HomeMy WebLinkAboutInsurance Certificate: The Village Arborist
ACOIR& CITY RGVV^LER
11/2013
k.--. CERTIFICATE OF LIABILITY INSURANCE DATE „//0
THIS CERTIFICATE 13 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: Nthe certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. R 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).
PROWLER CONTACT
NAME:
PAUL VOLZ INSURANCE AGENCY INC , PHONE AIL No
Ert : aINo:
650 SISKIYOU BLVD, STE 5 L
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAILS
ASHLAND OR 97520 INSURERA: NORTHFIELD INSURANCE COMPANY
INSURED INSURER B:
THE VILLAGE ARBORIST LLC INSURER L:
280 MEADE STREET INSURER D:
NSURER E:
ASHLAND OR 87520 INSURER F:
COVERAGES CERTIFICATE NUMBER:- REVISION NUMBER: -
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BE EN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER at D (MMIDDAYM LIMITS
GENERAL LIASILITV EACH OCCURRENCE j 500,000.
J COMMERCIAL GENERAL LIABILITY UAMAGE 10 HEN] ED
PREMISES Eeoccunexe $ 100,000.
DI-AIMS-MADE W OCCUR MED EXP (Any one person) $ 5,000.
A _ WS190824 11/09117 11109/14 PERSONALS ATV INJURY $ 500,000.
GENEPALAGGREGATE g 1,000,000.
GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOPAGG $ 1,000,000.
POLICY ~OJ- LOC $
AUTOMOBILE LIABILITY
(Ee accident) $
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY (Per acciderit) $
HIREDAUTOS OSWNED PROPERTY DAMAGE
(Per ecadem) $
UMEI ELLALIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CIAIMS-MADE AGGREGATE $
DED REENTION $ $
WORKERS COMPENSATIONAND
EMPLOYERS'LIABILITY YIN TORY LIMITS ER
$ -
ANVPROPRIETOR AMNERF_XECUTIVE NIA E.L. EAC4ACCIDENT
OFFICERIMEMBER EXCLUDED? u
(Mandatary 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, Additional Remartre Schedule, IF mom apace 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.
90 N MOUNTAIN AVE AUTHORIZED REP S rrA E
ASHLAND OR 97520 e
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