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HomeMy WebLinkAbout590755 SAV A TREE LLC - INSURANCE CERTIFICATE (3)'°`CC)R "® CERTIFICATE OF LIABILITY INSURANCE 10/3�20°i7YY) 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 Key Insurance & Benefits Services 726 Exchange Street Suite 900 Buffalo NY 14210 CONTACT Sarah Russell NAME: PHONE FAX (716)819-5500 A/C No: (716)819-5140 E-MAIL .sarah.russell@key.insurance INSURERS AFFORDING COVERAGE NAIC # INSURERA:Zurich American Insurance Co. 16535 INSURED SavATree, LLC and all related DBA' s 550 Bedford Road Bedford Hills NY 10507 INSURER B:American Guarantee & Liability 26247 INSURERC:Great American Insurance Co. 22136 INSURER D INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER:17-18 Swingle (Master) REVISION NUMBER: 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 UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000, 000 A X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE aOCCUR X X GLO 0381388 10/6/2017 /1/2018 DAMAGE RENTED PR EMSESOEaOccurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 X XCU INCLUDED X BLKT. CONTRACTUAL GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO JFCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 2,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED X AUTOS AUTOS X X AP 0381389 10/6/2017 /1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS PHYSICAL DAMAGE $ A. C . V . X $250 COMP X $500 COLL X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 20,000,000 AGGREGATE $ 20, 000, 000 B EXCESS LIAB CLAIMS -MADE UC 0178816 10/6/2'17 /1/2018 DED X RETENTION$ 10,000 $ X X A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A XX C 0381387 10/6/2017 /1/2018 WC STATU- OTH- E,L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E,L.DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT I $ 1,000,000 C CONTRACTOR'S EQUIPMENT CO247225 10/6/2017 7 /1/2 018 LEASED/RENTED $250, 000 ($10, 000 Deductible) SCHEDULED $5, 912,075 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate Holder is an Additional Insured on a primary and non-contributory basis in regard to the above General Liability and Automobile Liability 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. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Attn: Purchasing Division AUTHORIZED REPRESENTATIVE PO BOX 580 Fort Collins, CO 80522 M Bonetto/SJAROS ACORD 25 (2010/05) INS025 (201005) 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD