2019-678-E DEAPR - JB Tree Service Cedar Grove Park maintenance

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DocuSign Envelope ID:4FFF7FED-E7E2-40F9-88EC-573291651 E4D Ac" CERTIFICATE OF LIABILITY INSURANCE anrElMMroomrr) 09/03/2019 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 pollcy(les)must be endorsed. if SUBROGATION IS WAIVED, subject to tho 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 PHtAKONE 919-245-1020 (PicFAX, No):919-245-1010 110 Boone Square Street,Suite 7 E- MAIL ADDRESS: kni htinsurance@raleigh.twcbc.com Hillsborough,NIC 27278 INSURERS AFFORDING COVERAGE NAIL:n INSURER A:Travelers INSURED INSURER B: Northfield Insurance Company Bracken,Jeffrey DBA INSURERC: Integion National Insurance JB Tree Service INSURER D:USLI 7410 NIC Hwy 86 IN 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 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLCY ExP LIMITS m LTR POLICY NUMBER MMIDDIYYYY MMfODIYYYY GENERAL LIABILITY WS317090 712612019 7/26/2020 EACH OCCURRENCE 31 000 000 DAMAGE TO R�NT915_ B x COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $100 000 CLAIMS-MADE �OCCUR MED EXP(Arty one person) $ 000 PERSONAL&ADV I NJ U RY $1 000000 GENERAL AGGREGATE $x 000 ODD GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s27000,000 x I POLICY PRO LOC $ AUTOMOBILE LIABILITY OM BIN EDISINGLE LIMIT 1 DDD ODD X ANY AUTO BODILY INJURY(per person) $ 00O DDD ALL C AUTOS OWNED AUTOSULED 2006316394 1/3/29119 03121121 BODILY INJURY(Peraccident) 51 000 000 1111Y DAMAGE HIREDAUTOS AUTOS NON-OYMED PerOac d..I) $1 08D 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE s IEXCESS LIAR CLAIMS-MADE AGGREGATE $ CED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN A OFFICEOPRIE ER EXCLUDEDE ECUTIVE F NIA 6JUB 7H94031 1 19 2128119 2128120 E.L.EACH ACCIDENT $100 000 {Mandatory In NHI 'IE.L.DISEASE-EA EM PLOY Ed S10D 000 DESCRescribe under IPTION OF OPERATIONS below_TJ E.L.DISEASE-POLICY LIMIT I S50D 000 D Inland Marine C11550383F 11/10/18 11110/19 DESCRIPTION OF OPERATIONS l LOCATIONS r VEHICLES(Aflach ACORD 10t,Add III onaI Remarks Schedule,It more space is required) Vermeer Mid Atlantic,LLC is listed as loss payee on a VMA SC362 Stump Cutter,serial number 1VRF112Y2K1002669 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 ©1988-2010 ACO D CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD I