HomeMy WebLinkAboutInsurance Certificate: The Village Arborist
DATE(MM/
201D12Y)
ACORU® CERTIFICATE OF LIABILITY INSURANCE 11/13/2012
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, EXTENT) 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. H SUBROGATION IS WANED, 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 endorsemenas).
PRODUCER CONTACT
NAME:
PAUL VOLZ INSURANCE AGENCY INC pX
AIC No Est : aC No
450 SISKIYOU BLVD, STE 5 E-MWL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC e
ASHLAND OR 97520 INSURERA: NORTHFIELD INSURANCE COMPANY
INSURED INSURER B:
THE VILLAGE ARBORIST LLC INSURER C:
280 MEADE STREET INSURER O:
NSURER E:
ASHLAND OR 97520 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANY 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 TOALL THE TERMS,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR W VD POLICY NUMBER (MMIDDNYYY) (MWDDNYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 500,000.
COMMERCIAL GENERAL LIABILITY
PREMISES Ee occurrence $ 100,000.
CLAIMS-MADE 17/ OCCUR MED EXP (Any one person) $ 5,000.
A WS166743 11/09/12 11/09113 PERSONAL S ADV INJURY $ 500,000.
GENERA-AGGREGATE $ 1,000,000.
GENLAGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 1,000,000.
FV1 POLICY ECO'- LOC $
AUTOMOBILE LIABILITY (ECOMBINED $INGLE LIMIT
a accident) $
ANYAI.ITO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY (Per ecci dent) $
HIREDAUTOS NON-OWNED PROPERTY DAMAGE
AUTOS (Per accident) $
UMBRELLA LIAB OCCUR EACH OCCURRENCE f
EXCESS LMB CLAIMS MADE AGGREGATE is
DEC) RETENTION $ $
WORKERS COMPENSATION AND
EMPLOYERTIJABILITY YIN TORY LIMITS ER
ANY PROPRIETOR]PARTPER/EXECUrIVE - E.L. EACHACCIDEM Is
OFFICER/MEMBER EXCLUDED? L NIA
(Mandatory In NH) E.L DISEASE -EA EMPLOYEE $
It yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addglonal Remarks Schedule, a mom space Is required)
TREE TRIMMER
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF ASHLAND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ATTN: KARIANN OLSON ACCORDANCE WITH THE POLICY PROVISIONS. 1
90 N MOUNTAIN AVE AUTHORIZED REPRESENTATIVE
ASHLAND OR 97520
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