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,J - 2c°'1-11 ? <br />Certificate of Insurance <br />TItiS CERTIEICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CBFLM IC/4'E HOLDER THIS CERTIFICATE IS NOT AN <br />LIINSTDNALTHOUGH iFSIAY?INCLUD?AD I?TIQARL UBLIMIT/LI?Mf? NOOCSTED IISLAW POL]t IES LISTED EbIAW. POLICY LIDIITS ARgNO LESS THAN THOSE <br />This is to Certify that <br />TEST COAST ARBORISTS, INC <br />NAME ANA 02200 EAST VIA BURTON ADDI;.FSB Libe? <br />°F?SI >a Mutu0 <br />ANAHEIM CA 92806 <br />is, at the issue date of this certificate, insured by tho Cotnpany under the pollay(ics) listed below. no insurance afforded by the listed polioy(ies) i3 snbject to 211 ibeir to MI, exehutons and <br />Conditions and is not altered by any requirement, term or condition of any contract or other dooamont with respect to which this certificate may iw issuod. <br /> RXP A <br /> ? CONTINUOUS <br />TYPE OF POLICY <br />? EXTENDED POLICY NUMBER LIMIT OF LIABILITY <br /> ® POLICY TERM <br />' <br />fVURI?EItS <br /> <br />WORK RS <br />7/1/2012 WA2-66D-039499-071 COVF.BAGEAPFORDBDUNDERWC <br />WOFTHEFOLLOWINGSTATES: ) MVLOYERSLL411 <br />H= <br />CO A Bodrlyl <br />y <br />ry <br />STATUTORY 0 <br />00 000 t <br />1 <br /> Bodily Injury By Disease <br /> $1,000,000 <br /> Bodily Injury By Disease <br /> $1,000,000 <br />COMIERCIAL 7/112012 7132-661-039499-011 GmenlAypreyato <br />GENERAL LIABILITY $2,00U00 <br />OCCURRENCE Prodimts / Completed Operations Aggrogato <br /> QQ <br />? CLAIMS MADE Each Occurrence <br /> RETRO DATE Personal & Advertising Injury <br /> $1,000,()()0 PerPenon/Orgaoetatioa <br /> ' <br /> FIRE DAMAGES $100,000 MEDICAL PAYMENTS $5,000 <br />AUTOMOBILE <br />LLIBILZTX 7/1/2012 AS7-661-039499-031 Hnd P.D. ibitie l unit <br />1 000 000 B.I. L And .D. ombiaed <br /> <br />OWNED Each Person <br />® NON-OWNED Each Accident or Occurrence <br /> <br />M HIRED <br /> Eaeb Accident or Occurrence <br />OTHRR <br />Umbrella Excess Liability <br />711/2011 71112012 <br />THT-661-039499-041 <br />$5,000,000 PER OCCURRENCEIAGGREGATE <br /> APPROV ,E> AS 'F0 F'0RIM <br />ADDITIONAL 120119IENTS <br />See Addendum Attached. <br /> <br />[.air€a a Ju,`';t curly <br />f?SSl3tt)tIC'C <br />;it <br />Att <br />. <br />-y <br />ortt4.y <br />- If the certificate expiradan date is Continuous or oxtcadcd Corm, you will be notified if coverage is terminated or re u" before the oerdficato expim0oa data. <br />NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BBLOW.) <br />BEFORE THE STATED EXPIRATION DATE TUB COMPANY WILL NOT C CEL OR REDUCE THE <br />INSURANCE AFFORDED UNDER TEE ABOVE POLICIES UNTIL AT LEAST DAYS NOTICE <br />OF SUCH CANCELLATION HAS BEEN MAILED TO: <br />F?C7,ity of Santa Ana <br />Public Works Agency M85 <br />b <br />220 South Daisy Avenue Building-A <br />L_anta Ana CA 92703 <br />Liberty Afuttw <br />Insurance Group <br />CiC.[A,Umd L(.? Elaine Ulan <br />Los Angeles / 0603 AUTHORIZED REPRESENTATIVE <br />818 W 7th Street, Suite 850 0564408 <br />Los Angeles CA 90017 213-624-1171 6/15/2011 <br />OFFICE PHONE DATEISSUED <br />This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-I0 <br />LDI Cot 268896 02 11