West Coast Arborists - Insurance CertificateCertificate of Insurance
THIS CERTIFICATE 1S 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 NOT 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 SUBLIMIT/LIMITS NOT LISTED BELOW.
This is to Certify that
I WEST COAST ARBORISTS, INC INSURANCE
2200 ANA EAST VIA BURTON ADDRESS i er Mutual.
ANAHEIM VI 92806
OF INSURED
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 may be issued.
. 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:
Liberty Mutual
Insurance Group
FCity of Gilroy 7
7351 Rosanna Street Elaine Ulan
w Gilroy CA 95020 Los Angeles / 0603 AUTHORIZED REPRESENTATIVE
818 W 7th Street, Suite 850 0564408
Los Angeles CA 90017 213 -443 -0782 6/13/2017
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
36128777 1 LM 2819 1 7/17 -7/18 - GL /2/1, AL /2, WC /1, U/5 I Donna smitala 1 6/13/2017 11:20:48 AM (CDT) I Page i of 1
LDI COI 268896 02 11
EXP DATE
TYPE OF POLICY
❑ CONTINUOUS
❑ EXTENDED
POLICY NUMBER
LIMIT OF LIABILITY
❑ POLICY TERM
WORKERS
COMPENSATION
Statutory Limits
7/1/2018
WA7 -66D- 039499 -077
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
All States Except:
ND, OH, WA, VVY
EMPLOYERS LIABILITY
Bodily In ury by Accident
1 0QA OOOEach Accident
Bodily Injury By Disease
1,000,000
Bodily Injury By Disease
$1,000,000
COMMERCIAL
GENERAL LIABILITY
7/1/2018
TB2 -661- 039499 -017
General Aggregate
$2,000,000
Products / Completed Operations Aggregate
❑ OCCURRENCE
$2,000,000
❑ CLAIMS MADE
Each Occurrence
$1,000,000
Personal & Advertising Injury
$1,000,000 Per Person /Organization
RETRO DATE
Other 10ther
Damage to premises rented to
you 0
Medical Expense $5,000
AUTOMOBILE
LIABILITY
7/1/2018
AS7- 661 - 039499 -037
Each Accident — Single Limit
$2,000,000 B.I. And P.D. Combined
OWNED
Each Person
Each Accident or Occurrence
mNON -OWNED
HIRED
Each Accident or Occurrence
OTHER
7/1/2017 - 7/1/2018
TH7- 661- 039499 -047
$5,000,000 Per Occurrence /Aggregate
Umbrella Excess Liability
ADDITIONAL COMMENTS
The City of Gilroy, its officers, officials and employees are included as Additional Insured(s) for General Liability, as there interest may appear
where required by written contract per the attached endorsement.
. 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:
Liberty Mutual
Insurance Group
FCity of Gilroy 7
7351 Rosanna Street Elaine Ulan
w Gilroy CA 95020 Los Angeles / 0603 AUTHORIZED REPRESENTATIVE
818 W 7th Street, Suite 850 0564408
Los Angeles CA 90017 213 -443 -0782 6/13/2017
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
36128777 1 LM 2819 1 7/17 -7/18 - GL /2/1, AL /2, WC /1, U/5 I Donna smitala 1 6/13/2017 11:20:48 AM (CDT) I Page i of 1
LDI COI 268896 02 11
POLICY NUMBER: TB2- 661 - 039499 -017
COMMERCIAL GENERAL LIABILITY
CG 2010 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section 11 — 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:
SCHEDULE
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.
Location(s) Of Covered Operations
Any location listed in such agreement
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
CG 2010 0413 0 Insurance Services Office, Inc., 2012 Page 1 of
POLICY NUMBER: TB2- 661- 039499 -017
COMMERCIAL GENERAL LIABILITY
CG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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This endorsement modifies insurance provided under the following:,
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART
A. Section U — 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.
(dame 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 111— 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.
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