the extent permitted amount of insurance:by law; and 1.Required by the contract or agreement; orb.If coverage provided to the additionalinsuredisrequiredbyacontractor 2.Available under the applicable Limits ofagreement, the insurance afforded to such Insurance shown in the Declarations;additional insured will not be broader than whichever is less.that which you are required by the contract This endorsement shall not increase theor agreement to provide for such additional applicable Limits of Insurance shown in theinsured.Declarations.2.This insurance does not apply to: CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 State Or Governmental Agency Or Subdivision Or Political Subdivision: Where Required By Written Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Effective Date: 07/01/2022 at 12:01 A.M.Policy Number: 1000198198221 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 ofRecovery Against Others to Us, is amended to add: However, we will waive any right of recovery we have against any person or organization withwhom you have entered into a contract or agreement because of payments we make under thisCoverage Form arising out of an "accident" or "loss" if: (1)The "accident" or "loss" is due to operations undertaken in accordance with thecontract 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 oremployees of the person or organization, and we reserve our rights or lien to be reimbursed fromany 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 Steve Blakey, President Nehemiah E. Ginsburg, General Counsel SICA 1020 (03/12) Page 1 of 1Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved.Includes copyrighted material of ISO Properties, Inc., used with its permission. DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F y: 07/01/2022 100 0004228 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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 enforceour right against the person or organization named in the Schedule. (This agreement applies only to the extent thatyou 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 thework described in the Schedule. 2.0% of the California workers' compensation premiumThe additional premium for this endorsement shall beotherwise due on such remuneration. Schedule Person or Organization Job Description Where required by contractAny person or organization to whom you become obligated to waive your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Policy No.: Endorsement No.: Insured: W e s t C o a s t A r b o ri s ts , In c.Premium: Insurance Company: S t ar r S p e ci a lt y & L ia bili ty C o m p a n y Countersigned by WC 04 03 06 Page 1 of 1(Ed. 04-84) DocuSign Envelope ID: 19349B76-606E-4212-87BF-57555761747F