Orange County NC Website
DocuSign Envelope ID:68D03306-BE08-4226-8F38-FE1C9C52ED1F <br /> CERTIFICATE OF LIABILITY INSUR BATE[MMdDDI(YYY]ANCE 4/11/2018 <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 sines not confer rights to the <br /> certificate holder in lieu such endorsement(s). <br /> PRODUCER CONTACT <br /> York International Agency, LLC NAME: <br /> PHONE 914-376-2200 FAX <br /> Attn: bartlettcert @yorkintl.com �►— <br /> 500 Mamaroneck Avenue, Suite 220 E-MAIL m LV A DRESS, <br /> Harrison NY 10528 INSURERS AFFDRDING COVERAGE NAIL 4 <br /> „_- <br /> INSURER A:Travelers Pro erty&Casualty Co of 25674 <br /> INSURED INSURERB:Travelers lndemni!y Company 25658 <br /> The F.A. Bartlett Tree Expert Company INSURER C: <br /> 1290 East Main Street <br /> Stamford CT 06902 INSURER D: <br /> IINSURERE: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:902160896 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 /> INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MMIDD1YYYY MM10D1YYYY <br /> A X COMMERCIAL GENERAL LIABILITY Y TC2J-GLSA-1005A129-TIL-17 12/112017 12)112018 EACH OCCURRENCE $1,000100o <br /> CLAIMS-MADE �OCCUR DAMAGE TO RENTED <br /> PREMISES Eaaceurrence $1,400,000 <br /> X Contractual Liab MED EXP(Any one person) __ $1 0,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 <br /> POLICY[]jEG7 FI LOC PRODUCTS-COMPIOPAGG $2,004,000 <br /> OTHER: $ED INGLE LIMIT A AUTOMOBILE LIABILITY TC2J-CAP-1005A130-TIL-17 121112017 12!1!2018 Ea accident $2,000,000 _ <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> AUTOS ED AUTOS BODILY INJURY(Per accident) $ <br /> X HIRED AUTO y, NON-OWNED PROPERTYDAMAGE $ <br /> AUTOS Per accldenl <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DEO I I RETENTION$ $ <br /> B WORKERS COMPENSATION TC2K-UB-1005A105-17 12/112917 12/112018 R O7H- <br /> B ANB EMPLOYERS'LIABILITY YIN TiRK-UB-1005AI17-17 1211/2017 121112018 X STATUTE ER <br /> ANY PROPRIETORIPARTNEWEXECi1TIVE E.L.EACH ACCIDENT $1,000,400 <br /> OFFICERIMEMBER EXCLUDED? Z NIA <br /> (Mandatory In NH) E.LDISEASE-EAEMPLOYE $1,000,000 <br /> If es,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 141,Additional Remarks Schedule,may be attached It 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 /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 6823 Millhouse Road ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Chapel Hill NC 27516 <br /> AAUP THORIZED REPRESENTATIVE <br /> If F� <br /> D 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD <br />