Award Quote - 2024 Tree and Stump Removal - District 3 Proj No. 124-010B - American Tree & Lawn

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~ I DA TE (MMIDDIYYYY) A~RD• CERTIFICATE OF LIABILITY INSURANCE 04/23/2024 Phone: (574)235-5912 Fax: (574)235-9021 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain pollcles may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lleu of such endorsement(s). PRODUCER CONTACT Pam Little NAME : The Lapeer Agency rr.9N,t ~-·· (810)664-2966 I r~ Nol: (810)664-1102 145 E. Nepessing St E·MAIL pam(.@.lapeeragency.com ADDRESS : Lapeer, Ml 48446 INSURERISI AFFORDING COVERAGE NAJCf INSURER A: West Bend Mutual Ins. Co. 15350 INSURED INSURERS : Travelers lndemnit Co of American Tree & Lawn Care LLC INSURERC : 35 Sycamore St INSURERD : Niles, Ml 49120-2242 INSURERE : INSURERF : COVERAGES CERTIFICATE NUMBER· 00000250-1413354 REVISION NUMBER· 21 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 'MTH 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 1YPE OF INSURANCE ADDL SUBR POLICYEFF POUCYEXP LIMITS LTR POLICY NUMBER IM MIDD""""" IM MfDDIVVVV\ 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 MED EXP (Any one person) s 5000 ,__ PERSONAL & ADV INJURY ,__ $ 1,000 000 GEN"LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE s 2 000.000 ~ POLICY □ ff8= □LOC PRODUCTS -COMP/OP AGG s 2 000 000 OTHER : s A AUTOMOBILE LIABILITY A448059 05 05/04/2023 05/04/2024 ~~;'INGLE LIMIT $ 1000000 - ANY AUTO BODILY INJURY (Per person ) $ -OMIED X SCHEDULED BOOiLY INJURY (Per aa:ident) $ AUTOS ONLY ~ ~gr~MIED ~ HIRED PROPERTY DAMAGE $ AUTOS ONLY X AUTOSONLY /Per acciden tl s A UMBREllA LIAB ~ OCCUR A448059 05 05/04/2023 05/04/2024 EACH OCCURRENCE s 1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE s 1,000,000 OED I I RETENTION s s B WORKERS COMPENSATION 6KUB-6R15750-5-23 10/31/2023 10/31/2024 X I ~f:TUTE I I OTH- AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE @ NIA E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandato<y in NH) E.L. DISEASE -EA EMPLOYEE $ 500,000 ~s"c~ ~PERATIONS below E.L DISEASE -POLICY LIMIT $ 500 ,000 OESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (ACORD 101, Additional Remar1<1 Schedule, may be attached If more space Is required) Landscape Services City of South Bend is an additional insured with respect to the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 227 W. Jefferson Blvd, ACCORDANCE WITH THE POLICY PROVISIONS. Suite 1316 South Bend, IN 46601 AUTHORIZED REPRESENTATIVE fJ{)m( /dill I (PAM) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by PAM on 04/23/2024 at 01 :14PM