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JtL1 s2,4 04 09:21a Public Works 7146473345 P•3 <br />is ttrsi6mre is execmm Certificate of insurance <br />'Ibis cerducau is iszurd as a trenerof infarmasion only and canters no righo upon you <br />Nt ttrtifieare Holder. This cenill -te is Horan inwrmce polity sent daw not amend ez[md. or alter the cerverage <br />afN*d dw IkI, lined below. <br />This is to certify that (Name and address of Insured) <br />WEST COAST ARBORISTS, INC '4_ap03 _ t b b <br />ANAHEIM, CA 92806 ,A _ Liberty <br />2200 EAST VIA BURTON ^ M f 7'umra <br />a r aH <br />ATV' _ iinlir wbiect to all their tenor, exclusions and mnditians and <br />Continuous* <br />Extended <br />Policy Term <br />,,'orken Compensation <br />04/01 /2005 <br />General Liability <br />Claiins Made <br />X Occurrence <br />Retro Dete <br />04/01/2005 <br />Automobile Liability <br />X Owned <br />X Non -Owned <br />X Hired <br />Equipment Floater 104101/2005 <br />Package Property 04/0112005 <br />Policy 14umoe s <br />Coverage afforded under WC dew• of Employers Liability <br />the following states: Bodily Injury By Accident <br />Each Accident <br />Bodily Injury By Disease <br />Policy Limit <br />Bodily Injury By Disease <br />Each Person <br />TB2 -161- 039499 -014 General Aggregate -Other than Prod/Completed Operations <br />$2,000,000 <br />Products /Completed Operations Aggregate <br />$2 000 000 Per <br />Bodily Injury and Property Damage Liability Occurrence <br />$1000,000 <br />Personal and Advertising Injury Per Person <br />$1000.00'0 Orlin nizatlon <br />Other Liability Other Liability <br />$100,000 Fire Legal Liability $5,000 Med Pa <br />AS7 -161- 039499 -034 Each Accident - Single Limit - B. 1. and P. D. Combined <br />$1,000,000 <br />Each Person <br />Each Accident or Occurrence <br />Each Accident or Occurrence <br />C THE INSUREDS WORKERS COMPENSATION POLICY IS NOT WITH er attached LG 1016 endorsenxnq. This - vuuratsce is primary and <br />O volunteers and representatives, on the General Liability pole listed above (p <br />M due to the sole negligence of the named insured (per LG 1016). <br />M <br />E <br />N <br />T <br />agents, <br />ose losses <br />•ICm inuitioleexpirsntledare is connnwus or exm <br />...�...____,_ <br />the cud Noti fun Mo. Ange. <br />Specul Nadtt - Ohio: Any Person who. with intentodc6nud almowing slut he /she is faciliraling a6aud agair�uminsarcc suHmin an application orfiks attains conlai ring a se or <br />Gcepriw statement is guilty of inwrance flood. Y (ease contact Yaulaal mlea ptodacer, <br />lmponanr infumation m Florida Policyholders atal ceruficare holders: in she event you Have anopend, o Or need ffice mailing iskoes is ay als b,,andned by rwson,p <br />whoti name andteephane number appears in the lower left collar of this cenifru�le. The appeopted loealwks o0ice mailing eddrrsrot ancelwrtd eiriswlontetatFonbJoukrrheabovc <br />Notice ofcaolladon: (nos applicahle mles's a numbat ofdays is entered below). Before the elated ntpin[lan daze the campanya <br />ooli... anal at <br />office : PLEASANTON, CA Phone: 800 -343 -1534 <br />Certificate Holder <br />City of Santa Ana <br />Public Wa Agency ` ^ <br />220 South h Daisy Avenue ue Bldg -A <br />Santa Ana, CA 92703 �! <br />r / <br />//a <br />1a Licg 0786579 <br />Date issued: 04/01/2004 Prepared By: MW <br />