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HomeMy WebLinkAboutInsurance Certificate: Beaver Tree Services Inc ® j DATE(MM/DD/YYYY) ACC ) CERTIFICATE OF LIABILITY INSURANCE 6/4/2020 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. . 1 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 CONI ACT Marci Zimick NAME: Roland King Insurance dba RKI 'FA,Ext): Off:5414511313 FAX C,No): 1175,5.Main[Pb Box 157] DDRESS: Marci@rkiinc.com 1 INSURER(S)AFFORDING COVERAGE NAIC# Lebanon, OR 97355 INSURER A: Nova Casualty Company INSURED INSURER B: F Beaver Tree Service Inc INSURER C 270 Wilson Rd INSURER D:, I -) INSURER E , Central Point OR 97502 INSURER F: - 1 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 AUULDUCH POLICY EFF POLICY EXP • INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS K1COMMERCIAL GENERAL LIABILITY j EACH OCCURRENCE $ 1000000 UAMAtat I U HtIVI tU CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) $ 100000 f MED EXP(Any one person) $ 15000 A ARB-ML-10000362-02 05/26/2020 05/26/2021 PERSONAL&ADV INJURY $ 1000000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 POLICY n PRO- n LOC PRODUCTS-COMP/OP AGG $ 2000000 JECT K OTHER: t $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I- $ 1000000 _ I (Ea accident) K ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED —SCHEDULED AUTOS AUTOS ARB-ML-10000362-02 05/26/2020 05/26/2021 BODILY INJURY(Per.accident) $ — X HIRED AUTOS UTOSNON-OWNED ,. ( PROPER accidentDAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB —, CLAIMS-MADE . j AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION EMPLOYERS'LIABILITY Y/N • � PER ER 01H- AND ANY PROPRIETOR/PARTNER/EXECUTIVE ^ ' E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? I I N/A - -(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 f 1 I 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 I Ashland,OR 97520 i4 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD