The URL can be used to link to this page

Home My WebLink About463182 DAVEY TREE EXPERT COMPANY - INSURANCE CERTIFICATEACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(M612 YYYI ovnnol2 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: It 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' MARSH USA INC. PHONE I q/C No 200 PUBLIC SQUARE, SUITE 1000 E-MAIL CLEVELAND, OR 44114-1824 Arm: Cleveland.CertRequest9marsh.com ADDRESS: INSURERS AFFORDING COVERAGE NAICM INSURER A: Old Republic Insurance Co 24147 _08670-ALL-GAWU-11-12 138731 RESICA COLE INSURED THE DAVEY TREE EXPERT COMPANY INSURER B ; NIA N/A INSURERC: N/A N/A 1500 N. MANTUA ST "4V�` RENT, OR 44240 INSURER D: BrickStreet Mutual Insurance Co. 12372 E: fINSURER INSURER F : !LI COVERAGES CERTIFICATE NUMBER: CLE-003804494-01 REVISION NUMBER:3 E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD r 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 LrR TYPE OF INSURANCE ADDL IN9R SUBR POLICY EFF fMWDDNYYYI POLICY EXP (MWDDNYYYILIMITS A GENERAL LIABILITY MWZY 59319 09101/2011 09101/2012 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 2,GOO,000 s MOCCUR 5,000 t CLAIMS -MADE MED EXP (Any one person) $ PERSONAL& ADV INJURY $ 2.000,000 1 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATELIMIT APPLIES PER: PRODUCTS - COMP/OP AGG _ $ 2,000,000 �X POLICY PRO R T LOC $ } A I AUTOMOBILE LIABILITY MWTB 21342 09/0112011 09/0112012 COMBINED SINGLE LIMIT Ea accident 21000,000 X BODILY INJURY (Per person) $ ANY AUTO 1 f ALL OWNED SCHEDULED AUTOS AUTOS i BODILY INJURY (Per accidenaccident)$ fI! X NON -OWNED PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS Per accident $ ' 1 _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ i EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION MWC 11714400 (AOS) 0910112011 0910112012 X WC STATU- OTH- IER j + n AND EMPLOYERS' LIABILITY Y/N E%ECUTIVE MWXS 951 CA,OH,NC,PA,WA) 0910112011 0910112012 E.L. EACH ACCIDENT SEE ATTACHED $ i(Manck OFF CER/M MEER EXCLUDE WMEMBER EXCLUDED? N/A E.L. DISEASE - EA EMPLOYE $ SEE ATTACHED ti (Mantlatory in NH) �II Yes. describe untler WC10000136-08 (WV) 06/04/2011 06/04/2012 SEE ATTACHED DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ i OB.SrldWOGN OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 11 r FORT COLLINS IS(ARE) INCLUDED AS ADDITIONAL INSURED(S) AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT OR I AGRLE tEN AND ONLY AS RESPECTS OPERATIONS PERFORMED ON THEIR BEHALF BY THE NAMED INSURED. S i I CITY OF FORTCOLUNS SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE iOTN: PURCHASING THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Luann M. Glavac pt[s.�.....• Wjv 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 08670 LOC a: Cleveland A ® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA INC. NAMED INSURED THE DAVEY TREE EXPERT COMPANY 1500 N. MANTUA ST KENT, OH 44240 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance Workers Compensative does not apply in MN. Coverage is obtained from Workers Compensation Reinsurance Association (WC .R.A.) as required by the state. All above referenced Workers Compensation policies are Statutory. All Employers Liability limits are Each Accident; Disuseeachemployee: Disease - policy limit and are: E5MM, policy MWC11714400; SIMM, policy MWXS 951 (excess $5MM SIR); $IMM, policy WC10000136-08. ACORD 101 (200al0l) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD