Orange County NC Website
DocuSign Envelope ID: OC2A1 CFA -1 DE8- 4BAE- 8F4E- C6ADBAC95EO5 <br />CERTIFICATE OF LIABILITY INSURANCE <br />4/11/2018 E(MMI DIYYYY) <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />York International Agency, LLC <br />Attn: bartlettcert @yorkintl.com <br />500 Mamaroneck Avenue, Suite 220 <br />CONTACT <br />NAME: <br />PHONE 914- 376 -2200 FAx <br />EMAIL <br />Harrison NY 10528 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURERA:Travelers Property & Casualty Co of <br />25674 <br />12/1/2017 <br />INSURED <br />INSURERB:Travelers Indemnity Company <br />25658 <br />The F.A. Bartlett Tree Expert Company <br />1290 East Main Street <br />INSURER C ; <br />$1,000,000 <br />X <br />MEO EXP (Any one person) <br />Stamford CT 06902 <br />INSURER D: <br />INSURER E: <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY PRO - <br />JECT F—] LOC <br />OTHER: <br />INSURER F: <br />$5,000,000 <br />PRODUCTS - COMP/OP AGG <br />COVERAGES CERTIFICATE NLIMRFR- 902160896 RGVICInnI tit IIInRCD• <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 />i TR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />MMIDDY� <br />MM/DDY I <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑ OCCUR <br />Contractual Liao <br />Y <br />TC2J- GLSA- 1005A129- TIL -17 <br />12/1/2017 <br />12/1/2018 <br />EACH OCCURRENCE <br />$1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occu rence <br />$1,000,000 <br />X <br />MEO EXP (Any one person) <br />$10,000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY PRO - <br />JECT F—] LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$5,000,000 <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS )( NON -OWNED <br />AUTOS <br />TC2J- CAP- 1005A130- TIL -17 <br />1211/2017 <br />12/1/2018 <br />Ea accident) LIMIT <br />$2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />IX <br />BODILY INJURY Per accident <br />( ) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I I RETENTION $ <br />$ <br />B <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS'LIABILITY YIN <br />ANY PROPRIETOR/PARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? � <br />(Mandatory inNH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />TC2K- UB- 1005A105-17 <br />TRK- UB- 1005AI17 -17 <br />12/1/2017 <br />12/1/2017 <br />12/1/2018 <br />12/1/2018 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />- <br />$1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />Orange County is included as additional insured with respect to Commercial General Liability and Automobile Liability for work performed by <br />The F.A. Bartlett Tree Expert Company. <br />_'r i IFI_ � I c nw""�FX %,AIVI.CLLA I IUIV <br />Orange County <br />6823 Millhouse Road <br />Chapel Hill NC 27516 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />C ,41 <br />U 1988 -2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD <br />