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25E - WEST COAST ARBORIST
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11/17/2020
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25E - WEST COAST ARBORIST
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Last modified
11/12/2020 5:47:51 PM
Creation date
11/12/2020 3:19:53 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25E
Date
11/17/2020
Destruction Year
2025
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Certificate of Insurance <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RICHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN <br />INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAG£.4FFOROPD BY THE POLICIES LISTED BELOW, POLICY LIMITS ARE NO LESS THANT-HOSE <br />LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL. SUBLIMITILIMITS NOT LISTED BELOW. <br />This is to Certify that <br />I WEST COAST ARBORISTS, INC <br />ANA EAST VIA BUR2806 ADDRESS AND Liberty Mutual. <br />ANAHEIM CA 92806 <br />OF INSURED <br />L INSURANCE <br />is, at the issue data of this conificate, insured by the Company under the pelicy(ior) listed bebw. The insurance afforded by the listed policy(tes) is subject to all their Terms, exclusions and <br />Conditions and is not allmd by any rcquironni eertn or condiaion of any carouser it oiler docurncnt with msnect to which this eaniftcam may be issucd. <br />ExP DATE <br />TYPE OF POLICY <br />CCNTINUOUS <br />❑ EXTENDED <br />POLICY NUMBER <br />LIMIT OF LIABILITY <br />© POLICY TERM <br />WORKERS <br />COMPENSATION <br />Statutory Limits <br />7/112020 <br />WA7-66D-039499-079 <br />COVERAGE AFFORDEDUNDERWC <br />LAW OFTHE FOLLOWINGSTATES: <br />All States Except: <br />NO, OH, WA., A. <br />EMPLOYERS LIABILITY <br />Bodily In'aryby <br />d<.nI <br />1DOODDOF,.hA u�; <br />Roddy Injury By Disuau <br />1 000 000 <br />Bodily Injury By Disease <br />1000 000 : . <br />COMMERCIAL <br />GENERAL LIABILITY <br />7/112020 <br />T32-661-039499-019 <br />Gen rot AgSmgute <br />$2,000,000 <br />® OCCURRENCE <br />Peoducla! Completed Operations Ap3regate <br />© CLAIMS MADE <br />$2,000,000 <br />Each Occurrence <br />$2,000,000 <br />Personal& Advertising Injury $2,000,000 Per PcraanlOtirnvarion <br />RETRO DATE. <br />Other her <br />Dama a to grernises rented to <br />AUTOMOBILE <br />LIABILITY <br />7/1/2020 <br />AS7-661-039499-039 <br />Each Accident—Singleulnil <br />$2 ODD.ODD B.I. A"P-D- Carribined <br />OWNED <br />Each Pcrean <br />Each Accident or Occuti <br />0 NON.GWNED <br />0 HIRED <br />Each Accidens or Occurrence <br />OTHER <br />ADDITIONAL COMMENTS <br />If Phc ccni8cata cspirslion drlc is confinuous or csw dcd term, you will be notihcd if covtragc is laminated orreduced be}'ora 1hC ecrtificulc expiration dI <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 IHE <br />INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE <br />OF SUCH CANCELLATION HAS BEEN MAILED TO - <br />Evidence Only <br />2200 E Via Burton <br />Liberty Mutual <br />Insurance Group <br />�, Elaine Ulan <br />tiAnaheim CA 92806 Los Angeles l 0603 AUTHORIZED REPRESENTATIVE <br />.y i 818 W 7Ih Street, Suite 850 0564408 <br />Los Angeles CA 90017 213443-0782 6118/2019 <br />LDEFICE PHONE �DgATEISSUEDIInn <br />This certificate is executed by LIBERTY MUTUAL INSURANCE G215E such Insurance as is afforded by those Companies NM TW. a 2% <br />1.933I)SA 1 UP 2919 1 7/19-1/20 - GL12/2, AL/2, WC/r I nonaa stricala 1 6n9/2919 6:51;15 AR lWTI I Page 1 of l rr 9 <br />LDI COI 269896 0211 <br />
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