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HomeMy WebLinkAbout463182 THE DAVEY TREE EXPERT COMPANY - INSURANCE CERTIFICATEA41 %. O CERTIFICATE OF LIABILITY INSURANCE �/ D0 30'M011 YYVY) OB/30/2Mc 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 MARSH USA INC. CONTACT NAME: 200 PUBLIC SQUARE, SUITE 1000 CLEVELAND, OR 44114-1824 Alln: Cleveland.CerlRequesl@marsh.com; Fax: 212-948-0797 PHONE FAX A/C No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC a 08670-STND-GAWU-11-12 138731 RESICA INSURERA: Old Republic Insurance Co 24147 INSURED L �1 THE DAVEY TREE EXPERT COMPANY U INSURER B : N/A NIA INSURER C : NIA N/A 1500 N. MANTUA ST KENT, OH 44240 INSURER D: INSURER E : INSURER F : a.vr Qnnvoa CERTIFICATE, E, INumiRt CIF-nni30dOLL11 DDvrernar MnsrDVD.o 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 LTR I TYPE OF INSURANCEINSR ADDLSUaR WVDPOLICY NUMBER MWDD/VYYY ICYEFF MM/DD/YYOLICY VY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY MWZY 59319 09VOI2011 09101n012 EACH OCCURRENCE $ 2,000,000 DAMAGE TOR NTED PREMISES Ea currence $ 2,000,000 MED EXP (An we person) $ 5,000 CLAIMS -MADE � OCCUR PERSONAL B ADV INJURY $ 2.0DOBOO GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PFCT RO LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS MWTB 21342 ' 09/01/2011 09/01/2012 COMBINED SINGLE LIMIT Ea accident 2,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS - PROPERTY DAMAGE Per accitlenl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAR CLAIMS -MADE DED RETENTION$ S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YINIE ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER E%CLUDED? ❑N (Mandatory in NH) If yes. descries under DESCRIPTION OF OPERATIONS Below N/A MWC 117144 00 (ADS) SELF INSURED STATES: CA, MN, PA, NC, WA, OH 09/01/2011 09101I2012 4 WC STATU- oTH- E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYE $ S,000,000 EL DISEASE -POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attack ACORD 101, Additional Remarks Schedule. if more space is required) CITY OF FORT COLLINS ATTN: PURCHASING PO BOX 580 FORT COLLINS, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Luann M. Glavac or"4� pZ 'dl. © 1989-2010 ACORD CORPORATION. All rights reserved. —�• ••- -� t�� �••.../ 1 rte AL.vnu name ana logo are registered marks of ACORD AGENCY CUSTOMER ID: 08670 LOC a: Cleveland ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA INC. THE DAVEY TREE EXPERT COMPANY POLICY NUMBER 1500 N. MANTUA ST KENT, OR 44240 CARRIER I NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, - FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance CITY OF FORT COLLINS IS(ARE) INCLUDED AS ADDITIONAL INSURED(S) AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT AND ONLY AS RESPECTS OPERATIONS PERFORMED ON THEIR BEHALF BY THE NAMED INSURED. ACORD 101 (2008/01) m 2008 ACORD CORPORATION. All rights reservnrl 1 ne ACUHU name and logo are registered marks of ACORD