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HomeMy WebLinkAboutInsurance Certificate: Beaver Tree Service, Inc DATE(MMIDDIYYYY) '4`��® CERTIFICATE OF LIABILITY INSURANCE 5/26/2021 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(les)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 LON FACT i NAME: Marci Zimick Roland King Insurance dba RKI (A/C No,No,Ext): Off:5414511313 (N,No): 1175 S.Main[PO Box 157] ADDRESS: Marci@rkiinc.com INSURER(S)AFFORDING COVERAGE NAIC# Lebanon OR 97355 INSURER A: Greenwich Insurance Company INSURED INSURER B: Beaver Tree Service Inc INSURER C: 270 Wilson Rd INSURER D: INSURER E: Central Point OR 97502 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. INSR TYPE OF INSURANCE AUULJUBK POLICY bl+ POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 UAMAL,E I Li KEN I EU CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) $ 100000 MED EXP(Any one person) $ 15000 A NPC-1004750-00 05/26/2021 05/26/2022 PERSONAL&ADV INJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 POLICY n JECT n LOC PRODUCTS-COMP/OP AGG $ 2000000 X OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I $ 1000000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED -SCHEDULED AUTOS AUTOS NBA-1004749-00 05/26/2021 05/26/2022 BODILY INJURY(Per accident) $ X HIRED AUTOS v NON- AUTOOWNEDS PKOPEKI Y DAMAGE ^ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1000000 A X EXCESS LIAB CLAIMS-MADE NEC-6006504-00 05/26/2021 05/26/2022 AGGREGATE $ 1000000 DED RETENTION$ Prod/Comp Ops Work Al $ 1000000 _ WORKERS COMPENSATION PERTUTE I ER - AND EMPLOYERS'LIABILITY Y/N J STA OTH ANY PROPRIETOR/PARTNER/EXECUTIVE ^ N/A E.L.EACH ACCIDENT_ _$ - OFFICER/MEMBER EXCLUDED?- — - ' (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) For certificate holders file CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street AUTHORIZED REPRESENTATIVE 1�' I Ashland,OR 97520 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD