2022/07/01 West Coast Arborists, Inc. (5),.r..G|;CERTIFICATE OF LIAB!LITY INSURANCE
COVER CEnTIFICATE NUMBER: 5700s4093953 REVISION NUMBER:
o
1
!
!
I
Fi iisH*
DATE(MM/OO,YYYY)
0612712022
THIS CERTIFICATE IS ISSUED AS A MATTEB OF INFORMATIOI.I ONLY AND CONFEBS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OB NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEO BY THE POLICIES
BELOW. THIS CEBTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUT}IORIZED
REPRESENTATIVE OR PRODUCEB, AND THE CERTIFICATE HOLDEF.
|MPoRTANT: I th -E an AODmONAL INSURED, the policy(ies) must have aoolTlONAL INSUFED provisions or be endor3ed. ll
SUBROGATION lS wAlvED, subiect to the torms and conditions ot tho policy, certain policies may roquirs an endoEsment. A atatomonl on lhag
c6rtificato doer not conrer righlg to the certificate holdsr in lieu of such endorsement(s).
CONTACT
llqo.Nf,o. s.r, ceool zol-zrzz b6. No.) (8oo) r53-o1ot
ADDFESS
INSUBEB{S) AFFONOING COVEFAGE
PFODIrcEF
Aon Risk rnsLrrance services west, rnc
Los ano€]es ca offi ce707 l,l/i lchi r. Boul.verd
sui te 2600Los anqeles cA 90017-0460 usa
llrsuFEnAi starr Indemnity & Liability company 18118
t SUaERB: starr Specialty lnsurance Conpany 16109
II'EUREO
west coast arbori sts.
2200 E via aurtonAnahein cA 92806 usa
Inc
THIS IS 10 CEhTIFY THAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAII,,IED ABOVE FOF THE POLICY PERIOO
INDICATEO, NOTWITHSTANDING ANY BEQUIBEMENT, TEBM OR CONOITION OF ANY CONTBACT OF OTHER OOCUMENT WITH RESPECT TO WHICH THIS
CEFTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEHEIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ltmtts 3hown are s! roqu€sted
COUMERCIAL GENEFAL LIAgILITY
GEN LAGGNEGATE L MIT APPLIES PEF
POLICY
OTHER
JECT LOC
11.rCrO1U014tl2r s2,000,000
PAEMSES rEa o..ud6nc6r s1,000,000
MEo EXP (Any one p6l3on)$s,000
PERSONAL & ADV iNJI]RY s2,000,000
GFNFPAl AGGEEGATE s4,000,000
PROOUCTS, COMP]OPAGG t4,000,000
AUTOMOAILE L AA LITY
AUTOS ONLY
SCHEOULED
AUIOS
NON-OWNEO
AUTOSONLY
1000198198221 01/ot/2022 07 /ot/2023 COMBINEO SINGLE LIMIT s2 ,000,000
BOOILY INIUAY i Pd oelson)
BOD LY N.TURY iPor addent)
EX6E9S LlAa
OCCUF
CLAMS.MAOE
EACH OCCURAENCE
DED [:TENT ON
B WORI(EFS COMPENSATION AND
EMPLOYESS' LIAEII-ITY
ANY PROPFIETOA, PIFTNER / EXECLJTIVE
OFFICEfu M€MBER EXCLUOEO?
DESCRTPIION OF OFEFATIONS b6low
100000422E
workers comp ca
srR applies per po'licy ter
07/oL/zot2
na & condil
o7/ot/zoz3
:i ons
x OTH
E L EACH ACCIO€NT $1,000,000
€ L O SEAS E.EA EMPLOYEE $1,000,000
E L. O SEAS E-POLICY LIMIT 11,000,000
o€SCnlPT|oN OF OPE AATIO'IS / LOCATIOXai / VEIiCIES (ACOFD t 01 , lrdfiond F.nnrt. Sch.dur., ,r.y b. .t chrd r mr. lp.c. r. oaulr.d)
RE proi€ct: citv of Menifee Rioht-of-wav (Row) GPS Tree Inventory Services, Citv of Menifee, its officers. aoents and
enolove6s are rniluded as Additional rngirred in accordance with the Do'licv Droviiions of the cenera] Liabilitt and automobi'leLiibilitv Do'licies. Genera'l L'iabi'lity policy evidenced herein is pri;ary ana Non-contributory to other insu.ailce avai'1ab'le toan additioira'l rnsured, but on]y in atcbrdanie with the Dolicy's provisi6ns. A waiver of Subr6qation is qranted in favor of cityof ltenifee, its officers, aqenis and ernp'loyees in accordance with the policy provisions of the ceneral Liabi'lity, automobileLiabi'lity and workers compensation policies.
z
!!
=
:r
+..,its
E=
H,::isffi
CERTIFICATE HOLDER CANCELLATION
O1988.2015 ACORD CORPORATION. All rights ressrved
The ACORD name and logo are registered marks of ACOBO
E
I8
I
E
SHOUI.D ANY OF THE AEOVE DE9CNIBED FOL|CIES BE CANCELLED BEFOFE THE
EXPTEAIION DAIE THEHEOF. NOTICE WLL BE OELIVEFED IN ACCOFOANCE WTH THE
,M* @"/9*,,r. * 9*uo VA 9*
cit
297
of Meni fee
Haun Roadee cA 92586 usA
v14if
ACORD 25 (2016/03)
] c.rnas.ume []occun
AGENCY CUSTOMEH tD: s70000083713
LOC #:o-R'ADDITIONAL REMARKS SCHEDULE Page - of _
AGENCY
Aon Risk Insurance Services lriest, Inc.
NAMEO NSUFEO
l{est coast A.bori sts, Inc.
See certi ficate Number: 570094093953
See certi fi cate Number: 570094093953
NAIC CODE
AODITIONAL REMABKS
THIS AOOITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACOBD 25 FORM TITLE: C€dilicate of Liability lnsurance
INSUBER(S) AFFORDING COVERAGE
INST] RI.:R
INSLI R FJR
lNst,Rt-.R
INSURER
AI)I)ITI0NAI, PoLICIES If a policy below does not include limit informarion, refer to the corrcsponding policy on the ACORD
cenificate form for policy limits.
t\sRlj'R 'nl,u()rtNsl RAN(u ADDI-lNsl)st lllr utjt.F_('u\t.:axHRArl()N I tnnI]t
WORKERS CO[4PENSATION
L000004229
workers comp az
srR applies per policy te
07 /0t/2022
m5 & condit'
07 /07/2023
TIItIIIIIII
T
llII
TIIItII
IIII
TIIIII
acoRo 101 (2008/01)
Tho ACOFO nalri€.nd logo ars rogislored mrrks ot ACOBD
O 2OO8 ACOFD COBPOBATION. All rights rsserved.
I Herc *
=i-
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 lollowing
COMIVIEBCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
POLICY NUIVIBER: 1 0001 00 1 4 1 221
Effective: 0710112022
A. Section ll - Who ls An lnsured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability lor "bodily injury", "property
damage" or "personal and advertising injury"
caused, in whole or in pad, by:
1. Your acts or omissions; or
2. The acts or omissions ol those acting on your
behalf;
in the performance of your ongoing operations forthe additional insured(s) at lhe location(s)
designated above.
However:
1. The insurance alforded to such additional
insured only applies to the extent permitted by
law; and
2, lf coverage provided to the additional insured is
required by a contract or agreement, the
insurance allorded 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 atforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
COMMEBCIAL GENERAL LIABILITY
cG 20 10 04 13
1, All work, including materials, pads 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 ol "your work" out ol which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contraclor or subcontractor
engaged in performing operations lor 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 lll - Limits Ol lnsurance:
lf 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
lnsurance shown in the Declarationsi
whichever is less.
This endorsement shall not increase the
applicable Limits ol lnsurance shown in the
Declarations.
II.iiit
Eft
E
5
a
I
E
Name Ol Additional lnsured Person(s) Or
Organization(s):Location(s) Of Covered Operations
Where Bequired By Written Contract Where Required By Written Contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
H.ii&
t!={f
cG 20 10 04 13 @ lnsurance Services Office, lnc.,2012 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CABEFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS . COMPLETED OPERATIONS
This endorsement modilies insurance provided under the following:
COIVMERCIAL GENERAL LIABILITY COVEBAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
POLICY N UIVlBER : 1 OOO1 OO1 41 221
Effective: 07lU 12A22
A. Section ll - Who ls An lnsured 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 lor 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. lf coverage provided to the additional insured is
required by a contract or agreement, the
insurance aflorded to such additional insured
will not be broader than that which you are
COMMERCIAL GENERAL LIABILITY
cG 20 37 04 13
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 lll - Limits Of lnsurance:
lf 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
lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of lnsurance shown in the Declarations.
