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West Coast Arborists - Insurance Certificate (2019)Certificate of Insur4nce THIS CERTJFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIC41TS 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, AT;THOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that I WEST COAST ARBORISTS, INC 2200 EAST VIA BURTON NAME AND ANAHEIM CA 92806 ADDRESS OF INSURED L .i - __ _ -- � ­ - VV 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 may be issued. EXP DATE El UOUS TYPE OF POLICY ❑ EXTEND EXTENDED D POLICY NUMBER LIMIT OF LIABILITY 121 POLICY TERM WORKERS 711 /2019 WA7-66D-039499-078 COVERAGE AFFORDED UNDER WC EMPLOYERS LIABILITY LAW OF THE FOLLOWING STATES: COMPENSATION Statutory Limits All States Except: � Bodily Injury by Accident ND, OH, WA, WY' 1,000. Accident hAccident Bodily Injury By Disease $1,000,000 PnlirvUmit Bodily Injury By Disease $1 ,000.000 Each Person COMMERCIAL 7/1 /2019 TB2-661-039499-018 General Aggregate GENERAL LIABILITY $2,000,000 OCCURRENCE Products / Completed Operations Aggregate $2,000,000 ❑ CLAIMS MADE Each Occurrence $1,000,000 RETRO DATE Personal & Advertising Injury $1,000,000 Per Person /Organization Other Damagge to ppremises rented to (Other Medical Expense $5,000 you $300,000 AUTOMOBILE 7/1 /2019 AS7-661-039499-038 Each Accident —Single Limit $2,000,000 B.I. And P.D. Combined LIABILITY OWNED Each Person NON -OWNED Each Accident or Occurrence �0 L� HIRED Each Accident or Occurrence OTHER 7/l/2018 - 7/l/2019 TH7-661-039499-048 $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: F City of Gilroy 7351 Rosanna Street R Gilroy CA 95020 Liberty Mutual Insurance Group Elaine Ulan Los Angeles / 0603 AUTHORIZED REPRESENTATIVE x 818 W 7th Street, Suite 850 0564408 Los Angeles CA 90017 .213-443-0782 6/12/2018 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 42480346 1 LM_2819 1 7/18-7/19 - GL/2/1, AL/2, WC/1, U/5 I Donna Smitala 1 6/12/2018 12:05:13 PM (CDT) I Page l,of 1 LDI COI 268896 02 11 POLICY NUMBER: TB2-661-039499-018 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGiANIZ T'" 10 1 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organiaation(s): City of Gilroy, its officers, 7351 Rosanna Street Gilroy CA 95020 Service Agreement: Tree maintenances ervices performed by West Coast Arborists covers City of Gilroy, It's officers, officials and employees are named as an additional insured, per the endorsement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 in 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 Ill.— 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 26 0413 O Insurance Services Office, Inc., 2012 Page 1 of 1 Certificate 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 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 2200 EAST VIA BURTON NAME AND .� Libert M 1� ANAHEIM CA 92806 ADDRESS OF INSURED L I I NSU RAiNCE is, at the issue date of this certificate, insured by the Company under the policy(ies) listed - bellow. 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. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ❑ POLICY TERM WORKERS COMPENSATION Statutory Limits 7/1/2019 WA7- 66D- 039499 -078 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: All States Except: ND, OH, WA, WY EMPLOYERS LIABILITY Bodily Injury by Accident 1 0,000 Bach Accident Bodily Injury By Disease $1,000,000 Bodily Injury By Disease $1,000,000 . COMMERCIAL GENERAL LIABILITY 7/1/2019 TB2- 661 - 039499 -018 General Aggregate $2,000,000 m OCCURRENCE Products / Completed Operations Aggregate ❑ CLAIMS MADE $2,000,000 Each Occurrence $1,000,000 RETRO DATE Personal & Advertising Injury $1,000,000 Per Person/ Organization Other g p Damage rented to ther Medical Expense $5,000 AUTOMOBILE LIABILITY 7/1/2019 AS7- 661 - 039499 -038 trait $2,000,000 B.I. And P.D. Combined Each Person OWNED Each Accident or Occurrence mNON -OWNED HIRED Each Accident or Occurrence OTHER Umbrella Excess Liability 7/1/2018 - 7/1/2019 TH7 -661- 039499 -048 $5,000,000 Per Occurrence /Aggregate 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 [City of Gilroy 7351 Rosanna Street Elaine Ulan _ Gilroy CA 95020 Los Angeles / 0603 AUTHORIZED REPRESENTATIVE r = 818 W 7th Street, Suite 850 0564408 Los Angeles CA 90017 213 - 443 -0782 6/12/2018 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 42480346 1 LM_2819 1 7/18 -7/19 - GL /2/1, AL /2, WC /1, U/5 I Donna Smitala 1 6/12/2018 12:05:13 PM (CDT) I Page 1 of 1 LDI COI 268896 02 11 POLICY NUMBER:TB2- 661 - 039499 -018 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: 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 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 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER:TB2- 661- 039499 -018 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) 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 Or Organization(s): Location And Description Of Completed Operations All persons or organizations with whom you have All locations as required by a written contract or entered into a written contract or agreement, prior to an agreement entered into prior to an occurrence or occurrence or offense, to provide additional insured offense. status. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 04 13 C Insurance Services Office, Inc., 2012 Page 1 of 1