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PROOF OF INSURANCE (2021) CLOSEDCERTIFICATE OF LIABILITY INSURANCE I DAT061620 OYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CONTRACT HR THISCDCEITERNRR BY THE POLICIES CERTIFICATE OF INSURANCE DOES NOCONSTITUTE A BETWETHEISSUING NSURER(S),AUTHORI2ED CERTIFI ATE OES ATIVELY OR LY ND, EXTEND ALTER THE AGE AFFORDED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($), PRODUCER CONTACT Aon Risk Insurance Services West, Inc.NAMEr i1FliFU Los An el es CA Office (ArC. Ne, Ext): (866) 283-7122 INC. No.j: (800) 363-0105 707 wi shire Boulevard E.hRAIL suite 2600 ADDRESS - LOS Angeles CA 90017-0460 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED _ ... ., INSURER A: Starr Indemnity & Liability company 38318 West Coast Arborists, Inc. INSURER B: Starr Specialty Insurance Company m�16109 2200 E via Burton 'Anaheim CA 92806 USA INSURER C: - INSURER D: INSURER E: INSURER F: COVERAGE$ CERTIFICATE NUMBER: 570082348316 REVISION NUMBER: THIS 95 TO CERTIFY' THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FbR THE POLICY PERIOD INDICATED. NOTWITH'S'TANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO Wif HIGH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED) HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL.AVMS. Limits BhOWra Bre as requested (NSR ADDtJ SUBR POLICY EFF POIUCY EXP LT TYPE OF INSURANCE INS,DI US POLICY NUMBER MNAID[YIYyyY) ( IMM�ODI'YYYYIN LIMITS X COMMERCIAL GENERAL LIABILITY 1000100141ZU1 9t/01/ZUZO 0f/bl/ZUZi EACHOCCURRENCE $2 000 440 CLAIMS -MADE X � OCCUR --GGE-ENIAGGREG�AT-E1 LIMITAPPLIES PER: POLICY L PRO F-1 LOC OTHER: JECT A AUTOMOBILE LIABILITY 1000 198198201 X IANYAUTO OWNED $1,400,004 SCHEDULED MED EXP (Any one person) $5,000 AUTOS $2,004,000 HIREDAUOTOSY NON -OWNED r PRODUCTS - COMP/OP AGG —ONLY . AUTOS ONLY .-.A UMBRELLALIAB OCCUR r� EXCESS LIAR CLAIMS -MADE DED 8"TC141ION WORKERS COMPENSATION AND 100004229 EMPLOYERS' LIABILITY Y r N' Workers Comp AZ ANY PROPRIETOR/ PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? a N / A 1000004228 (Mandatory In NH) workers Comp CA If as, describe under (AGGREGATE DESCRIPTION OF OPERATIONS below ED M It m 00 0 CDLO 07(01/2020 07 01%1021 X I PER STATUTE tl 6TH rRi / 07/01/2020 07/01/2021 E.L. EACH ACCIDENT $1,400,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 EL. DISEASE -POLICY LIMIT $1,000,000 --- 2§ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Add4llonal Remarks Schedule, may be attached It more space Is required) The City Of El Segundo, its officials, and employees are included as Additional Insured in accordance with the policy � provision's of file General Liabilitp policy and Automobile Liability policies. General Liability policy evidenced herein are Primary and Non --Contributory to other ilnsurance available to an Additional insured, but only in accordance with the policy's � provisions. A Waiver of Subrogation is granted in favor of Additional insured in accordance with the policy provisions of the Workers Compensation policy. 31-3 CERTIFICATE HOLDER CANCELLATION .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. a.a City of El Segundo (AUTHORIZED REPRESENTATIVE 350 Main streets E1 Segundo CA 90245 USA ry"n eJ�ta e..�9ru 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD UAMAWa iOH£0'4 $1,400,004 PREMISES (Ea occurreneel MED EXP (Any one person) $5,000 PERSONAL&ADV INJURY I $2,004,000 GENERAL AGGREGATE $4,000,000 r PRODUCTS - COMP/OP AGG j4",'600,000 07/01/2020 0710112011 COMBIIN/E�DtSINGLE LIMIT $2,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) I� Y EACH OCCURRENCE (AGGREGATE ED M It m 00 0 CDLO 07(01/2020 07 01%1021 X I PER STATUTE tl 6TH rRi / 07/01/2020 07/01/2021 E.L. EACH ACCIDENT $1,400,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 EL. DISEASE -POLICY LIMIT $1,000,000 --- 2§ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Add4llonal Remarks Schedule, may be attached It more space Is required) The City Of El Segundo, its officials, and employees are included as Additional Insured in accordance with the policy � provision's of file General Liabilitp policy and Automobile Liability policies. General Liability policy evidenced herein are Primary and Non --Contributory to other ilnsurance available to an Additional insured, but only in accordance with the policy's � provisions. A Waiver of Subrogation is granted in favor of Additional insured in accordance with the policy provisions of the Workers Compensation policy. 31-3 CERTIFICATE HOLDER CANCELLATION .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. a.a City of El Segundo (AUTHORIZED REPRESENTATIVE 350 Main streets E1 Segundo CA 90245 USA ry"n eJ�ta e..�9ru 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1000100141201 Effective: 07/01/2020 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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 SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Where Required By Written Contract Where Required By Written Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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: 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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 1000100141201 Effective: 07/01/2020 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 SCHEDULE Name Of Additional Insured Person(s) Or Location And Description Of Completed Organization(s): Operations Where Required By Written Contract Where Required By Written Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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. 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 r, Starr Indemnity & Liability Company Dallas, TX 1-866-519-2522 Primary and Non -Contributory Condition Policy Number: 1000100141201 Named Insured: West Coast Arborists, Inc, This endorsement modifies insurance provided under the: Effective Date: July 1, 2020 at 12:01 A.M. Commercial General Liability Coverage Part A. SECTION IV — CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, President Nehemiah E. Ginsburg, General Founsel OG 107 (04/11) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. POLICY NUMBER: 1000198198201 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: West Coast Arborists, Inc. Endorsement Effective Date: 07/01/2020 SCHEDULE Name Of Person(s) Or Organization(s): Where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.0% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization to whom you become obligated to waive Where required by contract your rights of recovery against, under any contract or agreement you enter into prior to the occurrence of loss. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: 07/01/2020 Policy No.: 100 0004228 Endorsement No.: Insured: West Coast Arborists, Inc. Premium: Insurance Company: Starr Specialty & Liability Company Countersigned b ; WC 04 03 06 (Fri 04-84) Page 1 of 1