The URL can be used to link to this page

Home My WebLink About590755 SAVATREE LLC - INSURANCE CERTIFICATE (3)CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) -__---- - -_ 6/30/2020. THIS CERTIFICATE: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEG TIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(§), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CEi I ATE 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 antl 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). NY 14210 A: INSURED SavATree LLC and all related DBA's 550 Bedford Road Bedford Hills NY 10507 rcnvcver_Fc PCOTI09^AT u111215�-- __..._._-.....----- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD D.MAY NOTWITHSTANDINGREQUIREMENT,TERM INDICACERTIFICATE OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS OR MAY PERTAIN,IINSURANCE 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 ADD L SUBR- POLICY NUMBER MM/DDPOLICY EFF MOMILDD YyYi EXP LIMITS A �/ COMMERCIAL GENERAL LIABILITY GL00381388 7/1/2020 7/1/2021 �/ �/ EACH OCCURRENCE s2000000 Nlt PREMISES Ea occurrence $1 OOO 000. CLAIMS -MADE OCCUR ✓ XCU INCLUDED MED EXP (Any one person).$10 000 BLKT. CONTRACTUAL PERSONAL s ADV INJURY $1 000 000 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY EjE7 FILOC PRODUCTS-.COMP/OP AGG $4000000 $ OTHER: _ A AUTOMOBILE LIABILITY ✓ ✓ BAP 0381389 - _ -- 7/1/2020 7/1/2021 EaaacaideOtSINGLEUMl7 $2000000. ANY AUTO BODILY INJURY (Per person) $ OWNED SCHED J,( AUTOS ONLY AUTOSUL�BODILY INJURY (Per accident) $ D HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY H020 XCZ02FH21V 7/1/2020 7/1/2021 PROPERTY DAMAGE Per. accident $ Excess Auto $3 000 000 250 COMP ✓ 500 COLL B ✓ UMBRELLAUAB ✓ OCCUR ✓ ✓ AUC 6178816 7/1/2020 7/1/2021 EACH OCCURRENCE $20 OOO 000 AGGREGATE $ 20 000 000 EXCESS LU CLAIMS -MADE .DED I -I RETENTION $10,000 A WORKERS COMPENSATION WC 0381387 7/1/2020 7/1/2021 PER OTH- ✓ � STATUTE ER ANDEMPLOYER AND EMPLOYERS' LIABILITY �, I N E:L. EACH ACCIDENT $1,000 OOO ANYPROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under.000 E.L. DISEASE - POLICY LIMIT 1 $ 1 00Q 000 DESCRIPTION OF OPERATIONS below - C CONTRACTOR'S EQUIPMENT MACO247M 7/1/2020 7/1/2021 LEASED/RENTED $250,000 ($10,000 Deductible) SCHEDULED $12,254,175 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See attached acord 101 City of Fort Collins is included as an Additional Insured with I aspect to General Liability and Auto Liability as required by written contract, and a waiver of subrogation applies to the Genera covered by endorsement forms) U-GL-1175-F CW Edition elate Liability, Automobile Liability and Workers Compensation to the extent 04/13, U-CA-424-E NY Edition date 04/11, U-GL-1345-B CW Edition date 04/13, WC000313 Edition date 04/84. Cit of Fort Collins PgBox 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE. CANCELLED BEFORE THE EXPIRATION DATE. THEREOF, NOTICEWILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.. ... AU HVHR D. REPRESENTATIVE Michael Bonetto 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 56285067 1 253241 12020-21 Certificate of Liability Michael 5carcello 1 6/30/2020 10:46'.09 AM (EDT) I Page 1 of 2 ACORLY AGENCY CUSTOMER ID: 153241 LOC #: ADDITIONAL REMARKS SCHEDULE Page Of AGENCY NAMED INSURED USI Insurance Services SavATree LLC and all related DBA's 550.Bedford Road POLICY NUMBER GL0.0381388 �, Bedford Hills NY 10507 CARRIER NAIC CODE Zurich American Insurance.Co. 16535 EFFECTIVE 4ATE:711/2020 ka THIS ADDITIONAL REMARK$ FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of.Liability (03/16) HOLDER: City of Fort Collins ADDRESS: PO Box.580 Fort Collins CO 80522 To the extent covered by endorsement form(s): General Liability: CG 00 01 (04/13) COMMERCIAL GENERP. U-GL-1175-F CW (04/13) Additional O-GL-1521-A CW (10/12) Blanket Not U-GI.-i345-B CW (04/13) General Lia Waiver of Subrogation CG 20 10 (04/13) Additional Insure Organization CG 20 26 (04/13) ADDL INSD-DESIGNA CG 20 37 (04/13) Additional Insure CG 25 03 (05/09)Designated Constru CG 25 04 (05/09) DESIGNATED LOCATI LIABILITY COV FORM nsured-Automatic-Owners, Lessees or Contractors fication to Others of Cancellation or Non -Renewal ility Supplemental Coverage Endorsement - Includes -Owners; Lessees or Contractors -Scheduled Person or PERSON/ORGANIZATION wners, Lessees or Contractors -Completed Operations on Project(s) General Aggregate Limit GENERAL AGGREGATE Automobile Liability: CA 20 01 (10/13) ADDL INSD-LESSOR U-CA-387-A 07-94 SCHEDULE OF LOSS PAYEE(S) U-CA-832-A CW (01/13) BLANKET NOTIFCATION TO OTH CANC/NONREN U-CA-424-F NY (02/16) COVERAGE EXTENSION ENDT-NY Workers' Compensation: WC 00 03 13 (04/84) Blanket Waiver of Our Right to Recover from Others Endorsement WC 99 06 43 (01/13) Blanket Notifi ation to Others of Cancellation or Non -Renewal 101 (2008/01) rights reserved, ATTACHMENT The ACORD 56285067 1 153241 1 2020-21 Certificate of Liability I Ie and logo are registered marks of ACORD Scarcello 1 6/30/2020 10:46:04 AM (EDT) I Page 2 of 2