Loading...
HomeMy WebLinkAboutInsurance Certificate: Village Arborist iiUUR°® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11105/2015 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). PRODUCER CONTACT NAME: PAUL VOLZ INSURANCE AGENCY INC I FAX A/C, No, Ext): _ A! No 450 SISKiYOU BLVD, STE 5 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # ASHLAND OR 97520 INSURER A: NORTHFIELD INSURANCE COMPANY INSURED INSURER B: THE VILLAGE ARBORIST LLC INSURER C: 280 MEADE STREET INSURER D: INSURER 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 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. EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TYPE OF INSURANCE INSR WVD POLICY NUMBER MMfDONYYY MMIDDIWW LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 500,000. ✓ COMMERCIAL GENERAL LIABILITY PRf EMISES Ea occurrence $ 100,000. _ J CLAIMS-MADE F_/1 OCCUR MED EXP (Any one person) $ 5,000. A _ WS251491 11/09/15 I 11/09/16 PERSONAL &AOV INJURY $ 500,000. GENERAL AGGREGATE $ 1,000,000. GEN'LAGGREGATE LIMIT APPLIES PER 1 •000,000. PRODUCTS -COMP/OP AGC $ J POLICY PROD- ~LOF t $ AUTOMOBILE LIABILITY 7 =1 7771777L -IMI (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS ~ NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ r~ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMSMADE~ AGGREGATE $ DED RETENTION $ - $ WORKERS COMPENSATION AND T C TAi u- ER EMPLOYERS' LIABILITY Y 1 N , - - ANY PROPRIETOR/PARTIER/EXECUTIVE E.L. EACHACCIDEIIT $ 0" CL P/MEMBER EXCi UIE i? N/A u. i (Mandatory in NH) EL DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E 7 DISEASE-POLICY LIMIT $ II I I DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more 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. 90 N MOUNTIAN AVE AUTHORIZED REPRESENTATIVE ASHLAND OR 97520 © 1988-20 CORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD