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CERTIFICATE OF LIABILITY INSURANCE Date (MM/DD/YYYY) Producer: Insured: NAIC # Insurer A: Insurer B: Insurer C: Insurer D: COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INSR TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC EACH OCCURENCEDAMAGE TO RENTED PREMESIS MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ $ $ $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED HIRED AUTOS SCHEDULED COMBINED SINGLE LIMIT(Ea Accident) BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE(Per Accident) $ $ $ $ UMBRELLA LIAB OCCUR CLAIMS MADE DED EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION ANY PROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) WC STATU- E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION A OTH-X SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF PLEASANTON P.O. BOX 520 WAIVER OF SUBROGATION APPLIES IN FAVOR OF CITY OF PLEASANTON. ISSUE 07-26-24 (KLT). REISSUE 11-19-24 (KLT). REISSUE 11-20-24 (TD) State National Insurance Company, Inc. Insurer E: Plymouth Insurance Agency, Inc. 2739 U.S. Highway 19 North Holiday, FL 34691 11/20/2024 12831 PLEASANTON, CA 94566 South East Employee Leasing Services, Inc. 2739 U.S. Highway 19 N. Holiday, FL 34691 subcontractors or nonassigned employees of: (California Operations Only) Coverage is extended to assigned employees as approved and assigned by South East Employee Leasing Services, Inc. but not Project Name: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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(s). Insurer F: INSURER(S) AFFORDING COVERAGE CONTACT NAME:PHONE (A/C,No,Ext):1-800-966-5562 FAX (A/C,No): (LCF) CERTIFICATE NUMBER:REVISION NUMBER: INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 CLAIMS. ADDLINSR SUBRWVD POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS EXCESS LIAB RETENTION$ AUTOS PREMISES (Ea occurrence) LTR $ AUTOSNON-OWNED AUTOS $ OFFICER/MEMBER EXCLUDED? Y/N If yes, describe under DESCRIPTION OF OPERATIONS below AND EMPLOYERS' LIABILITY ERTORY LIMITS AUTHORIZED REPRESENTIVE ACORD 25 (2010/05) ©1998-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD N/A N CWC71949-1529 1/1/2024 1/1/2025 $1,000,000 Richard Smith dba Bay Area Tree Specialists $1,000,000 $1,000,000 Richard Smith dba Bay Area Tree Specialists $ $ $ Docusign Envelope ID: 31630204-995B-4DCC-A316-0219109A1493