HomeMy WebLinkAbout463182 THE DAVEY TREE EXPERT COMPANY - INSURANCE CERTIFICATE (12)AcoR CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
08 2512019
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 have ADDITIONAL INSURED provisions or 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.
200 Public Square, Suite 3760
Cleveland, OH 44114-1824
Attn: Cleveland.CertRequest@marsh.com
138731 RESICA _ _
INSURED
The Davey Tree Expert Company
1500 N. Mantua Street
Kent, OH 44240
NAME: _-
- --- — -
IAJC PHONE
Este _ IAIC. Nol:
E-MAIL
ADDRESS:
INSU S AFFORDING COVERAGE
I
INSURER A: Old Republic Insurance Company
24147
INSURERS:
INSURER C :
INSURER D :
INSURER E :
COVERAGES CFRTIFICATF NIIMRFR' CLE-00589062340 REVISION NUMBER: 3
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
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
MM DD/YYri
M/DD/YYYYJ
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
MAZY 31404219
09/01/2019
09101/2020
EACH OCCURRENCE
$ 5,000,000
CLAIMS -MADE F—x I OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 5,000,000
MED EXP (Any one person)
3 25,000
PERSONAL & ADV INJURY
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 5,000,000
PRODUCTS - COMP/OP AGG
$ 5,000,000
X POLICY1:1 PRO ❑ LOC
JEST
$
OTHER
A
AUTOMOBILE LIABILITY
MWTB 314041 19
09/0112019
09101/2020
COMBINED SINGLE LIMIT
Eo accident
$ 5,000,000
BODILY INJURY (Per Person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
IXX HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAS
OCCUR
EACHOCCURRENCE
$
AGGREGATE
$
EXCESS WAS
CLAIMS -MADE
LIED I RETENTION$
$
A
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED7 NI
(Mandatory in NH)
N/A
MWC31404019(ADS)
09/01/2020
H
X STATUTE ER
E.L. EACH ACCIDENT
$ 5,000,000
E.L. DISEASE - EA EMPLOYEE
$ 5,000,000
E.L. DISEASE - POLICY LIMIT
$ 5,000,000
If yes describe under
DESCRIPTION OF OPERATIONS below
A
EXCESS WORKERS COMPENSATION
MWXS 31404319 (CA, OH, PA, NC, WA)
09/0112019
0910112020
WORKERS COMPENSATION
STATUTORY
EXCESS OF $5,000,000 SIR
EMPLOYERS LIABILITY
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required)
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.
V CR I IrlI A 1 C RULUCR
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: PURCHASING THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS.
FORT COLLINS, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Luann M. Glavac ork at w, _ 0107 /yLr-r�a�i
V 191I1:5-LU1b AI.UKL1 L.UKVUKA I IL)N. All rights reserveu.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD