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HomeMy WebLinkAbout590755 SAV A TREE LLC - INSURANCE CERTIFICATEA/ ® DATE (MM/DD/YYYY) V CERTIFICATE OF LIABILITY INSURANCE 6/2s/zols 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 USI Insurance Services NAME: CONTACT Sarah Russell 726 Exchange Street PHONE FAX Buffalo, NY4210 tJ; 716-819-5678 AICNo: E-MAIL ADDRESS: Sarah.Russell ke .insurance INSURER(S) AFFORDING COVERAGE NAIC N INSURER A: Zurich American Insurance Co. 16535 INSURED INSURERB: American Guarantee & Liability 26247 SavATree, LLC and all related DBA's INSURERC: Great American Insurance Co. 22136 550 Bedford Road INSURER D: Bedford Hills NY 10507 INSURER E: COVERAGES ('FRTIFICATF NIIMRFR• e)nae17') RFVIS.Ir1N NI IMRFR- 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. ILTR TYPE OF INSURANCE ADDL SWVDUER POLICY NUMBER MM/ DY/YYYY MM/ D/YYYY LICY EXP LIMITS A COMMERCIALGENERAL LIABILITY ✓ �/ GLO0381388 7/1/2018 7/1/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE IV]OCCUR DAMAGE TO RENTECY PREMISES Ea occurrence $ 1,000,000 ✓ MED EXP (Any one person) _ $ 10 000 XCU INCLUDED ✓ BLKT. CONTRACTUAL PERSONAL & ADV INJURY $ 1 000,000 AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 GEN'L POLICY ✓❑ PE� LOC PRODUCTS - COMP/OP AGG $ 2 00O 000 $ OTHER: A AUTOMOBILE LIABILITY ✓ ✓ BAP 0381389 7/1/2018 7/1/2019(Ea accident) L LIMI $2 000 000 BODILY INJURY (Per person) $ ✓ ANY AUTO ✓ OWNED AUTOS ONLY AUTODULED BODILY INJURY (Per accident) $ ✓ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY Peorr acEcidenDAMAGE $ Physical Damage $A.C.V. ✓ $250 COMP ✓ $500 COLL B �/ UMBRELLA LIAB ,/ OCCUR AUC0178816 7/1/2018 7/1/2019 EACH OCCURRENCE $20000,000 AGGREGATE $20,000,000 EXCESS LIAR CLAIMS -MADE DEDT ✓ RETENTION$10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? a NIA ✓ WC 0381387 7/1/2018 7/1/2019 ,/ STATUTE ORH E.L. EACH ACCIDENT $ 1 000,000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, yes, describe under E.L. DISEASE- POLICY LIMIT $ 1 000,000 DESCRIPTION OF OPERATIONS below C CONTRACTOR'S EQUIPMENT MACO247225 7/1/2018 7/1/2019 LEASED/RENTED $250,000 ($10,000 Deductible) SCHEDULED $5,912,075 DESCRIPTION OF OPERATIONS I LOCATIONS / 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 respect to General Liability and Auto Liability as required by written contract. and a waiver of subrogation applies to the General Liability, Automobile Liability and Workers Compensation to the extent covered by endorsement form(s) U-GL-1175-F CW Edition date 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. l.tK I Ir ILA I t 1'11JLUtK L;ANLtLLA I IUN City SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box of of Fort ort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE Michael Bonetto ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 42864372 1 153241 1 2018-19 Certificate of Liability I Sarah Russell 1 6/28/2018 1:56:49 PM (EDT) I Page 1 of 2