2018-157-E DEAPR - Bartlett Tree tree work

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DocuSign Envelope ID: 2BEDCB08- D20D- 4C77- AF97- E4A01E11CBOF CERTIFICATE OF LIABILITY INSURANCE F 4/DATE (MMI DIYYYY) 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 York International Agency, LLC Attn: bartlettcert @yorkintl.com 500 Mamaroneck Avenue, Suite 220 CONTACT PHONE X FA 914- 376 -2200 E-MAIL INSURERS AFFORDING COVERAGE NAIC k Harrison NY 10528 INSURER A: Travelers Pro ert & Casualty Co of 25674 $1,000,000 INSURED INSURERB:Travelers Indemnity Company 25658 The F.A. Bartlett Tree Expert Company 1290 East Main Street INSURER C : $10,000 Stamford CT 06902 INSURER D: GENT AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PECT RO ❑ LOC J OTHER: INSURER E : $5,000,000 PRODUCTS- COMP/OP AGG INSURER F: $ COVERAGES CERTIFICATE NUMBER: 902160896 RFVISInN N1IMRFR- 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. 11TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MMIDDY� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR Contractual Liab Y TC2J- GLSA- 1005A129- TIL -17 12/1/2017 12/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 X MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PECT RO ❑ LOC J OTHER: GENERAL AGGREGATE $5,000,000 PRODUCTS- COMP/OP AGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS TC2J- CAP- 1005A130- TIL -17 12/1/2017 12/1/2018 MB En E MIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ X Y PROPERT MAGE Per accident DA $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A TC2K- UB- 1005A105 -17 TRK- UB- 1005A117 -17 1211/2017 12/1/2017 12/1/2018 12/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Orange County is included as additional insured with respect to Commercial General Liability and Automobile Liability for work performed by The F.A. Bartlett Tree Expert Company. CERTIFICATE HOLDER CANCELLATION Orange County 6823 Millhouse Road Chapel Hill NC 27516 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. (AUTHORIZED REPRESENTATIVE ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD