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DocuSign Envelo pe ID:2B500D4F-A05D-4147-B24B-6A0193E6957F^
<br /> T ® DATE(MMIDD/YYYY)
<br /> A�O CERTIFICATE OF LIABILITY INSURANCE
<br /> 08/02/2017
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),,AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> CONTACT
<br /> PRODUCER NAME:
<br /> Knight Insurance (A"/c°,"ri,Ext): 919-245-1020 (A/C,No): 919-245-1010
<br /> 110 Boone Square Street,Suite 7 E-MAIL
<br /> ADDRESS: kni g nsurance hti ralei g h.twcbc.com
<br /> Hillsborough,NC 27278 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A: Northfield Insurance Company
<br /> INSURED INSURERB: Travelers Property Casualty Co of America
<br /> Jeffrey Bracken INSURERC: Integon National Insurance Company
<br /> dba JB Tree Service INSURERD:
<br /> 7410 NC Hwy 86N INSURERE:
<br /> Hillsborough,NC 27278 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> ADDL SUER POLICY EFF POLICY EXP
<br /> LT INSURANCE INSR TYPE OF INSR LIMITS
<br /> R INSD WVD POLICY NUMBER {MMIDD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR 08/01/2017 08/01/2018 DAMAGE TO RENTED 1 OO OOO
<br /> WS317090 PREMISES(Ea occurrence) $
<br /> MED EXP(Any one person) $ 5,000
<br /> , PERSONAL&ADVINJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> PRO-
<br /> POLICY I JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER:
<br /> C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO 20022322193 03/23/17 09/23/17 BODILY INJURY(Per person) $ 1,000,000
<br /> OWNED -' SCHEDULED BODILY INJURY(Per accident) $ 1,000,000
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $ 1,000,000
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> S
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ _ $
<br /> WORKERS COMPENSATION PER EERH
<br /> AND EMPLOYERS'LIABILITY
<br /> B ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N A 6JUB-7H94031-1-17 02/28/17 02/28/18 E.L.EACH ACCIDENT $ 100,000
<br /> OFFICER/MEMBEREXCLUDED7 100 OOO
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under 500 000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ r
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Il
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD THE ABOVE POLICIES BE CANCELLED
<br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE BEFORE
<br /> DELIVERED IN
<br /> 131 W Margaret Ln ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 8181
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> f I L , e
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<br /> ©1988-2015 ACER CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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