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PACICOA-05 <br />SHOSSEINI <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE(Mi2020 MMMONYYY) <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: N the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />N 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 Ileu of such endorsemen s . <br />PRODUCER <br />jjRtg�CT <br />Paramount Exclusive Insurance Services, Inc. <br />15760 Venture Blvd. Suite 500 <br />aC N ,EXI: (919) 966-7293 Faazc,NP:(818) 886.4949 <br />Encino, CA 91436 <br />INSURERS AFFORDING COVERAGE <br />NAICI <br />INSURER A: Everest National insurance Co. <br />10120 <br />INSURED <br />INSURER B Benchmark insurance Co. <br />41394 <br />PCA Arborists & Consultants, Inc. DSA: Pacific Coast <br />Arborists <br />INSURER C:Great American Insurance Co. <br />16691 <br />910 E. Walnut St. <br />INSURER D: <br />INSURER E: <br />Santa Ana, CA 92701 <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 MAYBE 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 />INSR <br />TYPE OF WSURANCE <br />ADDL <br />SUBIR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY UP <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS.MADE ❑OCCUR <br />EACH OCCURRENCE <br />L <br />DAMAGE TO RENTED <br />MED UP (My one <br />PERSONAL X AOV INJURY <br />GEN'L AGGREGATE LIMIT APPLI SPER: <br />POLICY J LOC <br />GENERAL AGGREGATE <br />PRODUCTS -COMP,OPAGG <br />OTHER <br />A <br />AUTOMOBILE <br />LUMNLITY <br />COMBINED SINGLE LIMIT <br />1,000,000 <br />BODILY INJURY Per <br />ANY AUTO <br />CFSCA00119191 <br />5117/2019 <br />5/17/2020 <br />IX <br />BODILY INJURY Per accVJent <br />Or�q�E�SONLY %t SCHEDULED <br />A0PEERQ I AMAGE <br />AUTOS ONLY X AUTOB O0Y <br />UMBRELLA IJAB <br />EACH OCCURRENCE <br />HOCCUR <br />AGGREGATE <br />EXCESS LWB <br />CLAIMS -MADE <br />DELI I I RETENTIONS <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORMARTNER,EXECUTIVE <br />OOFFICEtR EM99EEREXCLUDED? Y <br />(ManOatoryln NH) <br />NIA <br />STSOIS070 <br />611712019 <br />5/1712020 <br />)( I PER OTH- <br />' <br />EL EACH ACCIDENT <br />1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />S 1,000,000 <br />rc yes. 4eecnoe MF O <br />DESCRIPTION OF OPERATIONS bebw <br />E.L. DISEASE -PoUCY LIMB <br />S 1,000,000 <br />C <br />Equipment Floater <br />IMP E461860 00 <br />5/17/2019 <br />511712020 <br />Any One Loss <br />133,234 <br />DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101, A4ditbrwl Remarks ScM4 ,may Oe etbch rc mom apca 4"uim4) <br />1GDL7C1GX8F417619 <br />1GDJ6C1G17F412754 <br />1GDESE1G76F406214 <br />1GDE5E1E34F519508 <br />1GBJC34U54E340834 <br />1GCEC19VX7E149160 <br />SALCR2RXBJH759604 <br />SEE ATTACHED ACORD 101 <br />`' i � Lv ()I r�(JI'I�O <br />City of Santa Ana k ANAGEVENT nil <br />Risk Management Division <br />20 Civic Center Plaza, 4th floorIS�O 2�2� Santa Ana, CA 92702 <br />E&ULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />ZA�E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />`'CORDANCE WITH THE POLICY PROVISIONS. <br />w rmm' 1c 11n., a m1, <br />n arse lose •rnnn rnnnnewr,nu wu ..s... .............. <br />The ACORD name and logo are registered marks of ACORD <br />