Laserfiche WebLink
This is to Certify that <br />F—WEST COAST ARBORISTS, INC <br />2200 EAST VIA BURTON <br />ANAHEIM CA 92806 <br />L <br />NAME AND <br />ADDRESS <br />OF INSURED <br />J <br />Liberty Mutual. <br />INSURANCE <br />b, at the issue date of this certificate, insured by the Company under the poliry(ies) listed below. The insurance afforded by the listed pokcy(ics) is subject o all their terns. exclusions and <br />Conditions and is not altered by my requirement, tarn or condition of any contract or other document with respect to which this certificate may be issued. <br />EXP DATE <br />TYPE OF POLICY <br />EXTENDEDXTENDED s <br />❑ E <br />POLICY NUMBER <br />LIMIT OF LIABILITY <br />POLICY TERM <br />WORKERS <br />COMPENSATION <br />Statutory Limits <br />7/1/2020 <br />WA7-66D-039499-079 <br />COVERAGE AFFORDED UNDER WC <br />LAW OF THE FOLLOWING STATES: <br />All States ExceppC <br />ND, OH, WA. VVY <br />EMPLOYERS LIABILITY <br />Bodily Injury by Accidcm <br />1 000 000 eh.necid�„� <br />Bodily Injury By Disease <br />1 000 000 <br />Bodily Injury By Disease <br />1 000 000 <br />COMMERCIAL <br />GENERAL LIABILITY <br />7/1/2020 <br />TB2-661-039499-019 <br />General Aggregate <br />$2,000,000 <br />❑ OCCURRENCE <br />Products f Completed Operations Aggregate <br />$2,000,000 <br />❑ CLAIMS MADE <br />Each Occurrence <br />$2,000,000 <br />Personal & Advertising Injury <br />$2,000,000 Per Person! Orgenvauon <br />RETRO DATE <br />Other <br />her <br />Dama a to remises ranted to <br />AUTOMOBILE <br />LIABILITY <br />7/1/2020 <br />AS7-661-039499-039 <br />Each And P.D.CoSingle Limit <br />$2 000,000 B.I. Ard P.D. Combined <br />r�I <br />LJ OWNED <br />Each Person <br />Each Accident or Occurrence <br />NON -OWNED <br />rmr�I <br />L� HIRED <br />Each Accident or Occurrence <br />OTHER <br />ADDITIONAL COMMENTS <br />Re: All jobs performed by the named insured during the policy term. <br />City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers are additional insured with regards to general <br />liability as their interest may appear where required by written contract. <br />The insurance afforded by the GL policy for the benefit of the additional insured shall be primary and non-contributory. <br />• If the certificate expiration date is continuous or exrerded terra you will be notified ifcovemge is terminated or reduced before the certificate expiration date. <br />NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) <br />BEFORE -THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE <br />INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE <br />OF SUCH CANCELLATION HAS BEEN MAILED TO: <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th <br />z z Santa Ana CA 92702 <br />,5 <br />L <br />This certificate is executed by LIBERTY MI <br />52390436 I LM 2819 1 '/19-7/20 - GL/2/2, Ai./2. WC/'- <br />LDI COI 268896 02 11 <br />Liberty Mutual <br />Insurance Group <br />Elaine Ulan <br />&APPROVE <br />/ 0603eles <br />IGEMENT DIVIS1bA Angeles <br />AUTHORIZED REPRESENTATIVE <br />818 W 7th Street, Suite 850 <br />0564408 <br />q (1 Los Angeles CA 90017 <br />2Ot9 I OFFICE <br />213-443-0782 11/1812019 <br />PHONE DATE ISSUED <br />.ew such insurance as is afforded by those Companies NM 772 07-10 <br />PM (CST) I Page : of 2 <br />