2019-612-E DEAPR - JB Tree dead tree removal

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DocuSign Envelope ID: D7B85F8F-DAC8-4ACB-BF06-EB272D57175A A�QR CERTIFICATE OF LIABILITY INSURANCE DATE `.� 0910312019 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 CONTACT NAME: _ Knight insurance PHONI .919-245-1020 we No:919-245-1010 110 Boone Square Street,Suite 7 E-MAIL ADDRESS' kni 11tinsurance ralei h.twcbc.corrl Hillsborough,INC 27278 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Travelers INSURED~•_"~ INSURERS:Northfield Insurance Company Bracken,Jeffrey DBA INSURER C. Integion National Insurance JS Tree Service INSURER D: USLI 741DNC Hwy 86N INSURER E Hillsborough, NC 27278 INSURER F: _ -- COVERAGES CERTIFICATE NUMBER: 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 VVHICH 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS POLICY NUMBER MWODNYYY MMIDDNYYY GENFRAL LIABILITY WS317090 712612D19 7/2612020 EACH OCCURRENCE $1 000 000 E TO B X COMMERCIAL GENERAL LIABILITY PREMISES EaENTE occurrsnoe $100 000 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $5 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 nGEMLAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOPAGG $2 DDD DDD x POLICY PRD LOC $ AUTOMOBILE LIABILITY COMBINED mIdent SINGLE LIMIT(Ea 1 D04 DDO x ANY AUTO BODILY INJURY(Par person) $1 000 DDD ALLO C AUTOS ED AUTOSULED 2006316394 03129119 03/29/20 ROPILY INJURY(Per aoddent) $1 DDD DDD HIRED AUTOS fl3WPJED PeOaocd DAMAGE 51 DDD DDD $ UMBRELLA LIAS H OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN LIMIT�; A ANY PROPRIETORIPARTNERIE](ECUTIVE OFFICERIMEMBER EXCLUDED? NIA 6JUB 71-194031 1 19 2128119 2128120 E.L.EACH ACCIDENT $1 DD DDD •-••- (Mandatory in NN) - 1E.L.DISEASE-EA EMPLOYE $100 000 IFyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $50D 000 D Inland Marine C11550383F 11/10118 11110119 DESCRIPTION OF OPERATIONS I LOCATIONS I VEKICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Vermeer Mid Atlantic,LLC is listed as loss payee on a VMA SC362 Stump Cutter,serial number 1VRF112Y2K1002569 CERTIFICATE HOLDER CANCELLATION Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept.of Environment,Agriculture,Parks and Recreation ACCORDANCE WITH THE POLICY PROVISIONS, PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE D 1988-2010 ACbl CORPORATION. All rights reserved. ACORD 25(201 D105) The ACORD name and logo are registered marks of ACORD