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Digitally signed by Francine R.
<br />Francine R. Villareal Villareal
<br />Date: 2021.09.08 16.04.16-07'00'
<br />PACICOA-05 IFATHIPOUR
<br />ACORO
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />8/20/2021
<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 policy(ies) 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 endorsement(s).
<br />PRODUCER
<br />Paramount Exclusive Insurance Services, Inc.
<br />16760 Ventura Blvd. Suite 600
<br />Encino, CA 91436
<br />CONTACT
<br />NAME:
<br />PHONE (A/C, No):(g18) 986-4949
<br />(A/C, No, Ext): (818 986-7283
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Associated Industries Ins Co
<br />23140
<br />INSURED
<br />INSURER B : California Automobile Ins. Co.
<br />38342
<br />PCA Arborists & Consultants, Inc. DBA: Pacific Coast
<br />Arborists
<br />910 E. Walnut St.
<br />INSURER C : Nautilus Insurance Company
<br />17370
<br />INSURER D : StarNet Insurance Company
<br />INSURER E: Great American Insurance Co.
<br />116691
<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 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 />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />AES119436201
<br />6/2/2021
<br />6/2/2022
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />100,000
<br />$
<br />MED EXP (Any oneperson)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X POLICY PRO-
<br />JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />$
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />BA040000069063
<br />6/17/2021
<br />6/17/2022
<br />BODILY INJURY Per accident
<br />$
<br />OWNED X SCHEDULED
<br />AUTOS ONLY AUTOS
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />$
<br />C
<br />UMBRELLA LIAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />X
<br />HCLAIMS-MADE
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />AN1237648
<br />4/3/2021
<br />6/2/2022
<br />DED I RETENTION$
<br />Aggregate
<br />$ 5,000,000
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N /A
<br />X
<br />BNUWC0154220
<br />5/17/2021
<br />5/17/2022
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />E
<br />Equipment Floater
<br />IMP E461860 02
<br />6/17/2021
<br />6/17/2022
<br />Any One Loss
<br />311,908
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Waiver of subrogation in favor of City of Santa Ana, its officers, employees, agents and representatives. 30 days notice of cancellation. City of Santa Ana, its
<br />officers, employees, agents and representatives are named additional insured. Primary and non contributory coverage applies.
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />Y
<br />THE EXPIRATION DATE THEREOF,
<br />NOTICE WILL BE DELIVERED IN
<br />Risk Management Division
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92702
<br />AUTHORIZED REPRESENTATIVE
<br />RAMwagmentDwtaian
<br />REVIEWED &APPROVED BY.-
<br />al
<br />v�
<br />ACORD 25 (2016/03)
<br />©1988-2015 ACORD C
<br />The ACORD name and logo are registered marks of ACORD
<br />TE�
<br />Risk Management Analyst
<br />
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