Name Of Additional lnsured Person(s) Or
Organization(s):
Location And Description Of Completed
Operations
Where Required By Written Contract Where Required By Written Contract
lnformation required to complete this Schedule, il not shown above, will be shown in the Declarations
cG 20 37 04 13 O lnsurance Services Office, lnc.,2012 Page 1 ol I
f Starr !ndemnity & tiability Company
Primary and Non-Contributory Condition
Policy Number: 1000100141221
Named lnsured: West Coast Arborists, lnc
Effective Date: July 1,2022 at 12:01 A.M
A. SECTION lV - CONDITIONS, condition 4. Other lnsurance is amended as tollows:
1. The following is added to paragraph 4.a. of the Other lnsurance condition:
This insurance is primary insurance as respects our coverage to the additional insured, where the written
contract or written agreement requires that this insurance be primary and non-contributory. ln that
event, we will not seek contribution from any other insurance policy available to the additional insured
on which the additional insured is a Named lnsured.
S u"",--fuL.Je
Nehem ns urg'eneral unsel
Dallas, TX 1 -866-51 9-2522
ffi
a
E
5
I
8
I
E
F"Jii*H&
oG 107 (04n1)
Copyright @ C. V. Star & Company and Starr lndemnlty & Llabillty Company. All .ight8 resorv6d
lnclud$ copyrlght6d material ol ISO Propertios, lnc., used wlth lts pormis6ion.
Page 1 ol 1
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
ALL OTHER TEBMS AND CONDITIONS REMAIN UNCHANGED,
Signed for STARR INDEMNITY & LIABILITY COMPANY
Stev6 Blaket, President )
POLICY NUI\4BER: 100019819822 1 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 modilies insurance provided under the following
AUTO DEALERS COVEBAGE FORtvl
BUSINESS AUTO COVERAGE FORi,4
I\4OTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unlessmodilied by this endorsement.
This endorsement identilies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverageunder the Who ls An lnsured provision ol the Coverage Form. Thts 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 lnsured: West Coast Arborists, lnc.
EndorsemenlEfrectiveDate: 0710112022
SCHEDULE
Name Ol Person(s) Or Organization(s):
Where required by written contract
ln{ormation uired to com lete this Schedule il not shown above will be shown in the Declarations.
Each person or organization shown in the Schodule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifiesas an "insured" under the Who ls An lnsured
provision contained in Paragraph A.1. of Section ll -Covered Autos Liability Coverage in the BusinessAuto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section l- Covered Autos
Coverages of the Auto Dealers Coverage Form.
cA 20 48 10 13 @ lnsurance Services Office, lnc., 201 1 Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
This endorsement modif ies insurance provided under the ,ollowing
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Aqency Or Subdivision Or Political Subdivision:
Where Required By Writlen Contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
POLICY NUIVIBER: 1 0001 001 41 221
Effective: 07lO1l2O22
A. Section ll - Who ls An lnsured is amended to
include as an additional insured any state or
governmental agency or subdivision or political
subdivision shown in the Schedule, subject to the
lollowing provisions:
1. This insurance applies only with respect to
operations performed by you or on your behall
lor which the state or governmental agency or
subdivision or political subdivision has issued a
permit or authorization.
However:
a. The insurance atforded to such additional
insured only applies to the extent permitted
by law; and
b. lf coverage provided to the additional
insured is required by a contract or
agreement, lhe insurance atforded 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.
2. This insurance does not apply to:
COMMERCIAL GENERAL LIABILITY
cG 20 12 04 13
a. "Bodily inJury", "property damage" or
"personal and advertising injury" arising outof operations performed for the federal
government, state or municipalily; or
b. "Bodily injury" or "property damage"
included within the "products-completed
operations hazard".
