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A <br />PACICOA-38 <br />CERTIFICATE OF LIABILITY INSURANCE <br />IMIMARUISC <br />DATE (MMR)DIYYYY) <br />1/24/2020 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement On <br />this certificate does not confer rights to the certificate holder In lieu of such endorsemen s . <br />PRODUCER <br />923?01 <br />Program Brokeraea Corp. <br />500 Mamaroneck Avenue, Suite 407 <br />PHONE F % <br />c, No, am);914 670.4200 c No I 914 670-4201 <br />Harrison, NY 10628 <br />INSURE 8 AP RIG COVERAGE <br />Ca <br />Ix A: New York Marine & General Insurance <br />16808 <br />INSURED <br />uRma;Starstone National Insurance Company <br />25496 <br />INSURER C: <br />PCA Arborista & Consultants dba Pacific Coast Arbodsts <br />INSURER D: <br />910 E. Walnut Street <br />Santa Ana, CA 92701 <br />- - ""— <br />INSURER E: <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NLTR SR <br />TYPE OF INSURANCE <br />ADDIL <br />INSO <br />BR <br />POLICY NUMBER <br />WY <br />POLICY 6XPODWM <br />uMITB <br />A <br />X <br />COMMERCIAL GENERAL LUUMUTY <br />CLAMS -MADE OX OCCUR <br />X <br />X <br />PK201900010070 <br />4M/2019 <br />4/1/2020 <br />EACH OCCURRENCE <br />11000,000 <br />DAMAGE TO RENTED <br />100,000 <br />X <br />M P <br />6,000 <br />Contractual Liab. <br />X <br />I Sev of Int <br />PERSONAL aAOV INJURY <br />1.000.000 <br />OEN9.AOIiRE� <br />SPER <br />GENERAL AGGREGATE <br />$000,000 <br />X <br />y�LTEIpLwpaRAPP <br />POLICY U T& II LOC <br />OTHER <br />PRODUCTS -COMPtOPAGG <br />1 2.000,0DB <br />S <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE IJM T <br />(Ea aoddm) <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BO LYINJURY Per <br />BODILY INJURY Per accJdenl <br />BODILY <br />�Or PERY PMAGE <br />AUTOS ONLY MOMS <br />B <br />UMBRELLALJAa <br />X <br />OCCUR <br />EACH OCCURRENCE <br />5.000,000 <br />X <br />AGGREGATE <br />6 61000,000 <br />EXCESS LAB <br />CWMS-MADE <br />864G191ALI <br />4/1/2019 <br />4M/2020 <br />DIED I I RETENTIONS <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PRR /PMRIIMT9OERREXCLUDEE"DTECUTNE Yn <br />(ManEafory In NN) <br />It ryos Gewribo u",EoPr <br />DES.. TIN F ERATIONS Imlow <br />NIA <br />PER O <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L DISEASE -POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS )VEHICLES `ACORD 101. Additional Remeiu SchWule, meY Ge eNecheJ I1 more space m mqulreEl <br />CITY OF SANTA ANA, RISK MANAGEMENT, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES AND VOLUNTEERS ARE ADDITIONAL <br />INSUREDS WITH RESPECT TO GENREAL LIABILITY AND ABORIST SERVICES PERFORMED BY THE ABOVE NAMED INSURED (ATIMA) GENERAL LIABILITY <br />INSURANCE IS PRIMARY AND NONCONTRIBUTORY. WAIVER OF SUBROGATION APPLIES TO GENERAL LIABILITY. EXCESS TO FOLLOW FORM, <br />BLANKET ENDORSEMENTS ATTACHED. <br />CERTIFICATE OF INSURANCE SHALL PROVIDE THIRTY(30) DAY PRIOR WRITTEN NOTICE OF CANCELLATION. <br />CITY OF SANTA ANA <br />RISK MANAGEMENT DIWS <br />20 CIVIC CENTER PLANZA <br />4TH FLOOR <br />Santa Ana, CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />O V 2UZU THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />S.AMANTHA M. <br />ACORD 26 (2016103) 019W20116 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />