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Opening of Quotes - 2024 Tree and Stump Removal - District 3 Proj No. 124-010B - American Tree
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Opening of Quotes - 2024 Tree and Stump Removal - District 3 Proj No. 124-010B - American Tree
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4/23/2024 2:57:29 PM
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Board of Public Works
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4/23/2024
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~ <br />I DA TE (MMIDDIYYYY) <br />A~RD• CERTIFICATE OF LIABILITY INSURANCE 04/23/2024 <br />Phone: (574)235-5912 Fax: (574)235-9021 <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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain pollcles may require an endorsement A statement on <br />this certificate does not confer rights to the certificate holder In lleu of such endorsement(s). <br />PRODUCER CONTACT Pam Little NAME : <br />The Lapeer Agency rr.9N,t ~-·· (810)664-2966 I r~ Nol: (810)664-1102 <br />145 E. Nepessing St E·MAIL pam(.@.lapeeragency.com ADDRESS : <br />Lapeer, Ml 48446 INSURERISI AFFORDING COVERAGE NAJCf <br />INSURER A: West Bend Mutual Ins. Co. 15350 <br />INSURED INSURERS : Travelers lndemnit Co of <br />American Tree & Lawn Care LLC INSURERC : <br />35 Sycamore St INSURERD : <br />Niles, Ml 49120-2242 INSURERE : <br />INSURERF : <br />COVERAGES CERTIFICATE NUMBER· 00000250-1413354 REVISION NUMBER· 21 <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. NOTVVITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 'MTH 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 1YPE OF INSURANCE ADDL SUBR POLICYEFF POUCYEXP LIMITS LTR POLICY NUMBER IM MIDD""""" IM MfDDIVVVV\ <br />A X COMMERCIAL GENERAL LIABILITY y A448059 05 05/04/2023 05/04/202-4 EACH OCCURRENCE s 1000000 -D CLAIMS-MADE [x] OCCUR -PREMISE S CEa oc:a.nenca l s 100.000 <br />MED EXP (Any one person) s 5000 ,__ <br />PERSONAL & ADV INJURY ,__ $ 1,000 000 <br />GEN"LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE s 2 000.000 <br />~ POLICY □ ff8= □LOC PRODUCTS -COMP/OP AGG s 2 000 000 <br />OTHER : s <br />A AUTOMOBILE LIABILITY A448059 05 05/04/2023 05/04/2024 ~~;'INGLE LIMIT $ 1000000 - <br />ANY AUTO BODILY INJURY (Per person ) $ <br />-OMIED X SCHEDULED BOOiLY INJURY (Per aa:ident) $ <br />AUTOS ONLY ~ ~gr~MIED ~ HIRED PROPERTY DAMAGE $ <br />AUTOS ONLY X AUTOSONLY /Per acciden tl <br />s <br />A UMBREllA LIAB ~ OCCUR A448059 05 05/04/2023 05/04/2024 EACH OCCURRENCE s 1,000,000 <br />X EXCESS LIAB CLAIMS-MADE AGGREGATE s 1,000,000 <br />OED I I RETENTION s s <br />B WORKERS COMPENSATION 6KUB-6R15750-5-23 10/31/2023 10/31/2024 X I ~f:TUTE I I OTH- <br />AND EMPLOYERS' LIABILITY ER <br />YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE @ NIA <br />E.L. EACH ACCIDENT $ 500,000 <br />OFFICER/MEMBER EXCLUDED? <br />(Mandato<y in NH) E.L. DISEASE -EA EMPLOYEE $ 500,000 <br />~s"c~ ~PERATIONS below E.L DISEASE -POLICY LIMIT $ 500 ,000 <br />OESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (ACORD 101, Additional Remar1<1 Schedule, may be attached If more space Is required) <br />Landscape Services <br />City of South Bend is an additional insured with respect to the General Liability policy. <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />227 W. Jefferson Blvd, ACCORDANCE WITH THE POLICY PROVISIONS. <br />Suite 1316 <br />South Bend, IN 46601 AUTHORIZED REPRESENTATIVE <br />fJ{)m( /dill I (PAM) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by PAM on 04/23/2024 at 01 :14PM
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