B, With respecl lo the insurance atforded to these
additional insureds, the following is added to
Section lll - Llmits Ol lnsurance:
lf coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behall of the additional insured is the
amounl ol insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits ol
lnsurance shown in the Declarations:
whichever is less.
This endorsement shall not increase the
applicable Limits of lnsurance shown in the
Declarations.
Y..ifr
x!-ltrd
Ei*
O lnsurance Services Olfice, lnc., 2012 Page 1 ot I
I
t
i
t
!
cG 20 12 04 13
Starr lndemnity & tiability Company
Dallas, TX 1 -866-51 9-2522
THIS ENDOBSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY
Policy Number: 1000198198221
Named lnsured: West Coast Arborists. lnc.
Effective Dale: 0710112022 al 12:01 A.M.
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Section lV - Business Auto Conditions, A. - Loss Conditions,5. - Transfer ol Rights ot
Becovery Against Others to Us, is amended to add:
However, we will waive any right ol recovery we have against any person or organization withwhom you have entered into a contract or agroement bscause of paymonts we make under this
Coverage Form arising out of an "accident" or "loss" if:
(1) fne "accident" or "loss" is due to oporations undertaken in accordance with thecontract existing between you and such person or organization; and(2) fne contract or agreement was entered into prior to any "accident" or "loss".
No waiver of the right ol recovery will directly or indirectly apply lo your employees or
employees of the person or organization, and we reserve our rig hts or lien to be reimbursed from
any recovered funds obtained by any injured employee.
Signed for STARR INDEMNITY & LIABILITY COMPANY
Sr.--- 6rli,Zb,/tJ e fu,r,lnSteveBlakey, President Nehemiah E. Ginsburg, General Counsel
SICA 1020 (03n2) Page 1 of 1
Copyright @ C. V, Starr & Company and Starr lndemnity & Liability Compary. Alt right! reserved.
lncludes copyrlghted matorlal ot ISO P.opartles, lnc., usod wlth lts permiselon.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
All other terms, conditions and exclusions of the policy shall remain unchanged-
WORKERS COMPENSATION AND EMPLOYEBS LIABILITY INSUBANCE POLICY wc 04 03 06
(Ed.04-84)
WAIVER OF OUR HIGHT TO HECOVER FROM OTHERS ENDORSEMENT. CALIFORNIA
We have the right to recover our payments from anyone liable lor 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 roquires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration ol your employees while engagod in the
work described in tho Schedule.
The additional premium lor this endorsement shall be
otherwise due on such remuneration.
2 . a% oI the Calilornia workers' compensation premium
Schedule
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 ol loss.
This endorsement chang€s the policy to which it is atlached and is €ffectiv€ on the dale issued unless otherwis€ stated.
Oh6 lnlormatlon below ls requirod only whsn lhla endors€menl is lssuod subsequent lo proparatlon olth€ pollcy,)
Endorsgment Ellective:071O112022 Policy No.: 100 0004228 Endorsement No.l
lnsured: West Coast Arborists, lnc. Premium:
lnsurance company: Starr Specialty & Liability Company
wc 04 03 06
(Ed. 04-84)
H,,::itffi
g
5
8
3
E
c
a
ffi
Countersign6d by,
Page 1 o, 1
Person or Organization
S>-.---- **)
Certificate No: 5700941 97393 AON
City of Menifee
29714 Haun Road
Menifee CA 92586 USA
Thursday, June 30, 2022
To whom it may concern:
Following a concentrated effort to reduce our environmental footprint and provide timely certificate
delivery, Aon will begin delivering our Certificates of lnsurance electronically in PDF format.
Please utilize one ol the {ollowing methods to ensure you will receive the electronic copy of your
Certificate (Certificate No: 570094197393) for tuture renewals:
- Visit aon.com/e-cert; or
- Utilize the QR Code below to enter/validate your information.
lf your email address has changed or will be changing in lhe future, or you no longer require this
certificate, please let us know using one of the methods above.
Thank you for your cooperation and willingness to help us reduce our impact to the environment.
MSC# 17755 |Aon
P.O. Box 1447
Lincolnshire, lL 60069
ffi
ffi
I
I E
5
E
3
8
8Ia
tr I
I
I
r-1
I I
tr